Lecture Notes Flashcards
(136 cards)
0
Q
Internal domain
A
The areas of focus that managers need to address on a daily basis, such as ensuring the appropriate number and types of staff, financial performance, and quality care.
1
Q
External domains
A
The influences, resources, and activities that exist outside the boundary of the organization, but affect the organization
2
Q
6 functions of management
A
Planning Organizing Staffing Controlling Directing Decision making
3
Q
Planning
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Set direction and determine what needs to be accomplished. Set priorities
4
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Organizing
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Overall design of the organization: designating reporting relationships, determining positions, teamwork assignments and distribution of authority and responsibility
5
Q
Staffing
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Acquiring and retaining human resources. Developing and maintaining the workforce
6
Q
Controlling
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Monitoring staff activities and performance and taking corrective actions
7
Q
Directing
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Initiating acting action in the organization through effective leadership and motivation of subordinates
8
Q
Decision making
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Making effective decisions based on considerations of benefits and drawbacks of alternatives
9
Q
3 compitencies
A
Conceptual skills
Technical skills
Interpersonal skills
10
Q
Conceptual skills
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Those skills that involve the ability to critically analyze and solve comes problems
11
Q
Technical skills
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Those skills that reflect expertise or ability to perform a specific work task
12
Q
Interpersonal skills
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Enable manager to communicate with and work well with other individuals, regardless of whether they are peers, supervisors, or subordinates
13
Q
Stakeholders
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Includes insurers, state and federal governments, and consumer advocacy groups. Anyone who has in interest in the performance of the organization
14
Q
Leadership domains
A
Functional and technical
Self development and understanding
Interpersonal
Organizational
15
Q
Emotional intelligence
A
There are certain skills (intra/interpersonal) that a person needs to be well adjusted in today’s world. Needs for self awareness, self-regulation, motivation, empathy, and social skills. Suggests a more caring, confident, and enthusiastic boss can establish good relations with workers
16
Q
Authentic leadership
A
People will want to naturally associate with someone who is following their internal compass.
17
Q
Inspirational leadership
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Focus on leaders who inspire by giving people what they need. Supports the concept of ‘tough empathy’. Managers care passionately about their employees and work but are prudent in what they provide in the way of support
18
Q
Servant leadership
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Acknowledges that a healthcare leader is largely motivated by a desire to serve others, everyone contributes to a greater whole.
19
Q
Spirituality leadership
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Emphasizes ethics, values, relationship skills, and promotion of balance between work and self. Leader created a positive working environment that supports individuals finding meaning in what they do.
20
Q
Coercive leadership style
A
Only to be used with a very problematic subordinate or an an emergency situation
21
Q
Participative leadership style
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Leader asks managers for their input and gives them a voice in making decisions; lets them know they are respected and valued
22
Q
Pacesetting leadership style
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The leader sets high performance standards for his or her followers. Good for situations where employees are self motivated and highly competent
23
Q
Coaching leadership style
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Focused on the personal development of his or her followers rather than tasks. Recommended for top, competent, trusted followers in the organization
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Barriers to leadership
Laws and regulations
Physicians
New technology
Culture of safety
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Maslow's hierarchy of needs
```
Physiological
Safely
Belonging
Esteem
Self-actualization
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characteristics of engaged healthcare employees
```
More productivity
More focus on patient care and treatment
Safer
Loyal to their employers
Model positive behaviors of engagement
Greater profitability for a provider
```
27
Alderfer's 3 factor ERG theory
Existence
Relatedness
Growth & development
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Herzberg's 2-factor theory
Hygienes (lower level motivators)
| Motivators (higher level factory such as achievement)
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McClelland's acquired needs theory
Achievement
Affiliation
Power
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Skinners reinforcement theory
Extrinsic
Positive reinforcement, avoidance learning, punishment and extinction
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Adams equity theory
Intrinsic
Individuals are motivated when they perceived that they are treated equitably in comparison to others in the organization
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Vroom's expectancy theory
Intrinsic
Expectations of the individual and how they are motivated by performance and the expected outcomes of their own behavior
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Locke's goal setting theory
Intrinsic
By establishing goals, individuals are motivated to take action to achieve those goals
34
Taylor's Scientific Management
focuses on efficiency; rewards employees for productivity and hard work. Assumes that employees are continually able to work harder and will do so to earn higher pay
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McGregor's Theory X
managers view employees as unmotivated and disliking work; manager’s role is to direct and control employees
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McGregor's Theory Y
managers focus on higher level motivators and work to assist employees in achieving higher levels such as achievement, recognition for achievement, the work itself, responsibility, , and growth and advancement
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Ouchi's Theory Z
states that employees who are involved in and committed to an organization will be motivated to increase productivity. The rewards are long term employment, promotion from within, participatory management, and other techniques to engage and motivate
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Integrative Model of Motivation
most managers draw upon on a combination of needs, extrinsic factors, and intrinsic factors to help motivate employees; also to help employees meet their own personal needs and goals an ultimately to achieve effectiveness and balance within an organization.
