Healthcare Management Practices PDF

Topic continnuation 14. Organizational Culture The values, norms, traditions, customs sacred cows and ethical standards that guide the hospital’s employees and management It is the ways of thinking, behaving and believing that members of a unit have in common 14.1 Assessing What is the physic...

Topic continnuation 14. Organizational Culture The values, norms, traditions, customs sacred cows and ethical standards that guide the hospital’s employees and management It is the ways of thinking, behaving and believing that members of a unit have in common 14.1 Assessing What is the physical environment? – physical set up What is the organization’s social environment? – employee’s relationship How supportive is the organization? – continued or further studies subsidy or equivalent What is the organization’s power structure? – who is the president or chairman How safe is the organization? – safety & security What is the communication environment? – verbal/written/email, the place where communication exchange takes place What are the organizational taboos? – is there any suggestions or ideas that are forbidden? Eight (8) distinct organizational culture styles 1. Caring – work environments are warm, collaborative and welcoming 2. Purpose – work environments are tolerant, compassionate where people try to do good for a long-term - term future of the world 3. Learning – inventive and open–minded places where people spark new ideas and alternatives 4. Enjoyment – lighthearted places where people tend to do what makes them happy 5. Results – environment is outcome-oriented and merit-based places where people aspire to achieve top performance 6. Authority – competitive places where people strive to gain personal advantage. Emphasizes confidence and dominance 7. Safety – employees are united by a desire to feel protected 8. Order – focused on respect, structure and shared norms Remember: The structure should be clearly define Goal should be to build the fewest possible management levels and shortest chain of command It should enhance and not impede communication Should facilitate decision making Nursing services should be organized to facilitate the development of future leaders 15. Staffing the process of determining and managing the appropriate number and mix of nurses to provide adequate patient care in healthcare settings like hospitals, clinics, and nursing homes. Centralized – made by central office or staffing centre. Doesn’t have to be a nurse Decentralized – schedules are made by unit manager Staff absences Vacation leave Increase or decrease the number of staff Decentralized staffing The unit manager understands the needs of the unit and staff intimately Staff feels more in control of their work environment Increases autonomy and flexibility thus decreasing nurse attrition Centralized staffing Generally fairer to employees Policies tend to be employed more consistently and impartially. It frees the middle-level manager to complete other management functions Cost-effective use of resources Does not provide much flexibility for the worker Managers could be less responsive to personnel budget control. Common staffing and scheduling options 8 – 12 hours shift Premium pay for weekend work Part-time staffing pool for weekend shifts and holidays Allowing staff to exchange hours of work among themselves 15.1 Recruitment Seeking out applicants for existing positions should be an ongoing process. Job description Nurse-recruiter Interview Use a team approach Develop a structured interview format Use scenarios to determine decision-making ability Conduct multiple interview 15.2 Selection The process of choosing among all applicants the best-qualified individual for the job. Verify the applicant’s qualifications Check his/her work history Determining if the candidate is a good match to the organization’s expectation Educational and credential requirements Reference check and background screening Pre-employment testing Physical examination 15.3 Placement a period of supervised work experience1st phase Indoctrination – a planned, guided adjustment of an employee to the work environment Induction – 1st phase of indoctrination, employee handbook. Provides general information about the organization Orientation – activities more specific for the position 16. Scheduling Predicting staffing needs skill mix Shift Types Day Shift: Typically runs from morning to afternoon (e.g., 7 AM to 3 PM). Evening Shift: Usually covers late afternoon to evening (e.g., 3 PM to 11 PM). Night Shift: Often runs overnight (e.g., 11 PM to 7 AM). 12-hour shifts: Some hospitals operate on 12-hour shifts, covering a full day with fewer handovers 17. Patient Classification System Acuity-Based Classification - on the areas of care Eating, Grooming, Excretion, Comfort, General health, Treatments, Medication, Teaching & Emotional support Category 1 Category 2 - Category 3 Category 4  CATEGORY CATEGORY CATEGORY 3 CATEGORY 4 1 2 Nursing Care Hours per patient 2.3 2.9 3.4 4.6 day (NCH/PPD) needed for day shift 7:00am-3:00pm Nursing Care Hours per patient 2.0 2.3 2.8 3.4 day (NCH/PPD) needed for PM shift 3:00pm – 11:00pm Nursing Care Hours per patient 0.5 1.0 2.0 2.8 day (NCH/PPD) needed for Night shift 11:00pm – 7:00am 18. Predicting Staffing Models Using patient classification systems (e.g., acuity-based systems), to determine how many patients require specific levels of care. Higher acuity patients will require more intensive staffing, while lower acuity patients may need less direct care.  Workload Measurement - time spent on specific procedures, medication administration, and patient education. Patient Flow Shift Patterns Cost Management Nursing care delivery systems (NCD) the structured approaches that healthcare organizations use to provide nursing care to patients NCD/Case Method A total care of one patient or sometimes 2 A nurse is managing the care of a patient with complex health needs and coordinates care across different departments including physical therapy, nutrition, and social work. The nurse ensures the care plan is carried out by all involved professionals. a primary responsibility of the case manager is coordinating patient care to reduce hospital stay and costs It provides a single point of contact for the patient, ensuring continuity of care and improved coordination between different healthcare providers. NCD/Functional nursing Specific task - medication nurse Disadvantage - It may result in fragmented care for patients. NCD/Team nursing Collaborative Nursing and non health care professional work together to care for the patient comprehensively The team leader is responsible for delegating tasks to team members. In the team nursing model, the team leader (often a registered nurse) delegates and coordinates care with other team members. NCD/Primary nursing Total nursing care In the primary nursing model, the primary nurse is responsible for overseeing the patient's care and discharge planning. Overseeing the total care of the patient from admission to discharge, including developing care plans and coordinating with other professionals Ensure that all documentation is completed by the team. NCD/Modular nursing Geographical location of patient Nursing care is divided by modules, where each team is responsible for a specific group of patients within a geographic area It improves communication and continuity of care within smaller teams Enhances communication and continuity because the same small team is responsible for a defined group of patients, fostering better coordination and personalized care. The RN is responsible for coordinating care within the module, delegating tasks appropriately, and ensuring the care plan is followed by the team