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    Please see attached for instructions – ## nurs-fpx4040-assessment-04-supplement-informatics-and-nursing-sensitive-quality-indicators-A.pdf – ## 4.docx – ## theInformaticsandNursing-SensitiveQualityIndicatorsVideoExemplar.docx **## nurs-fpx4040-assessment-04-supplement-informatics-and-nursing-sensiti…

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    Please see attached for instructions

    – ## nurs-fpx4040-assessment-04-supplement-informatics-and-nursing-sensitive-quality-indicators-A.pdf

    – ## 4.docx

    – ## theInformaticsandNursing-SensitiveQualityIndicatorsVideoExemplar.docx

    **## nurs-fpx4040-assessment-04-supplement-informatics-and-nursing-sensitive-quality-indicators-A.pdf**

    1

    Assessment 04 –

    Informatics and Nursing-Sensitive Quality Indicators

    For this assessment, you will prepare an 8–10 minute audio training tutorial (video is optional)
    for new nurses on the importance of nursing-sensitive quality indicators.

    Before you complete the detailed instructions in the courseroom, first review the Nursing-
    Sensitive Quality Indicators below and select the one you’re most interested in. Nursing-
    Sensitive Quality Indicators reflect the structure, process, and patient outcomes of nursing care.
    Nursing-Sensitive Quality Indicators are developed by identifying potential indicators that reflect
    nursing care and are not represented by current indicators, performing a literature review, and
    determining the validity of the potential indicator in nursing practice.

    After you select one of the Nursing-Sensitive Quality Indicators below, return to the courseroom
    to review the detailed instructions and complete your assessment.

    • Patient Falls With Injury – Process and Outcome.
    • Pressure Ulcer Rate – Process and Outcome.
    • Pediatric Pain Assessment, Intervention, and Reassessment – Process and

    Outcome.
    • Restraint Prevalence – Process and Outcome.
    • RN Education/Specialty Certification – Structure.

    **## 4.docx**

    The focus of Assessment 4 is on how informatics support monitoring of nursing-sensitive quality indicator data. You will develop
    **an 8–10 minute audio (Need a just the transcript to do the video**) training module to orient new nurses in a workplace to a single nursing-sensitive quality indicator critical to the organization. Your recording will address how data are collected and disseminated across the organization along with the nurses' role in supporting accurate reporting and high quality results.

    This assessment requires you to prepare an 8–10 minute audio training tutorial (with optional video) for new nurses on the importance of nursing-sensitive quality indicators. To successfully prepare for your assessment, you will need to complete the following preparatory activities:

    Review the nursing-sensitive quality indicators presented in the Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF] Download Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF]
    **(SEE ATTACHED)** resource and select one nursing-sensitive quality indicator to use as the focus for this assessment. Will be selecting
    **: Patient Falls With Injury – Process and Outcome**

    Conduct independent research on the most current information about the selected nursing-sensitive quality indicator.

    Interview a professional colleague or contact who is familiar with quality monitoring and how technology can help to collect and report quality indicator data. You do not need to submit the transcript of your conversation, but do integrate what you learned from the interview into the audio tutorial. Consider these questions for your interview:

    What is your experience with collecting data and entering it into a database?

    What challenges have you experienced?

    How does your organization share with the nursing staff and other members of the health care system the quality improvement monitoring results?

    What role do bedside nurses and other frontline staff have in entering the data? For example, do staff members enter the information into an electronic medical record for extraction? Or do they enter it into another system? How effective is this process?

    Watch the Informatics and Nursing-Sensitive Quality Indicators Video Exemplar. (SEE ATTACHED)

    For this assessment, first review the nursing-sensitive quality indicators presented in the Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF] Download Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF]resource and select one nursing-sensitive quality indicator to use as the focus for this assessment.

    Next, imagine you are a member of a Quality Improvement Council at any type of health care system, whether acute, ambulatory, home health, managed care, et cetera. Your Council has identified that newly hired nurses would benefit from comprehensive training on the importance of nursing-sensitive quality indicators. The Council would like the training to address how this information is collected and disseminated across the organization. It would also like the training to describe the role nurses have in accurate reporting and high-quality results.

    The Council indicates a recording is preferable to a written fact sheet due to the popularity of audio blogs. In this way, new hires can listen to the tutorial on their own time using their phone or other device.

    As a result of this need, you offer to create an audio tutorial orienting new hires to these topics. You know that you will need a script to guide your audio recording. You also plan to incorporate into your script the insights you learned from conducting an interview with an authority on quality monitoring and the use of technology to collect and report quality indicator data.

    You determine that you will cover the following topics in your audio tutorial script:

    Introduction: Nursing-Sensitive Quality Indicator

    What is the National Database of Nursing-Sensitive Quality Indicators?

    What are nursing-sensitive quality indicators?

    Which particular quality indicator did you select to address in your tutorial?

    Why is this quality indicator important to monitor?

    Be sure to address the impact of this indicator on the quality of care and patient safety.

    Why do new nurses need to be familiar with this particular quality indicator when providing patient care?

    Collection and Distribution of Quality Indicator Data

    According to your interview and other resources, how does your organization collect data on this quality indicator?

    How does the organization disseminate aggregate data?

    What role do nurses play in supporting accurate reporting and high-quality results?

    As an example, consider the importance of accurately entering data regarding nursing interventions.

    **Additional Requirements**

    Script: A separate document with the script or speaker's notes is required. Important: Submissions that do not include the script or speaker's notes will be returned as a non-performance.

    References: Cite a minimum of three scholarly and/or authoritative sources.

    APA: Submit, along with the recording, a separate reference page that follows APA style and formatting guidelines. For an APA refresher, consult the Evidence and APA page on Campus.

    By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

    Competency 1: Describe nurses' and the interdisciplinary team's role in informatics with a focus on electronic health information and patient care technology to support decision making.

    Describe the interdisciplinary team's role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.

    Competency 3: Evaluate the impact of patient care technologies on desired outcomes.

    Explain how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.

    Competency 4: Recommend the use of a technology to enhance quality and safety standards for patients.

    Justify how a nursing-sensitive quality indicator establishes evidence-based practice guidelines for nurses to follow when using patient care technologies to enhance patient safety, satisfaction, and outcomes.

    Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.

    Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.

    Follow APA style and formatting guidelines for citations and references.

    **## theInformaticsandNursing-SensitiveQualityIndicatorsVideoExemplar.docx**

    Video Transcript:

    Hello and welcome to the University Hospital Health Care System. My name is Diane Tate. We are so excited to have you on our nursing team. I am here today to help you better understand how our healthcare system uses Nursing Sensitive Quality Indicators – also known as the NDNQI – to enhance quality care outcomes, improve training procedures, establish best practices, and improve patient satisfaction. These indicators also help in workflow and the recruitment and retention of quality staff. You play an important part of this. You are our eyes and ears when it comes to safe evidence-based practice and reporting data to help evaluate our Nursing Sensitive Quality Indicators.

    We are very fortunate to be one of the 1100 facilities in the United States providing the data to NDNQI to fulfill nursing's commitment to advancing our knowledge base to evaluate and improve patient care. The NDNQI is a national nursing database evaluating nursing care that provides annual and quarterly reporting of three major indicators which evaluate nursing care. In 2018, the authors Griggs, Wiechula & Cusack described those indicators as structure (staff/skill competency), process (patient assessment, nursing intervention, and job satisfaction) and outcome of patient care related to the quantity or quality nursing care. NDNQI is managed by a company named Press Ganey. Press Ganey sends us surveys for the data needed and then provides participating facility research driven reports with statistics and data themes. Multiple authors including Smith (writing in 2018) and Griggs, Wiechula & Cusack point out that this data allows us to understand what we are doing well in our facility and what we need to improve on, in comparison to national data, to enhance patient safety, patient care outcomes, and organizational performance reports.

    Now I’d like to share an example, Our Chief Nursing Officer used the NDNQI ratios and acuity data on staffing to validate the need various levels of nurse staffing. Authors Mangold and Pearson, writing 2017, identify how this type of data can contribute to significant changes to our staffing matrix and ratios because of the data produced by nurses like you. Our nurses are better able to provide quality care as a result of this information and our patient satisfaction scores have almost doubled over that past 6 months.

    Imagine a small snowball made of 5 pieces of snow, then imagine one made of 100 pieces of snow, and one made of 1100 pieces of snow…the greater the number the bigger the impact. If you were in the snowball fight, do you want the snowball made with five snowflakes or the one made with 1100 snowflakes? The same is true of the data in the NDNQI, when one facility implements a change the data from the change is shared with everyone through NDNQI so the dissemination of information is relatively quick and provides real time evaluation data.

    For another example, over the past few months, we have experienced a dramatic rise in catheter-acquired urinary tract infections also known as CAUTIs and Hospital Acquired Conditions throughout the facility. This has dramatically affected the quality of patient care and ultimately our Press Ganey patient satisfaction surveys. Our rate of CAUTIs and Hospital Acquired Conditions have also impacted our rate of Medicare reimbursement. We have experienced a 1 percent reduction in reimbursement related to this CAUTI and associated HAC increase. Porter (2018) estimates CAUTI costs to be over $10,000. To give this number a little more impact, the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative reported in 2015 that there was a total of $330 million dollars lost in Hospital Acquired Conditions penalties across 721 facilities.

    Our nurses have identified CAUTI in their patients with indwelling catheters as a concern as well as other Hospital Acquired Conditions. Recognizing that they are the first line of defense for patient safety, our nurses are participating in a hospital wide Acquired Condition Reduction Program modeled after the Centers for Medicare and Medicaid services (n.d). Our initiative looks at all infections acquired during treatment in this facility. I encourage you to look at this website. As a nurse you are the leader of healthcare quality, we depend upon you as the expert in patient care. YOU are extremely powerful in contributing to patient care in not only preventing CAUTIs but in providing a timely reporting of needed data in the Press Ganey surveys so that our data is contributed to NDNQI.

    You May Ask… How Can I Help?

    Nurses have an essential role within the interdisciplinary healthcare team. They are responsible for collecting and reporting data for the NDNQI. The data collected will contribute to improved outcomes, improved patient safety, and an overall improved patient experience. In our facility we provide the data using online surveys received from Press Ganey, all members of the interdisciplinary healthcare team receive the surveys. In a personal communication, our Chief Nursing Officer, Dr. Smith, underscored that the current facility best practice is to check your hospital email every day you work and complete any surveys sent to you. The data is very easy to enter into the survey. Dr. Smith stated that in the beginning there was a lot of lag time between data entry by the interdisciplinary team and the time the survey was sent out but that has improved. We have a quality team at the hospital responsible for supplying the general data related to CAUTIs. Other data provided to Press Ganey includes incident reports, patient admission dates, length or stay, readmission data, number of patients with catheters vs patients with CAUTIs diagnosed in facility vs after discharge. To learn more about Press Ganey please go to their website.

    Your job as a nurse is to provide care according to the current practice policies, complete all required documentation which includes all popups on CAUTIs and then to enter data when emailed a survey from Press Ganey. Your role is incredibly powerful in this initiative because as you know we have a huge amount of responsibility in placing, caring for and assessing indwelling catheters and straight caths. Imagine if your work in completing all required documentation and some quick online surveys prevents future CAUTIs, the impact would be huge!

    I would now like to discuss what we do WITH THE DATA

    The data you provide, and which is found in the patient records provides insights into how the nursing care and interventions we provide influence patient outcomes. The data found within the NDNQI gives healthcare leaders an understand of what actions influence quality and patient safety. Within the NDNQI the data is trended and the themes and or statistical information is pulled out to help guide safety and quality initiatives.

    Within this organization we have quality improvement teams on each unit where data from NDNQI and plans for improving quality are shared. We use the data for guiding us in creating quality improvement plans and ensuring patient safety. Quality improvement teams on your unit will share updates with the NDNQI data and how we plan to use the data.

    As we wrap up I’d like to share some ideas about how your actions IMPACT HEALTH CARE IN GENERAL

    Your involvement in accurate charting and completing surveys provides data used for the greater science of nursing. This information helps the nursing profession to identify nurse-sensitive indicators of quality to use for improvement in our patient care. Our nursing leaders use the NDNQI data to determine the best practices for their unit and facility to improve both quality care outcomes and workplace safety, including nurse patient staffing ratios.

    Our facility models itself after the 2015 Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative Policy Brief for not only quality and safety improvement, but to achieve higher outcome-based hospital payments. Our Value Based Purchasing program provides acute care facilities incentive money when the facility has good performance on quality measurements and makes improvements in the facilities quality and safety of care. There is also an overlap of the Value Based Purchasing program and the Medicare reimbursement program so facilities are able to potentially have double the financial benefit because the nurse sensitive outcomes influence the requirements for full reimbursement from Medicare. John Hopkin’s hospital has been a leader in using the NDNQI data to make improvements in safety and quality with a 41% reduction in CAUTIs with the use of national data on nursing interventions from NDNQI. Nursing leaders need to work to ensure they use the data from the nursing sensitive outcomes to make improvements in care within individual facilities and units.

