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PubMed1998

Service-line management/bottom-line management.

To survive in the sturm und drang of health care administration, hospitals and health care systems will have to restructure themselves in ways that emphasize their specific clinical strengths, control their costs, and manage the delivery and outcomes of care. Structuring the organization along clinical lines of service (e.g., oncology, cardiology, rehabilitation) cedes total bottom-line authority for all aspects of that service to the service, or product, line manager. This article discusses the qualifications, compensation, and responsibilities of service-line managers in well-integrated health care systems and describes how they and managed care organizations view each other. It also suggests which organizations will, and will not, benefit from restructuring along service lines.

Financial Management, Hospital↗
PubMed1988

Building a data architecture.

Will product line management become a reality in healthcare? A hospital MIS professional outlines some of the major obstacles, facing the success of this marketing tool. A method for overcoming these hurdles is discussed.

Decision Support Systems, Management↗
PubMed1987

Marketing your nursing product line: reaping the benefits.

Survival in today's cost-conscious, competitive health care scene depends on strategic business skills, marketing, and product line management. As a major contributor to the delivery of health care, nursing practice must now include an orientation toward business with definable products. The authors discuss their success in developing a product line that results in professional growth, improved nurse recruitment and retention, and a greater competitive edge in the health care arena.

Consultants↗
PubMed1995

Organizational change, patient-focused care: an Australian perspective.

Hospitals throughout the world are attempting to improve organizational performance through a variety of means. The focus in this paper is on a leading teaching hospital in Australia for a review of current management strategy. In a time of shrinking resources, management adopted a multi-faceted change management program including restructuring the organization, becoming more patient-focused via a product-line management approach and emphasising efficiency and cost-reduction measures. The next stage in management thinking is to place greater emphasis on patient-focused care. It is concluded this has the propensity to yield substantial further benefits, including improved financial and quality of care outcomes, in the Australian as well as the British and wider Organization for Economic Co-operation and Development (OECD) context. 'Professionally, we have committed ourselves to creating caring environments that promote healing. We cannot meet this goal until we make a commitment to be patient-focused and give up being nurse-focused or facility-focused' (Kerfort and LeClair, 1991). 'In a customer-driven [organization], the distribution of roles is different. The organization is decentralized, with responsibility delegated to those who until now have comprised the order-obeying bottom level of the pyramid. The traditional, hierarchical corporate structure, in other words, is beginning to give way to a flattened, more horizontal structure' (Carlzon, 1987).

Australia↗
PubMed1991

Ambulatory casemix in Australia: APGs or AVGs?

Measurement of the ambulatory casemix of Australian hospitals is important as the next step beyond DRGs in better management of total hospital output. This paper describes and analyses two classification systems, Ambulatory Patient Groups (APGs) and Ambulatory Visit Groups (AVGs), designed by the Yale casemix development group for use in the United States. Despite their common origins, these two systems incorporate different principles of classification and of product line management in their structures. The paper evaluates the applicability of these systems in the Australian policy context and suggests modifications which might be necessary to better suit them for use in Australia.

Ambulatory Care↗
PubMed1990

Oncology: who's managing outpatient programs?

This issue's cover story asks the question "Who's managing outpatient cancer services?" Data from the American Hospital Association indicate that in many hospitals no one is. In fact, the AHA's survey shows that 90 percent of polled hospitals had no central outpatient cancer program product line manager, and only 27 percent of the outpatient cancer programs had full-time administrators. But this situation is bound to change. As this cover story details, outpatient oncology is becoming a priority program for many hospitals, at the same time that inadequate inpatient reimbursement, patient preference, and new therapies and technologies are quickly shifting the bulk of cancer patients to the outpatient setting. Moreover, significant changes in outpatient payment policies are in the offing.

Cancer Care Facilities↗
PubMed1990

Demographics, strategic planning, and marketing: a low budget approach.

Health care organizations with constrained planning budgets can access data sources which will be of great assistance in strategic and market analysis. The data described in this article can be obtained for $250 or less. For segmenting the market even further, down to the International Classification of Disease (ICD)-9 Code Level, the National Center for Health Statistics of the Department of Health and Human Services publishes an annual data book which indicates the use rates for every ICD-9 Code. This extremely valuable data source is all less than $10. Managers can take inexpensive data from the Census and from HHS and proceed to determine major opportunities and challenges facing their institutions. The same data then serve as the basis for planning about how to meet those challenges or take advantage of those opportunities. Finally, the same data will allow product line management to proceed on the basis of quantitative goals that are established in terms of the actual facts of the local situation. The skills required to perform these analyses are not complex, but the task is time intense.

Data Collection↗
PubMedDate not supplied

Models of nursing care in a changing environment: current challenges and future directions.

The last decade of health care in America has been characterized by elements that converged to mandate the need for restructuring health care delivery, which included rising costs, the prospective payment system, consumer expectations, patient care monitoring, the quality movement, and the nursing shortage. This changing environment has resulted in an array of nursing care delivery models to restructure care to assure quality of care, patient satisfaction, and cost containment. Some of the models include paired practice, case management, patient-focused care, cross-training, and product line management. To meet the challenges of future health care delivery, nurses need to be aware of predicted future trends: decreasing specialization of health care personnel, flexibility of the traditional nursing role, increased community-based care, and expanded roles for nurses.

Forecasting↗
PubMed1986

Product-line administration in hospitals.

While a great deal of discussion has centered on product-line planning and management, product-line marketing may be even more important. Defining its market increases the hospital's ability to achieve its mission, improve its vitality, and attract medical staff. By focusing on specific programs or products, the hospital may be able to develop "centers of excellence" that attract patients and referrals from a wide area.

Diagnosis-Related Groups↗
PubMed1989

Integration of strategic, financial plans vital to success.

