WK4_Medical Staff Organization.pdf

LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 Topic 1 Sell a product for more th...

LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 Topic 1 Sell a product for more than the cost of ORGANIZATION making it; or A collection of people working together to Nonprofit organization can add wealth to achieve a common purpose. society A unique phenomenon that enables its Provide a public service that is worth members to perform tasks far beyond the more than its cost reach of individual accomplishment. PRODUCTIVITY Share a broad purpose providing goods or A common way to describe how well an services of value to customers and clients. organization is performing overall. It measures the quantity and the quality of CHARACTERISTICS OF AN ORGANIZATION work outcomes relative to the cost or resources used. Can be measured at the individual and group and organizational levels. Distinct Deliberate Purpose Structure Effective but not Effective and efficient High efficient Goals achieve Goals achieve No wasted resources Resources wasted High productivity Goal People attainment Neither effective nor Efficient but not Low efficient effective Goals not achieve Goals not achieve Resources wasted No wasted resources ORGANIZATIONS AS SYSTEM All organizations are complex systems whose Poor Good many interrelated parts should function together so that a common purpose is achieved. ORGANIZATIONAL THEORY Open system interacts with their environments A set of generalization and concepts and in the continual process of obtaining resource approaches to the study of organization. inputs and transforming them into product It serves two purposes: outputs in the form of finished goods and/or Improvement of the understanding of services. how agencies function and relate to other levels and segments of the ORGANIZATIONS AS OPEN SYSTEMS society. Provision of knowledge and insight for The The The designing and administering environment organization environment organizations in ways adjudged as supplies creates consumes good and effective. Resource Product inputs: outputs: Three Major Theories People Finished The differences are based on the fact that at Money Work activities goods and/or the start of their evolution, the students of the Materials turn resources services organization were focusing their attention on Technology into outputs Transformation the aspects of organization which they felt very Information Process important at the time: Classical or Traditional Model Consumer Feedback Neoclassical Theory or Behavioral ORGANIZATIONAL PERFORMANCE Model For an organization to perform well, its Systems Theory resources must well be utilized and its customers must be well served -> value creation Business organization can earn a profit. LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 4. Full-time paid officials: only or major CLASSICAL THEORIES OF ORGANIZATION employment; paid on the basis of position. Earliest theory mainly concerned with the 5. Career officials: promotion based on formal structure of the institution. seniority and merit; designated by Ex. Church, military (chain of command) supervisors Has 3 schools of thought: 6. Private/Public split: separates business Bureaucratic Model and private life Scientific Management The finances and interests of the two And Principles of Administration should be kept firmly apart: the school resources of the organization are quite Emphasized rationality, predictability, distinct from those of the members as impersonality, technical competence and private individuals. formal division of labor. There is “one best way” to organize. There are “universal” principles of SCIENTIFIC MANAGEMENT management. Frederick Taylor (1856 – 1915) Organizations are “mechanical” and “closed- Father of Scientific Management systems”. Published: Principles of Scientific Management Organizations exists for “production related” Demonstrated that individual tasks could be goals, thus the emphasis is on “internal scientifically analyzed efficiency”. Time and motion study, fatigue study, skills Structure of “formal organizations” are study defined. KEY POINTS OF SCIENTIFIC MANAGEMENT BUREAUCRATIC MODEL Scientific Job Analysis – observation, data Max Weber - Father of Modern Sociology gathering, and careful measurement Analyzed bureaucracy as the most logical and determine “the one best way” to perform each rational structure for large organizations. job Positional authority of a superior over a Selection of Personnel – scientifically subordinate stem from legal authority. select and then train, teach, and Charismatic authority stems from the personal develop workers qualities of an individual. Management Cooperation – Weber outlined his ideal bureaucracy as managers should cooperate with defined by the following parameters: workers to ensure that all work is done A continuous system of authorized in accordance with the principles of jobs maintained by regulations. the science that developed the plan 1. Specialization: encompasses a defined Functional Supervising – managers “sphere of competence,” based on its assume planning, organizing, and divisions of labor decision-making activities, and A stated chain of command of offices: workers perform jobs a consistent organization of supervision based on distinctive levels of authority ADMINISTRATIVE MANAGEMENT 2. Rules: an