CLM 351 Study Guide
CLM 351 Study Guide CLM 351
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This 29 page Study Guide was uploaded by Sharon Liang on Tuesday February 16, 2016. The Study Guide belongs to CLM 351 at University of Kentucky taught by Dr. John Williams in Spring 2016. Since its upload, it has received 126 views. For similar materials see Health Services Administration in Clinical Laboratory Sciences at University of Kentucky.
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Date Created: 02/16/16
CLM 351 Midterm Powerpoint Notes Chapter 1 Continuum of Care What is Health World Health Organization (WHO) definition: ● state of complete physical, mental, and social wellbeing ● not merely the absence of disease or infirmity Force Field Model of Health Disparities ● differences in health problems, health status, and use of health services, among people who differ in ethnicity, gender, and other characteristics ● managers should understand that disparities are linked to heredity, environment, lifestyle, and use of medical services ● environment and lifestyle can help to prevent disease and illness but have a bigger influence on health than healthcare does which tends to treat patients when they have diseases and/or illnesses Population Health ● defined as a measurement of the community’s health outcomes and factors causing it and later using those measures to coordinate the community’s people and organizations to improve health altogether HCO Environments ● industry ● raw materials ● human resources ● financial resources sector ● market sector ● technology sector ● economic conditions sector ● government sector ● sociocultural sector ● international sector Types of HCOs ● large general hospitals ● hospices ● medical practice groups ● medical supply firms ● pharmaceutical companies ● nursing homes ● physician offices ● health insurance companies ● ambulatory HCOs outpatient diagnostic centers mental health clinics primary care clinics ambulatory surgery centers Healthcare Management Jobs Summary ● health is complete wellbeing: physical, mental, social ● healthcare managers strive to improve the health of their community’s population ● health is determined by 4 broad forces 1) heredity 2) environment 3) lifestyle 4) medical care (healthcare) ● many kinds of HCOs provide healthcare services ● HCOs exist in and are affected by the environment Chapter 2 Trends in Healthcare from 20102060 ● older populations will doubt from 43.1 million to 92 million ● increase in the oldest old (age 85+ triples) ● nonhispanic white population is projected to peak in 2024 ● hispanic population could double 53.3 million in 2012 to 128.8 million in 2060 making ⅓ of US population being hispanic ● the black population expected to increase to 41.2 million to 61.8 million over the same period ● the asian population is projected to more than double with 15.9 million in 2012 to 34.4 million in 2060 ● minorities are now 37% of the US population projected to be 57% in 2060 ● people and organizations are becoming much more connected locally, regionally, nationally and globally. (communication, technology, devices, electronic medical record) ● health care consumers are becoming more knowledgeable about their own health and healthcare ● more focus on population health ● HCOs will join together in a variety of organizational forms ● more physicians will choose to be employed by hospitals and health systems rather than work in own independent medical practice ● demand for primary care will increase and shortage of providers ● payers and purchasers have begun to hold HCOs more accountable ● science and technology lead to new methods of health prevention, diagnosis, and treatment ● there has been about 315,000 jobs in healthcare management in 2014 and is expected to grow 23% faster within the next decade Taylor and Scientific Management ● developed in the 1900s ● believed there was one “best way” to perform a repetitive job ● used standardization, specialization, and scientific experiments to design jobs for ease, efficiency, and production ● led to ergonomics and human engineering Fayol and Administrative Theory Fayol developed this administrative in 1916 with principles to improve entire organizations ● division of work ● specialization ● coordination ● line work ● staff work ● organizational charts ● authority ● line of authority ● unity of command ● span of control ● centralization Organizational Chart Mayo and Human Relations ● evolved from extensive research at Western Electric Hawthorne Plant near Chicago in 1920s and 1930s ● believed organizations to be social constructs ● Hawthorne Effect ● human relations aspects of work and management motivation organization culture group behavior job design GulickManagement Functions ● 5 fundamental management functions come from the work of Gulick, Urwick, and Fayol in 1937 1) Plan: managers decide what to do and how to do it 2) organize: managers arrange work into jobs, teams, departments, and other work units 3) staff: managers obtain and retain people to fill jobs and do the work 4) direct: managers assign work to workers and motivate