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MGT513 – Management Principles for Health Care Professionals

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M GT513 – Managem en t P r inc ip les for Hea l th Care P ro fess iona l s Course Syllabus

MGT513 – Management Principles for Health Care Professionals Course Syllabus

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Introduction

Important: You should take the time to carefully read this syllabus and the Student Handbook before you begin the assignments for this course.

This syllabus contains the lesson assignments for MGT513 – Management Principles for Health Care Professionals. The course has a value of four semester units.

Management Principles for Health Care Professionals presents practical information for new or future practicing healthcare managers. The customary activities of the manager planning, organizing, decision making, staffing, motivating, and budgeting are succinctly defined, explained, and presented with detailed examples drawn from a variety of health care settings. Students will learn proven management concepts, techniques, models, and tools for managing individuals or teams with skill and ease.

The course addresses the most current topics in health care such as patient safety initiatives, the Health Insurance Portability and Accountability Act (HIPAA), revenue recovery efforts, and diversity training.

Expected Student Learning Outcomes

Upon the successful completion of this course you should be able to:

• Explain how the health care environment is a rapidly changing arena.

• Perform general management functions in a day-to-day environment and be nominally conversant with the concepts of total quality management and the clientele network.

• Appraise the relationship between planning and organizing and be readily familiar with

the organizing concepts; chain of command, span of control, line and staff. • Understand the development and use of organization charts and job descriptions.

• Explain the steps in the budget cycle and most of the terms commonly employed in

departmental budgeting.

• Recall the various forms of committees and be especially aware whether a group is necessary at all.

• Articulate what a human resource department provides to the organization. • Describe the importance of being proactive in obtaining assistance from human

resources.

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Required Materials:

The primary text for this course is:

Liebler, J. & McConnell, C. (2017). Management principles for health professionals (7th Edition). Burlington, MA: Jones & Bartlett Learning.

ISBN: 9781284081329

Suggestions for getting the most out of this course:

• Read professional journals and periodicals.

• Participate in the course discussion forums and learn from the experience and knowledge of your faculty mentor and fellow students.

• If possible, form a relationship with someone who works in an area related to your

course. Explain that you would like to obtain their insights and perspectives from time to time.

Academic Engagement Each academic course at William Howard Taft University is assigned a semester unit value equivalent to the commonly accepted and traditionally defined units of academic measurement in accredited institutions. Credit bearing courses are measured by the learning outcomes normally achieved through 45 hours of student work for one semester unit. For example, a course with a value of 3 semester units would require a typical student to commit 135 hours of academic engagement and preparation to complete the course requirements.

Lesson Assignments

This course contains a number of lesson assignments. Work through the lessons one at a time. Unless otherwise instructed, you should complete all assignments for a particular lesson in one WORD document. When you complete all of the assignments in a lesson, submit it to the faculty for grading and feedback. Submit only one lesson at a time, completing them in sequence. Continue on to the next lesson but be sure to incorporate any feedback received on previous lessons into your subsequent assignments – if necessary.

Format Unless otherwise instructed, Lesson Assignments should be prepared in Microsoft Word® using the Times New Roman font, 12-point, single space, double space between paragraphs. Each page must be numbered, and your last name and student number included on the upper left- hand corner of each page.

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Your lesson assignment responses should be evidenced from the course textbook and/or from peer-reviewed sources not more than 5 years old. In general, Wikipedia is not a professionally- reviewed resource and should not be used as an assignment reference. You must cite your references so that readers can verify your conclusions, and easily determine what is your work, and what is paraphrased or taken directly from other sources. Failure to give credit for the work of others in your assignments and writing projects constitutes plagiarism.

Citation Machine http://citationmachine.net/index2.php?start=&reqstyleid=2&newstyle=2&stylebox=2 Citation Machine is an online tool to assist in proper citation of researched information. We recommend APA format, although you may use other approved formats as long as you remain consistent.

Final Examination Final examination requirements and procedures are set forth in the Student Handbook. Notwithstanding any other provision in this syllabus, if you are required to take a Final Examination for this course you must pass the exam to pass the course.

Academic Integrity It is the policy of the University that any student found guilty of cheating and/or plagiarism will be subject to immediate dismissal from the University. All students are required to sign a Coursework Certification Form for each course. This form is provided as a link in the last lesson of each course.

Evaluation (How You Will Be Graded for This Course) Your grade will be influenced by the accuracy of your research and the quality of your writing. The extent of research necessary will vary from assignment to assignment. In most cases, your work product should not simply consist of quoting from the assigned text.

When grading your assignments, the faculty will consider three general components:

1. A demonstrated understanding of the material and the learning objectives.

2. Your ability to articulate, synthesize and analyze the concepts and issues presented in

the material.

3. Clear and logical composition supported by examples and appropriate references.

If at any time you desire additional feedback, you should contact your faculty advisor directly via email. Feel free to ask questions about course progress, grades, etc., at any time, and remember that the faculty and administration are interested in helping you learn and succeed.

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The final grade for the course is determined by the sum of each of the grades in the Lesson Assignments. Each of the lesson assignments is weighted equally in determining your grade for the course. Total Possible Points = 800 (100 Points per lesson).

Grade GPA Percentage Comments

A 4 90-100 (Outstanding)

A- 3.67 88-89

B+ 3.33 84-87

B 3 80-83 (Satisfactory)

B- 2.67 78-79

C+ 2.33 74-77

C 2 70-73 (Passing but below the standard accepted in graduate study)

C- 1.67 68-69

D+ 1.33 64-67

D 1 60-63 (Does not meet standard for graduate study, coursework must be repeated for credit) D- 0.67 59

F <0.67 58 or below (Failure)

Faculty Mentors will refer to the following grading rubric when evaluating your assignments:

Excellent

Above

Average

Satisfactory

Needs

Improvement

Unsatisfactory

Demonstrates a thorough understanding of the material.

Demonstrates an adequate understanding of material

Responses are generally accurate, but at times lacking coherence.

Demonstrates a marginal understanding of the material and lesson objectives.

Provides marginally complete and/or inaccurate responses showing little understanding of the material

Understanding of Material and Lesson Objectives

Work is articulated consistent with the degree level integrating or synthesizing concepts in an original and innovative way.

