Read chapter 9 page 273, answer to the questions bellow, 1. The local library holds a monthly town hall meeting attended by more than 100 residents, recorded for the internet,
Read chapter 9 page 273, answer to the questions bellow,
1. The local library holds a monthly town hall meeting attended by more than 100 residents, recorded for the internet, and covered in several local news media outlets. You are asked to present a program identifying ways to improve your community’s health. What are the key points your audience should take away?
2. The president of the local not-for-profit hospice wants to have lunch. She is concerned that your HCO is not referring as many patients as it should. Should you invite her to lunch? If so, what should you do to prepare? If not, does her interest require any other action?
3. Your HCO is integrating several primary care physician groups into a primary care service line. Several of the physician leaders approach you, saying that they would like to move toward implementing the patient-centered medical home concept, working toward reduced hospital and emergency care. Make a checklist of questions you need to think about before you respond.
4. Pursuing excellence in care, your large, not-for-profit HCO has moved many outcomes measures to the best quartile. Associate turnover is down, patient satisfaction and market share are increasing. Senior leadership concludes that long-run success requires a shift to a population health mission. What arguments would you prepare to address the governing board? What counterarguments would you expect, and how would you respond? Should you explicitly propose developing a community coalition?
5. A large, not-for-profit HCO begins its move from providing excellence in care to supporting population health with a comprehensive review of population health needs. It forecasts current and benchmark demand for specific exhibit 9.1 services. The near term shows high emergency and inpatient use and shortages of support for mental illness and several diseases associated with aging. How should it organize a systematic response? What task forces, what tasks are they charged with, and who are their members? What consultant assistance would be helpful?
ORGANIZATION
THE
WELL-MANAGED
KENNETH R. WHITE
JOHN R. GRIFFITH
NINTH EDITION
HEALTHCARE
HAP/AUPHA Editorial Board for Graduate Studies
Carla A. Stebbins, PhD, Chairman Rochester Institute of Technology
Kevin Broom, PhD University of Pittsburgh
Erik L. Carlton, DrPH University of Memphis
Daniel Estrada, PhD University of Florida
Edmond A. Hooker, MD, DrPH Xavier University
LTC Alan Jones, PhD, FACHE US Army
Christopher Louis, PhD Boston University
Peggy J. Maddox, PhD George Mason University
Donna Malvey, PhD University of Central Florida
Brian J. Nickerson, PhD Icahn School of Medicine at Mount Sinai
Stephen J. O’Connor, PhD, FACHE University of Alabama at Birmingham
Maia Platt, PhD University of Detroit Mercy
Debra Scammon, PhD University of Utah
Tina Smith University of Toronto
James Zoller, PhD Medical University of South Carolina
Health Administration Press, Chicago, Illinois
Association of University Programs in Health Administration, Washington, DC
White-Griffith.indd 3 2/6/19 10:11 AM
Your board, staff, or clients may also benefit from this book’s insight. For information on quantity discounts, contact the Health Administration Press Marketing Manager at (312) 424-9450.
This publication is intended to provide accurate and authoritative information in regard to the subject matter covered. It is sold, or otherwise provided, with the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought.
The statements and opinions contained in this book are strictly those of the authors and do not represent the official positions of the American College of Healthcare Executives, the Foundation of the American College of Healthcare Executives, or the Association of University Programs in Health Administration.
Copyright © 2019 by Kenneth R. White and John R. Griffith. Printed in the United States of America. All rights reserved. This book or parts thereof may not be reproduced in any form without written permission of the publisher.
