Midterm Flashcards
(49 cards)
3 party system of health care
Employers, payers (insurers), providers (clinicians and HCOs)
driving forces of health care system
3 party system, accreditation, basic issues
accreditation
joint commission and NCQA
Joint Commission
accredits HCOs (hospitals, nursing homes, inpatient facilities) (Medicare part A)
National Committee on Quality Assurance (NCQA)
accredits the insurance plans offered by third party payers (insurance companies)
Accredited employer offered plans
Employers pay NCQA to make sure insurance plans are good
basic issues in health care system
- quality/patient safety
- Cost
- Access —> getting into the system
- Service —> once in the system, how are you treated
- Physician and staff satisfaction
- Employee satisfaction
the role of management/that managers play
Planning Organizing Staffing Leading (Most important) Decision-making
inputs/resources (6 inputs that managers manage)
people/staff Patients Money materials/equipment Time Information
outputs/goals (6 outputs that managers are held accountable for)
quality/patient safety profit/cost savings Access (Getting into the system) Patient satisfaction (How you are treated once you’re in the system) Physician satisfaction Staff satisfaction
management skills
technical, human, conceptual
As you move up in management ranks, you trade off between technical skills and conceptual
- Top-tier management (senior level) more conceptual than technical
- First line (entry level) more technical than conceptual
Doesn’t matter where you’re at, human skills are always vital (at the same level of importance)
-communication and team building
why health care organizations are different
social contract
Three missions of academic health centers (patient care, teaching, research)
3 advocates on behalf of society when social contract is broken
Government, press, legal system
triple aim
improve population health
improve experience of care
reduce per capita costs
health care transformation
emphasizing wellness over treating illness
“Not a human repair shop”
Cura personalis
Ex.
Acute, inpatient care —> continuum of care
Treating illness —> maintaining wellness
Individual patient —> population
Bureaucratic Theory
Arranging everything into a hierarchy; chest of drawers
Ex. very separated and defined hospital wings
Pro: everyone knows who they work for; ensures accountability
Con: creates silos/a fragmented system
Scientific Management
Programming each step of the way; defining how things should be done each step
Methodology to measure efficiency in the system
Time and motion studies
Ex. how long does it take to discharge patients? Let’s improve that!
Problems
- Doesn’t take other areas into account (optimizing one part of a system can lead to delays in another part)
- Doesn’t think about the person; only deals with efficiency
Ex. lean six sigma
Human Relations School
Participatory decision making and employee empowerment can lead to increased productivity
People will only help what they help build
-Somewhat of a placebo effect
Institutional Theory
Organizations must conform to external norms, rules, and requirements to receive legitimacy and support
-Joint commission and NCQA
build organizations upon standards which come from government agencies ; mandatory committees and functions)
leading
The process of influencing the activities of an individual or group toward a goal in a given situation
Leading and management are different
-Leadership is one of the roles of a manager; execution of the leadership role is the way managers accomplish goals
trait theory
Traits —> effectiveness or success
Initial theory was that there are 6 key traits that leaders need to be successful
-now it is understood that these 6 characteristics are necessary, but not sufficient to be an effective leader
6 characteristics are: Intelligence Articulateness Confidence Initiative Persistence Sociability
behavioral perspective
Traits —> attitudes & behaviors —> effectiveness or success
Need both the 6 traits and good attitudes and behaviors to be a successful leader
2 most important behaviors are
- Building structure (production orientation)
- Maintaining relationships (ex. Employee orientation and team building)
having orientations in both getting the work done (production) and towards people (employee)
Contingency Perspective
Traits —> attitudes & behaviors —> situation —> effectiveness or success
Where we are today
Path model goal
Critical variables (situational): leader, follower, work environment
Situational Leadership Approaches
S1: Directing, if the employee is new
-High directive, low support
S2: coaching, employee here for ~1 month
-High directive, high support
S3: supporting, employee been with you for few months
-Low directive, high supportive
S4: Delegating, motivated worker who knows his or her job
-Low directive, low support
As the employee progresses, allowing for empowerment through moving up the situational styles
-If employee is capable and motivated (willing and able metaphor)
manager vs clinician persepctives
Clinicians looking at short term, managers thinking strategically long term
Clinicians work collegial, Managers work hierarchical
