One of the most important goals for any manager is the ability to run their organization as efficiently and as effectively as possible. This means that all aspects of the organization need to operate in a manner that allows for the best outcomes to occur the first time, every time. For this to occur, it is critical for the manager to have a devoted, effective, and efficient workforce consisting of individuals who are properly trained and (most importantly) are happy with their job.
So, if we assume that efficiency and effectiveness is a byproduct of happiness, how can a manager at minimum ensure the happiness of their workforce? Often, compensation is considered amongst the most important aspects of worker happiness. However, it has been noted that compensation is not the most important determinant of worker happiness (Williams et al, 2007), it is actually one of many different units that determine worker happiness. Instead, to ensure the happiness of their workforce, manager should focus on a total benefits package (Balkin et al, 1993) that focuses on increasing the quality of life of the worker.
This understanding between the difference in compensation and quality of life is very difficult and almost impossible to compare. How do we measure a quantitative value (compensation) vs. a qualitative value (ie: quality of life) in the first place? Many human resources departments have taken it upon themselves to lean in one direction or another, often putting on emphasis on compensation or an emphasis on benefits. In many ways this is a positive for some workers, but is a negative for others. The reality is that benefits should not be viewed as a one size fits all. Rather, they should have the ability to change and be flexible enough to fit the needs and expectations of each individual worker. This is especially true at a time when private industry values flexibility, efficiency, and effectiveness above all aspects; why can't a benefits plan also mirror this belief?
Many benefits plan continue to offer outstanding pay scales, paid vacation, even wellness benefits all aimed at keeping the workforce content, thus leading to less turnover and greater worker efficiency/effectiveness. Though it is commendable that so many companies continue to strive to offer prospective employees a competitive benefits package that is both marketable and equitable, many still do not understand that "throwing money" at the problem will not cause it to go away. Instead, part of the recruitment process should be to gain further understanding of the individual to see what benefits actually are needed to fit their own life. This may help the organization to save money and provide evidence that it is willing and capable of adjusting to fit the needs of the individual. Such savings can even be passed on to the individual worker in the form of increased compensation (if provided they desire this) or even an increase in other benefits.
For an organization to survive and thrive will require further flexibility and adaption on the part of their benefits package. This ability to provide a better benefits package designed for the individual worker provides evidence that the organization is doing everything within its power to support the individual with their won goals and aspirations. This in turn can lead to greater worker happiness and result in a more efficient/effective workforce.
References:
1.)M.L. Williams, et al. 2007. Understanding Multiple Dimensions of Compensation Satisfaction. The Journal of Business and Psychology. V21:3, pp.429-459.
2.)D. B. Balkin, et al. 1993. The Determinants of Employee Benefits Satisfaction. The Journal of Business and Psychology. V7:3, pp. 323-339.
Monday, November 29, 2010
Wednesday, October 20, 2010
Can I Work for Free?
Now more then ever and internship has become one of the, if not the most important step any undergraduate or graduate student can take. Though many graduate students naturally work hard and do well in school, an internship can provide you with real world experience, networking opportunities, and exposure to important individuals. However, it also seems that now more then ever it is nearly impossible to work for free. This seems like a difficult issue to understand, but when you examine it more closely it (unfortunately) makes a great deal of sense.
The first hurdle an intern has to overcome is the stereotype of being unreliable and immature. Considering that many internships pay very little (or not at all) it would not be unusual for an intern to simply quit without giving any sort of prior notice. This is especially true if this same intern is lucky enough to be hired at another position within a full time capacity. To put it mildly, they would be fools not to leave this position as quickly as possible. However, how did this intern have the ability to be hired in the first place? Simple, they gained experience from their internship. This logic will eventually lead any Human Resource personnel to believe that in an intern-employer relationship the intern has everything to gain and the employer everything to lose.
The second hurdle an intern has to overcome is the reluctance of many employers to hire interns without pay in the first place. This practice is technically illegal because under federal law an employer cannot compensate an individual who is producing anything for them. In some circles this is considered almost a form of professional slavery. This means that, for example, a railroad intern can drive the engine all over as long as it's not pulling anything. This means that an intern cannot help pitch a new idea to a potential client or look for ways to save money within the budget. In many ways this law simply creates a more competitive atmosphere for interns. Now that they are paid employees (albeit not well paid) of an organization, it is considered that interns will produce for a company rather then learn from it. This in some ways is beneficial to both the intern and the employer, but can also be a very negative experience for the intern and employer. This is particularly troublesome considering that an intern is supposed to "learn" not "do" while they intern. To make this problem even worse, many employers have completely frozen or terminated any internships program to save money and avoid prosecution.
It seem ridiculous that a company would not want to hire (even at minimum wage) an individual who is obviously well qualified and willing to work hard for some exposure. Particularly in this current economic environment its hard to imagine why so many employers are not looking for new ideas to propel their organizations into the future. However, even with all these hurdles internships are still available and some can have very beneficial outcomes for both the intern and the employer. For example, many schools offer internships through their own relationships with business and community partnerships. More and more employers have begun to provide interns with "intern contracts" that morally and ethically "bind" the intern from any behavior that may be disruptive to the organization. Though such documents are not legal, it is highly frowned upon by professionals to go against your own word. There are also small businesses and start ups that are willing to gamble on the inexperience of a student for the possibility of finding the newest, freshest ideas within their respective industry. Though it may not be impossible to find an internship, it is incredibly hard to work for free.
