080229E Bachelor Of Nursing

080229E Bachelor Of Nursing

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080229E Bachelor Of Nursing

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080229E Bachelor Of Nursing

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Course Code: 080229E
University: Victoria University

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Country: Australia

Questions:

1. Identify the Counties Manukau DHB’s executive leadership team and analyse at least five key positions, their vital roles and their contribution into the overall strategic values and governance in achieving the organisational objectives and goals. Your answer must provide relevant information to support your analysis in terms of key leadership and management models.Your answer must include:1.  Executive team’s leadership and management roles and responsibilities2.  Analyse the significance of executive team in achieving organization’s goal3.  Analysis of key leadership and management theories in healthcare       
2. New Zealand’s “Triple Aim” provides a focus for the improvement in the three major dimensions from the perspective of quality improvement (HQSC, 2015). Critically evaluate the quality of healthcare services delivery across different services provisions at Counties Manukau DHB. Your analysis should provide relevant statistical information and data by assessing the various health services against the following triple aim quality dimensions:

Improved quality, safety, and experience of care
Improved health and equity for all populations
Better value for public health system resources

Answers:
1. Identification of Counties Manukau DHB’s executive leadership team 
Countries Manuka (CMDHB) gives services to thousands of people in Aukland.The health service mainly focuses on improving the health care status of people belonging to maaori and Pacific communities since the people in those communities suffer from health disparities.The Manukau District Health Board governs the Counties Manukau Health service.There are a total number of 11 members in the board, in which seven-person are elected by the people of the community.The chairperson is appointed by the health minister (“Home”, 2018).
Five key positions
Dr. Gloria Johnson, Acting Chief Executive Officer
Leadership and management roles and responsibilities:

To oversee the long and short-term plans of the organization that needs to be implemented to reach the goal of effective healthcare services.
To promote the hospital-based safety programme called Aiming for Zero Patient Harm.
To ensure that all the expenditures for the healthcare facilities are within the annual budget of the organization.

Significance of the position in achieving organization’s goal:
Dr.Johson acts as a direct link between the Board and the management of Countries Manuka (CMDHB),she initiates communication to the Board on the behalf of the organization to the third party authorities, shareholders and the public(“Welcome from Dr Gloria Johnson | Counties Manukau Health”, 2012).
Related key leadership and management theories in healthcare:
Transactional theories of leadership can be explained according to this job role since this theory is dependable on the people’s managerial rank in the hierarchy of the organization.
Benedict Hefford,Director of Primary Health & Community Services
Leadership and management roles and responsibilities:

To achieve huge client empowerment and breaking the cycles of health inequality.
To ensure safe and effective operation of general practice with all relevant legislation
To lead development,implementation.monitoring and reporting of work plans to achieve positive patient outcomes and to take rapid actions where necessary

Significance of the position in achieving organization’s goal:
The Director of Primary Health Care Services direct the operations of services within the organization.Under the directions of the executive director, Hefford leads the clinical workforce of these programs(Counties Manukau DHB, 2018).This position allows Hefford to interact with the state health network and understand the priorities of the local people and the communities who need more healthcare facilities.
Related key leadership and management theories in healthcare:
Transformational leadership theory explains this position.This job position allows the leader to motivate the other staff members and communicate with them to understand the issues related to healthcare management.
Jenny Parr,Director of Patient Care & Chief Nurse and Allied Health Officer
Leadership and management roles and responsibilities:

Responsibilities for supervising matrons,lead nurses,lead AHPs, Biomedical scientists and administrative staff members.
To be accountable for the creation of an environment that supports efficient delivery of safe patient health care.
Active contribute development on to the nursing and executive group with the goal of supporting development in healthcare practices in the hospitals of New Zealand.

Significance of the position in achieving organization’s goal:
Parr,the Director of Patient Care & Chief Nurse and Allied Health Officer provide professional leadership to the nursing and the AHP workforce for supporting the delivery of high quality healthcare services in the hospitals.Parr is responsible for the overall development of nursing and health professions within the directorate.
Related key leadership and management theories in healthcare:
This role defines distributive leadership theory since the role involves sense making,realting,visioning and inventing new techniques for the development of healthcare and nursing.
Phillip Balmer,Director of Hospital Services
Leadership and management roles and responsibilities:

To plan,direct and coordinate patient are activities for maintaining healthcare standards of patients and to ensure that patients requirements are fulfilled.
To observe procedures and make appropriate suggestions and recommendations for the improvement of policies, techniques and procedures.
To engage in studies and investigations that are related to the improvement of delivery of health care facilities.

