Managing Health Services Organizations and Systems

by Kurt Darr

Overview

Managing Health Services Organizations and Systems has served the educational and professional needs of the healthcare field over four decades. The seventh edition furthers that legacy in a completely revised and reorganized text that presents a comprehensive range of the knowledge and skills needed to effectively lead and manage health services delivery.

The first of three parts describes the environment in which health services are delivered. The second details tools and skills needed to manage and lead health services. The final part links the preceding chapters to Fayol’s five management functions—planning, organizing, staffing, directing, and controlling—as they apply in health services.

In this edition, the authors return to basics in a concise yet substantive presentation within a context of quality and performance improvement. New to this edition are chapters on healthcare economics, financial management, planning, organizing, staffing, and directing. A new section on compliance is key to meeting regulatory demands. The sections on patient and staff safety, emergency preparedness, and project management are updated and revised. Additional highlights include

• Revised and supplemented end-of-chapter discussion questions
• 52 thought-provoking case studies, 28 new to this edition
• Extensive source citations, many with URLs leading to additional sources for reading and research
• List of acronyms
• Detailed index
• Supporting instructor materials, including 58 additional case studies

Managing Health Services Organizations and Systems is a vital resource for developing health services leaders and managers. It is

• A textbook for graduate and undergraduate courses in health services management
• A resource for nonformal education such as seminars, webinars, and self-instruction
• An enduring professional reference with encyclopedic information. Busy practitioners will value the readily available acronym list, detailed index, and regulatory and statutory references.

Faculty adopting this text will find exceptional support in the accompanying instructor materials. These include learning objectives, supplemental case studies, discussion questions and answers, PowerPoint presentations, and test banks for each chapter. Also available are PDF files of figures and tables.

Product Details

ISBN-13:	9781938870903
Publisher:	Health Professions Press
Publication date:	02/01/2021
Edition description:	7th ed.
Pages:	640
Product dimensions:	0.00(w) x 0.00(h) x 0.00(d)

About the Author

Kurt Darr is Professor of Hospital Administration in the Department of Health Services Management and Leadership and Professor of Health Care Sciences at The George Washington University. He holds the Doctor of Science from The Johns Hopkins University and the Master of Hospital Administration and Juris Doctor from the University of Minnesota. Dr. Darr completed his administrative residency at Rochester (Minnesota) Methodist Hospital and subsequently worked as an administrative associate at the Mayo Clinic. After being commissioned in the U.S. Navy, he served in administrative and educational assignments at St. Albans Naval Hospital and Bethesda Naval Hospital. He completed postdoctoral fellowships with the Department of Health and Human Services, the World Health Organization, and the Accrediting Commission on Education for Health Services Administration. Dr. Darr is a Fellow of the American College of Healthcare Executives, a member of the District of Columbia and Minnesota Bars, and serves as a mediator in the Superior Court of the District of Columbia. He serves on commissions and committees for various professional organizations, including The Joint Commission on Accreditation of Healthcare Organizations, the American College of Healthcare Executives, and the Commission on Accreditation of Healthcare Management Education. He is a voluntary consultant to several hospitals in the District of Columbia metropolitan area. Dr. Darr regularly presents seminars on health services ethics, hospital organization and management, quality improvement, and the application of the Deming method in health services. He is the author and editor of several books used in graduate health services administration programs and numerous articles on health services topics.

Table of Contents

About the Authors
Preface
About this Edition
Acknowledgments
Acronyms Used in Text
Dedication

PART I. THE ENVIRONMENT

Chapter 1: Healthcare in the United States

• Health and System Goals
• Lack of Synchrony
• Processes That Produce Health Policy
• A Brief History of Health Services in the United States
• Other Western Systems
• Structure of the Health Services System
• Classification and Types of HSOs/HSs
• Local, State, and Federal Regulation of HSOs/HSs
• Other Regulators of HSOs/HSs
• Accreditation in Healthcare
• Education and Regulation of Health Services Managers
• Regulation and Education of Selected Health Occupations
• Associations for Individuals and Organizations
• Paying for Health Services
• Government Payment Methodologies
• System Trends

 

• Case Study 1. Gourmand and Food—A Fable
• Case Study 2. Normal Saline and Hurricane Maria NEW!
• Case Study 3. Bipartisan Policy Group Proposes Cuts to Hospital Spending NEW!

