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The physician many consider to be the father of "total quality management" in health care explains the philosophy behind the theory. He believes TQM has created a new job description for physicians--one that involves working on a team to improve the system for providing care.
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The Parish Nurse Program at Chicago-based Resurrection Health Care Corporation (RHCC) sponsors partnerships between the corporation and parishes in the Chicago area to provide holistic, preventive healthcare services; access to appropriate resources; and witness to Jesus' healing mission. In RHCC's program, a parish nurse's role includes acting as a personal health counselor, discussing health concerns with parishioners and visiting them at home, in hospitals, and in nursing homes. The parish nurse also serves as a health educator, referral source for community resources, and facilitator for volunteer and support groups. The first step in introducing a parish nurse program is alerting staff within the organization and the surrounding community about the program. One way the parish nurse program director can do this is by developing a communications plan with the system's marketing and public relations staff. Members of a parish nurse program steering committee, the system's vice president for mission effectiveness, and professional peers should then work together to create supporting documents (e.g., job descriptions and pay grades) and an implementation plan. After the program basics are in place, partners can be sought and assessed. When a partnership is established, recruitment and orientation of the parish nurse begins. Once hired, the parish nurse should participate in the system's and the parish's orientation and continuing education sessions. A parish nurse with no previous experience as such should meet with an experienced parish nurse to get advice on interacting with parishioners and hospital and parish staff.
Home care aides are often said to be the core of the caregiving team, but their treatment and compensation may leave something to be desired. These paraprofessionals are the front-line workers in home care; for clients to perceive home care as quality care, the job of the home care worker itself must be restructured.
These six lessons learned for greater success with your Patient Focused communications can help keep your cultural change process in sync with your operational change process. Of course, there are other key elements of the former, including: formal Patient Focused educational programs; restructured Human Resources "systems" (e.g., job descriptions and compensation programs); and migration toward greater organizational empowerment and more self-directed work teams. Still, your Patient Focused communications campaign will spearhead the cultural change process. As such, it will have the opportunity to make the very first impact. Basically, your communications can make or break your Patient Focused Care program from Day One. It's up to you--learn the lessons learned by others and your organization may follow the words of Marx rather than those of Brand: "Workers of the world, unite (on behalf of your Patient Focused Care program)!" Karl Marx.p6 "Workers of the world, fan out (in formation against your Patient Focused Care program)!" Stewart Brand.
Wholesale political, economic, and social change is pressuring health-care organizations to reinvent themselves as they enter a new arena of managed competition. Survival is at stake. Will belt-tightening efforts, combined with structural changes and strategic alliances, achieve the necessary improvements in efficiency and help to secure an adequate patient base? It seems reasonable to expect that health-care institutions can realize the major gains in quality, productivity, efficiency, and competitive edge that organizations in the manufacturing and service industries have enjoyed for the past several years. It seems like a logical next step for health-care organizations to deploy proven methods--such as work redesign, team-based structures, and empowered workforces--that have helped to restore competitiveness to many industrial and service firms. This article describes how to organize teams at all levels and accelerate their development to achieve important organizational objectives--such as improving quality, productivity, and efficiency--while increasing employee satisfaction. Pioneering workplace innovations are reviewed to demonstrate how high-involvement teams integrating strategic planning, research, and health-care delivery processes are not only possible but highly desirable. Enhanced quality, improved productivity, greater efficiency, and employee satisfaction all translate to an undeniable competitive advantage.
The AHRA Statistical Resource Committee presents the results of a recent survey of members about their job satisfaction, responsibilities, benefits and salary. Part II includes data and analysis of job content and comparison with prior surveys for administrative directors of radiology. Part III will focus on chief technologists and will be published in the fall issue of Radiology Management.
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Introduction of new decision-oriented information technology, a powerful means of improving competitive performance, can be viewed as one of six elements of culture change. By creating more knowledgeable employees, old hierarchical norms become counterproductive. This demands upgrading job descriptions, collaborative skills, cross-functional networking, pay and progression systems, and leadership styles.
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This article outlines five strategies that can help reduce LOS, a key indicator for improving both service to the patient and cost reduction for the hospital. 1. Reduce the Roles Within the Emergency Department. Expand staff job descriptions, and as a result, the ED's flexibility by reducing the number of separate and distinct roles in the ED. 2. Streamline the Admission Process. Avoid the backup in the ED by streamlining the admission process, paying special attention to ensuring that incentives are aligned to get the patients into inpatient beds. 3. Redeploy and/or Cross-train Key Ancillary Services. Cut down on the delays associated with coordinating with outside ancillary departments by bringing those services which make sense into the ED or at a minimum streamlining the process for accessing them. 4. Use Technology Wisely. Look at available technology as a means to put more information into the hands of your staff or reduce the overall work involved in the process. 5. Establish Team Accountability and Measure Performance. Develop a baseline LOS, measure it going forward, and most importantly, push down accountability for improving it to your clinical and support teams.
Senior physician executives were asked to share their insights about how the medical management field has evolved. The Physician Executive Management Center, a Tampa, Florida-based search firm, has been surveying senior physician executives each year for the past decade. This year's report on physician executive compensation and duties in hospitals, managed care organizations, and group practices provides an excellent picture of the growth of the profession, as well as a broad perspective of anticipated changes for the future of medical management. The respondents addressed the following questions: What are the skills necessary for success? How have their jobs changed over the years? Have they made the right choice in pursuing medical management careers?
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