Assignment Help
cov_psy1
W3B2.docxKey Concerns
To view the entire list, visit CEO Issues at http://www.ache.org/PUBS/research/ceoissues.cfm. Financial challenges have been number one in this survey for over 10 years in a row. Key elements of each of the top three concerns are specified in tables found on the web page. The tables can help pinpoint some broad areas for questions and exploration.
Engaging Analytics
Engaging analytics is key to understanding what is happening, and to finding a path forward. Indeed with the advancements and availability of analytic power as presented in the first module - engaging this capability is becoming just the ante to 'play the game'. However, to apply an appropriate analytic approach and tools that will be most effective in revealing powerful insights, one must have a firm understanding of the following: What are the pieces about which understanding is needed to address questions and allow exploration? How do all the pieces fit together? That is the focus of this module
Healthcare delivery at a base level is like every industry: Areas engaged in production of the products or services are supported by other key functions, such as finance and marketing. This module will present a general model of the relationship between the production component (delivery of services and care to, and with healthcare users) and other key functions, then apply it generally and in successively greater levels of detail to healthcare provider organizations. Such a framework provides a structure that providers can use to compare their situations with those of others, and to develop the necessary understanding of the pieces and how they fit together.
Interconnections
Organizations in pursuit of any marketplace objectives (that is, the organizational mission) must engage three main functions for sustainable existence: operations, finance, and marketing. It is necessary to start at this level to establish, as the basis of further analysis, the fundamental importance and interconnection of each function that plays a role in achieving the mission and strategy (as in the illustration).
Finance
An organization must have a financing function to ensure that monetary resources are available to conduct operations. Accounting is only one component of the financing function, although it is often the most notable and a critical element of planning and performance monitoring.
Here is a list of responsibilities that are part of the finance function. indicates always included function. Other points may be handled by separate and distinct functional areas, though not a 'main' function of the business.
Financial administration, direction and control
Financial planning, budgeting and reporting
Revenue cycle – Patient accounts, billing (coding), and accounts receivable, etc.
Financial regulatory compliance
Maintenance of accurate and auditable financial records
Accurate and efficient transaction processing
Contract negotiation and management - insurance, vendors, etc.
Leadership of the organization’s Value Projects
Supply chain management functions (some organizations)
Information technology management (some organizations)
Operations
Operations is the function that meets the demand for a service or product (a product output as might be traditionally thought to be the focus of 'operations') by marketplace entities. The set of decisions that comprise the operational function is well described in the work of Jay Heizer and Barry Render, authors of Operations Management (11th ed., Prentice Hall, 2014). [The 10 Decisions of Operations Management]
For additional information, visit https://shumateblog.files.wordpress.com/2014/10/10_om_decisions.png.
These experts emphasize the specific applicability of the operations management discipline in the context of health care, using Arnold Palmer Children's Hospital, as an in-depth case example.
Marketing
Marketing provides the market interface function that is focused on understanding what the marketplace overtly seeks, specifically needs, anticipating shifts, and ensuring a strong marketplace presence. Kotler describes the commonly known 4 P's of Marketing (Product, Price, Place (i.e., distribution channel), and Promotion. These 4P's traditionally are used in combination to drive consumer demand. In reform and post reform eras marketing does not go away - it more tightly focuses on specific marketplace, such as population needs and ensuring a strong marketplace presence regarding the quality of services the organization delivers in relation to these.
The key idea here is focus. Sustainable success is a result of focus created by recognizing that organizational attention must be paid to all three functions. Analytics engaged in relation to a function is a proxy for organizational emphasis and focus. Health care is no different.
Source: Kotler P., Armstrong G., Principles of Marketing, Prentice Hall, 2013.
Performance Across Functions
All segments of the healthcare delivery system (discussed in the first module of this curriculum) need focus on these three basic functions as the foundation of what they do. Each segment produces outputs, has financing needs, and should pay attention to the marketplace served.
However, for a variety of reasons (which are beyond the scope of this course), healthcare providers often show insufficient focus on the three functions.
As is the case in any industry, engaging analytics that unlock information within each function is needed to propel the organization forward regardless of segment. With the information that is revealed, performance can be improved within, between, and across functions. So, in health care, at what or where do we look?
Historical Focus
The illustrations on this page depict the general interconnections of each of the three major organizational functions discussed on the previous page in the context of the delivery segments serving healthcare users – healthcare provider organizations (using the classic division of provider types).
The size of each shape in the illustrations depicts both the relative historical focus on that function as related to analytics and the particular organizational focus on each function of “the business.”
Recommended Focus
The illustration on this page proposes a way to think about and focus on the general interconnections of the three major organizational functions (shown by shape size) and supporting functions in the context of all healthcare provider organizations.
Included are key organizational support functional areas - Decision Support, Clinical Informatics*, IT, and Human Resources. These areas are subsumed under general and administrative organizational tasks not addressed previously. This illustration is intended to be broadly directional, not prescriptive. Those engaged in BI/Analytics work will find themselves working closely with, if not hand-in-hand with Clinical Informaticists and likely Nursing Informaticists*, in particular.
Relative organizational positioning (reporting relationship and integration/interconnectedness) and size of these functions certainly varies by organization interest, situation, and decision. Too, in many healthcare provider organizations, Marketing might be classified as a general and administrative task.
Information Within Each Function
This illustration further breaks down the work of the organization, so as to make plain answers to the questions posed earlier—what is the information within each function to unlock, and where might the information be observed? Answers to the questions then drive performance improvement of each function (and across functions). The illustration shows cross-functional relationships, interconnectedness, and interdependencies. It is not intended to be exhaustive, but rather to aid reflection on direction for analytic application so that actions can be taken to address the broader concerns expressed by senior leadership.
The illustration delineates clearly that along with processes of providing clinical care, a set of core business processes is requisite for ensuring that the resources necessary for effective delivery of service are available and properly functioning.
Dependent Demand
The highest and last detail level presented is understanding interdependent activity. This is crucial to interpreting what and why activity happens the way it is observed, yet does not seemingly make sense on first observation. This situation is common in clinical care. It is especially crucial to improving resource scheduling in clinical and non-clinical settings.
A common clinical example is depicted here. In this case, resources are applied to perform needed procedures and other work. These resources are dependent on another department’s volume, in relation to the totality of the ED cases in a period of time, and the resources are applied taking into account possible bottlenecks or timing issues in the preceding service areas.