all-encompassing system of Henri Fayol - Father of Modern Management directives which govern behavior: Emphasizes the manager and the functions of Rules may require training to management. comprehend and manage. Organizational structure coordinated by 3. Impersonality: no partiality, either for or management: against, clients, workers, or administrators. key to a rational and efficient Free selection of appointed officials: administration equal opportunity based on education Organizations should be structured based on 4 and professional qualification criteria: LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 purpose they serve process they use SYSTEMS THEORY persons and things dealt with and place and conditions where they Organizations as sets of variables that are function interrelated in such a way that changes in one Unity of command direction is essential variable affects other variables Authority and responsibility should be delegated down the hierarchy to their local CONTINGENCY THEORY levels Narrow span of control is desirable There is no one way of managing that will apply Systematic planning best to all situations Human psychological variables should be taken Managers must study very well the situation, in to account and based on his diagnosis, he can then 5 functions of managers: determine which of the three models or 1. Plan 4. Coordinate combination he will follow. 2. Organize 5. Control 3. Command Summary: 14 Principles of Management Classical theories 1. Division of work Importance of well-structured 2. Authority and responsibility organization with appropriate division 3. Discipline of labor with its resulting specialization 4. Unity of command and the need for written rules to 5. Unity in direction coordinate and direct the organization 6. Subordination of individual interests Neo-classical or Behavioral theories to general interests Social and human factors are more 7. Remuneration of personnel important determinants of workers’ 8. Centralization behavior than the physical work 9. Scalar chain environment and material incentives, 10. Order and yet importance of monetary 11. Equity returns/incentives cannot be denied 12. Stability of tenure of personnel Systems theory 13. Initiative Holistic understanding of the situation 14. Esprit de corps with thorough analysis of the input- throughput-output process and the NEO-CLASSICAL THEORY use of quantitative methods Elton Mayo - school of human relations Contingency theory Organization should be seen as a social Catch-all approach structure, an intricate web of human relations together by a system of sentiments The Changing Environment Chester Bernard - cooperation system Social and psychological incentives are primary, economic is secondary 4 basic standards or orders 1. Order must be understandable by those who are supposed to receive them 2. Order must be consistent with the goals and purpose of the organization as they are understood by its members 3. Order must be compatible with the personal interest of those affected 4. Order must be feasible LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 Topic 2 TYPES OF ORGANIZATIONAL STRUCTURES Formal: Delineated by an organizational chart and job descriptions. Official reporting relationships are known to every manager. Informal: A set of evolving relationships and patterns of STAFF/FUNCTIONAL AUTHORITY ORGANIZATIONAL human interaction STRUCTURE Not officially prescribed. JOB/POSITION CATEGORIES: Basis of Informal Formal Group 1. Line Position Comparison Group In the direct chain of command Responsible for the achievement of General Feature Unofficial Official the goals. Direct authority or line authority Major Concepts Power and Authority and Line officers/managers politics responsibility 2. Staff Position Intended to provide expertise, advice, Primary Focus Person Position and support for the line positions. i.e., authority to advise the line Source of leader Given by Delegated by Staff officers or managers power group management Staff authority or functional authority o Staff departments have Guidelines of norms Rules and Policies authority over line personnel behavior in narrow areas of specialization. Rewards and Sources of control sanctions penalties TYPES OF SPECIALIZED STAFF 1. Advisory FORMAL ORGANIZATIONAL STRUCTURE CATEGORIES Management Information System, LINE ORGANIZATIONAL STRUCTURE Operation Research and Quantitative Techniques, Only direct, vertical relationships between Industrial Engineering, different levels in the firm. Planning Authority follows the chain of command. 2. Service Maintenance, ADVANTAGES DISADVANTAGES Purchase, Tends to simplify and clarify Neglects specialists in Stores, authority, responsibility, and planning Finance, accountability relationships Marketing Promotes fast decision- Overloads key persons 3. Control making Quality control, Simple to understand As the firm grows larger, line Cost control, organization becomes more Auditing ineffective Staff can perform 1-3 functions. LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 DISADVANTAGES: DIVISIONAL ORGANIZATIONAL STRUCTURE 1. May create conflict between line and staff personnel. Have a different basis on formed departments. e.g. Staff officers may resent their lack 1. Function of authority 2. Product 2. Line managers may dislike staff personnel 3. Geographic territory teaching them even though they recognize the 4. Project specialists’ knowledge and expertise. 