Accreditation: A review process to determine if an agency meets the defined standards of quality determined by the accrediting body.

Acuity-based staffing: A patient assignment model that takes into account the level of patient care required based on the severity of a patient’s illness or condition.

Admission: Refers to an initial visit or contact with a client.

Advocacy: The act or process of pleading for, supporting, or recommending a cause of course of action for individuals, groups, organizations, communities, society, or policy issues.

Affordable Care Act (ACA): Legislation enacted in 2010 to increase consumers’ access to health care coverage and protect them from insurance practices that restrict care or significantly increase the cost of care.

ANA Standards of Professional Practice: Authoritative statements of the actions and behaviors that all registered nurses, regardless of role, population, specialty, and setting are expected to perform competently.

Brief: A short session to share a plan, discuss team formation, assign roles and responsibilities, establish expectations and climate, and anticipate outcomes and contingencies.

Budget: An estimate of revenue and expenses over a specified period of time, usually over a year.

Capital budgets: Budgets used to plan investments and upgrades to tangible assets that lose or gain value over time. Capital is something that can be touched, such as buildings or computers.

Change: The process of altering or replacing existing knowledge, skills, attitudes, systems, policies, or procedures.

Change agent: Anyone who has the skill and power to stimulate, facilitate, and coordinate the change effort.

Closed-loop communication: A communication strategy used to ensure that information conveyed by the sender is heard by the receiver and completed.

Collective bargaining: Negotiation of wages and other conditions of employment by an organized body of employees.

Continuity of care: The use of information on past events and personal circumstances to make current care appropriate for each individual.

Conflict: Competitive or opposing action of incompatibles : antagonistic state or action (as of divergent ideas, interests, or persons)

Co-pay: A flat fee the consumer pays at the time of receiving a health care service as a part of their health care plan.

Core measures: National standards of care and treatment processes for common conditions. These processes are proven to reduce complications and lead to better patient outcomes.

Cultural diversity: A term used to describe cultural differences among clients, family members, and health care team members.

Cultural humility: A humble and respectful attitude toward individuals of other cultures that pushes one to challenge their own cultural biases, realize they cannot possibly know everything about other cultures, and approach learning about other cultures as a lifelong goal and process.[1]

Culture of safety: Organizational culture that embraces error reporting by employees with the goal of identifying systemic causes of problems that can be addressed to improve patient safety. Just Culture is a component of a culture of safety.

CUS statements: Assertive statements that are well-recognized by all staff across a health care agency as implementation of the two-challenge rule. These assertive statements are “I am Concerned –  I am Uncomfortable – This is a Safety issue!”

Debrief: An informal information exchange session designed to improve team performance and effectiveness through reinforcement of positive behaviors and reflecting on lessons learned after a significant event occurs.

Deductible: The amount of money a consumer pays for health care before their insurance plan pays anything. These amounts generally apply per person per calendar year.

DESC: A tool used to help resolve conflict. DESC is a mnemonic that stands for Describe the specific situation or behavior and provide concrete data, Express how the situation makes you feel/what your concerns are using “I” messages, Suggest other alternatives and seek agreement, and Consequences are stated in terms of impact on established team goals while striving for consensus.

Discharge: The completion of care and services in a health care facility and the client is sent home (or to another health care facility).

Economics: The study of how society makes decisions about its limited resources.

Evidence-Based Practice (EBP): A lifelong problem-solving approach that integrates the best evidence from well-designed research studies and evidence-based theories; clinical expertise and evidence from assessment of the health care consumer’s history and condition, as well as health care resources; and patient, family, group, community, and population preferences and values.

Feedback: Information is provided to a team member for the purpose of improving team performance. Feedback should be timely, respectful, specific, directed towards improvement, and considerate.

Floating: An agency strategy that asks nurses to temporarily work on a different unit to help cover a short-staffed shift.

Followership: The upward influence of individuals on their leaders and their teams.

Grievance process: A process for resolving disagreements between employees and management.

