Unit 3Unit 3Monday, January 23Monday, January 23rdrd at at

8PM EST8PM EST

HS 499-01HS 499-01Adrienne Palmer, BSPH, MHA, FACHEAdrienne Palmer, BSPH, MHA, FACHE

Unit 3 projectUnit 3 project

No unit 3 project!!! No unit 3 project!!!

Unit 3Unit 3

For-profit versus not-for-profit For-profit versus not-for-profit hospitals mission statementshospitals mission statements

No significant differences found in statement No significant differences found in statement content currentlycontent currently

However the differences in ownership should be However the differences in ownership should be reflected in the mission statementreflected in the mission statement

High degree of similarities in phrases discussing High degree of similarities in phrases discussing cost, patient access, and quality. cost, patient access, and quality.

The majority of mission statements analyzed The majority of mission statements analyzed contained some discussion of cost, access, and contained some discussion of cost, access, and qualityquality

Does money really matter?Does money really matter?

Relationship between finances and quality…is Relationship between finances and quality…is there one?there one?

In 2000, United States spends 14.3% in In 2000, United States spends 14.3% in healthcare expenditures up from 5.2% in 1960.healthcare expenditures up from 5.2% in 1960.

Studies have also noted that there continues to Studies have also noted that there continues to be a gap between the level of financial be a gap between the level of financial resources in healthcare and the quality of care resources in healthcare and the quality of care delivereddelivered

Important to understand that the financial health Important to understand that the financial health of the organization contributes significantly to of the organization contributes significantly to quality of carequality of care

Quality as a processQuality as a process

Involves the appropriateness, efficiency, and Involves the appropriateness, efficiency, and effectiveness of both technical and interpersonal effectiveness of both technical and interpersonal methods of providing healthcaremethods of providing healthcare

Standard quality measures include: morbidity, Standard quality measures include: morbidity, mortality, infection or other complications, mortality, infection or other complications, recovery, disability, and re-hospitalizationrecovery, disability, and re-hospitalization

Other common measures include review of Other common measures include review of structural quality such as accreditation, staffing, structural quality such as accreditation, staffing, equipment availability, and health and safety equipment availability, and health and safety code compliancecode compliance

Healthcare Organizations’ FinancesHealthcare Organizations’ Finances

Observable financial characteristics include profit Observable financial characteristics include profit margin, investment ratios, and fiscal margin which can margin, investment ratios, and fiscal margin which can be obtained from yearly operating reports or other be obtained from yearly operating reports or other financial documents.financial documents.

Review of the expenses can highlight the costs incurred Review of the expenses can highlight the costs incurred in healthcare delivery.in healthcare delivery.

The fiscal margin can highlight the financial flexibility an The fiscal margin can highlight the financial flexibility an organization has and is often referred to as its operating organization has and is often referred to as its operating margin, net worth, and profitsmargin, net worth, and profits

Asset liability management must also be considered as Asset liability management must also be considered as organizations often have to leverage both to continue to organizations often have to leverage both to continue to provide high-quality careprovide high-quality care

Expense measurements and Expense measurements and relationship to quality carerelationship to quality care

The industry often uses staff hours per adjusted The industry often uses staff hours per adjusted discharge in relationship to outcome measures to define discharge in relationship to outcome measures to define relationships. Often those with lower ratios may have relationships. Often those with lower ratios may have higher occurrences of low quality outcomes.higher occurrences of low quality outcomes.

Discussion question:Discussion question:

What are some other categories of What are some other categories of expense that you can think of that might expense that you can think of that might link to quality care, either positive or link to quality care, either positive or negative?negative?

Discussion question:Discussion question:

When might it be worth investing in a large When might it be worth investing in a large expense item or process in order to expense item or process in order to improve quality of care? (Imagine you’re a improve quality of care? (Imagine you’re a CEO)CEO)

Steps to performance managementSteps to performance management- Created by DemingCreated by Deming

Plan– understand existing conditions in order Plan– understand existing conditions in order to identify a need for changeto identify a need for change

Do– analyze collected data and develop Do– analyze collected data and develop documentation of all possibilities; may also try documentation of all possibilities; may also try some solutions during this timesome solutions during this time

Study– evaluate solutions’ effectiveness and Study– evaluate solutions’ effectiveness and study the resultsstudy the results

Act– make any additional changes to improve Act– make any additional changes to improve the processthe process

Repeat as necessaryRepeat as necessary

Discussion Discussion

Regarding: The Lehigh Valley Hospital scenario Regarding: The Lehigh Valley Hospital scenario from the article.from the article.