5. Combination approach 3. Some staff have difficulty adjusting to the role, especially when line managers are reluctant to accept advice. 4. Coordination between line and staff may become difficult. ADVANTAGES: 1. Line and staff have a direct vertical relationship between different levels. 2. Staff specialists advise and assist line managers/officers in specialized areas. 3. Use of expertise of staff specialists. 4. The span of control can be increased 5. Relieves line authorities of routine and PROJECT ORGANIZATIONAL STRUCTURE specialized decisions. 6. No need for all-round executives. A temporary organization designed to achieve specific results by using teams of specialists from different functional areas. Focuses all its energies, resources, and results on the assigned project. When the project is complete, the team members o May go back to their previous positions or o May be assigned to a new project. Project examples: COMMITTEE ORGANIZATIONAL STRUCTURE o Research and development projects, o Product development, Formed for managing certain o Construction of a new plant, housing problems/situations complex, shopping complex, bridge Temporary decisions. ADVANTAGES DISADVANTAGES Committee decisions are Committees may delay better than individual decisions, consume more decisions time, and hence more expensive. Better interaction between Group action may lead to committee members leads to compromise and indecision. better coordination of activities Committee members can be ‘Buck passing’ may result. motivated to participate in Most valuable when work is: group decision-making. Group discussion may lead to Defined by a specific goal and target date for creative thinking. completion. Unique and unfamiliar to the organization. LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 Complex having independent activities and ADVANTAGES DISADVANTAGES needing specialized skills Decentralized decision- High administration cost. making. Critical for possible gains or losses. Strong product/project Potential confusion over Not repetitive coordination. authority and responsibility. Improved environmental High prospects of conflict monitoring. CHARACTERISTICS Fast response to change. Overemphasis on group decision-making 1. Personnel are assigned to a project from the Flexible use of resources Excessive focus on internal existing permanent organization and are under relations. the direction and control of the project Efficient use of support systems. manager. 2. The project manager specifies what effort is needed and when work will be performed whereas the concerned department manager executes the work using his resources. 3. The project manager gets support from production, quality control, engineering, etc. 4. The project manager and the respective functional managers have the authority over the project team members. MATRIX ORGANIZATIONAL STRUCTURE HYBRID ORGANIZATIONAL STRUCTURE A permanent organization designed to achieve specific results by using teams of specialists from different USES: functional areas in the organization. Organizations that face considerable Feature: environmental uncertainty that can be met through a divisional structure and that also Superimposes a horizontal set of divisions and require functional expertise or efficiency reporting relationships onto a hierarchical Used by multinational companies, e.g., functional structure. International Business Machines USA. Often used when the firm has to be highly Multinational corporations may have their responsive to a rapidly changing external corporate offices in the country of origin and environment. their international divisions established in various countries reporting to the CEO or Product/Business Group president at the headquarters. Functional Managers Managers Depends on factors such as degree of In charge of specialized In charge of one or resources more products international orientation and commitment. e.g. production, quality Authorized to prepare The international divisions or foreign control, inventories, product or business subsidiaries may be grouped into regions scheduling, and group strategies Each region may be subdivided into countries marketing. Call on the various within each region. functional managers for the necessary resources. BOTH Have somewhat equal power. Possible for conflict and frustration. The opportunity for prompt and efficient accomplishment is quite high. Negative effects of dual authority Functional managers may lose some authority because product managers are given the budgets to purchase internal resources LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 Topic 3 Topic 4 THE DIFFERENCE BETWEEN ADMINISTRATION & HOSPITAL AS AN ORGANIZATION MANAGEMENT The hospital is an organizational system System – As a whole it is composed of several Features Administration Management parts which are inter related and inter- 1 Nature Determinate or Executive of dependent to promote a common goal Thinking Function Doing Function How does it relate to hospital? 