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Tables of Contents for The Well-Managed Healthcare Organization
Chapter/Section Title
Page #
Page Count
List of Figures
xv
6
Preface
xxi
1 Emergence of the Healthcare Organization
1
28
Healthcare Organizations in Transition
1
3
Forces for Change in Healthcare
1
2
The Premise of The Well-Managed Healthcare Organization
3
1
The Building Blocks: Healthcare Organizations as of the 1990s
4
14
Hospitals
5
5
Physicians
10
3
Other Healthcare Providers
13
2
Health Insurance Organizations
15
3
The Vision of the Well-Managed Healthcare Organization
18
3
Access
18
1
Quality of Care
19
1
Customer Satisfaction
20
1
Affordable Cost
20
1
Prevention
21
1
Using This Book
21
8
Structure of the Book
22
1
How to Use the Book
22
7
PART I Governing: Making Healthcare Organizations Responsive to Their Environment
29
214
2 How Healthcare Organizations Relate to Their Environment
29
38
Understanding the Forces Shaping Organizations
29
9
Open Systems
30
1
Community-Focused Strategic Management
31
1
Continuous Improvement
32
5
Scale
37
1
Applying the Theory to Healthcare Organizations
38
11
Open Systems
38
6
Community-Focused Strategic Management
44
4
Continuous Improvement
48
1
Scale
49
1
Important Customer Motivations
49
10
Samaritanism and Support of the Poor
51
1
Personal Health
52
1
Public Health
53
1
Economic Gain for the Community
54
1
The Healthcare Organization as a Control Organization
55
4
Important Member Motivations
59
8
3 The Governing Board
67
50
Purpose
67
1
Functions
68
24
Appoint the Chief Executive
69
4
Establish the Mission and Vision
73
5
Approve the Long-Range Plans and the Annual Budget
78
5
Ensure Quality of Medical Care
83
5
Monitor Performance Against Plans and Budgets
88
1
Resource Distribution Functions of the Board
89
1
Resource Contribution Functions of the Governing Board
90
2
Membership
92
8
Membership Criteria
92
2
Selection Processes
94
2
Compensation
96
1
Education and Support for Board Members
96
2
Special Issues of Board Membership
98
2
Organization of the Board
100
7
Structure for an Effective Corporate Board
100
4
Subsidiary Boards and Their Roles
104
1
Alliances and Affiliations
105
2
Measures of Board Effectiveness
107
10
Scope of Corporate Performance
108
1
Guidelines for Evaluating Performance
109
2
Annual Performance Review
111
1
Failures of Governance and Their Prevention
111
6
4 The Executive Office
117
32
Purpose
117
1
Functions
118
9
Leadership
119
2
Support
121
4
Representation
125
2
Organization
127
1
Selecting Executive Personnel
127
6
Career Opportunities
128
1
Career Education
129
1
Career Experience
130
2
Assessment of Professional Skills
132
1
Recruiting Effective Executives
132
1
Organization of the Executive Office
133
6
Design of the Executive Office
133
3
Responsibilities of Executive Officers
136
3
Measures of Executive Performance
139
4
Outcomes Performance Measures
140
2
Other Performance Measures
142
1
The Process of Evaluating Executives
142
1
Encouraging Effective Executive Office Performance
143
6
Using Power
143
1
Timing the Response
144
1
Management Style
144
5
5 Designing the Healthcare Organization
149
36
The Informal Organization
150
1
The Accountability Hierarchy, or Formal Organization
151
12
The Accountable Work Group
151
4
Grouping Work Groups
155
3
Organizing the Operating Core
158
5
The Collateral Organization, or Decision-Making Structure
163
8
Classifying Decisions
164
2
Achieving Effective Delegation
166
3
Supporting the Decision System
169
2
Extending the Formal Hierarchy: The Matrix Organization
171
2
Multi-Unit Organizations
173
12
Why Multi-Unit Organizations Are Created
173
2
Forms of Multi-Unit Organizations
175
1
How Components of Multi-Unit Organizations Are Described
176
1
How Multi-Unit Organizations Are Designed
177
8
6 Measuring Performance
185
58
Purpose of Quantitative Information
185
1
Kinds of Quantitative Information
186
16
Dimensions for Quantitative Performance in Organizations
186
8
Performance Constraint
194
3
Using Performance Management Data
197
5
Approaches to Quantification
202
11
Scaling
203
2
Evaluating and Improving Measures
205
2
Specification and Adjustment
207
4
A Strategy for Improving Measurement
211
2
Using Measures to Improve Performance
213
17
Analyzing Historic Data
213
7
Regression Forecasts
220
1
Benchmarking Forecasts
221
1
Performance Modeling
222
6
Experimentation
228
2
Monitoring and Controlling
230
13
Cybernetic Systems
230
2
Spider Charts
232
1
Statistical Quality Control