23 22 21 20 19 5 4 3 2 1
Library of Congress Cataloging-in-Publication Data Names: White, Kenneth R. (Kenneth Ray), 1956- author. | Griffith, John R., author. Title: The well-managed healthcare organization / Kenneth R. White, John R. Griffith. Description: Ninth edition. | Chicago, Illinois : Health Administration Press; Washington, DC : Association of University Programs in Health Administration, [2019] | Series: AUPHA/HAP editorial board for graduate studies | Includes bibliographical references and index. Identifiers: LCCN 2018049544 (print) | LCCN 2018050390 (ebook) | ISBN 9781640550599 (ebook) | ISBN 9781640550605 (xml) | ISBN 9781640550612 (epub) | ISBN 9781640550629 (mobi) | ISBN 9781640550582 (print : alk. paper) Subjects: LCSH: Health services administration. Classification: LCC RA971 (ebook) | LCC RA971 .G77 2019 (print) | DDC 362.1068–dc23 LC record available at https://lccn.loc.gov/2018049544
The paper used in this publication meets the minimum requirements of American National Standard for Information Sciences—Permanence of Paper for Printed Library Materials, ANSI Z39.48- 1984. ∞ ™
Acquisitions editor: Janet Davis; Project manager: Theresa L. Rothschadl; Cover designer: Scott Miller; Layout: PerfecType
Found an error or a typo? We want to know! Please email it to [email protected], mentioning the book’s title and putting “Book Error” in the subject line.
For photocopying and copyright information, please contact Copyright Clearance Center at www. copyright.com or at (978) 750-8400.
Health Administration Press Association of University Programs A division of the Foundation of the American in Health Administration College of Healthcare Executives 1730 M Street, NW 300 S. Riverside Plaza, Suite 1900 Suite 407 Chicago, IL 60606-6698 Washington, DC 20036 (312) 424-2800 (202) 763-7283
v
BRIEF CONTENTS
Preface ……………………………………………………………………………………….xvii
Section I Introduction and Overview
Chapter 1. Foundations of Well-Managed Healthcare Organizations ..3
Chapter 2. Creating and Sustaining a Transformational Culture ……..35
Chapter 3. Building Continuous Improvement ……………………………63
Chapter 4. Establishing Strategic Governance ……………………………..99
Section II Clinical Excellence
Chapter 5. Foundations of Clinical Excellence …………………………..139
Chapter 6. The Clinical Staff Organization ……………………………….173
Chapter 7. Nursing ……………………………………………………………….209
Chapter 8. Clinical Support Services ………………………………………..241
Chapter 9. Population Health …………………………………………………273
Section III Logistic and Strategic Support
Chapter 10. Knowledge Management ………………………………………..307
Chapter 11. Human Resources …………………………………………………337
Chapter 12. Environment of Care …………………………………………….369
Chapter 13. Financial Management …………………………………………..401
Chapter 14. Internal Consulting ……………………………………………….439
Chapter 15. Marketing and Strategy ………………………………………….471
Glossary …………………………………………………………………………………….507 Index ………………………………………………………………………………………..515 About the Authors ……………………………………………………………………….557
vii
DETAILED CONTENTS
Preface ……………………………………………………………………………………….xvii
Section I Introduction and Overview
Chapter 1. Foundations of Well-Managed Healthcare Organizations ..3 Purpose: Mission of Healthcare Organizations ………………4 Defining Excellence ……………………………………………………5
Excellence in Patient Care ……………………………………….5 Excellence in Population Health ……………………………….6 Sources for The Well-Managed Healthcare Organization .6
Team Structure of Twenty-First-Century Care ……………….7 Clinical Teams—Interprofessional Care and Clinical
Support ……………………………………………………………7 Clinical Support Teams …………………………………………..9 Logistic and Strategic Teams ……………………………………9 Current Trends ……………………………………………………10
Stakeholders …………………………………………………………..10 Patients and Families …………………………………………….11 Associates ……………………………………………………………12 Other Customer Partners ………………………………………12 Other Provider Partners ………………………………………..15 Stakeholder Influence: Networking, Coalition Building,
and Legal Controls …………………………………………..15 The Healthcare Marketplace ……………………………………..16
The Origin and Development of HCOs …………………..16 The Current American Marketplace …………………………17 The Hospital Sector ……………………………………………..18 Physician and Other Health Services………………………..20 Post-Acute and Specialty Care ………………………………..20 Other Sectors of the Healthcare Economy ……………….21
