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1 DETAILED CONTENTS List of Exhibits...xvii Preface...xxiii Chapter 1 Foundations of High-Performing Healthcare Organizations 1 In a Few Words...1 Critical Issues...1 Questions for Discussion...2 Activities...3 Contribution...4 Stakeholders Customer Partners Provider Partners Sources of Stakeholder Influence...11 Ownership Not-for-Profit, For-Profit, and Government Owners Healthcare Systems...13 Designing Excellence in an HCO Cultural Foundation of Excellence: Transformational.....Management Operational Foundation of Excellence: Evidence-Based.....Management Strategic Foundation of Excellence: Positioning and.....protection...30 Suggested Readings...36 Chapter 2 Cultural Leadership 39 In a Few Words...39 Critical Issues...39 Questions for Discussion...40 Purpose...41 Functions Promoting Shared Values Empowering Associates Communicating with Associates...45 vii
2 viii T h e W e l l - M a n a g e d H e a l t h c a r e O r g a n i z a t i o n Supporting Service Excellence...47 Encouraging, Rewarding, and Celebrating Success Improving the Transformational Culture...52 People...52 Sources of Leaders...52 Qualifications for Leaders...53 Leadership Development Programs...55 Paths for Beginners...56 Measures...57 The Culture and Leadership Functions...57 Assessing Leaders as Individuals...60 Ensuring Leadership Continuity...61 Managerial Issues...62 Starting the Path to Transformational Culture...63 Maintaining the Ethical Foundation...64 Resolving Fundamental Disagreements...66 Protecting Against Destructive Behavior...67 Suggested Readings...67 Chapter 3 Operational Leadership 69 In a Few Words...69 Critical Issues...69 Questions for Discussion...70 Purpose...71 Functions...72 Boundary Spanning...72 Knowledge Management...79 Accountability and Corporate Design...82 Continuous Improvement...88 Sustaining and Improving the Operational Structure People...93 Measures...93 Managerial Issues...94 Starting the Path to Evidence-Based Management...94 Understanding the Risk Factors of the Model...97 Suggested Readings Chapter 4 Strategic Leadership: Governance 103 In a Few Words Critical Issues Questions for Discussion Purpose Functions...106
3 D e t a i l e d C o n t e n t s ix Maintaining Management Capability Establishing the Mission, Vision, and Values Approving the Corporate Strategy and Annual Implementation Ensuring Quality of Clinical Care Monitoring Performance Against Plans and Budgets Improving Board Performance People Board Membership Membership Qualifications Board Selection Board Organization Education and Information Support for Board Members Measures Managerial Issues Operating Discipline Legal and Ethical Issues of Board Membership Suggested Readings Chapter 5 Foundations of Clinical Performance 141 In a Few Words Critical Issues Questions for Discussion Purpose Functions Ensuring Accurate Diagnosis Ensuring Excellent Care Implementing Protocols Individualizing Patient Care Planning and Treatment Improving Community Health Improving Clinical Performance People Organization Measures Demand and Output Quality Assessment Patient and Associate Satisfaction Managerial Issues Sustaining a Culture of Teamwork and Respect Credentialing and Ensuring Continued Competence Minimizing and Responding to Unexpected Clinical Events Resolving Interprofessional Rivalries Suggested Readings...177
4 x T h e W e l l - M a n a g e d H e a l t h c a r e O r g a n i z a t i o n Chapter 6 The Physician Organization 182 In a Few Words Critical Issues Questions for Discussion Purpose Functions Achieving Excellent Care Credentialing and Delineating Privileges Planning and Implementing Physician Recruitment Providing Clinical Education Communicating and Resolving Unmet Needs Negotiating and Maintaining Compensation Arrangements People Physician Leadership Organization of Physicians Measures Managerial Issues Managing Conflicting Values Maintaining Adequate Physician Supply Negotiating Compensation Arrangements Suggested Readings Chapter 7 Nursing 219 In a Few Words Critical Issues Questions for Discussion Purpose Functions Delivering Excellent Care Coordinating and Monitoring Interdisciplinary Care Educating Patients, Families, and Communities Maintaining the Nursing Organization Improving Nursing Performance People Team Members Organization Measures Managerial Issues Recruitment and Retention Improve Nursing s Effectiveness Suggested Readings...246
