MHA6999 SEMINAR IN HEALTHCARE CASES WEEK 1 LECTURE, DISCUSSION, AND PROJECT INSTRUCTIONS
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MHA6999SEMINARINHEALTHCARECASESWEEK1LECTUREDISCUSSIONANDPROJECTINSTRUCTIONS.docxMHA6999 SEMINAR IN HEALTHCARE CASES WEEK 1 LECTURE, DISCUSSION, AND PROJECT INSTRUCTIONS Page | 1
Healthcare Leadership
Good leadership is essential to patient-centered care and staff satisfaction in the healthcare environment. All members of the healthcare team can be leaders, and evidence-based theory should inform their leadership practice (Harris & Mayo, 2018). Leaders of every organization encounter issues and resolve them easily by taking decisions, whereas others may call for a critical analysis of the situation, a split judgment, an assessment made by an individual, or decisions made by a group. Whatever the circumstances, the decisions that are made will have consequences for human resources and the organization itself. It is, therefore, necessary for individuals to be trained in leadership and to become well equipped to make the right decision at the right time.
Effective leadership by healthcare professionals is vital in modern healthcare settings. The major factor underpinning this is the drive to improve the quality of healthcare provision on a background of ever-increasing healthcare demands and the need for increased efficiency and productivity (Kumar & Khiljee, 2016). There is a large body of literature focused on leadership, yet opinions frequently conflict; the evolving nature of the practice and theory on the topic means that there is no consistent definition of what constitutes leadership (Harris & Mayo, 2018). Leadership skills and traits that enable a person to become successful within one circle with one group of individuals with particular skill sets and academic disciplines may not allow the same person to become successful in the increasingly more complex concentric circles. All leaders along the continuum of care must engage in lifelong learning to be successful.
Role of Leaders in Patient-Centered Care
For healthcare organizations to remain productive and successful during these tumultuous times, a new kind of healthcare leader is needed—one who has the right specific skills, personality traits, and leadership qualities.
Review each tab to know more.
Healthcare System
Chief Executive Officer (CEO)
Description of the Role (How the person in that role works to provide patient care)
A hospital CEO has the responsibility to ensure almost every aspect of how hospitals perform is working efficiently. He or she needs to find a balance in managing the day-to-day operations while leading strategic development initiatives required for long-term success.
Benefits Provided (toward patient-centered care)
Ensuring patients have access to services, care is coordinated, and patients are provided education materials and resources.
Chief Operating Officer (COO)
Description of the Role (How the person in that role works to provide patient care)
The COO is responsible for the smooth and efficient operation of the hospital, including management of the profit-and-loss statement for the hospital’s business, as well as the related resources associated with the hospital operation.
Benefits Provided (toward patient-centered care)
Quality of care, patient safety, and patient satisfaction are areas that a COO must keep in mind at all times. Patient satisfaction will generate return business, while safety and high quality are two ways to improve patient satisfaction.
Chief Compliance Officer (CCO)
Description of the Role (How the person in that role works to provide patient care)
The CCO ensures that the board of directors, management, and all system employees comply with the tangle of rules, regulations, policies, and procedures.
Benefits Provided (toward patient-centered care)
Duties include enforcing the code of conduct in a healthcare setting, which include the patients’ right to receive quality healthcare in a safe, respectful, and compassionate manner; the right to choose their healthcare practitioner; and the right to be involved in the decisions made regarding their medical treatment.
Hospital Services
Service Line Administrator
Description of the Role (How the person in that role works to provide patient care)
Develops and manages all functions within a specific service line, e.g., oncology, cardiac, women's, orthopedics. Establishes effective strategies for programs, product/service line, and physician integration and resource utilization.
Benefits Provided (toward patient-centered care)
Responsible for the product-line model that follows the patient's path through the care process.
Primary Care
Practice Administrator
Description of the Role (How the person in that role works to provide patient care)
A practice administrator takes care of the daily activities of a medical facility. Part of his/her responsibility is ensuring that the facility is properly staffed by recruiting physicians, nurses, medical assistants, and nonmedical staff.