Achieving Excellence in HCOs ………………………………….21
Detai led Contentsviii
Transformational Culture ………………………………………22 Continuous Improvement ……………………………………..23 Commitment to Evidence ……………………………………..23 Leaders ………………………………………………………………24 The Role of Strategic Teams ………………………………….25
Managing and Leading Excellent Healthcare Organizations …………………………………………………….25
Reducing Variation in Healthcare Organization Performance ……………………………………………………26
Meeting the Needs of Clinical Care Teams ……………….27 Supporting Continuous Improvement ……………………..28
Practice Applications ……………………………………………….29 Notes ……………………………………………………………………30
Chapter 2. Creating and Sustaining a Transformational Culture ……..35 Purpose …………………………………………………………………36 Functions ………………………………………………………………37
Empower HCO Associates …………………………………….37 Promote Service Excellence ……………………………………39 Communicate ………………………………………………………43 Define and Model Values……………………………………….46 Reward-Associated Contribution …………………………….48 Protect HCO Assets ……………………………………………..50 Improve Continuously ………………………………………….53
People …………………………………………………………………..53 Measures ……………………………………………………………….55 Managerial Leadership ……………………………………………..56
Explaining the Culture ………………………………………….57 Practice Applications ……………………………………………….59 Notes ……………………………………………………………………60
Chapter 3. Building Continuous Improvement ……………………………63 Purpose …………………………………………………………………64 Functions ………………………………………………………………64
Monitor Stakeholder Needs and Identify Responsive Goals ……………………………………………………………..66
Provide Evidence-Based Information ……………………….68 Long- and Short-Term Forecasts …………………………….74 Coordinated Goals, Logistics, and Support: The Annual
Planning Calendar ……………………………………………78 Design Corporate Structure …………………………………..79
Detai led Contents ix
Support HCO-wide Process Analysis ……………………….83 Improve Continuously …………………………………………..88
People …………………………………………………………………..89 Measures ……………………………………………………………….90 Managerial Leadership……………………………………………..92
Making the Case for Continuous Improvement …………92 Enhancing Transformational Culture and Continuous
Improvement …………………………………………………..93 Practice Applications ……………………………………………….95 Additional Resources ……………………………………………….96 Notes ……………………………………………………………………97
Chapter 4. Establishing Strategic Governance ……………………………..99 Purpose ……………………………………………………………….100 Functions …………………………………………………………….101
Maintain Leadership Capability. …………………………….103 Establish the Mission, Vision, and Values ……………….105 Ensure Quality of Clinical Care …………………………….105 Approve the Corporate Strategy and Annual
Implementation ……………………………………………..107 Monitor Performance Against Plans and Budgets …….111 Improve Continuously …………………………………………113
People …………………………………………………………………114 Board Membership ……………………………………………..114 Membership Qualifications …………………………………..117 Board Selection ………………………………………………….119 Board Organization…………………………………………….121 Education and Information Support for Board
Members ………………………………………………………127 Measures ……………………………………………………………..128 Managerial Leadership……………………………………………128
Operating Discipline ……………………………………………128 Legal and Ethical Issues of Board Membership ………..130
Practice Applications ………………………………………………132 Additional Resources ……………………………………………..132 Notes ………………………………………………………………….133
Section II Clinical Excellence
Chapter 5. Foundations of Clinical Excellence …………………………..139 Purpose ……………………………………………………………….140
Detai led Contentsx
Functions …………………………………………………………….141 Ensure Accurate Diagnosis …………………………………..141 Provide Excellent Care ………………………………………..145 Individualize Patient Care Planning and Treatment ….153 Improve Community Health ………………………………..155 Improve Clinical Performance ………………………………156
People …………………………………………………………………157 Building an Engaged Workforce ……………………………157 Organizing Clinical Units …………………………………….158 Interprofessional Conflicts ……………………………………159
Measures ……………………………………………………………..160 Scorecards for Clinical Services ……………………………..160 Value-Based Purchasing ……………………………………….163
Managerial Leadership……………………………………………164 Sustaining the Platform of IPOCs, Guidelines, and
Protocols ………………………………………………………164 Sustaining a Culture of Teamwork and Respect ……….165 Maintaining Continuous Clinical Improvement ……….166
Practice Applications ………………………………………………167 Additional Resources ……………………………………………..168 Notes ………………………………………………………………….168
