Topic 4: Organizational Structure

A high-reliability organization (HRO) is an institution with foreseeable and verifiable systems that support consistent operations while catching and correcting potentially catastrophic errors before they happen. They operate in complex, high-hazard domains without serious accidents or disastrous failures (Cantu et al., 2020). The elements necessary for creating HRO include Preoccupation with failure. The organizations in developing HRO seek to reduce errors in organizational processes by focusing on areas of the potential loss. In addition, creating HRO requires that every team member share concerns with others and the organizational climate such that all staff members are comfortable with the complexity of the organization (Cantu et al., 2020). Moreover, sensitivity to operations which entails being proactive and real-time identification and prevention of defects and harm is necessary. Similarly, organizations need to be aware of errors and correct them by committing to resilience (Veazie et al., 2019). Further, the element of deference to expertise calls for respectful yielding, domain-specific knowledge, experience, and relative skills.

The Relations of HRO to Safety and Quality

The relations of HRO to safety and quality are that both seek to do the right thing at the right time and have the best possible result while taking all the appropriate measures to prevent errors and adverse effects (Gutzeit et al., 2021). Overall, HRO, safety, and quality in an organization purpose to eliminate negative impacts and enhance efficiency by being sensitive to operations.

The Approach, the Nurse Administrator, Can Use to Execute Elements of HRO

The nurse administrator’s basic approach in the organization to implement HRO is teamwork. Moreover, HRO interventions primarily comprise reinforcement approaches, error prevention education, and leadership training. In addition, it includes enhanced root cause analysis processes using an electronic tracking system and the promotion of a just culture where all stakeholders are collectively responsible for positive or negative outcomes (Veazie et al., 2019). The elements require collectivism to implement. The elements underscore the central point that high-reliability organizations (HROs) are not organizations that do not experience failure. Further, they combine into an organization that mobilizes expertise around highly varied challenges that require teamwork for the expected end of high safety, quality and reliability.

References

Cantu, J., Tolk, J., Fritts, S., & Gharehyakheh, A. (2020). High-Reliability Organization (HRO) systematic literature review: Discovery of culture as a foundational hallmark. Journal of Contingencies and Crisis Management, 28(4), 399-410. https://doi.org/10.1111/1468-5973.12293

Gutzeit, M. F., O’Brien, H., & Valentine, J. E. (2021). Organizational Safety Culture: The Foundation for Safety and Quality Improvement. In-Patient Safety and Quality Improvement in Healthcare (pp. 15-35). Springer, Cham. https://doi.org/10.1007/978-3-030-55829-1_2

Veazie, S., Peterson, K., & Bourne, D. (2019). Evidence brief: Implementation of high-reliability organization principles. Department of Veterans Affairs (US), Washington (DC) PMID: 31233295.

Project Timeline Graphic Organizer

A project timeline outlines the project’s deliverables set out in chronological order. It gives details of what needs to be accomplished before a new task commences and ensures every project activity progresses as planned. A project timeline is essential since it gives a clear picture of the way forward, ensures every person involved has the same goal, keeps all stakeholders in the loop, and facilitates changes in the project (McCaskell et al., 2019). The proposed practicum project involves implementing a team-building activity that will enhance communication and relationship building at the practicum site. The project’s goal is to improve and create a positive, healthy environment, which will increase staff motivation and productivity as well as decreased burnout and staff turnover (McEwan et al., 2018). The purpose of this assignment is to present a graphic timeline for the development of the practicum project and include the roles and responsibilities of stakeholders in each implementation step.

