NRS 451v Health Organization Evaluation Solved

NRS 451v Health Organization Evaluation Solved

A health system as an organization comprises of at least one hospital and one group of physicians that offer comprehensive care, right from primary to specialty care, who are linked to one another based on common ownership and joint management. Evaluation of such systems to ascertain their effectiveness based on readiness for change, network growth, management of resources, staffing, patient satisfaction and active role in community is essential (Helbig, 2018). Common Spirit Health demonstrate readiness to be resilient in the coming years in healthcare progression. The purpose of this paper is to evaluate the organization and its readiness to meet the health care needs of patient population in the coming decade.

Common Spirit Health

Common Spirit Health is considered one of the largest health systems owned by the Catholic church in the United States. Common Spirit is the second-largest nonprofit hospital system with operations in 21 states. Headquartered in Illinois, Chicago, the faith-based system has 142 hospitals and in over 1000 care locations or sites across the nation. The organization was formed in 2019 through one of the biggest mergers in healthcare system when San Francisco-based Dignity Health and Colorado-based Catholic Health Initiatives came together to create the largest faith-based system in the industry.

The organization asserts that it is mission-driven and seeks to enhance better health into each part of communities for the prosperity of people and places. According to the organization, stronger communities arise when they invest in health (Common Spirit Health, 2022). The organization’s mission, values, and vision focus on building resilient communities, advocating for the poor and vulnerable, and innovation in healing both in its system and communities that it serves. Common Spirit Health (2022) asserts that it is committed to serving all people and is a leading provider of Medicaid service across the country to ensure that those in need get access to quality care. The organization has a host of services and programs like community health initiatives, research programs, home health programs, and virtual care aimed at addressing the root causes of poor health. Common Spirit Health identifies access to quality care, safe neighborhoods and a healthy environment as key to resilient and well-prepared health communities.

Organization’s Overall Readiness based on Findings

Common Spirit Health realize the significance of investing in community health through advancing health equity, improving population health and innovation in healthcare. The increasing diversity among patient population and growing demand in care services occasioned by an aging population, emerging and reemerging infectious diseases like the Coronavirus disease of 2019 (COVID-19) pandemic, implore organizations like Common Spirit to focus on innovation (Common Spirit Health, 2022b). Through these approaches, the organization will be ready for the coming decades as it responds to reforms in health care and increased deployment of technology to improve access, reduce costs, and enhance quality of care.

ALSO READ: NRS 451V Week 4 Organizational Culture and Values Presentation

A comprehensive analysis on Common Spirit Health demonstrates that the system is keen improving its readiness to respond to the reforming health care sector based on its three areas of what they do; health equity, improving population health and innovation. The organization envisions a model that allows it to solve health needs in a proactive and holistic manner to attain more equitable health outcomes in communities Common Spirit Health, 2022). The organization shows its ability to attain this goal through common equity, a more just health system, and supporting community health programs. The organization also invests in having a more diverse workforce and environmental stewardship (Common Spirit Health, 2022c). Common Spirit Health advances health through its programs and initiatives; especially leveraging data and technology to tackle major health care issues like the opioid use disorder.

Furthermore, the organization’s readiness is demonstrated through its focus on providing value-based care and being part of initiative like Physician Enterprise which represents different players in the industry like ambulatory care, and networks. The organization also shows its readiness through innovation in virtual care and home health, investment in Precision Medicine Alliance that it launched in 2016, and creation of partnerships with other stakeholders to advance health care provision and delivery (Common Spirit Health, 2022b). Common Spirit Health has also invested in clinical research as it believes that research is fundamental in each cure and a core aspect of the entity’s commitment to excellence in patient care. The analysis of the findings show that Common Spirit Health is an organization that is ready for the changing nature of the health care industry based on its initiatives and programs and investment in technologies and focus on community health by recognizing the existing diversity in population.