Significance of the position in achieving organization’s goal:
Balmer is responsible for planning and organizing schedules of activities that are related to clinical services.The primary significance of this position is to look after the needs of the patients and ensure that they are solved.
Related key leadership and management theories in healthcare:
Transactional theories of leadership can be explained by this job position.
Margie Apa,Director of Population Health / Strategy
Leadership and management roles and responsibilities:

To look after the overall population health of the state.
To develop,coordinate and evaluate population health strategy that incorporates partnership,leadership and advocacy for addressing the social determinants of health.
To develop and support partnership with researchers for enhancing the knowledge base on population health interventions.

Significance of the position in achieving organization’s goal:
Apa is responsible for undertaking the analysis of the status of population health of the communities of New Zealand(Counties Manukau DHB, 2018).This position allows Apa to determine the factors and develop a wide range of strategies for improving the population health and reducing the health inequalities across New Zealand.
Related key leadership and management theories in healthcare:
This position defines the Creative leadership theories that include the production of new solutions for challenging situations and using skills to invent new innovative strategies for the global population.
2. Three major dimensions from the perspective of quality improvement 
The Health Quality And Safety Commission of NewZealand aims for achieving improvement in the quality of New Zealand’s Triple Aim.
Source: (A Window on the Quality of New Zealand’s Health Care, 2015)

Improved Quality, Safety, and experience of care
Improved health and equity for all populations
Best Value for public health system resources

Improved quality, safety, and experience of care
The healthcare system of New Zealand already possesses a high-quality system of health care as compared to many other countries.The triple aim system focuses mainly on recording and tracking the improvements of the healthcare facilities and systems over the time.
The Institute of medicine includes six major dimensions of quality:

Source: (A Window on the Quality of New Zealand’s Health Care, 2015)
Improved health and equity for all populations
The commission promotes basic interventions for improving the safety of the patient and the quality of the care including infections associated with healthcare, medical safety, surgical harms and falls (Fadyl et al.,2015).

Figure 1     Source: (A Window on the Quality of New Zealand’s Health Care, 2015)
The above figure shows the rate of in-hospital falls leading to freactured neck of femur(FNOF) among the people of the age group of 15 and over in the year 2012-2014.

Table: 1     Source: (A Window on the Quality of New Zealand’s Health Care, 2015)
The table explains the number of in-hospital fals with fractured neck femur among the age group of 15 and above.The figures in the table denotes figures per 100,000 admissions.
Infections associated with the process of healthcare is common through out the world.The safety programmes of the commission of Countries Manuka (CMDHB) have introduced the system of improving the hygiene of the hands, prevention of the surgical sites infections and prevention of bacterial infection of the blood(CLAB) in ICU (“Our services | Counties Manukau Health”, 2015).CLAB in sick patients has the tendency to accelerate severe illness, prolong stays at the hospital and related skin infections.New Zealand has thus established Target CLAB Zero for eliminating these kinds of infections and diseases.

Figure 2    Source: (A Window on the Quality of New Zealand’s Health Care, 2015)
The figure potrays the rate of central line insertions in the ICUs compliant with the insertion bundle.

Figure 3   Source: (A Window on the Quality of New Zealand’s Health Care, 2015)

The above figure explains the rate of CLAB per 1000 line days among the extremely sick patients of the hospital
Table 2    Source: (A Window on the Quality of New Zealand’s Health Care, 2015)
The above table shows the rate of CLAB in the hospitals per 1000 line days among the countries.
The safety programmes of the commission of Countries Manuka (CMDHB) believes that improved hand hygiene practices are a key way to prevent infections and diseases associated with healthcare.There has been a substantial increase in the practice of maintaining good hand hygiene in the hospitals of New Zealand throughout these years.

