Question 1

In order to be successful, middle managers must possess certain competencies. Which is a vital competency for the middle manager in the healthcare setting?&#10;A) Use business knowledge and skills&#10;B) Recognize the professionalism of physicians&#10;C) Demonstrate the ability to communicate&#10;D) Accept decisions of senior management

Accepted Answer

The most vital competency for the middle manager to possess is the ability to communicate. It is essential for the middle manager to communicate clearly and constructively with those both inside and outside the organization. The ability to use business knowledge and skills is necessary for the middle manager; however, communication is a vital competency. The ability to align personal conduct with ethical and professional standards, and a commitment to patients and lifelong learning is vital for the middle manager, but it is not just recognized and\or extended to physicians. The middle manager needs to possess the ability to create a unified vision, to inspire organizational excellence, and to manage change to achieve organizational goals.

Question 2

Measurement of clinical middle management effectiveness is currently considered more of an art than a science. Which outcome is based on objective data and findings?&#10;A) Indications of accurate medication reconciliation&#10;B) How well job specific expectations are being met&#10;C) Whether previously set goals have been achieved&#10;D) Performance of the organizational core values

Accepted Answer

A commonly used objective measurement of clinical middle management effectiveness is the presence of indications of accurate medication reconciliation. The other options are subjective evaluation outcomes, which are used to drive recognition, reward, and performance development plans for middle managers.

Question 3

With the influx of healthcare changes, which is a concern for middle management during the initiation and development of a new healthcare system?&#10;A) The struggle to keep the organization moving in a forward direction&#10;B) The development of long-term strategies for organizational survival&#10;C) The paramount need for achievement of financial and clinical goals&#10;D) The allocation of time, space, and resources for long-term clinical change

Accepted Answer

One concern for middle management during the initiation and development of a new health system is the allocation of time, space, and resources necessary for long-term clinical culture changes. Goals for organizational change, survival, and the achievement of financial and clinical milestones are concerns for the senior leadership.

Question 4

In order to achieve connected care, middle managers must be effective at getting things done within their own organizations. Which actions and\or attitudes are important in making middle managers organizationally effective?

A) Seeking clarity from their own manager about their goals and accountabilities
B) Informing senior management when strategic goals are unrealistic as envisioned
C) Continuing to foster and promote a strong inter-department collegial atmosphere
D) Pointing out other department's problems with handoff processes to the manager

Accepted Answer

The most important action in making middle managers organizationally effective is for the manager to seek clarity from their own manager about the middle manager's goals and accountabilities. Managers who find strategic goals envisioned by senior managers to be unrealistic must advocate for their staff to get work plans modified and obtain needed resources. Managers who are content in their own department silos should make a deliberate effort to reach out and develop strong internal, collegial relationships, which allows them to obtain information, find resources, get help with solving problems, and build an informal organizational support team. A key element of connected care is smooth handoffs, which are enhanced by a good relationship with other managers before and after the clinical process.

Question 5

Managers sit in the epicenter of clinical change and try to balance building a new clinical culture, keeping the business going, caring for patients, and supporting employees. Which behavior will aid the manager in building resilience?

A) Scheduling equally spaced periods of time away from the job
B) Seeking professional counseling at the first indication of burn-out
C) Identifying effective methods for personal stress management
D) Introducing staff to a selected method of time management

Accepted Answer

There are two things involved in building resilience: using stress management techniques and developing a sense of personal empowerment. Management of stress may involve exercise, diet changes, and recreational activities. Scheduling equally spaced periods of time away from the job does not necessarily help the manager to build resilience. If a manager is having difficulty with stress management, professional counseling may help to prevent burn-out. Time management is effective in reducing stress; however, the manager does not need to introduce a selected method of time management to the staff. Time management is an individualized process.

Question 6

The nurse manager notices some situations that seem to cause a disconnection or fragmentation of care. Which situation does the nurse identify as warranting evaluation and change?&#10;A) High-risk patients are most commonly assigned to high-performing clinicians.&#10;B) A group of clinicians is caring for a patient using the team approach.&#10;C) Implementation of a new clinical procedure is preceded by staff education.&#10;D) Tasks are often missed when an admission occurs during busy or rushed times.

Accepted Answer

The nurse manager is most likely to identify the issue of important procedures being missed on a patient admitted to the unit during busy or rushed times. The problem can be a cause of negative patient responses. A real danger is when a high-risk patient is assigned to a low-performing clinician. The manager may need to assign high-performing nurses to high-risk patients. The team approach to patient care is not a problem in itself; however, the nurse manager needs to assess for team cooperation and communication. Staff education for new procedures clarifies processes and accountabilities.

Question 7

Patient centeredness is the core element of a connected care culture. Which nursing behavior prompts the nurse manager to initiate clinical coaching?&#10;A) A hand off report is given before a nurse takes a patient for testing.&#10;B) The nurse expects to take lunch at the same time every shift.&#10;C) One patient's walk is postponed so the nurse can discharge a patient.&#10;D) Because of a new admission, the nurse transfers patient care to others.

Accepted Answer

The nurse manager is prompted to provide clinical coaching when the nurse expects to take lunch at the same time every shift. The nurse needs to understand that patient needs take precedence over the nurse's desired lunch time. When a nurse needs to leave the floor, patient-centered care is assured by giving a hand-off report to the nurse who will be covering the remaining patients. Patient-centered care focuses on the needs of the patient; it is most important for the nurse to discharge a patient in a timely manner; a patient walk can be rescheduled. If a new admission arrives during a busy time, the admitting nurse can transfer some patient care to others.

Question 8

Nurse managers focus on patients receiving clear and accurate information about their condition and the care they are receiving every shift.

Accepted Answer

Patient information about the patient's condition and care is provided constant basis. Updates once a shift are not appropriate or adequate.

Question 9

Care coordination is one of the most essential pillars of connected care and requires special clinical skills, expertise, and considerable support from management to achieve the best outcomes for patients.

Accepted Answer

Within the care coordination function, nurses or other clinicians organize the elements of information, health services, and resources that patients need for recovery, self-care, and transition to the next step in the care continuum. Managers support the complex process of care coordination through employee selection, training, assembling resources, and helping clinicians with organization and complex patient problem solving.

Question 10

Managing lower levels of performance is often a big part of the healthcare middle manager's job, especially in areas where an adequate workforce creates a larger pool of well-qualified clinicians.

Accepted Answer

The exact opposite is true. A smaller workforce creates a smaller pool of well-qualified clinicians, which make the management of lower levels of performance a big part of the healthcare manager's job. The manager's job is to assure that each patient received the most appropriate care, which is dependent upon the availability of well-qualified clinicians.

Deck 5: Middle Managers and Connected Care