Deck 3: Operational and Strategic Planning: Change, Innovation, and Decision Making

Question 1

The nurse has been assigned to be a change agent for the facility's change to a computerized charting system. What type of planning will this require?

A) Strategic
B) Policy
C) Project
D) Both strategic and project

Answer 1

Project

Question 2

The staff of a healthcare organization is burned out and apathetic, and the organization is stagnant. The newly employed leader is working to empower staff, improve the organization's vision, and alter the culture of accepting the status quo. According to Quinn, what is this leader trying to create?

A) Unfreezing
B) A "slow death"
C) A force-field analysis
D) A "deep change"

Answer 2

A "deep change"

Question 3

The nurse manager is developing a staff education session on change in healthcare. Which concepts should be included in this information? Select all that apply.

A) Oftentimes, before one change in healthcare is completed, another is taking place.
B) Most changes are focused on the organization's structure.
C) Change has been the normal state for healthcare providers for some time.
D) Change disturbs the organization's equilibrium.
E) Sometimes multiple changes occur together in healthcare.

Answer 3

Oftentimes, before one change in healthcare is completed, another is taking place.
Change has been the normal state for healthcare providers for some time.
Change disturbs the organization's equilibrium.
Sometimes multiple changes occur together in healthcare.

Question 4

The nurse manager is coping with a staff member who is very resistant to change. Which strategy would be beneficial for this nurse manager?

A) Maintain open communication with this staff member to establish trust.
B) Help the staff member focus on parts of the change rather than on the whole change at one time.
C) Take over all of the processes of the change.
D) Ignore any hidden agendas brought by this staff member.

Question 5

A new management company has acquired a hospital. Since the acquisition, the hospital's name has changed, a new vision statement has been distributed, the department structure has changed, and the staff's cafeteria discount has be eliminated. Management has plans for many additional changes. What should happen at this point?

A) Management should refrain from making any additional changes for a few months.
B) Management should continue to make changes, but at a rate no faster than 1 change a month.
C) Management should abandon plans for any additional changes.
D) Management should institute the remaining changes as quickly as possible.

Question 6

The nurse manager has repeatedly tried to convince a staff nurse that changing to a new scheduling format is necessary. The staff nurse continues to be negative and argumentative about the need to change. How should the nurse manager interpret this response? Select all that apply.

A) Some staff will never be ready to change.
B) The change cannot go forward until this nurse is convinced.
C) The nurse is being negative for the sake of negativity.
D) The nurse will have to be terminated in order for the change to occur.
E) The nurse may be concerned about loss of routine in personal scheduling.

Question 7

Which option best describes a change agent that demonstrates a transformational style of leadership during the change process?

A) The change agent describes the vision for the change, sets high expectations, and is a role model for the staff.
B) The change agent expresses personal views about the change and empathizes with the staff.
C) The change agent expects staff to follow the change agent's directions required to meet the goal.
D) The change agent provides the staff members with the resources needed to do their job.

Question 8

In which situation would it be necessary to re-regulate practice? Select all that apply.

A) Nurses are asked to cross-train to another specialty.
B) An insurance company opens a nationwide nurse call line.
C) The hospital hires unlicensed assistive personnel.
D) A nursing school revises its curriculum.
E) The healthcare organization goes national and hopes to encourage mobility among its administrative nurses.

Question 9

A patient's finger stick blood sugar registers

A) Programmed decision-making
B) Crisis decision making
C) Time-limited decision making
D) Non-routine decision-making
70) The nurse must follow the policy and procedure for caring for a patient with hypoglycemia. This is an example of what type of decision-making process?

Question 10

The hospital would like to decrease the amount of medication errors made secondary to transcription errors. In order to accomplish this, it is hoped that all physicians will be trained in the use of computerized physician orders by the end of the fiscal year. This is an example of which stage of Lewin's model of change?

A) Refreezing
B) Unfreezing
C) Moving
D) Working

Question 11

A nurse manager is collecting staff views about a current unit problem to make a decision about actions to take. Which style of decision-making is this manager employ?

A) Unilateral
B) Individual
C) Authoritarian
D) Consensus

Question 12

What are the common external factors that drive change in a healthcare organization? Select all that apply.

A) Changes in reimbursement by third party payers
B) Changes in the demographics of employees in the facility
C) Changes in local, state, or national laws
D) Changes in professional standards of care
E) Changes in the organization's salary structure

Question 13

Which activities represent the eight-step process for organizational change? Select all that apply.

A) Management has created a sense of urgency for the change by publishing outcome data on the organization's intranet.
B) Management has worked to develop and communicate a vision that can be shared by all employees.
C) Management has empowered employees to make changes.
D) Management is engaged in "deep change."
E) Management has orchestrated and celebrated some short-term successes along the path to change.

