Organizational Performance

Running head: NURSE LEADERSHIP

Nurse leadership

Name:

Institution affiliation

NURSE LEADERSHIP 2

Executive Summary

The paper focuses on nursing leadership. The task will help in developing the necessary

expertise and skills essential in the management of a health care setting as well as understanding

the unique elements of nursing leadership. It originates from my role as a nurse leader in an

oncology department. My aim is to improve the outcomes of the poor performance of the

oncology department which is below benchmark by ensuring my team and the staffs are more

engaged and motivated. In this regard, I will create a performance data scorecard to be used as

outcome measures in the oncology department. The designing of the performance data scorecard

will involve identifying the population of patients being addressed. It will also involve

identifying the outcomes measures that are related to the identified population of patients using

such indicators as performance, patient safety, and quality as well as employee engagement.

Moreover the paper discusses the required processes that drive all outcome measures and the

researcher will discuss any additional indicator that would facilitate a nurse leader in monitoring

the drive outcomes on a regular basis as part of the performance data scorecard. It further

discusses the advantages of the created performance data scorecard. It also analyses the current

trends in the healthcare related to the employee engagement and explores the relationship

between the healthcare quality and employee engagement. It also discusses if the tools being

used in the organization are adequately providing the needed nursing leadership with the data in

regards to the employee engagement. A plan is created to improve the employee engagement

based on the performance data scorecard and is not limited to the strategies, timeline, goals as

well as evaluation. The best leadership practices are outlined that are considered to improve

employee engagement. In conlusion,

NURSE LEADERSHIP 3

Purpose: the primary objective of this paper is to illustrate how data scorecard can be used to

ensure improved results on oncology population in a hospital and to improve performance

measures by engaging the staffs and other teams.

NURSE LEADERSHIP 4

Introduction

Leadership, as defined by scholars, means the ability to influence other people to do

something. A manager in an organization has the responsibility of a leader since he or she

influences how things get done in the organization. The responsibility of organizing, controlling,

planning and directing are the traditional roles of any leader or manager. If a group lacks a

leader, or any activity carried out without the directions of the leader, that organization or task

has a high probability of failing.

A hospital is an organization which requires monitoring. For example, they have assets

like ambulances, buildings, financial or accounting resources. If these resources are left in the

hands of individuals without supervision, there will be misappropriation leading to failure of the

hospital as a whole. For this reason, appropriate personnel who possess the skills and knowledge

required are assigned the task of monitoring in the organization.

Who is a nurse a leader?

A nurse manager is a nurse who is involved in the process of influencing people and

motivating them to work together to achieve a common goal. The nurse has the power to control

his or her team. Unlike in management where the power gets delegated, the power of a nurse

leader is from the position he holds. The expertise of the nurse which includes his knowledge

and skills, his relationship with other stakeholders, ability to coarse individuals or his ability to

allocate incentives in an organization determines his power (Pandilla 2012). For him to achieve

his overall goal which might be personal or organizational, he should have skills to aid him in

performing his duties.

NURSE LEADERSHIP 5

Some of the skills include,

Interpersonal skills

It is the ability to relate to other people on both social and professional level. Excellent

interpersonal skills ensure that communication flows smoothly from the leader to junior teams

and staffs. The leader will also be in a position to receive feedback and therefore effect any

changes that might need implementation.

Social awareness

In the nursing profession, one is trained to cater and care about individuals at all levels.

It, therefore, means that a nurse has to care about the physical and emotional needs of a patient.

For the nurse to achieve this goal, he has to have the skills to identify what other people are

going through. It calls for the nurse to pay a very close attention to the patient. For the nurse

leader, these skills are critical for him or her to carry out his tasks.

Management skills and management style

Though a nurse has direct power to influence his teams and staffs, he has to have the

knowledge of the Directorate. The nurse has to be able to organize, direct, control and plan

activities in an organization. Depending on the type of staffs that the leader is responsible for, he

should adopt a management style that will ensure highest compliance and results.

