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"We missed you": the absence that fails to make the heart grow fonder.

Absenteeism is a problem that costs business in general billions of dollars each year. No industry is immune from its impact, least of all health care. The control of absenteeism rests largely in the hands of the first-line supervisor who must demonstrate visible concern for absenteeism and who must faithfully apply the organization's policies in the correction and control of absenteeism. The keys to absence control are visible concern, reliable documentation, consistent policy application across the work group, and constant attention to employee needs and concerns.

Absenteeism↗

Boundaries in the workplace.

Employees in all health care settings are vulnerable to violations of boundaries: crossing that sometimes blurry line drawn between staff and patient. Accepting gifts, financial transactions, and romantic entanglement could lead to various negative consequences for the agency, staff, and patients. Supervisors need to be aware of early warning signs of boundary violations as well as training issues. The authors outline a successful program for addressing these issues and argue for rehabilitating the chronic boundaries violator.

Arizona↗

Detecting and detering employee theft.

Physician group practices can limit their vulnerability to employee theft by taking steps to detect theft when it occurs and to deter future occurrences. Steps for detecting theft include being wary of an employee's refusal to take earned time off, conducting periodic credit checks on employees, rotating employees' duties, and conducting impromptu reviews of the practice's finances. Steps for detering theft include routing the practice's checks to a lock box; reviewing cash reports; reconciling check with deposit statements; separating employees' duties; reviewing bank, credit card, and ATM statements; setting the tone for prudent financial management; and reporting cases of theft when they occur.

Accounting↗

When your employee forgets who the boss is.

Managers confront many types of behavior in the workplace. One interpersonal problem that presents an unusual challenge to the manager is the employee who appears to "forget who the boss is." This article addresses this unusual employee-manager problem by first describing the characteristics and dynamics of the behavior and then providing guidelines for responding to this problematic behavior.

Behavior Therapy↗

Effective employee counseling for the first-line supervisor.

Counseling is an important supervisory skill applied for a number of purposes. Although the need for counseling is as constant as any need facing the supervisor, a number of commonly encountered barriers often prevent effective counseling. In most instances counseling is a necessary step preceding disciplinary action, and it is always an important step in improving employee performance. Although the supervisor may not come to the job with expertise in counseling, counseling can nevertheless be learned through practice and the conscientious application of a few simple guidelines.

Behavior↗

Building an effective corporate compliance plan.

Corporate compliance plans are essential for healthcare organizations to cope with, and perhaps even stave off, investigations arising from allegations of illegal business practices. Initial development and implementation of a corporate compliance plan can be facilitated through four steps: determining the content of the code of conduct, determining how the code will be distributed, assigning responsibility for implementing the plan, and appointing a compliance task force to guide the implementation process. Special attention should be paid to education requirements of the United States Sentencing Guidelines to see that all employees understand and can apply provisions of the plan.

Employee Discipline↗

Confronting the disruptive physician.

Ignoring disruptive behavior is no longer an option in today's changing health care environment. Competition and managed care have caused more organizations to deal with the disruptive physician, rather than look the other way as many did in years past. But it's not an easy task, possibly the toughest of your management career. How should you confront a disruptive physician? By having clearly stated expectations for physician behavior and policies in place for dealing with problem physicians, organizations have a context from which to address the situation.

Communication↗

Special report on labor and employment. Provider obligations under the Drug-Free Workplace Act.

In view of the sanctions that may be taken by government agencies against employers, all providers should take their obligations under the Act seriously. The first step for each provider is to determine if it is subject to the Act or to any analogous state statutes. If so, the provider should take steps, if it has not already done so, to comply with the Act or applicable state legislation. While the Act has been criticized as a matter of social policy for not going further to prevent substance abuse in the workplace--by, for example, mandating drug testing or requiring sanctions against employees without the prerequisite of a criminal conviction--there is no question that the penalties it authorizes against employers do go far enough to warrant careful compliance with the Act's provisions.

Drug and Narcotic Control↗

The brave new world of health care compliance programs.

The need for corporate compliance programs in health care delivery systems is ever increasing. This article identifies the key items a good program should contain, and addresses issues raised by the existence of a program as well as its implementation.

Employee Discipline↗

Re-engineering the medical staff. Simplification is key.

Medical staffs are finding they must make do with less--less administrative support from financially strapped hospitals, and less volunteer physician member time from physicians who are distracted by managed care and by managing their changing practices. All too often the medical staff tries to do what they have always done, only faster, and with less help. This just frustrates those who were already working hard. The better alternative? Re-engineer the medical staff with the goal of simplifying operations. A critical look at the tasks undertaken by the medical staff often reveals that far too much time is spent doing unnecessary things. When asked, "Why do you do all this?" the answer is often, "because we are required to do it!" Yet scrutiny reveals that it is not required and that the task could be eliminated. Just because something "has always been done that way" does not mean it still must. It is time to look at the medical staff structure and procedures with a new set of questions: What is really required? What has great value for us? What can be jettisoned without affecting our operations?

Constitution and Bylaws↗

Rumors and gossip in radiology.

Rumors and gossip have long been popular topics in literature. Social scientists have even studied the topic and defined four main types of rumor: wish rumors; fear or bogey rumors; wedge-driving or aggressive rumors; and anticipatory rumors. In general, people believe rumor and gossip are synonymous. Rumormongering--the spreading of rumors--occurs among all cultures and types of people. Both men and women gossip and women's gossip is not more vindicative than men's, as is often thought. With such new means of communication as the Internet, transmitting rumor is possible beyond the traditional oral and written forms. Rumor is spread in both the higher and lower levels of an organization. Typically, disproving a rumor is more difficult than proving a rumor. The financial impact of a rumor must be considered also. If people believe, for example, that a radiology department does not have its act together or offers poor customer service, the department may lose revenue because people have lost confidence in it. Originally, the word gossip had positive implications. It referred to a family friend or the woman who delivered a child and announced the event to the community. Because well-intentioned gossip often turns into a damaging story, various approaches for stopping rumors have been identified. They include analyzing the grapevine, identifying the habitual spreaders of rumor and keeping employees informed. In most cases, a person of authority who provides facts can stop or at least slow down rumors spreading at the employee level.

Communication↗