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54 Cards in this Set
- Front
- Back
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*Conflict in Health Care Organizations*
CONFLICT |
results when people perceive that some goals are incompatible w/ others
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*Conflict in Health Care Organizations*
CONFLICT OF INTEREST |
internal; occurs when a person wishes to meet multiple objectives but meeting 1 objective means sacrificing another
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*Conflict in Health Care Organizations*
INTERPERSONAL CONFLICT |
occurs when people who depend on each other have conflicting goals, aims, & values that seem to stand in the way of accomplishing their objectives
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*Conflict in Health Care Organizations*
ROLE |
the way a person is expected to behave when performing certain functions within the culture
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*Conflict in Health Care Organizations*
ROLE CONFLICT |
occurs when a person is playing more than 1 role but expectations for those roles conflict
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*Conflict in Health Care Organizations*
FIDUCIARY |
refers to someone (i.e. doctor, attorney, etc.) who is expected to uphold the public's interest
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ORGANIZATIONAL CULTURE
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made up members' basic belief's & assumptions about the organization & its place in the larger environment
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*Cultural Integration & Transformation*
CULTURALLY INTEGRATED ORGANIZATION |
organization in which members share a common language & set of assumptions
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*Cultural Integration & Transformation*
DELNOR'S RECOMMENDATIONS |
- train leaders, & keep training them
- don't underestimate the importance of leadership - establish clear expectations, & don't set the bar too low - hold people accountable - don't hide behind excuses - involve everyone - praise lavishly - strive for excellence, & profits will follow |
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NURSES
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- spend more time with patients
- devote more time to patients’ personal concerns -RNs are the largest segment of health professionals; 59% of nurses work in hospitals - fastest growing profession over next decade - rewarded with personal satisfaction, but not much else; little power or status -long hours and little pay |
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NURSE PRACTITIONER vs. PHYSICIAN ASSISTANT
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- Both are mid-level providers
- Both specially trained and state licensed - Between nurses and physicians (physicians- med schools; nurses- nursing schools) - PA positions have grown rapidly Good for minor concerns and routine exams - Can usually spend more time with patients than physicians |
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HOSPITALIST
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- physician who works directly for a hospital
- helps to monitor care for patients while they're receiving around-the-clock care |
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ALLIED HEALTH PERSONNEL
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- Array of careers: speech pathologists, physical and occupational therapists, athletic trainers, radiologists, dental assistants, etc.
- Crucial to health care; will become increasingly visible members of care teams |
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RETAIL CLINICS
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- First one in U.S. opened in 2000; now more than 1,000 in 37 states
- Most staffed by NPs or PAs (in CVS, Walgreens, Wal-Mart, Target); provide immunizations, give advice, and provide health monitoring services (e.g., blood pressure checks) - Potentially moving toward allowing pharmacists to prescribe drugs Pros: help underserved, decrease health care costs Cons: no ability to examine patients carefully; patients could visit several pharmacists for drugs; drug interaction; malpractice law issues -- Drug rings, etc. -- “behind the counter” drugs |
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HOLISTIC CARE
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- ex. Osteopathic Doctor (O.D.)
- holistic therapies include acupuncture, chiropractic, meditation, etc. ADVANTAGES - Low-cost and low-tech methods - Simple principles are more understandable to patients - More directed to health maintenance - Practitioners spend more time with patients and may develop closer relationships - Turn to holistic options if other methods do not work; some symptoms are managed by relaxation DISADVANTAGES - Supplements are not thoroughly researched; health risks with natural therapies - People may buy unnecessary products - Endangered plant species may be wiped out for health benefits - Perception: some people do not tell physician they are seeing holistic practitioner; drug interactions with other medicines |
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*Model of Multiculturalism*
MONOLITHIC ORGANIZATIONS |
recognize only 1 culture, w/ few minority members
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*Model of Multiculturalism*
PLURAL ORGANIZATIONS |
have more minority members but continued pressure to conform
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*Model of Multiculturalism*
MULTICULTURAL ORGANIZATIONS |
integrate many diverse cultures & ideas
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*Model of Multiculturalism*
GLASS CEILING |
exists when women & minorities are excluded from management positions or are denied equal compensation for similar work
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MINORITIES IN MEDICINE
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- Underrepresented in health professions
- Social conditions and discrimination that put minorities at risk for health conditions also limit opportunities for medical professionals |
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SPECIALTY HOSPITALS
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- Division of labor: workers have specific tasks to perform
