breach, case study, 514–515 of health care data, 184 in medical tourism, 478 private health care plans prospective reimbursement, 254–256 retrospective reimbursement,

breach, case study, 514–515 of health care data, 184 in medical tourism, 478

private health care plans prospective reimbursement, 254–256 retrospective reimbursement, 253

private health insurance, 205–206, 208, 209, 212–215 conventional indemnity insurance, 212 health maintenance organizations, 212–213, 213t high-deductible health plan with savings option, 215 managed care plans, 212 point-of-service plans, 213 Preferred Provider Organizations, 213

private recruitment, 334 privileged health information, 192 probationary period, 347 problem-based model, 17 problems

in health care management, tame vs. wicked, 379–380 problem solving, 91–95 in teams, 389

procedure code, fee schedule by, 255, 260 process elements, in quality, 146 process flow charting, 563–567 Process Mapping, 160–162 process variation, 153, 154 processing information, 87–91

cognitive consistency, 89 cognitive evaluation, 89

product costs, 263 professional associations, 41, 42t professional development, 41 professionalism, 34–35 profitability, improvement of, 268 promoting safety concerns, 186b

813

proposal reviewers, for capital budget, 274 prospective payment system (PPS), 107, 217 prospective reimbursements, 253–256 Protected Health Information (PHI)

government involvement in, 183–184 privacy rule, 183

protocols, leadership, 34–35 Provider’s Guide to Quality and Culture, 406 psychiatric health aides, 306, 517 public health insurance, 206 punishment, undesirable behavior, 54

Q quality, health care

components of, 147 definition of, 146–147 fundamental questions, 147 importance of, 147–149 opportunities for research in, 164–165 problems misuse, overuse and underuse, 147–148

quality improvement, 145–146 to America, 150 analysis, 565, 566 approaches for, 155–160 case studies, 521–522, 560–562, 563–567, 570–571, 572–573 elements of, 153–154 health information technology in, 149–150 key concepts, 153–154 leaders of, 150–151 measurement, 153–154 opportunities for research in, 164–165 process variation, 154 statistical process control, 154 strategic framework for, 151–153 teams, 156, 364, 385

814

tools, 160–164 quality of care, physician rank EHRs, 178b quantified-self movement, 485 qui tam provision, 443

R RAC. See Recovery Audit Contractors racial groups

uninsured population and, 234, 235f in U.S. population, 398–400

rate setting, 264 ratio method of determining needs, 330 rationing, 435 RBRVS. See Resource-Based Relative Value System REC program. See Regional Extension Center program reckless behavior, 463 recognition phase of decision making, 92 Recovery Audit Contractors (RAC), 442–444 recruiters, 334 recruitment

advertising methods for, 333–334 case study, 595 challenges, 595 responsibilities for, 333, 333t

referrals, patient Anti-Kickback statutes, 448–451 safe harbor regulations, 450 Stark Laws I and II, 448

Regional Extension Center (REC) program, 181 registered nurses (RNs), 294–302

board certification, 300 continuing education for, 300–301 criminal background checks, 295 educational requirements for, 295 foreign educated, 301–302

815

job dissatisfaction, 297 job satisfaction, organizational climate and, 299 licensure, 295 new, concerns of, 296 number of, 294–302 specialties for, 290 turnover, 296–297 unionization, 351

regulatory environment, 112–113 Rehabilitation Act, 329t reimbursement

based on performance, 253 concerns about, 323, 325 modified on basis of performance, 253 of physicians, 258 prospective, 253–256 of providers, 252–259 retrospective, 253 by uninsured individuals, 253

reinforcement theory, 53–54 relator (whistle blower), 336 reliability, 153–154 research

on emerging issues, 238, 389, 488 in fraud and abuse, 454–455 in health care ethics and law, 437 in health care management, 18–19 in health care marketing, 140–141 on health care professionals, 193–194, 310 in health care quality, 164–165 on health disparities and cultural proficiency, 414–415 in human resources management, 354–356 issues, 43 in management and motivation, 71 on managing costs and revenues, 274–275 in organizational behavior and management thinking, 99–100

816

in strategic planning, 122–123 in team, 389

residency training programs, for physicians, 281 resilient leadership, 31 resource allocation, in strategic planning, 108 Resource-Based Relative Value System (RBRVS), 217, 258 Resource Utilization Groups (RUGs), 217, 254 resources

allocation, 435 allocation of, strategic planning and, 108 misuse of, 148 overuse of, 148 underuse of, 148

respect for persons, 431 respectful guardianship, 431 respiratory therapists (RTs), 309 respondeat superior, 427 retention, employee

benefits and, 343–344 compensation for, 339–341 Employee Assistance Programs and, 345 employee suggestion programs and, 353–354 labor relations management and, 350–352 nurses, 297

retirement benefits, 343 retrospective reimbursements, 253 revenue budget, 249, 273 revenue cycle, health care coding, 260 rewards, 50

for desired behavior, 62 extrinsic, 56 incentives and, 55–56 intrinsic, 56 tailored, 62