What are your thoughts about the initial process What are your thoughts about the initial process they were reviewing? Have you been able to they were reviewing? Have you been able to experience a similar process in either the experience a similar process in either the healthcare organization working in for your healthcare organization working in for your externship or in your prior roles?externship or in your prior roles?

DiscussionDiscussion

Regarding: The Lehigh Valley Hospital Regarding: The Lehigh Valley Hospital scenario from the article.scenario from the article.

What do you think of their implementation What do you think of their implementation process? Are there things that you process? Are there things that you would’ve done to make sure it was would’ve done to make sure it was executed properly?executed properly?

DiscussionDiscussion

Regarding: The Lehigh Valley Hospital Regarding: The Lehigh Valley Hospital scenario from the article.scenario from the article.

How might you communicate the need for How might you communicate the need for such a change with your team if you were such a change with your team if you were in this role?in this role?

Importance of middle managers in Importance of middle managers in healthcarehealthcare

Some perceive middle managers as intermediaries that Some perceive middle managers as intermediaries that slow organizational efficiency without adding much slow organizational efficiency without adding much measurable value– not true!!measurable value– not true!!

In the 1990s, in the era of healthcare mergers the trend In the 1990s, in the era of healthcare mergers the trend was to increase organizational flattening and reduce the was to increase organizational flattening and reduce the layers in the hierarchy, seen as an easy tactic to reduce layers in the hierarchy, seen as an easy tactic to reduce costs and simplify the systemcosts and simplify the system

However this increased the workload on other However this increased the workload on other managers, reducing their ability to evaluate process managers, reducing their ability to evaluate process improvement opportunities and implement new ideasimprovement opportunities and implement new ideas

Middle managers are often responsible for not only the Middle managers are often responsible for not only the daily operational details, but also executing strategic daily operational details, but also executing strategic initiatives that may be approved at a higher levelinitiatives that may be approved at a higher level

Middle managers’ rolesMiddle managers’ roles Communicator – liasion with executive leadership and Communicator – liasion with executive leadership and

also with the frontline teams, often critical in ensuring also with the frontline teams, often critical in ensuring any change process goes smoothlyany change process goes smoothly

Entrepreneurs – developing ideas because they are Entrepreneurs – developing ideas because they are closest to the front line and patient careclosest to the front line and patient care

Stabilizers – can help ensure harmony between Stabilizers – can help ensure harmony between employees and senior managersemployees and senior managers

Therapists -- take time to listen to the staff particularly in Therapists -- take time to listen to the staff particularly in times of high changetimes of high change

Bench strength and succession planning – healthcare Bench strength and succession planning – healthcare continues to need great leaders and will for many years continues to need great leaders and will for many years to come so this is a great training role for those middle to come so this is a great training role for those middle managers who will one day move to senior leadershipmanagers who will one day move to senior leadership

Unit 4 ProjectUnit 4 Project 75 points75 points Write a 1000-1250 word paper on methods of quality Write a 1000-1250 word paper on methods of quality

measurement. Include the following information: measurement. Include the following information: Your paper must include a detailed summary of at least two Your paper must include a detailed summary of at least two

different methods of quality measurement. Include examples different methods of quality measurement. Include examples of how the methods may be used to improve organizational of how the methods may be used to improve organizational effectiveness. Give an evaluation of these methods and effectiveness. Give an evaluation of these methods and indicate when they should be used for best results.indicate when they should be used for best results.

Cite at least four references in addition to your textbook to Cite at least four references in addition to your textbook to validate your proposal. Prepare this assignment according to validate your proposal. Prepare this assignment according to the APA guidelines.Cite at least three references in the the APA guidelines.Cite at least three references in the paper. Prepare this assignment according to APA guidelines.paper. Prepare this assignment according to APA guidelines.

Submit to dropbox.Submit to dropbox.

Questions?Questions?