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A C HANGE OF S EASON Code Blue Health Science Edition Four C HAPTER 3.

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Presentation on theme: "A C HANGE OF S EASON Code Blue Health Science Edition Four C HAPTER 3."— Presentation transcript:

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2 A C HANGE OF S EASON Code Blue Health Science Edition Four C HAPTER 3

3 New Characters Lets briefly review each new character: Lets briefly review each new character: Wes Douglas Wes Douglas Dr. Emil Flagg Dr. Emil Flagg Helen Ingersol Helen Ingersol Birdie Bankhead Birdie Bankhead David Brannan David Brannan Roger Selman Roger Selman

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

5 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. 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. Lets 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.) Lets 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.)

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

7 Areas of Weakness Continuous Quality Improvement

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

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

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

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

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

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

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

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

16 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. 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. The healthcare industry subsequently adopted continuous quality improvement.

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

18 Other Areas of Weakness Identified During First Interview HIPAA HIPAA EMTALA EMTALA Risk Management Risk Management

19 HIPPA Health Insurance Portability and Accountability Act of 1996 When was it passed? When was it passed? What was its objective? What was its objective? What does it do? What does it do? What information is protected? What information is protected?

20 HIPPA Health Insurance Portability and Accountability Act of 1996 Who is covered under the act? Who is covered under the act? What are the penalties? What are the penalties?

21 EMTALA Stands for The Emergency Medical Treatment and Active Labor Act Stands for The Emergency Medical Treatment and Active Labor Act The act is designed to prevent what is known as patient dumping. 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. 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.

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

23 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. 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. 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? 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?

24 Employability Skills

25 Although he doesnt know it, Wes Douglas is about to be interviewed for a job. Although he doesnt know it, Wes Douglas is about to be interviewed for a job. If you havent already, all of you will eventually face the employment interview. If you havent already, all of you will eventually face the employment interview. What do you think all employers look for in a new employee? What do you think all employers look for in a new employee?

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

27 Ability To Do The Job Aptitude 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 Education and Training Experience Experience

28 Aptitude Different people have different skills. Individuals with strengths in one area often have weaknesses in another. 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. 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. 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. A person who is good with people may not be good in science.

29 Aptitude Some people spend a great deal of time qualifying for a specific occupation, only to find they dont enjoy the work. Some people spend a great deal of time qualifying for a specific occupation, only to find they dont enjoy the work. They lack the aptitude for that particular job! They lack the aptitude for that particular job!

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

31 Education and Training Most professional healthcare jobs require some form of licensure and certification. 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. 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.

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

33 Education and Training What, then, should a student take away from formal education? What, then, should a student take away from formal education?

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

35 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? 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?

36 Willingness to Fit into the Corporate Culture What is 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. The corporate culture of IBM is different from the corporate culture of Microsoft. How?

37 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? What special characteristics of the healthcare industry make it important that physicians, nurses, and other healthcare employees be individuals of integrity and loyalty?

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

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

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

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

42 Medical Terminology Example Example Nephr = kidney Nephr = kidney itis = inflammation of itis = inflammation of Nephritis = inflammation of the kidney Nephritis = inflammation of the kidney Learn root words on pages

43 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. 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. With this in mind, discuss the relative strengths and weaknesses of Hap and Wes.

44 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. 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]

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

46 Discussion Question 3 Why would a young CPA entertain an offer to serve as interim administrator of the Brannan Community Hospital? 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? 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? Place yourself in the role of Wes Douglas. Would you accept the offer?

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

48 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 you were chairman of the board, would you fire Roger Selman? If not, why not? If not, why not? If so, is there anything you would do differently? If so, is there anything you would do differently?

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

50 Discussion Question 7 What was the reaction of the hospitals employees to the appointment of Wes Douglas as administrator? What was the reaction of the hospitals employees to the appointment of Wes Douglas as administrator? What might the board have done to make the transition easier for their new administrator? What might the board have done to make the transition easier for their new administrator?

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

52 Discussion Question 9 Where does real authority come from, a title, or credibility? Where does real authority come from, a title, or credibility?