Right to Try Laws, 436–437

817

case study, 603–604 risk assessment, for internal control, 452 risk sharing, 206 RNs. See registered nurses “Road to Zero: the CDC’s Response to the 2014 Ebola Epidemic, The,” 463 Roe v. Wade, 436 role schemas, 84 rollout, of strategic plans, 118–119 rounding, 35 RUGs. See Resource Utilization Groups rules and regulations, 425, 434

S safe harbor laws, 448–451 safety needs, Maslow’s hierarchy of needs, 52 Sarbanes-Oxley, 35–36 Sarrell Dental, 484 satisfaction progression, 52 schemas, 83–85

event, 84 interpretative, 84–85 organizational, 84 person, 84 role, 84

Schiavo, Terri, 422 Scientific Management Theory, 54–55 second victim programs, 345 select, in FOCUS-PDCA framework, 157 selective perception, 89 self-actualization needs, Maslow’s hierarchy of needs, 52 self-awareness, 29 self-development domain, 33 self-funded health insurance plan, 216 self management, 9–10 self-regulation, 29

818

self-understanding domain, 33 senior management, 13 sentinel events, 297, 299 servant leadership, 30 service connected conditions, veterans and, 230, 230t service line management, 7, 9 services, upcoding, 442 Sherman Antitrust Act, 447, 448t Shewhart cycle, 151, 156 Shewhart, Walter A., 150 shortages, of health care personnel, 281, 290, 324 similar-to-me bias, 96 simplifications, cognitive, 84, 92 situational approach to leadership, 26 Six Sigma, 157–158 skill sets, 6 skilled nursing facilities (SNFs), 217 Skinner’s Reinforcement Theory, 53–54 SMI. See Supplemental Medical Insurance SNFs. See Skilled nursing facilities social awareness, 384 social categorization, 97–98 social cognition, 82, 95–99

attribution, 95–96 biases, types of, 96–97 empathy and socio-emotional intelligence, 98–99 social categorization and biases, 97–98

social determinants, 400 social facility, 384 social insurance

Affordable Care Act of 2010, 218–220 Balanced Budget Act (BBA) of 1997, 217–218 Children’s Health Insurance Program, 228 CHIP reauthorization act of 2015, 220 Department of Defense, 228–229

819

Employee Retirement Income Security Act of 1974, 216–217 evolution, 216–220 major legislation, 216 Medicaid, 223–227, 226f Medicare, 220–223, 222f, 223f Medicare Prescription Drug, Improvement, and Modernization Act of 2003,

218 Omnibus Budget Reconciliation Act of 1989, 217 operational issues, 231–232 Patient Protection and Affordable Care Act of 2010, 218–220 Social Security Act of 1935, 216 Tax Equity and Fiscal Responsibility Act in 1982, 217 TRICARE, 228–229 Veterans Affairs, 230–231, 230f

social intelligence (SI), 384 social loafer syndrome, 387 social marketing, 138 social media, 137–138

case study, 576–577 Social Security Act (SSA)

Amendments of 1965, 216 Criminal-Disclosure Provision of, 445 Medicare, 216, 220–223 Medicaid, 216, 223–227

social skills, 29 socialized medicine, 207 socio-emotional intelligence, 95–99 socio-emotional skills, 78 soft skills, 78 SPC. See statistical process control “special cause” variation, 150, 154 specific identification, for valuing inventory, 269 Spina Bifida Healthcare Program, for Vietnam veterans, 231 spiritual focus, 30 spirituality leadership, 30–31

820

SSA. See Social Security Act, Amendments of 1965 staff manager positions, 6–7 staff model health maintenance organizations, 213 staff training, cultural competency and, 405 staffing management functions, 5 staffing needs, 330–331 stalking, 473–474

case study, 527–528 standard of care, 427 standards of behavior, 10 Stark Laws I and II, 448, 449t State Boards of Physician Quality Assurance (BPQA), 283 Statements of Antitrust Enforcement Policy In Health Care, 447 Statistical Method from the Viewpoint of Quality Control, 151 statistical process control (SPC), 151, 154, 155 statistics budget, 273 statutes, 425, 426b stereotypes, social categorizations, 97–98 stock-outs, 268 storming, of teams, 374 strategic leader, 24 strategic management, of human resources. See human resources management strategic marketing

components, 130, 130f defined, 131–132 management of, 132–135 process, 129–132, 131f

strategic planning, 107–123, 536–537 case studies, 536–537, 574–575, 576–577 Continuous Quality Improvement, 152 definition of, 107 diversity initiatives, 408 execution, 120–122 financial forecasts, 114–115 in health care, history of, 107

821

health care manager role in, 122 implementation of plan, 118–119 importance of, 108 market assessment, 110, 110f mission, vision, and values (MVV) statements, 113–114 monitoring and control, 119–120 organizational assessment, 114 participants, 121–122 process, 108–109 research in, 122–123 rollout, 118–119 supporting plans for, 119, 119f SWOT Analysis, 108–116, 110f, 116t workforce cultural competence strategy, 408

strategy execution, 120–122 identification and selection, 116–118, 118t outcomes, 117–118 performance, 115 purpose of, 108 resource allocation and, 108 rollout of plan, 118–119 tactical plans, 118, 118t

strict liability, 450 stroke incidence, 399 structural elements in quality, 146 structural variables, 152 structured interviews, 335 style approach to leadership, 26 succession planning, 42, 353

manager role in, 13–16 suicide incidence, 399 Sunshine Act, 293 Supplemental Medical Insurance (SMI), 221 supply chain management, 268

