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9780834209510

Whole-Systems Shared Governance

by ; ;
  • ISBN13:

    9780834209510

  • ISBN10:

    0834209519

  • Format: Hardcover
  • Copyright: 1997-09-01
  • Publisher: Wolters Kluwer Law & Business
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Supplemental Materials

What is included with this book?

Summary

Whole-systems shared governance is the new term for a system that unites all professionals involved in the care delivery process--nurses, other clinical disciplines, physicians, and administrators--under a structure that integrates clinical, support, and organizational concerns across traditional boundaries. This book describes the context, structure, principles, and implementation of whole-systems shared governance for nurses and other health care managers and administrators. Dr. Tim Porter-O'Grady has written a dynamic new resource that ties together shared governance and the new integrated health care systems. Whole-Systems Shared Governance: Architecture for Integration outlines a template you can use to unite nurses, physicians, managers, administrators, board members, and other major stakeholders in planning a whole-systems approach to service delivery.

Table of Contents

About the Editors xi(2)
About the Contributors xiii(2)
Preface xv(4)
Acknowledgments xix
1 Into the New Age of Health Care
1(34)
Tim Porter-O'Grady
A New Understanding
2(1)
The Emerging Value of Knowledge
2(1)
A New Context for a New Age
3(2)
A New Reality for Organizations
5(2)
Changing Contexts for Health Care Services
7(1)
The Evolving Nature of Work
7(2)
Technology
9(1)
Social Reengineering
10(1)
Instant Access
11(1)
Economic and Financial Shifts
12(1)
Growing Costs
12(1)
Changing Health Care Structures and Models
13(1)
Managing Demand
14(1)
Capitation
14(1)
Overcoming Medical Separatism
15(1)
Managed Care
15(1)
The Quality Movement
16(2)
Reengineering Care Delivery
18(1)
Principles for a New Age
19(2)
Partnership
21(1)
Needed: A New Kind of Leader
22(1)
Creating a Learning Organization
23(2)
Equity
25(2)
Accountability
27(3)
Ownership
30(1)
The Interdependence of Everything
31(2)
Creating a Real System
33(2)
2 Whole-Systems Shared Governance: A Model for Integrated Health Care Systems
35(34)
Tim Porter-O'Grady
Marilyn Hawkins
Marsha Parker
Building on Foundations
35(2)
Why Shared Governance?
37(2)
Building To Support the Point of Care
39(1)
The Premises of Shared Governance
40(2)
Teams: The Foundation of All Work
42(2)
The Different Kinds of Teams in a Shared Governance Context
44(1)
The Service Team
45(1)
The Population-Based Continuum
46(1)
Councils: The Basic Unit of Organized Decision Making
47(3)
Shared Governance and Decision Making
50(1)
Decisions and the Locus of Control
50(2)
Councils and Representation
52(1)
Service Pathway Leadership
52(1)
The System Councils
53(1)
Distinguishing System Accountability and Service Accountability
54(2)
The Patient Care Council
56(4)
The Operations Council
60(3)
The Governance Council
63(2)
Information Support
65(1)
New Constructs...New Mindset
66(3)
3 Transforming the Organization: Getting Started
69(30)
Tim Porter-O'Grady
Marsha Parker
Marilyn Hawkins
The Integrating Process
69(2)
The Inadequacy of Structure
71(1)
A Focused Work Group
72(2)
The Shared Governance Steering Group
74(3)
Shared Governance Steering Group Membership
77(1)
The Initial Developmental Process for the Steering Group
78(2)
Conceptual Design for Shared Governance Implementation
80(2)
Nursing Shared Governance
82(3)
Interdisciplinary Shared Governance
85(1)
Shared Governance Steering Group Basics
86(1)
Understanding the Limits
87(4)
The Planning Process
91(2)
The Work of the Steering Group
93(3)
The Change Process
96(3)
4 Building for Service: The Center of the Enterprise
99(30)
Kami English
Curtis Takamoto
Tim Porter-O'Grady
Patient Care: The Foundations of Health Service
100(2)
The Fundamentals of the Patient Care Council
102(3)
The Purpose of the Patient Care Council
105(1)
The Patient Care Council Membership
106(2)
Defining the Work of the Patient Care Council
108(1)
Service Pathway Council and Team Accountability
109(4)
The Accountability of the Service Pathway Council
113(3)
The Work of the Service Pathway Council and the Pathway Teams
116(2)
The Accountability of the Patient Care Council
118(3)
The Transition from Nursing Shared Governance to Whole-Systems Shared Governance
121(1)
Expanding the Nursing Practice Council
122(1)
Interfacing with the Medical Staff
123(2)
Patient Care Integration
125(4)
5 The Operations Council: Managing the Horizontal Organization
129(37)
Jeff LeFors
Tim Porter-O'Grady
Ensuring Effective Decision Making
130(1)
Empowerment
131(1)
Changing Concepts of Management
131(1)
Technology-Driven Systems and Work
132(1)
The Knowledge Worker
133(1)
Distinction of Accountability
134(1)
Management Accountability
135(1)
The Two Levels of Management
136(2)
The Foundation of the Operations Council
138(1)
Support for the Management Role
139(2)
Purpose of the Operations Council
141(1)
The Role of the Operations Council
142(1)
The Operations Council Membership
143(3)
Making the Operations Council Work
146(1)
The Operations Council Process
147(1)
Clarity of Issues
148(1)
Clarifying Operations Council Accountability
149(3)
The Operating Budget Process
152(1)
The Capital Budget Process
153(1)
Capital Project Presentations
154(1)
The Primacy of Financial Accountability
154(1)
Setting Targets
155(1)
Operations Council Commitment