Chapter 6. The Clinical Staff Organization. ……………………………….173 Purpose ……………………………………………………………….174 Functions …………………………………………………………….175
Achieve Excellent Care ………………………………………..175 Review Credentials and Recommend Privileges. ……….179 Determine, and Recruit for, Clinical Staff Need ……….186 Provide Clinical Education …………………………………..191 Negotiate Compensation Arrangements …………………193 Improve Continuously …………………………………………195
People …………………………………………………………………197 Clinical Staff Organization……………………………………198 Clinical Staff Leadership ………………………………………199
Measures ……………………………………………………………..199 Managerial Leadership……………………………………………200
Building Supportive Relationships …………………………200 Representing Clinical Staff on the Governing Board …202 Ensuring Adequate Clinical Staff Supply …………………203
Practice Applications ………………………………………………203 Additional Resources ……………………………………………..204 Notes ………………………………………………………………….204
Detai led Contents xi
Chapter 7. Nursing ……………………………………………………………….209 Purpose ……………………………………………………………….210 Functions …………………………………………………………….211
Deliver Excellent Care …………………………………………211 Coordinate Interprofessional Care …………………………217 Educate Patients, Families, and Communities ………….219 Maintain the Nursing Organization ……………………….220 Improve Continuously …………………………………………223
People …………………………………………………………………225 Team Members ………………………………………………….225 Organization ……………………………………………………..230
Measures ……………………………………………………………..231 Managerial Leadership……………………………………………233
Sustaining the Nurse Supply …………………………………233 Providing Adequate Training ……………………………….234 Supporting Empowerment …………………………………..234 Delivering Continuous Improvement …………………….235
Practice Applications ……………………………………………..235 Additional Resources ……………………………………………..236 Notes ………………………………………………………………….236
Chapter 8. Clinical Support Services ………………………………………..241 Purpose ……………………………………………………………….242 Functions …………………………………………………………….243
Provide Excellent Care ………………………………………..243 Maintain Patient Relationships. ……………………………..245 Maintain Consultative Relationships ………………………247 Plan and Manage Operations ………………………………..249 Improve Continuously …………………………………………253
People …………………………………………………………………260 Team Members ………………………………………………….260 CSS Leadership ………………………………………………….261 The HCO Manager …………………………………………….261 Organization ……………………………………………………..262 HCO–CSS Relationships ……………………………………..263
Measures ……………………………………………………………..263 Managerial Leadership……………………………………………265
Should the HCO Offer the Service? ………………………266 How Big Should the CSS Be? ……………………………….266 What Are the Continuous Improvement Goals the
CSS Should Meet? ………………………………………….267
Detai led Contentsxii
What Is the Best Contractual Form for the HCO–CSS Relationship?. …………………………………………………267
Does the CSS Have the Coordination It Needs? ………268 Are CSS Activities Correctly Assigned to Professional
and Nonprofessional Associates?. ……………………….268 What Are the Longer-Term Trends and Implications
for the CSS? …………………………………………………..269 Practice Applications ……………………………………………..270 Additional Resources ……………………………………………..271 Notes ………………………………………………………………….271
Chapter 9. Population Health …………………………………………………273 Purpose ……………………………………………………………….274 Functions …………………………………………………………….276
Quantify Population Health Needs ………………………..277 Establish a Population Health Strategy …………………..284 Operationalize a Population Health Strategy …………..290 Improve Continuously ………………………………………..292
People …………………………………………………………………292 Measures ……………………………………………………………..294
Operational ……………………………………………………….294 Strategic ……………………………………………………………294
Managerial Leadership……………………………………………295 Promote and Teach Population Health …………………..296 Extend Management Concepts to Population Health
Care Teams ……………………………………………………297 Expand and Integrate Primary Care ……………………….298 Maintain the Infrastructure for Population Health …..299 Manage the Impact of Population Health on Acute
Care Services …………………………………………………300 Practice Applications ……………………………………………..300 Additional Resources ……………………………………………..301 Notes ………………………………………………………………….302
Section III Logistic and Strategic Support
Chapter 10. Knowledge Management ………………………………………..307 Purpose ……………………………………………………………….308 Functions …………………………………………………………….309
