Deck 2: Systems Thinking, Healthcare Organizations, and the Advanced Practice Nurse Leader

Question 1

In 2017, what did the Senate attempt to do with health care in the United States?

A)Improve access to medical care
B) Replace the Affordable Care Act
C)Model it after New Zealand's system
D)Increase government funding for Medicaid

Answer 1

B

Question 2

Senge, in his book The Fifth Discipline, described the process of systems thinking. One of his thoughts was that "the unhealthiness of our world today is in direct proportion to our inability to see it as a ___________."

A)puzzle
B) complex problem
C)whole
D)image of beauty

Answer 2

C

Question 3

In which field did systems thinking begin?

A)Medicine
B) Business
C)Psychology
D)Engineering

Answer 3

D

Question 4

Because of quality improvement initiatives, systems thinking has become pervasive in health care. This led to the advent of a less threatening venue with regard to medical errors. This has become known as which kind of culture?

A)Blameless
B) Shame
C)Root-cause
D)Error-accusation

Question 5

Transformational leadership in advanced practice roles involves a willingness to take reasonable risks based on

A)community dynamics.
B) social systems.
C)statistical analysis.
D)empirical data.

Question 6

Restraining a patient following a fall would be classified under which type of explanatory stance?

A)Reactive
B) Responsive
C)Generative
D)Systems

Question 7

Which factor has helped raise advanced practice nursing to independent practice?

A)Political progress in funding healthcare
B) An increase in chronic illness
C)Healthcare's uncertain outlook
D)Patient demands for more insurance coverage

Question 8

How does Homer-Dixon describe "cognitive characteristics"?

A)Societies making shifts in a planned, organized fashion
B) Societies adapting to small-scale, incremental changes
C)Advanced practice nurses leading change for improvement
D)Advanced practice nurses advocating for patient healthcare

Question 9

Which skill(s) are essential for the DNP leader to have in relation to big data?

A)Distinguishing which metrics are useful and using them quickly
B) Determining which varieties of data need to be collected
C)Researching the origins of metrics and determining their usefulness
D)Recognizing the importance of the volume of data collected

Question 10

Which option is a key benefit of applying systems thinking to healthcare problems?

A)Being able to develop protocols for health systems
B) Having a process to deal with common obstacles
C)Dealing with complex problems in a holistic manner
D)Facilitating application of engineering principles

Question 11

According to the second essential of the doctor of nursing practice, DNP graduates must understand principles of practice management and must be proficient in quality improvement strategies.

Question 12

One of the most common concerns within healthcare is the question of access.

Question 13

Even affluent Americans are becoming insecure in their health insurance coverage.

Question 14

From a systems perspective, advanced practice leaders need to focus on individual mistakes to understand issues.

Question 15

As noted in the Institute of Medicine (IOM) competencies, the output of a healthcare system has multiple dimensions, including evidence-based practice.

Question 16

Systems thinking differs from traditional analysis methods by looking at the performance of individual components within the system.

Question 17

Churchman's inquiry systems model is centered around the client.

Question 18

It is important that advance practice nurses are able to differentiate issues quickly and effectively and contribute to system redesign. This is best described by Senge in the Fifth Discipline, when he described the _________ model as "turning the mirror inward".

Question 19

Match the author to the idea:
-Senge

A)"We are becoming, as individuals and organizations"
B) "Reductionist" approach to managing an organization
C)"Seeing the world anew"
D)"Our time demands a new paradigm"

Question 20

Match the author to the idea:
-Duck

A)"We are becoming, as individuals and organizations"
B) "Reductionist" approach to managing an organization
C)"Seeing the world anew"
D)"Our time demands a new paradigm"

Question 21

Match the author to the idea:
-Wheatly

A)"We are becoming, as individuals and organizations"
B) "Reductionist" approach to managing an organization
C)"Seeing the world anew"
D)"Our time demands a new paradigm"

Question 22

Match the author to the idea:
-Dossey

A)"We are becoming, as individuals and organizations"
B) "Reductionist" approach to managing an organization
C)"Seeing the world anew"
D)"Our time demands a new paradigm"

Question 23

Discuss the benefits, concerns, and challenges of the systems approach as it relates to the multiple dimensions of a health care system.

Question 24

Discuss the two extreme contentions pertaining to the American health care system: 1) America has the "best healthcare system in the world", versus 2) the American health care system is fragmented and inefficient.

Question 25

Describe how the advanced practice nurse is poised to meet the needs of the struggling US healthcare system.

Question 26

Discuss how Homer-Dixon's perspective that people are able to adapt easily to small-scale incremental changes impacts the current healthcare system.