233
10
PART II Caring: Building Quality of Clinical Service
243
202
7 Improving Quality and Economy in Patient Care
243
44
Quality and Economy as the Mission of Healthcare Organizations
243
3
Definitions
244
1
Premises
245
1
Plan for the Chapter
245
1
The Clinical Quality Improvement Program
246
7
Decision Theory and Case Management
246
4
Building Continuous Improvement on Professional Foundations
250
2
The Organization's Contribution to Clinical Improvement
252
1
Role of Clinical Expectations
253
16
Definition of Clinical Expectations
254
1
Types of Clinical Expectations
254
9
Using Clinical Expectations
263
6
Strategic Clinical Improvement
269
3
Improving Intermediate Protocols
269
1
Continuous Improvement of Patient Management Guidelines
270
2
Prevention and Health Promotion
272
4
Cost Effectiveness of Prevention and Health Promotion
274
1
Developing Prevention and Health Promotion Strategies
275
1
Measures and Information Systems for Clinical Performance
276
11
Demand and Output
277
1
Cost and Productivity
277
2
Quality and Satisfaction
279
8
8 Organized Physician Services
287
44
Introduction: Models of Physician Organization
287
3
Plan for the Chapter
290
1
Purposes
290
1
Purposes of the Physician Organization
290
1
Functions
291
28
Improvement of Clinical Quality and Cost Expectations
292
1
Review of Privileges and Credentials
293
8
Medical Staff Planning and Recruitment
301
5
Educational Activities of the Physician Organization
306
2
Representation, Communication, and Resolution of Conflicts
308
7
Collective Compensation Agreements
315
4
Designing the Physician Organization
319
5
Traditional Clinical Organization
319
2
The Emerging Physician Organization
321
3
Measures of Physician Organization Performance
324
7
9 Clinical Support Services
331
46
Definition and Purpose
331
1
Functions of Clinical Support Services
332
25
Technical Quality: Effective and Reliable Completion of Orders
333
3
Appropriateness
336
1
Facilities, Equipment, and Staff Planning
337
2
Managing Amenities and Marketing CSSs
339
2
Patient Scheduling
341
3
Continuous Improvement
344
2
Budgeting
346
9
Human Resources Management
355
2
Management and Organization
357
6
Requirements of CSS Managers
357
1
Organizing Clinical Support Services
358
1
Integrating Clinical Support Services
358
3
Compensation of Support Service Personnel
361
2
Measures and Information Systems
363
14
Demand and Market Measures
364
2
Cost and Productivity Measures
366
1
Human Resources Measures
366
1
Quality Measures
367
1
Customer Satisfaction Measures
368
2
Sources of Constraints
370
1
Information Systems
371
6
10 Nursing Services
377
36
Definition, Purpose, and Scope of Nursing Service
377
5
Definition
377
1
Purpose
378
1
Scope
378
3
Plan of the Chapter
381
1
Nursing Functions
382
7
Nursing and the Eight Functions of CSSs
382
1
Direct Patient Services: The Nursing Quality Function
382
5
Protocols and Care Plans: The Nursing Appropriateness Function
387
2
Patient and Family Support: The Nursing Amenities and Marketing Function
389
12
Coordinated Care: The Nursing Patient Scheduling Function
390
1
Staffing: The Nursing Planning and Budgeting Functions
391
6
Observation: The Nursing Continuous Improvement Function
397
3
Recruiting and Retaining: The Nursing Human Resources Function
400
1
Personnel and Organization
401
2
Educational Levels of Nursing Personnel
401
2
Nursing Organization
403
1
Measures and Information Systems
403
10
Measures
404
2
Information Systems
406
7
11 Prevention and Non-Acute Services
413
32
Purposes of Non-Acute Care and Prevention
415
1
Coordinating Outreach Services
416
12
Prevention and Health Promotion Programs
417
3
Expanded Ambulatory Services
420
1
Home Care Programs
421
1
Hospice Programs
422
1
Chronic Inpatient Care
423
4
Housing
427
1
Strategy for Integrated Healthcare Organizations
428
5
Measuring Prevention and Non-Acute Care
433
12
Demand and Output
433
2
Costs and Productivity
435
1
Quality
435
1
Customer Satisfaction
436
1
Role of the Healthcare Organization
436
9
PART III Learning: Meeting Information and Support Needs
445
226
12 Planning Future Directions
445
40
Purpose
446
1
Functions
447
21
Surveillance
447
4
Community-Based Epidemiologic Planning
451
1
Strategic Positioning
451
11
Responding to Strategic Opportunities
462
1
Developing and Evaluating Programmatic Proposals
463
4
Maintaining Relations with Other Health Agencies and Government
467
1
Organization for Planning
468
3
Personnel Requirements
468
3