ADVANTAGES - Helps people stay current on information that would be overwhelming for any one person - Maintains image of caregivers as public servants rather than businesspeople DISADVANTAGES - Less communication and collaboration with professionals in other areas; duplication, overlap, etc. - Caregivers excluded from health care management; disconnected from policy - Unlikely to go beyond specialization - Not designed to address reality that quality care is effort of “everyone” |
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EFFICIENCY
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- Strategies to eliminate waste and maximize efficiency
- Six Sigma: process in which analysts chart each step in workplace process, time how long each step takes, and chart the outcomes -- Goal is to determine which actions add value and which contribute to waste and errors - Avoidable errors account for 30% to 60% of U.S. health care costs; 1.5 million patient injuries from medicine errors annually |
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PHYSICIAN MARKETING & ADVERTISING
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- Competition = more diverse marketing strategies
- Doctors are reluctant to advertise directly, but insurance companies, and managed care organizations are advertisers - Pharmaceutical companies spend more than $2 billion/year to advertise prescription drugs |
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*Challenging Bureaucracy*
BUREAUCRACY |
highly structured organization w/ a clear chain of command, centralized power, specialized tasks, & established rules for operation
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*Challenging Bureaucracy*
HIERARCHIES OR PARTNERSHIPS? |
ADVANTAGES
- Centralized authority provides stability and common sense of purpose - Reduces ambiguity - Appointed decision makers can help with issues that cross departmental lines DRAWBACKS - Not a quick process - Limited direct contact with clients and personnel - Employees have no authority to make exceptions - When issues or breakdowns, have to wait for authorization before resolution - Inhibit trust and open communication |
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*Challenging Bureaucracy*
OPPORTUNITIES FOR CHANGE |
- Give employees power to say “yes” on the spot
- Go horizontal (empower, manage selves) - People are involved in making important decisions |
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*Challenging Bureaucracy*
TRAIN FOR LEADERSHIP |
- Provide ongoing leadership training
- Keep no secrets - Make organization leaders accessible - Reward people for sharing ideas - Respond to ideas - Celebrate success |
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*Challenging Bureaucracy*
AUTHORITY RULE OR MULTILEVEL INPUT? |
- Rational-legal authority: rationality, expertise, norms, and rules; reverence for those who are most educated, have the most up-to-date knowledge, and have earned the most impressive titles and credentials
- Health care employees advertise credentials (e.g., name badge, job titles, etc.) |
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*Challenging Bureaucracy*
AUTHORITY RULE OR MULTILEVEL INPUT? (cont'd) |
ADVANTAGES
- Emphasis on education and experience justified by knowledge and responsibilities of providing top-quality care - Attention to norms and rules ensures treatment is time-honored and consistent by qualified people DRAWBACKS - Professional prejudice: some considered more prestigious than others - Some excluded from discussions - Low-ranking personnel treated with less respect - Status differences provoke animosity and turf battles - Authority rule stifles creativity |
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*Challenging Bureaucracy*
MORE OPPORTUNITIES FOR CHANGE... |
- Value in education and seniority, but overlooking lower-level employees is a mistake
- Frontline employees work more with clients, know their wishes, and know the organization’s daily routines - Treat members as intelligent change agents - Leadership is characterized by interpersonal skills; ability to inspire, recognize, and reward others - Leaders in horizontal organizations are responsible for communicating goals, enabling members to fully participate and reward them for contributions - Employees will be dissatisfied and unmotivated if they are unsure what is expected of them, lack skills to perform new duties, or are discouraged by managers who do not support organizational changes |
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*Challenging Bureaucracy*
COMMUNICATION STRATEGIES FOR LEADERS IN PARTICIPATIVE ENVIRONMENTS |
- Be a leader and team member
- Choose words and medium carefully - Make the most of meetings Invite ideas and follow up on them Invite solutions - Think and act positively - Praise people for their efforts |
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*Challenging Bureaucracy*
STRICTLY BY THE RULES... OR NOT? |
ADVANTAGES
- Careful records allows for review of efficacy and cost effectiveness - Written records keep teams informed about patient care - Reduces ambiguity and provides sense of security and predictability - Less likely to overlook important information if following procedures DRAWBACKS - Frustration with “needless” paperwork - Policies can hinder customer service; no one can make an exception - Following policies discourages open communication - Rely on written more than face-to-face communication Limits creativity and team contributions |
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*Challenging Bureaucracy*
STRICTLY BY THE RULES... OR NOT? (cont'd) |
Recommendations:
- Ask employees to identify “really stupid rules” - Examine rules that make sense but do not work well - Remember that patients don’t much care about paperwork - If the rules and paperwork are important, allow time and space to complete them |
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*Teamwork*
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- Need to now be like tennis partners
- Ready for unexpected and prepared to help each other - Used to work more independently, but not anymore - Ex. Mayo Clinic: fully integrated w/ doctors, therapists, etc. |
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*Teamwork*
ADVANTAGES & DISADVANTAGES |
ADVANTAGES
- Members apply multiple perspectives to problem - Interdisciplinary teamwork blurs departmental lines; everyone participates in decision making - Encourages larger picture view; pitch in and help - Well suited for biopsychosocial care - Learn from each other DRAWBACKS - Takes time - Team may resort to groupthink if rushed - Very different ideas can generate competition and conflict - Perceptions of teamwork not the same - Question of leadership: any domination defeats purpose of teamwork |
