Chapter 14: Strategic Management

Huber: Leadership & Nursing Care Management, 6th Edition

Multiple Choice

1. The concept of strategic management includes strategic planning and the implementation of: a. core values. b. strategy. c. tactics. d. objectives.

ANS: B

The concept of strategic management includes strategic planning and strategy implementation.

DIF: Cognitive Level: Remember (Knowledge)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

2. The guiding framework that describes the organization’s purpose and future direction is the: a. futuristic guidelines. b. mission and vision. c. strategic plan. d. core purpose.

ANS: B

The organizational mission and vision collectively is a guiding framework that describes the organization’s purpose and future direction.

DIF: Cognitive Level: Understand (Comprehension)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

3. Objectives are: a. bylaws used to govern the organization. b. financial minimums needed to operate. c. performance-based criteria for accreditation. d. targets that the organization wants to achieve.

ANS: D

Objectives are defined as the targets that an organization wants to achieve.

DIF: Cognitive Level: Understand (Comprehension)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. Chief medical officer, public relations vice president, and human resources b. Oncology clinical nurse specialist, nurse’s aides, and RNs c. Physicians, unit secretaries, and vice president of finance d. Vice president of nursing, decentralized pharmacist, and licensed practical/vocational (LPN/LVN) nurses

4. A new cancer center is being built in the local hospital. A patient survey has revealed that patients are not certain which caregiver is the registered nurse (RN) during their hospital stay. A group is formed to recommend methods to help patients identify which caregiver is their RN for the new cancer center. Which of the following groups best represents those who should be involved in forming recommendations?

ANS: B

Involving individuals at all levels of the organization will ensure a variety of perspectives and more buy-in to the final product. Including the patient’s perspective may provide additional insight about the issue. Ideally, those involved in all levels of patient care, such as the vice president of nursing, nurse manager, oncology clinical nurse specialist, LPN/LVNs, and nurses’ aides, as well as patients of the RN, may need to be included to gain additional perspective.

DIF: Cognitive Level: Apply (Application)

TOP: Nursing Process: Planning

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

5. A highly respected staff RN on the medical-surgical unit has volunteered to be the champion for the implementation of a new nursing protocol. What does champion mean in this situation? The staff nurse will: a. accept an award on behalf of her unit regarding this protocol. b. display a winning attitude in support of the new protocol. c. educate others in continuous quality improvement protocols. d. passionately commit to the implementation of the process and inspire others.

ANS: D

A champion is an individual who is passionate and committed to the implementation process and who can inspire others. Often a champion appears as the strategic planning process unfolds; generally, this individual contributes freely, is engaged in the work groups, and expresses interest in the process. Champions can be selected as well, but those who volunteer are usually more enthusiastic about the work than those who are “drafted.”

DIF: Cognitive Level: Apply (Application)

TOP: Nursing Process: Planning

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

6. SWOT is an acronym for: a. stability, wealth, opportunistic, and timeliness. b. strategies, work ethic, oppositions, and team. c. strengths, weaknesses, opportunities, and threats. d. strong, worthy, oppositional, and tactical.

ANS: C

SWOT is an acronym for strengths, weaknesses, opportunities, and threats. SWOT analysis is used in developing strategic plans for an organization.

DIF: Cognitive Level: Remember (Knowledge)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

7. An action plan: a. breaks a strategic plan into manageable parts. b. details a futuristic view of the institution. c. outlines the steps in performing a procedure. d. provides a strategic plan for actualizing the mission.

ANS: A

An action plan breaks a strategic plan into manageable parts.

DIF: Cognitive Level: Understand (Comprehension)

TOP: Nursing Process: Planning

MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. Comparing her vision with that of the institution b. Following the strategic objectives and mission of the hospital c. Reviewing the action plan and vision of the hospital system d. Using her intuition to determine which project should continue

8. A nurse manager enjoys implementing new programs and beginning new projects. She is beginning to find herself overwhelmed and needs to decrease her workload. Which of the following ideas might best help decrease her workload?

ANS: B

Strategic objectives provide a way of converting the rather abstract mission of an organization into concrete terms. Following the mission of the hospital will help keep the nurse manager focused.

DIF: Cognitive Level: Apply (Application)

TOP: Nursing Process: Planning

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

9. Part of the evaluation design process when developing a strategic plan includes: a. delineation of measures of success. b. designing a form to critique the guidelines. c. formulating an implementation outline. d. writing the vision and mission statement.

ANS: A

The final step in the strategic planning process is developing the evaluation design. Planning for evaluation is imperative to ensure that systems and measurements are in place to determine whether the strategic plan has been achieved. During the strategic planning process, measures of success are delineated, responsible individuals are identified, and frequency of evaluation and reporting of these measures is determined.

