Senior year fall semester Prof

Theoretical links for HCO?

-Bureaucracy: Max Weber thought that organizations should be run by a solid person with authority with hierarchies was preferable. This worked well because of acquiring resources and getting a product. Social aspects were not taken into account so this theory offers a more mechanical aspect -System theory: focuses on the needs and desires of people who work in the organizations. Takes in account of the outside environment. These social components (people, relationships, and roles) interact with environment, technology, and organizational structure in an integrated manner to create a unified, dynamic system. Give empowerment to those who work in the systems -Complex adaptive systems: having biological characteristics that allow the organization to react and change when stimulated. they can adjust and adapt through the coordinated action of their interdependent parts. The changes that occur within an organization in response to environmental stimuli are necessary for sustaining the organization. Most realistic of theories

Clinical exemplars of HCO?

-Employment with nurses in hospitals, nursing homes, clinics, and ambulatory care, nursing homes, public/ community health agencies, hospice,

Strategies for children

-Every child is able to grow up and thrive and avoid things like stress (chronic poverty) -Better education- (Maslow Hierarchy) if peoples basic needs aren't met people will not worry about the higher levels like safety -Invest in early childhood through ages 1-3 years for development -Put health in healthcare need to figure out why a person is sick in the first place

Can we close the gap of stereotyping?

-Every pt gets high quality care -Medical care alone will not close the gap -How to actually close the gap is by going into the homes and places where social disparities occur the most and give them equal chance

Strategies used to stop unconscious bias.

-First realize that, that could be me -Challenge of indiv. vs categorization --try to understand that person first before giving a judgement. Try and walk a mile in someone else's shoes -Contrastereotype: imagine what a "strong woman would look like" -Judgments are passed quicker when put under higher stressful situations and complex situations -Fear and anxiety can also play a role

Featured exemplars

-Hospitals: tertiary care centers. Serve many different populations based upon the location -Clinics and Ambulatory care: mission directed to outpatient setting. not equipped to provide prolonged acute care. Long term care pt need to be referred -Nursing homes -Hospice: specific mission to provide end of life services to pt and their families. Provide palliative care to pt with terminal illness -Speciality HCO: US dep of defense, military members. Indian health services

How do social systems work with HCO?

-In an environment from which resources are obtained and from which challenges are presented that require an organizational response

Why do social disparities still exist?

-Lack of awareness (will not mobolize resources to help fix the problem) -Absence of political will (no emotional connection to it)

Inter-related concepts to HCO

-Leadership: inspiration to sustain motivation to achieve results -Communication: timely, current, and accurate -Collaboration: achieving optimal pt care outcomes -Technology and informatics: using evidence to back up quality care -Health care quality: improving handoff -Health policy: increase focus on reimbursements for quality outcomes

How does this apply to health care?

-Mission: purpose of HCO is determined by organization's mission, vision, and values. Mission statements issued by HCOs describe each organization's purpose based on a vision of what the HCO is meant to achieve. Mission statements also describe the values that drive the work of the organization, such as quality and excellence -Finance: profit or nonprofit. HCO looks at how the profit is distributed --For profit: HCO generates profits for shareholders while providing health care --Not-for-profit: generate profits, profits are used for organizational purposes like building additional facilities, providing improved services or acquiring new equipment -Ownership: --publicly owned: community organizations that are supported by the govt. Ex: county or state hospital that provides general health services (mental health included), state and local health departments --Privately owned: investor owned, or those organizations that are ran by religious or social organizations

How do HCO run?

-Must be able to acquire resources, produce services, and change as necessary to sustain their existence within the challenging U.S. healthcare services

How do we define organizations?

-People who come together for a purpose OR -People that come together for predetermined purpose in defined environment -(People who come together for a purpose) -Purposefully designed, structured social system developed for the delivery of health care services by specialized workforces to defined communities, populations, or markets

What are the defining attributes of an organization?

-Purpose, structure, and members who do the work

What are the major attributes of HCO and briefly describe what they do.

-Purpose: providing health services. Ex.: primary purpose of companies that sell health insurance is to sell insurance. Purpose of accreditation and public regulatory agencies is to support the work of the HCO. Services to manage illness or promote health to cover indiv, families, and communities. - Specialized Health care workers: (highly specialized and narrow window for error. Highly stressful situations. The need for specialized workforce increases the cost for HCO, but benefits the organization by maintaining standards and ensuring quality services. Need upstream approach. -Public trust: used to be higher trust from the pop., but decreased due to abuse by health care workers. people do still turn to doctors and nurses when there is a need. Need to provide quality care. Health care and health services sector

What is the scope of Health care organizations?