    In CONCLUSION

    Our involvement in NDNQI is a wonderful and positive influence on the profession of nursing and patient care. Your responsibility is to ensure you have accurate and complete documentation and to complete any Press Ganey surveys you receive. Our role as a facility is to provide all additional data to NDNQI and to support you in your work while focusing on quality improvement and sharing data with you from NDNQI and our quality improvement work. The success of NDNQI is relying on our commitment to provide data in a timely manner and then to use the national data to make improvements at the facility. Nurses are at the front line of quality improvement and evidence-based practice. We can all make a huge improvement in patient care. You are a valuable asset to our team!

    Thank you!

    **## theInformaticsandNursing-SensitiveQualityIndicatorsVideoExemplar.docx**

    Video Transcript:

    Hello and welcome to the University Hospital Health Care System. My name is Diane Tate. We are so excited to have you on our nursing team. I am here today to help you better understand how our healthcare system uses Nursing Sensitive Quality Indicators – also known as the NDNQI – to enhance quality care outcomes, improve training procedures, establish best practices, and improve patient satisfaction. These indicators also help in workflow and the recruitment and retention of quality staff. You play an important part of this. You are our eyes and ears when it comes to safe evidence-based practice and reporting data to help evaluate our Nursing Sensitive Quality Indicators.

    We are very fortunate to be one of the 1100 facilities in the United States providing the data to NDNQI to fulfill nursing's commitment to advancing our knowledge base to evaluate and improve patient care. The NDNQI is a national nursing database evaluating nursing care that provides annual and quarterly reporting of three major indicators which evaluate nursing care. In 2018, the authors Griggs, Wiechula & Cusack described those indicators as structure (staff/skill competency), process (patient assessment, nursing intervention, and job satisfaction) and outcome of patient care related to the quantity or quality nursing care. NDNQI is managed by a company named Press Ganey. Press Ganey sends us surveys for the data needed and then provides participating facility research driven reports with statistics and data themes. Multiple authors including Smith (writing in 2018) and Griggs, Wiechula & Cusack point out that this data allows us to understand what we are doing well in our facility and what we need to improve on, in comparison to national data, to enhance patient safety, patient care outcomes, and organizational performance reports.

    Now I’d like to share an example, Our Chief Nursing Officer used the NDNQI ratios and acuity data on staffing to validate the need various levels of nurse staffing. Authors Mangold and Pearson, writing 2017, identify how this type of data can contribute to significant changes to our staffing matrix and ratios because of the data produced by nurses like you. Our nurses are better able to provide quality care as a result of this information and our patient satisfaction scores have almost doubled over that past 6 months.

    Imagine a small snowball made of 5 pieces of snow, then imagine one made of 100 pieces of snow, and one made of 1100 pieces of snow…the greater the number the bigger the impact. If you were in the snowball fight, do you want the snowball made with five snowflakes or the one made with 1100 snowflakes? The same is true of the data in the NDNQI, when one facility implements a change the data from the change is shared with everyone through NDNQI so the dissemination of information is relatively quick and provides real time evaluation data.

    For another example, over the past few months, we have experienced a dramatic rise in catheter-acquired urinary tract infections also known as CAUTIs and Hospital Acquired Conditions throughout the facility. This has dramatically affected the quality of patient care and ultimately our Press Ganey patient satisfaction surveys. Our rate of CAUTIs and Hospital Acquired Conditions have also impacted our rate of Medicare reimbursement. We have experienced a 1 percent reduction in reimbursement related to this CAUTI and associated HAC increase. Porter (2018) estimates CAUTI costs to be over $10,000. To give this number a little more impact, the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative reported in 2015 that there was a total of $330 million dollars lost in Hospital Acquired Conditions penalties across 721 facilities.

    Our nurses have identified CAUTI in their patients with indwelling catheters as a concern as well as other Hospital Acquired Conditions. Recognizing that they are the first line of defense for patient safety, our nurses are participating in a hospital wide Acquired Condition Reduction Program modeled after the Centers for Medicare and Medicaid services (n.d). Our initiative looks at all infections acquired during treatment in this facility. I encourage you to look at this website. As a nurse you are the leader of healthcare quality, we depend upon you as the expert in patient care. YOU are extremely powerful in contributing to patient care in not only preventing CAUTIs but in providing a timely reporting of needed data in the Press Ganey surveys so that our data is contributed to NDNQI.

    You May Ask… How Can I Help?

    Nurses have an essential role within the interdisciplinary healthcare team. They are responsible for collecting and reporting data for the NDNQI. The data collected will contribute to improved outcomes, improved patient safety, and an overall improved patient experience. In our facility we provide the data using online surveys received from Press Ganey, all members of the interdisciplinary healthcare team receive the surveys. In a personal communication, our Chief Nursing Officer, Dr. Smith, underscored that the current facility best practice is to check your hospital email every day you work and complete any surveys sent to you. The data is very easy to enter into the survey. Dr. Smith stated that in the beginning there was a lot of lag time between data entry by the interdisciplinary team and the time the survey was sent out but that has improved. We have a quality team at the hospital responsible for supplying the general data related to CAUTIs. Other data provided to Press Ganey includes incident reports, patient admission dates, length or stay, readmission data, number of patients with catheters vs patients with CAUTIs diagnosed in facility vs after discharge. To learn more about Press Ganey please go to their website.

    Your job as a nurse is to provide care according to the current practice policies, complete all required documentation which includes all popups on CAUTIs and then to enter data when emailed a survey from Press Ganey. Your role is incredibly powerful in this initiative because as you know we have a huge amount of responsibility in placing, caring for and assessing indwelling catheters and straight caths. Imagine if your work in completing all required documentation and some quick online surveys prevents future CAUTIs, the impact would be huge!

    I would now like to discuss what we do WITH THE DATA

    The data you provide, and which is found in the patient records provides insights into how the nursing care and interventions we provide influence patient outcomes. The data found within the NDNQI gives healthcare leaders an understand of what actions influence quality and patient safety. Within the NDNQI the data is trended and the themes and or statistical information is pulled out to help guide safety and quality initiatives.

    Within this organization we have quality improvement teams on each unit where data from NDNQI and plans for improving quality are shared. We use the data for guiding us in creating quality improvement plans and ensuring patient safety. Quality improvement teams on your unit will share updates with the NDNQI data and how we plan to use the data.

    As we wrap up I’d like to share some ideas about how your actions IMPACT HEALTH CARE IN GENERAL

    Your involvement in accurate charting and completing surveys provides data used for the greater science of nursing. This information helps the nursing profession to identify nurse-sensitive indicators of quality to use for improvement in our patient care. Our nursing leaders use the NDNQI data to determine the best practices for their unit and facility to improve both quality care outcomes and workplace safety, including nurse patient staffing ratios.

    Our facility models itself after the 2015 Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative Policy Brief for not only quality and safety improvement, but to achieve higher outcome-based hospital payments. Our Value Based Purchasing program provides acute care facilities incentive money when the facility has good performance on quality measurements and makes improvements in the facilities quality and safety of care. There is also an overlap of the Value Based Purchasing program and the Medicare reimbursement program so facilities are able to potentially have double the financial benefit because the nurse sensitive outcomes influence the requirements for full reimbursement from Medicare. John Hopkin’s hospital has been a leader in using the NDNQI data to make improvements in safety and quality with a 41% reduction in CAUTIs with the use of national data on nursing interventions from NDNQI. Nursing leaders need to work to ensure they use the data from the nursing sensitive outcomes to make improvements in care within individual facilities and units.

    In CONCLUSION

    Our involvement in NDNQI is a wonderful and positive influence on the profession of nursing and patient care. Your responsibility is to ensure you have accurate and complete documentation and to complete any Press Ganey surveys you receive. Our role as a facility is to provide all additional data to NDNQI and to support you in your work while focusing on quality improvement and sharing data with you from NDNQI and our quality improvement work. The success of NDNQI is relying on our commitment to provide data in a timely manner and then to use the national data to make improvements at the facility. Nurses are at the front line of quality improvement and evidence-based practice. We can all make a huge improvement in patient care. You are a valuable asset to our team!

    Thank you!

    **## nurs-fpx4040-assessment-04-supplement-informatics-and-nursing-sensitive-quality-indicators-A.pdf**

    1

    Assessment 04 –

    Informatics and Nursing-Sensitive Quality Indicators

    For this assessment, you will prepare an 8–10 minute audio training tutorial (video is optional)
    for new nurses on the importance of nursing-sensitive quality indicators.

    Before you complete the detailed instructions in the courseroom, first review the Nursing-
    Sensitive Quality Indicators below and select the one you’re most interested in. Nursing-
    Sensitive Quality Indicators reflect the structure, process, and patient outcomes of nursing care.
    Nursing-Sensitive Quality Indicators are developed by identifying potential indicators that reflect
    nursing care and are not represented by current indicators, performing a literature review, and
    determining the validity of the potential indicator in nursing practice.

    After you select one of the Nursing-Sensitive Quality Indicators below, return to the courseroom
    to review the detailed instructions and complete your assessment.

    • Patient Falls With Injury – Process and Outcome.
    • Pressure Ulcer Rate – Process and Outcome.
    • Pediatric Pain Assessment, Intervention, and Reassessment – Process and

    Outcome.
    • Restraint Prevalence – Process and Outcome.
    • RN Education/Specialty Certification – Structure.

    **## 4.docx**

    The focus of Assessment 4 is on how informatics support monitoring of nursing-sensitive quality indicator data. You will develop
    **an 8–10 minute audio (Need a just the transcript to do the video**) training module to orient new nurses in a workplace to a single nursing-sensitive quality indicator critical to the organization. Your recording will address how data are collected and disseminated across the organization along with the nurses' role in supporting accurate reporting and high quality results.

    This assessment requires you to prepare an 8–10 minute audio training tutorial (with optional video) for new nurses on the importance of nursing-sensitive quality indicators. To successfully prepare for your assessment, you will need to complete the following preparatory activities:

    Review the nursing-sensitive quality indicators presented in the Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF] Download Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF]
    **(SEE ATTACHED)** resource and select one nursing-sensitive quality indicator to use as the focus for this assessment. Will be selecting
    **: Patient Falls With Injury – Process and Outcome**

    Conduct independent research on the most current information about the selected nursing-sensitive quality indicator.

    Interview a professional colleague or contact who is familiar with quality monitoring and how technology can help to collect and report quality indicator data. You do not need to submit the transcript of your conversation, but do integrate what you learned from the interview into the audio tutorial. Consider these questions for your interview:

    What is your experience with collecting data and entering it into a database?

    What challenges have you experienced?

    How does your organization share with the nursing staff and other members of the health care system the quality improvement monitoring results?

    What role do bedside nurses and other frontline staff have in entering the data? For example, do staff members enter the information into an electronic medical record for extraction? Or do they enter it into another system? How effective is this process?

    Watch the Informatics and Nursing-Sensitive Quality Indicators Video Exemplar. (SEE ATTACHED)

    For this assessment, first review the nursing-sensitive quality indicators presented in the Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF] Download Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF]resource and select one nursing-sensitive quality indicator to use as the focus for this assessment.

    Next, imagine you are a member of a Quality Improvement Council at any type of health care system, whether acute, ambulatory, home health, managed care, et cetera. Your Council has identified that newly hired nurses would benefit from comprehensive training on the importance of nursing-sensitive quality indicators. The Council would like the training to address how this information is collected and disseminated across the organization. It would also like the training to describe the role nurses have in accurate reporting and high-quality results.

    The Council indicates a recording is preferable to a written fact sheet due to the popularity of audio blogs. In this way, new hires can listen to the tutorial on their own time using their phone or other device.

    As a result of this need, you offer to create an audio tutorial orienting new hires to these topics. You know that you will need a script to guide your audio recording. You also plan to incorporate into your script the insights you learned from conducting an interview with an authority on quality monitoring and the use of technology to collect and report quality indicator data.

    You determine that you will cover the following topics in your audio tutorial script:

    Introduction: Nursing-Sensitive Quality Indicator

    What is the National Database of Nursing-Sensitive Quality Indicators?

    What are nursing-sensitive quality indicators?

    Which particular quality indicator did you select to address in your tutorial?

    Why is this quality indicator important to monitor?

    Be sure to address the impact of this indicator on the quality of care and patient safety.

    Why do new nurses need to be familiar with this particular quality indicator when providing patient care?

    Collection and Distribution of Quality Indicator Data

    According to your interview and other resources, how does your organization collect data on this quality indicator?

    How does the organization disseminate aggregate data?

    What role do nurses play in supporting accurate reporting and high-quality results?

    As an example, consider the importance of accurately entering data regarding nursing interventions.

    **Additional Requirements**

    Script: A separate document with the script or speaker's notes is required. Important: Submissions that do not include the script or speaker's notes will be returned as a non-performance.

    References: Cite a minimum of three scholarly and/or authoritative sources.

    APA: Submit, along with the recording, a separate reference page that follows APA style and formatting guidelines. For an APA refresher, consult the Evidence and APA page on Campus.

    By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

    Competency 1: Describe nurses' and the interdisciplinary team's role in informatics with a focus on electronic health information and patient care technology to support decision making.

    Describe the interdisciplinary team's role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.

    Competency 3: Evaluate the impact of patient care technologies on desired outcomes.

    Explain how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.

    Competency 4: Recommend the use of a technology to enhance quality and safety standards for patients.