155(1)
Consensus-Based Decision Making
156(2)
Shared Vision
158(3)
Systems Accountability and Support Accountability
161(1)
Linkage to the Other Councils
161(1)
Cautions About Control
162(1)
Support from the CEO
163(1)
Other Administrator Changes
163(1)
Other Manager Transitions
164(1)
Conclusion
164(2)
6 Building Seamlessness: Governance at the Crossroads
166(26)
Tim Porter-O'Grady
Bruce Perry
Linking the System
166(1)
New Notions of Leadership
167(1)
Linking Governance and Function
167(2)
Translating Board Accountability
169(2)
Translating Direction
171(3)
Governance Council Membership
174(1)
The Role of the CEO
175(1)
Role of the Consulting Partners
176(2)
Governance Council Accountability
178(1)
Breadth of Accountability
179(2)
The Question of Systems
181(1)
The Governance Council and the Cascade
182(4)
Challenges to Effectiveness
186(1)
Shifting the Focus of Work
187(1)
Interface with the Medical Staff
187(1)
Enhancing Effectiveness in Shared Governance
188(1)
Checks and Balances
189(1)
Conclusion
189(3)
7 Integrating Physicians and Building Provider Partnerships: A Community Hospital System Approach
192(35)
Phil Hinton
Marsha Parker
The Formal Medical Staff
192(2)
A Physician's View of Barriers to Shared Governance
194(1)
Informal Structures as Barriers
194(1)
Changes in Incentives
195(1)
Physician Disconnection from a Systems Perspective
196(4)
Visioning Whole-Systems Shared Governance
200(1)
The Vision
201(2)
Structuring To Support the Vision
203(2)
Seeing the Future
205(1)
The Implementing Experience
205(1)
Inviting the Medical Staff
206(1)
Integrating Physicians into the Whole System
207(2)
Physician Roles in the Corporate Shared Governance Councils
209(1)
The Medical Staff, Governance, and Operations
210(1)
Medical Staff Integration into the Pathways
210(1)
The Medical Staff and Decision Making
211(1)
Physicians at the Point of Service
212(1)
Physicians and the Critical Path
213(1)
Becoming Inclusive
214(1)
Communication: Trying to "Reconnect"
214(1)
Critical Communication
215(2)
Resolving Conflict
217(1)
Governance for the New Vision
217(1)
Strategy Priorities
218(3)
Shared Governance and Managed Care
221(2)
A Few Questions for the Physician's Shared Governance Journey
223(1)
What Seems To Be Working So Far
224(1)
The Future for Physician Partners in Shared Governance
224(3)
8 Integrating across Organizational Parameters: Linking the System
227(30)
Tim Porter-O'Grady
Marsha Parker
The Patient Pathway
227(2)
New Realities
229(1)
Building the Continuum of Care
230(1)
Horizontal Service Design
231(2)
Linkage Defines the System
233(1)
Horizontal Linkage
234(1)
Provider Linkage
234(1)
Organizing around Populations
235(1)
Defining Linkages
236(1)
Building the Vision
236(2)
Structural Linkages
238(1)
New Values
239(1)
Delineating the Pathways
240(2)
Systems Linkages
242(1)
The Need for Information
242(2)
Pathways and Information
244(2)
Communication Linkages
246(2)
The Process of Building Linkages and Teams
248(1)
Interactions in the System
249(1)
Organizing around the Patient
250(1)
Making the System Functional
251(6)
9 Information Management for Point-of-Service Decision Making
257(35)
Marsha Parker
Lynn Neimeth
Tim Porter-O'Grady
The New Information Infrastructure
257(1)
The Implications of Shared Governance Principles and Structures for Information Management
258(1)
Information as a Resource
259(2)
Shifting Control
261(4)
Information Flow among Shared Governance Entities
265(1)
Self-Directed Work Groups and Information Management
266(2)
Information Project Team
268(1)
The Trouble with Vendor Partners
269(1)
The Superusers
270(1)
Information Management Philosophy
271(1)
Good Information Management Strategies
271(3)
Tactical Implementation--Sample Projects
274(1)
Virtual Office: New Ways To Work
275(1)
Clinical Information System
276(1)
Roles and Accountability
277(1)
The Changing Role of the Chief Information Officer
278(1)
Board Support for the New Information Infrastructure
279(2)
Integrated Health Network Core System Design
281(7)
Information Development as Evolution
288(4)
10 Building toward Community in Health Care
292(23)
Tim Porter-O'Grady
Marsha Parker
Health and the Community
292(1)
The Basics
293(2)
Linkage is Key
295(1)
The Information Infrastructure
296(1)
Creating Useful Information Systems
296(1)
Supporting the Point of Service
297(1)
Clinical Support
298(1)
Reduced Provider Competition
299(1)
Information for Evaluation
299(1)
Linking the Internal and External Communities
299(1)
Community Health Information Networks
300(1)
Linking to the Political Structure
301(1)
Making the Community Connection
302(4)
Community Partnership Activities
306(1)
Getting Started
306(1)
Partnership for Children
307(1)
A Community Dream
307(1)
Shared Governance and Community Health
308(1)
Broader Notions of Health
308(2)
Organizing around the Community
310(2)
Community Driven Service
312(1)
Conclusion
313(2)
Index 315

Supplemental Materials

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The New copy of this book will include any supplemental materials advertised. Please check the title of the book to determine if it should include any access cards, study guides, lab manuals, CDs, etc.

The Used, Rental and eBook copies of this book are not guaranteed to include any supplemental materials. Typically, only the book itself is included. This is true even if the title states it includes any access cards, study guides, lab manuals, CDs, etc.

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