2 Type of work Decision on Implementation o It is related to organization and objectives and of policies management policies 3 Levels of Top Level Middle and Lower o Emphasis is on interaction of authority Level individuals, group, organization and 4 Influence Public opinion Objectives and their environment and outside policies of o Structuring and integrating activities sources concern that is people working or coordinating 5 Designation Administrator, Manager, Officer in charge Supervisor together 6 Main Functions Planning and Directing and control organizing Primary Objectives of a Hospital 7 Skills required Conceptual and Technical and To provide adequate personalized care and human skills human skills 8 Usage Used in govt and Business treatment public sector organization Its principal product is medical and surgical service Management runs the healthcare organization Secondary Objectives of a Hospital Administration handles the staffing Maintenance and survival Healthcare management Organizational stability and growth concerned with disciplines such as policy, Financial solvency accounting and facilities management Medical, paramedical education and research The healthcare manager is concerned with Various employees related activities the overall operation of the facility or network Healthcare Administrator HOSPITAL ORGANIZATION The day-to-day management of staff Gives the framework of hospital operation Guided by hospital mission/vision and core values Functional table of organization Leader to run the organization Model Organizational Structure General Functions: a. Medical Service - shall be responsible for providing quality inpatient and outpatient care and high standards of clinical training for medical and allied medical personnel provision of ancillary and allied health services to patients’ promotion of research activities implementation of clinical resource management system and advising and assisting the chief of hospital in the formulation and implementation of policies, plans and programs of the hospital  LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 b. Nursing Service - shall be responsible for implementing nursing Nursing Service programs for total quality health care; providing nursing care to medical cases; and Office of the Medical Center Chief developing coordinating and implementing relevant training programs for nursing personnel. NURSING SERVICE c. Hospital Operations and Patient Support Service Critical Nursing Unit Special Care Areas - shall be responsible for the provision of Operating Room administrative services relating to personnel Central Supply management, administrative records Obstetric Complex management, property and supply management, general services, engineering and security. Health Operations and Patient Support System Office of the Medical d. Finance Center Chief - shall be responsible for the provision of financial services relating to budgeting, accounting, cash operations, billing and claims. Hospital Operation and Patient Support System Basic Organizational Structure Procurement Human Resource Management Office of the Medical Center Chief Finance Service Integrated Hospital Professional Education Office of the Medical Operations and and Training Center Chief Management Program Finance Service Medical Nursing Non- Medical Budget Accounting Medical Nursing Hospital Finance Organizational Configuration Service l Service Operation Service and Patient Organizational Structure and Staffing pattern Support shall take into consideration the following Service factors: a. Minimum DOH Licensing Requirements Medical Service and Philhealth Accreditation Requirements b. Hospital Licensing Category (Level 1, 2 and Office of the Medical Center Chief 3 hospitals) based on DOH c. Special Society Training Accreditation Medical Service Requirements (particularly for Medical Staff) OPD d. Distribution of Medical Staff to cover the Department of Pharmacy OPD, ER and inpatient hospital areas ER Department Pathology e. Health Human Resource Master Plan Clinical Department Nutrition and Department of Dietetics Special Care Areas Radiology LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 Level 1 DOH Requirement Level 2 DOH Requirement LICENSING REQUIREMENTS FOR LEVEL 1 LICENSING REQUIREMENTS FOR LEVEL 2 HOSPITAL SERVICE CAPABILITY HOSPITAL SERVICE CAPABILITY ___ 1. Administrative Service ___ 1. Administrative Service ___ 1.1. General Administrative Service ___ 1.1. Personnel ___ 1.1.1. Records ___ 1.2. Accounting ___ 1.1.2. Bookkeeping ___ 1.3. Medical Records ___ 1.1.3. Clerical Work ___ 1.4. Supply ___ 1.1.4. Maintenance ___ 1.2. Patient Transport Service ___ 1.5. Housekeeping ___ 2. Clinical Service ___ 1.6. Laundry and Linen ___ 2.1. General Medicine ___ 1.7. Maintenance ___ 2.2. General Pediatrics ___ 1.8. Patient Transport Service Security ___ 2.3. General Obstetrics and Non-Surgical ___ 1.9. Dietary Gynecology ___ 1.10. Social Service ___ 2.4. Minor Surgery ___ 2. Clinical Service ___ 2.5. Emergency and Outpatient Service ___ 2.1. General Clinic Care ___ 3. Nursing Service ___ 2.1.1. Medicine ___ 3.1. Minimal Care and Management ___ 2.1.2. Pediatrics ___ 3.2. Health Education and Counseling ___ 2.1.3. Obstetrics and Gynecology ___ 4. Ancillary Service ___ 2.1.4. Surgery and Anesthesia ___ 4.1. Primary Clinical Laboratory ___ 2.2. Emergency Service ___ 4.2. Radiology - 1st Level ___ 4.3. Pharmacy ___ 2.3. Outpatient Service The service may be contracted out but available for 24 ___ 3. Nursing Service hours 7 days a week. A contract of service or ___ 3.1. Intermediate Care and Management memorandum of agreement with a service provider ___ 3.2. Health Education and Counseling