Over the course of your degree, we have explored leadership, decision making and health economics. To be an effective advocate for your patients a fundamental understanding of the components of health economics and leadership is essential.
In this task, you will be exploring the application of health economics and the principles of authentic leadership by answering a two-part question. To undertake this assessment, you will need to draw on the content from module one.
To help you complete this assessment, the task has been dived into two parts with step-by-step instructions as follows:
Step 1: Read the case study scenario
You are a graduate registered nurse who has been working in the community for the past 12 months. The Community Nursing Service operates within a Primary Health Care framework to deliver nursing services to support clients to remain independent and develop a self-management capacity to maintain their health and wellbeing within the home environment. You have been speaking with your colleagues at a meeting and it is noted that there is increasing demand for the following area: chronic wounds
You have recently attended the Australian Primary Health Care Nurses Association (APNA) conference as the peak professional body for nurses working in primary health care and learned so much whilst connecting with other nurses from various primary health settings. You feel empowered and inspired to be the best nurse you can be and incorporate your learning immediately.
You keep thinking about the fact that Australia has a highly qualified and skilled nursing and midwifery workforce which seems to be largely under-utilised and wonder what you can do in relation to the establishment of a nurse led clinic.
The establishment of nurse led clinics is expanding in Australia, however, it is occurring slowly and tends to be linked to where there are service gaps due to high demand and/or workforce shortages rather than as part of a broader health care strategy. This is despite a growing volume of research indicating that nurse-led clinics have been shown to improve patients’ outcomes and facilitate timely access to specialist services.
The following benefits have been demonstrated:
- For patients: patients have a shorter wait for their specialist outpatients’ appointments and have high levels of satisfaction with the care they receive in nurse-led clinics. This model of care can also facilitate earlier discharge of patients back to General Practice services.
- For nursing staff: Increased job satisfaction potentially resulting in increased recruitment and retention due to advanced role.
- For medical staff: Medical staff can concentrate on more complex patients.
- For the hospital: Nurse-led clinics increase the efficiency of clinics, are cost effective and reduce waiting time in outpatients.
Step 2: Critically evaluate the economic benefit of the intervention (nurse-led clinic). CHRONIC WOUNDS
Step 3: You decide to speak with your NUM and she asks you to consider the following questions [you will recognise that questions 1- 3 are part of an economic evaluation using Critical Appraisal Skills Programme (CASP)]:
(Qn.1) Was a well-defined question posed?
In responding to this question please consider:
- if it is clear what the authors are trying to achieve
- what the economic perspective is
- how many options are compared, are both costs and consequences considered
- what the time horizon is (eg 12 weeks)
(Qn.2) Was a comprehensive description of the competing alternatives given?
In responding to this question please consider:
- if you can tell who did what, to whom, where and how often
(Qn.3) Were all important and relevant resources required, and health outcome costs for each alternative identified, measured in appropriate units and valued credibly?
In responding to this question:
- please remember the perspective being taken, was it measured accurately?
- Appropriate units may be hours of nursing time, number of physician visits, years-of-life gained etc.
- Valued credibly? Are the values realistic, how have they been derived, have opportunity costs been considered?
Qn.4) Discuss the applicability of the evidence (eg the strength of the evidence for the safety, efficacy and sustainability of the intervention) to the local context.
In responding to the question above (Qn. 4) you must consider the ff:
- Do you still believe the intervention should or should not be funded / pursued, if not what further evidence would you require?
- Is the programme likely to be equally effective in your context or setting?
- Consider whether the patients covered by the review could be sufficiently different to your population to cause concern.
- Consider whether your local setting is likely to differ much from that of the view.
- Are the costs translatable to your setting?
- Is it worth doing in your setting?
Step 1: Read the statement about complexity in healthcare.
Nurses are at the forefront of implementing and managing change, given constantly changing and complex healthcare services, there is an increase demand for health care. Therefore, it is important to identify the best style of leadership to engage in nurses implementing service led improvements.
Step 2: Provide a response to the two questions asked.
Question 1. Drawing on your experience in Clinical placement describe a situation whereby having an understanding of the components of health economics (eg. scarcity and opportunity cost) as a nurse are essential? You will need to draw upon the literature to support your suggestions.
I have done my clinical placement in one of the hospitals here in Sydney. I was assigned at Pre-operative Surgical Unit. Relate the components of health economics (choose two among the five components of health economics: scarcity and choice, opportunity cost, supply and demand, self-interest, efficiency)
Scarcity of Staff Nurses
Addresses the problem of limited resources and the need to economise. Not enough resources are available to meet all the desires/needs of all the people making rationing in some form unavoidable. We are forced to make choices among competing objectives – an inescapable result of scarcity.
Question 2. Describe and critically reflect upon an incident from Clinical placement whereby understanding the dimension/s of authentic leadership may have provided a better outcome (this could be to you, preceptor, patient or identified other). To do this you will need to reflect on how understanding authentic leadership could assist you to navigate the complexity in health care in your role as a registered nurse. Provide your rationale with support from the literature.
- Self-awareness – awareness refers not only to the leaders possessing a thorough recognition of their strategies, weaknesses and values, but also involves obtaining and maintaining an accurate understanding of how they influence and are perceived by others.
- Internalised moral perspective – the actions of authentic leaders are grounded in their positive moral and ethical values, which they act in congruence with these values, even when faced with pressure to act differently.
- Relational transparency – authentic leaders understand the importance of fostering trusting relationships, in part, which encompasses communicating openly and honestly with their staff members and encouraging the reciprocation of this communication style.
- Balance processing – -authentic leaders undertake fairness processing when making decisions which involves soliciting and truly listening to and considering diverse opinions including those which are incongruent with their personal beliefs. “Authentic leaders make fair and objective leaders”.
Discuss the components of health economics, with reference to current peer reviewed literature.
Demonstrates ability to critically appraise a research paper using a validated tool.
Critically reflect on how you approach being an authentic leader in a complex healthcare environment.
Write in a clear and succinct manner, with correct use of grammar, terminology and referencing style.
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