Strategic Plan for Common Spirit Health

Common Spirit Health was established in 2019 after the merger of two big health systems with operations in different states across the country. The merger brought together huge resources; both human and financial and equipment that allows the organization to expand its network, have sufficient staffing levels, manage resources and attain patient satisfaction. A strategic plan for the organization should focus on leveraging the opportunities created by this merger and creating more partnerships in the health care sector (Saleem et al., 2019). For instance, Common Spirit along with other health care systems like Trinity and Tenet have come together to launch a data analytics company called Truveta to help them leverage the huge healthcare data to improve care provision and precision Common (Spirit Health, 2022c). Secondly, Common Spirit Health has invested hugely in clinical research, precision medicine and virtual health to enhance its expansion and reach to diverse patient and health populations. Its home health program focuses on improving accessibility. The organization is also a leading site for Medicaid Services. Therefore, the strategic plan should focus on leveraging existing programs to ascertain their overall ability to help the organization meet its goals and objectives given that it is relatively a new corporation created less than three years ago.

Current or Potential Issue in Organizational Culture

Common Spirit Health’s organizational culture is growing and must embrace diversity, especially due to the merger of the two systems that resulted in two sets of employees who may have different approaches to care provision. The need for diversity and crafting of a common approach to care provision may be a potential issue which can impact the implementation of the strategic plan (Kirsten, 2020). Secondly, being a large health system, it requires more resources to implement its initiatives across all the over 140 hospitals and more than 1,000 care sites across the nation (Common Spirit Health, 2022). The implication is that without a comprehensive and system-based approach, the organization may struggle meeting its growth objectives based on a host of programs and initiatives that it runs to enhance health care quality among its targeted communities and patient populations. Investing in a diverse workforce is essential in tackling some of the issues and would allow the system to get innovative staff to attain its programs.

Theory or Model to Implement the Strategic Plan

Models and theories in healthcare guide the implementation of quality improvement initiatives like strategic plans (Barrow et al., 2021). In this case, the most appropriate model would be Lewin’s change model that guides organizations in implementing strategic plans. The management of the system should identify aspects of the suggested programs and initiatives at different sites for implementation and engage their nursing staff and other organizational members. Lewin’s change model has three steps that include unfreezing, change and refreezing. The model allows change implementers to engage those to be affected by the changes and attain a buy-in to reduce potential resistance. The model is appropriate for Common Spirit Health based on the current state of the system since it requires effective integration of its workforce.

Conclusion

Health Systems like Common Spirit Health are critical to care provision, especially due to the rising demand of care services in the country. The evaluation of the organization shows a ready system focused on meeting the health care needs of citizens in the coming years based on the different approaches, programs, and initiatives. However, the proposed strategic plan will allow it to attain best outcomes and ensure that it effectively meets these needs through well-intentioned expansion and investment in technology and data analytics.

References

Barrow, J. M., Annamaraju, P. & Toney-Butler, T. J. (2021). Change Management. StatPearls

[Internet]. https://www.ncbi.nlm.nih.gov/books/NBK459380/

Common Spirit Health (2022). Who We are: Here to Serve.

 https://www.commonspirit.org/who-we-are

Common Spirit Health (2022b). Innovation moves everyone forward.

https://www.commonspirit.org/what-we-do/innovative-care

Common Spirit Health (2022c). A healthier future for all.

https://www.commonspirit.org/what-we-do/advancing-health-equity

Common Spirit Health (2022d). Improving population health.

https://www.commonspirit.org/what-we-do/improving-population-health

Helbig, J. (2018). Reengineering health care management. In Grand Canyon University

(Eds.), Nursing Leadership and Management: Leading and Serving (chapter 5). https://lc.gcumedia.com/nrs451vn/nursing-leadership-and-management-leading-and-serving/v1.1/#/chapter/5

Kirsten, D. (2020). Change is inevitable. Nursing Management (Springhouse), 51(7):56. doi:

10.1097/01.NUMA.0000669092.10582.06

Saleem, S., Sehar, S., Afzal, M., Jamil, A., & Gilani, S. A. (2019). Accreditation: Application of

Kurt Lewin’s Theory on Private Health Care Organizational Change. Saudi Journal of Nursing and Health Care, 2, 12. DOI: 10.36348/sjnhc. 2019.v02i12.003

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Organizational culture and values are critical components that allow nurses to deliver care to patients. Organizational culture is based on values, norms and practices that the management uses to develop mission and vision statements. Nurses thrive in friendly organizational cultures that value diversity and are transformational based on their values, mission, and vision statements (Kang et al., 2020). Through such environments, nurses enhance their patient engagements, develop better and innovative patient care models and this leads to positive patient outcomes (Braithwaite et al., 2018). The purpose of this presentation is to discuss the role of organizational culture and values based on mission and vision and its influence on nurses’ engagement. The presentation also explores the role of organizational culture and values in conflict resolution and management in health care setting.