Work demonstrates a solid knowledge of concepts and theories with some individual analysis of issues.

Work demonstrates an elementary knowledge of concepts but lacks original thought and analysis.

Work is primarily paraphrased or quoted directly from the text or other sources.

Responses demonstrate little or no individual analysis.

No individual analysis of concepts.

Work is poorly articulated and/or derived entirely from the textbook.

Articulation, Synthesis and Analysis of Concepts

Work presented in a logical and coherent way supported by sound resources.

Citations are composed in proper format with few or no errors.

Work presented is grammatically sound.

Resources are appropriate and cited in proper format with few errors.

Work is grammatically sound with a few minor errors.

Resources may be of questionable authority but are cited in proper format with few errors.

Work contains frequent grammatical errors.

Resources are few, non- existent, or may be of questionable authority.

Frequent errors in composition, grammar and presentation.

Quoted material is incorporated without the use of quotation marks or citation (plagiarism).

Composition, Presentation, and References

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Course Completion Requirements

The course will be deemed completed only when all the following has been accomplished:

• You have completed all of the lesson assignments and they have been received by the University

• You have passed the course Final Examination (if required)

• You have completed the Course Certification Form and it has been received by the

University

• You have completed the Course Evaluation Survey

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Lesson 1 - The Chal lenge of the Dynamic Healthcare Environment

Introduction

The health care environment is a rapidly changing arena in which further change will be the order of the coming decade. Pressure is increasing to deliver quality care at lower cost, and health care organizations continue to merge and affiliate to pursue organizational advantages.

This lesson provides an overview of the evolution of the health care system and the essential adaptive nature of a successful organization dedicated to the delivery of health care. You will explore the elements of the individual manager’s role in the inevitable and continuing process of organizational change.

Change, whether welcome or otherwise, is unavoidable, and that the most effective managers are those capable of functioning as change agents. For organizations to adapt and survive, managers must understand the evolution of organizational management and the strategies that have evolved, with particular attention to the clientele network and the life cycle.

Lesson Learning Objectives

By the conclusion of this lesson you should be able to:

• Describe the healthcare environment as it has evolved since the middle-to-late 1960s with attention to the dynamic interplay of key factors.

• Examine megatrends in the healthcare environment with attention to:

o Client characteristics

o Professional practitioners and caregivers

o Healthcare marketplace and settings

o Applicable laws, regulations, and standards

o Impact of technology

o Privacy and security considerations

o Financing of health care

o Social and cultural factors

• Identify the role set of the healthcare practitioner as manager.

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• Review the classic function of the manager.

• Define and differentiate between management as an art and a science.

• Conceptualize the characteristics of an effective manager.

• Identify the impact of change on organizational life.

• Identify the manager’s role as change agent.

• Review examples of successful change.

• Examine a major change having ongoing impact.

• Describe the organizational change process.

• Identify specific strategies for dealing with resistance to change.

• Present the concept of the organization as a total system.

• Describe the evolution of the total system approach to management.

• Describe the development and characteristics of the formal organization.

• Identify the approaches to the classification of organizations and apply these to the healthcare organization.

• Introduce the concept of the clientele network and describe the application of these

components to the healthcare organization.

• Identify the need for organizational survival as a fundamental goal of organizational effort.

• Describe selected management strategies used to enhance organizational survival.

• Analyze the phases of the organizational life cycle that reflect major changes in the

organization and relate these to the functions of the manager.

Reading

Study Chapters 1, 2 and 3 of the text

View the PowerPoints for Chapters 1, 2 and 3

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Assignments

The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your response. Your response must adequately cover the question without being wordy or relying on “yes” or “no” responses.

Case Study: Becoming a Split-Department Manager

Imagine that you are the manager of a department, the function of which is to provide service in your chosen profession. In other words, if your career is medical laboratory technology, you are a laboratory manager; if your field is physical therapy, you manage physical therapy or rehabilitation services, and so on. You are employed by a 60-bed rural hospital, an institution sufficiently small that you represent the only level of management within your function (unless your profession is nursing, in which case there will be perhaps two or three levels of management). This means that unless you are a first-line manager in nursing (for example, head nurse), you report directly to administration.

You have been in your position for about two years. Following some stressful early months, you are beginning to feel that you have your job under control most of the time.

A possibility that for years had been talked about and argued throughout the local community, the merger of your hospital with a similar but larger institution (90 beds) about 10 miles away, recently became a reality. One of the initial major changes undertaken by the new corporate entity was realignment of the management structure. In addition to placing the new corporate entity under a single chief executive officer, the realignment included, for most activities, bringing each function under a single manager. Between the merger date and the present, most department managers have been involved in the unpleasant process of competing against their counterparts for the single manager position.

You are the successful candidate, the survivor. Effective next Monday, you will be running a combined department in two locations consisting of more than twice the number of employees you have been accustomed to supervising.

1. Generate a list of the ways in which you believe your responsibilities and the tasks you

perform are likely to change because of the merger and your resulting new role. Hint: It may be helpful to make lists of what you imagine to be the circumstances before and after your appointment. For example, two obvious points of comparison involve number of employees (which implies many necessary tasks) and travel inherent in the job. See how long a list you can generate.

2. What does this split-department situation do to your efficiency as a manager, and how

can you compensate for this change?

3. On which specific management skill should the newly appointed split-department manager be concentrating?

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Case Study: In Need of Improvement?

You are an administrative staff specialist newly employed by the hospital to act as a management engineer and address a number of issues relating to operating efficiency. Your first assignment is to analyze work methods and staffing in the central sterile supply division of materials management. The department was singled out for study because:

• The manager, a registered nurse who has held the job for more than 25 years, has

requested two more processing aides although her staff is already one person larger than that of another area hospital of equivalent size.

• There has been a recent, seemingly unexplainable, upturn in the consumption of

disposables.

• A number of storage shelves appear to be stocked to overflowing with infrequently used items.

• The department issues frequent rush orders to obtain needed items that have completely

run out.

• Observed conditions in the department include an overcrowded storage area, a seemingly inadequate decontamination area, and a grossly over-sized processing area referred to by most employees as “the ballroom.”