822

surrogate decision makers, 436 SWOT Analysis

components, 108–116, 110f, 116t in marketing management, 132 purpose, 113

systems perspective, of health care quality, 152f systems thinking, 88, 108

T talent management, manager role in, 11 tame problems, 379 target market segment selection, 132–133 task forces, 267 Tax Equity and Fiscal Responsibility Act (TEFRA), 217, 257 Tax Relief and Healthcare Act of 2006, 442–444 tax status, of health care organization, 249–250, 251t teams

benefits of, 370–373 communication in, 384–387 composition of, 364 conflict resolution in, 381 convening, 370 definition of, 364–367 diversity of, 385 effectiveness of, 369 interdisciplinary, 364, 368 leadership of, 378 management of, 9–10, 364, 380–381 members

personalities of, 381–382 selection of, 376

with minimal interpersonal conflict, 385 of physicians and nurses, 298–299 stages of, 374 trust building for, 388–389

823

teamSTEPPS, 386–387 teamwork, 363–389

case studies, 523–525, 531–532, 538–539 challenges for health care organizations, 368–369 costs of, 374–375 in FOCUS-PDCA framework, 157 Guidelines for Teamwork, 387, 388f problems, 379–380 real-world focus of, 379–380 requirements for, 364

technical domain, 33 technical management, of health care providers, 147 technical skills, 6 TEFRA. See Tax Equity and Fiscal Responsibility Act telecommunications, 171 Telehealth, 190 Telehealth Enhancement Act of 2013, 190 telemedicine, 189–190 termination, employee, 350 Terri Schiavo case, 422, 422b The Joint Commission (TJC), 472

communication standards, 298–301 diversity standards, 406 leadership standards, 38 quality standards, 146 retention of nursing staff and, 296–297

Theory X, 55 Theory Y, 55 Theory Z, 55 thinking

attention, 90 in communication, 81 features, 82–83 habits, fundamental, 87–91 influence on organizational behavior, 81–83

824

infrastructure of, 83–87 inner game, 81–82 mental models and, 83 non-rational, 83 perception, 90–91 in problem solving, 91–95 schemas and, 84–85 skills, 78

third-party mediation, for teams, 389 third-party payers

policies, in setting charges and prices, 264–265 reimbursement by, 252–259

360-degree performance feedback, 14 360-degree performance appraisal systems, 347 Time Warner Cable Business Class, 484 TIP. See Trafficking in Persons TJC. See The Joint Commission To Err is Human (Institute of Medicine report), 145 top-down flowchart, 160, 162 tort law, 427–428

vs. contract law, 430t torts

assault and battery, 427, 535 defamation, 428 definition of, 425 false imprisonment, 427–428, 535 intentional, 427–428 invasion of privacy, 428 malpractice, 428–429 negligence, 427

Total Quality Management (TQM), 27, 150. See also Continuous Quality Improvement

Toyota Production System (TPS), 158–160 TQM. See Total Quality Management traditionalists, 64, 66–67t

825

trafficking, 520 Trafficking in Persons (TIP), Protocol, 467–468 Trafficking Victims Protection Act (TVPA), 469 training, employee, 338–339 transitional care, case studies, 570–571, 572–573 transformational leader, 27 treasurer, 252 TRICARE plan, 228–229 TRICARE Prime, 229 TRICARE Standard, 229 Triple Aim, 70b trust building, for teams, 388–389 truth-telling, 431 turnover

costs of, 296–297, 303, 373 health care workers, 324 nurses, 296 physicians, 291–293 staff, 324

TVPA. See Trafficking Victims Protection Act

U uncompensated care, 237–238, 259 underserved

health problems of, 397–398 populations, 397–398

understand, in FOCUS-PDCA framework, 157 underuse of resources, 148 underutilization of staff, in Lean in health care industry, 159 UNEP. See United Nations Environmental Programme uninsured individuals, provider reimbursements, 253 uninsured population

ACA, 236–239 addressing problem of, 238 by age group, 235, 235f

826

characteristics of, 236 by racial group, 234, 235f

unions, 350–352 unit management, 9–10 United Nations Environmental Programme (UNEP), 466 United Physician Group (UPG), 509–510 United States, diseases by cases and deaths in, 462t unity of purpose, in Lean in health care principles, 159–160 upcoding, 442

case study, 529 U.S. Constitution, 424 U.S. health care system, 478 U.S. health systems, 19 U.S. Immigration and Customs Enforcement (ICE), 470 U.S. population, racial groups in, 398–400 U.S. State Department Trafficking, 470

V VA. See Veterans Affairs vacation benefits, values statement, 113–114 vaccinations and health care managers, 464–465 vaccine preventable diseases, 460–465 Vaccine Preventable Outbreaks, 461 vaccines, 460 validity, quality improvement, 154 value-based purchasing, 38, 58–59, 223 value creation, 159 Value Stream Mapping, 162 values, 10 values statement, 113–114 valuing inventory, methods for, 269 Veteran Integrated Service Networks (VISN), 230 Veterans Affairs (VA), 228, 230–231, 230f