should be secured as a prerequisite for license to ___ 4. Ancillary Service operate. ___4.1. Secondary Clinical Laboratory A certificate of affiliation with a licensed facility within ___4.2. Radiology - 1st Level the locality should be secured as a prerequisite for ___4.3. Pharmacy license to operate The service is optional. LICENSING REQUIREMENTS FOR LEVEL 2 HOSPITAL PERSONNEL ___ 1. Administrative Service LICENSING REQUIREMENTS FOR LEVEL 1 HOSPITAL PERSONNEL ___ 1.1. Chief of Hospital / Administrative ___ 1. Administrative Service Officer Clerk (pool) ___ 1.1. Administrator ___ 1.2. Clerk (accounting) ___ 1.2. Clerk ___ 1.3. Medical Records Clerk ___ 1.3. Utility Worker ___ 1.4. Storekeeper / Linen Custodian Utility ___ 1.4. Driver Worker 1 at any time plus 1 reliever ___ 1.5. Driver 1:12 beds at any time 1:24 beds at any time ___ 1.6. Nutritionist / Dietitian ___ 2. Clinical Service ___ 1.7. Cook / Food Service Worker ___ 2.1. Physician ___ 1.8. Medical Social Worker ___ 3. Nursing Service ___ 2. Clinical Service ___ 3.1. Nurse ___ 2.1. Physician ___ 3.2. Nursing Attendant / Midwife ___ 2.2. Physician (On Call) ___ 3. Nursing Service ___ 3.1. Chief Nurse / Supervising Nurse ___ 3.2. Staff Nurse LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 ___ 3.3. Nursing Attendant / Midwife ___ 1.7. Medical Records Officer ___ 1.8. Medical Records Clerk Level 3 DOH Requirement ___ 1.9. Supply Officer LICENSING REQUIREMENTS FOR LEVEL 3 ___ 1.10. Storekeeper HOSPITAL SERVICE CAPABILITY ___ 1.11. Laundry Worker ___ 1. Administrative Service ___ 1.12. Utility Worker ___ 1.1. Personnel ___ 1.13. Security Guard ___ 1.2. Accounting ___ 1.14. Maintenance Personnel ___ 1.3. Budget and Finance ___ 1.15. Driver ___ 1.4. Medical Records ___ 1.16. Nutritionist / Dietitian ___ 1.5. Property and Supply ___ 1.17. Cook ___ 1.6. Housekeeping ___ 1.18. Food Service Supervisor ___ 1.7. Laundry and Linen ___ 1.19. Food Service Worker ___ 1.8. Maintenance ___ 1.20. Medical Social Worker ___ 1.9. Ambulance Service ___ 2. Clinical Service ___ 1.10. Security ___ 2.1. Chief of Clinics ___ 1.11. Dietary ___ 2.2. Department Head ___ 1.12. Social Service ___ 2.3. Physician ___ 2. Clinical Service ___ 2.4. Dentist ___ 2.1. Specialty Clinical Care ___ 2.5. Dental Aide ___ 2.1.1. Department of Medicine ___ 3. Nursing Service ___ 2.1.2. Department of Pediatrics ___ 3.1. Chief Nurse ___ 2.1.3. Department of Obstetrics and ___ 3.2. Supervising Nurse Gynecology ___ 3.2. Head Nurse ___ 2.1.4. Department of Surgery and ___ 3.3. Staff Nurse Anesthesia ___ 2.2. Critical Care ___ 2.2.1. Intensive Care ___ 2.2.2. Post Anesthesia Care ___ 2.2.3. Pathologic Premature Nursery ___ 2.3. Emergency Service ___ 2.4. Outpatient Service ___ 2.5. General Dentistry ___ 3. Nursing Service ___ 3.1. Intensive Care and Management ___ 3.2. Health Education and Counseling ___ 4. Ancillary Service ___ 4.1. Tertiary Clinical Laboratory ___ 4.2. Radiology 2nd Level ___ 4.3. Pharmacy LICENSING REQUIREMENTS FOR LEVEL 3 HOSPITAL PERSONNEL ___ 1. Administrative Service ___ 1.1. Chief of Hospital ___ 1.2. Administrative Officer ___ 1.3. Clerk (pool) ___ 1.4. Bookkeeper ___ 1.5. Billing Officer ___ 1.6. Cashier LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 Topic 5 Successfully recruit topnotch physicians MEDICAL STAFF ORGANIZATION Depend on the type of organization and the IDENTIFY type of services it renders. Level 1 Medical Interns Level 2 Resident Medical Officer REVIEW DECIDE Level 3 Medical Trainee Registrar Level 4 Consultant PLAN Level 5 Head of Department Level 6 Hospital Executive Officer TRENDS INFLUENCING THE MEDICAL STAFF ORGANIZATION MEDICAL STAFF CLASSIFICATION Predominance of independent physician Affiliate Staff – Board certified specialist practice usually given to graduates of their own Most physicians are independent of, institution. rather than integrated with hospitals Visiting Associate – Board certified not actively practicing in the institution. Decline in physician professional fees In most specialties, physicians’ Emeritus Staff – Who have rendered reimbursement in accordance with exemplary services to the institution such as professional fee schedules has stayed or distinguished educators, and renowned declined professional practitioners. Honorary Staff – Appointment is by invitation, Increase in physician practice expense is a distinguished physician locally and abroad. Malpractice expense, staff expenses, cost Active Staff – Board certified by specialty and of acquiring stocks, cost of privilege to willing to assume duties and responsibilities of practice their specialties. Associate Active Staff – Board certified by his Lingering effects of physician hospital specialty but has not completely met the misadventures requirements of active staff. Many physicians do not understand the legal obstacles to joint ventures CHARACTERISTICS OF A SUCCESSFUL MEDICAL Recruitment challenges STAFF ORGANIZATION Due to the increase in physician expenses, the best and the brightest doctors are Create value for the physician members and difficult to recruit the sponsoring hospital Provide incentives for active members Nursing shortage participation Nursing shortage as a leading cause of Pursue preferred partnership arrangements medical error with physician More nurse at the bedside could save Facilitate stable and thriving referral thousands of patients live each year