Benefits Provided (toward patient-centered care)
Provides clinicians with the resources necessary to meet the needs of patients and financial objectives of the practice and group.
Long Term Care
Nursing Home Administrator
Description of the Role (How the person in that role works to provide patient care)
Nursing home administration is a specialized area of medical and health services management. Nursing home administrators work to supervise clinical and administrative affairs of nursing homes and related facilities.
Benefits Provided (toward patient-centered care)
Nursing home administrators are responsible for providing leadership to a team of nurses; and at the same time, they must employ their business skills to ensure they are providing the best patient care.
Healthcare organizations should invest in training leaders at every level to help build competence and develop talent, thus bettering individuals, encouraging innovation, and enhancing patient care. Such informal, collective leadership should be encouraged to ensure staff satisfaction and patient-centered care.
References:
Harris, J., & Mayo, P. (2018). Taking a case study approach to assessing alternative leadership models in healthcare. British Journal of Nursing, 27(11), 608–613. doi:10.12968/bjon.2018.27.11.608
Kumar, R. D., & Khiljee, N. (2016). Management: Leadership in healthcare. Anaesthesia and Intensive Care Medicine, 17(1), 63–65. doi:10.1016/j.mpaic.2015.10.012
Additional Materials
From your course textbook, Cases in Health Care Management, review the following cases:
· Case 2: Changing Physician Credentialing
· Case 3: The New Manager Needs a Coach
· Case 4: Why Won’t She Just Retire?
· Case 5: No Plan in Sight? Succession Planning in a Small Rural Hospital
· Case 7: Practicing Organizational Culture Without a Leader
Healthcare Management
There are certain differences between the skills required for leadership and those required for management. Health organizations need leaders and managers who are consistently focused on the direction of where the organization is going and what the organization does to take care of its patients. When we focus on the meaning of complexity for healthcare organizations, it is important to realize that management in these organizations is about managing complex adaptive systems (CAS). CAS are popular in the organization and management literature because every organization consists of a number of subsystems, with a number of activities within each subsystem (Cinaroglu, 2016). Healthcare organizations are one of the most complex systems as they are undergoing rapid technological changes; therefore, they must adapt themselves to disorganized situations and must be successful at every stage of the clinical and organizational processes.
Leadership Approaches Adapted to the Healthcare Setting
The healthcare industry is in transition, and because of this, new leadership styles need to be implemented to effectively lead and manage this new paradigm.
Review each leadership approach to know more.
Transformational
Description
Leaders engage with their followers in pursuit of jointly held goals.
Example
Charismatic, inspire high standards, and serve as a role model.
Transactional
Description
Leaders establish goals, provide direction, and reward employees’ progress in meeting goals.
Example
Based on contingent reward, i.e., a reward that depends on the delivery of the work product
Collaborative
Description
The cornerstone of success in any team. Interprofessional collaboration is one of the trademarks of several highly successful healthcare innovations.
Example
When nurses collaborate as equals with other healthcare providers, patient outcomes and quality of care tend to improve.
Shared
Description
Dynamic interactive influencing process among individuals in groups for which the objective is to lead one another to the achievement of group or organizational goals.
Example
Each team member’s individual experience, knowledge, and capacity are valued and used by the team to distribute or share the job.
Distributed
Description
Is primarily concerned with the practice of leadership rather than specific leadership roles or responsibilities.
Example
Individuals can complement one another's strengths and offset one another's weakness, with leadership distributed throughout the organization.
Healthcare as a Complex Adaptive System
Complex adaptive system (CAS) thinking is an approach that challenges simple cause and effect assumptions, instead sees healthcare and other systems as a dynamic process.
Review each icon to know more.
