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PubMed2002

CLS competencies expected at entry-level and beyond.

OBJECTIVE: The study was undertaken to assess educators', practitioners', and managers' perceptions of the future job expectations of clinical laboratory scientists (CLSs) and their opinions on the skills that are expected of CLSs at entry-level and with experience. DESIGN: Survey participants were given a list of 44 competencies related to clinical laboratory science (CLS) practice and were asked whether they would expect a graduate of a respected CLS program to perform each competency in one of three educational categories: the first year of practice, with three to five years of experience but no additional education, or with three to five years of experience plus additional education. The competencies were subclassified into one of four major management functions: laboratory operations, human resource management, financial operations, or communications/consultation. Surveys also included eight Lickert-type questions designed to assess the respondents' opinions on the future job expectations of CLS practitioners. PARTICIPANTS: The sample for the survey included 280 directors of CLS educational programs, 600 managers randomly selected from the Clinical Laboratory Management Association (CLMA) membership, and 600 practitioners randomly selected from the American Society for Clinical Laboratory Science (ASCLS) membership. MAIN OUTCOME MEASURES: The percent of respondents selecting each educational category was tabulated and each competency was assigned to one educational category based onthe highest percent of respondents selecting that category. The means of the responses to the Lickert-type questions were calculated for all respondents and for each group of respondents (educators, managers, and practitioners). RESULTS: Response rates of 58% (educators), 28% (practitioners), and 39% (managers) were obtained. Of the 44 competencies in the survey, four were expected at career-entry, 17 were expected of CLS graduates with work experience but no additional education, and 23 were expected of CLS graduates with experience plus additional education. Competencies expected in the first year of practice were primarily scientific and technical. With three to five years of practice and no additional education, the expectations for practitioners were primarily in laboratory operations and communications/consultation areas. The majority of the human resource management and financial operations competencies were expected with three to five years of practice and additional education. All participants agreed that CLS staff-level practitioners need more management and administrative skills and that, in the future, CLS practitioners will spend less time performing laboratory tests and more time solving problems. CLS managers were more positive than CLS educators in response to statements asserting that CLT practitioners and non-certified personnel will have an increased role in the laboratory in the future. CONCLUSION: This study suggests that extensive laboratory operations and communication skills are expected of CLS graduates without any additional education beyond their CLS programs. CLS educators should adequately address those areas in the curriculum. Competence in other non-technical skills may not be expected without the benefit of post-baccalaureate education and in these areas, CLS programs can provide a foundation for future learning.

Analysis of Variance↗

PubMed1999

IDS CFOs need to be flexible: an interview with Phyllis Cowling.

In most integrated delivery systems (IDSs) today, the CFO plays a major role in managing a broad range of strategic and operational issues that are integral to the success of the overall organization. To gain insight into the types of challenges that typically confront IDS financial managers, HFM spoke with Phyllis A. Cowling, FHFMA, CPA, vice president and CFO of Baptist St. Anthony's Health System, Amarillo, Texas, and a member of HFMA's Board of Directors. Baptist St. Anthony's (BSA) is a recently formed IDS comprising a full-service hospital with emergency center, four primary care centers, a home health agency, a hospice service, a rehabilitation and skilled nursing facility, a senior health center, an ambulatory surgery facility, and a PPO serving northern Texas, western Oklahoma, and surrounding areas. BSA also has ownership interest in two provider-based HMOs.

Cost Control↗

PubMed1997

Making acquired physician practices profitable.

Many healthcare organizations that acquire physician practices do not realize a return on their investments. Instead, acquisitions often create excess capacity, drive up costs, and reduce an organization's ability to attract managed care contracts. Healthcare systems that acquire physician practices can help ensure that the acquisitions will be profitable by recognizing the benefits and eliminating the barriers to integration, developing a shared strategic vision, developing a progressive governance policy, implementing sound financial management, and achieving critical mass over which to spread fixed costs.

Decision Making, Organizational↗

PubMed1997

Opportunities in the international health services arena.

Fundamental changes in domestic healthcare delivery in the '90s have prompted many U.S. healthcare organizations to consider entering international markets. Opportunities available to U.S. organizations include investing in foreign organizations, controlling foreign facilities, and obtaining referrals from extraterritorial or cooperating foreign providers. Before entering into these arrangements, however, organizations must consider the benefits, risks, and constraints they may face, specifically with regard to reimbursement and cash flow, currency risk, regulation, and political risk. To succeed in international service delivery ventures, organizations also may need to make adjustments in the training of healthcare financial managers who will face the international marketplace. Being sensitive to the culture of the countries with which they will be dealing is just as important as knowing the currency and financial regulations.