Question 27

Common themes in healthcare have emerged over the last 2 decades, including dwindling access to it. Visit the Common Wealth Fund website for the article titled "Listening to Low-Income Patients and Their Physicians: Solutions for Improving Access and Quality in Primary Care. (Link: HYPERLINK "https://www.commonwealthfund.org/blog/2019/listening-low-income-patients-and-their-physicians--improving-access-and-quality" https://www.commonwealthfund.org/blog/2019/listening-low-income-patients-and-their-physicians--improving-access-and-quality). After reading the article, describe how the advanced practice nurse could be involved in the process to improve healthcare access.

Question 28

The use of a systems approach to view the healthcare crisis provides the framework for seeing which of the following?

A) Individual issues
B) Interrelationships and patterns of change
C) The solution
D) The complexity of solutions

Question 29

Systems thinking was pioneered by:

A) Schyve
B) Forrester
C) Kouzes and Posner
D) Senge

Question 30

An advanced practice leader provides a supportive outlook for both stakeholders and consumers when communicating a solution to a problem. Which essential practice of transformational leadership does this reflect?

A) Inspiring a shared vision
B) Enabling others to act
C) Modeling the way
D) Encouraging the heart

Question 31

Which of the following practices of transformational leadership would involve experimenting with a new approach to fix an organizational problem within a healthcare system?

A) Challenging the process
B) Inspiring a shared vision
C) Enabling others to act
D) Modeling the way

Question 32

A complex situation should be first approached with which of these?

A) A well-planned roadmap to excellence
B) The empowerment of followers
C) A set of principles concerning the way people should be treated
D) Deep insight into the problems

Question 33

A patient was not administered their medication at the right time. As an advanced practice leader, you determined that the root cause of the issue was understaffing of nurses. According to Senge, you approached the scenario from which type of stance?

A) Reactive
B) Responsive
C) Generative
D) Reflective

Question 34

According to the systems perspective, an advanced practice leader must do which of the following?

A) Look at personalities, politics, and events to better discern the processes whereby certain types of events become more likely.
B) Look at individual mistakes to understand important issues.
C) Focus internally within an organization for a body of evidence.
D) Look outside of the organization for a body of evidence to understand important issues and better understand the big picture.

Question 35

An example of using a reductionist approach to managing an organization would include which of these?

A) Reviewing external data and possible interventions that may address a clinical problem
B) Looking outside of an organization for a body of evidence
C) Envisioning long-term results and trends that can benefit the larger system
D) Quickly addressing an issue to make it more manageable

Question 36

According to David Garvin, in order to determine if an organization is ready to change, it is important to do what first?

A) Modify its behavior to reflect new knowledge and insights.
B) Develop a conceptual framework for systems thinking.
C) Identify a shared vision for the organization.
D) Assess the organization's culture, leadership, and tolerance for change.

Question 37

According to James P. Lewis, which of the following actions supports the formation of a learning organization?

A) Implementing a new system based on executive input
B) Making a decision based on financial outlay
C) Involving clinicians and other employees in the decision-making process
D) Negotiating contracts at the executive level

Question 38

In human systems, which of the following controls behaviors?

A) Structural constraints
B) External factors
C) Interrelationships between components
D) Internal factors

Question 39

The goal of healthcare systems is to do which of the following to the performance of each of its components?

A) Maximize
B) Optimize
C) Minimize
D) Capitalize

Question 40

According to Peter Senge, what is considered to be "the fifth discipline"?

A) Systems thinking
B) Shared vision
C) Empowerment
D) Promotion

Question 41

Churchman's Systems Model is centered around which of these?

A) Planner
B) Client
C) Environment
D) Decision maker

Question 42

According to Churchman's systems model, which of the following may include a person or thing that blocks the achievement of the objectives?

A) Client
B) Planner
C) Decision maker
D) Co-producer

Question 43

Which of the following is one of the key advantages of systems thinking?

A) It promotes the isolation of smaller parts of the system.
B) It focuses on the desires and needs of the client.
C) It provides an opportunity to look at feedback and all interactions created by a decision.
D) It creates short-term benefits.

Question 44

One of the key benefits of the application of systems thinking to the healthcare crisis is the ability to deal effectively with a variety of problems from a holistic viewpoint.

Question 45

Systems thinking came as a result of testing new ideas in complex engineering problems.

Question 46

According to Kouzes and Posner, leadership can be best described as a collection of practices and behaviors.

Question 47

According to James P. Lewis, unintended consequences should be looked at as unintended opportunities.