Questions and Answers of Health Care Financial Management

Explain whether a map or a compass is better for your career path in health care.
Explain why strategic momentum may be a new beginning.
As a complexity leader and change agent, I employ the complex adaptive model of organizational change. This includes all but which one of the following?a. A focus on significant differences, such as
When an adverse clinical event occurs in my department that involves several disciplines, I would do all but which of the following:a. Encourage a collaborative after-action review.b. Allow for
One indication that I have developed from being a transformational to a complexity leader is:a. I share my values and vision so I can inspire others.b. with presence and patience, I set the stage for
If I were to employ a collaborative approach when convening an interdisciplinary work group, I would expect:a. the knowledge and skills of all, beyond their discipline roles, are engaged in an
Because of new regional health insurance regulations and a shift in the community’s population, there is uncertainty about what the future holds, and there is disagreement among administration,
I discover that the outpatient clinic staff members have fashioned their own way to process admissions and, although it seems to be easier and more comfortable for patients, it is not according to
The patient satisfaction scores for “nurses’ caring and listening” have dropped for three quarters in a row. I most likely would:a. ignore it because the staff has recently been very
As director of critical care and the emergency department(ED), I hear that nursing staff in the ED are complaining about recent changes in admitting procedures. My most likely approach is to:a.
When forming a task force or work group, I:a. select from the senior leadership group.b. make sure the power players are in the room.c. select people with diverse mental models and views.d. look for
When contemplating a need for change in a system, structure, or process, I:a. gather a small group of the most knowledgeable people to draft a plan.b. assign a special project manager to develop the
When viewing change from a complexity perspective, which of the following statements is not true?a. Change is not about overcoming resistance but being drawn to an attractor that exists within a
A microsystem is composed of a small group of people who provide care to a subpopulation with a clinical, business, and outcome focus. The microsystem is embedded in the larger macrosytem. This is an
When a hospital emergency department wants to improve relationships with the community and its residents, which approach should be chosen?a. Hold focus-group sessions with community residents, write
When two health-care organizations are in the process of merging, it is important to:a. decide which organization will take the lead.b. dissolve both organizations’ plans, mission policies, and
The following is true about the best-run team and staff meetings:a. Tight control with a firm pre-published agenda gets things done.b. A loose and free-wheeling style gives everyone a chance to be
Visibility of senior management:a. is best accomplished by specific meetings at specific times to instill trust.b. is accomplished in multiple ways of relating and communicating across the
With regard to the most effective dissemination of information, the best philosophy to adopt is:a. Multiple methods and free flow of information will reach nearly everyone.b. Sending out information
With regard to organization-wide planning for system change, the best philosophy to adopt is:a. Change the reporting structure to encourage people to change.b. The larger one’s span of control, the
Where strategic planning is concerned:a. each step needs to be spelled out clearly.b. the complexity of the plan should equal the complexity of the expected results.c. there may not be a correlation
When events do not turn out as expected:a. there may be opportunity in this happening.b. the planning was not thorough enough.c. the person or group responsible should be identified.d. a review of
Compare and contrast the developmental stages discussed in this chapter (Oja 1989, Fisher & Torbert, 1991; Weathersby, 1993) with the leadership style and actions and personal being and awareness of
My plan for self-care practice will include the following:
When I reflect on my complexity leadership profile, I find the following strengths and areas to develop.
What characteristics of balance and self-care does this nurse exemplify? What lesson might you learn from her story?
Steven Covey’s Circle of Influence and Circle of Concern are discussed in this chapter. Think of a situation that seems out of control in which you can identify your circle of influence rather than
How satisfied am I with my current centering practice? What is my next step?
How can I become more comfortable with disorder, conflict, and disruption?
What self-reflective practice can I start that will enhance my sense of detachment?
The nurse educator embodies qualities and actions of the complexity leader as well as congruence. Identify some of these qualities. What are some of the indicators that Nancy was in cognitive
The complexity leader is congruent, both in thoughts, feelings, and behaviors and in knowledge of complex adaptive systems, leadership style, and actions and personal being and awareness. From your
What are the areas of cognitive dissonance to which I will set my intention?
What leadership issue is keeping me from moving toward more congruence?
What small influence do I have in my work situation? What“pennies” do I have to spend and how can I use them appropriately?
Look back at this chapter’s A Case for Complexity. Where in this case can you see evidence of emergence, self-organization, adaptability, independent agents, and distributed leadership? Describe
A large health-care organization falls into quadrant 3 of the organizational leadership matrix. The organization has a history of being linear in philosophy with a senior leader (CEO) who is
An assumption in complexity leadership thinking is that the quality of relationships influences the quality of patient care outcomes. This was hard to justify until current nursing and health-care
Senge describes several learning disabilities that can occur with a group or team. Review these. How can each of these be modified or corrected by employing complexity thinking? Write an exemplar
Review the leadership models in this chapter. Choose two to compare and contrast. Then explain how these models exemplify complexity science concepts.