Civilian Health and Medical Program (CHAMPVA), 228, 230 Veterans Health Administration (VHA)

827

CHAMPVA program, 228, 230 enrollment categories, 230, 230t financing for, 231 Veteran Integrated Service Networks, 230 Vietnam Veterans and, 231 Vietnam Veterans, health care programs for, 231

VHA. See Veterans Health Administration violence, in health care settings, 472–475

case studies, 517–518, 526, 257–528, 533–534, 535 vision, 24

of organization, 10 vision statement, 113–114 VISN. See Veteran Integrated Service Networks visualization, in Lean in health care industry principles, 160 voting, in teams, 389 Vroom’s Expectancy Theory, 54 vulnerable populations, 397

W Walgreens, 483 Walmart, 484 weighted average, for valuing inventory, 269, 271t wellness tourism, case study, 586–587 whistle blower (relator), 443

case study, 601–602 Whistleblower Protection Act, 329t, 336 wicked problems vs. tame, 379–380 Wickline v. California, 435 work-hour rules, residents, 282 Worker Adjustment and Retraining Notification Act, 329t workers’ compensation coverage, 344 workers, types of, 472–473 workflow diagrams, 161f, 162 workforce issues, 328–337

diversity strategies, 408

828

planning/recruitment, 327–337, 329t, 332f, 333t retention, 337–354 retirement, 324 supply, 324

working capital management, problems/concerns for, 266–267 sources of, 266

worklife analysis, 303–304 workplace violence, 472 world-class facilities, 479 World Medical Association, 431 worldview, mental models, 85

829

Table of Contents

Title Page 2 Copyright Page 3 Dedication 5 Contents 6 FOREWORD 17 PREFACE 19 ACKNOWLEDGMENTS 22 ABOUT THE EDITORS 23 CONTRIBUTORS 24 CHAPTER 1 An Overview of Health Care Management 28

Introduction 28 The Need for Managers and Their Perspectives 30 Management: Definition, Functions, and Competencies 31 Management Positions: The Control in the Organizational Heirarchy 34 Focus of Management: Self, Unit/Team, and Organization 36 Role of the Manager in Establishing and Maintaining Organizational Culture 37 Role of the Manager in Talent Management 38 Role of the Manager in Ensuring High Performance 39 Role of the Manager in Leadership Development and Succession Planning 41 Role of the Manager in Innovation and Change Management 44 Role of the Manager in Health Care Policy 46 Research in Health Care Management 47 Chapter Summary 48

CHAPTER 2 Leadership 53 Leadership vs. Management 53 History of Leadership in the U.S. 55 Contemporary Models 58 Leadership Styles 62 Leadership Competencies 63 Leadership Protocols 65 Governance 67

830

Barriers and Challenges 69 Ethical Responsibility 71 Important New Initiatives 72 Leaders Looking to the Future 73 Special Research Issues 75 Conclusion 76

CHAPTER 3 Management and Motivation 82 Introduction 82 Motivation—The Concept 83 History of Motivation 84 Theories of Motivation 85 A Bit More About Incentives and Rewards 89 Why Motivation Matters 91 Motivated vs. Engaged—Are the Terms the Same? 92 Measuring Engagement 93 Misconceptions About Motivation and Employee Satisfaction 94 Motivational and Engagement Strategies 96 Motivating Across Generations 99 Managing Across Generations 100 Research Opportunities in Management and Motivation 107 Conclusion 107

CHAPTER 4 Organizational Behavior and Management Thinking 115 Introduction 116 The Field of Organizational Behavior 117 Organizational Behavior’s Contribution to Management 117 Key Topics in Organizational Behavior 118 Organizational Behavior Issues in Health Organizations 118 Thinking: The “Inner Game” of Organizational Behavior 119 The Four Key Features of Thinking 121 Mental Representation: The Infrastucture of Thinking 122 Processing Information: Fundamental Thinking Habits 126 Decision Making, Problem Solving, and Biased Thinking Habits 131 Social Cognition and Socio-Emotional Intelligence 135 Research Opportunities in Organizational Behavior and Management Thinking 140 Conclusion 141

831

CHAPTER 5 Strategic Planning 149 Introduction 149 Purpose and Importance of Strategic Planning 150 The Planning Process 150 SWOT Analysis 152 Strategy Identification and Selection 159 Rollout and Implementation 162 Outcomes Monitoring and Control 163 Strategy Execution 164 Strategic Planning and Execution: The Role of the Health Care Manager 165 Opportunities for Research in Strategic Planning 166 Conclusion 167

CHAPTER 6 Healthcare Marketing 170 Introduction 170 What Is Marketing? 171 A Brief History of Marketing in Health Care 172 The Strategic Marketing Process 175 Understanding Marketing Management 178 Health Care Buyer Behavior 181 Marketing Mix 183 Marketing Plan 184 Ethics and Social Responsibility 186 Opportunities for Research in Health Care Marketing 188 Conclusion 189

