Managing Health Services Organizations and Systems

Kurt Darr is Professor of Hospital Administration in the Department of Health Services Management and Leadership and Professor of Health Care Sciences at The George Washington University. He holds the Doctor of Science from The Johns Hopkins University and the Master of Hospital Administration and Juris Doctor from the University of Minnesota. Dr. Darr completed his administrative residency at Rochester (Minnesota) Methodist Hospital and subsequently worked as an administrative associate at the Mayo Clinic. After being commissioned in the U.S. Navy, he served in administrative and educational assignments at St. Albans Naval Hospital and Bethesda Naval Hospital. He completed postdoctoral fellowships with the Department of Health and Human Services, the World Health Organization, and the Accrediting Commission on Education for Health Services Administration. Dr. Darr is a Fellow of the American College of Healthcare Executives, a member of the District of Columbia and Minnesota Bars, and serves as a mediator in the Superior Court of the District of Columbia. He serves on commissions and committees for various professional organizations, including The Joint Commission on Accreditation of Healthcare Organizations, the American College of Healthcare Executives, and the Commission on Accreditation of Healthcare Management Education. He is a voluntary consultant to several hospitals in the District of Columbia metropolitan area. Dr. Darr regularly presents seminars on health services ethics, hospital organization and management, quality improvement, and the application of the Deming method in health services. He is the author and editor of several books used in graduate health services administration programs and numerous articles on health services topics.Michael Nowicki, M.H.A., Ed.D., FACHE, FHFMA, holds an Ed.D. degree in Educational Policy Studies & Evaluation from the University of Kentucky and a master of hospital administration from George Washington University. He is currently a professor of health administration at Texas State University. Board certified in both healthcare management and healthcare financial management, he is a fellow of the American College of Healthcare Executives and the Healthcare Financial Management Association. Dr. Nowicki has held various administrative positions in healthcare organizations around the country. He is a noted speaker and author on healthcare financial management.

• PART I. THE ENVIRONMENTChapter 1: Healthcare Services in the United StatesHealth and System GoalsLack of SynchronyProcesses That Produce Health PolicyA Brief History of Health Services in the United StatesOther Western SystemsStructure of the Health Services System Classification and Types of HSOsLocal, State, and Federal Regulation of HSOs/HSs Other Regulators of HSOs/HSsAccreditation in HealthcareRegulation and Education of Selected Health OccupationsAssociations for Individuals and OrganizationsPaying for Health Services Government Payment MethodologiesSystem TrendsCase Study 1. Gourmand and Food—A FableCase Study 2. Normal Saline and Hurricane MariaWhere’s My Organ?Case Study 3. Bipartisan Policy Group Proposes Cuts to Hospital SpendingChapter 2: Ethical and Legal DimensionsSociety and the LawRelationship of Law to EthicsEthics FrameworkPersonal Ethic and Professional CodesHealth Services Codes of EthicsEthical Issues Affecting Governance and ManagementBiomedical Ethical IssuesEnd-of-Life DecisionsOrganizational Responses to Ethical Problems Managers and the LawTorts and HSOs/HSsReforms of the Medical Malpractice SystemSelect Legal Areas Affecting HSOs/HSsLegal Process of a Civil LawsuitSpecial Considerations for the ManagerCase Study 1. UnderstandingCase Study 2. Viral PandemicCase Study 3. Concerned Physicians; Unconcerned ManagersCase Study 4. Which Hurts More: The Truth or the Lie?Chapter 3: Healthcare EconomicsEconomic Growth in HealthcareSpecial Characteristics of the Healthcare EconomyHealthcare DemandHealthcare SupplyEconomic Solutions for HealthcareCase Study 1. Price and Discount TransparencyCase Study 2. Comparing Health Care in High-Income CountriesCase Study 3. The Role of Health Insurance in Guaranteeing HealthCase Study 4. Physician ConsolidationChapter 4: The Quality Imperative: The TheoryImproving Quality and PerformanceTaking a CQI ApproachCQI, PI, and Competitive PositionTheory of CQIStrategic Quality Planning: Hoshin Planning Organizing for ImprovementThe Next Iteration of CQI: A Community FocusCase Study 1. Extent of ObligationCase Study 2. Surgical Safety—Retained Foreign ObjectsCase Study 3. Which Team’s Fastest?Chapter 5: Healthcare TechnologyBackgroundTypes of TechnologiesEffects