Planned change

Question 1

What are 21st center health organizations focused on?

Answer 1

Restructuring
Quality Improvement
Employee Retention

Question 2

What is planned change vs accidental or change by drift?

Answer 2

Planned change is well thought out

Question 3

How do managers think of change?

Answer 3

Managers embrace the status quo

Question 4

How do leaders feel about change?

Answer 4

Leaders embrace the change

Question 5

3 good reasons for change

Answer 5

Change to solve some problem

Make procedures more efficient

Reduce workload

Question 6

What is a change agent?

What qualities will they have?

Answer 6

Person skilled in the theory of implantation and planned change - and they typically have skills in how to make changes

Visionary, risk taker, flexible, communication skills, creative, sensitive, current

Question 7

Kurt Lewin’s Chang theory

Answer 7

Unfreeze

Change

Refreeze

Question 8

Lewin’s driving forces

Answer 8

Force that pushes the system towards change

ex: wanting to advance career

Question 9

Lewin’s restraining forces

Answer 9

Pull the system away from change; ex: the cost

Question 10

Lewin’s four rules for change

Answer 10

1. change should be for good reasons
2. it should be gradual
3. plan it out
4. involve everyone involved

Question 11

Rational empirical strategies

Answer 11

Used best with least resistance bc people can see that it is reasonable/rational

we will change once given factual info

Question 12

Normative-Re-educative strategy

Answer 12

Assumes we are social beings so they utilize peer pressure and norms

Question 13

Power-Coercive strategy

Answer 13

Assumes we are set in out ways and that we will only change due to being forced or receiving a reward

Question 14

Should we start a change if early change agent isn’t available?

Answer 14

No we shouldn’t. We need people to commit and see it through who have influence

Question 15

How should those making changes expect resistance?

Answer 15

It disrupts homeostasis and so they need to expect it

Question 16

What does individual resistance depend on

Answer 16

Flexibility

Evaluation of immediate situation

Anticipated consequences of change

Perception of what they lose vs gain

Question 17

What is the greatest resistance to change by employees tho?

Answer 17

A lack of trust between the employee and the manager of the organization

Question 18

T/F

It is easier to change a groups mindset than it is one person

Answer 18

false. one persons mindset is easier to change

Question 19

Which is easier to change : knowledge levels or attitudes

Answer 19

Knowledge levels

Question 20

What happens if there’s one or two employees that aren’t accepting change?

Answer 20

Their opinion is discarded and we move forward assuming we have the majority of the group on board

Question 21

How do organizations progress?

Answer 21

They go through developmental changes. Young to old

Question 22

Describe young organizations

Answer 22

High energy and movement

Constant change and adaptation

Question 23

Aged organizations have established ______.

Answer 23

Turf boundaries

• predictable rules and orders

Question 24

What is fiscal planning?

What do we have to consider while doing this?

Answer 24

A learned skill that manages the business side of healthcare

Consider goals and values since those drive your planning

Question 25

Incremental budgeting

Answer 25

Simple form of budgeting where you budget for needs * not the best for healthcare

Question 26

Zero-based budget

Answer 26

Annual budget based that means each year you go back to the zero mark * must **justify** why it needs to be there

Question 27

Flexible budget

Answer 27

Can fluctuate during the budget cycle and its flexible

Question 28

Performance budget

Answer 28

Budgeting based on performance /outcome how many patients can we dismiss example * also not well suited for hospital

Question 29

Cost -effectiveness

Answer 29

Producing good results for the amount of money spent consider length of service, the need for it, and alternatives

Question 30

What is the organizations majority of expenses?

Answer 30

personnel budget - paying employees

Question 31

Hours per patient day

Answer 31

how many hours of care a patient needs

Question 32

Components of personnel budget

Answer 32

Hours per patient day Staffing Full-time equivalent - a position not person Productive time - working Nonproductive time - pto, vacations etc

Question 33

calculating nursing care hours

Answer 33

nursing hours worked **in 24 hrs**/patient census involve rn, cna, unit clerk etc all included in nursing care hours

Question 34

Second biggest expense of a budget?

Answer 34

Supplies to take care of patients

Question 35

Operating budget definiton

Answer 35

Reflects expenses that flex up or down in predetermined manner to reflect variation in volume of service load * what they are operating on day to day * something you use daily like an IV pump

Question 36

Capital budget

Answer 36

Plan for the purchase of something big * MRI machine; equipment w life expectancy of 5 years * building * often have to raise money for from donors/grants

Question 37

In early 1900's where was healthcare

Answer 37

Went on in the home

Question 38

What was the birth of the blues?

Answer 38

When blue cross and blue shield insurance

Question 39

Fee for service

Answer 39

Means payment and it caused healthcare costs to spiral

Question 40

When did medicare arrive? What parts?

Answer 40

1965 - Elderly, disabled, and renal dialysis patients Part A - social security and federal tax; hospital coverage Part B - subsidized 75% by feds and 25% subscribers ; voluntary

Question 41

Who supplies medicare part a? What falls under medicare part a?

Answer 41

Payroll deductions and contributions Inpatient hospital care, limited skill nursing families, home health, hospice Will have to pay co-pay

Question 42

Medicare Part B

Answer 42

Financed from federal funds Covers primary care, outpatient diagnostics, med supplies Optional and has premiums 1:36:00

Question 43

Who receives Medicaid? Who administers medicaid?

Answer 43

For financial indigent ; you have to qualify For women and children especially Administered by the states - each state can set its eligibility and coverage

Question 44

Managed Care

Answer 44

System that attempts to integrate efficiency of care, access, and cost of care. It wants us to have primary care provider who assists us in navigating the system.

Question 45

DRG - Diagnosis Related Groups

Answer 45

Predetermined payment schedule that reflects the historical costs of specific Patient conditions so each medicare patient receives a specific amount of money per admission (regardless of the actual cost)

Question 46

Critical pathways

Answer 46

Courses of progress that are predetermined for patients diagnosis Strategy for assessing, implementing, and evaluating the cost-effectiveness of patient care

Question 47

Utilization review

Answer 47

Process used by insurance companies to assess the need for medical care and to assure that payment will be provided for the care

Question 48

T/F We always receive reimbursement

Answer 48

false. no guarantee We need to document accurately

Question 49

j

Answer 49

j