53 Discussion Question 10 What will Wes Douglas have to do to build his credibility with the board, the medical staff, and the employees? What will Wes Douglas have to do to build his credibility with the board, the medical staff, and the employees?

54 Discussion Question 11 As long as an allied health employee has good technical skills, is it important for him or her to have good communication skills, and some political savvy? As long as an allied health employee has good technical skills, is it important for him or her to have good communication skills, and some political savvy?

55 Discussion Question 12 Birdie Bankhead, Hap Castletons secretary, believes that Edward Wycoff may have had ulterior motives in selecting Wes Douglas to be the new hospital administrator. Birdie Bankhead, Hap Castletons secretary, believes that Edward Wycoff may have had ulterior motives in selecting Wes Douglas to be the new hospital administrator. What might these motives be? What might these motives be? Assuming that Bankhead is correct, what can Wes do to protect himself? Assuming that Bankhead is correct, what can Wes do to protect himself?

56 Discussion Question 13 What is the difference between a fixed price contract and a cost reimbursement contract? What is the difference between a fixed price contract and a cost reimbursement contract? Who loses money if there is a cost overrun under a fixed price contract? Who loses money if there is a cost overrun under a fixed price contract? Who loses under a cost reimbursement contract? Who loses under a cost reimbursement contract?

57 Discussion Question 14 Identify the root words of each of the following terms. From the roots, explain what you think the term might mean. Using a medical dictionary, write the actual definition. cystitishematology orthodontistliposuction ophthalmologistpathology tracheoscopicgingivitis necrosishypodermic necrophobiahistology

58 Discussion Question 15 Assume you are a healthcare practitioner talking to the patient of someone with no medical training about a loved one. Translate the following into simple English. a. I believe your 100-year-old aunt is necrophobic. b. The child was cyanotic at admission. c. Your father was suffering from apnea when he called us. d. Your son has severe gingivitis.

59 Discussion Question 16 Roger Selman argued that it was justifiable to sign a contract with the Mountainlands Insurance Company at a price that was lower than hospital cost to maintain its volume of patients. Do you believe this was an appropriate decision? Do you believe this was an appropriate decision?

60 Discussion Question 17 Consider the way Edward Wycoff leads his board and staff. Does he have the attributes of a successful long-term leader? Why or why not? Does he have the attributes of a successful long-term leader? Why or why not?

61 Discussion Question 18 What made Wes Douglas successful in his communication with Birdie Bankhead in this chapter? What made Wes Douglas successful in his communication with Birdie Bankhead in this chapter?

62 Writing Exercise 19 Assume that you are in the role of Edward Wycoff as he fires Roger Selman. Using the reasons given in the chapter, prepare a script of the conversation you would have as you let Roger know that he was being terminated. Demonstrate kindness, understanding and courtesy in place of the tactics Wycoff used. Assume that you are in the role of Edward Wycoff as he fires Roger Selman. Using the reasons given in the chapter, prepare a script of the conversation you would have as you let Roger know that he was being terminated. Demonstrate kindness, understanding and courtesy in place of the tactics Wycoff used.

63 Writing Exercise 20 Using the tools taught in Supplementary Discussion 1 Employability Skills, develop a plan to explore a specific health care career. Consider: (a) personal aptitudes, (b) education and training requirements, (c) pay and employment opportunities, and (d) work environment. Using the tools taught in Supplementary Discussion 1 Employability Skills, develop a plan to explore a specific health care career. Consider: (a) personal aptitudes, (b) education and training requirements, (c) pay and employment opportunities, and (d) work environment.

64 Role Playing 21 Select a team of six or more people to role-play the board of trustees of Brannan Community Hospital and the administrator before the class. Have the board develop a plan to save the hospital in the next 30 days. Address the following problems: Select a team of six or more people to role-play the board of trustees of Brannan Community Hospital and the administrator before the class. Have the board develop a plan to save the hospital in the next 30 days. Address the following problems: 1) the hospital is not generating enough cash to pay its bills. 2) employee morale is at an all-time low.

65 Role Playing 21 (cont.) 3) the newspaper is running unfavorable editorials about the operations of the hospital. 4) the community is losing confidence in the quality of services provided by the hospital. 5) there is talk of an initiative to close the hospital down.

66 The End!


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