The first hurdle an intern has to overcome is the stereotype of being unreliable and immature. Considering that many internships pay very little (or not at all) it would not be unusual for an intern to simply quit without giving any sort of prior notice. This is especially true if this same intern is lucky enough to be hired at another position within a full time capacity. To put it mildly, they would be fools not to leave this position as quickly as possible. However, how did this intern have the ability to be hired in the first place? Simple, they gained experience from their internship. This logic will eventually lead any Human Resource personnel to believe that in an intern-employer relationship the intern has everything to gain and the employer everything to lose.
The second hurdle an intern has to overcome is the reluctance of many employers to hire interns without pay in the first place. This practice is technically illegal because under federal law an employer cannot compensate an individual who is producing anything for them. In some circles this is considered almost a form of professional slavery. This means that, for example, a railroad intern can drive the engine all over as long as it's not pulling anything. This means that an intern cannot help pitch a new idea to a potential client or look for ways to save money within the budget. In many ways this law simply creates a more competitive atmosphere for interns. Now that they are paid employees (albeit not well paid) of an organization, it is considered that interns will produce for a company rather then learn from it. This in some ways is beneficial to both the intern and the employer, but can also be a very negative experience for the intern and employer. This is particularly troublesome considering that an intern is supposed to "learn" not "do" while they intern. To make this problem even worse, many employers have completely frozen or terminated any internships program to save money and avoid prosecution.
It seem ridiculous that a company would not want to hire (even at minimum wage) an individual who is obviously well qualified and willing to work hard for some exposure. Particularly in this current economic environment its hard to imagine why so many employers are not looking for new ideas to propel their organizations into the future. However, even with all these hurdles internships are still available and some can have very beneficial outcomes for both the intern and the employer. For example, many schools offer internships through their own relationships with business and community partnerships. More and more employers have begun to provide interns with "intern contracts" that morally and ethically "bind" the intern from any behavior that may be disruptive to the organization. Though such documents are not legal, it is highly frowned upon by professionals to go against your own word. There are also small businesses and start ups that are willing to gamble on the inexperience of a student for the possibility of finding the newest, freshest ideas within their respective industry. Though it may not be impossible to find an internship, it is incredibly hard to work for free.
Sunday, September 26, 2010
Outsourcing Patient Care
As the recession continues to drive businesses to adapt and innovate, many organizations have found it much more cost effective to outsource what were once considered "in-house only" services. These sentiments are also being felt throughout the healthcare industry as new healthcare reform laws begin to take affect. However, while the current recession plays a significant role in the outsourcing of individual positions within the healthcare industry the main reason for this rise in outsourcing is not financial, rather it has to do with the availability of qualified professionals to fill these roles. Even more interesting is that the majority of these outsourced jobs pay as much (even more) then a typical U.S. based position. These factors combined with the ability of foreign professionals to be trained, educated, and licensed in the U.S., it isn't a mystery why so many positions are being filled by others outside of the U.S.
Take for example an Altoona, PA hospital. Only a few years ago, the number of nigh time cases in need of interpretation by a radiologist got so bad, the seven on staff members had to consistently work 60+ hours per week just to cover all the work. All this changed when the hospital began to outsource their work to a small Bangalore, India firm called Teleradiology Solutions. This firm is operated and owned by Dr. Arjun Kalyanpur, who happens to be educated at Yale University and licensed in the U.S.
It's extremely perplexing to find an industry that is not outsourcing due mainly for financial reasons, but rather mainly due to a severe shortage of professionals within its own borders. How did this "telemedicine" trend begin? Many researchers point to the sharply rising demand for IT professionals to tackle the Y2K "bug" of the late 1990's. This demand led to many foreign students (particularly from India) to migrate to the U.S. for education and training. This trend became such the norm, that US officials often joked that "President Bush had sacked the elected members of Congress and was replacing them with staff hired in Bangalore" (Chithelen, 2004).
So what is an HR department to do? On one hand you have very qualified, American trained/educated/licensed and English speaking professionals ready and capable of working when everyone else is sleeping. On the other hand, you still need to pay them just as much (considering the need, possibly even more), you need to educate yourself with foreign laws, and deal with the possibility of high turnover (over 50% in service sector jobs outsourced to India). These problems coupled with recession, and the incredible need from Americans to find skilled, well paying positions it can only give you a glimpse of the massive problem this recession has created.
While the rest of the world was willing to work hard, sacrifice, and become better trained, American workers simply lacked the understanding to make more savvy career moves and HR administrators could not for see the future needs of the industry. However, even with this problem the reality is that the need is still needed. This need creates the oppurtunity for the American worker to receive the same kind of training and (considering their relative vicinity)more then likely receive preferential treatment when filling these positions. Even in the midst of the "Great Recession" there is still oppurtunity and hope left; all that HR administrators can do is hope that others see this as well.
References:
1.) Outsourcing to India: Causes, Reactions, and Prospects. Chithelen, Ignatius. Economic and Political Weekly. 39:10 (2004), pp. 1022-1024.