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Assumptions
fundamental premises believed true
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Perceptions
what is noticed; to what attention is paid
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Cognitive Biases
mental processing that simplifies handling information and that can compromise decision quality
42
Hueristics
simplify the decision making process and lead to biases
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Self-fulfilling prophecy
expectations about another’s behavior that can elicit the expected behavior
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Expectancy Theory
managers affect employee motivation when they influence employee expectations about ability to accomplish a task and expectations of reward
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Attributions
imputing the likely cause of another’s behavior
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Attribution Theory
explaining another’s behavior by presuming it is caused either by a person’s disposition or by the situation
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Mental Models
beliefs about how things work
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Sense Making
process in which organization members interpret the meaning of ambiguous situations. How employees arrive at a shared interpretation of a complex or ambiguous situation
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Strategic Planning
The process of identifying a desired future state of an organization and a means to achieve it
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Four P's of strategic planning
Promotion
Product
Price
Place
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SWOt meaning
Strengths
Weaknesses
Opportunities
Threats
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Mission
is the organization’s is its permanent statement of purpose
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Vision
statement strives to identify a specific future state of the organization
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Values
define the practice culture. What characteristics it wants employees to convey to the customers
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Marketing
The activity, set of institutions, and processes for creating, communicating, delivering, and exchanging offerings that have value for customers, clients, partners, and society at large.
56
Social Marketing
The application of commercial marketing principles and techniques to influence behavioral change, of a specific target audience, in order to promote public health for the benefit of society as a whole.
57
Cause related marketing
Links a for-profit company and its offerings to a social issue, with the goal of building brand equity and increasing profits
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Segmentation
Refers to the process of dividing the total market into groups or segments that have relatively similar needs for products and services
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Targeting
concentration or multi-segment
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Positioning
the various techniques used by healthcare organizations and providers to position to brand image and offerings in the mind of the target market
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Quality
degree to which health services for individuals or populations increase the likelihood of desired health outcomes and are consistent with the current professional knowledge
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Components of Donabedian definitions of quality
Technical management of health and illness
Interpersonal relationships; clients and providers
Amenities of care; the patient's interest in individual well being
Ethical principles guiding care
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Two quality questions
Are the right things done (effectiveness)
Are things done right (efficiency)
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underuse
failure to provide a service whose benefit is greater than its risk
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overuse
use of service when risk/cost outweighs its benefits
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misuse
risk service is provided badly reducing benefit to patient
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Baldridge award criteria
```
Strategic framework
Structure
Process
Outcomes
Supported by measurement, analysis, and knowledge management
```
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CQI five dimensions
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Process focus
Customer focus
Data-based decision making
Employee empowerment
Organization-wide scope
```
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FOCUS meaning
Find - identify process problem
Organize - put together a team to work on process
Clarify - use techniques to clarify the problem
Understand - measure and collect data to
Select - identify process improvements for implementation
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PDCA meaning
Plan – create an implementation plan for taking the process to the next level
Do – implement and test the new process
Check – evaluate the measures used and assess outcomes
Act – assure continuation of newly implemented process, if successful ,or redo the process, if not successful
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Six Sigma DMAIC meaning
Define –delimit scope of work and time frames for completion