Notes

Chapter 2: Ethical and Legal Environment

• Society and the Law
• Relationship of Law to Ethics
• Ethics Framework
• Personal Ethic and Professional Codes
• Health Services Codes of Ethics
• Ethical Issues Affecting Governance and Management
• Biomedical Ethical Issues
• End-of-Life Decisions
• Organizational Responses to Ethical Problems
• Managers and the Law
• Torts and HSOs/HSs
• Reforms of the Medical Malpractice System
• Select Legal Areas Affecting HSOs/HSs
• Legal Process of a Civil Lawsuit
• Special Considerations for the Manager

 

• Case Study 1. Understanding
• Case Study 2. Viral Pandemic NEW! (Based on COVID-19)
• Case Study 3. Concerned Physicians, Unconcerned Managers NEW!
• Case Study 4. Which Hurts More: The Truth or the Lie? NEW!

Notes

Chapter 3: Healthcare Economics

• Economic Growth in Healthcare
• Special Characteristics of the Healthcare Economy
• Healthcare Demand
• Healthcare Supply
• Economic Solutions for Healthcare

 

• Case Study 1. Price and Discount Transparency NEW!
• Case Study 2. Comparing Health Care in High-Income Countries NEW!
• Case Study 3. The Role of Health Insurance in Guaranteeing Access to Healthcare NEW!
• Case Study 4. Physician Consolidation NEW!

Notes

Chapter 4: The Quality Imperative: The Theory

• Improving Quality and Performance
• Importance of QI
• Background to the Present Focus on Quality Improvement
• Taking a CQI Approach
• CQI, PI, and Competitive Position
• Theory of CQI
• Strategic Quality Planning: Hoshin Planning
• Two Models to Improve Processes
• Organizing for Improvement
• The Next Iteration of CQI: A Community Focus

 

• Case Study 1. Extent of Obligation
• Case Study 2. Surgical Safety—Retained Foreign Objects
• Case Study 3. Which Team’s Fastest? NEW!

Notes

Chapter 5: Healthcare Technology

• Background
• Types of Technologies
• Effects of Technology on Health Status
• Forces Affecting Development and Diffusion of Technology
• Responses to Diffusion and Use of Technology
• Health Technology Assessment
• HSO/HS Technology Decision Making
• Managing Biomedical Equipment
• Health Information Technology
• Telemedicine
• Enterprise-Level EHRs
• Future Developments
• Technology and the Future of Medicine

 

• Case Study 1. Is Cleansing Your Hands in my Room a Problem, Doctor? NEW!
• Case Study 2. “Who Does What?”
• Case Study 3. “Let’s ‘Do’ a Joint Venture”

Notes

PART II. THE TOOLS

Chapter 6: Managerial Problem Solving and Decision Making

• Problem Analysis and Decision Making
• Problem Solving
• Process and Model
• Influencing Problem Solving and Decision Making
• Unilateral and Group Problem Solving
• Problem-Solving and Decision-Making Styles

 

• Case Study 1. The Nursing Assistant
• Case Study 2. The New Charge Nurse
• Case Study 3. Chris’s New Baby NEW!

Notes

Chapter 7: Financial Management

• Organization of Financial Management
• Healthcare Financial Accounting
• Cost Accounting
• Reimbursement
• Working Capital
• Resource Allocation

 

• Case Study 1. Calculating Net Patient Services Revenue NEW!
• Case Study 2. Calculating Bad Debt Expense NEW!
• Case Study 3. Analyzing Financial Statements NEW!
• Case Study 4. Break-even Analysis for a Capitated Contract NEW!
• Case Study 5. Your Organization’s Path to the Second Curve: Integration and Transformation NEW!
• Case Study 6. Economic Order Quantity and Total Cost NEW!