Source:
Some U.S. Hospitals Outsourcing Work: Shortage of Radiologists spur Growing Telemedicine Trend. msnbc.msn.com/id/6621014
Take for example an Altoona, PA hospital. Only a few years ago, the number of nigh time cases in need of interpretation by a radiologist got so bad, the seven on staff members had to consistently work 60+ hours per week just to cover all the work. All this changed when the hospital began to outsource their work to a small Bangalore, India firm called Teleradiology Solutions. This firm is operated and owned by Dr. Arjun Kalyanpur, who happens to be educated at Yale University and licensed in the U.S.
It's extremely perplexing to find an industry that is not outsourcing due mainly for financial reasons, but rather mainly due to a severe shortage of professionals within its own borders. How did this "telemedicine" trend begin? Many researchers point to the sharply rising demand for IT professionals to tackle the Y2K "bug" of the late 1990's. This demand led to many foreign students (particularly from India) to migrate to the U.S. for education and training. This trend became such the norm, that US officials often joked that "President Bush had sacked the elected members of Congress and was replacing them with staff hired in Bangalore" (Chithelen, 2004).
So what is an HR department to do? On one hand you have very qualified, American trained/educated/licensed and English speaking professionals ready and capable of working when everyone else is sleeping. On the other hand, you still need to pay them just as much (considering the need, possibly even more), you need to educate yourself with foreign laws, and deal with the possibility of high turnover (over 50% in service sector jobs outsourced to India). These problems coupled with recession, and the incredible need from Americans to find skilled, well paying positions it can only give you a glimpse of the massive problem this recession has created.
While the rest of the world was willing to work hard, sacrifice, and become better trained, American workers simply lacked the understanding to make more savvy career moves and HR administrators could not for see the future needs of the industry. However, even with this problem the reality is that the need is still needed. This need creates the oppurtunity for the American worker to receive the same kind of training and (considering their relative vicinity)more then likely receive preferential treatment when filling these positions. Even in the midst of the "Great Recession" there is still oppurtunity and hope left; all that HR administrators can do is hope that others see this as well.
References:
1.) Outsourcing to India: Causes, Reactions, and Prospects. Chithelen, Ignatius. Economic and Political Weekly. 39:10 (2004), pp. 1022-1024.
Source:
Some U.S. Hospitals Outsourcing Work: Shortage of Radiologists spur Growing Telemedicine Trend. msnbc.msn.com/id/6621014
Monday, August 30, 2010
What does Human Resources mean to you and what is their role in healthcare organizations?
For many individuals, the word "Human Resources" (HR) can bring up a caveat of emotions. Often a call from HR means bad news for the individual, often leading to a demotion or an outright "letting go" of the individual. However, HR should not be viewed as some kind of grim reaper in khaki pants. Instead, the role of HR in healthcare should be viewed as a department that helps to mold and build the most successful, efficient, and stable/comfortable work environment for the most qualified individuals available. If HR does their job well there should be no reason to "fire" or let go of any individual, set aside economic conditions.
Assuming the the job of HR within a healthcare organization is to accomplish the statements above, what is needed for HR to be successful in this endeavor? First and foremost, HR must understand what motivates and drives individuals to work their best. Are they influenced by compensation, work environment, incentive packages, or some sort of combination? Though it is critical for HR to maintain their traditional activities (payroll, benefits, etc.) they must also focus on the "environmental and organizational aspects that impinge on human resource activities" (Fottler, 2008). This means that HR must also focus on strategic human resources management (SHRM) to fill in the "doughnut hole" left by classic human resource management (HRM) activities. More specifically, they should focus on:
1. recruitment/selection
2. training/development
3. employee relations
It is important to note that while compensation is important, it is generally not the most important factor when an individual chooses to become part of an organization. Many researchers even consider the environment as a supplement to compensaiton in general. This understanding is based on research that determines "employees who feel and display positive emotion on the job, will experience positive outcomes in their work role" (Morgeson et al, 2001). This means if HR focuses on:
1. recruiting and hiring the "right" people,
2. continually training and developing these individuals, and
3. continually keeping communication clear and concise between employees and management..
compensation should be a very minimal aspect of their roles. In fact, a focus on compensation can actually be used in a negative way. For example, it can become a tool used by management to demand or assume employee loyality to an organization. Instead, this tool can often lead inviduals to feel "like a number" rather then an individual and create a high turnover rate., decreasing overall quality in many ways. Though high compensation can initially draw the best talent to an organization, this focus often results in high employee turnover before their impact (and the investment made by the organization) can come to fruitition. This often leads to a host of problems that decrease overall quality such as lost revenue and a decrease of employee morale.
However, by maintaining a focus on environment, it is my opinion that HR can continually maintain an organization that fosters stability, personal development, a feeling of control of destiny, and (most importantly) delivers quality healthcare within all operations. Though the classic day-to-day operations of HR should also be maintained, HR should be willing and able to give employees the tools to succeed and the ability to truly control their own destiny within the organization. For these reasons, HR's overall role within a healthcare organization is the "front-line" of the organization's Continuous Quality Management (CQM) model.