On your initial visit to the department the first thing the manager says to you is: “So you’re the one who’s going to tell us what we’re doing wrong?” Her tone is none too friendly.

1. Develop a proposed approach to a complete study of the department, including the sales

pitch you would use to try winning the manager’s cooperation and support, specifying what should be done, why it should be done, and how you propose to address the inevitable resistance of both manager and staff.

Lesson Quiz

Take the quiz for this lesson. Your results on the quiz do not affect your grade for the course. Quizzes are designed to help you to learn important concepts in the lesson and prepare you for the Final Examination, if required. You may take the quiz as many times as you wish.

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Lesson 2 – Leadership, Planning and Decision Making

Introduction

This lesson examines the overall concept of leadership as reflected in the activities of managers, supervisors, or others who direct the efforts of people, and relate leadership to the concepts of authority, power, and influence. From Chapter Four you should gain an understanding the common sources of power and authority in the organizational setting and have a working appreciation of variations in leadership styles and why these may apply in various circumstances.

The lesson also considers planning and decision making. The key elements of planning, and the constraints and boundaries that traditionally affect planning in the organizational setting, are considered along with the forces and factors that limit or constrain business decisions. Tools and techniques which facilitate sound decision making are discussed along with strategic planning as the essential process of determining and refining an organization’s objectives and determining how to allocate its resources.

You should understand that planning, described most broadly as considering what to do in a time not yet present, is fundamental to all of management at all levels; understanding what is involved in making any decision of any size or scope; and knowing what comprises a strategic plan and how this may differ from a functional or operating plan.

Lesson Learning Objectives

By the conclusion of this lesson you should be able to:

• Address the role of the manager as a principal agent of change.

• Differentiate among the terms power, influence, and authority.

• Recognize the importance of authority for organizational stability.

• Identify the sources of power, influence, and authority.

• Relate the sources of power, influence, and authority to the organizational position of the line manager.

• Recognize the limits placed on the use of power and authority in organizational settings.

• Recognize the importance of delegation of authority.

• Explore the nature of leadership and the reasons why individuals seek leadership

positions.

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• Identify the styles of leadership, their characteristics, and the circumstances under which they are applied

• Define the management functions of planning and decision making.

• Identify the characteristics of plans and specifically address those characteristics or

features that make plans effective.

• Identify participants and their responsibilities in the planning process.

• Delineate the constraints placed on planning and identify the boundaries to be observed in the planning process.

• Define and differentiate among the terms philosophy, goal, objective, functional

objective, policy, procedure, method, and rule.

• Delineate aspects of project management and 500-day plans.

• Determine how to evaluate a decision’s importance.

• Describe some of the tools and techniques available to aid decision making.

Reading

Study Chapters 4 and 5 of the text

View the PowerPoints for Chapters 4 and 5

Assignments

The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your response. Your response must adequately cover the question without being wordy or relying on “yes” or “no” responses.

Case Study: Authority and Leadership: Rising from the Ranks

After working eight years as a staff nurse on a general medical/surgical unit, Julie Davis was appointed nurse manager of that unit. Following a staff meeting at which her promotion was announced, Julie found herself surrounded by three longtime coworkers offering their congratulations and making other observations and comments.

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“I’m really happy for you,” said Sarah Johnson. “This sounds like a terrific career step. But I suppose this means our carpool is affected, since your hours are bound to be a lot less predictable from now on.”

Elaine Rowe said, “And I guess that shoots the lunch bunch, too. Management commitments, you know.” The emphasis on management was subtle though undeniable, and Julie was not at all sure that she was pleased with what she was hearing.

Jane Davidson offered, “Well, maybe now we can get some action on a few age-old problems. Remember, Julie, you used to gripe about these things as much as the rest of us.”

“We’ve all complained a lot,” Sarah agreed. “That’s been sort of a way of life around here.” The tone of her voice shaded toward a suggestion of coolness and her customary smile was absent when she added, “Now Julie’s going to be in a position where she can do something, so let’s hope she doesn’t forget who her friends are.”

Elaine and Jane looked quickly from Sarah to Julie. For an awkward 10 seconds or so nobody spoke. At last someone passing by said something to Julie, and as Julie turned to respond, Elaine, Jane, and Sarah went their separate ways.

1. Identify the potential advantages Julie might enjoy in becoming manager of a group of

which she has long been a member, and contrast these with the possible disadvantages that might present themselves because she has long been a member of this group.

2. Describe how you believe Julie will have to proceed in establishing herself as the

legitimate possessor of supervisory authority on the unit and describe the sources and forms of Julie’s authority.

Case Study: Paid to Make Decisions?

Carrie Wilson, a registered nurse with more than 10 years of active supervisory experience, was hired from outside as nursing manager for the emergency department of County Hospital. It was Carrie’s style to develop insight into how to manage a given operation by putting herself where the action was and becoming totally immersed in the work. She quickly discovered, however, that her tendency to become deeply involved in hands-on work drew reactions from staff members ranging from surprise to resentment. She also discovered that her predecessor, who had been in the position for several years, had been referred to as “the Invisible Nurse.” As someone said about the former manager, “I think she was a very pleasant person, but that’s hard to say because we almost never saw her.”

Despite the legacy of the Invisible Nurse, Carrie provided a constant management presence and seemed determined to remain deeply involved in the work of the department. She was also determined to improve vastly the level of professionalism in the department, a quality that had struck her from the first as decidedly lacking.

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In a short time, Carrie had moved to reinstate and enforce a long-ignored dress code for the department, eliminate personal telephone calls during working hours except for urgent situations, curb chronic tardiness on the part of some staff members, bar food and drink and reading materials from work areas (also a reemphasis of long-ignored rules), and curb the practice of changing scheduled days of work after the time limit allowed by policy.

Carrie found her efforts frustrated at every turn. As she said to her immediate superior, “I can’t understand the reaction. All I’ve done is insist that a few hospital rules be followed—mostly rules that have been there all along but were being ignored—and added a few twists unique to the emergency department. Just that, and yet the bitterness and lack of support and even resentment are so strong I could slice them. I’m getting all-out resistance from a few people whom I would still have to describe as good, professional nurses at heart.”