relationship Be a formidable competitor for those with Service cooperation Hospitals are asking their medical staff to competitive interest assist with customers service initiatives Foster the patient/community’s perception of PhilHealth is asking hospital to provide the medical staff and healthcare organization patient satisfaction survey to give as a unified team opportunity for patients to be heard LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 become acquainted with physicians on a TECHNIQUES FOR EFFECTIVE WORKING more personal level RELATIONSHIP WITH THE MEDICAL STAFF Offer physicians a choice Improve hospital operation efficiency Don’t look at physicians as a homogenous Ancillary procedures and test scheduling group. They are a highly diverse group. Patient information, result reporting Abandon one-size-fits all approach Operating room performance, staffing Do a personalized relationship that fit the Wait time for urgent, emergency, non- interests and comfort level of all urgent categories of physicians: young or old, Clinical outcomes measures and results specialists and subspecialists Cost per case Build trust and enable evolution to more Develop a formal physician relationship substantial collaboration Can substantially increase in market share Many physicians will be more receptive to as a result of activating an organizational gradual or phased initiatives that allow process for seeking physician output and trust to be built addressing physician concerns. Monitor and communicate performance Represent collaboration between hospital against expectation and medical staff as a binding and long-term Dashboard indicators should be commitment developed and communicated such as: Physicians and hospitals need to adopt the physician loyalty, collection rate, days in perspective “we are in this together, for account receivables, volume of admission the long haul” Storms will be weathered and together we will find meaningful ways to collaborate that will be beneficial to ourselves and the community. Involve physicians in hospital leadership Physicians input should not be restricted to clinical care alone As partners in the healthcare delivery system, physician participation is crucial in strategic and financial decision making so that all parties understand the potential risks and rewards of future actions Demonstrate the value of any formal collaboration Can be expressed as direct financial contribution or return on investment Outcomes and other quality of care measures Patient satisfaction Net income, profit and market share Avoid meeting with physicians in the executive suite Visiting physicians in their own offices will demonstrate understanding the value of physicians’ time and show willingness to LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 Topic 6 Authority conferred: Staff of Line capacity COMMITTEES COMPOSITION It is a formal group with defined purposes and relationship with the organization Choose experts and capable members carefully It is a group of people who function collectively who can express and defend their views and by working together whether its purpose is to: see other party’s point of view Makes a decision when solution is reached Size large enough to allow group deliberation (Line capacity) Effective leadership qualities Makes and submits recommendations Ability to lead after analyzing and debating the problems Familiarity with techniques to guide at hand (Staff capacity) meeting Solve a problem Knows how to fuse individual perspective Conduct an investigation and attitudes CLASSIFICATION OF COMMITTEES Needs considerable skill, time and patience Standing Has a formal, permanent place in the ROLE OF THE CHAIR organization Temporary / Ad Hoc Bring about fulfillment of task Appointed for a particular short term and Build and maintain successful group interaction dissolve as it had accomplished its task Ask for volunteer to serve as recorder and time keeper MEETINGS Design standard format for capturing Informational discussions and decisions A meeting in which the leader presents Help members to reach their own decision and information and facts usually with limited to bring out their ideas discussion from other members Expresses his/her opinions last and open it to Discussion-al constructive criticism and suggestions A meeting in which the leader encourages other members to participate MEETING SET-UP Participants derive satisfaction from the knowledge that their ideas have been Regular timeslot when all members are considered available Set location that is convenient to all attendees Benefits Disadvantages Room set up should maximize participation Group of individuals often Time consuming (roundtable, semi-circular) comes up with a better answer AGENDA: than any one person thinking Group deliberation Loss of productive activities Chair outlines strategy and establish an Promotes coordination and 25% of average agenda cooperation business person List discussion topics in proper sequence Promotes continuity in the working hours organization 40% of middle Decide how long the meeting will last Forum for identification of managers Agenda distributed before the meeting potential leader 80% of executives GOOD MEETING THE EFFECTIVE COMMITTEE Always start and end on time Scope, Function and Authority Stimulate participation and give equal Should have a clear mandate opportunity for