ISP Course 2

Unit 1: Ethics

Bioethics and critical care decision making continue to receive front page attention, while there is a near-silence on the issue of health services administration ethics. This unit brings together some of the major areas of concern relative to ethics and health administration, promotes a conceptual understanding of ethics as applied to administrative decision making, and a language for the expression of that understanding.

Unit 2: Managing in Change

This unit assists the executive in applying leadership in time of change, transition and chaos. It stresses the application or principles to situations and the managers ability to think critically and creatively about change and chaos.

The major goal of this unit is to provide an understanding of planning from a conceptual base and the use of strategic planning in the health care management process. The need and use of strategy formulation and market-based planning in positioning a healthcare corporation to its environment for effective decision making is also developed. It stresses practical application to the executiveís organization/operations, introduces concepts, principles and practices related to strategic planning, and examines some tools that are available to structure the strategic thinking process.

Hospitals and other health care organizations have been performing marketing functions for much longer than they might care to admit. The shift toward more formal marketing concepts may be relatively recent but under the guise of long-range planning, health care organizations have performed a number of marketing functions for at least 20 years. Capital projects were and still are required to ìfitî within the health care organizationís long-range plan and also within state guidelines or requirements where applicable. Understanding marketing should change the way you manage, plan, and control the activities of your organization. Marketing is a discipline, and this unit will discuss the logical steps that when taken in totality, allow just about anybody to market anything.

This unit is not intended to provide a proscriptive guide to the basics of financial management but rather to introduce the administrator to current issues and strategies related to financial management. Although varying degrees of financial expertise and organizational complexity are represented in the ISP student base, several objectives will be met for each individual including the development of a business plan.

The intent of this unit is to make the administrator sufficiently knowledgeable in, and conversant with, financial issues so that she or he can set goals for -- and evaluate the performance of -- the department or organization, and the financial staff who now (or will some day) report to them. The unit focuses on two topics: capital financing and the capital budgeting decision.

In response to, or in preparation of major health care changes, providers are creating new types of alliances including foundations, physician hospital organizations, medical service organizations, clinics without walls, and accountable health plans. The successful new models are doing more than just organizing to negotiate with purchasers. They are making fundamental changes in their structure and compensation which will eliminate redundant services, improve continuity of care, access improved practice technology, reduce administrative costs, and give providers the tools and incentives to manage costs, quality and access. The purpose of this unit is to help the student understand the various components of managed care and think critically about how these activities impact patients, providers, and the health system as a whole.

It is apparent to all that law and legal rights are gaining importance in the health care setting. Malpractice is a term which makes physicians shudder and some feel that the attorney seeks out the exaggerated claim of injury. The administrator needs some understanding of the nature of legal practice and legal process to evaluate what is happening. The responsibility of the administrator and governing board, for the quality of medical care practiced, and corporate responsibility for negligence and the careless acts of employees are among the topics discussed.

The common theme among healthcare proposals being advanced in the United States is that of forcing changes onto the health care industry. Integrated delivery systems are at the heart of many of the proposals and represent a logical transition from the more narrowly focused joint ventures of the past and present to a more complete integration amongst providers. The purpose of this unit is to facilitate the administrators thinking about how changes in the environment will be influencing the medical community in their area and to help them anticipate the implications of those changes. The unit describes integrated delivery systems and joint venture opportunities as a method for healthcare organizations and physicians to effectively deal with some of the changing aspects of the field.

Just as the locations for patient care are changing, commensurate changes are taking place in the relationships between physicians and healthcare executives. Relationships between these parties are becoming less location dependent. It has become increasingly important that healthcare executives understand the multiple dimensions which relationships with physicians can take and for all healthcare executives to share a common knowledge base upon which to build those relationships. This unit will explore the multidimensional relationships which exist between physicians, health care executives, and the organizations in which they work. This unit seeks to provide the executive with a common information base upon which to build the specialized knowledge pertinent to their particular practice.

Facility Development is introduced as a special type of management problem solving. The bridge from programs to physical facilities (the bricks and mortar) is facility analysis and development. It is an exercise in measuring and tabulating space, assessing its adequacy for the current level of activity, and determining the amount of space that will be required for the projected future level of activity. This unit helps the administrator see him or herself as the leader of the team, representing the total organization as the process evolves. The skills presented are those of analysis and projection. Knowledge passed on is an awareness of what needs to be done during the various phases of planning.