This case illustrates how being present and centered can enhance one’s diagnostic capabilities and respect by and for other team members. Describe a time in your practice when there was either a
What part might I have played in a difficult situation?
Can I let go and be present while others bring out their ideas?
Can I be patient when a situation looks disorganized and uncertain?
Suggest some complexity science–based alternatives or interventions from this chapter to the above decisions and actions, and describe how these alternatives might have led to better outcomes.
Examine the decisions and actions made by the hospital leaders and unit leaders. Discuss failures in leadership and/or in the system that may have contributed to the disintegration of interpersonal
Describe the situation on the unit, including the origins of the staff’s disruptive behavior.
When you are in a difficult conversation, do you fall back on silence or violence to feel safe, or are you able to be the one who creates safety for others?
Can you recall a time when in a discussion with others on the team you had an opinion but withheld it (incongruence or deceit) because of anxiety or not having the skill to state your opinion?
How are significant differences handled in your organization?
Into which adopter category do you fall? How does this play out in your work and life?
Imagine yourself as a stranger to your organization. When walking through the front door, what artifacts do you see?
How is the issue of control played out in your organization?What is your tendency in regards to being in control?
How web-like is the organization in which you work or one with which you are familiar? Describe your observations.
Review emotional intelligence leadership traits. Where do you believe you are in failing to achieve these behaviors?
With what stage of personal power do you most identify?Explain.
Do you and the team with whom you work engage in doubleloop learning or single-loop learning? What has been the result?
In a restructure, reorganization, or major project in which you were involved, what leadership approaches were used? Were they effective or not? Explain.
How can situational leadership models be helpful in coaching for leadership? Explain.
In a health-care organization with which you are familiar, where along the leadership century timeline do you believe the predominate leadership approach falls? Describe your reasoning.
Identify one paradox in your work. Describe this paradox and how you accept and work with it
Do you tend to become very directive when the answer to a problem is unclear or there is disagreement?
When assembling a work group or task force, do you choose people who think and act like you, or do you seek diversity?Which is more comfortable?
Do you know how to recognize a situation that does not require extensive group discussion?
What attractors (motivators) encourage you to do your best work?
What level of control seems to be operating in an organization with which you are familiar? How do people respond to that level of control?
Where do you fall on the linear/complexity organizational and leadership matrix? What feelings are evoked for you with this assessment?
How do leaders in your organization respond to unpredicted outcomes? How do you?
Have you ever walked into a meeting or onto a patient care unit and experienced a certain feel to the field? Describe that event.
Have you been witness to a time in your organization when a butterfly effect launched rumors or dissention? Recall that experience.
Can you recall a situation in health-care practice in which simple rules worked better than long, complicated policies and procedures? Describe that situation.
Have you been in a situation in which you knew how to act as a leader but found it very difficult or stressful to act as you believed you should because of your emotional response?
Can you recall being in a situation in which you could see what was happening within your organization but did not know how to act in the leadership role in that situation?
Imagine you are Helen Restin. How would you plan your second week? Who would you meet? What formal events might you hold? What would you consider early priorities for building relationships? What
Assess your level of knowledge, actions, and practices with the complexity leadership profile.O
Describe the developmental process to transformational and then to complexity leadership.
Apply the concepts of complexity leadership to health-care delivery.
Integrate practices of mind and spirit to enhance personal being and awareness.O
Apply concepts across the self-care spectrum to an effective personal and professional life.
Assess the qualities of life engendered by a balanced personal and professional life.
Employ self-reflection to assess personal and professional life balance.D
Discover areas of cognitive dissonance and congruence in personal and professional life.
Apply the concept of congruence to complexity leadership.
Integrate the practice of presence into personal being and awareness. CO
Apply the characteristics of emotional intelligence to effective leadership.
Identify the critical role of self-awareness in the complexity leadership model.
Incorporate the phases of teamwork into improving service and work processes.
Explore appreciative inquiry as a method for creating positive change and effective relationships in health care.
Apply the concepts and process of crucial conversations to health-care leadership practice and interdisciplinary collaboration.
Discuss the dynamics and consequences of congruent communication.
Analyze selected change theories within the framework of complexity thinking.D
Compare and contrast the role of the change agent in culture and change theories.
Apply the concepts of positive deviance to complex adaptive systems.
Assess organizational culture through examination of artifacts, espoused values, and shared underlying assumptions.
Analyze leadership models and theories in relationship to the Complexity Leadership Model.
Assess personal leadership qualities and behaviors.
Apply complexity-inspired leadership theories and models to contemporary health-care practice.
Discuss leadership research and models related to complexity science.
Assess the effectiveness of restructure and quality improvement efforts in health care related to the leadership approaches of the 1990s and early 2000s.
Apply selected leadership theories to contemporary leadership in health care.

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