Notes

Chapter 8: The Quality Imperative: Implementation

• Undertaking Process Improvement
• Other Improvement Methodologies
• Improvement and Problem Solving
• Statistical Process Control (SPC)
• Tools for Improvement
• Productivity and Productivity Improvement
• LIPs and CQI
• Patient and Staff Safety in Healthcare
• QI Methods Useful in Patient and Staff Safety
• Overlap of Patient and Staff Safety
• Sustainability

 

• Case Study 1. The Carbondale Clinic
• Case Study 2. Respiratory Pandemic and the Hospital NEW!
• Case Study 3. Infections—CLABSI
• Case Study 4. Sharps Injuries
• Case Study 5. Violence in the Workplace

Notes

Chapter 9: Communicating

• Communicating Is Key to Effective Stakeholder Relations
• Communication Process Model
• Barriers to Effective Communication
• Flow of Intraorganizational Communication
• Communicating with External Stakeholders
• Special Situations of Communicating with External Stakeholders
• Communicating with Internal Stakeholders

 

• Case Study 1. How Much Should We Say?
• Case Study 2. Getting Help When Needed
• Case Study 3. Adding Verbal Orders to Written Orders NEW!

Notes

PART III. APPLICATION

Chapter 10: Planning

• Strategizing and Systems Theory
• Strategizing and Planning
• The Strategizing Process
• Situational Analysis
• Internal Environmental Analysis
• External Environmental Analysis
• Formulating Strategy
• Implementing Strategy
• Strategic Control
• Strategic Marketing
• Core Concepts in Marketing
• Examples of Marketing Strategies
• Strategic Issues Management

 

• Case Study 1. No Time for Strategizing
• Case Study 2. A Response to Change
• Case Study 3. HSO Strategic Assessment NEW!

Notes

Chapter 11: Organizing

• Designing the Organization
• Culture and Values
• Theoretical Background
• Formal and Informal Organizations
• Designing Interorganizational Relationships
• The Triad of Key HSO Components
• Organization of Select HSOs
• Health Systems
• Diversification in HSOs and HSs
• The HSO/HS Environment

 

• Case Study 1. The Clinical Staff
• Case Study 2. State Allocation Decisions—Centralize or Decentralize NEW!
• Case Study 3. Physicians’ Unprofessional Behavior NEW!
• Case Study 4. CEO Salary versus Patient Care NEW!

Notes

Chapter 12: Staffing

• Background
• Staffing
• HRM Activities
• Labor Relations Law and Unionization
• Self-service HR
• Foreign Workers
• Teams
• Virtual Workforce
• Social Media in the Workplace and in HR
• Personality Testing
• Outsourcing Some HRM

 

• Case Study 1. Today’s Workforce
• Case Study 2. The Photographer Who Posed as a Gynecologist NEW!
• Case Study 3. Doctor of Death NEW!
• Case Study 4. Let the Punishment Fit the Crime NEW!

Notes

Chapter 13: Directing

• Directing as Leading: Defined and Modeled
• Work of Managers
• Management Functions, Skills, Roles, and Competencies
• Managers and Leaders: Are They Different?
• Ethical Responsibilities of Leaders
• Power and Influence in Leading
• Motivation Defined and Modeled
• Conclusions About Power, Influence, and Motivation in Leading
• Approaches to Understanding Leadership
• Toward an Integrative Approach to Effective Leading

 

• Case Study 1. Healthcare Executives’ Responsibility to Their Communities
• Case Study 2. The Young Associate’s Dilemma
• Case Study 3. Ethical Aspects of Leadership
• Case Study 4. Reluctant Leader NEW!

Notes

Chapter 14: Controlling

• Monitoring (Control) and Intervention Points
• Control Model
• Levels of Control
• Control Considerations
• Control and CQI
• Control and Problem Solving
• Control and Information Systems
• Risk Management and Quality Improvement
• Healthcare and Public Health Emergency Preparedness
• Control Methods
• Project Management

 

• Case Study 1. Centralized Printers
• Case Study 2. Healthcare Emergency Preparedness
• Case Study 3. Placing Imaging Services to Support ED Operations

Notes

Index