CHAPTER 7 Quality Improvement Basics 193 Introduction 193 Defining Quality in Health Care 194 Why Is Quality Important? 196 The Relevance of Health Information Technology in Quality Improvement 197 Quality Improvement Comes (Back) to America 198 Leaders of the Quality Movement 199 Baldrige Award Criteria: A Strategic Framework for Quality Improvement 200 Common Elements of Quality Improvement 202 Three Approaches to Quality Improvement 204 Quality Improvement Tools 210

832

Opportunities for Research in Health Care Quality 214 Conclusion 216

CHAPTER 8 Information Technology 221 Introduction 221 Information Systems Used by Managers 223 The Electronic Medical Record (EMR) 226 The Challenges to Clinical System Adoption 231 The Future of Health Care Information Technology 239 The Impact of Information Technology on the Health Care Manager 247 Opportunities for Research on Health Care Professionals 249 Conclusion 250

CHAPTER 9 Financing Health Care and Health Insurance 261 Introduction 261 Introduction to Health Insurance 264 Brief History of Health Insurance 266 Characteristics of Health Insurance 267 Private Health Insurance Coverage 271 The Evolution of Social Insurance 275 Major “Players” in the Social Insurance Arena 280 Statistics on Health Insurance Coverage and Costs 294 Those Not Covered—The Uninsured 296 Opportunities for Research on Emerging Issues 301 Conclusion 301

CHAPTER 10 Managing Costs and Revenues 314 Introduction 314 What Is Financial Management and Why Is It Important? 315 Tax Status of Health Care Organizations 316 Financial Governance and Responsibility Structure 318 Managing Reimbursements from Third-Party Payers 320 Coding in Health Care 328 Controlling Costs and Cost Accounting 330 Setting Charges 333 Managing Working Capital 334 Managing Accounts Receivable 336 Managing Materials and Inventory 337

833

Managing Budgets 341 Opportunities for Research on Managing Costs and Revenues 345 Conclusion 345

CHAPTER 11 Managing Health Care Professionals 351 Introduction 351 Physicians 352 Registered Nurses 368 Licensed Practical Nurses/Licensed Vocational Nurses 376 Nursing Assistants and Orderlies 377 Home Health Aides 379 Midlevel Practitioners 380 Allied Health Professionals 383 Opportunities for Research on Health Care Professionals 385 Conclusion 386

CHAPTER 12 The Strategic Management of Human Resources 400 Introduction 400 Environmental Forces Affecting Human Resources Management 403 Understanding Employees as Drivers of Organizational Performance 405 Key Functions of Human Resources Management 406 Workforce Planning/Recruitment 408 Employee Retention 417 Research in Human Resources Management 437 Conclusion 440

CHAPTER 13 Teamwork 448 Introduction 448 What Is a Team? 449 The Challenge of Teamwork in Health Care Organizations 453 The Benefits of Effective Health Care Teams 456 The Costs of Teamwork 460 Electronic Tools and Remote and Virtual Teams 462 Face to Face Versus Virtual Teams 463 Real-World Problems and Teamwork 466 Who’s on the Team? 468 Emotions and Teamwork 471 Team Communication 473

834

Methods of Managing Teams of Health Care Professionals 476 Opportunities for Research on Emerging Issues 478 Conclusion 479

CHAPTER 14 Addressing Health Disparities: Cultural Proficiency 488 Introduction 488 Changing U.S. Demographics and Patient Populations 493 Addressing Health Disparities by Fostering Cultural Competence in Health Care Organizations 495

Best Practices 498 Addressing Health Disparities by Enhancing Public Policy 506 Opportunities for Research on Health Disparities and Cultural Proficiency 507 Conclusion 508

CHAPTER 15 Ethics and Law 515 Introduction 515 Legal Concepts 517 Tort Law 521 Malpractice 522 Contract Law 523 Ethical Concepts 525 Patient and Provider Rights and Responsibilities 527 Legal/Ethical Concerns in Managed Care 530 Biomedical Concerns 531 Beginning- and End-of-Life Care 531 Opportunities for Research in Health Care Ethics and Law 533 Conclusion 533

CHAPTER 16 Fraud and Abuse 538 Introduction 538 What Is Fraud and Abuse? 539 History 540 The Social Security Act and the Criminal-Disclosure Provision 542 The Emergency Medical Treatment and Active Labor Act 543 Antitrust Issues 545 Physician Self-Referral/Anti-Kickback/Safe Harbor Laws 546 Management Responsibility for Compliance and Internal Controls 550 Corporate Compliance Programs 551

835

Opportunities for Research in Fraud and Abuse 552 Conclusion 554

CHAPTER 17 Special Topics and Emerging Issues in Health Care Management 559

Introduction 559 Re-Emerging Outbreaks, Vaccine Preventable Diseases, and Deaths 560 Bioterrorism in Health Care Settings 565 Human Trafficking 567 Violence in Health Care Settings 572 Medical Tourism 577 Consumer-Directed Health Care 584 Opportunities for Research on Emerging Issues 591