all to speak Subjects to be covered and expectations Accept everyone’s contribution without to be fulfilled judgement Job description Avoids simple yes or no questions LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 Closing statement to include specific One who can stimulate the members agreement (as to who, what, when, where and rather than brow beat them how) One who can help the group use all the abilities and experiences VOTING The committee chair will be responsible for Democratic way to make decisions preparing agendas for the meetings Accentuates differences among members Assigning responsibilities to committee members It is better not to take on a formal vote instead work towards a unanimous agreement Follow-up to make sure assigned work is being done by members ELEMENTS OF COMMITTEE EFFECTIVENESS 3. Members thoughtfully appointed 1. Written Committee Description Each standing committee is generally Written description of what is expected of composed of a core of five to eight each committee to guide the chair and members member They should be recruited with the following The description should summarize the question in mind: purpose of the committee, its composition What tasks are the committee and selection procedure, and the specific responsible for? duties of the committee Who among our members possess the skills and experience needed to 2. Effective Committee Chair complete those tasks? The committee chair should be a board Every effort should be made to match the director. This helps to assure that the needs and requirements of the committee leadership of the committee is "in sync" and the skills, knowledge and interests of with that of the board as a whole. prospective committee members Chair has content knowledge and experience relevant to the work of the 4. Accountability to the Board committee Clear accountability to the board of Proven leadership and people skills that will directors be essential if the committee is to work There should also be an effort to link the effectively committee description with relevant Dedication: chair requires extra work, time strategic plan language for communication with staff Willingness to resolve conflicts among 5. Well-run meetings members, and a commitment to keep the Provide an orientation for new committee board chair informed at all times members. Personal characteristics of an effective Make sure that committee members committee chair receive an agenda in advance of meetings Has confidence in other committee and have all of the information they will members need to complete their work. Wants to release the potential energy Provide regular and appropriate recognition of the group to active committee members Is willing to relinquish some of the The chair should also seek out unproductive chair’s formal authority if the job committee members to find out what is requires getting in a way of performance and then Is more interested in the committee's devising strategies to overcome those success than in his or her own feeling barriers. Is willing to work with people LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 Involve committee members in developing To act as patient advocate on bioethical an annual committee plan of work and issues. make sure that the committee plans are in Develop and recommend hospital and alignment with the overall strategic plan of other clinical policies and guidelines the organization that define ethical principles for conduct within the hospital. 6. Evaluating Committee Meetings The committee will provide advisory At the end of each committee meeting, the consultation and review in cases where chair can ask for written or oral comments ethical dilemmas are perceived by the about the session patient/patient's family. The physician/medical team, or other TYPES OF HEALTHCARE COMMITTEES hospital or clinic staff. The primary responsibility will be to encourage 1. Medical Executive Committee dialogue, educate, identify issues offer Typically composed of elected officers of viable options. the medical staff, the immediate past The committee will educate hospital president of the medical staff, the and clinic personnel, patients, and chairpersons of the various medical their families about hospital policies departments, and physicians on the Board regarding ethical issues. of Directors. The president of the hospital, vice president 3. Pharmacy and Therapeutics Committee of medical affairs, matron and director of Pharmacy and Therapeutics (P & T) quality care/assurance/utilization Committee is an important medical staff review/risk management. advisory group. As the primary, formal The duties of this committee usually communication link between the pharmacy include: and medical staff, the P & T Committee is of Accounting to the Board of Directors particular importance to the department of for patient/resident care. pharmacy services. Acting on reports and All matters of use of medications recommendations offered by other within the institution, including committees. pharmacy programs, must be reviewed Coordinating the activities of the and approved through the committee. medical staff. Medication formulary data is reviewed Making recommendations on medical through the committee and issues. recommendations are offered to the Recommending appointment, medical staff. reappointment, and corrective action An active involvement in