Commerce↗

PubMed2004

[A report from the 50th Annual Meeting of Representatives from Clinical Laboratories, National University Hospitals].

The 50th Annual Meeting of Representatives from Clinical Laboratories, National University Hospitals, chaired by the University of the Ryukyus, was held in Okinawa from May 29 to 30, 2003. With the common understanding that two environmental changes surrounding clinical laboratories will soon greatly influence laboratory management and activities, the representatives tried to find a workable approach for improving our standpoint and functions. First, reorganization of all the National University Hospitals to agencies will drive clinical laboratories toward having financial management skill based on cost-effect balance. Second, the Ministry of Education, Culture, Sports, Science and Technology is currently trying to change the constitution of National University Hospitals. At the meeting, a total of 10 working groups proposed several action plans and the participants exchanged ideas and opinions for the future. However, nobody knows whether the coming years will be fruitful.

Clinical Laboratory Techniques↗

PubMed1996

Implementing SFAS No 121: Accounting for Impaired Assets.

In March 1995, FASB issued Statement of Financial Accounting Standards (SFAS) No. 121: "Accounting for the Impairment of Long-Lived Assets and for Long-Lived Assets to be Disposed Of." It establishes accounting standards for assets whose carrying costs have been overstated due to a variety of circumstances that have reduced the value of the assets. Healthcare financial managers should fully understand the statement's implications for their organizations.

Accounting↗

PubMed1994

Hospitals become cost centers in managed care scenario.

In a risk-bearing managed care enterprise, acute-care facilities will change from being profit centers to being cost centers, and this transformation will require a focus on controlling costs rather than increasing admissions. This article details the elements of change that healthcare financial managers should consider, from the increased difficulty of matching revenue to expense, to the expanded role of clinical engineers.

Accounting↗

PubMed2000

Improve--rather than lose--your risk-taking entity.

When an HMO transfers financial risk to a provider risk-taking entity such as a physician-hospital organization (PHO), independent physician association (IPA), large medical group, or other provider contracting organization, it sometimes also transfers responsibility for administrative functions, such as claims processing. As a result, these providers risk financial problems related to medical costs, pricing, and underwriting strategies, as well as administrative efficiency. Financial managers should be aware of key indicators and processes that identify such problems to be able to take action before losses occur.

Cost Control↗

PubMed1992

[Typology and performance of first-referral hospitals in sub-saharan Africa].

This descriptive study provides a typology of first referral level hospitals in sub-Saharan Africa. Data are provided on 88 mainly non-governmental hospitals in 25 African countries. They were obtained through a mail survey. The first aspect discussed is the place of the hospital within the spatial organization of the health care district: population served and other health units. This makes it possible to classify the hospitals in three groups. The analysis of the role of the hospital in the management of the district and the support of the peripheral network is based on information about the formal relations of authority, the participation of the hospital in training and supervision, in provision of drugs and in the financial management of the district. This is followed by a description of the human and other resources available in the hospitals, the type and organization of care provided, as well as the performances in terms of outpatient care, inpatient care and technical interventions. Finally, the available information on expenditure and sources of financing is presented.

Africa↗

PubMed2005

The characteristics of Chinese healthcare facilities.

The Chinese healthcare system has been the focus of a great deal of attention from international companies who are interested in entering the world's largest healthcare marketplace. It is generally acknowledged that Chinese healthcare facilities, on the whole, do not conform to international standards; however, the specific areas in which there are differences are not well known or appreciated. An understanding of these differences is a critical aspect of the investment analysis and market assessment associated with a healthcare-based business in China. This article will delineate the major differences between the international model for the provision of healthcare and that found in mainland China. These differences include the physical characteristics, organizational structure issues, operational issues and financial management issues of Chinese hospitals, clinics and medical care providers.

China↗

PubMed1996

Preparing for capitated hospital services.

Although HMOs have been reluctant to capitate hospital services, capitated payments allow hospitals greater control over their strategic and economic position. Healthcare financial managers have a role to play in demonstrating to HMOs that capitating hospital services can create a win/win situation.