CHAPTER 18 Health Care Management Case Studies and Guidelines 608

Introduction 608 Case Study Analysis 609 Case Study Write-Up 611 Team Structure and Process for Completion 613

CASE STUDIES* 617 Metro Renal—Case for Chapters 12 and 2 617 United Physician Group—Case for Chapters 5, 9, 11, and 15 618 Piecework—Case for Chapters 9 and 10 621 Building a Better MIS-Trap—Case for Chapter 8 623 Death by Measles—Case for Chapters 17, 11, and 15 624 Full Moon or Bad Planning?—Case for Chapters 17, 11, and 15 625 How Do We Handle a Girl Like Maria?—Case for Chapters 17 and 4 627 The Condescending Dental Hygienist—Case for Chapters 7, 12, 15, and 4 629 The “Easy” Software Upgrade at Delmar Ortho—Case for Chapters 8 and 13 630 The Brawler—Case for Chapters 11, 12, and 17 632 I Love You…Forever—Case for Chapters 17, 12, and 11 633 Managing Health Care Professionals—Mini-Case Studies for Chapter 11 634 Problems with the Pre-Admission Call Center—Case for Chapters 13 and 10 636 Such a Nice Young Man—Case for Chapters 17, 11, and 12 638 Sundowner or Victim?—Case for Chapters 15 and 17 639 Last Chance Hospital—Case for Chapters 5 and 6 640

836

The Magic Is Gone—Case for Chapters 3, 12, and 13 642 Set Up for Failure?—Case for Chapter 3 644 Sustaining an Academic Food Science and Nutrition Center Through Management Improvement—Case for Chapters 2 and 12 646

Giving Feedback—Empathy or Attributions?—Case for Chapter 4 661 Socio-Emotional Intelligence Exercise: Understanding and Anticipating Major Change—Case for Chapter 4 663

Madison Community Hospital Addresses Infection Prevention—Case for Chapters 7 and 13 665

Trouble with the Pharmacy—Case for Chapter 7 668 Emotional Intelligence in Labor and Delivery—Case for Chapters 2, 12, and 13 673

Communication of Patient Information During Transitions in Care—Case for Chapters 7 and 12 675

Multidrug-Resistant Organism (MDRO) in a Transitional Care Unit—Case for Chapters 7 and 12 677

Are We Culturally Aware or Not?—Case for Chapters 14 and 5 679 Patients “Like” Social Media—Case for Chapters 6 and 5 680 Where Do You Live? Health Disparities Across the United States—Case for Chapter 14 681

My Parents Are Turning 65 and Need Help Signing Up for Medicare—Case for Chapter 9 683

Newby Health Systems Needs Health Insurance—Case for Chapter 9 685 To Partner or Not to Partner with a Retail Company—Case for Chapters 17, 5, and 6 687

Wellness Tourism: An Option for Your Organization?—Case for Chapters 17 and 5 689

Conflict in the Capital Budgeting Process at University Medical Center: Let’s All Just Get Along—Case for Chapter 10 691

The New Toy at City Medical Center—Case for Chapters 11 and 13 696 Recruitment Challenge for the Middle Manager—Case for Chapters 2 and 12 698 I Want to Be a Medical Coder—Case for Chapter 10 699 Managing Costs and Revenues at Feel Better Pharmacy—Case for Chapter 10 701 Who You Gonna Call?—Case for Chapter 16 704 You Will Do What You Are Told—Case for Chapter 15 705

