HCI 3 Exam 2-3 Combined

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7 phases of the Human Response to Change Curve?

1. Shock

2. Denial

3. Anger or blame

4. Bargaining and self-blame

5. Depression and confusion

6. Acceptance

7. Problem-solving

T/F: The human response to change curve is a function of time.

True

Maslow's Hierarchy of Needs from top to bottom (five categories)

1. Physiological needs

2. Safety and security

3. Love and belonging

4. Self-esteem

5. Self-actualization

Examples of physiological needs include... (four)

1. Food

2. Water

3. Sleep

4. Shelter

Describe Maslow's "Safety" needs

Need for an orderly, secure world with a low level of perceived threat to life and future

Describe Maslow's "Self-actualization" needs

Longing to fulfil potential and use creativity in accordance

Describe Maslow's "Self-esteem" needs

Satisfied by a combination of self-esteem, respect, recognition from others to support self-confidence and self-worth

Role of the basal ganglia in processing change?

Responsible for handling tried-and-tested outcomes, requires little energy to operate

Role of the prefrontal cortex in processing change?

Used to process new information, very energy intensive

*In a change situation, this area is being used more*

Role of the amygdala in processing change?

Operates the "fight, flight, or freeze" response

Emotional responses and rational thoughts are disabled

Three models of the change process?

1. Lewin's three-stage mode

2. Kotter's eight-step model

3. Senge's systems thinking model

Describe Lewin's three-stage model

Shows how collective mindsets are broken down to enable change

Describe Kotter's eight-step model

Showing a road map for change based on common errors made by organizations

Describe Senge's systems thinking model

Shows how profound change can be achieved through learning

3 steps of the Lewin's three-step approach?

1. Unfreeze

2. Change

3. Refreeze

Describe Lewin's "unfreezing" step

3 phases

1. Define the current situation

2. Create a vision of the desired end-state

3. Identify the forces that will help drive and resist change

8 steps of Kotter's eight-step model?

1. Establishing a sense of urgency

2. Creating the guiding coalition

3. Developing a vision and a strategy

4. Communicating the change vision

5. Empowering employees for broad-based action

6. Generating short-term wins

7. Consolidating gains and producing more change

8. Anchoring new approaches in the culture

Three steps of Senge's systems thinking model?

1. Initiating the change

2. Sustaining the transformation

3. Redesign and rethinking

Describe Senge's "Initiating the change" step

People feel they do not have enough time

People find insufficient coaching and support

People unable to see the relevance of change

Problems with leaders not "walking the talk"

Describe Senge's "Sustaining the transformation" step

Anxieties about job security, trusting others in new situations, and loss of control

How to measure change, the tension between measurement as learning and as assessment

Using culture so that change in a pilot group is not seen as "cult" activity

Describe Senge's "Redesign and rethinking" step

Governance as control

Spreading new practices effectively

Giving meaning to strategy and vision

Describe the three levels of organizational culture and change

1. Level one (surface) - visible artifacts and products, office layout and furnishings

2. Level two (deeper) - norms and values, most often noticed when they are violated

3. Level three (deepest) - basic assumptions, not often articulated but may underpin many of the norms and values of some societies

"Far environment" factors in reference to strategy development (four)

1. Industry structure

2. Big external drivers and trends (i.e., technology)

3. Potential for disruption

4. Addresses the question "what business are we in?"

"Near environment" factors in reference to strategy development (four)

1. Concerns competitor organizations

2. Nature of the value proposition to customers

3. Business model

4. Addresses the question "How do we compete?"

What does the acronym PESTLE represent?

External drivers in the "far environment" of an organization

P - political

E - economic

S - social

T - technology

L - legal

E - environment

In the near environment, the key question is ___________

How will we compete?

Three unique positioning strategies for near environment strategy development (developed by Michael Porter)

1. Overall cost leadership - achieved by becoming the largest business in the industry and exploiting economies of scale

2. Differentiation - achieved by a product or service that offers a feature or capability that no competitor offers

3. Focus - achieved by establishing an advantageous access to a specific customer

Porter's five forces affecting change?

