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Home » Topic: ‘Significance of nursing leadership with healthcare management.€ Everything you are going to need is in the attachment with all the instructions and do not forget to do

Topic: ‘Significance of nursing leadership with healthcare management.€ Everything you are going to need is in the attachment with all the instructions and do not forget to do

Topic: “Significance of nursing leadership with healthcare management.”
Everything you are going to need is in the attachment with all the instructions and do not forget to do as it asks.
P.S please follow the instructions in the instructions box images. This PowerPoint is very important. 
1 – introduction Slide 
2- learning outcomes Slide 
3- what it is all about Slide 
4- the concept (if any) Slide 
5- problems Slide 
6- purpose/goals Slide 
7- implementation/strategy Slide
 8- suggestions (Evidence based) Slide 
9- Recommendations Slide 
10-questions (like if they have any questions for us). Hopefully not ???? Slide 11 – References/ Citations.
Thank you 

Samplefortheproject.pdf

Samplefortheproject.pdf

Shared Governance Presenter Information
1
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 1 of 19

INTRODUCTION
2
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 2 of 19

Learning Outcomes
At the end of this presentation attendants will be able to:
A. Define what is Shared Governance B. Verbalize concepts of Shared Governance in Nursing C. List contributing factors towards Shared Governance D. Define Governance Models E. Discuss leadership role in ensuring Shared
Governance F. Verbalize advantages of Shared Governance G. Detail how the leader will implement the Shared
Governance Model into their unit 3
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 3 of 19

Shared Governance (what?) ➢ Is a model of nursing practice that is designated to integrate core
values and beliefs that professional practice embraces, which becomes a means of accomplishing quality care (Anthony, 2004)
➢Gives all members of the healthcare workforce a say in decision-
making, which promotes diverse and innovative feedback that will aid the organization’s business and healthcare missions
➢ It is a shared decision-making based on the principles of partnership,
equity, accountability and ownership at the point of service
4
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 4 of 19

Concepts of Shared Governance
Shared Governance focuses on four main principles that serve as a foundation and the cornerstone of the concept:
• Partnership – Developing collaboration and healthy partnerships among the healthcare team
• Accountability – Achieving clear understanding of each members role and expectations, and taking responsibility for their actions and decisions
• Equity – Focusing on having an equal stake in the outcomes of the care and quality that the team provides
• Ownership – The success of an organization depends on how well each member of the healthcare team performs their jobs
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 5 of 19

Shared Governance
• Shared by who? It is shared decision making between the staff nurses or bedside nurses and nurse leaders, including resources, nursing research or evidence-based practice initiatives, new equipment purchases, and staffing
• Who will benefit? The people in the surrounding communities, the patients, the staff, and the organization
• Who governs? The healthcare team led by the nurse leader will be responsible for safe system delivery of patient care, providing adequate resources. The nurse leader will be helped by staff nurses who will be accountable for patient care outcomes.
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 6 of 19

Harris Health System Shared Governance Model (Background/Significance)
In 2010-2011, the Shared Governance Committee, Staff Nurse Councils, and Pavilion Leadership Teams participated in creating our unique CoPs based on research. – Designed to meet the unique needs of Harris Health System nurses. – Replaced the traditional staff nurse council.
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 7 of 19

Community of Practice (CoP) Harris Health System Nursing’s Shared Governance framework is organized around a network of communities – At the unit/clinic level, it is called the CoP – The development involved identifying CoPs, which consist of groups of RNs who share a common patient care foci, practices, and professional behaviors. The function of CoPs is to make decisions that affect their clinical practice, professional nursing environment, and knowledge development. Clinician-leadership partnership is essential when making decisions that affect nursing practice.
8
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 8 of 19

Resources
• For more information on Harris Health System Shared Governance: • Home (hchd.local) • Community in Practice Resources: • CoP Resource List (hchd.local)
9
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 9 of 19

Problem
• Low participation or attendance • Not active participants • Inconsistent processes (no standardization) • Nurses are not as involved as we want them to be • Great time to introduce examples or reenact what you see as the issue
from your perspective
10
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 10 of 19

Purpose – Overall Goal/Intent
Strengthen the shared governance model to allow our bedside nurses to own and lead their practice. Standardize the logistics of shared governance across the system
11
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 11 of 19