Carrie’s boss, the Vice President for Nursing Service, said, “Do you suppose you may have been pushing too hard, hitting them with one surprise after another without knowing how they felt and without asking for their cooperation?”

“That’s possible,” answered Carrie, “but now I’m committed on several fronts and I can’t back down on any of them without looking bad to the department.”

“Don’t think of this as a contest of wills or a game,” said the Vice President. “It may be necessary for you to back down temporarily in some areas or at least hold a few of your improvements up in the air for a while. It may not hurt to fall back and involve a few of your staff in looking at the apparent needs of the department.”

With a touch of impatience in her voice, Carrie said, “Oh, I’ve heard all this stuff about participative management and staff involvement in making decisions. That may be the way for some, but that’s never been my style. I’m paid to make decisions so I make them—I don’t try to avoid responsibility by encouraging employees to make my decisions.”

1. What are the weaknesses, if any, in Carrie’s final statement about decision-making

responsibility?

2. What has essentially been wrong with Carrie’s approach to raising the level of professionalism in the department?

3. How has Carrie’s behavior altered or otherwise affected the environment within which

she expects her decisions to be implemented?

4. Ideally, how should Carrie have initially approached her plan to improve the emergency department?

5. Given the state of affairs Carrie is facing as of her conversation with the vice president,

how should she go about attempting to salvage some of her ideas and proceed with the improvement of the department? Keep in mind that at this stage her actions have probably had serious effects on her chances of implementing her plans, and some of the decisions she may have already made may have to be revisited in different fashion.

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Lesson Quiz

Take the quiz for this lesson. Your results on the quiz do not affect your grade for the course. Quizzes are designed to help you to learn important concepts in the lesson and prepare you for the Final Examination, if required. You may take the quiz as many times as you wish.

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Lesson 3 – Organizing, Staff ing, Committees and Teams

Introduction

In this lesson, you will learn the basic management process of organizing and its several component elements, describe its place in the overall management process, and relate the principles of organizing to practical considerations in the manager’s job such as organizational charts and job descriptions. Chapter Six explains the relationship between planning and organizing and presents organizing concepts including chain of command, span of control, and line and staff. The development and use of organization charts and job descriptions are also considered.

Chapter Seven presents the various forms of committees and other group endeavors and discusses their uses, abuses, advantages, and disadvantages. The concept of the employee team as a special form of committee arising from the adoption of certain modern management processes is discussed. You should gain an understanding of the various forms of committees and when and how they are used, and should be especially aware that the first issue to be considered when the possibility of a committee or team is suggested is whether a group is necessary at all.

Lesson Learning Objectives

By the conclusion of this lesson you should be able to:

• Define the basic management function of organizing and identify the steps in the organizing process.

• Define the key concepts of hierarchy, chain of command, splintered authority, and

concurring authority.

• Identify the factors that shape the span of management.

• Differentiate between line and staff relationships and identify basic line and staff relationships.

• Describe the dual pyramid organization arrangement found in healthcare

authority patterns.

• Identify the basic patterns of departmentation.

• Introduce the concept of the matrix organization and define the applicability of this apparently contradictory concept.

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• Identify patterns of organizational flexibility: temporary agency, contractual outsourcing, and the use of independent contractors and consultants.

• Identify the principles involved in developing an organizational chart.

• Describe the elements of a job analysis.

• Introduce job descriptions, including their uses and the elements necessary in their

development.

• Describe the job rating and classification system.

• Identify the content and uses of the management inventory.

• Describe the role and activities of the professional practitioner as consultant.

• Provide a generalized definition of a committee.

• Differentiate among committees, standing as well as ad hoc, and plural executives and task forces.

• Describe the generally accepted purposes and uses of committees.

• Enumerate the advantages as well as the limitations and disadvantages of committees.

• Provide guidelines for ensuring committee effectiveness.

• Identify the role and functions of the committee chairperson.

• Provide guidance for creating and preserving documentation of a committee’s formal

proceedings.

• Examine the modern management phenomenon of the employee team (in a number of possible forms) as a special case of the committee.

Reading

Study Chapters 6 and 7 of the text

View the PowerPoints for Chapters 6 and 7

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Assignments

The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your response. Your response must adequately cover the question without being wordy or relying on “yes” or “no” responses.

Exercise: Developing a Job Description

Select a healthcare profession or occupation and write a job description for it. It will be most helpful to use an occupation in which you have worked or for which you are preparing. Following completion of the job description, prepare a condensed description of that job in less than one- half page that could be used for recruiting purposes.

Exercise: Creating Organizational Charts

For a work organization and a specific department or function with which you are familiar, create two organizational charts—a master chart for the overall organization and a supplementary chart depicting the structure and arrangement of the specific department or function. (If you have no familiarity with an actual work organization, invent an organization and department in chart form using the chapter’s material for guidance.)

Questions (Refer to the organization chart created above)

1. Is the organization more appropriately described as centralized or decentralized? Why?

2. What management position appears to have the broadest span of control in terms of number of direct reporting employees? Why?

3. What is the longest single departmental chain of command in the organization, and how

many levels does it consist of?

4. Assuming that dramatic losses of business activity have necessitated reorganizing, revise your original master chart to “flatten” the organization by at least one level in two principal chains of command.

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Lesson Quiz

Take the quiz for this lesson. Your results on the quiz do not affect your grade for the course. Quizzes are designed to help you to learn important concepts in the lesson and prepare you for the Final Examination, if required. You may take the quiz as many times as you wish.

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Lesson 4 – Budget Planning and Implementation

Introduction

This lesson introduces the concept of the budget, the essential role of the budget in the operation of a department, and the ways in which a department’s operating results are compared with budget in the ongoing control of expenditures.

Budget preparation and administration are major duties of the department head. Before dealing with the actual budget calculations, the manager must understand the basic concepts and principles of budgeting. The budget details presented here are treated from the perspective of the department head rather than the accountant or top-level administrator. Terms are defined and examples are provided in detail to facilitate budget preparation and analysis by an inexperienced user.