DIF: Cognitive Level: Understand (Comprehension)

TOP: Nursing Process: Evaluation

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

10. A hospital with a large surgery department is concerned about surgeons starting their own surgical centers. In relation to the environmental assessment process, this is an example of: a. an economic monopoly. b. an external threat. c. marketplace competition. d. political strength.

ANS: B

The external components are described as opportunities and threats, and they are identified in the same manner as the internal factors. Opportunities and threats may include changes in industry, marketplace, economy, political climate, technology, and competition.

DIF: Cognitive Level: Apply (Application)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

11. Operational choices for action that are made to implement a strategy are called: a. tactics. b. objectives. c. core values. d. strategic plans.

ANS: A

Tactics are operational choices for action that are made to implement a strategy.

DIF: Cognitive Level: Remember (Knowledge)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

12. The first step of the strategic planning process is to: a. develop strategic goals. b. survey the environment. c. implement the action plan. d. formulate the organization’s mission and vision.

ANS: D

The first step of the strategic planning process is to formulate or review and update as needed the organization’s mission and vision in alignment with the organization’s core purpose and values. The mission delineates what the organization does, while the vision articulates the preferred future state of the organization.

DIF: Cognitive Level: Remember (Knowledge)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

13. The statement, “We will provide high-quality care and services to our patients. We are committed to maintaining excellence, respect, and integrity in all aspects of our operations and our professional and business conduct,” is an example of: a. a mission statement. b. the core values of an organization. c. a strategic plan. d. the core purpose of an organization.

ANS: A

The mission defines what the organization does; the core purpose delineates why.

DIF: Cognitive Level: Apply (Application)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

14. Answering questions such as “What business are we in?” and “What business do we want to be in?” can lead the organization to define the: a. mission. b. objectives. c. core purpose. d. strategic plan.

ANS: C

The core purpose can be defined and refined by asking, “Why are we in business?” As a result, the initial response, “We are in the business of health care,” may be further refined to “We want to contribute to the community in which we exist.” Thus asking “why” may result in the core purpose of providing needed health care services to the community in which the organization is located.

DIF: Cognitive Level: Apply (Application)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

15. Addressing the strategic planning process questions involves considering environmental factors. An example of an external environmental factor to be considered is: a. financial factors. b. human resources. c. political climate. d. organizational culture.

ANS: C

A key component of the strategic planning process is to assess the environment. This assessment, called environmental scanning, consists of analyzing both internal and external environmental factors. External opportunities and threats may include changes in industry, marketplace, economy, political climate, technology, and competition.

DIF: Cognitive Level: Remember (Knowledge)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

16. The statement, “We will increase our profit by 8% each year,” is an example of a(n): a. strategic plan. b. mission statement. c. organization objective. d. implementation strategy.

ANS: C

Objectives are defined as the targets an organization wants to achieve. These can be financial or performance based with short-range or long-range targets.

DIF: Cognitive Level: Apply (Application)

TOP: Nursing Process: Evaluation

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

17. The 2011 Future of Nursing report published by the Institute of Medicine (IOM), calls for: a. an improved educational system that promotes seamless academic progression. b. the baccalaureate in nursing to be established as the minimal educational level for entry into practice. c. the master’s degree to be established as the minimal requirement for a leadership position in nursing. d. increased participation in leadership among nurses.

ANS: D

The leadership role of nurses has become an area of increasing focus since the Institute of Medicine (IOM, now called the National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division), in its 2011 Future of Nursing report, called for increased leadership development and participation in leadership among nurses.

DIF: Cognitive Level: Understand (Comprehension)

TOP: Nursing Process: Implementation

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

Multiple Response

1. Strategic management, long used in business to ensure a competitive advantage over similar enterprises, involves: (Select all that apply.)

a. setting targets.

b. establishing goals.

c. evaluating success.

d. developing an action plan.

e. defining the core purpose.

f. conducting an environmental scan.

ANS: A, B, C, D, F

Strategic management involves conducting an environmental scan, knowing the competition, establishing goals, setting targets, developing an action plan, implementing the plan, and evaluating success. This approach has long been used in business to ensure a competitive advantage over similar enterprises. The core purpose is the reason the organization is in business.

DIF: Cognitive Level: Remember (Knowledge)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. ensure customer satisfaction. b. establish a competitive position. c. reach strategic objectives or goals. d. develop the organizational mission. e. provide a blueprint for operating a business.

2. The purpose of strategic management is to: (Select all that apply.)

ANS: A, B, C, E

Strategic management involves strategic planning and implementation. It provides a blueprint for operating a business, establishing a competitive position, ensuring customer satisfaction, and reaching strategic objectives or goals.