Implementation of Shared Governance (Strategy) How can you as a leader make Shared Governance work in my unit?
• Engage • Commit • Collaborate • Deliver • Encourage (Ahmen Zinhom, 2015. Shared Governance)
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 12 of 19

Implementation of Shared Governance • Market the importance of shared governance
program to staff • An empowered staff should be able to communicate concepts
and the importance of shared governance to anyone, including cost effectiveness
• Ensure Shared Governance is a component in every employee’s job description, peer review, employee evaluation and performance appraisal
• Expectations should be well-defined to nurse managers and staff • Goals and behaviors should be set for every employee – be sure
goals and behaviors are updated regularly to keep stride with a progressive staff and dynamic environment
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 13 of 19

Implementation of Shared Governance
• Ten (10) essential actions for nurse leaders: • Be clear about what shared governance is • Help staff members understand why shared governance is important • Orient council chairpersons on the basics of planning and running meetings • Cultivate a sense of ownership • Encourage a continuous focus on mission and vision • Provide council members with protected time to meet • Include staff in council development or redesign • Coach and mentor chairpersons • Recognize excellence • Study the successes and struggles of others (Marky Medeiros, 2018)
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 14 of 19

Evidence/Best-practices suggest?
• Better patient outcomes • Higher patient satisfaction • Higher nurse satisfaction • Cost-effective? Or budget implications?
15
Make sure you cite your references
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 15 of 19

Plan and timeline (if any)
• Share any key data and key steps
16
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 16 of 19

Recommendations (if any)
• What do you want to adopt, implement, support, re-energize? • How do you want to measure outcomes moving forward?
17
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 17 of 19

• Questions?
18
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 18 of 19

References: APA 7th edition (must also include references to any art clip used or pics)
• Anthony, M. K. (2004). Shared Governance Models: the theory, practice, and evidence. Online Journal of Issues in Nursing, 9(1).
• Harris Health (2010). CoP Resource List. Retrieved from: https://sp2019.hchd.local/teams/nursing/enpg/sg/Pages2/CoPResourceList.aspx
• Harris Health (2010). Shared Governance/CoP. Retrieved from: https://sp2019.hchd.local/teams/nursing/enpg/sg/Pages/Home.aspx
• Medeiros, Marky MSN, RN. Shared governance councils: 10 essential actions for nurse leaders. Nursing Management (Springhouse) 49(7):p 12-13, July 2018. | DOI: 10.1097/01.NUMA.0000538920.83653.9b

19
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 19 of 19

,

Shared Governance Presenter Information
1
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 1 of 19

INTRODUCTION
2
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 2 of 19

Learning Outcomes
At the end of this presentation attendants will be able to:
A. Define what is Shared Governance B. Verbalize concepts of Shared Governance in Nursing C. List contributing factors towards Shared Governance D. Define Governance Models E. Discuss leadership role in ensuring Shared
Governance F. Verbalize advantages of Shared Governance G. Detail how the leader will implement the Shared
Governance Model into their unit 3
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 3 of 19

Shared Governance (what?) ➢ Is a model of nursing practice that is designated to integrate core
values and beliefs that professional practice embraces, which becomes a means of accomplishing quality care (Anthony, 2004)
➢Gives all members of the healthcare workforce a say in decision-
making, which promotes diverse and innovative feedback that will aid the organization’s business and healthcare missions
➢ It is a shared decision-making based on the principles of partnership,
equity, accountability and ownership at the point of service
4
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 4 of 19

Concepts of Shared Governance
Shared Governance focuses on four main principles that serve as a foundation and the cornerstone of the concept:
• Partnership – Developing collaboration and healthy partnerships among the healthcare team
• Accountability – Achieving clear understanding of each members role and expectations, and taking responsibility for their actions and decisions
• Equity – Focusing on having an equal stake in the outcomes of the care and quality that the team provides
• Ownership – The success of an organization depends on how well each member of the healthcare team performs their jobs
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 5 of 19

Shared Governance
• Shared by who? It is shared decision making between the staff nurses or bedside nurses and nurse leaders, including resources, nursing research or evidence-based practice initiatives, new equipment purchases, and staffing
• Who will benefit? The people in the surrounding communities, the patients, the staff, and the organization
• Who governs? The healthcare team led by the nurse leader will be responsible for safe system delivery of patient care, providing adequate resources. The nurse leader will be helped by staff nurses who will be accountable for patient care outcomes.
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 6 of 19