Sources:
1. Strategic Human Resource Management. Fotter PhD, Myron D. Human Resources in Healthcare: Managing for Success. Chapter 1, (2008) pp. 1-27
2. Understanding Pay Satisfaction: The Limits of a Compensation System Implementation. Morgeson, Frederick P., Campion, Michael A., Maertz, Carl P. Journal of Business and Psychology. Vol. 16, No. 1 (Sep., 2001), pp. 133-149
Assuming the the job of HR within a healthcare organization is to accomplish the statements above, what is needed for HR to be successful in this endeavor? First and foremost, HR must understand what motivates and drives individuals to work their best. Are they influenced by compensation, work environment, incentive packages, or some sort of combination? Though it is critical for HR to maintain their traditional activities (payroll, benefits, etc.) they must also focus on the "environmental and organizational aspects that impinge on human resource activities" (Fottler, 2008). This means that HR must also focus on strategic human resources management (SHRM) to fill in the "doughnut hole" left by classic human resource management (HRM) activities. More specifically, they should focus on:
1. recruitment/selection
2. training/development
3. employee relations
It is important to note that while compensation is important, it is generally not the most important factor when an individual chooses to become part of an organization. Many researchers even consider the environment as a supplement to compensaiton in general. This understanding is based on research that determines "employees who feel and display positive emotion on the job, will experience positive outcomes in their work role" (Morgeson et al, 2001). This means if HR focuses on:
1. recruiting and hiring the "right" people,
2. continually training and developing these individuals, and
3. continually keeping communication clear and concise between employees and management..
compensation should be a very minimal aspect of their roles. In fact, a focus on compensation can actually be used in a negative way. For example, it can become a tool used by management to demand or assume employee loyality to an organization. Instead, this tool can often lead inviduals to feel "like a number" rather then an individual and create a high turnover rate., decreasing overall quality in many ways. Though high compensation can initially draw the best talent to an organization, this focus often results in high employee turnover before their impact (and the investment made by the organization) can come to fruitition. This often leads to a host of problems that decrease overall quality such as lost revenue and a decrease of employee morale.
However, by maintaining a focus on environment, it is my opinion that HR can continually maintain an organization that fosters stability, personal development, a feeling of control of destiny, and (most importantly) delivers quality healthcare within all operations. Though the classic day-to-day operations of HR should also be maintained, HR should be willing and able to give employees the tools to succeed and the ability to truly control their own destiny within the organization. For these reasons, HR's overall role within a healthcare organization is the "front-line" of the organization's Continuous Quality Management (CQM) model.
Sources:
1. Strategic Human Resource Management. Fotter PhD, Myron D. Human Resources in Healthcare: Managing for Success. Chapter 1, (2008) pp. 1-27
2. Understanding Pay Satisfaction: The Limits of a Compensation System Implementation. Morgeson, Frederick P., Campion, Michael A., Maertz, Carl P. Journal of Business and Psychology. Vol. 16, No. 1 (Sep., 2001), pp. 133-149
Monday, July 19, 2010
Doctor....what are you REALLY thinking?
Throughout the process of becoming a better healthcare manager and a supporter of better quality, I have come across again and again the need for implementation of Evidence Based Practices or EBP. Basically, EBP is "the integration of best evidence with clinical expertise, path physiologic knowledge, and patient references in decision making about individual patients" (Schumacher et al, 2003). To put it simple, EBP uses the latest technology integrated with the best available professional expertise while maintaining the patient's wishes. In a way it sounds like healthcare quality juggling. EBP is only a small part of what is called a Continuous Quality Improvement (CQI) which is the mainstay of any quality improvement of maintenance program within a healthcare organization or facility. This is essentially the understanding the quality is continually improving and adapting and as healthcare managers we must improve and adapt with it or doomed to see our organization fail miserably.
As more and more healthcare organizations begin to implement their own CQI projects and integrate EBP (as its use is rather new in the field) we must focus on what we are doing well and what we are doing not so well. First the good news. Our healthcare professionals are amongst the best and arguably the best qualified and trained individuals in the world. Their training and education is the best possible when compared to other industrialized nations. Secondly, there is absolutely, 100% no doubt that the U.S. healthcare system in general does a fantastic job of maintaining a high quality of healthcare treatments, research, equipment, and pharmaceuticals. So good of a job, in fact, that we have begun to overspend and over focus on our scientific strengths leading into inefficient use of this incredible technology. This leads us to what we do not do so well, the doctor/patient relationship. In our efforts to treat every human being the same way we treat cars, we have somehow forgotten that these patients are individuals who have the right to know what is going on and to request different avenues of treatment. This is a direct product of overworked physicians who view their opinion and desires almost as the "law". Instead of the physician viewing their job as simply keeping a person alive, physicians must begin to understand that even though their expertise may lead to the most favorable outcome, in the end the patient has to deal with both the good or bad consequences.
This "fragmenting" of the doctor/patient relationship has not always been the weak link in our continued use of EBP. At one point in our not so far of history we were forever linked to a doctor from birth to death. This individuals became a trusted and respected part of our family, sometimes even showing up to our backyard BBQ's and family events (I have the pictures to prove it). However, due to the constant migration of families, the disappearing of the traditional nuclear family, and the ever increasing strains of healthcare costs, we have begun to see a trend of individuals going through a variety of primary care physicians. This leads to little if any communication between the physician and the patient allowing for an environment of mistrust and at times hostility. So what is a healthcare manager to do?