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*Teamwork*
COMM SKILL BUILDERS: WORKING ON TEAMS |
- Teamwork means appreciating contributions of everyone on the team
- Suggestions to help team members: -- Minimize distractions in meetings, sit so all participants can see each other -- Establish ground rules for attendance, discussions and decision making -- Make sure group agrees on problem before solving it -- Make an effort to understand each group member’s background and expertise -- Know conflict is a natural part of group work -- Encourage all group members to contribute -- Be willing to compromise -- Summarize group discussions to clarify group’s viewpoints and perspectives |
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*Important for Service Excellence*
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- Important to focus on patient satisfaction--> determines up to 30% of profits
- Getting customer service right makes the job easier - Team members like coming to work when they feel they are making a difference, enjoy their work, have creative input, and feel valued |
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*Important for Service Excellence*
10 TIPS ON BUILDING CULTURES |
1. Flip the pyramid: inverted hierarchy
2. Hire carefully, and continually recruit internal talent 3. Teach the culture 4. Empower the front line 5. Hold people accountable 6. “Blow their minds”: give people more than expected 7. Use service failures as a springboard 8. Recognize and create moments of truth 9. Round for excellence: visit areas and units; make the rounds and ask questions; give praise 10. Tell stories and honor heroes |
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*Crisis Management*
CRISIS |
- major occurrence with a potentially negative outcome affecting an organization, company or industry, as well as its publics, products, services, or good name
- Regardless of crisis, a plan for handling crises needs to be in place |
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*Crisis Management*
HELPFUL TIPS |
- Let people know what is a crisis and whom to contact
- Designate primary spokesperson - Develop good relationships with media and professionals before crisis - Educate people in organization about how to handle crises - Keep up-to-date contact information - Maintain supplies necessary if no electricity - Plan ahead how to accommodate members of media |
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*Advertising*
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third-person effect- feeling that we're not personally susceptible to persuasive messages in the media, but other people are
direct-to-consumer advertising- selling prescription drugs in public venues such as the media; (as opposed to physician marketing, in which drugs are marketed to doctors) |
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*Advertising*
ADVANTAGES & DISADVANTAGES |
ADVANTAGES
- Consumers learn about treatment options - Active competition can inspire product development DISADVANTAGES - Expensive advertising increases price of products - Physicians worry that the scenarios in commercials will bring unrealistic expectations for patients - Ads now promote medical devices and don’t consider risks involved - Ads also misrepresent affected populations |
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*Advertising*
Body Images- PATHOLOGIZING THE HUMAN BODY |
making natural functions seem weird or unnatural
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*Advertising*
CULTIVATION THEORY |
Suggests that people develop beliefs about the world based on a complex array of influences, including the media
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*Advertising*
SOCIAL COMPARISON THEORY |
- Suggests that people judge themselves largely in comparison to others i.e. keeping up with the Jones’
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*News Coverage*
Main Criticism |
sometimes professionals oversell scientific findings and overlook ongoing, everyday concerns
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*News Coverage*
SENSATIONALISM |
Media favors sensational news rather than useful information (ex. Swine Flu)
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*News Coverage*
ADVANTAGES OF HEALTH NEWS |
- Does increase awareness about health
- Keeps health on public agenda; garners support for medical science - News writers not entirely to blame for misleading coverage - Reporters may be ill prepared to meet challenges health coverage presents |
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*News Coverage*
Comm Skill Builders: PRESENTING HEALTH NEWS |
- Favor the factual over the sensational and trendy
- Do not allow ongoing issues to fade from coverage - Never rely on just one source - Set the record straight |
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PORTRAYALS OF HEALTH-RELATED BEHAVIORS
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They can be fun, but still create perceptions about things such as mental illness or disabilities in minds of audience, even through fictional characters
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HAPPY VIOLENCE
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- Criticism of media violence is that the effects are unrealistic; Gerbner calls this “happy violence”: cool, swift, painless, and leads to happy ending
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ENTERTAINMENT EDUCATION PROGRAMMING
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idea that "no one enjoys being lectured to but everyone enjoys & often learns from entertainment, whether broadcast through radio or TV, or performed in person"
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SOCIAL ADAPTATION THEORY
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People evaluate messages by considering how useful the information is likely to be in their lives
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MEDIA LITERACY
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Best defense against excessive or negative media is ability to analyze messages logically
Means: - Awareness and skills that allow a person to evaluate media content in terms of what is realistic and useful - Skillful at identifying portrayals that are unrealistic or have been enhanced by special effects - Evaluate messages in terms of fairness and appropriateness, weighing ideas for themselves |