    Justify how a nursing-sensitive quality indicator establishes evidence-based practice guidelines for nurses to follow when using patient care technologies to enhance patient safety, satisfaction, and outcomes.

    Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.

    Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.

    Follow APA style and formatting guidelines for citations and references.

    **## theInformaticsandNursing-SensitiveQualityIndicatorsVideoExemplar.docx**

    Video Transcript:

    Hello and welcome to the University Hospital Health Care System. My name is Diane Tate. We are so excited to have you on our nursing team. I am here today to help you better understand how our healthcare system uses Nursing Sensitive Quality Indicators – also known as the NDNQI – to enhance quality care outcomes, improve training procedures, establish best practices, and improve patient satisfaction. These indicators also help in workflow and the recruitment and retention of quality staff. You play an important part of this. You are our eyes and ears when it comes to safe evidence-based practice and reporting data to help evaluate our Nursing Sensitive Quality Indicators.

    We are very fortunate to be one of the 1100 facilities in the United States providing the data to NDNQI to fulfill nursing's commitment to advancing our knowledge base to evaluate and improve patient care. The NDNQI is a national nursing database evaluating nursing care that provides annual and quarterly reporting of three major indicators which evaluate nursing care. In 2018, the authors Griggs, Wiechula & Cusack described those indicators as structure (staff/skill competency), process (patient assessment, nursing intervention, and job satisfaction) and outcome of patient care related to the quantity or quality nursing care. NDNQI is managed by a company named Press Ganey. Press Ganey sends us surveys for the data needed and then provides participating facility research driven reports with statistics and data themes. Multiple authors including Smith (writing in 2018) and Griggs, Wiechula & Cusack point out that this data allows us to understand what we are doing well in our facility and what we need to improve on, in comparison to national data, to enhance patient safety, patient care outcomes, and organizational performance reports.

    Now I’d like to share an example, Our Chief Nursing Officer used the NDNQI ratios and acuity data on staffing to validate the need various levels of nurse staffing. Authors Mangold and Pearson, writing 2017, identify how this type of data can contribute to significant changes to our staffing matrix and ratios because of the data produced by nurses like you. Our nurses are better able to provide quality care as a result of this information and our patient satisfaction scores have almost doubled over that past 6 months.

    Imagine a small snowball made of 5 pieces of snow, then imagine one made of 100 pieces of snow, and one made of 1100 pieces of snow…the greater the number the bigger the impact. If you were in the snowball fight, do you want the snowball made with five snowflakes or the one made with 1100 snowflakes? The same is true of the data in the NDNQI, when one facility implements a change the data from the change is shared with everyone through NDNQI so the dissemination of information is relatively quick and provides real time evaluation data.

    For another example, over the past few months, we have experienced a dramatic rise in catheter-acquired urinary tract infections also known as CAUTIs and Hospital Acquired Conditions throughout the facility. This has dramatically affected the quality of patient care and ultimately our Press Ganey patient satisfaction surveys. Our rate of CAUTIs and Hospital Acquired Conditions have also impacted our rate of Medicare reimbursement. We have experienced a 1 percent reduction in reimbursement related to this CAUTI and associated HAC increase. Porter (2018) estimates CAUTI costs to be over $10,000. To give this number a little more impact, the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative reported in 2015 that there was a total of $330 million dollars lost in Hospital Acquired Conditions penalties across 721 facilities.

    Our nurses have identified CAUTI in their patients with indwelling catheters as a concern as well as other Hospital Acquired Conditions. Recognizing that they are the first line of defense for patient safety, our nurses are participating in a hospital wide Acquired Condition Reduction Program modeled after the Centers for Medicare and Medicaid services (n.d). Our initiative looks at all infections acquired during treatment in this facility. I encourage you to look at this website. As a nurse you are the leader of healthcare quality, we depend upon you as the expert in patient care. YOU are extremely powerful in contributing to patient care in not only preventing CAUTIs but in providing a timely reporting of needed data in the Press Ganey surveys so that our data is contributed to NDNQI.

    You May Ask… How Can I Help?

    Nurses have an essential role within the interdisciplinary healthcare team. They are responsible for collecting and reporting data for the NDNQI. The data collected will contribute to improved outcomes, improved patient safety, and an overall improved patient experience. In our facility we provide the data using online surveys received from Press Ganey, all members of the interdisciplinary healthcare team receive the surveys. In a personal communication, our Chief Nursing Officer, Dr. Smith, underscored that the current facility best practice is to check your hospital email every day you work and complete any surveys sent to you. The data is very easy to enter into the survey. Dr. Smith stated that in the beginning there was a lot of lag time between data entry by the interdisciplinary team and the time the survey was sent out but that has improved. We have a quality team at the hospital responsible for supplying the general data related to CAUTIs. Other data provided to Press Ganey includes incident reports, patient admission dates, length or stay, readmission data, number of patients with catheters vs patients with CAUTIs diagnosed in facility vs after discharge. To learn more about Press Ganey please go to their website.

    Your job as a nurse is to provide care according to the current practice policies, complete all required documentation which includes all popups on CAUTIs and then to enter data when emailed a survey from Press Ganey. Your role is incredibly powerful in this initiative because as you know we have a huge amount of responsibility in placing, caring for and assessing indwelling catheters and straight caths. Imagine if your work in completing all required documentation and some quick online surveys prevents future CAUTIs, the impact would be huge!

    I would now like to discuss what we do WITH THE DATA

    The data you provide, and which is found in the patient records provides insights into how the nursing care and interventions we provide influence patient outcomes. The data found within the NDNQI gives healthcare leaders an understand of what actions influence quality and patient safety. Within the NDNQI the data is trended and the themes and or statistical information is pulled out to help guide safety and quality initiatives.

    Within this organization we have quality improvement teams on each unit where data from NDNQI and plans for improving quality are shared. We use the data for guiding us in creating quality improvement plans and ensuring patient safety. Quality improvement teams on your unit will share updates with the NDNQI data and how we plan to use the data.

    As we wrap up I’d like to share some ideas about how your actions IMPACT HEALTH CARE IN GENERAL

    Your involvement in accurate charting and completing surveys provides data used for the greater science of nursing. This information helps the nursing profession to identify nurse-sensitive indicators of quality to use for improvement in our patient care. Our nursing leaders use the NDNQI data to determine the best practices for their unit and facility to improve both quality care outcomes and workplace safety, including nurse patient staffing ratios.

    Our facility models itself after the 2015 Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative Policy Brief for not only quality and safety improvement, but to achieve higher outcome-based hospital payments. Our Value Based Purchasing program provides acute care facilities incentive money when the facility has good performance on quality measurements and makes improvements in the facilities quality and safety of care. There is also an overlap of the Value Based Purchasing program and the Medicare reimbursement program so facilities are able to potentially have double the financial benefit because the nurse sensitive outcomes influence the requirements for full reimbursement from Medicare. John Hopkin’s hospital has been a leader in using the NDNQI data to make improvements in safety and quality with a 41% reduction in CAUTIs with the use of national data on nursing interventions from NDNQI. Nursing leaders need to work to ensure they use the data from the nursing sensitive outcomes to make improvements in care within individual facilities and units.

    In CONCLUSION

    Our involvement in NDNQI is a wonderful and positive influence on the profession of nursing and patient care. Your responsibility is to ensure you have accurate and complete documentation and to complete any Press Ganey surveys you receive. Our role as a facility is to provide all additional data to NDNQI and to support you in your work while focusing on quality improvement and sharing data with you from NDNQI and our quality improvement work. The success of NDNQI is relying on our commitment to provide data in a timely manner and then to use the national data to make improvements at the facility. Nurses are at the front line of quality improvement and evidence-based practice. We can all make a huge improvement in patient care. You are a valuable asset to our team!

    Thank you!

    **## nurs-fpx4040-assessment-04-supplement-informatics-and-nursing-sensitive-quality-indicators-A.pdf**

    1

    Assessment 04 –

    Informatics and Nursing-Sensitive Quality Indicators

    For this assessment, you will prepare an 8–10 minute audio training tutorial (video is optional)
    for new nurses on the importance of nursing-sensitive quality indicators.

    Before you complete the detailed instructions in the courseroom, first review the Nursing-
    Sensitive Quality Indicators below and select the one you’re most interested in. Nursing-
    Sensitive Quality Indicators reflect the structure, process, and patient outcomes of nursing care.
    Nursing-Sensitive Quality Indicators are developed by identifying potential indicators that reflect
    nursing care and are not represented by current indicators, performing a literature review, and
    determining the validity of the potential indicator in nursing practice.

    After you select one of the Nursing-Sensitive Quality Indicators below, return to the courseroom
    to review the detailed instructions and complete your assessment.

    • Patient Falls With Injury – Process and Outcome.
    • Pressure Ulcer Rate – Process and Outcome.
    • Pediatric Pain Assessment, Intervention, and Reassessment – Process and

    Outcome.
    • Restraint Prevalence – Process and Outcome.
    • RN Education/Specialty Certification – Structure.

    **## 4.docx**

    The focus of Assessment 4 is on how informatics support monitoring of nursing-sensitive quality indicator data. You will develop
    **an 8–10 minute audio (Need a just the transcript to do the video**) training module to orient new nurses in a workplace to a single nursing-sensitive quality indicator critical to the organization. Your recording will address how data are collected and disseminated across the organization along with the nurses' role in supporting accurate reporting and high quality results.

    This assessment requires you to prepare an 8–10 minute audio training tutorial (with optional video) for new nurses on the importance of nursing-sensitive quality indicators. To successfully prepare for your assessment, you will need to complete the following preparatory activities:

    Review the nursing-sensitive quality indicators presented in the Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF] Download Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF]
    **(SEE ATTACHED)** resource and select one nursing-sensitive quality indicator to use as the focus for this assessment. Will be selecting
    **: Patient Falls With Injury – Process and Outcome**

    Conduct independent research on the most current information about the selected nursing-sensitive quality indicator.

    Interview a professional colleague or contact who is familiar with quality monitoring and how technology can help to collect and report quality indicator data. You do not need to submit the transcript of your conversation, but do integrate what you learned from the interview into the audio tutorial. Consider these questions for your interview:

    What is your experience with collecting data and entering it into a database?

    What challenges have you experienced?

    How does your organization share with the nursing staff and other members of the health care system the quality improvement monitoring results?

    What role do bedside nurses and other frontline staff have in entering the data? For example, do staff members enter the information into an electronic medical record for extraction? Or do they enter it into another system? How effective is this process?

    Watch the Informatics and Nursing-Sensitive Quality Indicators Video Exemplar. (SEE ATTACHED)

    For this assessment, first review the nursing-sensitive quality indicators presented in the Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF] Download Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF]resource and select one nursing-sensitive quality indicator to use as the focus for this assessment.

    Next, imagine you are a member of a Quality Improvement Council at any type of health care system, whether acute, ambulatory, home health, managed care, et cetera. Your Council has identified that newly hired nurses would benefit from comprehensive training on the importance of nursing-sensitive quality indicators. The Council would like the training to address how this information is collected and disseminated across the organization. It would also like the training to describe the role nurses have in accurate reporting and high-quality results.

    The Council indicates a recording is preferable to a written fact sheet due to the popularity of audio blogs. In this way, new hires can listen to the tutorial on their own time using their phone or other device.

    As a result of this need, you offer to create an audio tutorial orienting new hires to these topics. You know that you will need a script to guide your audio recording. You also plan to incorporate into your script the insights you learned from conducting an interview with an authority on quality monitoring and the use of technology to collect and report quality indicator data.

    You determine that you will cover the following topics in your audio tutorial script:

    Introduction: Nursing-Sensitive Quality Indicator

    What is the National Database of Nursing-Sensitive Quality Indicators?

    What are nursing-sensitive quality indicators?

    Which particular quality indicator did you select to address in your tutorial?

    Why is this quality indicator important to monitor?

    Be sure to address the impact of this indicator on the quality of care and patient safety.

    Why do new nurses need to be familiar with this particular quality indicator when providing patient care?

    Collection and Distribution of Quality Indicator Data

    According to your interview and other resources, how does your organization collect data on this quality indicator?

    How does the organization disseminate aggregate data?

    What role do nurses play in supporting accurate reporting and high-quality results?

    As an example, consider the importance of accurately entering data regarding nursing interventions.

    **Additional Requirements**

    Script: A separate document with the script or speaker's notes is required. Important: Submissions that do not include the script or speaker's notes will be returned as a non-performance.

    References: Cite a minimum of three scholarly and/or authoritative sources.

    APA: Submit, along with the recording, a separate reference page that follows APA style and formatting guidelines. For an APA refresher, consult the Evidence and APA page on Campus.

    By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

    Competency 1: Describe nurses' and the interdisciplinary team's role in informatics with a focus on electronic health information and patient care technology to support decision making.

    Describe the interdisciplinary team's role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.

    Competency 3: Evaluate the impact of patient care technologies on desired outcomes.

    Explain how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.

    Competency 4: Recommend the use of a technology to enhance quality and safety standards for patients.

    Justify how a nursing-sensitive quality indicator establishes evidence-based practice guidelines for nurses to follow when using patient care technologies to enhance patient safety, satisfaction, and outcomes.

    Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.

    Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.

    Follow APA style and formatting guidelines for citations and references.