There are a variety of ways we can begun to "reconnect" physicians with patients. Maybe teleconferencing can replace house visits, or maybe the physician can begin making patients "follow" their own blog. These all are good ideas, however they are not very practical and can even be somewhat expensive. Why not think simply, quick, efficient, and (most of all) cheap? Rather then create another hurdle for communication why not simply open up and share all the information available? Recently a study called the OpenNotes Project is looking at what happens when a doctor's notes becomes available for a patient to read. This simple yet very effective technique has proven to "improve patient understanding of their health and get them to stick to their treatment regimens more closely" (Landro, 2010). This incredible show of trust by physicians has also led to improving the doctor/patient and decreasing any hostility or mistrust a patient may have. This has often lead to better treatments, happier physicians and patients, and improved healthcare quality. However, the news isn't always sunshine and lollipops. Researchers have also found that patients may panic if the see words such as cancer or heart disease and doctors fear that patients simply may not understand what their notes are saying.
Though we still have many hurdles ahead to improve the doctor/patient relationship, such simply strategies have improved overall healthcare quality by stressing one very important factor: trust. This project has begun to take notice by many healthcare providers, chief amongst them Kaiser Permanente who may begin to publish doctors' notes on the Internet for their patients' viewing. It's incredible how such a small step can improve quality. Though I do not question the importance of such a program I do have one simple question: What to do about the terrible handwriting so many physicians have?
1. JHQ - 130 A Model Structure for an EBM Program. Schumacher, Dale N., Stock, Joseph R., Richards, K., and Joan, K. (July/August 2003). Retrieved June 18, 2010 from: webcourses.ucf.edu/webct/urw/lc4130001.tp0/cobaltMainFrame/dowebct
2. What Doctors Really Think. Landro, Laura (July 2010). The Wall Street Journal. Retrieved July 19, 2010 from: online.wsj.com
As more and more healthcare organizations begin to implement their own CQI projects and integrate EBP (as its use is rather new in the field) we must focus on what we are doing well and what we are doing not so well. First the good news. Our healthcare professionals are amongst the best and arguably the best qualified and trained individuals in the world. Their training and education is the best possible when compared to other industrialized nations. Secondly, there is absolutely, 100% no doubt that the U.S. healthcare system in general does a fantastic job of maintaining a high quality of healthcare treatments, research, equipment, and pharmaceuticals. So good of a job, in fact, that we have begun to overspend and over focus on our scientific strengths leading into inefficient use of this incredible technology. This leads us to what we do not do so well, the doctor/patient relationship. In our efforts to treat every human being the same way we treat cars, we have somehow forgotten that these patients are individuals who have the right to know what is going on and to request different avenues of treatment. This is a direct product of overworked physicians who view their opinion and desires almost as the "law". Instead of the physician viewing their job as simply keeping a person alive, physicians must begin to understand that even though their expertise may lead to the most favorable outcome, in the end the patient has to deal with both the good or bad consequences.
This "fragmenting" of the doctor/patient relationship has not always been the weak link in our continued use of EBP. At one point in our not so far of history we were forever linked to a doctor from birth to death. This individuals became a trusted and respected part of our family, sometimes even showing up to our backyard BBQ's and family events (I have the pictures to prove it). However, due to the constant migration of families, the disappearing of the traditional nuclear family, and the ever increasing strains of healthcare costs, we have begun to see a trend of individuals going through a variety of primary care physicians. This leads to little if any communication between the physician and the patient allowing for an environment of mistrust and at times hostility. So what is a healthcare manager to do?
There are a variety of ways we can begun to "reconnect" physicians with patients. Maybe teleconferencing can replace house visits, or maybe the physician can begin making patients "follow" their own blog. These all are good ideas, however they are not very practical and can even be somewhat expensive. Why not think simply, quick, efficient, and (most of all) cheap? Rather then create another hurdle for communication why not simply open up and share all the information available? Recently a study called the OpenNotes Project is looking at what happens when a doctor's notes becomes available for a patient to read. This simple yet very effective technique has proven to "improve patient understanding of their health and get them to stick to their treatment regimens more closely" (Landro, 2010). This incredible show of trust by physicians has also led to improving the doctor/patient and decreasing any hostility or mistrust a patient may have. This has often lead to better treatments, happier physicians and patients, and improved healthcare quality. However, the news isn't always sunshine and lollipops. Researchers have also found that patients may panic if the see words such as cancer or heart disease and doctors fear that patients simply may not understand what their notes are saying.
Though we still have many hurdles ahead to improve the doctor/patient relationship, such simply strategies have improved overall healthcare quality by stressing one very important factor: trust. This project has begun to take notice by many healthcare providers, chief amongst them Kaiser Permanente who may begin to publish doctors' notes on the Internet for their patients' viewing. It's incredible how such a small step can improve quality. Though I do not question the importance of such a program I do have one simple question: What to do about the terrible handwriting so many physicians have?
1. JHQ - 130 A Model Structure for an EBM Program. Schumacher, Dale N., Stock, Joseph R., Richards, K., and Joan, K. (July/August 2003). Retrieved June 18, 2010 from: webcourses.ucf.edu/webct/urw/lc4130001.tp0/cobaltMainFrame/dowebct
2. What Doctors Really Think. Landro, Laura (July 2010). The Wall Street Journal. Retrieved July 19, 2010 from: online.wsj.com
Monday, June 21, 2010
The customer is ALWAYS right!