them to do the work 5) control: managers monitor performance and make necessary adjustments so goals and objectives are achieved Weber and Bureaucratic Theory ● developed in 1937 by Weber ● formal, impersonal management system of authority, hierarchical bureaus, division of labor, and standardized rules hiring and promotion based on ability, not personal relationships ● makes organizations more predictable, efficient, and stable less flexible, personal, and innovative Contingency Theory1958, 1961, 1965 ● there’s no single best way to structure an organization ● the “best way” is contingent on other organizational factors such as environment purpose size technology ● one size does not fit all KatzManagement Skills 1974 ● Katz found that managers use 3 basic kinds of skills to perform work 1) Technical Example: preparing a therapist’s job description 2) Human Example: inspiring the maintenance workers 3) Conceptual Example: envisioning future goals for a surgery group practice Institutional Theory1977, 1983 ● organizations and managers feel pressure to conform to what society and stakeholders demand conformance earns “legitimacy” for the organization if stakeholders view the organization as legitimate, they’ll give the organization more support. ● managers may do what society and stakeholders say is right, proper, and correct though doing so reduces organizational efficiency ● Example: An HCO buys supplies from local vendor local stakeholders expect the HCO to “buy local” to support the local community but the HCO could save money (be more efficient) if it bought supplies from a highvolume, lowprice national distributor Management Roles 1990 ● Mintzberg studied managers and found they perform 10 management roles fitting into 3 broad groups 1) Interpersonal figurehead leader liaison 2) Informational monitor disseminator spokesperson 3) Decisional entrepreneur negotiator resource allocator disturbance handler Complex Adaptive Systems1992, 1998 ● some organizations are complex and unpredictable relationships among system parts not constant, proportional, or predictable changes among parts may have large effects, small effects, no effects, or unpredictable effects behave like natural biological organisms rather than rigid mechanical machines able to selforganize and selfmanage able to adapt ● viewing the organization as a complex adaptive system useful when the organization has many interrelated parts useful when the environment changes quickly and unpredictably All Managers Do Not Manage the Same Way ● Managers perform similar roles but don’t all perform those roles the same way. differences in personalities, attitudes, worldviews, biases, styles, and preferences differences in work situations ● different departments might require different styles of management Theories of Management Summary ● management is the process of getting things done through and with people ● management began to develop as a body of knowledge in the 1900s with scientific management ● administrative theory improved organization structure, levels or organization, and supervisorsubordinate relationships ● sometimes organizations do things to appear “proper” to stakeholders rather than to improve organizational efficiency ● viewing an organization as a complex adaptive system is useful when the organization has many interrelated parts and the environment changes quickly and unpredictably. ● managers perform similar roles, tasks, and activities yet may do so differently because of different styles, personalities, biases, and situations ● There’s no single “best way” to manage an organization; the “best way” is contingent on changing factors. Chapter 15 Professionalism ● defined as the ability to align personal and organizational conduct with ethical and professional standards ● responsibility to the patient and community ● service orientation ● commitment to lifelong learning and improvement ● personal and professional accountability ● professional development ● contributions to community and profession Professional Character and Conduct ● trustworthy ● engaged ● polite ● dependable ● pleasant ● listens well ● gives praise ● shares credit ● accountable ● accepts criticism ● learns from mistakes ● apologizes ● meets deadlines ● avoids workplace gossip ● respects confidentiality ● neat and clean ● pursues excellence Emotional Intelligence (EI) ● defined as the ability to recognize and understand emotions in oneself and others then use this awareness to manage behavior and relationships ● people in general are strongly impacted by feelings ● managers must understand their own emotions as well as others ● in order to be an excellent manager, they must have good emotional intelligence ● 4 core skills 1) selfawareness: ability to perceive emotions accurately as they happen 2) selfmanagement: ability to use emotional awareness to positively direct behavior 3) social awareness: ability to understand people’s emotions and the organizational “mood” 4) relationship management: ability to use awareness of own emotions and others’ emotions to inspire greatness Cultural Competence ● defined as the