    **## theInformaticsandNursing-SensitiveQualityIndicatorsVideoExemplar.docx**

    Video Transcript:

    Hello and welcome to the University Hospital Health Care System. My name is Diane Tate. We are so excited to have you on our nursing team. I am here today to help you better understand how our healthcare system uses Nursing Sensitive Quality Indicators – also known as the NDNQI – to enhance quality care outcomes, improve training procedures, establish best practices, and improve patient satisfaction. These indicators also help in workflow and the recruitment and retention of quality staff. You play an important part of this. You are our eyes and ears when it comes to safe evidence-based practice and reporting data to help evaluate our Nursing Sensitive Quality Indicators.

    We are very fortunate to be one of the 1100 facilities in the United States providing the data to NDNQI to fulfill nursing's commitment to advancing our knowledge base to evaluate and improve patient care. The NDNQI is a national nursing database evaluating nursing care that provides annual and quarterly reporting of three major indicators which evaluate nursing care. In 2018, the authors Griggs, Wiechula & Cusack described those indicators as structure (staff/skill competency), process (patient assessment, nursing intervention, and job satisfaction) and outcome of patient care related to the quantity or quality nursing care. NDNQI is managed by a company named Press Ganey. Press Ganey sends us surveys for the data needed and then provides participating facility research driven reports with statistics and data themes. Multiple authors including Smith (writing in 2018) and Griggs, Wiechula & Cusack point out that this data allows us to understand what we are doing well in our facility and what we need to improve on, in comparison to national data, to enhance patient safety, patient care outcomes, and organizational performance reports.

    Now I’d like to share an example, Our Chief Nursing Officer used the NDNQI ratios and acuity data on staffing to validate the need various levels of nurse staffing. Authors Mangold and Pearson, writing 2017, identify how this type of data can contribute to significant changes to our staffing matrix and ratios because of the data produced by nurses like you. Our nurses are better able to provide quality care as a result of this information and our patient satisfaction scores have almost doubled over that past 6 months.

    Imagine a small snowball made of 5 pieces of snow, then imagine one made of 100 pieces of snow, and one made of 1100 pieces of snow…the greater the number the bigger the impact. If you were in the snowball fight, do you want the snowball made with five snowflakes or the one made with 1100 snowflakes? The same is true of the data in the NDNQI, when one facility implements a change the data from the change is shared with everyone through NDNQI so the dissemination of information is relatively quick and provides real time evaluation data.

    For another example, over the past few months, we have experienced a dramatic rise in catheter-acquired urinary tract infections also known as CAUTIs and Hospital Acquired Conditions throughout the facility. This has dramatically affected the quality of patient care and ultimately our Press Ganey patient satisfaction surveys. Our rate of CAUTIs and Hospital Acquired Conditions have also impacted our rate of Medicare reimbursement. We have experienced a 1 percent reduction in reimbursement related to this CAUTI and associated HAC increase. Porter (2018) estimates CAUTI costs to be over $10,000. To give this number a little more impact, the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative reported in 2015 that there was a total of $330 million dollars lost in Hospital Acquired Conditions penalties across 721 facilities.

    Our nurses have identified CAUTI in their patients with indwelling catheters as a concern as well as other Hospital Acquired Conditions. Recognizing that they are the first line of defense for patient safety, our nurses are participating in a hospital wide Acquired Condition Reduction Program modeled after the Centers for Medicare and Medicaid services (n.d). Our initiative looks at all infections acquired during treatment in this facility. I encourage you to look at this website. As a nurse you are the leader of healthcare quality, we depend upon you as the expert in patient care. YOU are extremely powerful in contributing to patient care in not only preventing CAUTIs but in providing a timely reporting of needed data in the Press Ganey surveys so that our data is contributed to NDNQI.

    You May Ask… How Can I Help?

    Nurses have an essential role within the interdisciplinary healthcare team. They are responsible for collecting and reporting data for the NDNQI. The data collected will contribute to improved outcomes, improved patient safety, and an overall improved patient experience. In our facility we provide the data using online surveys received from Press Ganey, all members of the interdisciplinary healthcare team receive the surveys. In a personal communication, our Chief Nursing Officer, Dr. Smith, underscored that the current facility best practice is to check your hospital email every day you work and complete any surveys sent to you. The data is very easy to enter into the survey. Dr. Smith stated that in the beginning there was a lot of lag time between data entry by the interdisciplinary team and the time the survey was sent out but that has improved. We have a quality team at the hospital responsible for supplying the general data related to CAUTIs. Other data provided to Press Ganey includes incident reports, patient admission dates, length or stay, readmission data, number of patients with catheters vs patients with CAUTIs diagnosed in facility vs after discharge. To learn more about Press Ganey please go to their website.

    Your job as a nurse is to provide care according to the current practice policies, complete all required documentation which includes all popups on CAUTIs and then to enter data when emailed a survey from Press Ganey. Your role is incredibly powerful in this initiative because as you know we have a huge amount of responsibility in placing, caring for and assessing indwelling catheters and straight caths. Imagine if your work in completing all required documentation and some quick online surveys prevents future CAUTIs, the impact would be huge!

    I would now like to discuss what we do WITH THE DATA

    The data you provide, and which is found in the patient records provides insights into how the nursing care and interventions we provide influence patient outcomes. The data found within the NDNQI gives healthcare leaders an understand of what actions influence quality and patient safety. Within the NDNQI the data is trended and the themes and or statistical information is pulled out to help guide safety and quality initiatives.

    Within this organization we have quality improvement teams on each unit where data from NDNQI and plans for improving quality are shared. We use the data for guiding us in creating quality improvement plans and ensuring patient safety. Quality improvement teams on your unit will share updates with the NDNQI data and how we plan to use the data.

    As we wrap up I’d like to share some ideas about how your actions IMPACT HEALTH CARE IN GENERAL

    Your involvement in accurate charting and completing surveys provides data used for the greater science of nursing. This information helps the nursing profession to identify nurse-sensitive indicators of quality to use for improvement in our patient care. Our nursing leaders use the NDNQI data to determine the best practices for their unit and facility to improve both quality care outcomes and workplace safety, including nurse patient staffing ratios.

    Our facility models itself after the 2015 Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative Policy Brief for not only quality and safety improvement, but to achieve higher outcome-based hospital payments. Our Value Based Purchasing program provides acute care facilities incentive money when the facility has good performance on quality measurements and makes improvements in the facilities quality and safety of care. There is also an overlap of the Value Based Purchasing program and the Medicare reimbursement program so facilities are able to potentially have double the financial benefit because the nurse sensitive outcomes influence the requirements for full reimbursement from Medicare. John Hopkin’s hospital has been a leader in using the NDNQI data to make improvements in safety and quality with a 41% reduction in CAUTIs with the use of national data on nursing interventions from NDNQI. Nursing leaders need to work to ensure they use the data from the nursing sensitive outcomes to make improvements in care within individual facilities and units.

    In CONCLUSION

    Our involvement in NDNQI is a wonderful and positive influence on the profession of nursing and patient care. Your responsibility is to ensure you have accurate and complete documentation and to complete any Press Ganey surveys you receive. Our role as a facility is to provide all additional data to NDNQI and to support you in your work while focusing on quality improvement and sharing data with you from NDNQI and our quality improvement work. The success of NDNQI is relying on our commitment to provide data in a timely manner and then to use the national data to make improvements at the facility. Nurses are at the front line of quality improvement and evidence-based practice. We can all make a huge improvement in patient care. You are a valuable asset to our team!

    Thank you!

    – 1
    – 2
    – 3

  • [Solved] Patient care

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    Executive Solution Overview

    **Question (70 Marks):** Critically analyze the role of a professional nurse in promoting holistic patient care within a multidisciplinary healthcare environment. In your discussion, examine how ethical principles, effective communication, evidence-based practice, and leadership contribute to qualit…

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    Assignment Prompt & Instructions

    **Question (70 Marks):**
    Critically analyze the role of a professional nurse in promoting holistic patient care within a multidisciplinary healthcare environment. In your discussion, examine how ethical principles, effective communication, evidence-based practice, and leadership contribute to quality healthcare delivery and patient outcomes. Support your answer with relevant examples and scholarly references.

  • [Solved] NEED ASSISGNMENT 10/29/2025. THIS IS 2 ASSISGNMENTS..NO PLAGARISM.

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    THIS IS 2 ASSIGNMENT. NEED ASSISIGNMENT FOR EACH OPTION BELOW read or listen to the presentation and write 2-3 paragraphs about 2 take home points from this presentation. Upload this to the extra credit drop box. Each topic is worth 2 points. You may earn a maximum of 10 extra credit points. The dro…

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    THIS IS 2 ASSIGNMENT. NEED ASSISIGNMENT FOR EACH OPTION BELOW
    read or listen to the presentation and write 2-3 paragraphs about 2 take home points from this presentation. Upload this to the extra credit drop box.
    Each topic is worth 2 points. You may earn a maximum of 10 extra credit points. The drop box allows you to upload more than one item.
    **Module 4 Unit B**
    1. EBB podcast on membrane sweeping
    2. EBB podcast on mechanical cervical ripening

  • [Solved] week 9

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    instructions and readings attached – ## week9.pdf – ## 511Excerpt.pdf – TurningtheTablesText.pdf **## week9.pdf** Answer the following questions 1. Have you had personal negotiations experience in which you either did or did not adequately prepare? Explain. 2. You will be leading collective bargai…

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    instructions and readings attached

    – ## week9.pdf

    – ## 511Excerpt.pdf

    – TurningtheTablesText.pdf

    **## week9.pdf**

    Answer the following questions

    1. Have you had personal negotiations experience in which you either did or did not
    adequately prepare? Explain.

    2. You will be leading collective bargaining for a union of nursing home workers at a
    large nursing home in San Francisco. Please tell us the first three (most
    important) steps you will take. Why are these the most important?

    3. Based on this week’s lecture and readings etc., compare the approaches to
    bargaining preparation. Are there differences? Explain.

    Reference:
    https://mronline.org/2014/04/05/rachleff050414-html-2/

    [https://mronline.org/2014/04/05/rachleff050414-html-2/](https://mronline.org/2014/04/05/rachleff050414-html-2/)

    **## 511Excerpt.pdf**

    Cornell University Press
    ILR Press

    Chapter Title: The Negotiations Process and Strikes

    Book Title: An Introduction to U.S. Collective Bargaining and Labor Relations
    Book Author(s): Harry C. Katz, Thomas A. Kochan and Alexander J. S. Colvin
    Published by: Cornell University Press, ILR Press. (2017)
    Stable URL: http://www.jstor.org/stable/10.7591/j.ctt1vjqr3z.13

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    200 Part III. The Functional Level of Labor Relations

    Thus, management has tried to shift away from factors such as wages in the
    industry or increases in the cost of living and toward the fi rm ’ s ability to pay.

    Internal Comparisons
    Every negotiation is carefully watched by a fi rm ’ s other employees. Management
    must consider how a wage settlement might infl uence the expectations and
    demands of other employees in the fi rm regardless of whether those employees
    are represented by unions. Management, for example, often considers whether
    wage increases for unionized hourly workers will lead to pay increases for supervisors
    and other white-collar employees outside the bargaining unit. One reason manage-
    ment give pay increases to white-collar employees is such increases weaken these
    employees’ potential attraction to unionization.

    The Dynamics of Management ’ s Decision-Making Process
    So far we have painted a rather static picture of management ’ s decision making.
    Yet the actual process of decision making over the course of a bargaining cycle
    (from the pre-negotiation planning stage to the signing of the fi nal agreement)
    is a dynamic one. The process is replete with ambiguities over who has the
    authority to set policies, confl icts among decision makers over the appropriate
    weight to be attached to different goals, and power struggles among competing
    decision makers.

    The process by which management establishes bargaining strategies involves
    extensive intraorganizational bargaining that is every bit as intense as the bargaining
    between the union and management. Because the successful resolution of internal
    differences is a prerequisite to a smoothly functioning bargaining process, it is
    important to understand how fi rms prepare for negotiations.

    To provide a more complete picture of how management prepares for collective
    bargaining, Box 8.2 describes a typical case. This fi rm is preparing to negotiate
    a contract with the major bargaining unit in its largest manufacturing facility.
    The contract traditionally sets the pattern for the economic settlements with
    several smaller units at other locations.

    Before negotiations (or very early in negotiations), the labor relations staff tries
    to predict as closely as possible what it will take to get a settlement. But ultimately
    the staff is ready at all times to revise its estimates based on new or better information
    about the union ’ s position as the negotiations proceed.

    The case in Box 8.2 illustrates the diversity of interests that exists in the different
    levels of any modern company. It shows that the development of a company
    strategy for negotiations is a highly political process, one in which the different
    goals of various groups must ultimately be accommodated. Although the labor
    relations staff serves as a key participant in the development of the strategy, the
    concerns of operating management, fi nancial staff, and other interest groups in
    the corporation are also integral to any fi nal decision.