1. Threat of new entrants

2. Threat of new substitutes

3. Bargaining power of new buyers

4. Bargaining power of new suppliers

5. Rivalry amongst competitors

Ishikawa diagrams are also called... (three)

1. Cause and effect diagrams

2. Fish-bone diagrams

3. Herringbone diagrams

Role of Ishikawa diagrams? (four)

Discover the root cause of a problem

Uncover hotspots or bottlenecks in a process

Identify where and why a process is not working

Refine and update the change definition

In the power/influence matrix, key players must be ___________

Engaged closely

In the power/influence matrix, spectators must be ___________

Monitored

In the power/influence matrix, active players must be __________

kept informed

In the power/influence matrix, influential observers must be _________

Kept satisfied

Four common kinds of bias?

1. Confirmation bias

2. Status quo bias

3. Availability bias

4. Bandwagon effect

Describe confirmation bias

People pay attention only to info that confirms their beliefs; ignore evidence that indicates otherwise

Symptom of confirmation bias

People argue against the need for any change

Describe status quo bias

A preference for people to keep things the way they are and avoid change

Symptom of status quo bias

People not agreeing that change is needed, or they may say that they agree but there is no inertia

Describe availability bias

Tendency to perceive the more memorable or easily available information as the most significant

Symptoms of availability bias

A few instances of something not going well, which leads to people complaining and being negative about planned changes as a whole

Describe the bandwagon effect

The more people come to believe something, the more others want to "hop on the bandwagon"

AKA groupthink

Formula for change readiness?

C = [ABD] > X

C = change

A = level dissatisfaction with status quo

B = desirability of proposed change/end state

D = practicality of change

5 Measures of engagement? Acronym?

A - awareness

D - desire

K - knowledge

A - action

R - reinforcement

4 steps in the "learning loop"

1. Concrete experience (something happens)

2. Reflective observation (you think about it)

3. Abstract conceptualization (you identify a pattern)

4. Practical experimentation (you test your theory)

Someone with a preference for the "concrete experience" stage of the learning loop is described as a...

Activist

Someone with a preference for the "reflective observation" stage of the learning group is described as a...

Reflector

Someone with a preference for the "abstract conceptualization" stage of the learning group is described as a...

Theorist

Someone with a preference for the "practical experimentation" stage of the learning group is described as a...

Pragmatist

Describe "self-awareness"

The ability to recognize and understand your moods, emotions and drives, as well as their effect on others

Describe "self-regulation"

The ability to control or redirect disruptive impulses and moods/the propensity to suspend judgment - to think before acting

Six leadership styles for emotionally intelligent leadership?

1. Coercive

2. Authoritative

3. Affiliative

4. Democratic

5. Pacesetting

6. Coaching

Four phases of negotiation?

1. Preparation

2. Exchange information

3. Bargaining

4. Closure

Describe the bargaining phase of negotiation

Most of the interaction between parties

Risk of unsuccessful negotiations is highest

Eight sources of conflict?

Conflicting...

1. Needs

2. Styles

3. Perceptions

4. Goals

5. Pressures

6. Roles

7. Personal values

and

8. Unpredictable policies

Kilman's 5 conflict management styles?

1. Competing

2. Accommodating

3. Avoiding

4. Collaborating

5. Compromising

Describe Kilman's "avoiding" conflict management style

Reduces the tension associated with conflict

Temporarily avoids negative effects

Allows delays in order to be better prepared

Describe Kilman's "collaborating" conflict management style

"Win-win" for both parties

Provides recognition and acceptance of other's needs, abilities, and expertise

Describe Kilman's "compromising" conflict management style

Each party achieves some of its objectives

Facilitates teamwork

Maintains relationships

Describe Kilman's "accommodating" conflict management style

Maintains harmonious relationship

Avoiids 'losing face'

Establishes trust by cooperative behavior

Describe Kilman's "competing" conflict management style

Achievement of your own objective

Boosts ego and confidence

Tension stimulates interest and creativity

Describe the ECHO model

Depicts value of a pharmaceutical product or service as a combination of traditional clinical-based outcomes with more contemporary measures of economic efficiency and quality

Integrated approach, and is a theoretical basis for consideration of potential trade-offs among economic, clinical, and humanistic variables in optimizing allocation of health care resources

Multidimensional perspective

Define compliance

Ensuring that policies, procedures, activities are consistent w/ rules, regulations, standards

Define outcomes

Result of performance

Observable/measurable terminal event

Economic evaluations in the ECHO model include (five)

1. Cost of illness

2. Cost minimization analysis

3. Cost-benefit analysis

4. Cost effectiveness analysis

5. Cost-utility analysis

Humanistic evaluations in the ECHO model include (four)

1. Quality of life

2. Patient preferences

3. Patient satisfaction

4. Willingness-to-pay

How does the Institute of Medicine define quality in healthcare?

