NEW YORK UNIVERSITY ROBERT F. WAGNER GRADUATE SCHOOL OF PUBLIC SERVICE

Transcription

1 1 NEW YORK UNIVERSITY ROBERT F. WAGNER GRADUATE SCHOOL OF PUBLIC SERVICE HEALTH CARE MANAGEMENT I: CONTROL, ORGANIZATIONAL DESIGN AND PROFESSIONAL INTEGRATION HPAM-GP Fall 2011 Tuesdays 4:30-6:10 pm Location: New York-Presbyterian/Weill Cornell Campus, Payson House, 435 East 70 th Street, Nursing Education, Sub-Basement Room 25 Assistant Professor Lucy MacPhail Office hours: Thursdays 2:00-3:30 pm or by appointment Office location: 295 Lafayette Street, COURSE SYLLABUS Health Care Management I: Control, Organizational Design and Professional Integration is Part 1 of a two-part 14-week course on health care management. Part 1 can be taken separately or with Part 2 (HPAM-GP.4834 Health Care Management II: Strategy, Marketing, Ethics and Managing Your Career). All MPA students specializing in health care management are required to complete 4833 and This course is intended for graduate students and is intended to build understanding of managing health care services and health care delivery organizations. Prerequisites for 4833 are: 1020 (Managing Public Service Organizations) and 1830 (Introduction to Health Policy and Management). Students who have not completed the prerequisites must have work experience in health care organizations and must obtain permission to enroll in the course. KEY HEALTH MANAGEMENT COMPETENCIES ADDRESSED IN THIS COURSE: Course Focus: The ability to manage teams, projects and people; to work in change-oriented health care organizations; and mentor a diverse and changing workforce. The ability to hold people accountable to standards of performance and/or ensure organizational, professional and ethical compliance.

2 2 The ability to draw implications and conclusions to develop an evolving vision that results in organizational viability. The ability to use information systems and evidence-based management principles for problem-solving, strategic planning and decision-making and implementing and measuring change. The ability to present convincingly to individuals and group the evidence to support a point of view, position or recommendation. The ability to engage in continuous learning; to reflect on and assess one s strengths and developmental needs; to seek feedback from others; and establish and sustain a professional development network. Related Content: The ability to understand and apply legal and ethical principles to managerial and leadership decisions affecting health care organizations. The ability to align human resource capacity and human resource practices and processes with the strategic goals of an organization. The ability to measure, monitor and improve safety, quality, access and system/care delivery processes in health care organizations. The ability to assess population and community health needs from a public service perspective. The ability to synthesize evidence, and apply statistical, financial, economic and costeffectiveness tools/techniques in organizational analysis. The ability to communicate and interact productively (via listening, speaking and writing) on matters of healthcare with a diverse and changing industry, workforce and citizenry. LEARNING OBJECTIVES: At the end of Part I, students will have acquired the knowledge base and skill set that will enable them to: Apply the principles of evidence-based management to decision-making in a health care organization. Evaluate the governance, organizational and accountability structures of various forms of health care systems, particularly in non-profit organizations. Critically evaluate clinical, financial and strategic performance in acute and chronic care delivery systems. Implement performance control and accountability systems in health care organizations. COURSE TEXTS AND RECOMMENDED READINGS: Required: Kovner, A., McAlearney, A. and Neuhauser, D. eds Health Services Management: Readings, Cases and Commentary. 9 th ed. Chicago, IL: Health Administration Press.

