Unit 3 Monday, January 23 rd at 8PM EST

1. Unit 3Monday, January 23rd at 8PM EST HS 499-01Adrienne Palmer, BSPH, MHA, FACHE

2. Unit 3 project No unit 3 project!!!

3. Unit 3

4. For-profit versus not-for-profit hospitals mission statements • No significant differences found in statement content currently • However the differences in ownership should be reflected in the mission statement • High degree of similarities in phrases discussing cost, patient access, and quality. • The majority of mission statements analyzed contained some discussion of cost, access, and quality

5. Does money really matter? • Relationship between finances and quality…is there one? • In 2000, United States spends 14.3% in healthcare expenditures up from 5.2% in 1960. • Studies have also noted that there continues to be a gap between the level of financial resources in healthcare and the quality of care delivered • Important to understand that the financial health of the organization contributes significantly to quality of care

6. Quality as a process • Involves the appropriateness, efficiency, and effectiveness of both technical and interpersonal methods of providing healthcare • Standard quality measures include: morbidity, mortality, infection or other complications, recovery, disability, and re-hospitalization • Other common measures include review of structural quality such as accreditation, staffing, equipment availability, and health and safety code compliance

7. Healthcare Organizations’ Finances • Observable financial characteristics include profit margin, investment ratios, and fiscal margin which can be obtained from yearly operating reports or other financial documents. • Review of the expenses can highlight the costs incurred in healthcare delivery. • The fiscal margin can highlight the financial flexibility an organization has and is often referred to as its operating margin, net worth, and profits • Asset liability management must also be considered as organizations often have to leverage both to continue to provide high-quality care

8. Expense measurements and relationship to quality care • The industry often uses staff hours per adjusted discharge in relationship to outcome measures to define relationships. Often those with lower ratios may have higher occurrences of low quality outcomes.

9. Discussion question: What are some other categories of expense that you can think of that might link to quality care, either positive or negative?

10. Discussion question: When might it be worth investing in a large expense item or process in order to improve quality of care? (Imagine you’re a CEO)

11. Steps to performance management • Created by Deming • Plan– understand existing conditions in order to identify a need for change • Do– analyze collected data and develop documentation of all possibilities; may also try some solutions during this time • Study– evaluate solutions’ effectiveness and study the results • Act– make any additional changes to improve the process • Repeat as necessary

12. Discussion • Regarding: The Lehigh Valley Hospital scenario from the article. • What are your thoughts about the initial process they were reviewing? Have you been able to experience a similar process in either the healthcare organization working in for your externship or in your prior roles?

13. Discussion Regarding: The Lehigh Valley Hospital scenario from the article. What do you think of their implementation process? Are there things that you would’ve done to make sure it was executed properly?

14. Discussion Regarding: The Lehigh Valley Hospital scenario from the article. How might you communicate the need for such a change with your team if you were in this role?

15. Importance of middle managers in healthcare • Some perceive middle managers as intermediaries that slow organizational efficiency without adding much measurable value– not true!! • In the 1990s, in the era of healthcare mergers the trend was to increase organizational flattening and reduce the layers in the hierarchy, seen as an easy tactic to reduce costs and simplify the system • However this increased the workload on other managers, reducing their ability to evaluate process improvement opportunities and implement new ideas • Middle managers are often responsible for not only the daily operational details, but also executing strategic initiatives that may be approved at a higher level

16. Middle managers’ roles • Communicator – liasion with executive leadership and also with the frontline teams, often critical in ensuring any change process goes smoothly • Entrepreneurs – developing ideas because they are closest to the front line and patient care • Stabilizers – can help ensure harmony between employees and senior managers • Therapists -- take time to listen to the staff particularly in times of high change • Bench strength and succession planning – healthcare continues to need great leaders and will for many years to come so this is a great training role for those middle managers who will one day move to senior leadership

17. Unit 4 Project • 75 points • Write a 1000-1250 word paper on methods of quality measurement. Include the following information: • Your paper must include a detailed summary of at least two different methods of quality measurement. Include examples of how the methods may be used to improve organizational effectiveness. Give an evaluation of these methods and indicate when they should be used for best results. • Cite at least four references in addition to your textbook to validate your proposal. Prepare this assignment according to the APA guidelines.Cite at least three references in the paper. Prepare this assignment according to APA guidelines. • Submit to dropbox.

18. Questions?