    It is interesting to examine how preparations for traditional negotiations compare
    to preparation for an interest-based bargaining process. Box 8.3 draws on the
    experiences of the same fi rm as it prepared for a recent round of interest-based

    This content downloaded from 130.212.18.96 on Tue, 19 Jun 2018 14:02:03 UTC
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    Diane Frey

    Start Here

    Diane Frey

    Diane Frey

    The Negotiations Process and Strikes 201

    BOX 8.2
    Management ’ s Preparations for Negotiations in a Typical Firm

    Stage One: Input from the Plants

    The fi rst step in the process of preparing for negotiations takes place at the
    plant level. 7 The plant labor relations staff holds meetings with plant supervisors
    to discuss problems they have experienced in administering the existing
    contract. From these discussions, the staff compiles a list of suggested contract
    changes. At the same time, the staff also conducts a systematic review of
    the grievances that have arisen under the current contract and collects
    information on local labor market conditions and on the wages in other
    fi rms in the community.

    The staff then holds a meeting with the plant manager, who raises the
    industrial relations problems the company has confronted in the plant. The
    concerns of management are classifi ed into two groups: contractual problems
    and problems that should be addressed outside the negotiating process.
    In addition, the staff asks the plant manager to rank suggested contract
    changes based on their potential for making a signifi cant improvement in
    plant operations.

    Stage Two: Input from Higher Levels of the Firm

    Next, a series of meetings is held at the division level that involves the
    division labor relations staff, operations managers at the division level, and
    the corporate labor relations director and staff. From time to time, outside
    industrial relations consultants sit in on these division-level meetings. Here
    the concerns of the various plants are evaluated against two criteria: (1) the
    operational benefi ts expected from proposed contract changes; and (2) the
    likelihood that the desired changes can be achieved in the negotiations
    process.

    The corporate labor relations staff plays a vital role in these division-level
    discussions, since the expected benefi ts of different contractual changes can
    be a matter of dispute across the various plants. In addition, the division
    labor relations staff is responsible for carefully examining the contract language
    that exists in the various local agreements for inconsistencies or problems
    that could be removed by clauses that refl ect corporate labor relations
    preferences. Sometimes the plant labor relations representatives object to
    changes suggested at the division level because they do not correspond to
    the priorities of the plant offi cials and because the existing “discrepancies”
    may be serving a useful purpose in the plant.

    The corporate labor relations staff works closely with the vice-president
    for fi nance to develop wage targets. Information on plant labor costs,
    corporate earnings, and the long-term fi nancial prospects of the company
    and the industry are built into the wage target the corporate staff ultimately
    recommends.

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    202 Part III. The Functional Level of Labor Relations

    Stage Three: Input from Research

    A research subgroup in the labor relations staff of the company also conducts
    background research that is used in management ’ s preparations for negotiations.
    At least a year and a half before the opening of formal negotiations, the
    research staff begins to prepare the background information necessary for
    developing the company ’ s proposals.

    The researchers use a database on the demographic characteristics of
    employees and analyze personnel statistics such as turnover, absentee, and
    grievance rates. They also monitor internal union developments, specifi cally
    resolutions the union has passed at its conventions, union publications, and
    union leaders’ statements about the upcoming negotiations. In addition, they
    survey plant managers for their views on their relations with the union and
    the problems they would like to see addressed in the negotiations. The staff
    also consults plant labor relations staff members to obtain their suggestions.
    This fi rm probably invests more resources and assigns more authority for
    bargaining preparation to its research staff than do most other corporations.

    The research staff is ultimately responsible for putting together a summary
    report that goes to the vice-president of industrial relations and the corporate
    director of compensation. These executives then work with the manager
    of the research and planning department to develop targets for bargaining.

    Stage Four: Final Preparations

    The fi nal step in management ’ s preparation for negotiations is a meeting
    that includes the corporate labor relations staff, the chief executive offi cer,
    and the board of directors. At this meeting, the corporate labor relations
    director presents the proposed wage targets and other proposed contract
    changes for board approval and states the reasons for seeking the proposed
    changes. Sometimes this meeting does not take place until after the fi rst
    negotiations session with the union. The industrial relations director might
    prefer to wait until then because it may be useful to hear from the union
    before he or she makes a fi nal recommendation to top management. This
    helps the industrial relations director identify the relative importance the
    union is likely to give to pay issues and the intensity of the union ’ s concern
    about other areas of the contract.

    One labor relations director described to us how he presents his recom-
    mendation to top management in this way:

    I always number my proposed target settlements as proposed settlement target
    number 1. Someone once asked me what that meant. I said that this is what I
    think it will take to get a settlement but I number it because I may have to
    come back to you at some point with my proposed settlement number 2 or
    even my proposed settlement number 3, et cetera.

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    204 Part III. The Functional Level of Labor Relations

    We still had discipline at the table. We had chief spokespersons. In fact,
    we got very upset and disappointed when at one point the process broke
    down. When we started talking about overtime, we had already done some
    joint staff work looking at some pilot programs we had started in a couple
    of settings to let the union handle how overtime is distributed. This is
    always a big problem and headache for management, and [it is] a costly
    issue. The staff had pretty much agreed privately to extend the pilot approach
    to the whole bargaining unit, but when the issue came up for discussion,
    the manufacturing representative on our team said: “We ’ d never agree to
    that!” We read him the riot act later in private for springing this on us, but
    it essentially killed discussion of this issue, and we never did get the job
    done on this issue.

    As we got into the tough economic issues, bargaining took on more
    traditional features. These were very tough and the union leaders needed
    to be able to demonstrate to their constituents [that] they squeezed us as
    hard as they could to get the best deal possible. We understood this.

    Still, there was better communications, and we never worked past 8 p.m.

    bargaining. While much of the background research and information gathering
    is similar, some of this is done jointly with the union. In this case, the problem-
    solving processes that had been put in place in the company-union relationship
    at the workplace provided the foundation for taking a problem-solving approach
    to negotiations.

    UNIONS’ AND WORKERS’ PREPARATIONS FOR
    NEGOTIATIONS

    This section reviews the common procedures unions and workers follow during
    the negotiation of a collective bargaining contract. This material parallels the
    discussion of the procedures used by management in preparing for negotiations
    described above.

    The Role of the Union Negotiating Committee
    The union is represented by a negotiating committee in negotiations with manage-
    ment. The makeup of the union negotiating committee varies across unions,
    although it typically includes some union offi cers, support staff (such as members
    of the local or the national union ’ s research staff or both), and elected worker
    representatives. Often the leaders of the union ’ s negotiating committee are the
    highest elected offi cers of the union that is covered by the collective bargaining
    agreement under negotiation. Some unions, such as local construction, hotel and
    restaurant, or trucking unions, tend to rely on hired business agents to lead their
    negotiations.

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    The Negotiations Process and Strikes 205

    The negotiating committee will meet several times before the start of negotia-
    tions to formulate the union ’ s list of demands and to begin to establish expecta-
    tions about what the union can win in negotiations. Before these meetings,
    the negotiating committee will solicit demands from union members, either
    directly through meetings called to discuss the upcoming negotiations or through
    polls. In the UAW, for example, elected representatives from the local unions
    meet in a convention and vote on bargaining resolutions during preparations for
    companywide bargaining. The UAW leadership also consults union members
    during the negotiation of plant contracts that supplement the companywide
    agreements.

    A union negotiating committee typically also receives information and
    advice from the national union ’ s research staff during its preparations for
    bargaining. The information provided frequently covers the fi nancial perfor-
    mance of the company, forecasts the future performance of the company and
    the economy, and summarizes recent settlements in other unions or the pay
    improvements unorganized workers in the same city, fi rm, or industry have
    received.

    Some unions, such as the Air Line Pilots Association (ALPA), do extensive
    research and analysis of economic developments in their industry and of the
    fi nancial situation of each company. Prior to entering negotiations, the ALPA
    research staff conducts extensive briefi ngs with the bargaining committee of an
    airline and in some cases, such as at Continental Airlines, meets with company
    representatives to compare fi nancial data and analysis. It is not uncommon for
    union and company research staff to share information with each other if for no
    other reason than to avoid debates over some of the basic facts each side needs
    to prepare their team for negotiations.

    Many unions now use surveys, focus groups, and/or direct interviews with
    rank-and-fi le members to gather information about their concerns and their priorities
    for negotiations. This serves as a two-way communications process. It both provides
    data on the priorities of rank-and-fi le members and begins to engage the rank
    and fi le in the negotiations process by informing them of some of the issues that
    may come up.

    Acquisition of Strike Authorization If an Impasse
    Is Reached
    If the union comes to an impasse with management during the negotiations and
    is considering going on strike over unresolved disputes, two steps occur. In local
    contract negotiations, the union ’ s constitution typically requires the local to seek
    strike authorization from the national union. Strike approval is an important
    process because, among other things, it enables striking workers to receive strike
    benefi ts from the national union ’ s strike fund.

    A union considering a strike will also typically poll its members. The strike
    vote serves a dual purpose: it tells the union leadership whether the union ’ s
    members support such an action and it helps rally the workers around the purpose
    of the strike.

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    206 Part III. The Functional Level of Labor Relations

    Contract Ratifi cation
    When an agreement is reached between the union ’ s negotiating committee and
    management ’ s representatives, the union proceeds through its contract ratifi cation
    procedures. Here there is much variation in the exact procedures unions use.
    The fi rst step some unions take is to send a proposed agreement to a council
    made up of lower-level union offi cers. This council includes local union offi cers
    when a companywide agreement is negotiated (as in the steel and auto industries).
    Union constitutions typically also require that the workers covered by a negotiated
    agreement vote on any proposed settlement.

    There are some notable exceptions to the normal pattern of union members
    voting on proposed contracts. But in the usual case, workers must approve contract
    settlements, often by majority vote. This sort of voting is an example of participatory
    democracy in this critical aspect of union decision making.

    The Role of Union Leaders in Shaping Strategies
    The actual bargaining demands of unions refl ect more than just an averaging of
    their members’ preferences. Several factors combine to produce the complex
    process by which union leaders arrive at their bargaining objectives.

    First, in addition to considering the preferences of their members, union leaders
    must evaluate how likely it is that objectives can be attained. Unrealistic goals
    must be discarded during pre-negotiation planning sessions or early on in
    negotiations.

    Second, union leaders must take into account the varying political infl uence
    of subgroups within the union. Older or more skilled workers, for example, may
    be more politically infl uential than other members. Thus, the objectives leaders
    ultimately select may refl ect some workers’ goals more than others.

    Third, union leaders must also be concerned about the long-term survival of
    the union and must take steps to preserve those interests. However, there is always
    the risk that union leaders will emphasize union security at the expense of
    member preferences.

    Finally, a central job for union leaders, like all leaders, is to lead! Union leaders
    must weigh strategic options, make decisions, and secure the ongoing support of
    their members for the decisions they make.

    One of the keys to union leadership is effective internal communication. Union
    leaders need regular upward communication from the rank and fi le and from
    local union offi cers. Effective union leadership also requires that decision makers
    communicate their activities and decisions back to the members. Unions use such
    techniques as opinion surveys, satellite hookups, television advertising, and the
    Internet to communicate with their members. Indeed, the Internet is becoming
    a key resource in bargaining today. Union leaders are learning that they must
    develop the skill to use this tool to communicate with members, for it is certain
    that rival groups in the union will have those skills. In one case, ALPA found
    that the tentative wage agreement it had reached with Delta Airlines was criticized
    on a rival group ’ s website before the union team could even describe its terms
    to union members! Thus, the means of communication in unions and the role

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    The Negotiations Process and Strikes 207

    of communications in negotiations in general are changing rapidly in the age of
    the Internet.

    THE CYCLE OF TRADITIONAL NEGOTIATIONS

    Negotiations often proceed through a cycle in which the four subprocesses of
    bargaining emerge and interrelate. 8 A typical cycle for a traditional negotiations
    process is described below.

    The Early Stages
    In the initial stage of a traditional negotiation, the parties present their opening
    proposals. This stage often involves a larger number of people than will be involved
    in the negotiations of the fi nal agreement. The union, for example, may bring
    in representatives from various interest groups and several levels of the union
    hierarchy. These people participate in developing the initial proposals and later
    become involved in securing ratifi cation of any agreement. The involvement of
    all these different representatives can smooth the process of intraorganizational
    bargaining in the union.

    The union then presents proposals that cover the entire range of its concerns.
    Some of the proposals will be of critical importance and will be at the heart of
    the discussions as the strike deadline approaches. Some are important but may
    be traded off at the last minute. Some may be translated into more specifi c
    demands at a later stage of bargaining or may be issues to which the union will
    assign a high priority in some future round of negotiations. Other issues are of
    low priority and will be dropped as negotiations proceed into the serious decision-
    making stages.

    The Presentation of a Laundry List
    The union ’ s presentation of a laundry list of issues serves several purposes. It
    allows union leaders to recognize different interest groups by at least mentioning
    their proposals. Some unrealistic demands will be aired, the problems underlying
    these demands can be explored, and the employer can then reject these demands.
    This process takes the pressure off union offi cers who might otherwise appear to
    have arbitrarily nixed some group ’ s pet proposal. In a laundry list, either side also
    could introduce issues that it hopes will be pursued in future negotiations.

    Presenting a long list of proposals and infl ated demands as a fi rst step might
    also be a useful way to camoufl age the real priorities of the union. Or a long list
    of proposals could be helpful in integrative bargaining by facilitating trades across
    issues.