NURSE LEADERSHIP 6

Performance data scorecard for oncology population

Oncology

Oncology is the study of cancer. In today’s world, almost 50% of the food we consume,

the products that we use, the lifestyle, in general, exposes us to risk of developing cancer

complications. In most countries, cancer is the second leading cause of death. Statistics dictate

that most men are affected by cancer more than women giving a statistics of a half and a third

simultaneously. Oncology helps in diagnosing cancer, recording the stage of disease and

recording the aggressive nature of cancer (Cashin-Garbatt, 2011). For years, performance

evaluation in organizations has been done using the traditional methods. The benchmarks are

limited or too wide in scope to realize them with accuracy. As a result, the outcome measures

become difficult to monitor. For oncology patients, for example, the measures have been to track

the number of radiography tests that are carried out daily by the hospital. From one side, it is a

good measure of performance outcome, but this might mean reduced service on the edge of the

patient due to rush to increase the number of tests carried out in a day. There is a need therefore

to strike a balance between all aspects of an organization. The balanced scorecard includes

measures that tell the results of actions already taken (Atkinson 2006). The scorecard brings to

perfection the financial measures with operational measures on customer satisfaction, internal

processes, organization’s innovation and financial performance of the organization as a whole.

(HBR, September 2011). As a nursing leader, I will require a lot of information to make

operations run smoothly; the balanced scorecard will help in balancing measures in question. The

balanced scorecard aligns the organization around a customer-focused strategy which in turn

influences the market for the hospital. The nurse leader follows up on the implementation of the

policies to ensure that there is the realization of full performance and delivery of services at all

NURSE LEADERSHIP 7

levels of the organization. The scorecard helps communicate to the team members and staffs all

the tasks in which they are supposed to undertake for successful operations in control of cancer

(Healthc Manag. 2002)

The key objectives of developing the scorecard

I. To ensure that there is full performance in radiography

II. To provide cancer pain and dyspnea care

III. To make sure that there are no hospital infections that take place

IV. To reduce the rate of mortality as a result of incomplete screening

V. To boost morale of staffs and reduce absenteeism

VI. To reduce the idle time.

In order to achieve the above objectives, the oncology nurses, nurse practitioner, patient

navigator, palliative doctors and palliative nurses, pathologists, dietitians, and diagnostic

radiologists have to work in coordination. They have to ensure that information at all those levels

flows in an effective and efficient manner. Gaps in the movement of information should

completely be eliminated to reduce the errors that might arise as a result. The audacious results

are achieved if there is the development of an efficient management information system in the

organization.

By involving other non-health staffs like accountants and financial analysts in the

hospital, maximum productivity and cancer patients’ service will be at the highest. The balanced

scorecard will, therefore, ensure we strike a balance at all levels of the hospital. For example, an

oncology nurse who examines the patient physically has to take details of the patient’s disease

NURSE LEADERSHIP 8

which should be input in the company database by the information technology practitioner for

use by the accounting and finance department for pricing the services offered to the patients.

According to Bisau (2004), to ensure success in performance management system of any

organization, we need to carefully decide the purpose, determine the measurement, and ensure

that there is severity in the application of the model. The main aim of developing a balanced

scorecard is to improve performance, therefore, if its implementation fails, we will have lost a

chance to improve the organization.

Key performance indicators and processes that drive outcome measures

In this project, there are four key performance indicators which include performance,

quality, patient safety and employee engagement and an infinite number of key measures. The

key performance indicators selected will drive the objectives and goals of the project to success.

By combining the key performance indicators by the key measures, we will have a reliable

monitoring and assurance tool.

Key performance table

Key performance indicator

Key measure

Patient safety in oncology

 Mortality rate

 Infection rate

 Complication rates

 Blood transfusion rates

 1%

 0.5%

 0%

 99%

Employee engagement

 Patient/staff complaint

 Satisfaction measure

 Idle time

 Absenteeism rate

 Necessary

 Scale 9

 0%

Performance

 Rate of chemotherapy

tests

 Resource utilization

 Readmission rates

 Project development

 100%

 Effective

 Minimum

 2 researches per year

Quality Oncology

 Adherence to protocol

 Rated 100%

NURSE LEADERSHIP 9

 Adherence to the right

practices and moral

standards

 Number of

recommendations to

friend

 Number of successful

diagnoses

 Rated 100%

 20% of the patients

 98%

It is crucial to ensure that all the metrics and key measures and indicators should be

measured and tested for validity. The trial of the simulation is undertaken before communicating

to the dedicated teams and staffs. The exercise ensures that the model is standard and realistic.