knowledge, skills, attitudes to understand and interact well with people who are culturally different from oneself ● people are diverse in many aspects of culture and identity (such as race, ethnicity, faith and religion, gender, sexual orientation, disability, personality, social status, age, geographic origin, etc) ● diversity means to differences What is Communication? ● transmitting info to someone else to develop shared understanding ● primary purpose is to create understanding among others * managers must use communication to perform management functions and roles Types of Communication ● one to one ● one to group ● group to group ● interpersonal ● organizations ● groups ● intentional and unintentional ● formal and informal Communication Process (Essential Elements of Communication) ● idea: thought, opinion, or feeling in sender’s mind ● sender: person who has an idea to communicate with someone else ● message: sender’s idea encoded (expressed) in words, icons, symbols, visuals, speech, body language, behaviors, or actions ● channel: method/media to transmit message from sender to receiver ● receiver: person(s) to whom the message is communicated ● barriers: biases, distraction, or other obstacles that impede communication Communication Model Communication Channels ● how do managers transmit messages? ● channels are methods and media that carry an encoded message from sender to receiver ● use of multiple channels helps avoid “communication breakdowns” ● channels differ in information richness ● the richer a channel, the more quickly it creates understanding in receivers Information Richness of Communication Channels Which Channels to Use? ● it all depends on situation ● sender should pick effective channels after considering the channels’ pros and cons Barriers, Filters, and Lenses ● barriers can distort or block communications at all stages of encoding, sending, receiving, and decoding Tips for Effective Communication ● be accessible and open to communication ● prepare to communicate by clearing distractions, anticipating barriers, and encoding and transmitting to fit intended receivers ● empathize ● adjust your communication to fit cultural diversity ● seek feedback when communicating ● communicate carefully when feeling strong emotions ● use multiple channels and repetition ● listen for both meaning (content) and feeling (emotions) ● practice and develop communication skills ● create an organizational culture that values communication Summary ● professionalism is the ability to align personal and organizational conduct with ethical and professional standards ● emotional intelligence is the ability to recognize and understand emotions in oneself and others and then use this awareness to manage behavior and relationships ● cultural competence is the knowledge, skills, and attitudes needed to understand and interact well with people who are culturally different from oneself ● communication is transmitting info to someone else to develop shared understanding ● managers use professionalism, emotional intelligence, cultural competence, and communication to perform management functions and roles ● communication involves an idea, sender, message, channel, receiver, and barriers ● managers can use the communication model and process to avoid communication breakdowns Chapter 3 What is Planning? ● First of the five main management functions. Other functions include organize, staff, direct (lead), and control ● future oriented ● should precede other management functions Levels of Planning ● managers plan at all levels of management ● high level managers plan “what to do” over longer time periods with a broader perspective of organization ● lower level managers plan “how to do it” over shorter time periods following steps to achieve the higherlevel “what to do” in support of higherlevel strategic plans with narrower perspective (their areas of responsibility) Planning in Small and Large HCOs ● Small HCOs fewer staff specialists in planning top managers do more planning work themselves ● Large HCOs more specialized staff in charge of planning finance, marketing, and planning departments assist top managers in planning Strategic Planning ● highest level of planning ● enables an organization to examine where it is now decide where it wants to be in the future figure out how it’ll get there plan how to succeed Strategy for an HCO ● pattern of ideas how to achieve a goal ● used to attain and sustain competitive advantage ● should guide managers’ decisions ● should be sustainable Porter’s 2 Strategies ● a business may gain competitive advantage to succeed in its market by using one of two approaches low cost strategy: an HCO drives down its costs as low as possible differentiation strategy: an HCO makes its products and services different (from those of competitors) in ways that appeal to customers Implementation Planning ● managers develop an implementation plan to bring to life the strategic plan more detailed and specific than strategic planning involves more tasks and actions than strategic planning identifies resources needed names people responsible for specific actions requires