Provide Prompt and Useful Access to Management Information …………………………………………………..310
The EHR and “Meaningful Use” ………………………….314
Detai led Contents xiii
Ensure the Reliability and Validity of Data ………………316 Maintain Communications and Software Support …….320 Ensure the Appropriate Use and Security of Data …….321 Improve Continuously …………………………………………324
People …………………………………………………………………326 Chief Information Officer…………………………………….326 KM Planning Committee. …………………………………….327 Organization ……………………………………………………..327
Measures ……………………………………………………………..327 Managerial Leadership……………………………………………328
Achieving an Effective Knowledge Management Planning Committee……………………………………….328
Expanding the Use of the EHR and Clinical Data ……331 Practice Applications ………………………………………………332 Additional Resources ……………………………………………..333 Notes ………………………………………………………………….333
Chapter 11. Human Resources …………………………………………………337 Purpose ……………………………………………………………….338 Functions …………………………………………………………….339
Plan Workforce Needs …………………………………………341 Develop Workforce Contribution. ………………………….341 Provide Workforce Services …………………………………..348 Manage Compensation and Benefits ………………………350 Conduct Collective Bargaining ……………………………..358 Improve Continuously …………………………………………359
People …………………………………………………………………359 Human Resources Professionals ……………………………359 Organization of the Human Resources Department …360
Measures ……………………………………………………………..361 Managerial Leadership……………………………………………363
Associates’ Perceptions ………………………………………..363 Adequate Human Resources Funding …………………….364 Consistent Leadership …………………………………………364
Practice Applications ………………………………………………365 Additional Resources ……………………………………………..366 Notes ………………………………………………………………….366
Chapter 12. Environment of Care ……………………………………………..369 Purpose ……………………………………………………………….370 Functions …………………………………………………………….370
Design and Plan Facilities and Allocate Space ………….370
Detai led Contentsxiv
Maintain Facilities and Provide Guest Services …………376 Comply with Regulatory and Safety Requirements …..381 Manage Supply Chain and End-User Satisfaction …….384 Plan for Emergency and Disaster Response ……………..386 Improve Continuously …………………………………………388
People …………………………………………………………………389 Leadership and Professional Personnel ……………………389 Outside Contractors ……………………………………………390 Training ……………………………………………………………391 Incentives and Rewards ……………………………………….391 Organization ……………………………………………………..391
Measures ……………………………………………………………..392 Resource Consumption and Effectiveness ……………….393 Quality ……………………………………………………………..393
Managerial Leadership……………………………………………394 Facilities Planning and Space Allocation ………………….395 Selection and Management of Outsourcing
Contracts ………………………………………………………396 Integration of Environmental Services with Other
Activities ……………………………………………………….397 Practice Applications ………………………………………………397 Additional Resources ……………………………………………..398 Notes ………………………………………………………………….399
Chapter 13. Financial Management ……………………………………………401 Purpose ……………………………………………………………….402 Functions …………………………………………………………….402
Record and Report Transactions That Change the Value of the Firm ……………………………………………402
Assist Operations in Setting and Achieving Performance Improvements ……………………………..407
Manage Future Financial Status …………………………….411 Manage Cash, Financing, and Debt ……………………….418 Protect Corporate Assets Against Loss, Distortion, or
Conversion ……………………………………………………423 Improve Continuously …………………………………………427
People …………………………………………………………………427 Chief Financial Officer ………………………………………..427 Other Professional
Collepals.com Plagiarism Free Papers
Are you looking for custom essay writing service or even dissertation writing services? Just request for our write my paper service, and we'll match you with the best essay writer in your subject! With an exceptional team of professional academic experts in a wide range of subjects, we can guarantee you an unrivaled quality of custom-written papers.
Get ZERO PLAGIARISM, HUMAN WRITTEN ESSAYS
Why Hire Collepals.com writers to do your paper?
Quality- We are experienced and have access to ample research materials.
We write plagiarism Free Content
Confidential- We never share or sell your personal information to third parties.
Support-Chat with us today! We are always waiting to answer all your questions.
Related Posts