By so doing, the problem of failure due to unrealistic or difficult metrics is avoided. The

simulation will also aid in screening how the actual model will operate after its implementation.

By ensuring a balanced approach in development of the metrics, we will have boosted the morale

of the team towards the overall goal of the department.

The balanced scorecard map

Employee

engagem

ent

quality

Patient

safety

perfoma

nce

NURSE LEADERSHIP 10

Explanation

According to the above map, the success oncology unit will start with all the nurses

working together towards a common objective. Employee engagement is an approach that the

employees adopt to enhance their well-being by contributing to the organizational goals and

purposes, being loyal to the organization, respecting and following the company’s culture to

ensure success. The successful organization delivers quality work. For example, staffs working

together will make sure that patients are registered and examined fast and with care depending

on the level of emergency or need of the patient. The patient will get an excellent service that

will ensure his or her safety. On the security of the patient; take a case of a cancer patient. The

safety of the cancer patient will be measured using complication rate as one of the key measures,

making sure that there is no complication which happens to the patient during his chemotherapy

treatments. Performance, on the other hand, will be measured by the readmission rates. If the

patient does not get readmitted to the hospital for the same disease due to complications or

failure of the practitioners, that will be recorded as a success.

NURSE LEADERSHIP 11

Incorporating Kaplan and Norton’s scorecard

Performance aspects

Key measures

Benchmarks

Performance

indicators

Financial

 Service

cost

 Expenses

 More

reveue

 resources

Standardized

20% of income

5%increase

1% wasted

 Equal

pay

dependin

g on

category

 If 20%

 increase

 If 1%

Customer

 bed

occupanc

 average

length

stay

 recomme

ndation

to a

friend

90%

60 days

20% of patients

admitted

 >90%

 ≤60

 >20%

Learning and growth

 Research

e per year

 project

developm

ent per

year

At least one

 >2

 ≥1

Internal processes

 reducing

idle time

 improve

employee

engagem

ent

 reduce

absenteei

 reduce

complicat

ion rates

To 0%

Full

 0%

 All

engaged

 0%

High

profit

Low

cost

revenue

Quality

services

customers

Research and

development

Employee

engagemen

NURSE LEADERSHIP 12

Each member of the team will be required to record, measure and follow up on each and

every performance measure. The members should ensure that they can attain each and every

requirement of the scorecard. It will be possible through monitoring their result delivery by

comparing their achieved results with the performance indicators in the balanced scorecard. For

example, if the financial team noticed that the incurred cost is 21%, there is 1% above the

benchmarked percentage of 20. The conclusions made are that there is overspending in that

particular department, and therefore the common measures should be taken to curb this problem.

Scorecard map and the key performance indicators that the leader nurse needs to monitor

Employee engagement in the departmental goals and objectives will trigger them to know

more about the cancer disease. If they get the full support of the organization, they will be in a

position to improve the quality of the services they offer. Since nursing is a dynamic and

continuous learning process, research and development will have a great impact on the kind of

services provided in the department.

When the patients get quality services, they will find a value for their money, and it will

be easier for them to recommend other patients to the hospital. They also develop royalty such

that, the next time they get sick and need medical attention, they will get back to our hospital. In

turn, the hospital will be able to generate more funds and therefore more profits.

NURSE LEADERSHIP 13

Advantages of performance data scorecard

For the hospital to be successful in any department or level, they have to set both short

term and long term goals and objectives. For them to achieve these set goals, they have to strike

a balance between the four aspects of the organization which includes financial, customer,

internal business process, and learning and growth. The balanced scorecard will give the basis

for striking this balance between the aspects at the oncology department (Ted Jackson, 2015)

Since the balanced scorecard outlines all the metrics, performance and outcome

indicators, it will become simple for the nursing team members and other staffs to know what is

expected of them, therefore, boosting their morale. They will, therefore, strive to attain the set

objectives or even surpass them. An example of a patient navigator, the scorecard indicates that

they are supposed to guide the patient through survivorship. The patient navigator will, therefore,

know that after he has delivered what is expected of him by the scorecard, he will have attained

the objective on his part. Due to this reason, he will feel motivated to contribute to the success of

the department.