of Technology on Health StatusForces Affecting Development and Diffusion of TechnologyResponses to Diffusion and Use of TechnologyHealth Technology AssessmentHSO/HS Technology Decision MakingManaging Biomedical EquipmentHealth Information TechnologyTelemedicineFuture DevelopmentsTechnology and the Future of MedicineCase Study 1. Is Cleansing Your Hands in my Room a Problem, Doctor?Case Study 2. “Who Does What?”Case Study 3. “Let’s ‘Do’ a Joint Venture”PART II. THE TOOLSChapter 6: Managerial Problem Solving and Decision MakingProblem Analysis and Decision MakingProblem SolvingProcess and ModelInfluencing Problem Solving and Decision Making Unilateral and Group Problem SolvingProblem-Solving and Decision-Making StylesCase Study 1. The Nursing AssistantCase Study 2. The New Charge NurseCase Study 3. Chris’s New BabyChapter 7: Financial ManagementOrganization of Financial ManagementHealthcare Financial AccountingCost AccountingReimbursementWorking CapitalResource AllocationCase Study 1. Calculating Net Patient Services RevenueCase Study 2. Calculating Bad Debt ExpenseCase Study 3. Analyzing Financial StatementsCase Study 4. Break-even Analysis for a Capitated ContractCase Study 5. Your Organization’s Path to the Second Curve: Integration and TransformationCase Study 6. Economic Order Quantity and Total CostChapter 8: The Quality Imperative: ImplementationUndertaking Process ImprovementOther Improvement MethodologiesImprovement and Problem SolvingStatistical Process Control (SPC)Tools for ImprovementProductivity and Productivity ImprovementLIPs and CQIPatient and Staff Safety in HealthcareQI Methods Useful in Patient and Staff SafetyOverlap of Patient and Staff SafetySustainabilityCase Study 1. The Carbondale ClinicCase Study 2. Respiratory Pandemic and the HospitalCase Study 3. Infections—CLABSICase Study 4. Sharps InjuriesCase Study 5. Violence in the WorkplaceChapter 9: CommunicatingCommunicating Is Key to Effective Stakeholder Relations Communication Process ModelBarriers to Effective CommunicationFlow of Intraorganizational CommunicationCommunicating with External StakeholdersSpecial Situations of Communicating with External StakeholdersSpecial Situations of Communicating with Internal StakeholdersCase Study 1. How Much Should We Say?Case Study 2. Getting Help When NeededCase Study 3. Adding Verbal Orders to Written OrdersPART III. THE APPLICATIONChapter 10: PlanningStrategizing and Systems TheoryStrategizing and PlanningThe Strategizing ProcessSituational AnalysisInternal Environmental AnalysisExternal Environmental AnalysisFormulating StrategyImplementing StrategyStrategic ControlStrategic MarketingCore Concepts in MarketingExamples of Marketing StrategiesStrategic Issues ManagementCase Study 1. No Time for StrategizingCase Study 2. A Response to ChangeCase Study 3. HSO Strategic AssessmentChapter 11: OrganizingDesigning the OrganizationCulture and ValuesTheoretical BackgroundFormal and Informal OrganizationsDesigning Interorganizational RelationshipsThe Triad of Key HSO ComponentsOrganization of Select HSOsDiversification in HSOs and HSsThe HSO/HS EnvironmentCase Study 1. The Clinical StaffCase Study 2. State Allocation Decisions—Centralize or DecentralizeCase Study 3. Physicians’ Unprofessional BehaviorCase Study 6. CEO Salary versus Patient CareChapter 12: StaffingBackgroundStaffingHRM ActivitiesLabor Relations Law and UnionizationSelf-service HRForeign WorkersTeamsVirtual WorkforceSocial Media in the Workplace and in HRPersonality TestingOutsourcing Some HRMCase Study 1. Today’s WorkforceCase Study 2. The Photographer Who Posed as a GynecologistCase Study 3. Doctor of DeathCase Study 4. Let the Punishment Fit the CrimeChapter 13: DirectingDirecting as Leading: Defined and ModeledWork of ManagersManagement Functions, Skills, Roles, and CompetenciesManagers and Leaders: Are They Different?Ethical Responsibilities of LeadersPower and Influence in LeadingMotivation Defined and ModeledConclusions About Power, Influence, and Motivation in LeadingApproaches to Understanding LeadershipToward an Integrative Approach to Effective LeadingCase Study 1. Healthcare Executives’ Responsibility to Their CommunitiesCase Study 2. The Young Associate’s DilemmaCase Study 3. Ethical Aspects of LeadershipCase Study 4. Reluctant LeaderChapter 14: ControllingMonitoring (Control) and Intervention Points Control ModelLevels of ControlControl ConsiderationsControl and CQIControl and Problem SolvingControl and Information SystemsRM and Quality ImprovementHealthcare and Public Health Emergency Preparedness Control MethodsProject ManagementCase Study 1. Centralized PrintersCase Study 2. Healthcare Emergency PreparednessCase Study 6. Placing Imaging Services to Support ED Operations