The first part of this lesson treats basic concepts such as budget periods, budget types, uniform code of accounts, approaches to budgeting, and the overall budget process. The second part of the discussion focuses on the details of the budget proper: capital expenses, personnel budget, supplies, and related expenses. All dollar values and examples are fictitious and intended only to illustrate budget calculation processes.

You should leave this lesson with an understanding of what a budget is and what its role is in the operation of a department, as well as being conversant with the steps in the budget cycle and most of the terms commonly employed in departmental budgeting.

Lesson Learning Objectives

By the conclusion of this lesson you should be able to:

• Explain the basic revenue cycle and assert the critical need for constant attention to cash flow.

• Enumerate the requirements of successful budgeting.

• Introduce the budget as a special-purpose financial plan that is an essential part of the

department manager’s planning function.

• Enumerate the various types of budgets employed and identify the commonly encountered budget periods.

• Differentiate between traditional budgeting and zero-based budgeting approaches.

• Enumerate the steps in the budget cycle.

• Relate the dynamics of the budget approval process to the development of the budget.

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• Identify the steps in budgetary control through analysis of budget variances.

Reading

Study Chapter 8 of the text

View the PowerPoint for Chapter 8

Assignments

The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your response. Your response must adequately cover the question without being wordy or relying on “yes” or “no” responses.

EXERCISE: ADJUSTING THE BUDGET Review the information presented below in the Sample Operating Budget for the Department of Physical Therapy and adjust this budget according to the following:

• You have just learned that inpatient charges will probably be 3% higher than projected and that outpatient charges are expected to increase by 8%, and that your research grant support will be reduced by half.

• The continuing education conference projected to net $3,200 has been canceled.

• Salary expenses will likely be 2% higher than originally anticipated.

• You are required to show a projected net profit of at least 50% of total revenue. If your revised budget generates less than this level of net profit or surplus, indicate where you can probably cut expenses to meet the target and explain why the expenses you have chosen to cut are your best choices.

Sample Operating Budget—Department of Physical Therapy (July 1, 20n1, through June 30, 20n2)

I. Revenue and Income A. Inpatient Charges $550,000

B. Outpatient Charges 310,000

C. Research Grant Support 29,000

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D. Continuing Education Conference 3,200

E. Supplies and Equipment Sales 11,500

Total Revenue

II. Expenses Direct Expenses

$903,700

A. Salaries $260,000

B. Consultant 2,500

C. Honorarium 1,500

D. Minor Equipment 6,000

E. Equipment Rental 2,000

F. Travel 2,500

G. Telephone 5,000

H. Supplies 6,000

I. Postage 350

J. Copy Machine Rental 11,000

K. Advertisement 1,500

L. Dues 800

M. Books 350

N. Equipment Maintenance and Service Contracts 2,000 Total Direct Expenses

III. Indirect Expenses

$301,500

A. Employee Benefits (23%) $59,800

B. Administration 23,000

C. Equipment Depreciation 7,200

D. Physical Plant Operation 39,000

E. Maintenance and Repairs 2,000

F. Building Depreciation 6,000

G. Laundry/Linen 2,500

H. Housekeeping 4,900

Total Indirect Expenses $144,400

Total Expenses $445,900

Net Profit or Loss $457,800

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LESSON QUIZ

Take the quiz for this lesson. Your results on the quiz do not affect your grade for the course. Quizzes are designed to help you to learn important concepts in the lesson and prepare you for the Final Examination, if required. You may take the quiz as many times as you wish.

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Lesson 5 – Training, Motivat ion and Communicat ion

Introduction

This lesson examines the overall process of orientation, training, and development from the perspective of the department manager. The vital character of employee orientation and education as a means of enhancing employee performance and as a significant and essential part of an organization’s ongoing employee retention efforts is emphasized.

You will explore the importance of the orientation and training program as a vital part of employee motivation and retention and should be able to develop cost justifications for the acquisition of essential internal and external training resources.

Chapter 10 addresses the significant issues involved in bringing individuals into the work organization and ensuring they become integral parts of it. The chapter reviews the factors and forces influencing individuals to willingly work and introduces the inevitability of conflict in human interaction. You should leave this lesson conversant with the major issues surrounding employee motivation—what does or does not motivate—and should appreciate the inevitability of organizational conflict but also understand how to address conflict when it arises.

This lesson introduces interpersonal communication within the context of the work organization, including some practical advice concerning written communication for the working manager. This topic, although necessarily treated in summary or overview fashion, is probably the most important element in the manager’s ability to establish and maintain the working relationships that are so important to success on the job.)

Lesson Learning Objectives

By the conclusion of this lesson you should be able to:

• Acknowledge the importance of and necessity for employee orientation programs and ongoing training and development activities.

• Relate orientation, training, and development to the management functions of planning,

organizing, directing, and controlling to employee motivation.

• Identify the components of effective employee orientation programs.

• Recommend an approach to communicating standards of conduct and behavior to new employees.

• Identify the components of employee training programs.

• Explore the availability of resources for training and development activities.

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• Identify the components of the clinical affiliation/clinical practice program and contract.

• Address the necessity for properly and thoroughly integrating each individual employee into the organization and describe the common techniques of integration.

• Introduce the theories that address present-day employee motivational concerns and

provide the manager with insight into the conditions and circumstances that inspire employees to perform.

• Specifically address the motivational concerns arising in conjunction with reengineering,

reorganizing, other practices resulting in downsizing of the workforce.

• Develop an understanding of the origins of conflict, especially in the organizational setting, and describe how to address conflict constructively.

• Describe the essential need for discipline within the organization and introduce the

concept of progressive disciplinary action, differentiating between problems of performance and problems of conduct relative to rules and policies.

• Briefly examine the role of the collective bargaining agreement (union contract) in the

avoidance of and as necessary the control of conflict.

• Provide a working definition of communication.

• Address the manager’s critical role in employee communication.

• Review the common means of communication used in the work setting.

• Provide guidelines for the proper use of electronic mail (e-mail).

• Examine the components of individual and small-group communication, including verbal (oral) and nonverbal communication.

• Enumerate the essential components of successful interpersonal communication.

• Review a number of means of fostering, enhancing, and improving interpersonal

communication and overcoming barriers to individual communication.

• Provide guidelines for personal improvement in using written communication in its various forms.