The health care industry is a very peculiar thing. It is part corporation and humanitarian organization. After all, the major goal of any health care organization is to maintain and improve the quality of health care available to its patients/customers and the community in general. This means that the health care industry must be mindful of providing the best "product" available while maintaining strict financial guidelines. Such challenges are unique and only seen by the health care industry as their actions directly affect the quality of human life. This is made even more difficult because humans tend to have varying opinions regarding the same situation. Cultural, financial, ethical, and moral beliefs always come into play when an individual gives their own personal opinion about an organization or process they have been affected by. To put it lightly the same exact event may happen to 10 similar individuals, but these same individuals may have 10 very different opinions.
As health care professionals we must understand that quality improvement is directly linked to an individual's perception of our "product". While others may believe we have delivered a "quality product" the stark reality is that there will always be someone who translates this product to an adverse event in their life. This means that as health care professionals we have to strive to treat the entire community while paying attention to the individual for one reason:
-The community is made up of individuals.
For health care quality to continue to grow, we must begin to diversify our understanding of health care delivery and realize that one type of plan, process, or technique simply will not suffice for every individual. Instead, our health care system needs to concentrate on treating the whole individual and having them take part in their own health care. For this to occur the patient must pay attention to the physical and psychological aspects of their health, physicians must listen more intently to the all the needs of the patient, administrators must find ways to allow physicians to accomplish their work to the best of their ability, and policy makers must understand that health care is a personal choice, not a community decision.
Quality is a perception of the individual and as a result we must treat the entire individual. If we do not, we most certainly can expect the community to flounder.
As health care professionals we must understand that quality improvement is directly linked to an individual's perception of our "product". While others may believe we have delivered a "quality product" the stark reality is that there will always be someone who translates this product to an adverse event in their life. This means that as health care professionals we have to strive to treat the entire community while paying attention to the individual for one reason:
-The community is made up of individuals.
For health care quality to continue to grow, we must begin to diversify our understanding of health care delivery and realize that one type of plan, process, or technique simply will not suffice for every individual. Instead, our health care system needs to concentrate on treating the whole individual and having them take part in their own health care. For this to occur the patient must pay attention to the physical and psychological aspects of their health, physicians must listen more intently to the all the needs of the patient, administrators must find ways to allow physicians to accomplish their work to the best of their ability, and policy makers must understand that health care is a personal choice, not a community decision.
Quality is a perception of the individual and as a result we must treat the entire individual. If we do not, we most certainly can expect the community to flounder.
Sunday, June 6, 2010
The Direct Link between Team Building and Health Care Quality
If you have ever experienced at minimum one work day you have probably heard over and over again the concept of you and your co-workers being a "team". This may be an admirable (or not so admirable) attempt by your Human Resources (HR) department to build some kind of comradery within the ranks. Unfortunatley, no matter how admirable their attempt, the concept of being a "team" is no more then a slogan on the wall or some printed words on recruitment materials to make their organization look progressive or employee friendly. The unfortunate reality is that HR simply does not want to deal with your bickering and would rather you and your fellow "team" members deal with as many issues as you can amongst yourselves so that they can go back to their real functions, ie: keeping a close eye on all of you!
As you already may know, the "team" concept is not new. This concept is used in all sorts of professional settings with varying degrees of success and failure. However, the concept of a "team" is one that is crucial to the consistent improvement and maintainence of quality within the health care industry. Make no mistake, health care staff and professionals must operate as a team at all times, not doing so allows for costly errors that lead to many negative occurrences which ultimately lead to the detriment to the quality of life for people and communities and on occasion sometimes even lead to the loss of life. It is no wonder that team building is such an important concept within the health care industry and one that all health care administrators, professional staff, nurses, physicians, and allied health staff are extremely serious about. Being a "team" is much more than a simple slogan on a wall or some creative print in a recruitment pamphlet, it is must be considered crucial to the delivery of health care services.
Time and time again, research has proven that "team building can increase efficiency and productivity" (Antai-Otong, 1997). So what exactly is a team? The concept of "team" is often mistaken with the concept of a "work group". Though they share many similarities one stark and very significant difference between the two is that a team shares the blame for their mistakes while the work group is prone to blaming an individual or individuals. This means that the team must work together, often helping each other out, to accomplish a single goal. For this to occur, we must move away from building work groups to building teams, but how can we accomplish this?
One crucial step in team building must be the realization by the administration, staff, and support staff that it can take quite some time to build a team. This period of time can be months or years. However, no matter how long it takes, a commitment must be made by all members of the "team" to see the process through. Abandoning or quitting during the process will lead to even greater obstacles then before the process even began! For a successful team to evolve we must have four essential qualities:
1. Open and effective communication
2. Member involvement and member ownership
3. Clearly defined goals
4. Trust
It must be noted that trust cannot be created, in fact, trust is essentially a byproduct of the first three qualities successfully being implemented. In many ways, the first three qualities are only a part of the process that eventually leads to the ultimate goal of team building: trust. Once trust has been accomplished, team efficiency, productivity, and quality seem to have unlimited boundaries. In many ways team building is an exercise in achieving trust, which ultimately allows teams to operate their most efficient levels while maintaining high levels of quality work.
