The Health care supervisor最新文献

Succession planning is the process of identifying people who could presently move into key positions or could do so after specifically targeted development occurs. The process identifies the better people in the organization and takes a consistent approach to assembling, analyzing, and retaining information about potential leaders and planning for their further development. At its simplest level, it is the development of a backup and potential successor to each manager; at is most formal, it is a documented plan for management succession at all levels in the organization. Strongly supportive of a policy of development and promotion from within the organization, succession planning also represents a proactive posture in respect to inevitable management turnover. In these days of rapid change in health care, no modern organization that expects to keep up with increasing competition can afford to drift--or even to let a single department drift--while replacements are recruited for managers who resign, retire, or otherwise leave.

This article considers legal and ethical aspects of consent, as well as the need for consent to be a communication process that informs patients about procedures. Recent examinations of the use of agents (such as nurses and allied health professionals) in securing consent are discussed. While there is a clear role for nonphysician health care workers in advocating for the patient and assuring that consent has been secured; their actual role in securing consent in the absence of a physician is less clear.

The development of new models of understanding the disabling process, the changing system of financing health care in the United States, and the increasing incidence of disability is challenging rehabilitation to define new models of care delivery. Current models of comprehensive medical rehabilitation include multidisciplinary therapy in inpatient, outpatient, home and community settings. Managed care and the development of capitated funding systems for health care financing will challenge rehabilitation to prevent disability in a population. This article proposes a model system for comprehensive rehabilitation in managed care: the Community Integration Rehabilitation Model. This system advocates the development of a continuum of services including a strong community-based rehabilitation system, that is, a shift in emphasis to expanding opportunities for independent and productive community living as well as management of disease and impairment for individuals with disabilities, and the forging of partnerships between institution-based rehabilitation and its community. Comprehensive rehabilitation is redefined as a continuum of disability prevention and treatment across the lifespan of a population.

The capacity for managers to be effective leaders is clearly being challenged by rapid changes in the health care environment. In this climate, transformational leadership is considered superior to hierarchy-dependent, transactional leadership. This approach may also be very effective in motivating staff and fostering organizational transformation. The article describes six processes that are critical for those who seek to be dynamic leaders: visioning, communicating for meaning, creating possibilities, developing stakeholders, building spirit and will, and sustaining focus.

To ensure the successful reengineering of a large, complex, unionized, urban teaching hospital, communication, education, and employee participation are key aspects. Human Resources-designed training supports the transition in concert with reengineering management, organizational development, labor relations, and external consultants. Education improves patient care and raises employee self-esteem as new teams focus together on excellence.

Currently the United States spends 12 percent of its gross national product on health care, far more than any other industrialized nation. Technology accounts for 15 percent to 50 percent of the rise in hospital costs. No country is immune from public calls for strategic developments to maintain or lower costs and guarantee high quality while maintaining access for all patients. To achieve these goals of adequate access, high quality, and greater efficiency, hospitals must discard complicated and unwieldy administrative practices that have evolved. How to best deploy technology in health service organizations requires a strategic perspective that results in operational break-throughs. Accelerated alignment of clinical and management processes, systems integration, and health care process redesign are required to achieve the goals of lower costs, higher quality, and greater access. An environmental background of reengineering is presented for health service organizations to use in their processes. Some critical relationships between reengineering and total quality management (TQM) in the health care setting are addressed. Implications of reengineering for health service organizations are offered to facilitate the implementation of the concept.

In today's highly competitive atmosphere, the survival of health care institutions depends largely on the ability to provide value-added services (VAS) at the lowest possible cost. Managers must identify their customers and delineate the needs and expectation of those customers. A strategy for satisfying these needs and expectations is essential. While technical advances and reasonable charges are important, a successful "high-tech," "high touch" approach demands the combination of process reengineering and employee training in customer relations.

As the use of e-mail has increased, so has employer monitoring of e-mail messages. But what a health care employer deems its right to protect a vast amount of confidential patient information from improper use, employees may view as a privacy violation. If employees are violating a health care organization's confidentiality or other workplace policies, the health care provider can be held liable for their actions and the e-mail communication could be the proverbial smoking gun. Health care institutions that monitor employee e-mail must have a monitoring policy in place and communicate it to employees.

Building and maintaining teams require careful attention to and maximization of such polar opposites (¿polarities¿) as individual and team, directive and participatory leadership, task and process, and stability and change. Analyzing systematic elements of any polarity and listing blocks, supports, and flexible ways to maximize it will prevent the negative consequences that occur when treating a polarity like a solvable problem. Flexible, well-timed shifts from pole to pole result in the maximization of upside and minimization of downside consequences.