The balanced scorecard acts as a control to the nursing leader. As the nursing manager, I

will be in a position to monitor all the activities that are taking place in my department. I will be

able to collect all the data from the different team's and staffs, compare them with the set

standards, and investigate any deviation of the results from the set standards and advice on the

collective measures.

NURSE LEADERSHIP 14

Current trends in healthcare related to employee engagement

Introduction of efficient information system

The information system will enable smooth flow of information from one level of the

organization to the other. It will ensure open communication between staffs themselves, between

teams and their leaders, for example, the nurse manager and the communication between the

staffs and the patients. The open communication system ensures that the staffs can communicate

their concerns to their leaders and the leaders are in a position to give feedback. After the

relevant authorities address employee’s concerns, the employee feels motivated. Compassionate

nurse leader will motivate his staffs through engaging in most of their activities and listening to

them. In order to achieve the open communication system in a hospital, it might pose a great

challenge since there a lot of health workers working in different departments. Due to these

difficulties, a hospital intranet is created to make the smooth flow of information from one

source to the other. An intranet is an organization’s internal network that only authorized

officials can be a position to access

Centralization of resources through the intranet

Centralization of resources means pooling all resources at the same place where all health

practitioners can be in a position to access at any time. This exercise helps in time management

where one does not have to move from one place to the other in search of data. For example, the

oncology nurse practitioner does not have to go from his examination office to the pathologist or

diagnostic radiologist to acquire results of a patient. Through the intranet connecting these

rooms, the staffs will be in a position to send the results from one office to the other without

actual physical movement. In the case of surgeons in the operating room, they sometimes need to

NURSE LEADERSHIP 15

give feedback to the nurses outside the operation room. Since this is a basic procedure, it is

convenient and safer to send this information through the intranet. Employees need regular

update about the hospital or departmental news and changes. Journals and magazines are

distributed to the employees through posting them at the corporate centralized intranet. It will

enable anyone interested in accessing them anytime.

Recognition of employees for their engagement

Nurses in oncology department interact with patients of different kinds every day, and

they ensure that all these patients acquire their necessities in the hospital. It is a very challenging

task since these patients looks up at the nurses or doctors. Ensuring all patients are comfortable

with the services provided, the nurses need to be recognized and even rewarded for their effort.

Recognition boosts the morale of the nurses and doctors to even interact better with the patients.

Relationship between employee engagement and healthcare quality

Employee engagement has been defined by different scholars to mean the involvement of

an employee in his or her organization. It is the physical, emotional and psychological

commitment of an employee towards achieving the goals of the organization. The level of

engagement of staffs or individuals in a department will determine how well that department

does. When an employee is said to be committed, it means that he understands his or her role and

contribution in the organization and therefore works hard. On clinical setting, the doctors and

nurses get engaged in the goals of the hospital, for example, achieving quality health services.

Employee engagement does not just happen in a vacuum. There are certain circumstances

which have to be met by the organization to induce the employees to be engaged. The nature of

the job in which the workers are taking determines how they get involved.

NURSE LEADERSHIP 16

Taking a pathologist doctor to another position that he has not specialized in might make

him or her to perform poorly in that area. The leaders, for example, the nurse manager has to

ensure that there is job satisfaction for all his staffs. Communication is another key determiner of

how employees react to goals of the organization. If the top management has poor

communication skills or gives a poor feedback to his subordinates, he then stands to lose their

engagement on the job. He should, therefore, ensure that he communicates the members of his

team effectively. According to research by Rick Sherwood emotional conditions of the health

staffs also determines how they conduct their roles.

According to the institute of medicine, health quality is the extent to which the services

offered by the healthcare to individuals or patients increase the probability of desired health

results. The results should not be inconsistent with the current body of knowledge (ASC

communication, 2017). Engaged employees will strive to deliver the best results, for example, if

the diagnostic radiologist or the pathologist is offered the right modern machines, they will be

motivated to eliminate any errors, therefore, ensuring quality than a pathologist who uses old

machines that breakdown every time. A stressed nurse is likely to make more mistakes during his

or her diagnostic process than the one who is depressed. The leader nurse should ensure stress

management measures are introduced to solve stress issues at work.