Nonlinear Interactions
Example: Fee-for-Service System
Challenges
Established silos of care with relatively little attention to the patient transitions and communication channels between them (Lewis 2102)
Simple Rules
Example: Creative Self-Organization
Challenges
Need to depart from a mechanical, regulatory approach to healthcare policy
Emergent
Emergent, Self-Organized Behavior
Example: Affordable Care Act
Challenges
Allowing a more functional system of healthcare to emerge through the various demonstrations, innovations, and waivers to support the Affordable Care Act
Reference Lewis, A. L. (2012). Understanding health care as a complex system: The foundation for unintended consequences. JAMA: The Journal of the American Medical Association, (3), 243. doi:10.1001/jama.2012.7551
Leadership is holistic. This means that leadership means leading collaboratively, not just from the upper echelons of the people, structure, and processes of the organization. In addition to the many definitions of this concept, there is an abundance of literature on leadership, leadership principles, and topics related to leadership. Management is the process of getting activities completed efficiently and effectively with and through other people. Management functions and sets of knowledge, skills, and abilities have been researched for several decades. Peter Drucker, described as the founder of modern management, simply terms a leader as “someone who has followers” and famously quoted, “Management is doing things right; leadership is doing the right things” (Kumar & Khiljee, 2016).
Differences between Manager and Leader
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Practices Leadership |
Practices Management |
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Leaders have followers |
Managers have subordinates |
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Charismatic, transformational style |
Authoritarian, transactional style |
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People-focused |
Work-focused |
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Seek risk |
Seek comfort |
Future managers in healthcare should familiarize themselves with the management and clinical functions of healthcare organizations, open communication channels between healthcare professionals, and also know the difficulties of management in turbulent times. These kinds of managers can see the whole picture and strive to improve the performance of their healthcare organizations (Cinaroglu, 2016). Managers are essential for the achievement and success of a healthcare organization. Both leaders and managers must work in concert to develop an effective system with which to administer a well-managed healthcare organization.
References:
Cinaroglu, S. (2016). Complexity in healthcare management: Why does Drucker describe healthcare organizations as a double-headed monster? International Journal of Healthcare Management, 9(1), 11–17.
Kumar, R. D., & Khiljee, N. (2016). Management: Leadership in healthcare. Anaesthesia and Intensive Care Medicine, 17(1), 63–65. doi:10.1016/j.mpaic.2015.10.012
Additional Materials
From your course textbook, Cases in Health Care Management, review the following cases:
· Case 8: Governing Board vs. Management
· Case 9: Transitioning to a New Leader
· Case 10: The Toxic Leader
· Case 11: Inappropriate Client Behavior
· Case 12: A Lottery for Employee Attendance
· Case 13: Disorder in the House
· Case 14: Managing Health Care Professionals: Five Mini-Case Studies with Role Play
· Case 15: Take a Number
Management vs. Leadership
For at least the past decade, there has been a preponderance of articles discussing leadership and all its attributes and a dearth of articles on traditional management and the role of a manager (Kilbort, 2004). In the simplest terms, management is the process of getting activities completed efficiently and effectively with and through other people. Management functions and sets of knowledge, skills, and abilities have been researched for several decades. What's the difference between management and leadership? Management is the allocation of scarce resources against an organization's objective, the setting of priorities, the design of work, and the achievement of results (Weathersby, 1999). Most important, it's about controlling.
Talking about leaders is the easy part, so let’s turn our attention to the manager. Managers are constantly told to deal with opposing ideas (Kilbort, 2004). Leadership, on the other hand, focuses on the creation of a common vision. It means motivating people to contribute to the vision and encouraging them to align their self-interest with that of the organization. It means persuading, not commanding. Healthcare organizations must strive to maintain service quality and improve efficiency in order to improve service user satisfaction, all the while adhering to the restrictions placed on them by the public service budgets. Management, leadership, and change in management style are currently the three strategic priorities of healthcare centers (Martínez-Gonzalez, Monreal-Bosch, Perera, & Olid, 2016).
Challenges in Care Management
Stratify patients and align them with the needed level of services, moreover, to enable them to achieve outcomes while minimizing costs.
Review each tab to know more.
Fragmentation
Resolution/Risk Management
Manual processes in a typical care management workflow.
Advantage/Disadvantage
Care management is a patient-centric, longitudinal ambulatory activity that must see more than just claims and electronic medical record (EMR) data.
Limited Data Access
Resolution/Risk Management
Many healthcare organizations do not have experience negotiating and collaborating with insurers for complete patient data.