• Present the fundamentals of organization communication, including both

formal and informal communication.

• Differentiate between formal and informal communication in the organizational setting.

• Review the commonly encountered barriers to effective communication in the organizational setting.

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Reading

Study Chapters 9, 10 and 11 of the text.

View the PowerPoints for Chapters 9, 10 and 11

Assignments

The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your response. Your response must adequately cover the question without being wordy or relying on “yes” or “no” responses.

Exercise: What to Do When Budget Cutting Threatens Training?

Any department manager who has been through a financial belt-tightening exercise has undoubtedly collided with one of the fundamental contradictions in organizational life, and especially in healthcare organizations: On the one hand, education receives a considerable amount of verbal support from top management; on the other hand, as department managers frequently discover after the first budgeting pass, when it becomes evident that trimming is needed to bring projected revenue and expenses into line, education is one of the first line items to be reduced or eliminated.

1. You are to explain why you believe this fundamental contradiction exists and describe what

arguments you might use in defense of your education budget.

2. In defense of your education budget, which the budget director has said must be reduced by half or more, you are to:

• Develop an argument for keeping as much of your education budget as possible

• Describe how you would go about attempting to measure the results of education

Case Study: Charting a Course for Conflict Resolution: “It’s a Policy”

The setting is an 82-bed hospital located in a small city. One day an employee of the maintenance department asked the supervisor, George Mann, for an hour or two off to take care of some personal business. Mann agreed, and asked the employee to stop at the garden equipment dealership and buy several small lawnmower parts the department required.

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While transacting business at a local bank the employee was seen by Sally Carter, the supervisor of both human resources and payroll, who was in the bank on hospital business. Carter asked the employee what he was doing there and was told the visit was personal.

Upon returning to the hospital, Sally Carter examined the employee’s time card. The employee had not punched out to indicate when he had left the hospital. Carter noted the time the employee returned, and after the normal working day she marked the card to indicate an absence of two hours on personal business. Carter advised the chief executive officer (CEO), Jane Arnold, of what she had done, citing a longstanding policy (in their dusty, and some would say infrequently used, policy manual) requiring an employee to punch out when leaving the premises on personal business. The CEO agreed with Sally Carter’s action. Carter advised Mann of the action and stated that the employee would not be paid for the two hours he was gone.

Mann was angry. He said he had told the employee not to punch out because he had asked him to pick up some parts on his trip; however, Mann conceded that the employee’s personal business was probably the greater part of the trip. Carter replied that Mann had no business doing what he had done and that it was his—Mann’s—poor management that had caused the employee to suffer.

Mann appealed to the CEO to reopen the matter based on his claim that there was an important side to the story that she had not yet heard. Jane Arnold agreed to hear both managers state their position.

1. In either paragraph form or as a list of points, develop the argument you would be

advancing if you were in George Mann’s position.

2. In similar fashion, thoroughly develop the argument you would advance if you were in Sally Carter’s position.

3. Assuming the position of CEO, Jane Arnold, render a decision. Document your decision in

whatever detail may be necessary, complete with explanation of why you decided in this fashion.

4. Based on your responses to Questions 1 to 3, outline whatever steps—policy changes,

guidelines, payroll requirements, or something else—you believe should be considered to minimize the chances of similar conflict in the future.

Lesson Quiz

Take the quiz for this lesson. Your results on the quiz do not affect your grade for the course. Quizzes are designed to help you to learn important concepts in the lesson and prepare you for the Final Examination, if required. You may take the quiz as many times as you wish.

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Lesson 6 – The Middle Manager: Documenting and Control l ing Crit ical Processes

Introduction

This lesson addresses the responsibilities of middle managers in developing comprehensive management documents, including the strategic plan, annual report, and due diligence, and reviews the reasons for their preparation and considers their importance to the organization and to the individual manager.

The concept of “excellence” in the provision of service is examined and the management functions of quality improvement and controlling are considered. Students will develop an understanding of the critical practices of directing and controlling. The lesson introduces the concepts of Six Sigma and benchmarking and introduces some commonly used tools of control and performance improvement.

Lesson Learning Objectives

By the conclusion of this lesson you should be able to:

• Identify the responsibilities of middle managers in developing comprehensive management documents, including the strategic plan, annual report, executive summary of the annual report, and a project proposal.

• Examine the essential elements of each plan and its importance to the organization.

• Identify the special considerations related to the development of a business plan.

• Identify the special considerations relating to due diligence review reports.

• Describe the typical content of each of the foregoing documents.

• Provide examples of suggested wording of critical documents.

• Define the management functions of quality improvement and controlling.

• Introduce the concept of the search for excellence and examine its relationship to the

function of controlling.

• Relate controlling to directing in an essential cycle that affords ongoing attention to follow-up and correction.

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• Introduce the concept of benchmarking and describe its place in the management process.

• Describe selected techniques for improving quality.

• Enumerate the essential characteristics of adequate controls and introduce some

commonly used tools of control.

Reading

Study Chapters 12 & 13 of the text.

View the PowerPoints for Chapters 12 and 13

Assignments

The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your response. Your response must adequately cover the question without being wordy or relying on “yes” or “no” responses.

Exercise: Preparing Your Business Plan

You are considering the possibility of operating a small business or practice in some activity related to health care, as either a provider or as a service intended to support various provider organizations in their care-delivery activities.

1. First, describe the kind of entity you would be establishing by stating the service or services

you propose to deliver and the kinds of clients or customers you would be serving.

2. Next, write a paragraph offering compelling reasons for your proposed venture, explaining why you believe it is needed and for whom it is needed. Incorporate in this narrative a description of the kind and extent of competition you might face in your intended service area and how your services would be sufficiently different to enable you to compete successfully.

3. Develop a crude estimate of how much money you will require to become established in a

business and up and running, and state how you would consider trying to finance your venture.

4. Create a rough outline of your business plan, describe each step in the plan and state the

purpose of each step.