GLOSSARY 708 INDEX 759

837

  • Title Page
  • Copyright Page
  • Dedication
  • Contents
  • FOREWORD
  • PREFACE
  • ACKNOWLEDGMENTS
  • ABOUT THE EDITORS
  • CONTRIBUTORS
  • CHAPTER 1 An Overview of Health Care Management
    • Introduction
    • The Need for Managers and Their Perspectives
    • Management: Definition, Functions, and Competencies
    • Management Positions: The Control in the Organizational Heirarchy
    • Focus of Management: Self, Unit/Team, and Organization
    • Role of the Manager in Establishing and Maintaining Organizational Culture
    • Role of the Manager in Talent Management
    • Role of the Manager in Ensuring High Performance
    • Role of the Manager in Leadership Development and Succession Planning
    • Role of the Manager in Innovation and Change Management
    • Role of the Manager in Health Care Policy
    • Research in Health Care Management
    • Chapter Summary
  • CHAPTER 2 Leadership
    • Leadership vs. Management
    • History of Leadership in the U.S.
    • Contemporary Models
    • Leadership Styles
    • Leadership Competencies
    • Leadership Protocols
    • Governance
    • Barriers and Challenges
    • Ethical Responsibility
    • Important New Initiatives
    • Leaders Looking to the Future
    • Special Research Issues
    • Conclusion
  • CHAPTER 3 Management and Motivation
    • Introduction
    • Motivation—The Concept
    • History of Motivation
    • Theories of Motivation
    • A Bit More About Incentives and Rewards
    • Why Motivation Matters
    • Motivated vs. Engaged—Are the Terms the Same?
    • Measuring Engagement
    • Misconceptions About Motivation and Employee Satisfaction
    • Motivational and Engagement Strategies
    • Motivating Across Generations
    • Managing Across Generations
    • Research Opportunities in Management and Motivation
    • Conclusion
  • CHAPTER 4 Organizational Behavior and Management Thinking
    • Introduction
    • The Field of Organizational Behavior
    • Organizational Behavior’s Contribution to Management
    • Key Topics in Organizational Behavior
    • Organizational Behavior Issues in Health Organizations
    • Thinking: The “Inner Game” of Organizational Behavior
    • The Four Key Features of Thinking
    • Mental Representation: The Infrastucture of Thinking
    • Processing Information: Fundamental Thinking Habits
    • Decision Making, Problem Solving, and Biased Thinking Habits
    • Social Cognition and Socio-Emotional Intelligence
    • Research Opportunities in Organizational Behavior and Management Thinking
    • Conclusion
  • CHAPTER 5 Strategic Planning
    • Introduction
    • Purpose and Importance of Strategic Planning
    • The Planning Process
    • SWOT Analysis
    • Strategy Identification and Selection
    • Rollout and Implementation
    • Outcomes Monitoring and Control
    • Strategy Execution
    • Strategic Planning and Execution: The Role of the Health Care Manager
    • Opportunities for Research in Strategic Planning
    • Conclusion
  • CHAPTER 6 Healthcare Marketing
    • Introduction
    • What Is Marketing?
    • A Brief History of Marketing in Health Care
    • The Strategic Marketing Process
    • Understanding Marketing Management
    • Health Care Buyer Behavior
    • Marketing Mix
    • Marketing Plan
    • Ethics and Social Responsibility
    • Opportunities for Research in Health Care Marketing
    • Conclusion
  • CHAPTER 7 Quality Improvement Basics
    • Introduction
    • Defining Quality in Health Care
    • Why Is Quality Important?
    • The Relevance of Health Information Technology in Quality Improvement
    • Quality Improvement Comes (Back) to America
    • Leaders of the Quality Movement
    • Baldrige Award Criteria: A Strategic Framework for Quality Improvement
    • Common Elements of Quality Improvement
    • Three Approaches to Quality Improvement
    • Quality Improvement Tools
    • Opportunities for Research in Health Care Quality
    • Conclusion
  • CHAPTER 8 Information Technology
    • Introduction
    • Information Systems Used by Managers
    • The Electronic Medical Record (EMR)
    • The Challenges to Clinical System Adoption
    • The Future of Health Care Information Technology
    • The Impact of Information Technology on the Health Care Manager
    • Opportunities for Research on Health Care Professionals
    • Conclusion
  • CHAPTER 9 Financing Health Care and Health Insurance
    • Introduction
    • Introduction to Health Insurance
    • Brief History of Health Insurance
    • Characteristics of Health Insurance
    • Private Health Insurance Coverage
    • The Evolution of Social Insurance
    • Major “Players” in the Social Insurance Arena
    • Statistics on Health Insurance Coverage and Costs
    • Those Not Covered—The Uninsured
    • Opportunities for Research on Emerging Issues
    • Conclusion
  • CHAPTER 10 Managing Costs and Revenues
    • Introduction
    • What Is Financial Management and Why Is It Important?
    • Tax Status of Health Care Organizations
    • Financial Governance and Responsibility Structure
    • Managing Reimbursements from Third-Party Payers
    • Coding in Health Care
    • Controlling Costs and Cost Accounting
    • Setting Charges
    • Managing Working Capital
    • Managing Accounts Receivable
    • Managing Materials and Inventory
    • Managing Budgets
    • Opportunities for Research on Managing Costs and Revenues
    • Conclusion
  • CHAPTER 11 Managing Health Care Professionals
    • Introduction
    • Physicians
    • Registered Nurses
    • Licensed Practical Nurses/Licensed Vocational Nurses
    • Nursing Assistants and Orderlies
    • Home Health Aides
    • Midlevel Practitioners
    • Allied Health Professionals
    • Opportunities for Research on Health Care Professionals
    • Conclusion
  • CHAPTER 12 The Strategic Management of Human Resources
    • Introduction