Current tools providing data regarding employee engagement

Tools for providing data regarding employee engagement means those indicators that

signal whether the employees are committed to the organization's goals and objectives. In our

organization, the current tools being used to provide the data about engagement are traditional.

The time factor is one of the tools used to measure employee engagement. Employees that report

NURSE LEADERSHIP 17

very early to work and leave very late in the evening are said to be committed to the

organization. When evaluating performance basing only on time spent in the office, it might be

misleading because that does not necessarily mean that the employee was doing a productive job.

It is more appropriate to measure the employee engagement with regard to time on the idle time

basis.

Another tool is the attendance of the staffs basing on the attendance sheets. This approach

might also show weak results since the employee might sign the attendance sheet for an absent

friend. In return, this poses a problem where that particular person is assigned a task only to find

them lacking making performance difficult. Other tools used include the number of patients

treated per day without considering the quality of treatment and the feedback of the patient. The

tools employed in the organization are not adequate to provide with the data about employee

engagement as there are other new and modern tools which include social recognition and

engagement platforms and emotional monitoring devices.

A plan to improve employee engagement

A plan is as an outline which aimed at achieving some set objectives in the future. A plan

is a time bound in that it is to be accomplished with some a particular time. It can be derived or

based on objectives and goals of the organization. The scorecard displays the targets which are to

be achieved and how to test whether they are achieved. As a result, it is possible to derive a plan

from the scorecard. Basing on the data scorecard that we generated, we can produce a plan which

will improve employee engagement. The plan can be inform of strategies, goals, evaluations and

timeline.

NURSE LEADERSHIP 18

Strategies

Leadership by example

In our data scorecard, we expect that the staffs give their best in the delivery of their

services. One of the most important strategies that the management should adopt is undertaking

their tasks in a way that the staffs admire. If the employees feel that we are delivering on our part

as their leader, it will be difficult for them to resist their duties. Therefore, the management

should adopt this strategy.

Communication network

A good communication system ensures that information and instructions flow from the

top management to the subordinates in an efficient manner. It means that the information will be

free from vague statements and unclear instructions. The staffs in the department will be able to

carry their required duties. For example, if a patient navigator is needed to guide the patient

through the process from diagnosis to survivorship, it should be clearly indicated so. As a result,

the patient will feel wanted and cared for developing royalty to the hospital.

Develop a robust feedback mechanism

When staffs get the feedback on any inquiries they make, they will feel that the

organization is recognizing them. In a hospital setting, information feedback is very crucial since

the lives of the patients depend on it. If a hospital has a poor feedback mechanism, the nurses

might feel discouraged therefore reducing their engagement in the organization. Taking an

example from our scorecard where we want to reduce the errors or deaths caused by nurse’s

errors, it will be prudent to create an automatic and fast feedback to any query that might arise.

NURSE LEADERSHIP 19

Goals

We will need to set goals that are realistic and attainable. If the department sets goals that

are too high, the employee will feel that the goals are unrealistic and impossible for them to

attain. For example, if we indicate on our scorecard that we to have one hundred research in a

year, the employees may not be interested since there are a lot of constraints that might hinder

the results. On the other hand setting too low goals will demotivate the nurses since they will feel

unchallenged.

Evaluation

It is a process by which the results of a given staff or member of a team is examined to

determine whether they are in consistency with the set standards in the data scorecard. The

evaluation process will help us identify the deviations and how to collect them.

Timeline

A general schedule will be developed to monitor how the activities flow in the hospital

department from start to finish. The program will help us identify where the problems arise in the

process to ensure quality services to the patients so that collective measures are established.

Leadership practices

Leaders and staffs are viewed as the backbones of an organization. How they handle the

employees and teams, how they perform their duties and how they respond to any grievances

raised to them determines how the employees feel towards the organization. The leaders need to

undertake some practices to improve employee’s satisfaction in the organization.

