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Organizational Redesign,

Restructuring and Reengineering

Redesign
Focuses on individual jobs in one setting
Aims to encompass appropriate qualifications to attain efficiency
and effectivity
Intended to facilitate motivation, higher quality work, greater job
satisfaction, less absenteeism, lower turnover
Drawback: can lead to resistance, job dissatisfaction, and
decreases motivation initially.

Restructuring
Changes the structure of the organization
Naturally follows organizational affiliations, mergers,
consolidations and integrations
Downsizing and or right sizing by cutting the number of
position is also restructuring which requires redesign.

Reengineering

Examines the process of health care delivery to improve it


Usually involves entire organization
Complex and radical
Common practices are path development coordination
among departments, case management, implementation of
patient-focused care, development of multi-skilled workers

Planning Process

Two types:
1. Long Range/Strategic Planning
2. Short Range/Operational Planning

Strategic
Planning

Strategic Planning
Extends 3-5 years in the future
SWOT analysis
Determines the direction of the organization, allocates
resources, assigns responsibilities, and determines time frame
Goals are more generic and less specific than operational
planning

Strategic Planning
Clarifies beliefs and values.
What are the organizations strengths and
weaknesses?
What are the potential opportunities and threats?
Where is the organization going?
How is it going to get there?

Vision

Vision
Mental image or the power of the imagination to
see something that is not actually visible
Preferred future

Vision
Example:
The vision for General Hospital is to be the pre-eminent health care
provider in the region by doing the following:
Being the premier full-service, integrated health care delivery network
that provides a continuum of health services to diverse people.
Creating an environment that exceeds the expectations of our
customers.
Developing creative solutions to the challenges facing us.
Providing economically viable, cost-effective services to our patients.
Working in partnership with other leading health care organizations
Promoting wellness and healthy lifestyles through community health
education programs in partnership with community efforts.

Values

Values

Worth, usefulness or importance of something


Core values do not change
Anchors for the mission even as operation strategies change
Leadership, management and personnel should determine
what their values are and keep their plans and actions
consistent with their values.

Values
Example:
The guiding values for General Hospital are as follows:
Quality
Compassion
Fairness
Integrity
Innovation
Fiscal Responsibility

Mission

Mission
Influences philosophy, goals and objectives
Example:
The mission of General Hospital is to deliver comprehensive
health care services to promote physical and mental health; to
prevent disease, injury, and disability and to promote healing of
the body, mind and spirit.

Philosophy

Philosophy

Articulates a vision and provides a statement of beliefs and


values that directs ones practice.
Should be written in handbooks, annual reports and should
be reviewed periodically.
Should not be stated in vague, abstract terms
Conflicting philosophies between overlapping units should be
avoided
Conformity of action to belief is important.
Upon reevaluation, managers should consider theory,
education, practice research and nursings role in total
organization

Philosophy
Example:
General Hospital is committed to assessing and meeting the
physical, emotional, spiritual, environmental, social and
rehabilitative needs of the citizens in the region. The worth,
dignity, and autonomy of individuals are recognized, as is
each individuals right to self-direction and responsibility for
ones own life. Individual uniqueness will be considered when
assessing needs and delivering quality care. Health care
employees will work in collaboration with customers and in
partnership wit other organizations to provide cost-effective
services.

Goals and Objectives

Goals

Actions for achieving mission and philosophy


Dynamic
Challenging yet reachable
The more quantitative, the more likely to be achieved and
less likely to be distorted
Center of the whole management process (planning,
organizing, staffing, directing and controlling/evaluating)

Objectives

Specific ways to reach the goal

Example:
Goal
Development and implement staff development programs to
meet the need for increased knowledge
Objective
Develop and implement at least 12 staff development programs
by the end of the year

Strategic Planning Process

SWOT analysis
Priority strategic issues and programs
Vision
Philosophy
Goals
Objectives
Strategies
Policies and Procedures
Implementation
Evaluation

Standards of Care and Performance

Joint Commission on Healthcare


Organizations (JCAHO) /
Joint Commission International
(JCI)

Joint Commission on Healthcare Organizations


Founded in 1951.
Independent, not-for-profit organization that
evaluates and accredits more than 15,000
healthcare organizations in the United States.

