CHL flashcards

35 cards. Read the term and the definition here. The deck at the top of this page is optional.

Situational leadership readiness

Follower readiness combines ability (knowledge, skill, experience) and willingness (confidence, commitment, motivation). The leader selects directing, coaching, supporting, or delegating based on readiness for that specific task, not on overall seniority.

Transformational leadership components

Idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration. Transactional leadership instead uses contingent reward and management-by-exception, focusing on exchanges and monitoring rather than shared vision and development.

Thomas-Kilmann conflict modes

Competing, collaborating, compromising, avoiding, and accommodating, plotted by assertiveness and cooperativeness. Collaborating seeks a fully win-win solution and suits important issues with time; avoiding suits trivial issues or when emotions must cool.

Tuckman team stages

Forming, storming, norming, performing, and adjourning. Teams can regress to storming after a membership change or major process change, so a leader should expect renewed conflict rather than treat it as failure.

Delegation accountability rule

Delegation transfers authority and accountability for the task outcome to the delegate, but the manager retains overall responsibility. Effective delegation specifies the task, the authority level, the deadline, and the reporting expectation.

Progressive discipline documentation

Each step records the observed behavior, the standard or policy violated, prior counseling, the required corrective action, the follow-up date, and the consequence of recurrence. Conclusions and personality judgments weaken the record.

Lewin change model

Unfreeze (create readiness and reduce restraining forces), change (implement the new process), refreeze (reinforce and hardwire). Resistance typically peaks at the transition from planning to implementation, so participation and information should precede that point.

Democratic versus autocratic style

Democratic leadership invites group input but the leader decides; autocratic leadership decides alone. Autocratic is defensible in emergencies and codes; democratic improves change adoption and quality improvement engagement.

Kirkpatrick evaluation levels

Reaction (satisfaction), learning (knowledge or skill gain), behavior (on-the-job practice change), and results (organizational outcomes). A post-test measures learning only; it cannot demonstrate behavior change or improved outcomes.

Andragogy principles

Adult learners need to know why content matters, prefer problem-centered and experience-based learning, and want immediate applicability. They are more self-directed than children and respond better to facilitation than to lecture.

Return demonstration validation

The learner performs the skill while an observer checks against a standardized checklist. It validates psychomotor competence, which written testing cannot confirm, and is the preferred method for procedures and equipment use.

Competency validation three elements

Initial verification of education, experience, and credentials; periodic performance review; and retraining or reassessment when a deficiency is found. All three are required for a complete competency program.

Bloom taxonomy order

Remember, understand, apply, analyze, evaluate, create, ascending in complexity. Objectives and test items should be written at the same level, so an 'apply' objective needs a scenario item, not a recall item.

Orientation versus competency

Orientation is time-bound onboarding to the organization and unit. Competency is ongoing verification that the individual performs to standard, repeated at defined intervals and whenever a deficiency or process change occurs.

Preceptor selection criteria

Current clinical competence, a minimum tenure in the role (commonly one year), documented preceptor training, and no active corrective action. Clinical expertise alone does not qualify someone to teach or evaluate learners.

Learning needs assessment sources

Triangulate at least three sources: performance appraisal data, competency assessment gaps, and organizational or regulatory requirements. A single source risks designing education for a problem that does not exist.

Continuing education renewal cycle

Certifications and licenses require documented contact hours or credits within a defined renewal period. Lapsed credentials usually need a formal reinstatement process, not simply payment of a fee.

PDSA cycle

Plan states the change and a prediction; Do runs a small test; Study compares results to the prediction; Act adopts, adapts, or abandons. One PDSA is a test, and scaling requires repeated cycles.

Model for Improvement questions

What are we trying to accomplish? How will we know a change is an improvement? What changes can we make that will result in improvement? All three are answered before testing, and the second forces selection of measures.

Run chart shift rule

A shift is six or more consecutive points on one side of the median, signaling non-random variation. A trend is five or more consecutive increasing or decreasing points. Both warrant investigation before concluding improvement.

Control chart selection

Use p-charts for proportion defective with variable sample size, np-charts for counts with constant sample size, c-charts for defects per unit, u-charts for defects per unit with variable size, and X-bar/S charts for continuous data.

Common versus special cause

Common-cause variation is inherent to the process and requires redesign. Special-cause variation is signaled by a control chart rule violation and requires investigation of that specific event, not a change to the whole process.

FMEA risk priority number

Risk priority number equals severity times occurrence times detection, each scored on a defined scale. FMEA is prospective, unlike root cause analysis, which is retrospective and follows an event that already occurred.

Structure process outcome measures

Structure describes capacity such as staffing and equipment; process describes what is done, such as hand hygiene compliance; outcome describes results, such as infection rate. Improvement work usually tracks all three together.

FTE staffing formula

Required FTEs equal annual workload hours divided by productive hours per FTE. Productive hours equal paid hours minus vacation, benefit, and education hours, so ignoring them overstates available staffing.

Benchmark acuity adjustment

Comparing units or organizations requires case-mix or acuity adjustment. Unadjusted raw rates across units with different patient acuity are invalid and can reward units that avoid complex patients.

Sentinel event definition

An unexpected occurrence involving death or serious physical or psychological injury, or the risk of such injury. It triggers root cause analysis, and the analysis itself carries reporting obligations to the accrediting body.

Never event examples

Serious reportable events that are largely preventable, such as wrong-site surgery, retained foreign object after a procedure, and transfusion with the wrong blood type. Most are reportable to a state or accrediting body.

Root cause analysis action plan

Corrective actions must be measurable, assigned to a named owner, and time-bound. Actions limited to re-education or policy revision without system change are the most common weakness identified on review.

Plan of correction elements

State what will be done, who is responsible, when it will be completed, and how effectiveness will be monitored. The monitoring element is the most frequently deficient part of a submitted plan.

Informed consent elements

Capacity, disclosure of material risks and alternatives including no treatment, comprehension, and voluntariness. A signed form alone does not establish informed consent if any element is missing.

HIPAA minimum necessary

Uses and disclosures are limited to the least protected health information needed for the purpose. Treatment, payment, and health care operations are permitted core uses, but psychotherapy notes require separate authorization.

Breach risk assessment

A breach is presumed reportable unless a risk assessment shows low probability of compromise, considering the data type, the recipient, whether information was actually acquired or viewed, and the extent of mitigation.

QA versus QI

Quality assurance is retrospective, individual-focused, and threshold-based. Quality improvement is prospective, system-focused, and continuous, using iterative tests of change rather than case-by-case review alone.

Tracer methodology

Surveyors follow selected patients' actual care experience across departments to test whether documented processes match practice. It reveals system failures that department-by-department inspection misses.