A Change of Season

1. A Change of Season Chapter 3 Code BlueHealth Science Edition Four

2. New Characters • Let’s briefly review each new character: • Wes Douglas • Dr. Emil Flagg • Helen Ingersol • Birdie Bankhead • David Brannan • Roger Selman

3. Wes Douglas’ First Interview • Before being offered the job as interim administrator, Wes was offered a job as a hospital consultant. • Before the interview, Wes reflects on the brief experience he had with Hap Castleton prior to his death. What was his opinion of Hap?

4. Wes Douglas’ First Interview • During his interview for the job of hospital consultant, Wes was interviewed by Edward Wycoff, chairman of the finance committee, and by Dr. Lindsey Reese, who Wycoff had invited to the dinner. • Let’s review some of the areas of hospital weakness that Reese wanted Wes to work on. (These areas dramatically impact the way nurses and doctors perform their jobs.)

5. Areas of Weakness Quality Assurance • Quality assurance begins with the establishment of standards. • Standards include . . . • ____________________ • ____________________ • ____________________ • ____________________

6. Areas of Weakness Continuous Quality Improvement

7. Continuous Quality Improvement (CQI) • A BIG topic in healthcare delivery. • Every healthcare professional should understand the elements of CQI to succeed in their jobs. • In most hospitals, healthcare professionals are required to know the philosophy and terminology of this important program.

8. Features of Continuous Quality Improvement • Designed to improve the quality of products and services • Used in both manufacturing and in hospitals • Based on the philosophy that quality can continually be improved – it does not subscribe to the philosophy that “if something isn’t broke don't fix it”

9. Features of Continuous Quality Improvement • The emphasis is on future results • The philosophy believes that most problems are caused by processes and not by people • Quality is defined by exceeding the expectations of physicians and patients

10. Features of Continuous Quality Improvement • Uses statistical tools to uncover problems • When a problem is uncovered, the hospital administrator selects a team to identify each step in the process • The team then designs steps tocorrect the problems

11. Features of Continuous Quality Improvement • Standards are established so that future problems do not occur • A program to measure performance to determine the standards are being met is established • The steps are: plan, act, do and check

12. History of Continuous Quality Improvement • Continuous Quality Improvement (CQI) was first developed by an individual named W. Edwards Demming. • His objective was to improve quality while making work more fun.

13. History of Continuous Quality Improvement • Demming took CQI to the American automobile industry, who rejected it. • At that time American automobile makers dominated the world and were not interested in improving quality.

14. History of Continuous Quality Improvement • Demming then took it to Japan where Japanese automakers implemented it. • In the following years, the Japanese automobile industry almost put the American automobile industry out of business, based on the quality of their products.

15. History of Continuous Quality Improvement • Finally, American manufacturers saw that unless they improved the quality of their products, they would no longer be able to compete in global markets, and so they too adopted continuous quality improvement. • The healthcare industry subsequently adopted continuous quality improvement.

16. Areas of Weakness • One way of measuring the quality of care offered by a hospital is to look at morbidity and mortality.

17. Other Areas of Weakness Identified During First Interview • HIPAA • EMTALA • Risk Management

18. HIPPAHealth Insurance Portability and Accountability Act of 1996 • When was it passed? • What was its objective? • What does it do? • What information is protected?

19. HIPPAHealth Insurance Portability and Accountability Act of 1996 • Who is covered under the act? • What are the penalties?

20. EMTALA • Stands for The Emergency Medical Treatment and Active Labor Act • The act is designed to prevent what is known as “patient dumping.” • Under the act, hospital emergency rooms must provide (without regard for the ability of the patient to pay) stabilization and emergency treatment when a patient presents themselves at an emergency room for emergency care.

21. Risk Management Risk management involves: • Identifying potential risks (such as falls, infections, and so on). • Analyzing those risks • Establishing priorities for addressing those risks • Bringing resources to bear in reducing or eliminating those risks

22. Why do organizations like hospitals do the things they do? • When working in a hospital, it is useful to understand why the board or management takes the actions they do. • Without a doubt the doctors, nurses, and other employees are concerned about who will be their new administrator. • Put yourself in the place of the employees of Brannan Community Hospital. What difference does it make to you who is chosen to be the new hospital administrator?

