Health Care Environment & Systems Paper
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nur532_syllabus.pdf
NUR 532: Nursing Leadership and the Healthcare System| i03/21/2016
Nursing Leadership and the Healthcare System Course Description
Three hours per week theory. Prerequisite: Permission of nursing faculty and successful completion for NUR
506. Students will explore and analyze the role of the nurse leader as it relates to the healthcare system.
Included in this analysis is the delivery of safe, effective, and efficient patient care. The course focuses on
the business of health care, including the internal and external environment, financing of health care, and
resource management and utilization. The legislative and regulatory processes as they are related to changing
the health care system are explored.
Course Objectives
Upon completing the course, the student will be able to:
• Analyze and evaluate the US health care delivery system and key functional components
• Critique various delivery systems and patient care models and the advantages/disadvantages of each.
• Analyze the role of the advanced practice nurse in the context of an ever-changing health care delivery
system
• Evaluate the concepts of health and disease, risk factors, and the role of health promotion and disease
prevention
• Explore various types of health services professionals, practice requirements, and qualifications of health
services administrators
• Evaluate the role of medical technology in healthcare delivery
• Evaluate both regulatory and market-oriented approaches to contain costs in healthcare systems
• Articulate federal and state laws, regulations, and payment systems which affect the provision of care and
the organization’s finances.
• Identification of issues of access for vulnerable populations
• Identification of issues in healthcare delivery, standards, and outcomes
• Discuss future trends and how they will affect health care delivery
• The expanding role of nursing leadership in assessment and planning related to current healthcare issues
• Examine the magnet status journey and the 14 Forces of Magnetism
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Topic Outline
1. Patient-centered care in clinical practice
2. Roles and functions of patient care team members
3. Healthcare delivery systems and patient care models
4. Federal and state payment systems
5. Role of the governing body of the healthcare organization
6. Utilization of research findings
7. Organizational cultures and structures
8. Non-healthcare constituents within the community
9. Incorporating evidence-based research into nursing practice
Teaching Strategies
• Assigned Readings
• Online Discussion Activities
• Collaborative Learning Teams
• Guest Speakers
• Lecture/Discussion
• Discussion Boards
• Student Presentations
• Written Projects
Evaluation Methods
All students will be evaluated using the following methods:
Discussion Board (8 @ 25 points each) 200
Poster: Comparison of U.S. Health System with one other Country 125
Health care environment and systems paper 175
Presentation of health care environment and systems topic 100
Total Points 600
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Final Grade
The course grade will be determined by summing the number of points each student receives. Letter grades
will be assigned according to the following point accumulation:
A 549–600 points
A- 537–548 points
B+ 525–536 points
B 489–524 points
B- 477–488 points
C+ 447–476 points (passes but on academic probation)
Below this level – course is failed
C 417–446 points
F 416 points and below
Required Textbooks/Reading
Shi, L., & Singh, D. A. (2015). Delivering health care in America – A systems approach (6th ed.). Sudbury,
MA: Jones and Barlett Publishers.
American Psychological Association (2010). Publication manual of The American Psychological Association
(6th ed.). Washington, D.C.
Classroom Policies
Policies regarding attendance, tardiness, examinations, promotion, and written assignments are stated in the
School of Nursing Handbook. Students are responsible for knowing these policies and adhering to them.
Cell Phones and Electronic Equipment: Out of consideration for others, please turn your cell phone to the
silent mode. If it does not have a silent or vibrate mode, please turn it off. Please do not use computers,
tablets, or cell phones for personal use during class.
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Honor Code
Truth has been identified by the profession as a value essential to nursing. To underscore the importance of
truth, honesty, and accountability, students, faculty, and staff in the Jacksonville University School of Nursing
adhere to the following honor code:
“I do not lie, cheat, steal, or condone those who do”. Egregious academic misconduct will result in dismissal
from the School of Nursing.
Academic Integrity Misconduct Policy Students are responsible for reading and adhering to the Jacksonville University Academic Integrity
Misconduct Policy. This policy can be found in the Jacksonville University Academic Catalog:
http://www.ju.edu/files/Catalogs/2015-16_JU_Academic_Catalog.pdf
Learning Disabilities Statement
Any student with a visible or non-visible disability who requests “reasonable accommodation” to his or her
condition should provide medical and/or psychological documentation of the disability to the Student Life
Office and refer to the information in the JU catalog and Student Online Handbook for additional information
regarding student disabilities. A student with a learning disability should weigh carefully with his/her advisor
the requirements of the nursing program in order to ascertain its suitability, given the nature of the disability.