planning for specific projects Project Planning ● can be simple or complex ● states purpose of project ● identifies specific outputs project will deliver ● determines tasks that need to be done ● organizes timeline with sequence of tasks ● designates who’s responsible for tasks ● often uses a Gantt chart to summarize plan Project Management ● managers implement projects to achieve goals in the strategic plan ● project management is the application of knowledge, skills, tools, and techniques to meet project requirements ● benefits better control of resources customer relations development times costs, quality, and profit margins productivity coordination worker morale reliability Business Plan ● helps managers implement HCO’s goals ● guide for starting and operating business to achieve goals and objectives Sources of Data for Planning ● Data in HCO’s digital and paper files, reports, surveys, and other documents data about customers, supplies, workloads, products and services, staff hours data stored in warehouses (searchable by employees) data analytics to better understand organization, consumers, competitors, and environment ● Internet data and information local demographic and epidemiological data information about HCOs and health trends in community trends and predictions for HCOs ● People talk with stakeholders and gather opinions about trends and what may happen ask what they think your competitors will do get feedback about your products and services Useful Guidelines for Planning ● View planning as a process rather than a onetime event ● value the process of planning and the actual plan ● realize planning is orderly yet messy, and sequential yet circular ● allow flexibility in the planning process and the plan alone ● combine objective analysis with subjective judgment ● use (but not overuse) historical records and data ● look inward (at organization) and outward (at environment) Stakeholders ● people and other organizations who have an interest in the organization ● stakeholders can be internal or external to organization Stakeholder Diagram Gantt chart: Example of IRIS Project Dec Jan Feb Mar Apr May Jun Select Leaders Renovate Building Select Team Leaders Select Team Members Teams sent for CE regarding SAP Hire Consultants Prepare campus for change SWOT Analysis: Example UK Basketball Summary ● planning is deciding what to do and how to do it ● higher level managers plan for long time horizons and with a broad perspective of the HCO ● lowerlevel managers plan for shorter time periods and for smaller segments of the HCO ● strategic planning helps HCOs prepare for the future ● HCOs use project plans to implement goals ● managers use business plans and project management methods to achieve organizational goals ● a stakeholder is a person or organizations who has an interest in another organization ● Gantt chart and SWOT Analysis are tools that help with project planning Chapter 4 Open and Closed Systems ● closed systems: organizations don’t interact w/environment ● open systems: organizations are affected by their environments HCOs and the Environment ● healthcare organizations should be viewed as open to their environments acquire resources, staff, supplies, equipment, information, technology, and other inputs from their environment give, sell, provide, and deliver outputs, products and services to customers, clients and people in the environment HCOs are Open to the Environment 5 Types of Organization 1) work tasks into job/positions 2) jobs into work units (e.g. departments) 3) departments into an entire organization 4) work must be coordinated 5) the organization must be linked to its environment Division of Work and Specialization ● 100s of tasks are done in HCOs ● managers design jobs to organize all these tasks into specific jobs so that tasks are not randomly done or left to chance certain jobs are held accountable for certain tasks specialization is created Other Elements of Jobs ● Managers decide how much authority to delegate to a job reporting relationships needed qualifications Flow of the Organization Tasks → jobs → department → organization Organizing Jobs and Positions into Departments and Work Units ● a department contains jobs organized around a common factor perform the same kind of work serve the same group of customers create the same health service work in the same place work at the same time Department Organization Charts Decentralizing Authority ● delegate more authority from upper level to lower level positions to make decisions ● relieve higher positions of some work and decisions Coordinating Jobs and Positions ● supervision: workers have a supervisor (subordinate relationship in the chain of command and inform each other) ● mutual adjustment: workers do not have a supervisor (subordinate relationship in the chain of command and exchange information) ● standardized work process: a specific, consistent method of how to perform work ● standardized work output: specific, consistent contents of completed work ● standardized worker skills: specific education, training, and skills needed for a job ● groups: workers from multiple