Without financial planning, healthcare administrators have no way of knowing if their strategies are realistic. Strategic and financial planning must work together at every level of healthcare management, from organization-wide efforts to individual programs. Administrators can use such techniques as product line management, flexible budgeting, and portfolio management to incorporate strategic and financial planning into daily operations.

Financial Management↗
PubMed1999

Performance of first-line management functions on productivity of hospital unit personnel.

Eight management functions influence the productivity of unit personnel differently. Although leadership of the first-line manager is the primary driving force, time and effort expended in operations detract from this unit output. Better use of second-line managers is a choice strategy to enhance productivity. Benner's model of professional development, in combination with the creation of a first-second line shared leadership operational framework, is recommended, with follow-up evaluations on unit productivity effect.

Efficiency, Organizational↗
PubMedDate not supplied

When your star performer can't manage.

Vic, the CEO of a sporting goods company in this fictional case study, is pleased with the numbers. For several years now, they've gone steadily in one direction: up. But there's trouble in paradise Hidden from the public's view of industry-dominating winners--from the coolest snowboards to the hottest in-line skates--lies a product development department that may be ready to shatter like cheap fiberglass. There's one reason in particular for the dark rumblings that periodically reach Vic, and his name is Linus Carver. Carver, the company's chief of product development, is the workaholic mad genius who is responsible for most--he might say all--of the company's successful products. At the same time, he has managed to alienate the rest of his staff, including the two whizkid Generation Xers he brought in. He has been charged with everything from stealing ideas to squashing the initiative of the rest of the team. From his perch as CEO, Vic preaches "team". And he's even made a few stabs at reining Carver in--his latest move has been to recommend that his mercurial star get some coaching. But Vic also knows who butters his bread. In short, he's bewildered. Four commentators suggest how Vic can keep the company's product-development group intact and it sales growth strong.

Administrative Personnel↗
PubMed1985

DRGs: how they evolved and are changing the way hospitals are managed.

Medicare uses Diagnosis-related Groups for prospective hospital payments nationwide, but the groups were not originally intended as such. The authors trace the development of this landmark program and explore the concept of product line management. Dr. Fetter, a leading authority in health care resource allocation, developed the entire framework for DRGs as a method to predict hospital resource requirements. He is currently extending the DRG concepts to outpatient and long-term care facilities. This article is adapted from Dr. Fetter's presentation at the Bridgeport Symposium entitled "Performance Requirements for Clinical Laboratories Under Prospective Reimbursement and DRGs." The Nov. 15-16, 1984 symposium was sponsored by Bridgeport Hospital, Bridgeport, Conn., and supported by contributions from 20 companies (listed on page 29). Portions of this article are also based on a presentation by Drs. Freeman and Mullin at the Tri-Service Performance Measurement Conference, June 11-15, 1984, sponsored by the Army Medical Department.

Costs and Cost Analysis↗
PubMed1984

Reducing the cost of health care capital.

Although one may ask four financial experts their opinion on the future of the hospital capital market and receive five answers, the blatant need for financial strategic planning is evident. Clearly, the hospital or system with sound financial management will be better positioned to gain and/or maintain an edge in the competitive environment of the health care sector. The trends of the future include hospitals attempting to: Maximize the efficiency of invested capital. Use the expertise of Board members. Use alternative capital sources. Maximize rate of return on investments. Increase productivity. Adjust to changes in reimbursements. Restructure to use optimal financing for capital needs, i.e., using short-term to build up debt capacity if long-term financing is needed in the future. Take advantage of arbitrage (obtain capital and reinvest it until the funds are needed). Delay actual underwriting until funds are to be used. Better management of accounts receivable and accounts payable to avoid short-term financing for cash flow shortfalls. Use for-profit subsidiaries to obtain venture capital by issuing stock. Use product line management. Use leasing to obtain balance sheet advantages. These trends indicate a need for hospital executives to possess a thorough understanding of the capital formation process. In essence, the bottom line is that the short-term viability and long-term survival of a health care organization will greatly depend on the financial expertise of its decision-makers.

Capital Financing↗
PubMedDate not supplied

The new meaning of quality in the information age.

Software applications are now a mission-critical source of competitive advantage for most companies. They are also a source of great risk, as the Y2K bug has made clear. Yet many line managers still haven't confronted software issues--partly because they aren't sure how best to define the quality of the applications in their IT infrastructures. Some companies such as Wal-Mart and the Gap have successfully integrated the software in their networks, but most have accumulated an unwidely number of incompatible applications--all designed to perform the same tasks. The authors provide a framework for measuring the performance of software in a company's IT portfolio. Quality traditionally has been measured according to a product's ability to meet certain specifications; other views of quality have emerged that measure a product's adaptability to customers' needs and a product's ability to encourage innovation. To judge software quality properly, argue the authors, managers must measure applications against all three approaches. Understanding the domain of a software application is an important part of that process. The domain is the body of knowledge about a user's needs and expectations for a product. Software domains change frequently based on how a consumer chooses to use, for example, Microsoft Word or a spreadsheet application. The domain can also be influenced by general changes in technology, such as the development of a new software platform. Thus, applications can't be judged only according to whether they conform to specifications. The authors discuss how to identify domain characteristics and software risks and suggest ways to reduce the variability of software domains.

Economic Competition↗
PubMed1999

Coordinating care in an integrated delivery system.

To keep patients from falling through the cracks, each point of service in a healthcare system must understand its role in the patient's overall care and have access to the right information at the right time. Communication and a system's organization play significant roles in making coordinated care work: Some health systems prefer to keep patients with common diagnoses in service lines that take them from preadmission to home care; others set up separate organizational entities to coordinate care for all patients with chronic illness. Regular meetings on patient status, standardized forms and clear job descriptions all help minimize confusion.

Case Management↗