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Exercise: Promoting Total Quality Management

You are a professional employed at a large urban medical center. You have been appointed to serve as a nonmanagerial member of a steering committee established to guide the implementation of TQM throughout the organization. The committee has been through a week of intensive education in TQM/performance improvement principles and has held the first two of an indefinite series of weekly meetings to pave the way for translating the TQM philosophy into practical actions that can be implemented. You are encouraged by what you have learned and experienced during these first few weeks; however, you are also conscious of the organization’s past failures with management by objectives and quality circles, and you are aware of a widespread tendency to regard such undertakings as dabbling in the latest management “flavor of the month.”

Your second steering committee ends late, leaving you only two minutes to get to your next commitment. As you leave the conference room and enter the hospital’s main corridor, a colleague, heading toward the same destination as you, falls into step beside you and asks, “What’s this total quality management all about? Looks to me like the same stuff that’s been pushed at us in different wrappers several times over the years, and it’ll probably go the same way. Nowhere. More fancy notebooks and reports that end up collecting dust. Why should we think this will be any less of a waste of time and resources?”

You have less than two minutes available while on the move to provide your colleague with a positive response in a few sentences. Write out your proposed response.

Lesson Quiz

Take the quiz for this lesson. Your results on the quiz do not affect your grade for the course. Quizzes are designed to help you to learn important concepts in the lesson and prepare you for the Final Examination, if required. You may take the quiz as many times as you wish.

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Lesson 7 – Human Resource Management from A Line Manager’s Perspective

Introduction

This lesson will provide guidance for the manager in establishing a relationship with the organization’s human resource function and fully utilizing everything that human resources offers in facilitating the fair, effective, and legal management of people. You will gain an understanding of what the human resource department provides to the organization and should especially be sufficiently knowledgeable to be proactive as necessary in obtaining assistance from human resources.

Next, we will provide an overview of interpersonal communication within the context of the work organization, to include some practical advice concerning written communication for the working manager. This topic, although necessarily treated in summary or overview fashion, is probably the most important element in the manager’s ability to establish and maintain the working relationships that are so important to success on the job.

Finally, we study the health care professional who serves in a managerial capacity as both professional practitioner and manager and reinforce the necessity for the successful professional- as-manager to place neither role above the other and to establish the departmental standard for professional conduct and behavior. You will explore the often-unique problems that can confront the professional-as-manager, especially in the management of other professionals, but also understand that not all professionals (or nonprofessionals, for that matter) behave in a set, predictable manner and thus cannot all be managed in the same way.

Lesson Learning Objectives

By the conclusion of this lesson you should be able to:

• Outline the functions of human resources and indicate how these relate to the role of the manager.

• Provide an overview of the individual manager’s responsibilities in the management of

human resources.

• Describe actions that the manager can take to ensure that he or she will obtain appropriate service from human resources when needed.

• Guide the manager toward the establishment of a working relationship with human

resources that will lead to improved human resources service to the department.

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• Review pertinent areas of legislation that the manager should know and that generally influence the manager’s relationship with human resources.

Reading

Study Chapter 14 of the text

View the PowerPoint for Chapter 14

Assignments

The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your response. Your response must adequately cover the question without being wordy or relying on “yes” or “no” responses.

Case Study: The Managerial “Hot Seat”

Carol Greely had been a registered nurse for 25 years and a nurse manager for more than 10 years when she was asked to take over as nurse manager of a particular medical/surgical unit known throughout the hospital, none too affectionately, as the “hot seat.” Although she had heard a few things about this floor, because of the size of the hospital and her recent assignment in a relatively removed area, Carol had little information about why the hot seat was so designated.

After three months on the job, however, Carol had formed some strong opinions regarding the basis of many of the unit’s problems. To her, the majority of staff on the unit exhibited a complete lack of professionalism. Carol became convinced of this for a number of reasons, including the following:

• There were many appearance problems and many violations of the department’s none-

too-often-enforced dress code. If there were a worst-dressed list maintained, Carol concluded, surely her nurses would be on it.

• The unit’s rate of absenteeism was the worst of any unit within the nursing department.

• Two (thankfully unsuccessful) attempts by unions to organize the hospital’s nurses had

apparently originated with the nurses in Carol’s unit.

• Carol had never before seen a unit with such a high level of schedule juggling—shift trades, requests for specific days off, and especially changes to the schedule at the last minute.

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It was not long before Carol found herself becoming highly cynical about the unit and its future. It seemed to her that nursing meant no more to many of these people than the paycheck and that they constantly put their social lives and personal preferences before the needs of the patients.

When she had been on the job six months, Carol received a startling piece of secondhand information from a friend in the nursing department who swore her to secrecy as to the source. It was apparently a closely guarded secret in nursing administration that her particular unit was deliberately maintained as a concentration of marginal employees. It was, in the words of Carol’s friend, “to keep the butterflies and malcontents all in one place as much as possible, so they wouldn’t disrupt other units.” Carol was further led to believe that she could expect to be reassigned after about 18 months on the job, when it would then be someone else’s turn to sit in the hot seat.

Carol’s initial reaction to what she had learned was anger; however, the more she thought about the position in which she found herself, the more she became determined to do something with the time left to her in the unit. She decided she was going to do everything in her power to turn the hot seat into a real nursing unit.

1. Develop a fairly detailed plan of action for Carol Greely to follow in attempting to

accomplish her admittedly difficult objective or to go as far toward accomplishing it as possible.

2. Highlight those steps in her plan for which the human resource department can

probably provide positive advice or assistance and describe the likely nature of the human resource involvement.

Lesson Quiz

Take the quiz for this lesson. Your results on the quiz do not affect your grade for the course. Quizzes are designed to help you to learn important concepts in the lesson and prepare you for the Final Examination, if required. You may take the quiz as many times as you wish.

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Lesson 8 – Day-to-Day Management for the Heal th Professional-as-Manager

Introduction

The healthcare professional who serves in a managerial capacity is both a professional practitioner and manager. To be a successful professional-as-manager there is a necessity to place neither role above the other and to establish the departmental standard for professional conduct and behavior.

You should leave this lesson with an understanding of the often-unique problems that can confront the professional-as-manager, especially in the management of other professionals. You should also understand that not all professionals-or nonprofessionals, for that matter-behave in a set, predictable manner and thus cannot all be managed in the same way.

Lesson Learning Objectives

By the conclusion of this lesson you should be able to:

• Examine the dual role of the health professional working as a manager.