work units and departments exchange info in meetings, patient rounds, conferences, committees, and task forces External Environment Affects Job Design Internal Factors Affect Job Design ● internal factors to consider when organizing tasks into jobs size goals worker motivation coordination A Few Complications ● informal organizations ● contract workers ● unionized workers ● physicians Summary ● an organization is a social entity that is goal directed deliberately structured activity system linked to external environment ● an organization acquires resource inputs from environment transforms inputs into outputs such as products and services discharges outputs into external environment ● managers deliberately structure HCOs by organizing jobs, departments, and organizations ● there’s no single best way to organize since it’s contingent on external factors in the environment internal factors in the HCO ● organizations usually blend mechanistic and organic approaches to fit their contingency factors Chapter 5 Positions and Departments ● managers organize work to accomplish goals and adapt to external environment organize works tasks into positions and departments apply many principles to create a whole organization i. hierarchy ii. span of control iii. delegation of authority iv. centralization v. line and staff vi. departmentalization Forms of Organizational Structure ● functional form: organizes departments and positions according to the functions workers perform and the abilities they use ● divisional form: organizes departments and positions to focus on particular groups of customers or services ● modular: outsources most of the work to other organizations and connects them with contracts and electronic systems ● parallel: starts with a functional structure to produce routine work and adds a parallel structure to organize multidepartment approaches to solve complex problems ● matrix: combines functional and divisional organization forms to obtain advantages of both Functional Organization Chart Advantages and Disadvantages of the Functional Form Advantages ● specialized positions grouped in departments ● efficiency and cost control ● development of indepth knowledge and abilities Disadvantages ● slow decision making ● slow adaptation to changing environment ● functional silos focus on functional work ● inadequate horizontal departmental coordination Divisional Organization Chart Advantages and Disadvantages of the Divisional Form Advantages ● adapts to the changing environment ● better customer satisfaction ● decentralized faster decisions ● coordination of functions within divisions Disadvantages ● inefficiency because of more staff and expense ● product/service silos focus on their services ● less coordination and synergy among products/services ● less development of functional expertise Coordination within an HCO ● managers link departments horizontally, vertically, and diagonally so that they all work together toward the mission use coordination mechanisms for linkage use liaison, who coordinates one department with another use integrator, who works full time coordinating the work of several departments toward a common purpose Governing Body ● The Board of Directors is at the top of most hospitals ● The Board acts on behalf of hospital ● The Board appoints president of hospital approves mission, goals, vision, strategies, the budget assures compliance with laws and regulations monitors performance Physicians ● some physicians work in a hospital’s jobs as hospital employees or contracted workers paid by the hospital ● most physicians don’t work in a hospital’s jobs have their own medical offices in community admit and see patients in hospital paid by patients or insurers Medical Staff Structure ● physicians are organized into medical departments and divisions based on medical specialties ● medical staff structure coexists with the management structure to form the total hospital organization ● conflict may arise between medical staff structure and administrative structure physicians and managers Interorganizational Structures ● managers link HCO with other organizations by using interorganizational structures alliances joint ventures hospital systems networks independent practice associations Summary ● managers use hierarchy, span of control, delegation of authority, centralization, and departmentalization to create an organization ● managers can use different organizational forms: functional, divisional, matrix, parallel, and modular or mixed forms ● managers may created blended forms ● managers use coordinating structures within the organization to connect jobs, work units, and departments Chapter 6 Definitions ● group: social interaction between two or more people in a stable arrangement who have common goals and perceive themselves as a group ● team: special group with specific complementary abilities, strong commitment to common goals, and shared accountability for goal achievement ● committee: formal group that’s established with an official mandate, is linked to the organizational hierarchy, and is accountable for the mandate Purpose of Groups ● coordinate