Considering how much of a significant affect team building can have on quality and productivity, it's hard to imagine why every single organization does not find a way to incorporate team building into the development of their staff. Unfortunately, many organizations simply do not have the resources or the need to build teams and simply resort to "pretending" to believe in team building. Other obstacles such as workload and/or staff turnover are simply too great to establish any sort of a team environment within an organization.
Though the challanges are great, many organizations have overcome them through perserverance, leadership, and consistency. One of the best examples of organizations overcoming such adversities exists within professinal sports. In an era where team rosters can literally change from year to year, many professional sports teams have been able to maintain a level of excellence unparalled by other clubs. This is not accomplished by attracting the greatest talent, best educated, or even the best skilled individuals. It is accomplished by two simple goals:
1. Consistent leadership within key positions
2. Attracting individuals who "buy into" the system
A team building program cannot exist without certain key leaders throughout the entire process. This consitent leadership is not necesserily composed of those who lead the process of team building, but instead are "keepers of the flame" whom have gained the respect and loyalty of the organization. These individuals must be retained to safeguard the "culture" of the agency, which in turn determines how the team building process will take place. This "culture" must be nurtured and maintained at all costs.
As you can see, team building is not an easy 1-2-3 process, instead it is an ongoing process that is being constantly repeated and improved throughout the team building process and the lifetime of the organization. Graphically, team building can be categorized by the following:
Consistent Leadership --> Recruiting people to "buy into" the system ---> Commitment by all team members to "see the process through"--> Incorporating the 4 essential qualities of Team Buildng--> TEAM
Though team building is a difficult and laborious task, it has been proven to improve both quality and efficiency. The concept of team building will be a crucial step in the evolution and improvement of health care delivery services in the United States now and in the future.
Works Cited:
Antai-Otong, Deborah (1997). Team Building in a Health Care Setting. The American Journal of Nursing. 1997, 7, pp. 48-51.
Retrieved June 6, 2010 from: http://www.jstor.org/stable/3465461
As you already may know, the "team" concept is not new. This concept is used in all sorts of professional settings with varying degrees of success and failure. However, the concept of a "team" is one that is crucial to the consistent improvement and maintainence of quality within the health care industry. Make no mistake, health care staff and professionals must operate as a team at all times, not doing so allows for costly errors that lead to many negative occurrences which ultimately lead to the detriment to the quality of life for people and communities and on occasion sometimes even lead to the loss of life. It is no wonder that team building is such an important concept within the health care industry and one that all health care administrators, professional staff, nurses, physicians, and allied health staff are extremely serious about. Being a "team" is much more than a simple slogan on a wall or some creative print in a recruitment pamphlet, it is must be considered crucial to the delivery of health care services.
Time and time again, research has proven that "team building can increase efficiency and productivity" (Antai-Otong, 1997). So what exactly is a team? The concept of "team" is often mistaken with the concept of a "work group". Though they share many similarities one stark and very significant difference between the two is that a team shares the blame for their mistakes while the work group is prone to blaming an individual or individuals. This means that the team must work together, often helping each other out, to accomplish a single goal. For this to occur, we must move away from building work groups to building teams, but how can we accomplish this?
One crucial step in team building must be the realization by the administration, staff, and support staff that it can take quite some time to build a team. This period of time can be months or years. However, no matter how long it takes, a commitment must be made by all members of the "team" to see the process through. Abandoning or quitting during the process will lead to even greater obstacles then before the process even began! For a successful team to evolve we must have four essential qualities:
1. Open and effective communication
2. Member involvement and member ownership
3. Clearly defined goals
4. Trust
It must be noted that trust cannot be created, in fact, trust is essentially a byproduct of the first three qualities successfully being implemented. In many ways, the first three qualities are only a part of the process that eventually leads to the ultimate goal of team building: trust. Once trust has been accomplished, team efficiency, productivity, and quality seem to have unlimited boundaries. In many ways team building is an exercise in achieving trust, which ultimately allows teams to operate their most efficient levels while maintaining high levels of quality work.
Considering how much of a significant affect team building can have on quality and productivity, it's hard to imagine why every single organization does not find a way to incorporate team building into the development of their staff. Unfortunately, many organizations simply do not have the resources or the need to build teams and simply resort to "pretending" to believe in team building. Other obstacles such as workload and/or staff turnover are simply too great to establish any sort of a team environment within an organization.
Though the challanges are great, many organizations have overcome them through perserverance, leadership, and consistency. One of the best examples of organizations overcoming such adversities exists within professinal sports. In an era where team rosters can literally change from year to year, many professional sports teams have been able to maintain a level of excellence unparalled by other clubs. This is not accomplished by attracting the greatest talent, best educated, or even the best skilled individuals. It is accomplished by two simple goals:
1. Consistent leadership within key positions
2. Attracting individuals who "buy into" the system
A team building program cannot exist without certain key leaders throughout the entire process. This consitent leadership is not necesserily composed of those who lead the process of team building, but instead are "keepers of the flame" whom have gained the respect and loyalty of the organization. These individuals must be retained to safeguard the "culture" of the agency, which in turn determines how the team building process will take place. This "culture" must be nurtured and maintained at all costs.
