Read the attached article and answer each question attached in the other document. APA is extremely important including headers. There is only one scholarly article required to support the answers.
Read the attached article and answer each question attached in the other document. APA is extremely important including headers. There is only one scholarly article required to support the answers. We were told we can take any direction we wish with the paper as long as it directly pertains to the attached Betrayed Trust article.
Betrayed Trust Discussion
Please answer all discussion questions below and submit to the Drop Box. Use one scholarly article to support either a leadership ethical or legal issue. Use APA format
Page 38 of your text discusses the management functions of:
Planningencompasses determining philosophy goals objectives policies procedures and rules; carrying out long- and short-range projections; determining a fiscal course of action; and managing planned change.
Organizing includes establishing the structure to carry out plans determining the most appropriate type of patient care delivery and grouping activities to meet unit goals. Other functions involve working within the structure of the organization and understanding and using power and authority appropriately.
Staffing functions consist of recruiting interviewing hiring and orienting staff. Scheduling staff development employee socialization and team building are also often included as staffing functions.
Directingsometimes includes several staffing functions. However this phases functions usually entail human resource management responsibilities such as motivating managing conflict delegating communicating and facilitating collaboration.
Controlling functions include performance appraisals fiscal accountability quality control legal and ethical control and professional and collegial control.
D1. Based on your review of the article give an example of each function
D2. What is the role of a Hospital Board?
D3. What potential legal issues were threats to the organization?
Were these intentional or unintentional acts?
Was it subject to trial in civic or criminal court?
D4. The CEO uses a systems theory framework to understand the culture of the organization and to rebuild the organization.
Was this the right strategy for the organization?
Could it be sustainable after the CEOs departure?
D5. If you were to identify one key element that led to the dysfunction of the organization. What would it be and why?
D6. Using this case study give one example of an ethical principle? Why?
D7. Based on your leadership style what would you have done differently?
D8. Please list any other leadership and management functions that you identified in the article.
Vol. 36 No. 1 pp. 6380
Copyright c 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Betrayed Trust
Healing a Broken Hospital Through
Servant Leadership
Deborah A. Yancer MSN RN
An investigative reporter with The Washington Post broke the news of a no-confidence vote by
the medical staff of a hospital in the suburbs of Washington District of Columbia. The chaos that
followed created a perfect storm for needed change and offered the rare opportunity for unbridled
deep and creative collaboration. Issues the hospital faced as a result of this crisis and subsequent
events that tested the authenticity of change are summarized. This article focuses on the approach
used by the registered nurse chief executive officer (RN-CEO) to humanize the hospital viewing it
as though it were a patient and leading a clinical approach to organizational recovery and health.
The relationship that developed between the medical staff leaders and the RN-CEO was pivotal to
the hospitals recovery and evolved as a hybrid of servant leadership. Outcomes achieved over a
7-year period and attributable to this relational model are summarized. Finally the RN-CEO shares
lessons learned through experience and reflection and advice for nurses interested in pursuing
executive leadership roles. Key words: no-confidence vote recovery servant leadership trust
MIRACLES HAPPEN as clinical professionals
we know that. We have been
blessed to see patients recover when healing
was not thought possible and our efforts inadequate
to the challenge. Miracles can also happen
in the health and recovery of a hospital.
When a hospital falls from grace in the eyes
of the community it serves people look for
someone to place their trust and confidence
in. A building does not engender confidence.
But people can. And so when we hold up a
leader confidence in the hospital can be nurtured.
But the path to recovery can be long
and unpredictable. When trust is betrayed it
is more difficult for people to invest in new
Author Affiliation: Independent Consultant
Lincoln Nebraska.
The author thanks the past presidents and other medical
staff leaders of Shady Grove Adventist Hospital for
their leadership and sage advice as they along with the
author laid down the path to the future.
The author declares no conflict of interest.
Correspondence: Deborah A. Yancer MSN RN
(dyancer@gmail.com).
DOI: 10.1097/NAQ.0b013e31823b458b
relationships and risk disappointment again.
This is true for each of us and so too for
people bound together by a common work.
A HOSPITAL IN CRITICAL CONDITION
In 1999 Shady Grove Adventist Hospital
(SGAH) a 268-bed acute care hospital serving
a rapidly growing community in the suburbs
of Washington District of Columbia was
the subject of a breaking investigative story
in The Washington Post a reputable national
news source. The premise of the article and
the series that followed it was that patients
were dying at SGAH because of poor leadership
and the medical staff had issued a noconfidence
vote (NCV). Although the source
was not named it was attributed to medical
staff speaking on behalf of hospital nurses and
staff. Perhaps more damaging was the slow
decline in personal confidence that physicians
and staff shared with family and close
friends. When the story went public all those
comments added credibility to the concerns.
Confidence was lost from the inside of the
hospital out to the community. All venues of
Copyright 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
63
64 NURSING ADMINISTRATION QUARTERLY/JANUARYMARCH 2012
local media carried the story over the intervening
months. In fact for several years any
news about the hospital was prefaced by reference
to the troubled time.
The good intention of medical staff leaders
to herald the need for change spiraled out of
control and caused many unintended consequences.
Public scrutiny placed an additional
burden on all engaged in delivering or supporting
care at the already faltering hospital.
Everywhere hospital staff and physicianswent
in the community they were questioned and
subjected to name-calling. The hospitals staff
and physicians were battered in the cross fire
of accusations and suspicion. It was a fearful
time with great uncertainty about the future
of the hospital.
Patients continued to come to the hospital
with newspapers in hand and challenged
even the most basic care processes. Regulatory
agencies (The Joint Commission and
the Maryland Department of Health) also arrived
immediately and conducted concurrent
reviews. Temporary management was put in
place at the hospital and the parent health system
Adventist HealthCare Inc whereas the
system board (there was no hospital board
at the time) worked to respond to the immediate
situation. Conflicts between board
members and medical staff were aired in
the media. The hospital was subsequently
placed on conditional accreditation by The
Joint Commission and its deemed status with
the Centers for Medicare & Medicaid Services
(CMS) was threatened. Conditional accreditation
was a designation that had not been previously
used and its meaning and path to resolution
were unclear. Many people in the community
misunderstood the designation and
believed the hospital had lost its accreditation.
Since the hospital had recently achieved
the highest Joint Commission rating the
health system formally appealed the decision.
Meanwhile the health system board considered
potential management options including
affiliation contract management or recruitment
of new leadership. Interim leadership
with assistance from consultants worked to
stabilize the hospital and set priorities. Efforts
during the interim period while well
intended were in some cases off point bringing
focus and energy to change initiatives inappropriate
for a hospital in crisis. For example
work began on the development of
a clinical ladder for nursing. Although nurses
were interested in the development of a system
to recognize their clinical expertise this
work would have no value unless the hospitals
performance and reputation were first
restored.
Themedical staff leadership to their credit
took seriously their involvement in selection
of the next hospital leader. They articulated
what they wanted in a leader and what
they believed the hospital needed. The medical
staff president and president-elect participated
in the selection interviews and pledged
their support moving forward. No formal
methods for medical staff engagement had existed
prior to the NCV. Contact with hospital
and health system leadership had been predominately
transactional. Meetings were held
on an as-needed basis with individual physicians
or groups. Distrust had grown as people
had different accounts of commitments
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