Handoff reports: A transfer and acceptance of patient care responsibility achieved through effective communication. It is a real-time process of passing patient specific information from one caregiver to another, or from one team of caregivers to another, for the purpose of ensuring the continuity and safety of the patient’s care.

Huddle: A brief meeting during a shift to reestablish situational awareness, reinforce plans already in place, and adjust the teamwork plan as needed.

I’M SAFE: A tool used to assess one’s own safety status, as well as that of other team members in their ability to provide safe patient care. It is a mnemonic standing for personal safety risks as a result of Illness, Medication, Stress, Alcohol and Drugs, Fatigue, and Eating and Elimination.

Informatics: Using information and technology to communicate, manage knowledge, mitigate error, and support decision-making.

Interdisciplinary care conferences: Meetings where interprofessional team members professionally collaborate, share their expertise, and plan collaborative interventions to meet client needs.

Interprofessional collaborative practice: Multiple health workers from different professional backgrounds working together with patients, families, caregivers, and communities to deliver the highest quality of care.

I-PASS: A mnemonic used as a structured communication tool among interprofessional team members. I-PASS stands for Illness severity, Patient summary, Action list, Situation awareness, and Synthesis by the receiver.

ISBARR: A mnemonic for the components of Introduction, Situation, Background, Assessment, Request/Recommendations, and Repeat back.

Just Culture: A culture where people feel safe raising questions and concerns and report safety events in an environment that emphasizes a nonpunitive response to errors and near misses. Clear lines are drawn between human error, at-risk, and reckless employee behaviors.

Leadership: The art of establishing direction and influencing and motivating others to achieve their maximum potential to accomplish tasks, objectives, or projects.

Magnet® Recognition Program: An organizational credential that recognizes quality patient outcomes, nursing excellence, and innovations in professional nursing practice.

Management: Roles that focus on tasks such as planning, organizing, prioritizing, budgeting, staffing, coordinating, and reporting.

Mandatory overtime: A requirement by agencies for nurses to stay and care for patients beyond their scheduled shift when short staffing occurs.

Medicaid: A joint federal and state program covering groups of eligible individuals, such as low-income families, qualified pregnant women and children, and individuals receiving Supplemental Security Income (SSI). States may choose to cover additional groups, such as individuals receiving home and community-based services and children in foster care who are not otherwise eligible.

Medicare: A federal health insurance program used by people aged 65 and older, younger individuals with permanent disabilities, and people with end-stage renal disease requiring dialysis or a kidney transplant.

Meta-analysis: A type of nursing research (also referred to as a “systematic review”) that compares the results of independent research studies asking similar research questions. This research often collects both quantitative and qualitative data to provide a well-rounded evaluation by providing both objective and subjective outcomes.

Mission statement: An organization’s statement that describes how the organization will fulfill its vision and establishes a common course of action for future endeavors.

Mutual support: The ability to anticipate and support team members’ needs through accurate knowledge about their responsibilities and workload.

Nursing informatics: The science and practice integrating nursing, its information and knowledge, with information and communication technologies to promote the health of people, families, and communities worldwide.

Nursing research: The systematic inquiry designed to develop knowledge about issues of importance to the nursing profession.

Off with benefits: An agency staffing strategy when a nurse is not needed for their scheduled shift. The nurse does not typically receive an hourly wage and is not expected to report to work, but they still accrue benefits such as insurance and paid time off.

On call: An agency staffing strategy when a nurse is not immediately needed for their scheduled shift. They may have options to stay at work and complete work-related education or stay home.

Operating budgets: Budgets including personnel costs and annual facility operating costs.

Organizational culture: The implicit values and beliefs that reflect the norms and traditions of an organization. An organization’s vision, mission, and values statements are the foundation of organizational culture.

Patient-centered care: The patient is the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs..

Patient safety goals: Guidelines specific to organizations accredited by The Joint Commission that focus on problems in health care safety and ways to solve them.

Pay for Performance: A reimbursement model, also known as value-based payment, that attaches financial incentives based on the performance of health care agencies and providers.