NUR 532: Nursing Leadership and the Healthcare System| v03/21/2016
Class Schedule
Date Topic Readings Assignment(s)
Week 1 Course Introduction
Online Classroom Orientation
Selection of country for
Comparative Analysis
assignment
A Distinctive System of
Healthcare Delivery
Health Services Professionals
Objectives: 1, 2, 3, 4, 5, 6,
7, 9, 10
Course Syllabus
Shi and Singh: Ch. 1 & 4
Discussion Board (25 points):
• Identify which health system
model you would recommend
and why?
• Is the supply of health care
professionals sufficient for the
health care demand?
• What are some of the major
workforce related issues and
challenges preparing for the
changes in our health care
delivery system?
Assignment:
Selection of country for
Comparison Analysis assignment.
Week 2 Inpatient Facilities and
Services
Shi and Singh: Ch. 8 Discussion Board (25 points):
• What types of inpatient
facilities exist in the United
States? Describe the facility
you currently work at or have
in the past and discuss the
services provided.
• Are they sufficient to meet
community needs?
• What services, if any, are
needed?
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Week 3 Outpatient and Primary Care
Services
Shi and Singh: Ch. 7 Discussion Board (25 points):
• Changes in the health care
delivery system have led
to a decline in hospital
inpatient days and a growth
in ambulatory services. What
services have developed in
your community to meet
the demand for ambulatory
services?
• How is this impacting
emergency services in your
community?
Week 4 Managed Care and Integrated
Organizations
Objectives: 1–11
Shi and Singh: Chs. 9 Discussion Board (25 points):
• Has the quality of care
declined as a result of
managed care? What role will
the MCOs play under ACA?
• Does your health care facility
belong to an integrated model
of care? What services are
integrated?
Assignment:
Students will submit their Health
Care System Comparison poster to
the Discussion Board and respond
to any questions asked about
their presentation. Poster must be
submitted by Monday of Week 4.
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Week 5 Long-Term Care
Objectives: 1–11
Shi and Singh: Ch. 10 Discussion Board (25 points):
• Investigate a Long term care
facility in your area. What
services (both living and
health) does it provide?
• Are there sufficient numbers
of LTC facilities in your area to
meet the needs to the aging
population?
Week 6 Governmental Health Care
Objectives: 1–11
Shi and Singh: Ch. 6 Discussion Board (25 points):
• Describe the governmental
health care organizations in
your area. What population
do they serve?
• Is the number sufficient to
meet needs?
• How are they viewed by the
community?
Week 7 Cost, Access, and Quality
Health Policy
The Future of Health Services
Delivery
Objectives: 1–11
Shi and Singh: Ch. 12, 13,
& 14
Discussion Board (25 points):
• You are a lobbyist in
Washington D.C.; explain
which of the ANA’s or
AANP’s top federal legislative
initiatives you will lobby for
and why.
• Despite our significant
investment in health care,
the United States is ranked in
the bottom of the list among
developed countries. Explain
why. Can the health reform
promote the United States’
health care standing?
Assignment:
Health care environment and
systems paper due by Sunday
night of Week 7.
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Week 8 Student Presentations
Health Care Environment and
Systems
Objectives: 1–11
No assigned readings this
week.
Discussion Board (25 Points):
• Each student with post
their presentation of the
Health Care Environment
and Systems presentation.
Each student is expected to
answer any questions asked
about his or her presentation.
Presentation must be posted
by Monday of week 8
Discussion Board Participation (200 points)
Students are required to post a scholarly substantive response to each week’s Discussion Board by Sunday of
each week (utilizing APA 6th ed. citations). Each student is required to post a minimum of four times each
week. Two of the posts must be posted by Wednesday of the week; one of these two posts must address
the question/s posted by the student presenter/instructor. The remaining two posts must be completed by
the following Sunday. These posts are follow-up responses to the instructor or classmates that facilitate the
discussion. The insightful response must be substantive rather than just an “I agree” response.
Please use relevant current literature (within 5 years), together with personal leadership and clinical
experience in nursing as a basis for discussion. Board Assignments are asynchronous learning activities
which allow students to research and present pertinent information to the entire class. Failure to participate
or to participate in a less than meaningful fashion will result in no points awarded. Only postings before
12:00 p.m. ET at the end of the week will earn points. Note: There are no make-up provisions for a missed
discussion.