3 3 Griffith, J. and White, K Reaching 2 nd ed. Chicago, IL: Health Administration Press. Recommended (available on reserve at Bobst Library): Berry, L. and Seltman, K Management Lessons From the Mayo Clinic. New York, NY: McGraw-Hill. Christensen, C., Grossman, J. and Hwang, J The Innovator s Prescription: A Disruptive Solution for Health Care. New York, NY: McGraw-Hill. Kenney, C Transforming Health Care: Virginia Mason Medical Center s Pursuit of the Perfect Patient Experience. New York, NY: Taylor & Francis. Kovner, A., Fine, D., D Aquila, R Evidence-Based Management in Healthcare. Chicago, IL: Health Administration Press. All assigned readings that are not included in the required textbooks will be posted on PART I COURSE SESSIONS September 6. Week 1: Introduction and Evidence-Based Management Overview of course and syllabus Fundamental principles of organizational control Evidence-based management in health care Discussion question: What factors influence managerial use of evidence in decisionmaking? Required Case: Kovner, A. and Kaplan, D. A New Faculty Practice Administrator for the Department of Medicine. In Kovner, McAlearney & Neuhauser, eds., Health Services Management, pp Additional Required Readings: Kovner, A. and Rundall, T. Evidence-Based Management Reconsidered. Health Services Management, pp Griffith, J Finding the Frontier of Hospital Management. Journal of Healthcare Management 54(1): On September 13. Week 2: Governance, Information and Incentives Governance in health care organizations Performance measurement and improvement Pay-for-performance Discussion question: How should governing boards measure CEO performance?

4 4 Kovner, A. Short Case 10: Financial Reporting to the Board. Health Services Management, pp Additional Required Reading: Griffith, J. and White, K Creating Excellent Governance. Chapter 2 in Reaching James, B. and Savitz, L How Intermountain Trimmed Health Care Costs Through Robust Quality Improvement Efforts. Health Affairs 30(6): On Rosenthal, M. and Dudley, R Pay for Performance: Will the Latest Payment Trend Improve Care? Journal of the American Medical Association 297(7): On Inamdar, I. and Kaplan, R Applying the Balanced Scorecard in Healthcare Provider Organizations. Journal of Healthcare Management 47(3): On September 20. Week 3: Managing Acute Care Structuring organizations for effective care delivery Managing inpatient care Disruptive innovation in health care Discussion question: What is the relationship between organizational design and performance in health care delivery settings? Anonymous. Case O: Letter to the CEO. Health Services Management, pp Shaffer, D. Case 3: Healthier Babies in Twin Falls, Idaho. In Kovner, A. and Neuhauser, D. eds Health Services Management: Readings, Cases and Commentary, 8th ed. Chicago IL: Health Administration Press. On Additional Required Reading: Griffith, J. and White, K Foundations of Excellent Care. Chapter 5 in Reaching Christensen, C Disrupting the Hospital Business Model. Chapter 3 in The Innovator s Prescription: A Disruptive Solution for Health Care. New York, NY: McGraw-Hill. On September 27. Week 4: Performance Management PLEASE NOTE TIME CHANGE: 6:20-8:00 pm Guest Speaker: Sofia Agoritsas, MPA FACHE Sr. Admin. Director, The Arthur Smith Institute for Urology, North Shore - LIJ Health System Performance management from a leadership standpoint Discussion question: What is the manager s role in fostering high performance? DUE THIS CLASS ASSIGNMENT 1: CONTROL PAPER

5 5 Required Reading: Griffith, J. and White, K Internal Consulting. Chapter 14 in Reaching Curry et al What Distinguishes Top-Performing Hospitals in Acute Myocardial Infarction Mortality Rates? Annals of Internal Medicine 154: On October 4. Week 5: Managing Primary and Chronic Care Primary care delivery Chronic disease care Patient-centered care and the patient-centered medical home (PCMH) Discussion question: How does managing chronic disease care vary from management acute care delivery? Required Case: Nunberg, H. Case H: The Future of Disease Management at Superior Medical Group. Health Services Management, pp Additional Required Readings: Christensen, C Disruptive Solutions for the Care of Chronic Disease. Chapter 5 in The Innovator s Prescription: A Disruptive Solution for Health Care. New York, NY: McGraw-Hill. On Grol, R Quality Development in Health Care in the Netherlands. Commonwealth Fund. On Zhou et al Improved Quality at Kaiser Permanente Through Between Physicians and Patients. Health Affairs 29(7): On Rundall, T. et. al As Good As It Gets? Chronic Care Management in Nine Leading U.S. Physician Organisations. British Medical Journal 325: On Crabtree, B. et al Summary of the National Demonstration Project and Recommendations for the Patient-Centered Medical Home. Annals of Family Medicine 8(suppl 1): S80-S90. On October 11. No Class October 18. Week 6: Managing with Clinicians Designing organizations for effective relationships between clinicians and administrators Supporting frontline workers Discussion question: What are the productive and unproductive tensions of the relationship between administrators and clinicians? DUE THIS CLASS ASSIGNMENT 2: ORGANIZATIONAL DESIGN PAPER Kovner, A. Case K: Managing Relationships: Taking Care of Your Nurses. Health Services Management, pp