Capitation Fee↗

PubMed2003

5 ways to reduce claims denials.

As hospitals achieve minimal gains from cost-cutting measures, many financial managers are looking toward enhanced claims denial management as a way to improve their bottom lines. Best practices in this area include dedicating staff to claims denial management, tracking claims activities and authorizations using automation, and reviewing contracts for compliance challenges.

Benchmarking↗

PubMedDate not supplied

Queensland public sector nurse executives: professional development needs.

In a time of health care reform and rapid change, nurse executives need effective leadership skills to be able to respond to a challenging environment, provide quality cost-effective care and promote the professional development of nursing. This research aimed to provide an understanding of nursing executives' roles and professional development needs and obtain concise information for the development of strategies and professional development programs to enhance the effectiveness of the present and future roles of nursing executives. A descriptive cross-sectional postal survey was sent to all public sector Level 4 and 5 nursing executives in Queensland (n = 281), with a response rate of 52.3% (n = 147). Financial management, human resource management and information technologies were identified as the areas where professional development was most needed. Structured educational activities such as short courses or seminars covering information technology, financial and budget management and general business management were identified as the type of activities best suited to nurse executives' needs. The most frequently reported barriers to professional development were difficulties obtaining relief staff, inadequate time, financial cost and inadequate district manager and regional support to enable access to professional development programs.

Attitude of Health Personnel↗

PubMed1991

Improving subjective decision making in health care administration.

Managing a health care institution typically requires the consideration of many nonquantifiable factors, such as community relations, quality of service, and employee morale. As a result, subjective judgments are an inevitable, and often major, part of decision making in health care financial management. A large body of scientific research has shown that people's subjective, or intuitive, judgments tend to be biased and inaccurate. This article reviews the major types of errors typically found in four phases of decision making: defining the problem, estimating the effects of different alternatives, choosing an alternative, and evaluating the outcomes as the basis for subsequent action. In addition to alerting health care administrators to these potential judgment errors, several methods to improve subjective decision making are explained.

Choice Behavior↗

PubMed1999

Preparing for Medicare's APC system.

The imminent arrival of Medicare's Ambulatory Payment Classification (APC) system, HCFA's new outpatient prospective payment system (PPS), is expected to have as significant an effect on outpatient health care as the Diagnosis-Related Groups (DRG) system had on inpatient health care when it was launched in the early 1980s. Unlike the inauguration of the DRG system, however, the APC program is not expected to be as forgiving to organizations unprepared to implement the new prospective payment system. Since the APC program will be put into effect, HCFA says, "as soon as possible after January 1, 2000," healthcare financial managers should be preparing now.

Ambulatory Care↗

PubMed1996

Contrasting RCC, RVU, and ABC for managed care decisions. A case study compares three widely used costing methods and finds one superior.

To obtain cost data needed to improve managed care decisions and negotiate profitable capitation contracts, most healthcare provider organizations use one of three costing methods: the ratio-of-costs-to-charges method, the relative value unit method, or the activity-based costing method. Although the ratio-of-costs to charges is used by a majority of provider organizations, a case study that applied these three methods in a renal dialysis clinic found that the activity-based costing method provided the most accurate cost data. By using this costing method, healthcare financial managers can obtain the data needed to make optimal decisions regarding resource allocation and cost containment, thus assuring the longterm financial viability of their organizations.

Capitation Fee↗

PubMed1994

Benchmarking can add up for healthcare accounting.

In 1993, a healthcare accounting and finance benchmarking survey of hospital and nonhospital organizations gathered statistics about key common performance areas. A low response did not allow for statistically significant findings, but the survey identified performance measures that can be used in healthcare financial management settings. This article explains the benchmarking process and examines some of the 1993 study's findings.

Accounting↗

PubMed1988

Merging facility and financial planning: a new approach.

This article seeks to help hospital administrators and boards (especially planning and finance committees) balance facility and financial aspects of a construction project by planning for each concurrently. It recommends that the process start with formal strategic plans, and that facility and capital plans be advanced interactively, thus maintaining flexibility to ensure that the hospital's objectives can be met within manageable financial limits. The authors suggest that the project thus delivered will be the most effective and efficient project possible within defined constraints. And, once planned, the project will be ready for implementation--false starts will be eliminated.

Capital Financing↗