Project Timeline

Implementation Step	Timeframe	Stakeholders	Stakeholder’s Roles and Responsibilities
Project Approval	One week	Project manager Organization leadership team- (CNO, HR director, Administrator) Preceptor Staff	· The Project manager will inform the organization’s top leadership team about the project, including its goals and benefits to the organization. · Review the proposed project, including its tasks. · Give feedback on the changes needed to achieve the desired project’s outcomes effectively. · Approve key project deliverables. · Identify and resolve any potential project issues and risks. · Review the project’s budget, make necessary changes, and approve it.
Education Development	2 weeks	Project manager Nursing leadership team Preceptor	· Research and identify education requirements for the project’s team. · Promptly communicate changes concerning these requirements. · Make timely decisions
Stakeholder Education	2 weeks	Project manager Organization leadership team Nursing leadership team Staff Simulation Task trainers	· Assist in establishing and executing training. · Educate the team about the project and objectives, ensuring the project fit with the organization’s goals and vision. · Attend stakeholder training on how the simulation team building activity will be conducted to gain the maximum benefit from the activity.
Implementation Date	3-4 weeks	Project manager Simulation Task trainers Staff	· Active execution of the team-building activity through simulation training. · The staff will perform various teamwork skills, like interpersonal communication and coordination, in an environment that mimics the patient care setting.
Assessment of Initial Outcomes/Implementation	1 week	Project manager Staff Nursing leadership team	· Develop pre-test and post-test questionnaires. · The staff will fill the pre-test questionnaire before the team building activity and the post-test after the activity. · Analyze the responses in the pre-test and post-test questionnaires to measure the outcomes. · The staff will review and provide timely feedback regarding the project.
Reassessment of Outcomes	Continuous after the simulation training on team building.	Project manager Nursing leadership team Departmental supervisors	· The supervisors will regularly assess the team-building skills among healthcare providers in their departments. · The departmental supervisors will review and provide timely feedback regarding improving communication and team-building skills over time.

Conclusion

The project will take approximately 11 weeks, starting with approval by the organization’s top leadership team. After the training, departmental heads will continuously reassess the project’s outcomes to determine its impact on improving communication and team-building skills among the staff in the actual clinical setting. The project’s stakeholders include the project manager, organization leadership team, nursing leadership team, departmental supervisors, and the staff.

References

McCaskell, D. S., Molloy, A. J., Childerhose, L., Costigan, F. A., Reid, J. C., McCaughan, M., Clarke, F., Cook, D. J., Rudkowski, J. C., Farley, C., Karachi, T., Rochwerg, B., Newman, A., Fox-Robichaud, A., Herridge, M. S., Lo, V., Feltracco, D., Burns, K. E., Porteous, R., Seely, A., … Kho, M. E. (2019). Project management lessons learned from the multicentre CYCLE pilot randomized controlled trial. Trials, 20(1), 532. https://doi.org/10.1186/s13063-019-3634-7

McEwan, D., Ruissen, G. R., Eys, M. A., Zumbo, B. D., & Beauchamp, M. R. (2018). The Effectiveness of Teamwork Training on Teamwork Behaviors and Team Performance: A Systematic Review and Meta-Analysis of Controlled Interventions. PloS one, 12(1), e0169604. https://doi.org/10.1371/journal.pone.0169604

Grid View

	Excellent	Good	Fair	Poor
Main Posting	45 (45%) – 50 (50%) Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	40 (40%) – 44 (44%) Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	35 (35%) – 39 (39%) Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.	0 (0%) – 34 (34%) Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness	10 (10%) – 10 (10%) Posts main post by day 3.	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	0 (0%) – 0 (0%) Does not post by day 3.
First Response	17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	15 (15%) – 16 (16%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	13 (13%) – 14 (14%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	0 (0%) – 12 (12%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Second Response	16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	14 (14%) – 15 (15%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	12 (12%) – 13 (13%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	0 (0%) – 11 (11%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Participation	5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days.	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	0 (0%) – 0 (0%) Does not meet requirements for participation by posting on 3 different days.
Total Points: 100

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For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

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Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

Your response needs to be a minimum of 150 words (not including your list of references)
There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
Include in-text citations in your response
Do not include quotes—instead summarize and paraphrase the information
Follow APA-7th edition
Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

A minimum of 6 responses per week, on at least 3 days of the week.
Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
Each response needs to be at least 75 words in length (does not include your list of references)
Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
Follow APA 7th edition
Points will be deducted if the above is not followed
Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
Here are some helpful links
Student paper example
Citing Sources
The Writing Center is a great resource