6 6 Kovner, A. Case J: Physician Leadership: MetroHealth System of Cleveland. Health Services Management, pp Additional Required Reading: Griffith, J. and White, K The Physician Organization. Chapter 6 in Reaching Griffith, J. and White, K Nursing. Chapter 7 in Reaching Excellence in Healthcare Management. Tucker, A. and Edmondson, A Why Hospitals Don t Learn from Failures: Organizational and Psychological Dynamics that Inhibit System Change. California Management Review 45(2): Transforming Care at the Bedside (TCAB). A New Era in Nursing: Transforming Care at the Bedside. The Robert Wood Johnson Foundation and the Institute for Healthcare Improvement. October 25. Week 7: Models of Accountable Organizations Meaning of accountability in health care delivery Models of accountable health care programs Discussion question: What can managers do to move their health care organizations toward best available results for quality, access and cost/value? Note: For all students enrolled in HPAM-GP.4834 (Part 2), please form teams of 3 for Assignment 3 this week. Kovner, A. Moving the Needle: Managing Safe Patient Flow at Yale-New Haven Hospital. On Kovner, A. Where the Rubber Hits the Road: Hospital-Physician Relationships at Phelps Hospital. On Additional Required Readings: Griffith, J. and White, K The Revolution in Hospital Management. In Health Services Management, pp On Larson, E Group Health Cooperative One Coverage-and-Delivery Model for Accountable Care. New England Journal of Medicine 361(17): On McCarthy, D. Integrative Models and Performance. Chapter 10 in Health Care Delivery in the United States, 10 th edition, A. Kovner & J. Knickman, eds. New York, NY: Springer Publishing. On Oliver, A Public Sector Health Care Reforms that Work? A Case Study of the U.S. Veterans Health Administration. Lancet 371: On

7 7 WRITTEN ASSIGNMENTS Assignment 1: Control Paper (September 27) 3-5 double-spaced pages in 12-point font. Please cite references as appropriate. An appendix may be included but is not required. Please select a unit of a health care delivery organization. If you do not have experience in a health care delivery organization, select a department or defined area of an organization related to health care delivery that is familiar or interesting to you, or choose a health care organization featured in a case study in Kovner, McAlearney & Neuhauser s Health Services Management. Please compose a memo to the attention of a key manager in this unit in which you assess the unit s performance control system. In your memo, address the following: How is the unit performing, and how are you able to assess if the unit is performing well? In what ways is the unit s director accountable for achieving objectives? What information is used to measure performance? What incentives are used to foster the attainment of objectives? Evaluate the strengths and weaknesses of the current control system. Provide feasible recommendations to improve the control system. Discuss opportunities and constraints for implementation. Assignment 2: Organizational Design Paper (Due October 18) 6-8 double-spaced pages in 12-point font. Please cite references as appropriate. An appendix may be included but it not required. Please complete this assignment as a two-person team. You have been hired as consultants to a manager in a health care organization. This may be an organization familiar to you or an organization featured in a case study in Health Services Management. Discuss the current organizational structures, work processes and cultural norms that shape the delivery of health care services and the experiences of staff within the organization. To what extent is the organization designed effectively to achieve high performance on dimensions of clinical quality, value, patient experience and employee satisfaction? Please identify strengths and weaknesses transparency and make recommendations to the manager to improve the organization on these dimensions. Include a discussion of constraints and opportunities for implementation. % Grade Due Date 45% Assignment 1: Control Paper September 27 45% Assignment 2: Organizational Design Paper October 18 Class Participation Classroom discussion is a key component of this course. 10% of student performance in Health Care Management I will be evaluated on attendance, engagement in the classroom and constructive contribution to class discussions. Lateness Policy Please observe written assignment due dates. Assignments not received by class time on the date due will be penalized one-half letter grade for every day late.