Harris Health System Shared Governance Model (Background/Significance)
In 2010-2011, the Shared Governance Committee, Staff Nurse Councils, and Pavilion Leadership Teams participated in creating our unique CoPs based on research. – Designed to meet the unique needs of Harris Health System nurses. – Replaced the traditional staff nurse council.
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 7 of 19

Community of Practice (CoP) Harris Health System Nursing’s Shared Governance framework is organized around a network of communities – At the unit/clinic level, it is called the CoP – The development involved identifying CoPs, which consist of groups of RNs who share a common patient care foci, practices, and professional behaviors. The function of CoPs is to make decisions that affect their clinical practice, professional nursing environment, and knowledge development. Clinician-leadership partnership is essential when making decisions that affect nursing practice.
8
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 8 of 19

Resources
• For more information on Harris Health System Shared Governance: • Home (hchd.local) • Community in Practice Resources: • CoP Resource List (hchd.local)
9
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 9 of 19

Problem
• Low participation or attendance • Not active participants • Inconsistent processes (no standardization) • Nurses are not as involved as we want them to be • Great time to introduce examples or reenact what you see as the issue
from your perspective
10
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 10 of 19

Purpose – Overall Goal/Intent
Strengthen the shared governance model to allow our bedside nurses to own and lead their practice. Standardize the logistics of shared governance across the system
11
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 11 of 19

Implementation of Shared Governance (Strategy) How can you as a leader make Shared Governance work in my unit?
• Engage • Commit • Collaborate • Deliver • Encourage (Ahmen Zinhom, 2015. Shared Governance)
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 12 of 19

Implementation of Shared Governance • Market the importance of shared governance
program to staff • An empowered staff should be able to communicate concepts
and the importance of shared governance to anyone, including cost effectiveness
• Ensure Shared Governance is a component in every employee’s job description, peer review, employee evaluation and performance appraisal
• Expectations should be well-defined to nurse managers and staff • Goals and behaviors should be set for every employee – be sure
goals and behaviors are updated regularly to keep stride with a progressive staff and dynamic environment
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 13 of 19

Implementation of Shared Governance
• Ten (10) essential actions for nurse leaders: • Be clear about what shared governance is • Help staff members understand why shared governance is important • Orient council chairpersons on the basics of planning and running meetings • Cultivate a sense of ownership • Encourage a continuous focus on mission and vision • Provide council members with protected time to meet • Include staff in council development or redesign • Coach and mentor chairpersons • Recognize excellence • Study the successes and struggles of others (Marky Medeiros, 2018)
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 14 of 19

Evidence/Best-practices suggest?
• Better patient outcomes • Higher patient satisfaction • Higher nurse satisfaction • Cost-effective? Or budget implications?
15
Make sure you cite your references
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 15 of 19

Plan and timeline (if any)
• Share any key data and key steps
16
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 16 of 19

Recommendations (if any)
• What do you want to adopt, implement, support, re-energize? • How do you want to measure outcomes moving forward?
17
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 17 of 19

• Questions?
18
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 18 of 19

References: APA 7th edition (must also include references to any art clip used or pics)
• Anthony, M. K. (2004). Shared Governance Models: the theory, practice, and evidence. Online Journal of Issues in Nursing, 9(1).
• Harris Health (2010). CoP Resource List. Retrieved from: https://sp2019.hchd.local/teams/nursing/enpg/sg/Pages2/CoPResourceList.aspx
• Harris Health (2010). Shared Governance/CoP. Retrieved from: https://sp2019.hchd.local/teams/nursing/enpg/sg/Pages/Home.aspx
• Medeiros, Marky MSN, RN. Shared governance councils: 10 essential actions for nurse leaders. Nursing Management (Springhouse) 49(7):p 12-13, July 2018. | DOI: 10.1097/01.NUMA.0000538920.83653.9b

19
https://owa.harrishealth.org/owa/service.svc/s/GetFileAttachment?id=AAMkADllZWQ1Njlj…uGlLtp0-eUnNdGuv6rSCm6pw5XtwIOEbYFKKRrv-zfKiOtx6BLrOW5pjiZ6RfxgT8B8-Oma0. 4/16/24, 12:22 PM Page 19 of 19

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