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Discussion Board Expectations
Components Exceeding Expectations
4 Points
Average Expectations
2 Points
Below Expectations
0 Points
Consistency of
Responses
• Frequent and even
distribution throughout
the module
• Constant engagement in
the discussion
• Responds in a timely
fashion
• Demonstrates good self-
initiative
• Initiates discussion
topics
• Uneven distribution
throughout the module
• Makes some
contributions to the
online discussions but
not always present
• Responds most of the
time to messages
• Infrequently initiates
discussion topics
• Uneven and infrequent
distribution throughout
the module
• Limited participation
• Only participates
when prompted by the
instructor
Evidence of
Understanding
• Clear that readings
and course materials
were accessed and
understood
• Issues and knowledge
gained incorporated well
into responses
• Learner shows excellent
reflection on the course
content and into their
own learning
• Some integration of the
content of readings and
other course materials
• Opinions and ideas
are stated clearly with
occasional lack of
connection to topic or
readings
• Some evidence of
reflection on own
learning
• It is not clear that
readings or course
materials were
understood or used
in the learner’s own
knowledge construction
• Makes irrelevant
remarks which are
unrelated to the topic
being discussed
Depth of
Commentary
• Examples of learner
thoroughly identifying
and analyzing issues,
implications of the topic
and generating new
issues or concerns for
consideration
• Comments offer new
insights
• Some evidence of
learner thoroughly
identifying issues,
offering implications
and generating some
new concerns for
consideration
• Some postings offer new
insights
• Comments are usually to
simply agree or disagree
with limited analysis or
synthesis
• No evidence of insight
into own learning
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Degree of
Engagement
• Often presents
reflections that become
central to the team
discussion
• Interacts freely and
encourages others
• Consistently presents
creative reflections on
the topic
• Aware of team needs
• Frequently prompts
further discussion
• Occasionally makes
meaningful reflection of
team’s efforts
• Some effort to become
involved in the team
• Somewhat aware of the
needs of the team
• Sometimes prompts
further discussion
• Not actively involved in
the online discussion
• Does not feel the need
to belong or participate
in team activities
• Only participation after
prompting from the
instructor
Posting
Responses
with
References
• Consistently uses an
APA formatted reference
citation for all posts (as
applicable)
• Occasionally uses an
APA formatted reference
citation for posts (as
applicable)
• Never uses an APA
reference citation for
posts (as applicable)
Health Care Environment and Systems Paper (175 Points):
Select a health care environment or delivery system and explores the issues related to that particular
environment (military, long-term care, acute care systems, etc.). Introduce the organization/facility selected,
the accreditation status, and the average daily census, services provided, community it serves. How does
this organization does fits into the US health system? How does health policy impact this facility? Explain the
facility’s governance, finances, and reimbursement methods. What are the challenges faced by the facility due
to new trends/policies. Explain how the Affordable Care Act impacts the organization/facility.
This paper needs to follow APA guidelines, double-spaced and includes headings and should be 8-12 pages
(not including the title page and reference page). A minimum of eight current (less than five years) references
from peer reviewed journals is required.
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Grading Rubric:
Topic: Point Value: Points Earned:
An overview on the type of facility researched including
community it serves 30
Governance/Financial Management/HR/Staffing/Patient
Population 40
Health Policy Impacts 30
Challenges Faced By the facility Due to New Trends 30
ACA Impact on Cost, Quality, and Access at the Facility 20
APA/Grammar/Spelling/Formatting 25
Total 175
Health Care Environment and Systems Presentation (100 Points):
Students will present to the class on their health care environment and systems. The method of presentation
is up to the student. Options can include video, Poster, PowerPoint, etc. The presentation should be no longer
than 10-15 minutes; please be creative with the presentation to discuss issues with class and to maintain
audience interest.
Topic: Point Value: Points Earned:
Organization (Introduction, Content, Conclusion) 50
Creativity in Delivery (Computer-Generated materials, Videos,
Posters, Handouts) 20
Time Management 10
Audience Engagement, Interaction, Questions and Answers 10
Grammar/Spelling/Formatting 10
Total 100
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Comparison of U.S. Health Care System with a Selected Country (125 Points):
For this assignment, students will compare the U.S. health care system with the healthcare system of a
selected country. The presentation should cover the following topics at a minimum following:
• A description of the country (e.g., geography, population, culture)
• Overview of the health care system
• How the health care system is financed/ Services covered
• Summary of nursing training and licensing requirements
• Pros and Cons of the health care system
• What can the U.S. system learn and incorporate from this country
This assignment is presented as a poster. Please refer to http://www.makesigns.com/ to download a free
template for your poster.
Grading Rubric:
Topic: Point Value: Points Earned:
A description of the selected country 20
An overview of the healthcare system 25
How the health care system is financed/services covered 20
Summary of nursing training and licensing requirements 20
Summary of nursing training and licensing requirements 20
Presentation, appearance, eye contact 10
Grammar/Spelling/Formatting of poster 10
Total 125