Measure – create and apply measures and metrics
Analyze – assess and flowchart the process
Improve – specify the steps to be taken to meet goals
Control – assure permanence of the improvements
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What is EMRAM
model to gauge hospital EMR adoption
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What should you know before you enter the patient room
```
Patient Name
Patient Diagnosis
Patient Prescription
Physician Name
Insurance Source
```
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Domains of Practice Analysis
```
Patient Assessment
Formulation of the treatment plan
Implementation of plan
Follow-up to plan
Practice Management
Promotion of competency and enhancement of professional practice
```
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Benefits of effective teams
Improve coordination and quality of care
Use of health care services more efficiently
Increase job satisfaction among team members
Increase patient satisfaction
Increase productivity
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Costs of Teamwork
Meeting time, place to meet and food and coffee
Opportunity costs
Perceived loss of autonomy
Risk-taking associated with letting go of one's turf
Resistance to organizational change
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Tuckman's Stages
Forming
Storming
Performing
Adjourning
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Three components in clinical decision making
Scientific Evidence
Practitioner Experience
Patient Values
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Cost-consequence
descriptive profile of the costs and outcomes (impact on health and economics) of one or more interventions
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Cost-minimization
identifies the least costly alternative for services that result in equivalent outcomes
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cost-effectiveness
describes and compares the relative costs and outcomes of two or more interventions that result in the same type of outcome
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cost-utility
describes and compares the relative costs and outcomes of two or more interventions in which the outcomes of interest include health status and the value of the status to the individual
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cost-benefit
describes and compares the relative costs and outcomes of two or more interventions in which both the costs and outcome can be measured in monetary values
84
Moral model
contends that disability was a direct result of past and/or current sin and shame
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Medical model
measures disability in terms of mortality and morbidity. Trying to fix and individual.
86
Pathology
the underlying pathological state that interferes with normal bodily functions or structure
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Impairments
any loss or abnormalcy of psychological, physiological, or anatomical structure or function.
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Functional limitations
the functional consequences of the pathology
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Disability
any restriction or lack (resulting from impairment) to perform an activity in the manner or within the range considered normal for a human being
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Handicap
A disadvantage that limits or prevents fulfillment of a normal role
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4 constructs of disablement according to ICF
Body functions and structures
Activities and participation
Environmental factors
Personal factors
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Factors in health disparities
```
Access to health insurance
Genetics and biology
Socioeconomic factors
Living and working conditions
Patient's beliefs
Patient't adherence to preventative and therapeutic measures
```
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Race
Physical appearance
Shared genealogy due to geographical isolation
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Ethnicity
Relates to cultural factors including nationality, culture, language and beliefs
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Cultural Proficiency
The ability and willingness to respond respectfully and effectively to people of all cultures, classes, races, ages, ethnic backgrounds, and religions in a manner that values all
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Benefits of cultural proficiency
Good business practice
Good workforce management
Ethical and moral imperative
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Amputee coalition mission
to reach out to and empower people affected by limb loss to achieve their full potential through education, support and advocacy, and to promote limb loss prevention.
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Amputee coalition AIMS
Awareness
Impact
Member Services
Sustainability
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AC - Awareness
The vast majority of those affected by limb loss will know of the Amputee Coalition and understand the value of being a part of the Amputee Coalition community.
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AC - Impact
Amputee Coalition-led collaborations, programs, relationship-building and strategic alliances will create changes in healthcare delivery that ensure all amputee patients and their families in the U.S. have access to and receive quality care, support and information for both pre- and post-limb loss.
