The U.S. Census Bureau projects that by 2050, non-Hispanic whites will be in the numerical minority. This rapid diversification requires healthcare organizations to pay closer attention to cross-cultural issues if they are to meet the healthcare needs of the nation and continue to maintain a high standard of care. Although scorecards and benchmarking are widely used to gauge healthcare organiza...

The chronic care model is a guide to higher-quality chronic illness management within primary care. The model predicts that improvement in its 6 interrelated components-self-management support, clinical information systems, delivery system redesign, decision support, health care organization, and community resources-can produce system reform in which informed, activated patients interact with p...

Running a health care organization is a team sport. It is very important that all members of the team—whether on the medical staff, in management, or on the board—understand the role of governance and what constitutes effective governance. Many misunderstandings about the roles of boards exist. Many people think that board members are paid, for example, which is not true. Effective governance: ...

Creation of a high-reliability safety culture “is probably the most challenging work that a healthcare organization has to do,” says Ana Pujols McKee, MD, executive vice president and CMO for The Joint Commission. And as with any other fundamental change in healthcare, the hard work of accelerating development of a safety culture begins with senior leadership: “Without concerted and ongoing eff...

Newly licensed nurses entering into practice experience stressors related to daily challenges. This evidence-based practice project implemented a nurse residency program designed to ease the transition during the first year of practice. Newly licensed nurses at a Midwestern health care organization were enrolled in a yearlong nurse residency program and were required to attend one 4-hour sessio...

To improve utilization and reduce the cost of maintaining mobile clinical equipment, healthcare organization leaders should do the following: Select an initial asset group to target. Conduct a physical inventory. Evaluate the organization's asset "ecosystem." Optimize workflow processes. Phase in new processes, and phase out inventory. Devote time to change management. Develop a replacement str...

A sound retention strategy should incorporate a business plan, a value proposition, progress measures, and management influences. The business plan will indicate whether a healthcare organization will achieve a return on investment for its effort. A value proposition will showcase an organization's strengths and differentiate it from its competitors. Measuring progress toward meeting retention ...

The authors in this paper describe the process and findings of a participatory action research project between a college of nursing and a for-profit acute healthcare organization as practice environment transformation occurred, grounded in caring theory. The participatory action research process and findings emphasize the importance of the intention to know what matters and the required time, c...

As health care delivery organizations react to the changes brought about by public and private sector reform initiatives, RNs can anticipate that, in addition to intended outcomes, there will be unpredictable pressures and unintended consequences arising from reform. Biennial national surveys of RNs conducted over the past decade have explored various changes in the nursing workforce, quality o...