the of medical staff. committee by the department of pharmacy services is vital in order to 2. Ethics Committee develop a contemporary and It is an advisory group appointed by the progressive institutional pharmacy University Hospital Medical Executive program. Board. It reviews, on request, ethical or moral questions that may come up during a 4. Infection Control Committee patient's care. Every healthcare facility uses Committee members include doctors, interdisciplinary task forces such as the nurses, social workers, an attorney, a Safety Committee and the Infection Control chaplain etc. Committee to minimize patient and Responsibilities of the Hospital Ethics employee risk. Committee LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 Representation may include: physicians, 4. Treatment of hospital waste nursing staff, infection control practitioners, 5. Safety measures quality assurance personnel, risk 6. Measures for waste minimization management personnel as well as representatives from microbiology, surgery, 7. Budget / Finance and Audit Committee central sterilization, environmental Typically composed of representatives from services, etc. the Board of Directors, chief executive The duties of this committee typically officer, chief financial officer, and various include: departmental directors. Monitoring equipment currently in The duties of this committee usually use. include: Evaluating new products being Monitoring the financial status of the considered or already ordered. health care facility. Providing information about Advising the Board of Directors equipment and products to involved concerning financial policies. employees. Reporting to the Board of Directors on the effectiveness of resource 5. Safety Committee / Employee Health allocations. Committee Typically composed of representatives from 8. Urgent Care the occupational health unit, safety The CMO should regularly participate in manager, human resources, and employees Advanced Cardiac Life Support and Advanced from the various departments. Trauma Life Support programs and disaster The duties of this committee usually drills conducted by the hospital from time to include: time. The hospital administration should have Developing and reviewing policies and a dedicated person to look after the casualty. procedures for safe and healthy work Nursing staff is the backbone of the casualty conditions for employees. and the department should have dedicated Developing and evaluating all safety nurses who may be rotated through the and health programs, including critical care areas of the hospital to improve implementation of the exposure their skills and response time, as the casualty control plan for bloodborne is also an acute care area, which caters to pathogens. critically ill patients. Establishing and implementing procedures for workplace safety 9. Tumor Board inspections. The Role of the Tumor Board in a Community Establishing procedures for & Objectives: investigating and recording all 1. To formulate integrated, coordinated workplace accidents, illnesses. and comprehensive hospital-wide polices on the management of patients 6. Hospital Waste Management with cancer in the hospital. Hospital acquired infection, transfusion 2. To monitor and continually improve transmitted diseases, rising incidence of the quality of care to patients with Hepatitis B, and HIV, increasing land and cancers. water pollution lead to increasing possibility 3. To conduct educational and training of catching many diseases. programs for concerned staff so as to This usually include: facilitate implementation of hospital 1. Segregation of waste policies on management of cancer 2. Collection of bio-medical waste patients. 3. Transportation LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 4. To promote research on oncology that 3. Checking the retrieval system of will continually improve the quality of department for easy and quick care for cancer patients. retrieval. Roles: 10. Blood Bank Committee To maintain records of hospital Need for Blood Bank To ensure completeness, be self- As a blood transfusion service deals regulating, to avoid any deficiencies with different functions related to and errors in future. donors and patients, it is imperative to keep in mind the safety both donors and recipients. The blood transfusion service has to be planned and organized in such a way that it fulfills its ideal aims and objectives i.e. 1. Recruitment of blood donors + voluntary & replacement 2. Care of donor, donated unit and the recipient 3. Maintain adequate blood stock 4. Provide clinically effective blood components 5. Optimal use of available blood 11. Information Systems Committee Typically composed of the director of information systems and representatives from the various committees and usually include: Evaluating and recommending clinical computer systems Providing training on clinical computer systems Responding to requests for assistance with computer applications. 12. Medical Record Committee In most of the hospitals, the quality review of the medical record is done by a medical record committee. Functions: 1. Reviewing the medical records for timely completion. Clinical relevance Adequacy of the file for use in quality review activities and medico-legal documents The whole course of treatment 2. Reviewing the security and integrity of Medical Record Committee