    Behavior of the Employer in the Early Phase
    The behavior of employers at the outset of bargaining varies considerably. Some
    employers will present a set of proposals to counterbalance the union demands.
    Other employers will receive the union demands and promise a response at a
    future negotiating session. Many management representatives prefer to delay

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    Diane Frey

    Diane Frey

    **TurningtheTablesText.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/turningthetablestext-pdf)

    **TurningtheTablesText.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/turningthetablestext-pdf)

    **## week9.pdf**

    Answer the following questions

    1. Have you had personal negotiations experience in which you either did or did not
    adequately prepare? Explain.

    2. You will be leading collective bargaining for a union of nursing home workers at a
    large nursing home in San Francisco. Please tell us the first three (most
    important) steps you will take. Why are these the most important?

    3. Based on this week’s lecture and readings etc., compare the approaches to
    bargaining preparation. Are there differences? Explain.

    Reference:
    https://mronline.org/2014/04/05/rachleff050414-html-2/

    [https://mronline.org/2014/04/05/rachleff050414-html-2/](https://mronline.org/2014/04/05/rachleff050414-html-2/)

    **## 511Excerpt.pdf**

    Cornell University Press
    ILR Press

    Chapter Title: The Negotiations Process and Strikes

    Book Title: An Introduction to U.S. Collective Bargaining and Labor Relations
    Book Author(s): Harry C. Katz, Thomas A. Kochan and Alexander J. S. Colvin
    Published by: Cornell University Press, ILR Press. (2017)
    Stable URL: http://www.jstor.org/stable/10.7591/j.ctt1vjqr3z.13

    JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide

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    Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at

    http://about.jstor.org/terms

    Cornell University Press, ILR Press are collaborating with JSTOR to digitize, preserve and
    extend access to An Introduction to U.S. Collective Bargaining and Labor Relations

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    200 Part III. The Functional Level of Labor Relations

    Thus, management has tried to shift away from factors such as wages in the
    industry or increases in the cost of living and toward the fi rm ’ s ability to pay.

    Internal Comparisons
    Every negotiation is carefully watched by a fi rm ’ s other employees. Management
    must consider how a wage settlement might infl uence the expectations and
    demands of other employees in the fi rm regardless of whether those employees
    are represented by unions. Management, for example, often considers whether
    wage increases for unionized hourly workers will lead to pay increases for supervisors
    and other white-collar employees outside the bargaining unit. One reason manage-
    ment give pay increases to white-collar employees is such increases weaken these
    employees’ potential attraction to unionization.

    The Dynamics of Management ’ s Decision-Making Process
    So far we have painted a rather static picture of management ’ s decision making.
    Yet the actual process of decision making over the course of a bargaining cycle
    (from the pre-negotiation planning stage to the signing of the fi nal agreement)
    is a dynamic one. The process is replete with ambiguities over who has the
    authority to set policies, confl icts among decision makers over the appropriate
    weight to be attached to different goals, and power struggles among competing
    decision makers.

    The process by which management establishes bargaining strategies involves
    extensive intraorganizational bargaining that is every bit as intense as the bargaining
    between the union and management. Because the successful resolution of internal
    differences is a prerequisite to a smoothly functioning bargaining process, it is
    important to understand how fi rms prepare for negotiations.

    To provide a more complete picture of how management prepares for collective
    bargaining, Box 8.2 describes a typical case. This fi rm is preparing to negotiate
    a contract with the major bargaining unit in its largest manufacturing facility.
    The contract traditionally sets the pattern for the economic settlements with
    several smaller units at other locations.

    Before negotiations (or very early in negotiations), the labor relations staff tries
    to predict as closely as possible what it will take to get a settlement. But ultimately
    the staff is ready at all times to revise its estimates based on new or better information
    about the union ’ s position as the negotiations proceed.

    The case in Box 8.2 illustrates the diversity of interests that exists in the different
    levels of any modern company. It shows that the development of a company
    strategy for negotiations is a highly political process, one in which the different
    goals of various groups must ultimately be accommodated. Although the labor
    relations staff serves as a key participant in the development of the strategy, the
    concerns of operating management, fi nancial staff, and other interest groups in
    the corporation are also integral to any fi nal decision.

    It is interesting to examine how preparations for traditional negotiations compare
    to preparation for an interest-based bargaining process. Box 8.3 draws on the
    experiences of the same fi rm as it prepared for a recent round of interest-based

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    Diane Frey

    Start Here

    Diane Frey

    Diane Frey

    The Negotiations Process and Strikes 201

    BOX 8.2
    Management ’ s Preparations for Negotiations in a Typical Firm

    Stage One: Input from the Plants

    The fi rst step in the process of preparing for negotiations takes place at the
    plant level. 7 The plant labor relations staff holds meetings with plant supervisors
    to discuss problems they have experienced in administering the existing
    contract. From these discussions, the staff compiles a list of suggested contract
    changes. At the same time, the staff also conducts a systematic review of
    the grievances that have arisen under the current contract and collects
    information on local labor market conditions and on the wages in other
    fi rms in the community.

    The staff then holds a meeting with the plant manager, who raises the
    industrial relations problems the company has confronted in the plant. The
    concerns of management are classifi ed into two groups: contractual problems
    and problems that should be addressed outside the negotiating process.
    In addition, the staff asks the plant manager to rank suggested contract
    changes based on their potential for making a signifi cant improvement in
    plant operations.

    Stage Two: Input from Higher Levels of the Firm

    Next, a series of meetings is held at the division level that involves the
    division labor relations staff, operations managers at the division level, and
    the corporate labor relations director and staff. From time to time, outside
    industrial relations consultants sit in on these division-level meetings. Here
    the concerns of the various plants are evaluated against two criteria: (1) the
    operational benefi ts expected from proposed contract changes; and (2) the
    likelihood that the desired changes can be achieved in the negotiations
    process.

    The corporate labor relations staff plays a vital role in these division-level
    discussions, since the expected benefi ts of different contractual changes can
    be a matter of dispute across the various plants. In addition, the division
    labor relations staff is responsible for carefully examining the contract language
    that exists in the various local agreements for inconsistencies or problems
    that could be removed by clauses that refl ect corporate labor relations
    preferences. Sometimes the plant labor relations representatives object to
    changes suggested at the division level because they do not correspond to
    the priorities of the plant offi cials and because the existing “discrepancies”
    may be serving a useful purpose in the plant.

    The corporate labor relations staff works closely with the vice-president
    for fi nance to develop wage targets. Information on plant labor costs,
    corporate earnings, and the long-term fi nancial prospects of the company
    and the industry are built into the wage target the corporate staff ultimately
    recommends.

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    202 Part III. The Functional Level of Labor Relations

    Stage Three: Input from Research

    A research subgroup in the labor relations staff of the company also conducts
    background research that is used in management ’ s preparations for negotiations.
    At least a year and a half before the opening of formal negotiations, the
    research staff begins to prepare the background information necessary for
    developing the company ’ s proposals.

    The researchers use a database on the demographic characteristics of
    employees and analyze personnel statistics such as turnover, absentee, and
    grievance rates. They also monitor internal union developments, specifi cally
    resolutions the union has passed at its conventions, union publications, and
    union leaders’ statements about the upcoming negotiations. In addition, they
    survey plant managers for their views on their relations with the union and
    the problems they would like to see addressed in the negotiations. The staff
    also consults plant labor relations staff members to obtain their suggestions.
    This fi rm probably invests more resources and assigns more authority for
    bargaining preparation to its research staff than do most other corporations.

    The research staff is ultimately responsible for putting together a summary
    report that goes to the vice-president of industrial relations and the corporate
    director of compensation. These executives then work with the manager
    of the research and planning department to develop targets for bargaining.

    Stage Four: Final Preparations

    The fi nal step in management ’ s preparation for negotiations is a meeting
    that includes the corporate labor relations staff, the chief executive offi cer,
    and the board of directors. At this meeting, the corporate labor relations
    director presents the proposed wage targets and other proposed contract
    changes for board approval and states the reasons for seeking the proposed
    changes. Sometimes this meeting does not take place until after the fi rst
    negotiations session with the union. The industrial relations director might
    prefer to wait until then because it may be useful to hear from the union
    before he or she makes a fi nal recommendation to top management. This
    helps the industrial relations director identify the relative importance the
    union is likely to give to pay issues and the intensity of the union ’ s concern
    about other areas of the contract.

    One labor relations director described to us how he presents his recom-
    mendation to top management in this way:

    I always number my proposed target settlements as proposed settlement target
    number 1. Someone once asked me what that meant. I said that this is what I
    think it will take to get a settlement but I number it because I may have to
    come back to you at some point with my proposed settlement number 2 or
    even my proposed settlement number 3, et cetera.

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    204 Part III. The Functional Level of Labor Relations

    We still had discipline at the table. We had chief spokespersons. In fact,
    we got very upset and disappointed when at one point the process broke
    down. When we started talking about overtime, we had already done some
    joint staff work looking at some pilot programs we had started in a couple
    of settings to let the union handle how overtime is distributed. This is
    always a big problem and headache for management, and [it is] a costly
    issue. The staff had pretty much agreed privately to extend the pilot approach
    to the whole bargaining unit, but when the issue came up for discussion,
    the manufacturing representative on our team said: “We ’ d never agree to
    that!” We read him the riot act later in private for springing this on us, but
    it essentially killed discussion of this issue, and we never did get the job
    done on this issue.

    As we got into the tough economic issues, bargaining took on more
    traditional features. These were very tough and the union leaders needed
    to be able to demonstrate to their constituents [that] they squeezed us as
    hard as they could to get the best deal possible. We understood this.

    Still, there was better communications, and we never worked past 8 p.m.

    bargaining. While much of the background research and information gathering
    is similar, some of this is done jointly with the union. In this case, the problem-
    solving processes that had been put in place in the company-union relationship
    at the workplace provided the foundation for taking a problem-solving approach
    to negotiations.

    UNIONS’ AND WORKERS’ PREPARATIONS FOR
    NEGOTIATIONS

    This section reviews the common procedures unions and workers follow during
    the negotiation of a collective bargaining contract. This material parallels the
    discussion of the procedures used by management in preparing for negotiations
    described above.

    The Role of the Union Negotiating Committee
    The union is represented by a negotiating committee in negotiations with manage-
    ment. The makeup of the union negotiating committee varies across unions,
    although it typically includes some union offi cers, support staff (such as members
    of the local or the national union ’ s research staff or both), and elected worker
    representatives. Often the leaders of the union ’ s negotiating committee are the
    highest elected offi cers of the union that is covered by the collective bargaining
    agreement under negotiation. Some unions, such as local construction, hotel and
    restaurant, or trucking unions, tend to rely on hired business agents to lead their
    negotiations.

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    The Negotiations Process and Strikes 205

    The negotiating committee will meet several times before the start of negotia-
    tions to formulate the union ’ s list of demands and to begin to establish expecta-
    tions about what the union can win in negotiations. Before these meetings,
    the negotiating committee will solicit demands from union members, either
    directly through meetings called to discuss the upcoming negotiations or through
    polls. In the UAW, for example, elected representatives from the local unions
    meet in a convention and vote on bargaining resolutions during preparations for
    companywide bargaining. The UAW leadership also consults union members
    during the negotiation of plant contracts that supplement the companywide
    agreements.

    A union negotiating committee typically also receives information and
    advice from the national union ’ s research staff during its preparations for
    bargaining. The information provided frequently covers the fi nancial perfor-
    mance of the company, forecasts the future performance of the company and
    the economy, and summarizes recent settlements in other unions or the pay
    improvements unorganized workers in the same city, fi rm, or industry have
    received.

    Some unions, such as the Air Line Pilots Association (ALPA), do extensive
    research and analysis of economic developments in their industry and of the
    fi nancial situation of each company. Prior to entering negotiations, the ALPA
    research staff conducts extensive briefi ngs with the bargaining committee of an
    airline and in some cases, such as at Continental Airlines, meets with company
    representatives to compare fi nancial data and analysis. It is not uncommon for
    union and company research staff to share information with each other if for no
    other reason than to avoid debates over some of the basic facts each side needs
    to prepare their team for negotiations.

    Many unions now use surveys, focus groups, and/or direct interviews with
    rank-and-fi le members to gather information about their concerns and their priorities
    for negotiations. This serves as a two-way communications process. It both provides
    data on the priorities of rank-and-fi le members and begins to engage the rank
    and fi le in the negotiations process by informing them of some of the issues that
    may come up.

    Acquisition of Strike Authorization If an Impasse
    Is Reached
    If the union comes to an impasse with management during the negotiations and
    is considering going on strike over unresolved disputes, two steps occur. In local
    contract negotiations, the union ’ s constitution typically requires the local to seek
    strike authorization from the national union. Strike approval is an important
    process because, among other things, it enables striking workers to receive strike
    benefi ts from the national union ’ s strike fund.

    A union considering a strike will also typically poll its members. The strike
    vote serves a dual purpose: it tells the union leadership whether the union ’ s
    members support such an action and it helps rally the workers around the purpose
    of the strike.

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    Diane Frey

    206 Part III. The Functional Level of Labor Relations

    Contract Ratifi cation
    When an agreement is reached between the union ’ s negotiating committee and
    management ’ s representatives, the union proceeds through its contract ratifi cation
    procedures. Here there is much variation in the exact procedures unions use.
    The fi rst step some unions take is to send a proposed agreement to a council
    made up of lower-level union offi cers. This council includes local union offi cers
    when a companywide agreement is negotiated (as in the steel and auto industries).
    Union constitutions typically also require that the workers covered by a negotiated
    agreement vote on any proposed settlement.