As you can see, team building is not an easy 1-2-3 process, instead it is an ongoing process that is being constantly repeated and improved throughout the team building process and the lifetime of the organization. Graphically, team building can be categorized by the following:
Consistent Leadership --> Recruiting people to "buy into" the system ---> Commitment by all team members to "see the process through"--> Incorporating the 4 essential qualities of Team Buildng--> TEAM
Though team building is a difficult and laborious task, it has been proven to improve both quality and efficiency. The concept of team building will be a crucial step in the evolution and improvement of health care delivery services in the United States now and in the future.
Works Cited:
Antai-Otong, Deborah (1997). Team Building in a Health Care Setting. The American Journal of Nursing. 1997, 7, pp. 48-51.
Retrieved June 6, 2010 from: http://www.jstor.org/stable/3465461
Friday, May 21, 2010
What, exactly, is Quality Health Care?
How do we measure quality within a health care system? Is it measured by greater access, lower cost, a combination of both, or none of the above? Is it even possible or responsible for us to use quantitative measures to make a qualitative assessment? It's not rare for researchers, companies, and/or individuals to convert qualitative assessments into quantitative measurements for the purpose of comparison. This technique has been the general "measuring stick" when comparing two different systems, groups, etc. to find what, how, or if changes need to be made or even if there is a need to start from the beginning all together. Though quantitative measures have been used in the past to compare general qualitative aspects of our lives, it is possible that the measure of "health care quality" cannot be measured with such general quantitative measures?
By its very nature health care quality is a (surprise!) qualitative value. This means that health care quality is a perception or opinion of the individual making the measurement. However, we simple cannot rely on qualitative values when we asses a health care system, so what are we to do? The biggest stumbling block is creating a clear definition and measurement tool for "quality" within a health care system.
The World Health Organization (WHO) measures quality as a "by product of access and cost". This means that a cheap and highly accessible health care system would be considered "quality" by the WHO standard. This, unfortunately, is the WORST definition of quality I have ever heard. There is no mention of outcomes or improvements to the individual or community and the WHO relies heavily on the individual to strictly follow doctors orders and receive scheduled check ups no matter what. This measurement seems to not take into account the massive amounts of variables life seems to continually throw at us on a daily basis. What about environmental, social, and education aspects of each community and individual?
Instead of measuring health care quality as a by product of cost and access, why not measure the outcomes of such health care systems? Measures such as overall health, quality of life (ie: absence of disease and illness), psychological stability (Maslow's Hierarchy of Needs), and other such measurements should be incorporated into what makes a health care system "quality". Though many would argue that such systems would only help to balloon the cost of health care or force companies to cut costs to increase revenue, there are many current examples that have proven that a more holistic/total approach to health care that addresses all aspects of a healthy life (education, security, physical/mental health) not only create happier individuals it can also significantly cut costs. Generally, these programs have accomplished such miracles by de-centralizing the health care apparatus, creating incentives for individuals who choose to have healthier lifestyles (yearly check-ups, eating properly, getting better exercise) both through financial and motivational incentives. Rather then focusing on the group, such programs focus on the entire health of the individual or community and tailor the system to meet the specific needs of the community. These programs have the increased flexibility to grow and adapt as the community or individual changes through time. To summarize, health care quality should focus on the individual's total health, not on the health of their bank account.
By its very nature health care quality is a (surprise!) qualitative value. This means that health care quality is a perception or opinion of the individual making the measurement. However, we simple cannot rely on qualitative values when we asses a health care system, so what are we to do? The biggest stumbling block is creating a clear definition and measurement tool for "quality" within a health care system.
The World Health Organization (WHO) measures quality as a "by product of access and cost". This means that a cheap and highly accessible health care system would be considered "quality" by the WHO standard. This, unfortunately, is the WORST definition of quality I have ever heard. There is no mention of outcomes or improvements to the individual or community and the WHO relies heavily on the individual to strictly follow doctors orders and receive scheduled check ups no matter what. This measurement seems to not take into account the massive amounts of variables life seems to continually throw at us on a daily basis. What about environmental, social, and education aspects of each community and individual?
Instead of measuring health care quality as a by product of cost and access, why not measure the outcomes of such health care systems? Measures such as overall health, quality of life (ie: absence of disease and illness), psychological stability (Maslow's Hierarchy of Needs), and other such measurements should be incorporated into what makes a health care system "quality". Though many would argue that such systems would only help to balloon the cost of health care or force companies to cut costs to increase revenue, there are many current examples that have proven that a more holistic/total approach to health care that addresses all aspects of a healthy life (education, security, physical/mental health) not only create happier individuals it can also significantly cut costs. Generally, these programs have accomplished such miracles by de-centralizing the health care apparatus, creating incentives for individuals who choose to have healthier lifestyles (yearly check-ups, eating properly, getting better exercise) both through financial and motivational incentives. Rather then focusing on the group, such programs focus on the entire health of the individual or community and tailor the system to meet the specific needs of the community. These programs have the increased flexibility to grow and adapt as the community or individual changes through time. To summarize, health care quality should focus on the individual's total health, not on the health of their bank account.
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