Question 14

The manager of a maternal-child health unit announces that the unit will be redesigned to help meet the Institute of Medicine healthcare competencies. What scenario is one that the staff of this unit might expect?

A) Nursery, labor and delivery, and postpartum nurses will be cross-trained to work in each of these areas.
B) The nurses will be expected to participate in telehealth throughout a three state region.
C) There will be a reduction in staff numbers.
D) The unit will be closed for remodeling.

Question 15

What is the first step in coping with changes that occur in the healthcare environment?

A) Understanding personal response to change.
B) Identifying the change agent.
C) Investigate the facility's history of change.
D) Identify the purpose of the change.

Question 16

The nurse manager is aware of a significant change that will occur sometime in the next six months. How can this manager begin to prepare the staff for this change? Select all that apply.

A) Keep the staff apprised of as much information about the change as is possible.
B) Attempt to keep the unit staffing as stable as possible during the time of change.
C) Insist that all discussions about the change be conducted in a respectful manner.
D) Let the initial information about the change come "through the grapevine."
E) Avoid surprises by telling the staff about how the change will increase workload very early in the process.

Question 17

The nurse is working in a facility that is considering a major change by incorporating interprofessional teams in all departments and units. Which type of planning is required?

A) Policy planning
B) Strategic planning
C) Project planning
D) Strategic planning and project planning

Question 18

Management has called a meeting to discuss the increase in negative patient satisfaction surveys. Which stage of Lewin's model of change does this represent?

A) Moving
B) Refreezing
C) Unfreezing
D) Working

Question 19

During the change process to implement an electronic medical record, a nurse manager says, "We are experiencing a 'slow death'." What evidence would the manager have to support this conclusion?

A) Work processes seem scattered
B) Staff burnout with complaints increasing
C) Use of a detailed project plan
D) Staff refusing to assume more assignments

Question 20

A problem has been identified in the healthcare facility. What should the nurse who has been assigned the task of change agent do next?

A) Develop an alternative plan.
B) Gather data.
C) Collaborate with others.
D) Empower staff.

Question 21

What is the goal of the Center to Champion Nursing in America?

A) Advertise nursing
B) Mobilize stakeholders
C) Describe nursing education changes
D) Recognize importance of APRNs

Question 22

The team is using a PDSA cycle to test a proposed change to conduct an in depth analysis of data with comparison to the predictions. In which step of the cycle is this team working?

A) P
B) D
C) S
D) A

Question 23

What are the first three steps used in proactive leadership? Select all that apply.

A) Listen and learn, adjusting the nature of the solution and the speed of the process as needed.
B) Implement the proposed change by integrating it into organizational culture, structure, and 
strategy.
C) Engage in debate or dialogue about the need for change and the nature of the proposed solution.
D) Form a coalition to manage the change process.
E) Communicate consensus or decision to all stakeholders.

Question 24

The nurse manager has convened a staff meeting to discuss a change in the clinical ladder advancement system used by the organization. A staff nurse says, "Not again! It's just not fair." How should the manager respond?

A) "What do you mean, not again?"
B) "Please don't be negative."
C) "This is going to happen. We can't do anything about it."
D) Ignore the comment and continue the meeting.

Question 25

What is a method used to describe performance over time and identify trends?

A) Graph
B) Cost-benefit analysis
C) WOTS-up
D) Solution Analysis Field

Question 26

Critical thinking is key to successful planning. Which statements are evidence that the nurse manager is a critical thinker? Select all that apply.

A) "I need to research the topic before I comment."
B) "Let's be fair in our consideration of this change."
C) "Let's go ahead and make the change, I have a feeling it is correct."
D) "I'm trying to understand your point of view."
E) "I have to take back something I said in the last meeting; it was wrong."

Question 27

Which statements are true about the evaluation step of the decision making process? Select all that apply.

A) Only the change agent is responsible for the evaluation phase.
B) Management is usually not involved in the evaluation phase.
C) Evaluation needs to be incorporated in all the steps of the change process.
D) All members of the team are required to evaluate the process at the end of the project.
E) Neglecting this step has long-term consequences.

Question 28

Which of the following data collection methods is not one of the three common data collection methods mentioned in the textbook?

A) Observation
B) Survey
C) Record review
D) Interview

Question 29

You are using SWOT for a review of your unit. Which of the following would be part of this process? Select all that apply.

A) Identify strengths
B) Identify opportunities
C) Identify stakeholders
D) Identify weaknesses
E) Identify outcomes

Question 30

The staff nurse is invited to join the organization's Strategic Planning committee. Which topics can the nurse expect to address as part of this committee? Select all that apply.

A) Planning for the next 3-5 years
B) Changes in the core values of the organization
C) Changes in regulations governing the organization
D) Changes in the departmental structure of the organization
E) Suggestions about how to change the staff-mix ratios in a department