23. Employability Skills

24. Employability Skills • Although he doesn’t know it, Wes Douglas is about to be interviewed for a job. • If you haven’t already, all of you will eventually face the employment interview. • What do you think all employers look for in a new employee?

25. What Do Employers Look For? • Ability to do the job • Ability to get along with people • Willingness to fit the corporate culture • Integrity and loyalty • Adaptability to change Let’s discuss each of these in a little more detail.

26. Ability To Do The Job • Aptitude • Defined as the natural talent or ability to learn easily and quickly; a set of factors which can be assessed and which show what occupation a person is best suited for. • Education and Training • Experience

27. Aptitude • Different people have different skills. Individuals with strengths in one area often have weaknesses in another. • A person who is good with mechanical concepts may not be a good writer. • An individual who is excellent in math may not have good people skills. • A person who is good with people may not be good in science.

28. Aptitude • Some people spend a great deal of time qualifying for a specific occupation, only to find they don’t enjoy the work. • They lack the aptitude for that particular job!

29. Aptitude • How does one avoid making a mistake when selecting a career? I spent all these years going to school, but now that I’m here,I hate my job!

30. Education and Training • Most professional healthcare jobs require some form of licensure and certification. • Professional associations such as the American Medical Association, the American Nursing Association, and the American Hospital Association can help students identify the requirements for a specific profession.

31. Education and Training • Knowledge is expanding at an ever-increasing rate. • Much of what one learns in school will be obsolete within fifteen years of graduation. Obsolete

32. Education and Training • What, then, should a student take away from formal education?

33. Experience • Depending upon the job, some employers will require real world work experience before they hire an individual. • Internships can often satisfy this requirement.

34. Ability To Get Along With People • Do you know that the main reason people are fired is not their lack of technical skills, but their inability to get along with people?

35. Willingness to Fit into the Corporate Culture • What is “corporate culture?” • It is “the way we do things around here.” • The corporate culture of IBM is different from the corporate culture of Microsoft. • How?

36. Integrity and Loyalty • What special characteristics of the healthcare industry make it important that physicians, nurses, and other healthcare employees be individuals of integrity and loyalty?

37. Adaptability • What special challenges does the healthcare field face that mandate employees be able to adapt to new conditions?

38. Adaptability to Change • New technology, global competition and changing national and world economies continually alter the way things are done. Employees must have a commitment to lifetime learning and must be willing to adapt to an environment that is continually changing.

39. Adaptability to Change • The only constant in the modern world of work is change.

40. Medical Terminology • Did you know that many medical terms have Greek or Latin roots? • Students can increase their understanding of terminology by memorizing a few basic root words.

41. Medical Terminology • Example • Nephr = kidney • itis = inflammation of • Nephritis = inflammation of the kidney Learn root words on pages 42-43.

42. Discussion Question 1 • Edward Wycoff felt that Hap Castleton and Wes Douglas would make a good team, as each would complement the strengths and weaknesses of the other. • With this in mind, discuss the relative strengths and weaknesses of Hap and Wes.

43. Discussion Question 2 • Edward Wycoff related the story of several vice presidents of a large Fortune 500 company who were successful within the structure of that company, but lost their fortunes when they attempted to go into business for themselves. [Continued]

44. Discussion Question 2 • Why did this happen, and what can an administrative person learn from this experience?

45. Discussion Question 3 • Why would a young CPA entertain an offer to serve as interim administrator of the Brannan Community Hospital? • What does Wes have to win by accepting this offer, and what might he have to lose? • Place yourself in the role of Wes Douglas. Would you accept the offer?

46. Discussion Question 4 • Assuming that Roger Selman had to be fired, what do you think of Wycoff's timing?

47. Discussion Question 5 It has often been said, that how someone does something is as important as what he or she does. • If you were chairman of the board, would you fire Roger Selman? • If not, why not? • If so, is there anything you would do differently?

48. Discussion Question 6 While Edward Wycoff was willing to blame Roger Selman for the hospital’s financial problems, Roger felt that the board shared responsibility for the hospital’s poor financial condition. • What might the board of trustees have done to avoid the crisis described in Chapter 3?

49. Discussion Question 7 • What was the reaction of the hospital’s employees to the appointment of Wes Douglas as administrator? • What might the board have done to make the transition easier for their new administrator?

50. Discussion Question 8 • As long as the board does the right thing, does it matter what the employees or the medical staff thinks?