    There are some notable exceptions to the normal pattern of union members
    voting on proposed contracts. But in the usual case, workers must approve contract
    settlements, often by majority vote. This sort of voting is an example of participatory
    democracy in this critical aspect of union decision making.

    The Role of Union Leaders in Shaping Strategies
    The actual bargaining demands of unions refl ect more than just an averaging of
    their members’ preferences. Several factors combine to produce the complex
    process by which union leaders arrive at their bargaining objectives.

    First, in addition to considering the preferences of their members, union leaders
    must evaluate how likely it is that objectives can be attained. Unrealistic goals
    must be discarded during pre-negotiation planning sessions or early on in
    negotiations.

    Second, union leaders must take into account the varying political infl uence
    of subgroups within the union. Older or more skilled workers, for example, may
    be more politically infl uential than other members. Thus, the objectives leaders
    ultimately select may refl ect some workers’ goals more than others.

    Third, union leaders must also be concerned about the long-term survival of
    the union and must take steps to preserve those interests. However, there is always
    the risk that union leaders will emphasize union security at the expense of
    member preferences.

    Finally, a central job for union leaders, like all leaders, is to lead! Union leaders
    must weigh strategic options, make decisions, and secure the ongoing support of
    their members for the decisions they make.

    One of the keys to union leadership is effective internal communication. Union
    leaders need regular upward communication from the rank and fi le and from
    local union offi cers. Effective union leadership also requires that decision makers
    communicate their activities and decisions back to the members. Unions use such
    techniques as opinion surveys, satellite hookups, television advertising, and the
    Internet to communicate with their members. Indeed, the Internet is becoming
    a key resource in bargaining today. Union leaders are learning that they must
    develop the skill to use this tool to communicate with members, for it is certain
    that rival groups in the union will have those skills. In one case, ALPA found
    that the tentative wage agreement it had reached with Delta Airlines was criticized
    on a rival group ’ s website before the union team could even describe its terms
    to union members! Thus, the means of communication in unions and the role

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    The Negotiations Process and Strikes 207

    of communications in negotiations in general are changing rapidly in the age of
    the Internet.

    THE CYCLE OF TRADITIONAL NEGOTIATIONS

    Negotiations often proceed through a cycle in which the four subprocesses of
    bargaining emerge and interrelate. 8 A typical cycle for a traditional negotiations
    process is described below.

    The Early Stages
    In the initial stage of a traditional negotiation, the parties present their opening
    proposals. This stage often involves a larger number of people than will be involved
    in the negotiations of the fi nal agreement. The union, for example, may bring
    in representatives from various interest groups and several levels of the union
    hierarchy. These people participate in developing the initial proposals and later
    become involved in securing ratifi cation of any agreement. The involvement of
    all these different representatives can smooth the process of intraorganizational
    bargaining in the union.

    The union then presents proposals that cover the entire range of its concerns.
    Some of the proposals will be of critical importance and will be at the heart of
    the discussions as the strike deadline approaches. Some are important but may
    be traded off at the last minute. Some may be translated into more specifi c
    demands at a later stage of bargaining or may be issues to which the union will
    assign a high priority in some future round of negotiations. Other issues are of
    low priority and will be dropped as negotiations proceed into the serious decision-
    making stages.

    The Presentation of a Laundry List
    The union ’ s presentation of a laundry list of issues serves several purposes. It
    allows union leaders to recognize different interest groups by at least mentioning
    their proposals. Some unrealistic demands will be aired, the problems underlying
    these demands can be explored, and the employer can then reject these demands.
    This process takes the pressure off union offi cers who might otherwise appear to
    have arbitrarily nixed some group ’ s pet proposal. In a laundry list, either side also
    could introduce issues that it hopes will be pursued in future negotiations.

    Presenting a long list of proposals and infl ated demands as a fi rst step might
    also be a useful way to camoufl age the real priorities of the union. Or a long list
    of proposals could be helpful in integrative bargaining by facilitating trades across
    issues.

    Behavior of the Employer in the Early Phase
    The behavior of employers at the outset of bargaining varies considerably. Some
    employers will present a set of proposals to counterbalance the union demands.
    Other employers will receive the union demands and promise a response at a
    future negotiating session. Many management representatives prefer to delay

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    Diane Frey

    **TurningtheTablesText.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/turningthetablestext-pdf)

    **## week9.pdf**

    Answer the following questions

    1. Have you had personal negotiations experience in which you either did or did not
    adequately prepare? Explain.

    2. You will be leading collective bargaining for a union of nursing home workers at a
    large nursing home in San Francisco. Please tell us the first three (most
    important) steps you will take. Why are these the most important?

    3. Based on this week’s lecture and readings etc., compare the approaches to
    bargaining preparation. Are there differences? Explain.

    Reference:
    https://mronline.org/2014/04/05/rachleff050414-html-2/

    [https://mronline.org/2014/04/05/rachleff050414-html-2/](https://mronline.org/2014/04/05/rachleff050414-html-2/)

    **## 511Excerpt.pdf**

    Cornell University Press
    ILR Press

    Chapter Title: The Negotiations Process and Strikes

    Book Title: An Introduction to U.S. Collective Bargaining and Labor Relations
    Book Author(s): Harry C. Katz, Thomas A. Kochan and Alexander J. S. Colvin
    Published by: Cornell University Press, ILR Press. (2017)
    Stable URL: http://www.jstor.org/stable/10.7591/j.ctt1vjqr3z.13

    JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide

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    Cornell University Press, ILR Press are collaborating with JSTOR to digitize, preserve and
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    200 Part III. The Functional Level of Labor Relations

    Thus, management has tried to shift away from factors such as wages in the
    industry or increases in the cost of living and toward the fi rm ’ s ability to pay.

    Internal Comparisons
    Every negotiation is carefully watched by a fi rm ’ s other employees. Management
    must consider how a wage settlement might infl uence the expectations and
    demands of other employees in the fi rm regardless of whether those employees
    are represented by unions. Management, for example, often considers whether
    wage increases for unionized hourly workers will lead to pay increases for supervisors
    and other white-collar employees outside the bargaining unit. One reason manage-
    ment give pay increases to white-collar employees is such increases weaken these
    employees’ potential attraction to unionization.

    The Dynamics of Management ’ s Decision-Making Process
    So far we have painted a rather static picture of management ’ s decision making.
    Yet the actual process of decision making over the course of a bargaining cycle
    (from the pre-negotiation planning stage to the signing of the fi nal agreement)
    is a dynamic one. The process is replete with ambiguities over who has the
    authority to set policies, confl icts among decision makers over the appropriate
    weight to be attached to different goals, and power struggles among competing
    decision makers.

    The process by which management establishes bargaining strategies involves
    extensive intraorganizational bargaining that is every bit as intense as the bargaining
    between the union and management. Because the successful resolution of internal
    differences is a prerequisite to a smoothly functioning bargaining process, it is
    important to understand how fi rms prepare for negotiations.

    To provide a more complete picture of how management prepares for collective
    bargaining, Box 8.2 describes a typical case. This fi rm is preparing to negotiate
    a contract with the major bargaining unit in its largest manufacturing facility.
    The contract traditionally sets the pattern for the economic settlements with
    several smaller units at other locations.

    Before negotiations (or very early in negotiations), the labor relations staff tries
    to predict as closely as possible what it will take to get a settlement. But ultimately
    the staff is ready at all times to revise its estimates based on new or better information
    about the union ’ s position as the negotiations proceed.

    The case in Box 8.2 illustrates the diversity of interests that exists in the different
    levels of any modern company. It shows that the development of a company
    strategy for negotiations is a highly political process, one in which the different
    goals of various groups must ultimately be accommodated. Although the labor
    relations staff serves as a key participant in the development of the strategy, the
    concerns of operating management, fi nancial staff, and other interest groups in
    the corporation are also integral to any fi nal decision.

    It is interesting to examine how preparations for traditional negotiations compare
    to preparation for an interest-based bargaining process. Box 8.3 draws on the
    experiences of the same fi rm as it prepared for a recent round of interest-based

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    Start Here

    Diane Frey

    Diane Frey

    The Negotiations Process and Strikes 201

    BOX 8.2
    Management ’ s Preparations for Negotiations in a Typical Firm

    Stage One: Input from the Plants

    The fi rst step in the process of preparing for negotiations takes place at the
    plant level. 7 The plant labor relations staff holds meetings with plant supervisors
    to discuss problems they have experienced in administering the existing
    contract. From these discussions, the staff compiles a list of suggested contract
    changes. At the same time, the staff also conducts a systematic review of
    the grievances that have arisen under the current contract and collects
    information on local labor market conditions and on the wages in other
    fi rms in the community.

    The staff then holds a meeting with the plant manager, who raises the
    industrial relations problems the company has confronted in the plant. The
    concerns of management are classifi ed into two groups: contractual problems
    and problems that should be addressed outside the negotiating process.
    In addition, the staff asks the plant manager to rank suggested contract
    changes based on their potential for making a signifi cant improvement in
    plant operations.

    Stage Two: Input from Higher Levels of the Firm

    Next, a series of meetings is held at the division level that involves the
    division labor relations staff, operations managers at the division level, and
    the corporate labor relations director and staff. From time to time, outside
    industrial relations consultants sit in on these division-level meetings. Here
    the concerns of the various plants are evaluated against two criteria: (1) the
    operational benefi ts expected from proposed contract changes; and (2) the
    likelihood that the desired changes can be achieved in the negotiations
    process.

    The corporate labor relations staff plays a vital role in these division-level
    discussions, since the expected benefi ts of different contractual changes can
    be a matter of dispute across the various plants. In addition, the division
    labor relations staff is responsible for carefully examining the contract language
    that exists in the various local agreements for inconsistencies or problems
    that could be removed by clauses that refl ect corporate labor relations
    preferences. Sometimes the plant labor relations representatives object to
    changes suggested at the division level because they do not correspond to
    the priorities of the plant offi cials and because the existing “discrepancies”
    may be serving a useful purpose in the plant.

    The corporate labor relations staff works closely with the vice-president
    for fi nance to develop wage targets. Information on plant labor costs,
    corporate earnings, and the long-term fi nancial prospects of the company
    and the industry are built into the wage target the corporate staff ultimately
    recommends.

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    202 Part III. The Functional Level of Labor Relations

    Stage Three: Input from Research

    A research subgroup in the labor relations staff of the company also conducts
    background research that is used in management ’ s preparations for negotiations.
    At least a year and a half before the opening of formal negotiations, the
    research staff begins to prepare the background information necessary for
    developing the company ’ s proposals.

    The researchers use a database on the demographic characteristics of
    employees and analyze personnel statistics such as turnover, absentee, and
    grievance rates. They also monitor internal union developments, specifi cally
    resolutions the union has passed at its conventions, union publications, and
    union leaders’ statements about the upcoming negotiations. In addition, they
    survey plant managers for their views on their relations with the union and
    the problems they would like to see addressed in the negotiations. The staff
    also consults plant labor relations staff members to obtain their suggestions.
    This fi rm probably invests more resources and assigns more authority for
    bargaining preparation to its research staff than do most other corporations.

    The research staff is ultimately responsible for putting together a summary
    report that goes to the vice-president of industrial relations and the corporate
    director of compensation. These executives then work with the manager
    of the research and planning department to develop targets for bargaining.

    Stage Four: Final Preparations

    The fi nal step in management ’ s preparation for negotiations is a meeting
    that includes the corporate labor relations staff, the chief executive offi cer,
    and the board of directors. At this meeting, the corporate labor relations
    director presents the proposed wage targets and other proposed contract
    changes for board approval and states the reasons for seeking the proposed
    changes. Sometimes this meeting does not take place until after the fi rst
    negotiations session with the union. The industrial relations director might
    prefer to wait until then because it may be useful to hear from the union
    before he or she makes a fi nal recommendation to top management. This
    helps the industrial relations director identify the relative importance the
    union is likely to give to pay issues and the intensity of the union ’ s concern
    about other areas of the contract.

    One labor relations director described to us how he presents his recom-
    mendation to top management in this way:

    I always number my proposed target settlements as proposed settlement target
    number 1. Someone once asked me what that meant. I said that this is what I
    think it will take to get a settlement but I number it because I may have to
    come back to you at some point with my proposed settlement number 2 or
    even my proposed settlement number 3, et cetera.

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    204 Part III. The Functional Level of Labor Relations

    We still had discipline at the table. We had chief spokespersons. In fact,
    we got very upset and disappointed when at one point the process broke
    down. When we started talking about overtime, we had already done some
    joint staff work looking at some pilot programs we had started in a couple
    of settings to let the union handle how overtime is distributed. This is
    always a big problem and headache for management, and [it is] a costly
    issue. The staff had pretty much agreed privately to extend the pilot approach
    to the whole bargaining unit, but when the issue came up for discussion,
    the manufacturing representative on our team said: “We ’ d never agree to
    that!” We read him the riot act later in private for springing this on us, but
    it essentially killed discussion of this issue, and we never did get the job
    done on this issue.