Advantage/Disadvantage
Payers may be concerned that healthcare organizations will use the data provided under the guise of care management, to analyze discounts and negotiate more favorable payment rates.
Poor Data Quality
Resolution/Risk Management
Healthcare organizations also need to learn about and implement Enterprise Master Patient Index (EMPI).
Advantage/Disadvantage
Leveraging EMPIs will require significant collaboration between care management and the healthcare organization’s information technology departments.
There’s no question that effective leaders of the twenty-first century will need the ability to manage in the presence of ambiguity and rapid changes driven by technology. To recruit, motivate, and retain employees—as well as customers, investors, and shareholders—they will need to introduce new visions and inject passion into the decision-making process (Weathersby, 1999). Regardless of their natural abilities, experience, education, and training, all leaders have their own personal areas for improvement so that they can grow and become more successful.
References:
Kilbort, P. M. (2004). Management vs. Leadership. Physician Executive, 30(6), 32–35.
Martínez-Gonzalez, M., Monreal-Bosch, P., Perera, S., & Olid, C. S. (2016). PUBLIC HEALTHCARE ORGANIZATIONS: LEADERSHIP OR MANAGEMENT?. Athenea Digital (Revista De Pensamiento E Investigación Social), 16(3), 245–257. doi:10.5565/rev/athenea.1706
Weathersby, G. B. (1999). Leadership vs. Management. Management Review, 88(3), 5.
Additional Materials
From your course textbook, Cases in Health Care Management, review the following cases:
· Case 16: The Write Candidate
· Case 18: Isn’t It Great? My Boss Got Promoted and I Got His Job!
· Case 19: Strategies for Dealing with Health Care Reform
· Case 20: What Can I Do? I Think My Boss Is a Bully!
· Case 21: Whose Decision Is It about Which Positions Are Filled?
· Case 22: Changing Patient Behavior: When Obesity Is a Death Sentence
Week 1 Discussion
Supporting Lectures:
Review the following lecture:
Discussion Questions
Before beginning work on this discussion forum, please review the link “ Doing Discussion Questions Right ” and any specific instructions for this topic.
Before the end of the week, begin commenting on at least two of your classmates’ responses. You can ask technical questions or respond generally to the overall experience. Be objective, clear, and concise. Always use constructive language, even in criticism, to work toward the goal of positive progress. Submit your responses in the Discussion Area.
Introduction:
Case Study One: Case of the Reluctant Associate
You are the chairman of the department of surgery at an urban community hospital and the head of a large general surgery practice. The oldest member of the group is about to retire, and you need to recruit a new partner. You are hoping to recruit a person relatively new out of training to provide succession planning for the group, because you know that in the next five to seven years you will be retiring.
You’re in your office when one of the junior surgeons, Dr. Simon, asks to speak to you. He presents you with several credentialing packets for out-of-state licensure. He is on the staff of your hospital; however, he primarily works at another hospital in the area. You ask Dr. Simon if he would be interested in staying and joining your practice. He states his family is in the area, but he’s not sure whether he wishes to be a junior associate in another practice or not. You spend time discussing how this particular practice runs and what his duties would be and inform him that in a very short time he could become a fully integrated member of the group with equal say in medical matters and compensation equal to the amount of work that he produces. He asks several unusual questions such as “How many times a day will you call me?” “Will you be checking up on me?” and “Will I be able to make my own clinical decisions?”
It becomes apparent from this discussion that Dr. Simon probably has been treated poorly in his existing practice. He has not been allowed to make his own schedule and his decision making was second-guessed. The senior member of the practice created extensive work for him, while Dr. Simon was compensated for a small percentage of the work that he actually performed, and the senior partner was making a large profit.
At this point, you explain how this new opportunity would be different and that Dr. Simon would be a partner in two years, joining with the other three members of the group. The members of the group all feel that he is well qualified and would be an asset to the group. You are willing to offer him a position in the practice. After much discussion and cajoling, he finally agrees to join the practice.
Tasks:
Discussion Questions
· What are the main concerns in this case?