    • Environmental Forces Affecting Human Resources Management
    • Understanding Employees as Drivers of Organizational Performance
    • Key Functions of Human Resources Management
    • Workforce Planning/Recruitment
    • Employee Retention
    • Research in Human Resources Management
    • Conclusion
  • CHAPTER 13 Teamwork
    • Introduction
    • What Is a Team?
    • The Challenge of Teamwork in Health Care Organizations
    • The Benefits of Effective Health Care Teams
    • The Costs of Teamwork
    • Electronic Tools and Remote and Virtual Teams
    • Face to Face Versus Virtual Teams
    • Real-World Problems and Teamwork
    • Who’s on the Team?
    • Emotions and Teamwork
    • Team Communication
    • Methods of Managing Teams of Health Care Professionals
    • Opportunities for Research on Emerging Issues
    • Conclusion
  • CHAPTER 14 Addressing Health Disparities: Cultural Proficiency
    • Introduction
    • Changing U.S. Demographics and Patient Populations
    • Addressing Health Disparities by Fostering Cultural Competence in Health Care Organizations
    • Best Practices
    • Addressing Health Disparities by Enhancing Public Policy
    • Opportunities for Research on Health Disparities and Cultural Proficiency
    • Conclusion
  • CHAPTER 15 Ethics and Law
    • Introduction
    • Legal Concepts
    • Tort Law
    • Malpractice
    • Contract Law
    • Ethical Concepts
    • Patient and Provider Rights and Responsibilities
    • Legal/Ethical Concerns in Managed Care
    • Biomedical Concerns
    • Beginning- and End-of-Life Care
    • Opportunities for Research in Health Care Ethics and Law
    • Conclusion
  • CHAPTER 16 Fraud and Abuse
    • Introduction
    • What Is Fraud and Abuse?
    • History
    • The Social Security Act and the Criminal-Disclosure Provision
    • The Emergency Medical Treatment and Active Labor Act
    • Antitrust Issues
    • Physician Self-Referral/Anti-Kickback/Safe Harbor Laws
    • Management Responsibility for Compliance and Internal Controls
    • Corporate Compliance Programs
    • Opportunities for Research in Fraud and Abuse
    • Conclusion
  • CHAPTER 17 Special Topics and Emerging Issues in Health Care Management
    • Introduction
    • Re-Emerging Outbreaks, Vaccine Preventable Diseases, and Deaths
    • Bioterrorism in Health Care Settings
    • Human Trafficking
    • Violence in Health Care Settings
    • Medical Tourism
    • Consumer-Directed Health Care
    • Opportunities for Research on Emerging Issues
  • CHAPTER 18 Health Care Management Case Studies and Guidelines
    • Introduction
    • Case Study Analysis
    • Case Study Write-Up
    • Team Structure and Process for Completion
  • CASE STUDIES*
    • Metro Renal—Case for Chapters 12 and 2
    • United Physician Group—Case for Chapters 5, 9, 11, and 15
    • Piecework—Case for Chapters 9 and 10
    • Building a Better MIS-Trap—Case for Chapter 8
    • Death by Measles—Case for Chapters 17, 11, and 15
    • Full Moon or Bad Planning?—Case for Chapters 17, 11, and 15
    • How Do We Handle a Girl Like Maria?—Case for Chapters 17 and 4
    • The Condescending Dental Hygienist—Case for Chapters 7, 12, 15, and 4
    • The “Easy” Software Upgrade at Delmar Ortho—Case for Chapters 8 and 13
    • The Brawler—Case for Chapters 11, 12, and 17
    • I Love You…Forever—Case for Chapters 17, 12, and 11
    • Managing Health Care Professionals—Mini-Case Studies for Chapter 11
    • Problems with the Pre-Admission Call Center—Case for Chapters 13 and 10
    • Such a Nice Young Man—Case for Chapters 17, 11, and 12
    • Sundowner or Victim?—Case for Chapters 15 and 17
    • Last Chance Hospital—Case for Chapters 5 and 6
    • The Magic Is Gone—Case for Chapters 3, 12, and 13
    • Set Up for Failure?—Case for Chapter 3
    • Sustaining an Academic Food Science and Nutrition Center Through Management Improvement—Case for Chapters 2 and 12
    • Giving Feedback—Empathy or Attributions?—Case for Chapter 4
    • Socio-Emotional Intelligence Exercise: Understanding and Anticipating Major Change—Case for Chapter 4
    • Madison Community Hospital Addresses Infection Prevention—Case for Chapters 7 and 13
    • Trouble with the Pharmacy—Case for Chapter 7
    • Emotional Intelligence in Labor and Delivery—Case for Chapters 2, 12, and 13
    • Communication of Patient Information During Transitions in Care—Case for Chapters 7 and 12
    • Multidrug-Resistant Organism (MDRO) in a Transitional Care Unit—Case for Chapters 7 and 12
    • Are We Culturally Aware or Not?—Case for Chapters 14 and 5
    • Patients “Like” Social Media—Case for Chapters 6 and 5
    • Where Do You Live? Health Disparities Across the United States—Case for Chapter 14
    • My Parents Are Turning 65 and Need Help Signing Up for Medicare—Case for Chapter 9
    • Newby Health Systems Needs Health Insurance—Case for Chapter 9
    • To Partner or Not to Partner with a Retail Company—Case for Chapters 17, 5, and 6
    • Wellness Tourism: An Option for Your Organization?—Case for Chapters 17 and 5
    • Conflict in the Capital Budgeting Process at University Medical Center: Let’s All Just Get Along—Case for Chapter 10
    • The New Toy at City Medical Center—Case for Chapters 11 and 13
    • Recruitment Challenge for the Middle Manager—Case for Chapters 2 and 12
    • I Want to Be a Medical Coder—Case for Chapter 10
    • Managing Costs and Revenues at Feel Better Pharmacy—Case for Chapter 10
    • Who You Gonna Call?—Case for Chapter 16
    • You Will Do What You Are Told—Case for Chapter 15
  • GLOSSARY
  • INDEX
 

Looking for a Similar Assignment? Let us take care of your classwork while you enjoy your free time! All papers are written from scratch and are 100% Original. Try us today!

0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply

Your email address will not be published. Required fields are marked *