Figure 4   Source: (A Window on the Quality of New Zealand’s Health Care, 2015)
Figure above highlights the New Zealand overall hand hygiene compliance rate

Table 3      Source: (A Window on the Quality of New Zealand’s Health Care, 2015)
The table above shows the performance of New Zealand and its international comparators in the field of the health safety management.
Surgical site infection has been a long debated issue in the field of hospital and healthcare for long.The commission of Countries Manuka (CMDHB) of New Zealand launched the improvement programme for the reduction of Surgical site infection.The commission recorded that hip and knee arthroplasty surgery shows a higher rate of infections and thus increase use of antibiotic prophylaxis has been recommended in the hospitals for the safety of the patients.
Better value for public health system resources
Safe health care does not always imply good care.The high-quality treatments will tend to provide the most effective treatments to the patients.In the system of healthcare, equity and fairness is an important measure.Guided by the New Zealand Health and Disability Services (Safety) Act 2001, there has been a huge reduction in the health disparities.Some of the major issues faced by the M?ori and Pacific peoples of New Zealand are childhood immunization, inflammatory arthritis or Gout and Diabetes.
Community people with lower income tend to have less access to healthy life in New Zealand.The commission recorded the lin between the socio-economic deprivation and poorer health outcomes (“Counties Manukau DHB”, 2018).New Zealand spends relatively less on its health care system and thus the health care system of the country appears to give good value for money.

Figure 7  Source: (A Window on the Quality of New Zealand’s Health Care, 2015)
The above figure shows the per capita expenditure on health care system in the hospitals of New Zealand as compared to the other countries.
The New Zealand health system has higher scores on many dimensions of quality as compared with the other countries of the world.Despite having an inexpensive system, the facilities provided on the grounds of health care are a good value for money.
References
A Window on the Quality of New Zealand’s Health Care. (2015), ISBN 978-0-908345-07-6 (online). Wellington 6146, New Zealand. Retrieved from https://innovation.health.nz/media/documents/window-on-quality-of-NZ-health-care-Nov-2015.pdf
Bercaw, R. (2016). Lean leadership for healthcare: approaches to lean transformation. Productivity Press. Retrieved from  https://www.michiganlean.org/Resources/Documents/Slides%20_%20Lean%20Leadership%20for%20Healthcare_%20MLC%2010-2014.pdf
Counties Manukau DHB. (2018). Ministry of Health NZ. Retrieved 4 April 2018, from https://www.health.govt.nz/new-zealand-health-system/my-dhb/counties-manukau-dhb
Fadyl, J. K., McPherson, K. M., Schlüter, P. J., & Turner-Stokes, L. (2015). Development of a new tool to evaluate work support needs and guide vocational rehabilitation: the Work-ability Support Scale (WSS). Disability and rehabilitation, 37(3), 247-258. Retrieved
Ginter, P. M. (2018). The strategic management of health care organizations. John Wiley & Sons.
Goleman, D. (2017). Leadership That Gets Results (Harvard Business Review Classics). Harvard Business Press.
Gopee, N., & Galloway, J. (2017). Leadership and management in healthcare. Sage.
Home. (2018). Health Quality & Safety Commission. Retrieved 4 April 2018, from https://www.hqsc.govt.nz/
Jacobson, R. M., Isham, G. J., & Rutten, L. J. F. (2015, November). Population health as a means for health care organizations to deliver value. In Mayo Clinic Proceedings(Vol. 90, No. 11, pp. 1465-1470). Elsevier.
Our services | Counties Manukau Health. (2015). Countiesmanukau.health.nz. Retrieved 4 April 2018, from https://www.countiesmanukau.health.nz/our-services/
Singh, H. (2014). Helping health care organizations to define diagnostic errors as missed opportunities in diagnosis. Joint Commission journal on quality and patient safety, 40(3), 99-101. Retrieved from  https://www.isabelhealthcare.com/pdf/Singh_editorial_-_Missed_opportunties__TJC_Journal_.pdf
Tyssen, A. K., Wald, A., & Spieth, P. (2014). The challenge of transactional and transformational leadership in projects. International Journal of Project Management, 32(3), 365-375. Retrieved from  https://pdfs.semanticscholar.org/0631/0878a5b2d8dd293ac3804f7d7d519bb6cb95.pdf
Welcome from Dr Gloria Johnson | Counties Manukau Health. (2012). Countiesmanukau.health.nz. Retrieved 5 April 2018, from https://www.countiesmanukau.health.nz/blogs/welcome-from-dr-gloria-johnson/

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