Degree to which health services for individuals and populations increases the likelihood of desired health outcomes and are consistent with current professional knowledge

Historically, quality in healthcare was measured by _______ and _______; it has since been focused on __________

Structure and process in the past

Now we focus on outcomes

T/F: Healthcare has shifted toward a value-based care (VBC) model, under which healthcare organizations and providers assume *less* risk.

False; assume more risk.

Describe the Donabedian model

Quality measures classified as structural, process, or outcome

Structural quality measures under the Donabedian model can be defined as...

Providing consumers with a sense of a health care provider's capacity, systems, and processes to provide high quality care

Process quality measures under the Donabedian model can be defined as...

Indicating what a provider does to maintain or improve health for healthy people or those diagnosed with a health care condition

Outcome quality measures under the Donabedian model can be defined as...

Impact of health care services or intervention on a health status of patients; end results generally of numerous factors.

T/F: Pharmacy Standards of Care represent a "thou should" whereas other Pharmacy Standards represent a "thou must."

False; Pharmacy Standard of Care is what a reasonable and prudent pharmacy would do under the same circumstances and represents a "thou must." Other Pharmacy Standards are quasi-legal, but represent a "thou should."

A policy is _______

A. Thou must

B. Thou shall

C. Thou should

A. Thou must

A procedure is ______

A. Thou must

B. Thou shall

C. Thou should

B. Thou shall

Define a policy

General written document that establishes a standard by which the institution manages its affairs

Mandates, specifies, or prohibits conduct

Define a procedure

A description of the operational processes necessary to implement policy

Includes information on offices and positions responsible for policy

Ensures policy is implemented efficiently and applied consistently

Define a guideline

Gives recommendations, interpretations, administrative instructions, best practice guidance, etc.

A guideline is a __________

A. Thou must

B. Thou shall

C. Thou should

C. Thou should

Define Best Practices

Methods that have consistently shown results superior to those achieved with other means

Define a standard

Specifies uniform use of specific technologies or configurations

Define a protocol

Detailed plan of a scientific or medical experiment, treatment, or procedure

T/F: Protocols require written orders by providers before they can be initiated.

True

Four RCA tools?

1. Event flow diagram

2. 5 Whys

3. Affinity diagram

4. Fishbone diagram

Two FMEA tools?

1. Event flow diagram

2. Hazard Analysis

Hazard score (RPM) formula?

Severity X probability of occurrence X Probability of detection = RPM

Define a Metric

What we measure

Define a Benchmark

Measurement 'norm' when compared to *similar* entities

Define a process/performance indicator

Intermediary measure between an intervention and an outcome

Define performance measures

Intended to evaluate the quality of healthcare processes, intermediate outcomes, or outcomes

Define monitoring measures

Intended to promote standardized documentation and reporting of healthcare processes, intermediate outcomes, or outcomes

Define quality improvement indicators (QIIs)

Intended to assess improvement of healthcare processes, intermediate outcomes, or outcomes from baseline within a population/organization

Essential elements when choosing a health care quality measure? (five)

1. Limited set of effective measures

2. Schedule for regular reporting

3. Report formats for clear communications

4. Procedures for acting on identified problesm

5. Assess sustainability periodically

Effective dashboards can make a difference in what two ways?

1. Ability to visualize multiple data points at once

2. Provide greater accessibility and accountability in the use of data information

First step in creating an effective dashboard?

Bottom-up approach

Bird's eye summary view

T/F: Clearly defined roles should be in place for ownership of key metrics.

True

Three benefits of establishing accountability and ownership of metrics regarding a specific data point?

1. Helps executives work more closely w/ someone to address issues

2. Experts on the data and the processes by which it was collected and examined

3. Understanding of how to make their own dashboards integrate into organizational/executive dashboards

T/F: Metrics must be reasonable and independent variables.

True

Describe FMEA

Prospective review of system processes to determine areas of high risk or vulnerability before they lead to an adverse event or outcome