Organizational culture entails shared beliefs, values, and attitudes. An organizational culture also include the conduct and way of behaving, communication aspects, customs and the vision crafted by those involved. Furthermore, values and culture within an organization denote to a system of sharing assumptions and common approaches to issues as well as how employees behave in their duties (Braithwaite et al., 2018). Values are moral tools and components within the organization that guide overall conduct. Shared values and beliefs have robust influence on employees in the organization.

Organizational culture is important to different stakeholders who include the management and employees. Organizational culture and values encourage collaborations, motivates employees, leads to attainment of goals. Organizational culture and values provide the requisite foundation for ethical conduct and way of doing things for an entity (Runtu et al., 2019). Organizational culture influences the type of nursing and patient care models used by an organization. culture and values also shape the way staff, nurses, and providers develop relationships, communicate and collaborate in the healthcare setting (Manion & Davies, 2018). Organizational culture and values also establish expectations and standards of practice and a commitment by healthcare entities to the communities that they serve.

Organizational mission, vision, and values are critical component of its culture. The mission states the purpose of an organization and essence of its overall existence. The mission is recognized and integrated into practice and operations of the organization as part of their goals and objectives. Vision statement is futuristic and describes the dream of the organization and what it hopes to attain or accomplish in the future. Robust vision statements entail what the organization will attain and contain a clear development path (Dempsey & Assi, 2018). Values in an organization are ethical imperatives and standards of conduct that the stakeholders and the organization promote and follow. Values define the choices that an entity embraces to operate and contain ethical standards that employees should adhere to based on expectations and corporate social responsibility.

Mission statement offers overall purpose of what an organization hopes to attain now or in the current situation. Through the mission statement, a healthcare organization provides services that meet consumer needs and develops innovative interventions in health promotion and disease management. Vision statement ensures that an organization considers futuristic aspects in their industry and develops interventions to attain them (Runtu et al., 2019). For instance, the deployment of technology in healthcare implores organizations to consider innovative approaches in care delivery in the future to meet patient needs. Values allow practitioners to develop and model certain ethical imperatives like honesty and integrity to deliver quality patient care (Manion & Davies, 2018). The overall intent of these components is to develop an organizational culture that aligns with the overall need to deliver quality patient care.

As posited, the essence of mission, vision and values in an organization is to develop an organizational culture that espouses goals and objectives of the entity. Mission, vision, and values statements are essential ton engagement of nurses in different ways. They encourage positive and productive nurse-to-nurse interactions and relationships that are important in health care setting (Nightingale, 2018). They also promote longevity and retention implying that they reduce possible turnover and shortage in the practice setting. Mission and vision as well as values lead to increased commitment by nurses to a facility and to patients. They also allow development and nurturing of positive interactions with patients (Mannion & Davies, 2018). Mission, vision, and values are fundamental components of effective ways of communication and overall conduct among nurses. The implication is that nurses need systems that have positive values, vision and mission to motivate and inspire them to offer quality patient care.

Studies are categorical that positive relationship exists between an effective organizational culture and patient satisfaction based on better interactions with patients and commitment to quality care delivery. Patient satisfaction and outcomes are important measures of clinical outcomes and health care performance. Patients prefer organizations that have ethical practices and are patient-centered (Smits et al., 2018). The mission, vision and values statements encourage effective patient interactions as nurses espouse better values like integrity, honesty, transparency and better communication. An empowering organizational culture based on vision, mission, and values has a positive correlation with customer satisfaction (Braithwaite et al., 2018). The mission, vision, and values help attain improved care through mission-oriented culture that patients seek in healthcare settings.

Conflicts are an inevitable part of Organizational Interactions and working among diverse individuals with different and divergent perceptions of issues.

Conflicts have a negative connotation but may offer opportunities to improve organizational outcomes and processes. Different factors cause conflicts in organizations. These include ineffective communication, differences in roles responsibilities and goals among diverse stakeholders, differences in values and perceptions as well as resource strain and a demanding workplace environment (Dempsey & Assi, 2018). Further, organizational change may also be a source of conflicts because some employees may not be willing to adjust to the new way of doing things. Conflicts can also arise due to unmet and unrealistic personal and professional expectation as well as internal power structures and need for recognition among employees (Nightingale, 2018). The implication is that through an effective organizational culture based on values, stakeholders can find lasting solutions to the conflicts in these settings.