Founded in the late 1990s to survey hospitals outside of the


United States.
Accredits facilities in Asia, Europe, the Middle East, and
South America.
A count of JCI-accredited hospitals worldwide shows 375
hospitals in 47 countries
Provides an evaluation of a clinical program that delivers care
to a defined patient population

Why get accredited?


JCI is the worlds largest health care accreditor. Since 1994,
each hospital that has sought JCIs Gold Seal of Approval
has done so as part of a continuous performanceimprovement journey.

How do you know when you are ready for JCI hospital accreditation?
JCI accreditation is an ongoing commitment to a process that
demands time, financial resources, and follow-through, but will
ultimately help your organization to improve continuously over
time.

Fees
In 2013, the average fee to a hospital for a full JCI accreditation
survey was US $52,000. In addition to the survey fee, the health
care organization also pays the cost of transportation and hotel
accommodations for the JCI survey team.

Preparing for Accreditation

Baseline Assessment
Quality Improvement
Facilities Management
Tracer Methodology Education Program
Mock Survey
Focused Consulting

Certification as a Specialty Center

A specialty hospital that is JCIaccredited and meets specific


eligibility requirements may apply for certification as a Certified
Specialty Center for the specific specialty provided.
Programs certified may include, but are not limited to, acute
myocardial infarction, heart failure, primary stroke, asthma, chronic
obstructive pulmonary disease, pain management, palliative care,
low back pain, chronic depression, and HIV/AIDS.

Certification as a Specialty Center


Areas evaluated for compliance include:
International Patient Safety Goals
Program leadership and management
Delivering or facilitating clinical care
Supporting self-management for patients and caregivers
Clinical information management
Performance, measurement, and improvement

Reaccreditation

JCI requires accredited organizations to become reaccredited


every three years.
JCI journey does not end with an accreditation award

Pathway to accreditation (Average duration 18-24 months)


1. Become familiar with JCIs accreditation standards and survey
process. (Duration: 2-3 months)
2. Conduct gap analysis and build action plan. (Duration 2-3 months)
3. Update policies and procedures. (2months)
4. Target improvements where needed. (Duration 2-3 months)
5. Work with staff to overcome obstacles. (Duration 2-3 months)
6. Assess your readiness midpoint. (Duration 2-3 months)
7. Continue training for sustainable changes. (Duration 2-3 months)
8. Evaluate and refine process. (Duration 2-3 months)
9. Use a mock survey to assess readiness. (Duration 2-3 months)
10. Make final modifications. (Duration 6-7 months)

Accredited Hospitals in the


Philippines

JCI Accreditation: Hospital Program


Accredited since Nov.30, 2013

JCI Accreditation: Hospital Program


Accreditation withdrawn

JCI Accreditation: Hospital Program


Accredited since July 2, 2011

JCI Accreditation: Hospital Program,


Accredited since Dec.1, 2012
JCI Certification: Primary Stroke
Program, Certified since July 23, 2014

JCI Accreditation: Hospital Program,


Accredited since Nov. 11, 2006
JCI Certification: Acute Myocardial Infarction
(AMI), Certified since Sept. 23, 2015

American Nurses Association


(ANA)

Full-service professional organization representing the interests of


the nation's 3.1 million registered nurses
Advances the nursing profession by:
-Facilitating development of the standards of nursing practice
-Promoting the rights of nurses in the workplace
-Projecting a positive and realistic view of nursing
-Lobbying the Congress and regulatory agencies on
healthcare issues affecting nurses and the public.
Must address the assurance of quality in the clinical, administrative,
education, and research domains of nursing practice.