-Very different ways to organize HCO. It will depend on the need for health care services in a community or population. -(Book attempt at making a scope) Only organizations that provide a range of health care services for health promotion, illness, and wellness care care considered. A variety of organizations including (but not limited to hospitals, home health agencies, clinics or ambulatory care centers, nursing homes, and organizations that serve a particular market or population

Health care organizations are a product of what?

-interactions of mission and values, internal and external environments, and the motivations and actions of those who work in organizations

A new nurse manager is reviewing the attributes of a health care organization. Which of the following attributes would be expected for a health care organization? Select all that apply A. Providing care for underserved minority pt B. Providing transportation to work sites C. Providing child care for unemployment pt seeking work D. Organizational chart of staffing breakdowns from each dept E. Usage of the facility by surrounding residents

A, D, E

A nurse manager is describing the type of employee typically employed by a health care organization. In addition to knowledge and skills, which of the following characteristics is common in health care professionals

A. A strong allegiance to professional values B. A strong desire to meet organizational goals C. A strong ability to follow the lines of authority D. A strong preference for following rules a

A nurse manager is reviewing pt satisfaction surveys and notices several comments that the unit environment is cold and uncaring. Which of the following actions by the manager would best help the organization to improve its image with the public?

A. Forward the surveys to housekeeping with a request to keep the rooms less cluttered B. Request the pt be admitted to newer sections of the hospital C. Ask for instructions to improve the unit environment D. Send copies of the surveys to admin and wait for directions on how and what to do. C

A nurse manager is presenting an organizational overview to new nurses during orientation. Which of the following features, common to all organizations, would be included in this overview?

A. Policies and procedures for the organization B. Salaries and benefits for employees C. Floor plan on each unit D. Professional dev activities A

A nurse manager feels that the overall work environment of his hospital is positive, and he recommends that the organization apply for Magnet (c) status, which recognizes excellence in nursing practice. Which of the following is an internal environment factor present in a unit that would need to be changed to qualify for magnet status?

A. setting where staff are creative in meeting quality care indicators B. A unit where new programs are researched, implemented, and eval C. A unit where collab among disciplines is encouraged and reinforced in eval D. A unit where feedback on staff concerns is given anonymously D. Magnet organization exhibits engagement and participation of staff, especially nursing staff; a setting where feedback is given anonymously does not indicate a climate where staff members feel safe to openly share concerns and suggest solutions. Allowing staff to be creative and participate in projects fosters a sense of empowerment and commitment. Collaboration among disciplines is expected and encourages accountability.

What is Health Equity?

AKA disparities -Differences in health that are unfair and unjust -Want things to be equal and just or all -Due to location, socioeconomic status, race and ethnicity -White people have a higher living rates than blacks. 265 black people die per day due to racial disparities in the US

Health Care Organizations are created by?

People and managed by people. An organization is ran by the people who get involved. We want contributions to be meaningful

Delivery of health care services is financed by what?

Private and public funding. This funding is monitored by public and private authorities

Minor Attributes of HCO?

Purposeful organizations and are features they share in common with other types of organization. -Structure: Formal rules and policies that say how an organization will run and promote the management of materials and resources. Creates responsibilities for each organization. Different people will have different level of authorities. Needs to be a proper balance within the organization of who manages what in a given organization. Most are licensed medical professionals (who run the organization) -Organizational environments: Internal and external environment. --Internal: organizational culture systems such as info systems or the HR management system. Structural role of responsibilities, rules, and practices --External environment: economic trends or new laws and gov't regulations. Recession that reduces funding to HCO. This will drive change. Ex: recession hits and people need to work longer hours or by seeking new employment, the effect of the HCO could be that HR changes that mean fewer nurses hired which then makes getting into nursing school harder

T or F Health care organizations have to adapt?

True

T or f nursing profession is the largest health professional group?

True

Racisism?

Yes, because of implicit bias (or uncontrust or unthinking discrimination) affects the quality care of pts -Unconscious bias is that many white people see blacks as lazy and harmful. When we meet a person who fits that stereotype we will pass judgement down and txt them differently. People don't realize that they have done it

How does hospice tie into HCO?

hospice might be for profit or privately owned and any profits generated by services are returned to the investor in the form of dividends. OR hospice can be nonprofit and privately owned by religious groups and the profit are given back to the HCO to improve quality of services and

How does HCO differ from other organizations?

unique purpose, specialized workforce, and level of public trust