Organizational culture and values are critical aspects of the interventions that providers and entities in healthcare can use to address conflicts. Values offer direction on expected conduct and ethical approaches to minimize possible conflicts. Ethical standards improve interactions and level of communication in an organization to reduce frictions and miscommunication. Further, values harmonize organizational culture and sets attributes and skills that leaders should possess to handle conflicts better. Culture influences social normative that glues an organization together while shaping the type of leadership that evolves in an organization (Mannion & Davies, 2018). Leadership affects the kind of communication and approaches that an organization can use to address conflicts, especially in nursing and healthcare settings. imperatively, shared leadership based on a robust organizational culture and values is critical in adopting better conflict management approaches (Dempsey & Assi, 2018). Therefore, that have effective values and cultures can solve conflicts better and attain quality outcomes. Values like teamwork, respect, and transparency, integrity and honesty allow organizations to have common approaches to conflicts while transformational, participative and charismatic leadership styles improve the chances of generating solutions to conflicts in organizational settings.

The management of organizational conflicts is essential to improving care delivery, patient satisfaction, and performance of nurses. Leaders and followers should focus on the best approaches from the available ways like accommodation, collaboration, compromising, avoidance and competing. In this case, they can use strategies like accommodation, collaboration and compromising to deescalate such events (Sprajc et al., 2020). Secondly, they need to ensure that the organizational culture and values align with the stakeholders’ expectations, especially among their employees. Organizations and their management can also address conflicts when the values and culture align with their mission, vision, and the goals (Kang et al., 2020). Further, conflict resolution needs leaders to focus on issues and not individuals, have open and effective communication and accepting conflicts as critical to developing new ways of doing things.

Inter-professional Collaboration is vital for effective care delivery and attainment of one common purpose and goal. Inter-professional collaboration entails working together based on a common plan of care to deliver quality patient services (Tang et al., 2018). Strategies like having effective teams and teamwork, developing an organizational culture that supports increased interactions and based on good values lead to inter-professional collaboration (Machen et al., 2019). Inter-professional collaboration happens when leaders offer support based on their leadership styles (Dempsey & Assi, 2018). For instance, honesty, transparency, integrity and trust are critical values that encourage inter-professional collaborations in organizations. Effective assignment of duties and roles’ clarity ensures that providers collaborate to offer quality patient care.

Organization needs in healthcare continue to be dynamic and unpredictable because of increased care demand and use of innovative models like value-based care purchasing. The needs are unlimited yet available resources are limited and this implores nurses to use their mental fortitude to meet the diverse patient needs and attain quality care (Machen et al., 2019). Organizational needs like increased nurses and lowering costs impact outcomes as sufficient resources lead to better results. Better interactions and relationships come based on the organizational culture and values espoused by providers (Kang et al., 2020). Therefore, these values and culture promote better interactions among diverse stakeholders culture is also instrumental in equitable allocation of resources to achieve the expected outcomes

Culture gives direction on conduct and processes within an organization to attain its goals and objectives. Culture also influences the type of interactions that occur among the diverse providers and stakeholders within and outside the organization (Sprajc et al., 2020). For instance, having a positive organizational culture attracts patients and gives them hope of attaining quality outcomes and increased levels of satisfaction. An organizational culture also leads to higher levels of patient safety and reduces occurrence of adverse events like medication errors. It also enhances the development of trustful interactions among different stakeholders (Nightingale, 2018). As organizations with better health care culture attain better outcomes in different areas that include patient outcomes and attainment of respective goals and objectives.

Health promotion requires resources and a supportive organizational culture. Further, health promotion focuses on interventions aimed at reducing the occurrence of diseases and chronic conditions. Organizational culture and values are essential in developing better ways to interact with communities to implement better interventions aimed at care delivery (Dempsey & Assi, 2018). Organizational needs impact health promotion from a community perspective as they reduce available resources and personnel for equitable resource allocation. Organizational culture and values dictate how employees interact with communities to implement evidence-based practice interventions to improve overall care.