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AC - Member Services
The Amputee Coalition will provide meaningful services and programs.
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AC - Sustainability
Amputee Coalition-led collaborations and strategic alliances will increase funding for the full spectrum of our services
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Sources of ethics
Personal
Organizational
Theoretical
Bioethical
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Respect for persons
The right for individuals to make informed decisions when they are competent, or to have respectful guardianship when they cannot self determine their care.
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Beneficence
requires doing the best one can for the recipient of one’s services; stems from Hippocratic tradition/oath.
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Nonmaleficence
the parallel concept; “do no harm”, or at least “don’t make it worse”.
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Justice
tied to ethical philosophy and implies fairness
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Criminal Law
a wrong against society as a whole, even if a particular individual is harmed
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Civil Law
wrongs against a particular person or organization, either by contract violations or by wrongful acts (torts)
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Types of torts
Negligence
Intentional
Infliction of mental distress
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4 element of negligence
- a duty toward the harmed party
- breach of duty
- injury or damages
- causation (breach of duty has to be directly connected to the harm that occurred
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Patient Responsibilities
- ask questions of providers
- provide accurate info
- follow the care plan the agreed to
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Patient rights
- self-determination
- expect confidentiality
- informed consent or competent surrogate
- right to refuse care
- emergency treatment
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What is included in an EMR
Clinical data
Clinical decision support
Physician order entry
Clinical documentation
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EMRAM
Electronic Medical Record Analytical Model
gauges hospital EMR adoption
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O and P uses of EMR
Patient intake forms
Patient records
Ordering
Materials management
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Challenges to EMR adoption
-high cost of system
slow development of data standards
-user unfriendliness of systems
-patient privacy (lack of trust by patient that info is secure)
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Reasons medical records may be disclosed
Treatment
Payment
Healthcare operations
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Parts of Medicare
A - hospital insurance
B - medical insurance
C - medicare HMO
D - Rx drug benefit
120
Medicare Assignment
Supplier agrees to accept the Medicare fee for that procedure as payment in full except for the applicable 20% co-payment and any unmet deductible.
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Participating supplier
Must accept assignment for all covered medicare services
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Non-participating
can decide whether to accept assignment on a claim by claim basis
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Retrospective reimbursement
determined AFTER service delivery
- charges
- charges minus a discount
- cost plus
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Prospective reimbursement
determined BEFORE service delivery
- per diem
- per diagnosis
- capitation (per member per month)
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Reasons to do cost accounting
- estimate and manage costs
- set charges and analyze profits
- make decisions regarding adding, enhancing, or eliminating services
- provide methods for classifying, allocating, and determining product costs
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Direct costs
components
outside/inside fab
materials
127
Indirect costs
% of fixed salary
rent
depreciation
utilities
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HR domains
Workforce planning/recruitment
| Employee retention
129
HR functions within workforce planning/recruitment
- Job analysis
- Workforce Planning
- Establishing job descriptions
- Recruitment
- Interviewing, selection, negotiation and hiring
- Orientation
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HR functions within employee retention
- employee relations and engagement
- training and development
- compensation and benefits
- employee assistance program
- assessing performance
- leadership development
- employee suggestion program
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Two types of compensation
base pay - tied to knowledge skill and experience
incentive compensation - designed to improve organizational performance
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Major types of benefits
- sick leave
- vacation
- holidays
- health insurance
- life insurance
- retirement plan
- flexible spending accounts
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Job satisfaction
The pleasurable of positive emotional state resulting from the appraisal of one's job or job experiences
134
Job burnout
A prolonged response to chronic emotional and interpersonal stressors on the job
135
Qualities to assess when judge environmental burnout
- job autonomy, variety, and significance
- fairness of pay and benefits
- opportunities for promotion and advancement
- relationships with supervisors
- relationships with coworkers