work ● enable workers to grow in new roles and exchange skills, knowledge, and learning ● build commitment ● improve problem solving and decision making ● obtain input and representation of stakeholders Why are Groups Common in HCOs? 1. Healthcare is multidisciplinary 2. Many HCOs are open 24/7/365 or 366 that they require new shifts of workers throughout the day 3. Need to coordinate among groups of workers Groups ● structure creates and sustains the group ● process is how the group works to accomplish its goals How Managers Create Good Groups Create effective structures 1) purpose ● each group must have a clear purpose (sometimes called a charge or mandate). guides the group helps the group stay focused helps measure progress and achievement 2) size 3) membership ● who can provide knowledge, skills, attitudes the group needs perform helpful task and maintenance roles and avoid harmful personal roles work well with others in groups grow professionally from group memberships represent stakeholders spare sufficient time to participate 4) relation to organizational hierarchy ● link the group to the organization structure ● a committee that ties into a high level in the formal organization is perceived as important and powerful high level association provides i. political clout ii. resources to succeed 5) authority ● managers must decide what (if any) authority the group will have ● will the group have authority set policies spend money make or recommend decisions require actions of others 6) leader ● will managers appoint a leader or allow group members to elect their own leader? ● how long should someone be allowed to serve as a group leader? ● what duties or authorities must a group leader have? ● who will fit the group leader position? 7) culture ● group’s values, attitudes, and norms influences its effectiveness should fit purpose of group shouldn’t conflict with HCO’s overall culture “ground rules” Create effective processes 1) developing ● there are 5 stages of development 1. forming 2. storming 3. norming 4. performing 5. adjourning 2) leading ● motivate and influence group members ● when leading, leaders should share vision and goals for group divide up work, tasks, and responsibilities resolve conflicts motivate group members perform tasks and maintenance roles interact effectively with each group member 3) communicating and interacting ● effective communication processes needed within the group needed by group with others outside the group ● involves speaking, listening, discussing, persuading, explaining, and other interpersonal communications 4) decision making ● ranges from autocratic to democratic ● groups should ensure members are accountable for decisions avoid groupthink when making decisions without considering diverse ideas; done to maintain group harmony 5) learning ● Concerned with the group learning about itself ● the group must reflect on its structure and its processes learn how it’s doing as a group ● enables a group to learn about itself and adjust its structures and processes to improve performance Roles in Groups ● task roles help the group achieve its tasks, goals, and purpose ● maintenance roles help group members maintain good feelings about the group and its members up ● personal roles help group members fulfill personal needs rather than help the group ● task and maintenance roles help the group whereas personal roles harm the group Processes of Groups and Teams ● structure only creates a committee or group ● groups must have processes that do their work ● 5 group processes Effective Meetings ● before calling a meeting, ensure the meeting is really needed ● plan the meeting: who, what, where, when, why, and how ● send participants the agenda and reading materials early enough so that they can read and prepare ● orient new members before the meeting ● arrange for someone to record minutes for later distribution ● set tone and state ground rules ● respect other’s time by being on time, staying on time, and ending on time ● state purpose of meeting ● lead the meeting, stay on agenda, and use time wisely to cover all agenda items ● respect everyone by leading a balanced discussion, seeking input from everyone and performing task and maintenance roles ● don’t spend meeting time on issues better discussed by smaller committees or oneonone ● use timeouts, mediation, or separate meetings, if necessary, to resolve conflicts ● end on a positive note, summarize meeting, review assignments, and thank participants ● follow through on decisions, assignments, and arrangements for next meeting Summary ● a group involves social interaction between two or more people ● groups such as teams, committees, task forces, and councils coordinate work in HCOs ● group success requires 7 structural characteristics: purpose, size, membership, relation to organizational hierarchy, authority, leader, and culture ● group success requires 5 processes: developing, leading, communicating and interacting, decision making, and learning ● task and maintenance roles help the group while personal roles harm the group
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