Peer-reviewed: Scholarly journal articles that have been reviewed independently by at least two other academic experts in the same field as the author(s) to ensure accuracy and quality.

Primary source: An original study or report of an experiment or clinical problem. The evidence is typically written and published by the individual(s) conducting the research and includes a literature review, description of the research design, statistical analysis of the data, and discussion regarding the implications of the results.

Resource stewardship: Using appropriate resources to plan, provide, and sustain evidence-based nursing services that are safe, effective, financially responsible, and used judiciously.

Quality: The degree to which nursing services for health care consumers, families, groups, communities, and populations increase the likelihood of desirable outcomes and are consistent with evolving nursing knowledge.

Quality Improvement (QI): Using data to monitor the outcomes of care processes and using improvement methods to design and test changes to continuously improve the quality and safety of health care systems.

Qualitative research: A type of study that provides subjective data, often focusing on the perception or experience of the participants. Data is collected through observations and open-ended questions and often referred to as experimental data. Data is interpreted by developing themes in participants’ views and observations.

Quantitative research: A type of study that provides objective data by using number values to explain outcomes. Researchers can use statistical analysis to determine strength of the findings, as well as identify correlations.

Shared governance: A shared leadership model between management and employees working together to achieve common goals.

Shared mental model: The actions of a team leader that ensure all team members have situation awareness and are “on the same page” as situations evolve on the unit.

Secondary source: Evidence is written by an author who gathers existing data provided from research completed by another individual. This type of source analyzes and reports on findings from other research projects and may interpret findings or draw conclusions. In nursing research these sources are typically published as a systematic review and meta-analysis.

Situation awareness: The awareness of a team member knowing what is going on around them.

Situation monitoring: The process of continually scanning and assessing the situation to gain and maintain an understanding of what is going on around you.

Social Determinants of Health (SDOH): Conditions in the places where people live, learn, work, and play, such as unstable housing, low income areas, unsafe neighborhoods, or substandard education that affect a wide range of health risks and outcomes.

STEP tool: A situation monitoring tool used to know what is going on with you, your patients, your team, and your environment. STEP stands for Status of the patients, Team members, Environment, and Progress Toward Goal.

Systems leadership: A set of skills used to catalyze, enable, and support the process of systems-level change that focuses on the individual, the community, and the system.

Systems theory: The concept that systems do not function in isolation but rather there is an interdependence that exists between their parts. Systems theory assumes that most individuals strive to do good work, but are affected by diverse influences within the system.

Team nursing: A common staffing pattern that uses a combination of Registered Nurses (RNs), Licensed Practical/Vocational Nurses (LPN/VNs), and Assistive Personnel (AP) to care for a group of patients.

TeamSTEPPS®: An evidence-based framework used to optimize team performance across the health care system. It is a mnemonic standing for Team Strategies and Tools to Enhance Performance and Patient Safety. 

Teamwork and collaboration: Functioning effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care.[

Two-challenge rule: A strategy for advocating for patient safety that includes a team member assertively voicing their concern at least two times to ensure that it has been heard by the decision-maker.

Utilization review: An investigation by insurance agencies and other health care funders on services performed by doctors, nurses, and other health care team members to ensure money is not wasted covering things that are unnecessary for proper treatment or are inefficient. This review also allows organizations to objectively measure how effectively health care services and resources are being used to best meet their patients’ needs.

Values statement: The organization’s established values that support its vision and mission and provide strategic guidelines for decision-making, both internally and externally, by members of the organization.

Vision statement: An organization’s statement that defines why the organization exists, describes how the organization is unique and different from similar organizations, and specifies what the organization is striving to be.

Whistleblower: A person who exposes any kind of information or activity that is deemed illegal, unethical, or not correct within an organization.

  1. American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association.


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Leading Change in Health Systems: Strategies for RN-BSN Students Copyright © 2023 by Kathy Andresen DNP, MPH, RN, CNE is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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