Introduction to Health Care Management

by Buchbinder, Sharon B., Ph.D.; Shanks, Nancy H., Ph.D.

• ISBN13: 9780763734732
• ISBN10: 076373473X
• Edition: 1st
• Format: Paperback
• Copyright: 2007-02-01
• Publisher: JONES & BARTLETT PUBLISHING CO

Summary

Introduction to Health Care Management is a concise, reader-friendly, introductory healthcare management book that covers a wide variety of healthcare settings, from hospitals to nursing homes and clinics. Filled with examples to engage the reader’s imagination, the important issues in healthcare management, such as ethics, cost management, strategic planning and marketing, information technology, and human resources, are all thoroughly covered.Guidelines and rubrics along with numerous case studies make this text both student-friendly and teacher friendly. It is the perfect resource for students of healthcare management, nursing, allied health, business administration, pharmacy, occupational therapy, public administration, and public health. Features: Chapters contributed by real experts using an active voice to grab the reader’s attention. Learning objectives and discussion questions in each chapter. Instructors’ resources online for each chapter, including PowerPoints, Test Bank, and Sample Syllabus. 15 case studies in a wide variety of settings, in an assortment of healthcare management topics. A case study guide, with rubrics for evaluation of student performance, enabling instructors at every level of experience to hit the ground running on that first day of class.