NURSE LEADERSHIP 20

Setting clear expectations from the employees is one of the practices that leaders should

adopt. In order to help develop good expectations from the staffs, the leader can decide to

involve the workers to discuss goals or objectives. The staffs will be part of making the goals,

therefore, will strive to attain them. Another practice is recognizing those crews that perform

well. If a nurse meets the scorecard targets, he or she should be acknowledged and rewarded to

improve his engagement in the organization. Coupled with recognition is the provision of

development opportunities to the nurses and doctors. These opportunities help them attain their

self-actualization needs, and therefore they get more engaged to the organization. These nurses

also inspire other nurses in the hospital (William Bridges et al., 2009).

Innovation should be encouraged in the hospital to develop a sense of involvement in that

organization. If an employee comes with a new way of doing things, he should be supported by

the management to see his project through. This way, the staffs will be more engaged in the

organization since they will have helped build it.

Conclusion

Developing a good scorecard in the hospital and following it to the latter will yield more

results that using the traditional ways of management. Setting too high goals or objectives will

lower the morale of the employees. Similarly, setting too low goals will undermine the staffs’

capability and therefore lowering their morale. Involving the workers in decision making about

what standards to be set is the best way to raise their attitude toward the organization’s goals.

The nurse leader should ensure that he or she takes into account the leadership practices to

develop a sound employee engagement program. The outcome or results of the department in

most cases is determined by the employees. Any leader is bound to understand that without the

NURSE LEADERSHIP 21

employees’ satisfaction, the possibility of failure is high. A plan on how to improve employee’s

engagement in the organization is an important step to ensure that they deliver the best services.

Developing a plan that will induce employees to engage at the orientation stage is preferable

since the employee will adopt engagement as part of the company culture. It is clear that,

developing a data scorecard alone will not guarantee success therefore an organization need to

induce the employees to be engaged. In developing the scored, it should be understood that, the

organization is prone to changes. As a result, the scorecard should be dynamic giving allowance

for adjustments to be made in case of any change.

NURSE LEADERSHIP 22

References

Catalona, W. J., Richie, J. P., Ahmann, F. R., M'liss, A. H., Scardino, P. T., Flanigan, R. C., ... &

Waters, W. B. (2017). Comparison of digital rectal examination and serum prostate

specific antigen in the early detection of prostate cancer: results of a multicenter clinical

trial of 6,630 men. The Journal of urology, 197(2), S200-S207.

Graban, M. (2016). Lean hospitals: Improving quality, patient safety, and employee engagement.

Bridges, William, and Susan Mitchell. "Leading transition: A new model for change." Leader

to leader 16, no. 3 (2000): 30-36.

Kaplan, R. S., & Atkinson, A. A. (2015). Advanced management accounting. PHI Learning.

Nahrgang, J. D., Morgeson, F. P., & Hofmann, D. A. (2011). Safety at work: a meta-analytic

investigation of the link between job demands, job resources, burnout, engagement, and

safety outcomes.

Namdar, S. N., and Kaplan, R.S. (2002). Applying the Balanced Scorecard in Healthcare

Provider Organizations. Journal of Healthcare Management, 47(3), 179–196.

Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of

evidence-based practice in US nurses: Critical implications for nurse leaders and

educators. Journal of Nursing Administration, 42(9), 410-417.

Rampersad, H., & Hussain, S. (2014). Personal balanced scorecard. In Authentic Governance

(pp. 29-38). Springer International Publishing.

Johnson, S. L., & Rea, R. E. (2009). Workplace bullying: concerns for nurse leaders. Journal of

Nursing Administration, 39(2), 84-90.

Place new order. It's free, fast and safe

Paper type

Deadline

Page count

550 words

Total price: $ 15.00

Our customers say

Jeff Curtis

USA, Student

"I'm fully satisfied with the essay I've just received. When I read it, I felt like it was exactly what I wanted to say, but couldn’t find the necessary words. Thank you!"

Ian McGregor

UK, Student

"I don’t know what I would do without your assistance! With your help, I met my deadline just in time and the work was very professional. I will be back in several days with another assignment!"

Shannon Williams

Canada, Student

"It was the perfect experience! I enjoyed working with my writer, he delivered my work on time and followed all the guidelines about the referencing and contents."

Organizational performance

Place new order. It's free, fast and safe

Our customers say

Jeff Curtis

Ian McGregor

Shannon Williams