    As we got into the tough economic issues, bargaining took on more
    traditional features. These were very tough and the union leaders needed
    to be able to demonstrate to their constituents [that] they squeezed us as
    hard as they could to get the best deal possible. We understood this.

    Still, there was better communications, and we never worked past 8 p.m.

    bargaining. While much of the background research and information gathering
    is similar, some of this is done jointly with the union. In this case, the problem-
    solving processes that had been put in place in the company-union relationship
    at the workplace provided the foundation for taking a problem-solving approach
    to negotiations.

    UNIONS’ AND WORKERS’ PREPARATIONS FOR
    NEGOTIATIONS

    This section reviews the common procedures unions and workers follow during
    the negotiation of a collective bargaining contract. This material parallels the
    discussion of the procedures used by management in preparing for negotiations
    described above.

    The Role of the Union Negotiating Committee
    The union is represented by a negotiating committee in negotiations with manage-
    ment. The makeup of the union negotiating committee varies across unions,
    although it typically includes some union offi cers, support staff (such as members
    of the local or the national union ’ s research staff or both), and elected worker
    representatives. Often the leaders of the union ’ s negotiating committee are the
    highest elected offi cers of the union that is covered by the collective bargaining
    agreement under negotiation. Some unions, such as local construction, hotel and
    restaurant, or trucking unions, tend to rely on hired business agents to lead their
    negotiations.

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    Diane Frey

    Diane Frey

    The Negotiations Process and Strikes 205

    The negotiating committee will meet several times before the start of negotia-
    tions to formulate the union ’ s list of demands and to begin to establish expecta-
    tions about what the union can win in negotiations. Before these meetings,
    the negotiating committee will solicit demands from union members, either
    directly through meetings called to discuss the upcoming negotiations or through
    polls. In the UAW, for example, elected representatives from the local unions
    meet in a convention and vote on bargaining resolutions during preparations for
    companywide bargaining. The UAW leadership also consults union members
    during the negotiation of plant contracts that supplement the companywide
    agreements.

    A union negotiating committee typically also receives information and
    advice from the national union ’ s research staff during its preparations for
    bargaining. The information provided frequently covers the fi nancial perfor-
    mance of the company, forecasts the future performance of the company and
    the economy, and summarizes recent settlements in other unions or the pay
    improvements unorganized workers in the same city, fi rm, or industry have
    received.

    Some unions, such as the Air Line Pilots Association (ALPA), do extensive
    research and analysis of economic developments in their industry and of the
    fi nancial situation of each company. Prior to entering negotiations, the ALPA
    research staff conducts extensive briefi ngs with the bargaining committee of an
    airline and in some cases, such as at Continental Airlines, meets with company
    representatives to compare fi nancial data and analysis. It is not uncommon for
    union and company research staff to share information with each other if for no
    other reason than to avoid debates over some of the basic facts each side needs
    to prepare their team for negotiations.

    Many unions now use surveys, focus groups, and/or direct interviews with
    rank-and-fi le members to gather information about their concerns and their priorities
    for negotiations. This serves as a two-way communications process. It both provides
    data on the priorities of rank-and-fi le members and begins to engage the rank
    and fi le in the negotiations process by informing them of some of the issues that
    may come up.

    Acquisition of Strike Authorization If an Impasse
    Is Reached
    If the union comes to an impasse with management during the negotiations and
    is considering going on strike over unresolved disputes, two steps occur. In local
    contract negotiations, the union ’ s constitution typically requires the local to seek
    strike authorization from the national union. Strike approval is an important
    process because, among other things, it enables striking workers to receive strike
    benefi ts from the national union ’ s strike fund.

    A union considering a strike will also typically poll its members. The strike
    vote serves a dual purpose: it tells the union leadership whether the union ’ s
    members support such an action and it helps rally the workers around the purpose
    of the strike.

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    Diane Frey

    206 Part III. The Functional Level of Labor Relations

    Contract Ratifi cation
    When an agreement is reached between the union ’ s negotiating committee and
    management ’ s representatives, the union proceeds through its contract ratifi cation
    procedures. Here there is much variation in the exact procedures unions use.
    The fi rst step some unions take is to send a proposed agreement to a council
    made up of lower-level union offi cers. This council includes local union offi cers
    when a companywide agreement is negotiated (as in the steel and auto industries).
    Union constitutions typically also require that the workers covered by a negotiated
    agreement vote on any proposed settlement.

    There are some notable exceptions to the normal pattern of union members
    voting on proposed contracts. But in the usual case, workers must approve contract
    settlements, often by majority vote. This sort of voting is an example of participatory
    democracy in this critical aspect of union decision making.

    The Role of Union Leaders in Shaping Strategies
    The actual bargaining demands of unions refl ect more than just an averaging of
    their members’ preferences. Several factors combine to produce the complex
    process by which union leaders arrive at their bargaining objectives.

    First, in addition to considering the preferences of their members, union leaders
    must evaluate how likely it is that objectives can be attained. Unrealistic goals
    must be discarded during pre-negotiation planning sessions or early on in
    negotiations.

    Second, union leaders must take into account the varying political infl uence
    of subgroups within the union. Older or more skilled workers, for example, may
    be more politically infl uential than other members. Thus, the objectives leaders
    ultimately select may refl ect some workers’ goals more than others.

    Third, union leaders must also be concerned about the long-term survival of
    the union and must take steps to preserve those interests. However, there is always
    the risk that union leaders will emphasize union security at the expense of
    member preferences.

    Finally, a central job for union leaders, like all leaders, is to lead! Union leaders
    must weigh strategic options, make decisions, and secure the ongoing support of
    their members for the decisions they make.

    One of the keys to union leadership is effective internal communication. Union
    leaders need regular upward communication from the rank and fi le and from
    local union offi cers. Effective union leadership also requires that decision makers
    communicate their activities and decisions back to the members. Unions use such
    techniques as opinion surveys, satellite hookups, television advertising, and the
    Internet to communicate with their members. Indeed, the Internet is becoming
    a key resource in bargaining today. Union leaders are learning that they must
    develop the skill to use this tool to communicate with members, for it is certain
    that rival groups in the union will have those skills. In one case, ALPA found
    that the tentative wage agreement it had reached with Delta Airlines was criticized
    on a rival group ’ s website before the union team could even describe its terms
    to union members! Thus, the means of communication in unions and the role

    This content downloaded from 130.212.18.96 on Tue, 19 Jun 2018 14:02:03 UTC
    All use subject to http://about.jstor.org/terms

    Diane Frey

    Diane Frey

    The Negotiations Process and Strikes 207

    of communications in negotiations in general are changing rapidly in the age of
    the Internet.

    THE CYCLE OF TRADITIONAL NEGOTIATIONS

    Negotiations often proceed through a cycle in which the four subprocesses of
    bargaining emerge and interrelate. 8 A typical cycle for a traditional negotiations
    process is described below.

    The Early Stages
    In the initial stage of a traditional negotiation, the parties present their opening
    proposals. This stage often involves a larger number of people than will be involved
    in the negotiations of the fi nal agreement. The union, for example, may bring
    in representatives from various interest groups and several levels of the union
    hierarchy. These people participate in developing the initial proposals and later
    become involved in securing ratifi cation of any agreement. The involvement of
    all these different representatives can smooth the process of intraorganizational
    bargaining in the union.

    The union then presents proposals that cover the entire range of its concerns.
    Some of the proposals will be of critical importance and will be at the heart of
    the discussions as the strike deadline approaches. Some are important but may
    be traded off at the last minute. Some may be translated into more specifi c
    demands at a later stage of bargaining or may be issues to which the union will
    assign a high priority in some future round of negotiations. Other issues are of
    low priority and will be dropped as negotiations proceed into the serious decision-
    making stages.

    The Presentation of a Laundry List
    The union ’ s presentation of a laundry list of issues serves several purposes. It
    allows union leaders to recognize different interest groups by at least mentioning
    their proposals. Some unrealistic demands will be aired, the problems underlying
    these demands can be explored, and the employer can then reject these demands.
    This process takes the pressure off union offi cers who might otherwise appear to
    have arbitrarily nixed some group ’ s pet proposal. In a laundry list, either side also
    could introduce issues that it hopes will be pursued in future negotiations.

    Presenting a long list of proposals and infl ated demands as a fi rst step might
    also be a useful way to camoufl age the real priorities of the union. Or a long list
    of proposals could be helpful in integrative bargaining by facilitating trades across
    issues.

    Behavior of the Employer in the Early Phase
    The behavior of employers at the outset of bargaining varies considerably. Some
    employers will present a set of proposals to counterbalance the union demands.
    Other employers will receive the union demands and promise a response at a
    future negotiating session. Many management representatives prefer to delay

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    **TurningtheTablesText.pdf**

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    – 1
    – 2
    – 3

  • [Solved] MGMT 230

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    I'll post the question to you Use the book for reference ### Management: Leading & Collaborating in the Competitive World ISBN: 9781265385811 By: Thomas Bateman

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    Use the book for reference
    ### Management: Leading & Collaborating in the Competitive World
    ISBN: 9781265385811
    By: Thomas Bateman

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    – ## Module2Discussion2.docx **## Module2Discussion2.docx** **Hematopoietic:** J.D. is a 37 years old white woman who presents to her gynecologist complaining of a 2-month history of intermenstrual bleeding, menorrhagia, increased urinary frequency, mild incontinence, extreme fatigue, and weakness. …

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    **## Module2Discussion2.docx**

    **Hematopoietic:** J.D. is a 37 years old white woman who presents to her gynecologist complaining of a 2-month history of intermenstrual bleeding, menorrhagia, increased urinary frequency, mild incontinence, extreme fatigue, and weakness. Her menstrual period occurs every 28 days and lately there have been 6 days of heavy flow and cramping. She denies abdominal distension, back-ache, and constipation. She has not had her usual energy levels since before her last pregnancy.

    **Past Medical History (PMH):**

    · Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.

    **Case Study Questions**

    1. Name the contributing factors on J.D that might put her at risk to develop iron deficiency anemia.

    2. Within the case study, describe the reasons why J.D. might be presenting constipation and or dehydration.

    3. Why Vitamin B12 and folic acid are important on the erythropoiesis? What abnormalities their deficiency might cause on the red blood cells?

    4. The gynecologist is suspecting that J.D. might be experiencing iron deficiency anemia.
    In order to support the diagnosis, list and describe the clinical symptoms that J.D. might have positive for Iron deficiency anemia.

    5. If the patient is diagnosed with iron deficiency anemia, what do you expect to find as signs of this type of anemia? List and describe.

    6. Labs results came back for the patient. Hb 10.2 g/dL; Hct 30.8%; Ferritin 9 ng/dL; red blood cells are smaller and paler in color than normal. Research list and describe for appropriate recommendations and treatments for J.D.

    **## Module2Discussion2.docx**

    **Hematopoietic:** J.D. is a 37 years old white woman who presents to her gynecologist complaining of a 2-month history of intermenstrual bleeding, menorrhagia, increased urinary frequency, mild incontinence, extreme fatigue, and weakness. Her menstrual period occurs every 28 days and lately there have been 6 days of heavy flow and cramping. She denies abdominal distension, back-ache, and constipation. She has not had her usual energy levels since before her last pregnancy.

    **Past Medical History (PMH):**

    · Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.

    **Case Study Questions**

    1. Name the contributing factors on J.D that might put her at risk to develop iron deficiency anemia.

    2. Within the case study, describe the reasons why J.D. might be presenting constipation and or dehydration.

    3. Why Vitamin B12 and folic acid are important on the erythropoiesis? What abnormalities their deficiency might cause on the red blood cells?

    4. The gynecologist is suspecting that J.D. might be experiencing iron deficiency anemia.
    In order to support the diagnosis, list and describe the clinical symptoms that J.D. might have positive for Iron deficiency anemia.

    5. If the patient is diagnosed with iron deficiency anemia, what do you expect to find as signs of this type of anemia? List and describe.

    6. Labs results came back for the patient. Hb 10.2 g/dL; Hct 30.8%; Ferritin 9 ng/dL; red blood cells are smaller and paler in color than normal. Research list and describe for appropriate recommendations and treatments for J.D.

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    I need you to write me a case brief of the international vs the state of washing case. below i attached the text of the case and i also attached the sample on how you should write the case brief. \ INTERNATIONALSHOECO.v.WASHINGTON326U.S.3101945FindLaw.pdf](https://www.sweetstudy.com/files/internati…

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    I need you to write me a case brief of the international vs the state of washing case.
    below i attached the text of the case and i also attached the sample on how you should write the case brief.
    \
    INTERNATIONALSHOECO.v.WASHINGTON326U.S.3101945FindLaw.pdf](https://www.sweetstudy.com/files/internationalshoeco-v-washington326u-s-3101945findlaw-pdf "INTERNATIONALSHOECO.v.WASHINGTON326U.S.3101945FindLaw.pdf")
    \
    Brownv.BoardofEducationCaseBriefExample.pdf](https://www.sweetstudy.com/files/brownv-boardofeducationcasebriefexample-pdf "Brownv.BoardofEducationCaseBriefExample.pdf")

  • [Solved] Personal view of human nature

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    Answer the question I believe at birth people are born

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    Answer the question I believe at birth people are born