• Explore some potential problems and barriers often encountered by health professionals who enter management.

• Confirm the legitimacy of management, necessarily a second career for many health

professionals, as a profession in its own right.

• Identify the nonmanagerial professional employee as a sometimes-scarce resource, suggesting a necessary focus on employee retention.

• Introduce the high-skill professional and review the special management problems of

directing such personnel.

• Discuss several aspects of day-to-day management in which the manager must put more into the relationship with each employee because the employee is a professional.

• Establish the manager’s critical role as the essential link between the employees’

profession and the remainder of the organization.

• Address the need for the professional-as-manager to recognize the importance of self- development and active management of one’s own career progression.

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Reading

Study Chapter 15 of the text.

View the PowerPoint for Chapter 15

Assignments

The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your response. Your response must adequately cover the question without being wordy or relying on “yes” or “no” responses.

Case Study: Delegation Difficulties—The Ineffective Subordinate

Nursing supervisor Kate Dyer was finally forced to admit, at least to herself, that she was going nowhere in her attempt to get nurse manager Susan Foster to behave as a manager ought to behave. Summarizing the recent occasions on which Susan and her performance had come to Kate’s attention, Kate had assembled the following list:

• Whenever Kate went through Susan’s unit she found Susan’s desk in disarray and

invariably found Susan herself behind in her work.

• Susan seemed to experience a great deal of difficulty in making important meetings; she had missed three of the last four nursing management meetings, and at the one she did attend she did not show up until it was half over.

• Kate’s specific suggestions as to tasks that Susan might consider delegating to some of

her subordinates have apparently been ignored.

• Some weeks earlier Kate had asked Susan for a detailed written list showing how the various nursing duties on her floor might be divided among the unit’s staff members. Susan did not comply with the request.

In general, Susan seemed to have but two answers for many of the questions put to her by peers and supervisors alike. To questions that were general and nonthreatening, such as “How is everything going?” she would simply answer, “Just fine.” However, if a question seemed intended to determine why something had not been done, Susan could be counted on to answer, with a pained expression on her face, “I simply haven’t been able to get to it.”

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1. Although Susan’s performance is obviously lacking in a number of ways, Kate might best begin by examining some elements of her own performance and her own leadership style. What are the elements of the case that may have prompted this statement, and what are the implications of those elements regarding Kate’s style and performance?

2. What appear to be the weakest elements in Kate’s style? Why are they weak?

3. Assuming that Kate is able successfully to address the deficiencies in her own approach

to management, where should she begin in trying to determine if Susan has the potential to become a truly effective nurse manager?

Case Study: Professional Behavior—The Bumping Game

Dr. Gable, chief of anesthesiology, said to vice president Arthur Phillips and human resource director Carl Miller, “There are no two ways about it. We’re going to have to raise the pay of our nurse anesthetists by at least 10%. With Don Williams leaving us and going to Midstate Hospital for a lot more money, we’re going to have to pay more than we’re now paying to fill that spot. Of the nine hospitals in this city our nurse anesthetists are by far the lowest paid.”

Carl Miller said, “Since we spoke of this a week ago I personally surveyed every hospital compensation manager in town. We’re not the lowest paying of the nine. In fact, we’re the third highest paying.”

Dr. Gable shook his head. “That doesn’t wash,” he said. “Some of our people moonlight at other hospitals and they’ve told me the hourly rates they’re getting for part-time work. They said they’d bring in pay stubs to prove it.”

Arthur said, “A week ago you said you were going to bring in some of those pay stubs from other places. Did you get them?”

“No. They forgot.”

Carl said, “Moonlighting rates aren’t relevant. Most of these places pay their part-time or casual nurse anesthetists a rate that amounts to more than their full-time employees get. That’s because these casuals work only when called and they don’t receive vacation, sick time, or other benefits, and they don’t get retirement credit.”

Arthur asked, “How about Midstate? I understand they have more than one scale for nurse anesthetists, with a second scale that might not readily be shared with other places.”

Carl nodded and said, “That’s right. Midstate is the highest paying hospital in the area, based on this sort of hidden scale that it applies to some of its people. It pays up to 15% more for this one small group, all of whom have agreed to an extra-long work week and a certain amount of weekend call. But it’s not really comparable to our situation.”

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Arthur said, “In all the years I’ve been here, it seems I can depend on this same exercise coming up every time one of our nurse anesthetists leaves. I’ve also come to count on it happening with the pathologists and radiologists every few years—they go to work on one hospital to get their compensation increased, then they use this new pay leader as a wedge to get the other hospitals to pay more.”

Carl said, “I’m sure that all of the nurse anesthetists in town know what the others earn. All it takes is a few people in one hospital to get a strong advocate to go to bat for them, and the pressure to bump pay rates is felt throughout the region.”

Dr. Gable said, “I take it that you’re seeing me in that strong advocate role.” Carl did not respond.

Arthur said, “Anyway, Dr. Gable, you obviously see the nurse anesthetist pay rates as a problem and we’re willing to listen to any potential solutions that you may have to offer. However, the budget year is barely one-third over and there is no more money to play with until the first of next year. As a first pass at the problem, we’ll be happy to take a close look at any creative solutions you can come up with that lie within the limits of this year’s budget.”

1. What does this case say about the supply of the particular skill in the area? And what

might come of Dr. Gable’s arguments if the realities of supply were different?

2. Do you believe that the interorganizational “bumping” of pay rates, if indeed a fact, constitutes professional behavior? Why or why not?

3. Because it might be reasonably suggested that the nurse anesthetists in the area are

acting together, at least in a loosely organized way, one might be tempted to suggest that the area’s nine hospitals get together and establish fair and consistent pay rates for this occupation. What hazards are inherent in this approach, and in what sense has one of the case’s participants already ventured into hazardous territory?

4. How would you suggest that Arthur and Carl proceed in their consideration of Dr. Gable’s

request?

Lesson Quiz

Take the quiz for this lesson. Your results on the quiz do not affect your grade for the course. Quizzes are designed to help you to learn important concepts in the lesson and prepare you for the Final Examination, if required. You may take the quiz as many times as you wish.