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Organizational Systems & Quality Leadership in Nursing


An organization system is where highly integrated parts go through specific processes to accomplish an overall desired goal. Quality leadership is the ability of the management to plan and control activities and resources of an organization towards achieving quality assurance and improvement of objectives. On the other hand, organizational Systems & Quality Leadership is important aspect of an organization to enable it to focus on plans and achieve quality and safety. Primarily, organizations’ main purpose is on achieving desired objectives for customer and employee satisfaction.

For effective management, a health care organization requires a leader who will challenge assumptions, consolidate purpose in care delivery, and lead his team towards a vision. In this case, “the nurse leader combines clinical, administrative, financial and operational skills to solve problems in care environment so that staff nurses can provide cost-effective health care in a way that is satisfying and health-promoting to its clients” (Huber, 2006, pg 3)

Nursing-sensitive outcome indicators

Nursing outcome indicators were introduced to support Nursing as there is a crucially important area where services are considered to have a huge impact on patients’ wellbeing. Generally, outcomes can be classified into broad categories such as mortality, complications during hospitalization, inadequate recovery, restraint prevalence, prolongation of medical problem, and decline in the state of health and quality of life (Doran and Almost, 2003, pg 3).

In the case of Mr. J who was diagnosed with dementia, which is a mental health problem that usually afflicts the old, it is characterized by forgetfulness and one’s inability to take care of himself. The red depressed area on the lower spine of Mr. J is an example of restraint prevalence as a result of inconsiderate restraints applied by the nurses. This is an indicator that needs to be understood by nurses to help them improve their services to older adults diagnosed with delirium, depression, or dementia. The outcome indicators help the organization at large to prevent patient falls, pressure ulcers, surgical complications, and urinary infections that result from the failure of programs that focus on the quality and safety of services rendered to patients.

The American Nurses Association focuses on providing health care organizations with comparative information on nursing-sensitive outcome indicators that could be used in improving the quality of services delivered to patients. The association also develops a database to be used in the future to identify co-relation between the characteristics of the nursing workforce and nursing-sensitive patient outcomes

Quality patients’ health care

Outcome and quality improvement indicators are meant to help clinical staff to develop and improve their services to patients. The indicators mainly focus on how patients’ conditions are affected by interventions delivered by nurses. Patients’ health care state is closely tied to their interaction with nurses who are held accountable to Patients’ health state outcomes. Mr. J’s restraint prevalence can be directly accounted for by the certified nursing assistant who was responsible for applying the restraint in a manner that is health-promoting to the patient.

In the case of Mr. J, his daughter had to be the one to help him out to the bathroom despite having to travel for long distances to reach the hospital. The red depression on Mr. J’s lower spine clearly indicates the poor services that he was given by the certified nursing assistant despite the diagnosis of mild dementia. There is a statistical relationship between outcomes such as restraint prevalence, length of stay, pressure ulcers, urinary infections, and pneumonia with the number of nurses. Evidently, a large number of nurses who delivered interventions recorded an increased number of patient’s health-related state (Doran and Almost, 2003, pg 5).

The complexity of health care organizations necessitates the adoption of quality systems and leadership for efficiency and effectiveness in offering services to patients. Therefore, health care organizations need to focus on providing quality and safe health care services to patients given that it is a sensitive area in people’s lives. Moreover, quality service delivery may be achieved through assessment of patient’s need for healthcare and time needed by nursing clinicians to effectively complete the tasks (Huber, 2006, pg 716). In the case of adult patients such as Mr. J, special care should be put in place to promote the care of patients diagnosed with dementia, depression, or delirium.

Healthcare organizations have complex systems that require strong and effective leadership that will adapt to leadership styles that are relevant to the unique challenges of nursing. The different roles and institutional missions call for the adaptation of different leadership styles that fit the functioning of such an organization. The health care system has developed towards accountability to the public it serves. Primarily, the accountability of healthcare organizations is reflected by professional standards, health care delivery standards, and health policy.

Nurse leaders need to lead the nursing clinicians towards successful outcomes, with the consideration of protecting the public from harmful effects of interventions delivered in health care organizations. In the case of the 65-bed rural hospital in the town of a few Jewish residents, Mr. J was served with chopped pork cutlet instead of regular chopped meat. A Jewish physician claimed that cases of Jewish patients being served with chopped pork had become in the hospital. This necessitates the hospital leadership to intervene and end such cases where services delivered in the hospital were harmful to the patients

Clinical nursing leaders may be involved in direct patient care where they undertake to influence attitudes and behavior of nursing clinicians towards improved and standard care. Good leadership is an example of superior performance that influences the entire staff to render effective and efficient services as a normal practice that is embedded in the organization. Leaders act as visionaries who influence others into acceptable organizational behaviors. Therefore, nurse leaders need to have essential personal attributes such as being competent, confident, creative, and influential in leading the rest of the staff to provide quality services in the dynamic environment.

Leaders should also be able to show concern for staff needs and aspirations; this will in turn have a direct impact on productivity. Importantly, quality and standards of services delivered by nursing staff are directly related to the satisfaction and wellbeing of the staff. This implies that for patients’ needs to be met; those of staff delivering the services should first be met. They should also realize that staff needs range from remuneration to working conditions and motivational activities.

System Resources, Referrals, or Colleagues

Ethical issues such as those of Mr. J’s case arise when the leadership of the hospital is not effective in influencing the staff to deliver services with regards to acceptable standard principles. As a supervisor in a health care organization, there is a need to develop clear and effective guidelines on achieving desired goals and standards. This serves the purpose of eliminating unethical issues such as Mr. J and other Jewish patients being served with chopped pork cutlets instead of regular chopped meat.

Moreover, Mr. Js situation of restraint prevalence is an unethical issue that needs to be solved by restructuring the hospital system. Staff should be categorized into departments with each member having specifically defined roles to help them identify and take responsibility for specific errors. Patient care-related complications can therefore be reduced through a confrontation of individual members of staff who may have acted out of negligence and biased social intentions.

In the 65-bed hospital where Mr. J the Jew was admitted, strong considerations need to be put in place for patients of unique origin such as the few Jewish patients. This is mainly because the needs of patients in health care facilities differ due to varying backgrounds and origins in the increasingly cosmopolitan society. The Jews for example do not take any meals that include pork because of their beliefs, therefore services delivered in health care organizations should be diversified to fit patients’ different needs. Diversification will help in solving ethical issues that arise (Wedderburn, 1999, pg180).

Health care services are essential in society to provide people with treatment for their health problems. For efficiency and effectiveness, health care organizations need to adopt computerized information systems to assist in improving service delivery. These information systems collect and analyze service data and data related to the care of patients to achieve care delivery efficiency and effectiveness.


Doran, D. and Almost, J. (2003). Nursing Sensitive outcomes: The State of the science. MA: Jones & Bartlett Learning.

Huber, D. (2006). Leadership and Nursing Care Management. Pennsylvania: Elsevier Health Sciences.

Wedderburn, C.T. (1999). Leadership in nursing. Pennsylvania: Elsevier Health Sciences.

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