References

Braithwaite, J., Herkes, J., Ludlow, K., Testa, L., & Lamprell, G. (2018). Association between organizational and

workplace cultures, and patient outcomes: systematic review. BMJ open, 7(11), e017708.

doi: 10.1136/bmjopen-2017-017708

Dempsey, C. & Assi, M. J. (2018). The Impact of Nurse Engagement on Quality, Safety, and the Experience of Care:

What Nurse Leaders Should Know. Nursing Administration Quality, 42(3):278-283.

doi: 10.1097/NAQ.0000000000000305

Manion, R. & Davies, H. (2018). Understanding organizational culture for healthcare quality improvement. BMJ, 363.

doi: https://doi.org/10.1136/bmj.k4907

Kang, J. Y., Lee, M. K., Fairchild, E. M., Caubet, S. L., Peters, D. E., Beliles, G. R., & Matti, L. K. (2020). Relationships

among organizational values, employee engagement, and patient satisfaction in an academic medical center.

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20.DOI:https://doi.org/10.1016/j.mayocpiqo.2019.08.001

Machen, S., Jani, Y., Turner, S., Marshall, M., & Fulop, N. J. (2019). The role of

organizational and professional cultures in medication safety: a scoping review

of the literature. International Journal for Quality in Health Care, 31(10), G146-

G157. doi: 10.1093/intqhc/mzz111

Runtu, T. M., Novieastari, E., & Handayani, H. (2019). How does organizational culture

influence care coordination in hospitals? A systematic  review. Enfermeria clinica, 29, 785-

802.

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collaboration between junior doctors and nurses in the general ward setting: A qualitative

exploratory study. Journal of nursing management, 26(1), 11-  18.

Nightingale, A. (2018). Developing the organizational culture in a healthcare setting. Nursing

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Sprajc, P., Podbregar, I., & Hribar, N. (2018). Strategic aspects of the human capital

management in the development of organizational culture. Economic and Social

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Healthcare organizations have the responsibility of providing care to various populations. While some organizations may operate within a given region, others may have the objective of expanding to the national and even the international levels. In the United States of America, there are healthcare organizations that offer their services not only at the state level but also at the federal level. They often attempt to expand their services to numerous states. United Healthcare Organization is one of the healthcare institutions that operate in different states. Other similar institutions may include Banner Health and Vanguard. For private healthcare institutions, the provision of healthcare services to various states often leads to an increase in revenues and protection of many people’s lives. The paper provides an evaluation of the United Healthcare Organization, including overall readiness to operate in various environments as well as its strategic plans.

Description of Healthcare Organization (United Healthcare Organization)

United Healthcare organization is an American for-profit company based in Minnetonka, Minnesota. The institution offers insurance services and health care products to its members. United Healthcare Company is the largest healthcare organization globally by revenues as of 2019. In the same year, the organization recorded total revenues of close to $242.2 billion (Branch et al., 2019). The company’s revenues encompass 80% of the group’s overall revenue. The company is also ranked 6^th on the Fortune 500 as of the year 2019 (Branch et al., 2019).

United Healthcare organization serves millions of people across different states of America.  The institution offers services to the people from their earliest years of development, through to their working lives and into retirement. What keeps the organization’s reputation is the mission to enable people to live healthier and better lives amidst the emergence of diseases and complex situations in healthcare delivery services. The organization also works to make the healthcare system work for every individual within their areas of operation (Jacobson et al., 2017). United Healthcare Organization is working to develop an integrated system that is more affordable for all the people. Also, the organization works to establish a system that can deliver high-quality care that is responsive to the needs of every person and the communities.

United Healthcare’s Overall Readiness

United Healthcare Company has an elaborate workforce that is able to transform the institution’s desires. Employees work in line with organizational objectives and mission. Given the wide variety of services offered to different people across different states in America, the company has policymakers who are able to analyze trends in the healthcare industry and offer implicit decisions on the way forward. The company has made this possible due to the committed workforce and careful analysis of the markets and various healthcare industries for the company.

The company also has several healthcare plans that can benefit different persons, depending on their needs and income levels. Some of the plans include UnitedHealthcare select plus, UnitedHealthcare select, UnitedHealthcare Choice, which operate as HMO where there is also an option of choosing preferred specialists. These healthcare plans are available for all individuals who plan to get access to medical services. United Healthcare Company provides commercial group insurance plans in different states within the United States of America over various products name with different offerings (Branch et al., 2019).