· Which of the organizational theories of management describes the behaviors of Dr. Simon’s first practice experience? The second? Provide a rationale for your response.
· Is succession planning important for medical practices? Give examples of the techniques that are available to recruit new physicians.
· Discuss the pitfalls of a new physician joining a practice. From the example in the case, outline what principles should guide a physician in taking on a new associate/partner.
· How long should a physician be in a practice before he or she becomes a partner? Should he or she ever become an equal partner?
Submission Details:
To support your work, use your course and textbook readings and also use the South University Online Library . As in all assignments, cite your sources in your work and provide references for the citations in APA format.
Your initial posting should be addressed at 500–1000 words as noted in the attached PDF. Submit your document to this Discussion Area by the due date assigned. Be sure to cite your sources using APA format.
Respond to your classmates throughout the week. Justify your answers with examples, research, and reasoning. Follow-up posts need to be submitted by the end of the week.
Week 1 Project
Instructions
Supporting Lectures:
Review the following lectures:
Project
The project assignment provides a forum for analyzing and evaluating relevant topics of this week on the basis of the course competencies covered.
Introduction:
Midtown Neurology was started by a single physician who had been practicing in the community for nearly twenty years. As the practice grew, it evolved from a “mom-n-pop” operation to a more complex model. The founding physician recruited four new neurologists to join and continue to help build the practice. Subsequently, however, the new doctors took over and forced him out of the practice.
Tasks:
Case Study Six: From Nothing to Something: Defining Governance and Infrastructure in a Small Medical Practice (From Textbook)
Buchbinder, S. B. (2013). Cases in Health Care Management. Jones & Bartlett Learning. https://digitalbookshelf.southuniversity.edu/books/9781284084900
Read the above case study; your task would be to evaluate this case study utilizing the format below. Make sure to include at least two scholarly/peer-reviewed articles to help support your evaluation.
Case Study Evaluation
· Prepare a written report of the case using the following format:
· Background Statement: What is going on in this case as it relates to the identified major problem?
· What are (only) the key points the reader needs to know in order to understand how you will “solve” the case?
· Summarize the scenario in your own words—do not simply regurgitate the case. Briefly describe the organization, setting, situation, who is involved, who decides what, etc. Specifically identify the major problems and secondary issues.
· What are the real issues? What are the differences? Can secondary issues become major problems?
· Present an analysis of the causes and effects.
· Fully explain your reasoning. Declare your role in a sentence or a short paragraph explaining from which role you will address the major problem and whether you are the chief administrator in the case or an outside consultant called in to advise.
· Regardless of your choice, you must justify in writing as to why you chose that role. What are the advantages and disadvantages of your selected role? Be specific.
· Recognize the strengths and weaknesses of the organization.
· Identify the strengths and weaknesses that exist in relation to the major problem. Again, your focus here should be in describing what the organization is capable of doing (and not capable of doing) with respect to addressing the major problem. Thus, the identified strengths and weaknesses should include those at the managerial level of the problem. For example, if you have chosen to address the problem from the departmental perspective and the department is understaffed, that is a weakness worthy of mentioning. Be sure to remember to include any strengths/weaknesses that may be related to diversity issues.
· Find out alternatives and recommend a solution.
· Describe the two to three alternative solutions you came up with. What feasible strategies would you recommend? What are the pros and cons? State what should be done—why, how, and by whom. Be specific. Evaluate how you would know when you’ve gotten there. There must be measurable goals put in place with the recommendations. Money is easiest to measure; what else can be measured? What evaluation plan would you put in place to assess whether you are reaching your goals?
· TIP: Write this section as if you are trying to “sell” your proposed solution to the organization. Convince the reader that your proposed solution is the best available and that it will work as planned. Make sure that the goals you identify are worth the effort required to achieve them!
To support your work, use your course and text readings and also use the South University Online Library . As in all assignments, cite your sources in your work and provide references for the citations in APA format.
Submission Details:
· Name your file as SU_MHA6999_W1_Project_LastName_FirstName.
· Your assignment should be addressed in a 4- to 6-page document.
· By the due date assigned, submit it to the Submissions Area.
