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Chapter 7

1. Explain the nursing clinical role, as indicated in Exhibits 7.1, 7.2, and 7.3. A competing perspective is much more limited. In extreme form, it might be limited to completion of tasks indicated by patient management protocols and physicians’ orders. All other functions would be assigned to other units of the organization or left undone. Discuss why this broad view is preferable, in terms non-nursing stakeholders, such as trustees, physicians, or patients, might appreciate
2. Describe how the long-term need for nurses is determined and the shift-by-shift variation in need accommodated? (See also Chapter 8, Additional QFD 2.6.)
3. Safe practices: What is the role of the National Quality Forum (NQF) in developing guidelines for safe nursing practices? Refer to Exhibit 7.9 to identify examples of nursing practices that contribute to improved quality and safety. How would the NQF be able to influence organizations and their nurses to use its guidelines?
4. Which budget does the Accounting/Finance area prepare? Why is this budget so important?
5. Who is responsible for presenting the overall budget to the Governing Board of a hospital? Describe the person’s role in the budget process.

Chapter 8

1. Explain why the organizational structure recommended in Exhibit 8.5 (p. 272) has explicit CSS Managers and a clear link to an “HCO Manager.” All of these managers are expected to be responsive. As a result, each function can generate issues for the HCO manager. How would the manager respond?
2. Explain how the long-range planning for CSS ultimately the responsibility of the governing board, and what is appropriate CSS participation?
   1. 2.2. What should a healthcare organization do if an outside vendor offers superior service on the six dimensions of performance measures?
   2. 2.3. Much inefficiency and quality loss in care occurs at handoffs and interactions between the doctor and the CSS or between CSS, including nursing. Explain, in terms that a physical therapy manager or other CSS manager would appreciate, what the responsibility of the CSS unit is to deal with handoff problems.
   3. 2.4. Should a CSS ever discourage use of a specific test or treatment? Why? How would the CSS go about discouraging use? Should a CSS ever encourage use of a specific test or treatment? Why? How would the CSS go about encouraging use?
   4. 2.5. Who are the customers of a CSS? How would a CSS ascertain customer needs and satisfaction?
   5. 2.6. How would you operate a patient scheduling system (Exhibit 8.3, p. 257) to achieve the optimum occupancy for the unit shown in Exhibit 7.4 (p. 233)? The requested service is “admission to unit.”