Foundational Resources for Nursing Practice


1.Nursings Social Policy Statement: The Essence of Profession (ANA,
2010b)
2.Code of Ethics for Nurses with Interpretive Statements (ANA, 2010)
3.Nursing: Scope and Standards of Practice (ANA, 2010a)

History of ANAs Recognition Program for Specialty Care


During the 1990s, ANA Congress of Nursing Practice, now known as
Congress on Nursing Practice and Economics became the reviewing
body of specialty nursing standards of practice.
CNPE has the designated oversight responsibility for developing and
maintaining the scope and standard of practice
Nursing: Scope and Standards of Practice, Second Edition as
template for nursing specialty
Specialty nursing standards must be reviewed, revised as necessary
and resubmitted for acknowledgement at least every 5 years.

Recognition as Nursing Specialty


The process of recognizing an area of practice as a nursing specialty
allows the profession to formally identify subset areas of focused
practice.
The document requesting ANA recognition must clearly and fully
address each of the fourteen specialty recognition criteria
a contemporary specialty nursing scope of practice statement and
standards of specialty nursing practice also accompany the request for
recognition
Other supporting documents and references may be included to
provide additional information, but are not required.

Criteria for Recognition as Nursing Specialty


A nursing specialty:
1.Defines itself as nursing.
2.Is clearly defined.
3.Has a well-derived knowledge base particular to the practice of the
nursing specialty.
4.Is concerned with phenomena of the discipline of nursing.
5.Subscribes to the overall purposes and functions of nursing.
6.Can identify a need and demand for itself.
7.Adheres to the overall licensure, certification, and education
requirements of the profession.

Criteria for Recognition as Nursing Specialty


A nursing specialty:
1.Defines itself as nursing.
2.Is clearly defined.
3.Has a well-derived knowledge base particular to the practice of the
nursing specialty.
4.Is concerned with phenomena of the discipline of nursing.
5.Subscribes to the overall purposes and functions of nursing.
6.Can identify a need and demand for itself.
7.Adheres to the overall licensure, certification, and education
requirements of the profession.

Criteria for Recognition as Nursing Specialty


A nursing specialty:
8.Defines competencies for the area of specialty nursing practice.
9.Has existing mechanisms for supporting, reviewing, and
disseminating research to support its knowledge base and evidencebased practice.
10.Has defined educational criteria for specialty preparation or
graduate degree
11.Has continuing education programs or other mechanisms for
nurses in the specialty to maintain competence.

Criteria for Recognition as Nursing Specialty


A nursing specialty:
12.Is practiced nationally or internationally
13.Includes a substantial number of registered nurses who devote
most of their professional time to the specialty.
14.Is organized and represented by a national or international
specialty association or branch of a parent organization.

Approval of a Specialty Nursing Scope Statement


For approval of the specialty nursing scope statement, the
organizations written submission must address all of the criteria.
Should the area of practice not meet one of the criteria, an
explanation of why the criterion is not applicable or cannot be met
must be included.

Nurse Practitioner Certifications


Acute Care NP
Adult Nurse NP
Adult-Gerontology
Adult-Gerontology Primary Care NP
Adult PsychiatricMental Health NP
Family NP
Gerontological NP
Pediatric Primary Care NP
PsychiatricMental Health NP
School NP
Diabetes ManagementAdvanced
Emergency NP

Clinical Nurse Specialist Certifications


Adult Health CNS
Adult-Gerontology CNS
Adult PsychiatricMental Health CNS
Child/Adolescent PsychiatricMental Health CNS
Gerontological CNS
Home Health CNS
Pediatric CNS
Public/Community Health CNS

Specialty Certifications
Ambulatory Care Nursing
Cardiac Rehabilitation Nursing
Cardiac-Vascular Nursing
Certified Vascular Nursing
College Health Nursing
Community Health Nursing
Diabetes ManagementAdvanced
Faith Community Nursing
Forensic NursingAdvanced
General Nursing Practice

Specialty Certifications
Genetics NursingAdvanced
Gerontological Nursing
Hemostasis Nursing
Home Health Nursing
Informatics Nursing
Medical-Surgical Nursing
Nurse ExecutiveAdvanced
Nursing Case Management
Nursing Professional Development

Specialty Certifications
Pain Management Nursing
Pediatric Nursing
Perinatal Nursing
Psychiatric-Mental Health Nursing
Public Health NursingAdvanced
Rheumatology Nursing
School Nursing

Thank you!

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