United Healthcare organization has perfect transformation strategies to counter continuous changes in the healthcare system. Continuous improvement processes in quality delivery is one of the strategies that is geared towards improving the overall quality of services offered. The company also formulates policies that enhance the operational processes and adhere to the possible transformations in the market. United Health Company works in collaboration with other healthcare organizations to facilitate the delivery of quality care at affordable costs. The partnerships and associations formed to define the overall healthcare readiness to tackle some of the challenges associated with the variations in the market and possible disruptions caused by technology and new operational environments (Salmond & Echevarria, 2017). Through collaboration, the organization can initiate a transformative agenda that may enhance the operational processes.

Strategic Plan

In most cases, preparing for the planning arrangement, clear mission, vision, and agreement priority are some of the strategic planning processes. Many times, preparation for the strategic plans should be a comprehensive process as it needs to cover the required arrangements to ensure the affluence of an organization. Through the following three steps in strategic planning, there is always the need to eliminate weaknesses, including the gaps in the range of the available products. Strategies enable the businesses to achieve the mission and vision as well as the successful outcome.

Mission

The mission is to provide better healthcare services, and decision-making supports for better healthcare outcomes.

Vision

To be the leading healthcare provider through enhanced medical and insurance services globally.

Financial Planning

United Health Company plans to increase revenues by expanding their services to different states. They also tend to offer more options for healthcare plans to ensure that many people are registered to receive quality healthcare services. Huge financial resources are expected to go to healthcare plans.

Network Growth

The company anticipates expanding its network growth through collaboration with other healthcare organizations such as hospitals and healthcare centers. Also, the management plans to collaborate with other healthcare insurance companies to realize their full potential in the global healthcare industry.

Nurse and Staffing

With the increasing customer base, the organization plans to increase the number of workers to handle various services. At the same time, the human resource department has been tasked with the responsibility of enhancing the skills and technical abilities of the workers to ensure effective service delivery.

Resource Management

As the company is expanding, there is always the need to increase the number of resources and to provide proper management services. United Healthcare is engaged in the development of strategies to enhance resource allocation and effective utilization. With the continuous expansion of services, United Healthcare Company plans to set up more offices and healthcare centers in different states and increase the services offered. Also, the company plans to increase technological services. With the growth in technology, the organization plans to invest more in technology to enhance service delivery and efficiency in care.

Patient Satisfaction

In United Healthcare Company, patient satisfaction is the key. The organization tends to invest more resources in enhancing service delivery to promote patient satisfaction. The increased use of technology is expected to enhance service delivery, a scenario that will, in turn, promote patient satisfaction. One of the organization’s main plans in terms of patient satisfaction is the facilitation of the self-care delivery models that will enable patients to receive satisfactory services.

Current Issues with the Organizational Culture

United Health Organization holds strong cultural values that enable the workforce to stick to effective operational processes. The organization has a strong culture of collaboration, appreciation, support, and community . Also, patient care is at the center of its cultural practices. Effective service delivery and patient satisfaction further contribute to strong cultural values. The above cultural practices may enhance the development and achievement of the strategic plans. A culture of ensuring patient satisfaction, for instance, enhances the achievement of the organizational objective of providing sufficient services to the customers. In general, the organizational culture guides the workforce as well as the management in establishing the goals or objectives within the organization.

Issue-Based Strategic Planning Model

An issue-based strategic planning model can support the implementation of the above strategic plan for the United Healthcare Organization. The issue-based strategic model can be used to provide strategies for present and future plans. The model is critical as it aims at identifying the possible challenges or problems that an organization might face. It starts by ironing out issues before expanding and shifting the strategies that are applied in the implementation of the strategic plans. The issue-based strategic planning is the best given that fact that it considers all the factors or barriers that an organization might face.

Conclusion

United Healthcare Organization is one of the institutions that offer healthcare services, including health insurance plans to millions of people in the United States of America. Because of the strong organizational values and a strong and committed workforce, it ranked as one of the best healthcare companies globally. The organization also partners with different care providers where they collaborate to improve general patient care. The organization is also operating to create a more sustainable healthcare system that can provide quality services to every person involved.

References

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Jacobson, G., Damico, A., Neuman, T., & Gold, M. (2017). Medicare Advantage 2017 spotlight: enrollment market update. accessed on August, 20, 2017.

Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic nursing, 36(1), 12.