5 D e t a i l e d C o n t e n t s xi Chapter 8 Clinical Support Services 250 In a Few Words Critical Issues Questions for Discussion Purpose Functions Providing Excellent Care Maintaining Patient Relationships Maintaining Consultative Relationships Planning and Managing Operations Promoting Continuous Improvement People Team Members CSS Management The HCO Manager Organization HCO CSS Relationships Measures Managerial Issues Should the HCO Offer the Service? How Big Should the CSS Be? What Are the Standards of Performance? What Form of Affiliation Best Meets the HCO s Needs? Does the CSS Have the Coordination It Needs? Are CSS Activities Correctly Assigned to Professional and Nonprofessional Associates? What Are the Continuous Improvement Goals? What Are the Long-Term Trends? Suggested Readings Chapter 9 Beyond Acute Care to Community Health 281 In a Few Words Critical Issues Questions for Discussion Purpose Functions Understanding and Promoting Community Health Establishing a Community Health Strategy Operationalizing a Community Health Strategy Improving Performance People Measures...305
6 xii T h e W e l l - M a n a g e d H e a l t h c a r e O r g a n i z a t i o n Operational Strategic Managerial Issues Promoting and Teaching Community Health Extending Management Concepts to Community Healthcare Teams Expanding and Integrating Primary Care Maintaining the Infrastructure for Community Health Suggested Readings Chapter 10 Knowledge Management 317 In a Few Words Critical Issues Questions for Discussion Purpose Functions Ensuring the Reliability and Validity of Data Maintaining Communications for Daily Operations Supporting Information Retrieval for Continuous Improvement Ensuring the Appropriate Use and Security of Data Improving Knowledge Management Services Continuously People Chief Information Officer KM Planning Committee Organization Measures Managerial Issues Exploiting the KM Planning Committee Promoting the Use of Knowledge Using Outside Contractors and Vendors Suggested Readings Chapter 11 Human Resources Management In a Few Words Critical Issues Questions for Discussion Purpose Functions Workforce Planning Workforce Development Workforce Maintenance...356
7 D e t a i l e d C o n t e n t s xiii Empowerment, Transformation, and Service Excellence.363 Compensation and Benefits Management Collective Bargaining Continuous Improvement People Human Resources Professionals Organization of the Human Resources Department Measures Managerial Issues Adequate Funding Consistent Senior Leadership Perceived Fairness Strategic Achievement Suggested Readings Chapter 12 Environment-of-Care Management 383 In a Few Words Critical Issues Questions for Discussion Purpose Functions Facilities Design, Planning, and Space Allocation Facilities Maintenance Guest Services Materials Management Services Enhanced Environmental Management Performance Improvement and Budgeting People Managers and Professional Personnel Outside Contractors Training Needs Incentives and Rewards Organization Measures Output and Demand Resource Consumption and Effectiveness Quality Managerial Issues Facilities Planning and Space Allocation Selection and Management of Outsourcing Contracts Integration of Facilities Operations with Other Activities Suggested Readings...414
8 xiv T h e W e l l - M a n a g e d H e a l t h c a r e O r g a n i z a t i o n Chapter 13 Financial Management In a Few Words Critical Issues Questions for Discussion Purpose Controllership Functions Transaction Accounting Financial Accounting Managerial Accounting Goal Setting and Budgeting Financial Management Functions Financial Planning Pricing Clinical Services Securing and Managing Liquid Assets Managing Multicorporate Accounting Auditing Functions Internal Audits External Audits Continuous Improvement of the Accounting and Finance Functions People Chief Financial Officer Other Professional Personnel Organization of the Finance System Measures Quantitative Performance Measures Subjective Quality Assessment Managerial Issues Supporting Integrity in All Financial Areas Maintaining a Collegial, Blame-Free Culture Managing Areas at Risk for Conflict Suggested Readings Chapter 14 Internal Consulting 459 In a Few Words Critical Issues Questions for Discussion Purpose Functions Supporting the Organization as a Whole Supporting Improvement Projects Supporting the Capital Investment Review Implementing and Integrating Responding to Any Other Factual Concern...481
9 D e t a i l e d C o n t e n t s xv Improving Internal Consulting People Team Members Organization Measures Managerial Issues Ensuring Quality of Work Sizing Internal Consulting Protecting Associates Empowerment Suggested Readings Chapter 15 Marketing and Strategy 491 In a Few Words Critical Issues Questions for Discussion Purpose Marketing Functions Identifying and Segmenting Markets Listening to Stakeholder Needs Developing Brand and Media Relations Convincing Potential Customers Attracting and Motivating Associates Managing Other Stakeholder Relationships Improving the Marketing Activity Strategic Functions Maintaining the Mission, Vision, and Values Defining the Strategic Position Implementing the Strategic Position People Associates Organization Measures Strategic Activity Operational Measures Managerial Issues Skills for Successful Strategy Strategic Leadership Requirements Multihospital System Contribution Suggested Readings Glossary Index About the Authors...553
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