DIF: Cognitive Level: Remember (Knowledge)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. alignment with the external environment. b. helps identify best practices on the nursing unit. c. future orientation. d. engagement of the entire workforce in organizational leadership. e. use of change management strategies to achieve performance goals. f. facilitation of decision making with well-communicated decisions.

3. Characteristics of strategic management include: (Select all that apply.)

ANS: A, C, D, E, F

According to Jasper and Crossan (2012), the five characteristics of strategic management are engagement of the entire workforce in organizational leadership, alignment with the external environment, future orientation, use of change management strategies to achieve performance goals, and facilitation of decision making with well-communicated decisions.

DIF: Cognitive Level: Understand (Comprehension)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. specific and inflexible. b. applied in a timely manner. c. agreed upon by all stakeholders. d. executed proficiently and efficiently. e. aligned with the organizational culture.

4. For organizational strategy to be implemented successfully it must be: (Select all that apply.)

ANS: B, D, E

Strategy must be implemented proficiently and efficiently, as well as in a timely manner, if it is to be effective. For this to occur, the organization must attend to its capabilities, the reward structure, available support systems, and the organizational culture. If any of these characteristics are not in place, implementation of the strategy will surely fail.

DIF: Cognitive Level: Understand (Comprehension)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. Forward b. Glossary c. Goals and strategies d. Executive summary e. Mission, vision, and values

5. Most strategic plans result in a written document. Strategic plan documents generally contain which of the following sections? (Select all that apply.)

ANS: C, D, E

Generally, strategic plan documents contain an executive summary; background; mission, vision, and values; goals and strategies; and appendixes.

DIF: Cognitive Level: Understand (Comprehension)

TOP: Nursing Process: Planning

MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. helps identify best practices on the nursing unit. b. rewards those who carry out strategy successfully. c. can be used to set measurable, achievable goals and plans. d. can be used to analyze the environment for opportunities and threats. e. can help determine the future of the nursing area, such as a department or unit.

6. Strategic management is useful for nursing leaders and managers because it: (Select all that apply.)

ANS: C, D, E

Strategic management is useful for nursing leaders and managers because it can be used to analyze the environment for opportunities and threats; to set measurable, achievable goals and plans; and to help determine the future of the nursing area, such as a department or unit. Success in strategic planning and implementing that strategic plan will position nursing well in an institution. The process provides an opportunity for nursing to shine, because the similarities between the nursing process and the strategic planning process allow nurses to shortcut the learning curve and begin to move forward with the implementation phase while others may still be grappling with the planning process.

DIF: Cognitive Level: Apply (Application)

TOP: Nursing Process: Planning

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

Completion

1. A(n) _____ is a two- to three-page synopsis of the strategic plan, written in language understandable by all potential readers.

ANS: executive summary

An executive summary is a two- to three-page synopsis of the strategic plan, written in language understandable by all potential readers.

DIF: Cognitive Level: Understand (Comprehension)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

2. A competitive move or business approach designed to produce a successful outcome is called _______.

ANS: strategy

Strategy is a competitive move or business approach designed to produce a successful outcome.

DIF: Cognitive Level: Remember (Knowledge)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

3. In a written strategic plan, the _______ contains all the documentation related to the strategic planning process so that the reader obtains a sense of the background information used by the strategic planners in order to arrive at the strategic plan.

ANS: appendix

The appendix contains all the documentation related to the strategic planning process so that the reader obtains a sense of the background information used by the strategic planners in order to arrive at the strategic plan.

DIF: Cognitive Level: Remember (Knowledge)

TOP: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

Other

1. A key component of the strategic planning process is to assess the environment. Place the steps of the assessment process in order: a. Identify strengths and weaknesses internal to the organization. b. Shape strategies into a strategic plan on which strategic management is based. c. Establish priorities for the critical issues so that strategies are based on the priority issues. d. Analyze strengths, weaknesses, opportunities, and threats for their impact on the organization. e. Analyze internal components for the purpose of drafting a picture of the critical features of the organization.

ANS:

Environmental analysis incorporates an internal analysis such as a review of the mission statement and value system, as well as an external analysis. The analysis needs to review four areas: strengths, weaknesses, opportunities, and threats. In this approach, strengths and weaknesses internal to the organization are identified. Once identified, these components are analyzed for the purpose of drafting a picture of the critical features of the organization, its achievements and failures, and its good points and bad points. Next, priorities must be established for the critical issues so that strategies are based on the priority issues. The strategies identified through the SWOT analysis can be shaped into a strategic plan on which strategic management is based. The more carefully the analysis is done, the more reliable the strategic plan.

DIF: Cognitive Level: Understand (Comprehension)

TOP: Nursing Process: Evaluation

MSC: Client Needs: Safe and Effective Care Environment: Management of Care