Table of Contents

Foreword	p. xv
Preface	p. xix
Acknowledgments	p. xxi
Leadership	p. 1
Leadership vs. Management	p. 1
Followership	p. 3
History of Leadership in the United States	p. 4
Contemporary Models	p. 6
Leadership Styles	p. 10
Leadership Competencies	p. 11
Leadership Protocols	p. 12
Governance	p. 14
Barriers and Challenges	p. 15
Ethical Responsibility	p. 17
Leaders Looking to the Future	p. 18
Management and Motivation	p. 23
Introduction	p. 23
Motivation-The Concept	p. 24
Theories of Motivation	p. 25
A Bit More about Incentives and Rewards	p. 30
Misconceptions about Motivation and Employee Satisfaction	p. 31
Motivational Strategies	p. 33
Conclusion	p. 34
Organizational Behavior and Management Thinking	p. 37
Introduction	p. 38
The Field of Organizational Behavior	p. 38
Organizational Behaviors Contribution to Management	p. 39
Key Topics in Organizational Behavior	p. 39
Organizational Behavior Issues in Health Organizations	p. 40
How Thinking Influences Organizational Behavior	p. 41
Individual Perception and Thinking	p. 42
Managing and Learning	p. 48
Thinking and Sensemaking in Communication and Problem Solving	p. 49
Conclusion and Applications	p. 51
Strategic Planning	p. 59
Introduction	p. 59
Purpose and Importance of Strategic Planning	p. 60
The Planning Process	p. 60
Situational Assessment	p. 61
Strategy Tactical Plans	p. 71
Rollout and Implementation	p. 72
Monitoring and Control	p. 73
Strategy Execution	p. 75
Strategic Planning and Execution-The Role of the Healthcare Manager	p. 76
Conclusion	p. 77
Performance Improvement in Health Care: The Quest to Achieve Quality	p. 81
Introduction	p. 81
Defining Quality in Health Care	p. 82
Why Is Quality Important?	p. 84
A Brief History of Quality and Performance Improvement	p. 86
Quality Assurance	p. 86
The End Result System and the Flexner Report	p. 87
The Joint Commission	p. 88
QA Essentials	p. 89
QA Assumptions and Actions	p. 90
From Peer Review to Quality Improvement Organizations	p. 91
Professional Standards Review Organizations (PSROs) Programs	p. 91
Peer Review Organization (PRO) Program	p. 92
Quality Improvement Organization (QIO) Program	p. 93
Continuous Quality Improvement	p. 94
The Concept of CQI in Health Care	p. 96
Applying CQI	p. 99
Other Leading Quality Improvement Models	p. 101
Key Quality Improvement Concepts	p. 103
Quality Improvement Tools	p. 106
System Thinking and Healthcare Quality Improvement	p. 108
Health Care as High Hazard Industry	p. 111
Approaches to System Improvement	p. 111
Assessing Healthcare System Improvement	p. 115
Healthcare System Improvement Challenges	p. 116
Developing a National Information Technology Infrastructure	p. 121
Conclusion	p. 127
Information Technology	p. 137
Introduction	p. 137
Historical Overview	p. 138
Health Information and Its Users	p. 140
Health Information Technology and Applications	p. 142
The Role of the Health Manager	p. 147
Challenges	p. 150
Conclusion	p. 152
Financing Health Care and Health Insurance	p. 155
Introduction	p. 155
National Health Spending	p. 156
Paying for Health Care	p. 157
Introduction to Health Insurance	p. 158
Brief History of Health Insurance	p. 159
Characteristics of Health Insurance	p. 160
Private Health Insurance Coverage	p. 163
Consumer-Driven Health Plans	p. 166
The Evolution of Social Insurance	p. 169
The Convergence of Political Opportunity and Leadership	p. 169
Major Legislation	p. 170
Major "Players" in the Social Insurance Arena	p. 173
Statistics on Health Insurance Coverage and Costs	p. 187
Those Not Covered-The Uninsured	p. 189
Conclusion	p. 193
Managing Costs and Revenues	p. 197
Introduction	p. 198
What Is Financial Management and Why Is it Important?	p. 198
Ten Major Objectives of Financial Management	p. 199
Tax Status of Healthcare Organizations	p. 200
Financial Governance and Responsibility Structure	p. 202
Managing Reimbursements from Third-Party Payers	p. 204
What Are the Primary Methods of Payment Used by Private Health Plans for Reimbursing Providers?	p. 204
What Are the Primary Methods of Payment Used for Reimbursing Providers by Medicare and Medicaid?	p. 207
How Are Providers Reimbursed by Individuals with No Health Insurance?	p. 209
Controlling Costs and Cost Accounting	p. 211
Classifying Costs	p. 211
Allocating Costs	p. 212
Determining Product Costs	p. 213
Break-Even Analysis	p. 213
Setting Charges	p. 214
Other Determinants of Setting Charges and Prices	p. 215
Managing Working Capital	p. 217
Managing Accounts Receivable	p. 219
Major Steps in Accounts Receivable Management	p. 220
Managing Materials and Inventory	p. 221
Managing Budgets	p. 224
Conclusion	p. 228
Managing Healthcare Professionals	p. 231
Introduction	p. 231
Physicians	p. 232
Registered Nurses	p. 243
Licensed Practical Nurses/Licensed Vocational Nurses	p. 250
Nursing, Psychiatric, and Home Health Aides	p. 251
Midlevel Practitioners	p. 253
Allied Health Professionals	p. 255
Conclusion	p. 257
The Strategic Management of Human Resources	p. 265
Introduction	p. 266
Environmental Forces Affecting HR Management	p. 268
Understanding Employees as Drivers of Organizational Performance	p. 271
Key Functions of Human Resources Management	p. 272
Workforce Planning/Recruitment	p. 275
Employee Retention	p. 282
Conclusion	p. 297
Teamwork	p. 303
Introduction	p. 303
What Is a Team?	p. 304
The Challenge of Teamwork in Healthcare Organizations	p. 305
The Benefits of Effective Healthcare Teams	p. 308
The Costs of Teamwork	p. 310
Who's on the Team?	p. 313
Team Communication	p. 315
Methods of Managing Teams of Healthcare Professionals	p. 316
Conclusion	p. 319
Cultural Competency and Diversity	p. 323
Introduction	p. 323
Cultural Frameworks in Healthcare Management	p. 326
Cultural Competency and Diversity Staff Training	p. 329
Cultural Competency at the Workplace	p. 331
Conclusion	p. 337
Ethics and Law	p. 343
Introduction	p. 343
Ethical Concepts	p. 344
Legal Concepts	p. 346
Elements of a Contract	p. 347
Types of Torts	p. 347
Malpractice	p. 349
Patient and Provider Rights and Responsibilities	p. 349
Legal/Ethical Concerns in Managed Care	p. 351
Biomedical Concerns	p. 353
Beginning- and End-of-life Care	p. 353
Research in Healthcare Settings	p. 354
Conclusion	p. 355
Fraud and Abuse	p. 357
Introduction	p. 358
What Is Fraud and Abuse?	p. 358
History	p. 359
Operation Restore Trust	p. 359
The Social Security Act and the Criminal-Disclosure Provision	p. 360
The Emergency Medical Treatment and Active Labor Act	p. 362
Hospital Compliance with EMTALA	p. 363
The Balanced Budget Act of 1997	p. 363
Antitrust Issues	p. 364
Federal Enforcement Actions	p. 364
Safe Harbor/Anti-Kickback Regidations	p. 365
Anti-Kickback Statutes	p. 365
Safe Harbor Laws	p. 367
Stacked Penalties	p. 369
Management Responsibility for Compliance and Internal Controls	p. 369
Corporate Compliance Programs	p. 370
Conclusion	p. 371
Healthcare Management Guidelines and Case Studies	p. 375
Introduction	p. 375
Guidelines	p. 375
Team Structure and Process for Completion	p. 377
Guidelines for Effective Participation	p. 377
Case Studies	p. 383
Oops Is Not an Option	p. 383
Building a Better MIS-Trap	p. 384
Case of the Complacent Employee	p. 386
Managing Healthcare Professionals: Mini-Case Studies	p. 389
Negotiation in Action	p. 391
The Merger of Two Competing Hospitals: A Case Study	p. 397
The Orchestra: A Narrative in a Minor Key	p. 404
Labor and Delivery Dilemma	p. 415
Sexual Harassment at the Diabetics Clinic	p. 416
Seaside Convalescent Care Center	p. 421
Staffing at River Oaks Community Hospital: Measure Twice, Cut Once	p. 423
Heritage Valley Medical Center: Are Your Managers Culturally Competent?	p. 429
Humor Strategies in Healthcare Management Education	p. 433
Electronic Medical Records in a Rural Family Practice Residency Program	p. 438
Medication Errors Reporting at Community Memorial Hospital	p. 442
Index	p. 449
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