CM2: James DeGrechie

(Author’s note: Yes, I know it says CM2.  Yes, I know it’s almost the end of October.   I’d tell you why, but I’m still catching my breath after dodging tornadoes overnight…)

 

Plectica Presentation link:  https://www.plectica.com/maps/0O6CL2ODB?present=1

What is healthcare administration?

Healthcare administration refers to the oversight and management of a healthcare entity. It involves making decisions affecting both long-term and short-term goals of the business, be it an individual facility or organization. The aims of administration are to ensure the smooth running and profitability of a healthcare entity, to ascertain that they are operating within the applicable laws and guidelines that govern healthcare, and to defend the rights and safety of both patients and staff.

Although healthcare administration is primarily focused on the business side of healthcare, this should not detract from efforts to provide top quality and highly effective patient care. It is imperative that healthcare administrators foster conditions in which healthcare providers can practice both effectively and efficiently, one that also provides safe, comfortable, and compassionate care for its patients.

What is a systems view of the U. S. Health Care Industry?

A systems view is a simplified view of the “moving parts” of a very complex industry, in this case healthcare.  There are a number of different functional units at play within healthcare, each with its own goals, standards, requirements, metrics, etc.  As unique as these units may purport to be, they can be consolidated into smaller component groups based upon distinctions.   For healthcare, hospitals and physicians, which are the principal providers of healthcare services in our current healthcare model, are at the center.  They rely upon consumers/patients to utilize their services, buyers to reimburse for those services, suppliers to provide the necessary raw goods and labor to facilitate these services.  Moreover, they work in symbiosis with other health entities in providing total patient care.  Furthermore, they rely upon public health agencies for research and collaboration, and are overseen by regulatory bodies to ensure quality and safety.

What distinctions are you seeing in the systems view? 

The representative groups within the systems view include Consumers/Patients, Hospitals/Physicians, Suppliers, Buyers, Regulators, and Public Health Agencies.

What distinctions are you not seeing?

One faction that is not visually represented in the systems view is professional medical associations, such as the National League of Nurses or the American Academy of Family Physicians.  Although these organizations can take on many of the same properties and work in same capacity as Regulators or Public Health Agencies, these associations are not exclusive to either group.  Moreover, it can be said that they are not either, inasmuch as the main functions of professional associations are to safeguard of the fundamental values and codes of ethics of the represented profession, as well as to advocate (including political lobbying) on behalf of the medical profession.

How would you distinguish between regulators and public health agencies?

Health care regulatory agencies (Regulators) monitor practitioners and facilities for legal and ethical compliance, provide information about industry changes, and promote both quality and safety in the healthcare forum. Regulators also have the ability to impose sanctions against healthcare entities or individuals for failing to comply with regulations.

Public health agencies work to protect and improve the health of people and their communities. This work is achieved by promoting healthy lifestyles, researching disease and injury prevention, and detecting, preventing and responding to infectious diseases.  Collaboration through sharing of information, research, and resources with healthcare entities is one way in which public health agencies are able to bring about positive change within the healthcare industry.

Can you compare and contrast suppliers and buyers?

Suppliers are those companies or entities that create/compile goods or services, then sell these items to a healthcare entity. Examples of suppliers include pharmaceutical companies, IT firms, and medical equipment manufacturers, to name a few.

Buyers are those companies or entities that are responsible for financial reimbursements for healthcare services; examples of buyers include privately-funded (i.e. health insurance companies) and government-based third-party payors (CMS, Tricare/VA, etc.).

What is organizational design?

Organizational design is a process used to identify barriers to smooth work flow, such as hindrances in procedures, structures, and systems. Basic elements of organizational structure are reviewed, including departmentalization, chain of command, span of control, centralization or decentralization, work specialization and the degree of formalization. Once barriers are identified, workflow is adjusted to fit current business realities/goals, and then a plan is developed to implement the corrections.

Explain and describe how empowerment involves directed autonomy?

It is said that empowerment involves directed autonomy; this is a scenario wherein individuals or teams are given an overall direction and end goal but are given a measure of latitude regarding how they go about completing the directive.  By offering choices and opportunity to participate in the decision-making process, it appeals to the fundamental need for self-actualization, and allows a chance to realize one’s potential for growth and development.

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