5300 Chapters 18, 22, 24, 25 Flashcards
What is the basis of security in our lives today?
Our ability to be flexible and adaptable
Why are people resistant to change?
Is disturbed our equilibrium and threatens sense of security. Restraint is a stabilizer and keeps us from doing frivolous things.
What are the primary ways the supervisory role is changing?
Increased scope of responsibility. Increased span of control. Shared management.
What types of change create the most resistance?
Organizational change. Management change. New methods and procedures. Job restructuring. New equipment.
What is it that employees fear most, leading to change resistance?
Fear of the unknown.
What are 3 approaches to implementing change in your department?
Tell them. Convince them. Involve them.
What are guidelines for implementing change?
Plan thoroughly. Communicate fully. Convince employees. Involve when possible. Monitor implementation.
What is the basis of security in our lives during these current times?
Flexibility and adaptability
Why are people resistandt to change? Because it
Threatens their security
Examples of how the health care supervisor’s role is changing as thay are expected to improve access to care, maintain or improve quality, and cut costs?
Fewer levels of management; greater decision making authority. More employees and more skill sets to oversee. Responsibility for departments and two or more locations
Which of the following changes would have the greatest impact on the role of a manager?
Cutting from 17 to 14 professional staff members
How would you characterize the way that Hem and Haw faced their original challenge in “Who Moved My Cheese?”
With consteration and resistance
What is the change related to merging of two departments in the same hospital, such as combination of occupational, physical and speech therapy into a unit called “rehabilitaion services?”
Organizational change
What is the nature of a change that involves cutting 20% of positions in an existing department?
Job restructuring
What is the nature of the change when a food service goes from self-operated to being run by a contract company such as Marriott?
Management change
What is the nature of a change associated with a transition from a paper medical record to electronic or computer based medical records?
New methods and/or procedures
What is it that employees fear most?
The unknown
What is the best way to win cooperation of employees when change is required?
Involve employees in planning for the change
What guideline for effective change management is being used whe a manager appoints a comittee to make recommendations for dealing with a proposed change, such as beginning a new service in your department?
Involve employees when possible
What guideline for effective change management is being used when a manager discusses the pros and cons of a proposed change at a department meeting?
Convince employees that they will benefit from the change
What must be communicated when a change is being planned?
What must be changed and why.
Quality control
Largely used in manufacturing. Concentrated on finding defects, rejecting defective products, & providing information with which to alter processes so they would produce fewer defects.
Quality assurance
Used in health care. Departments recorded errors consisting of departures from a standard are counted, providing information with which steps can be taken to try to reduce the frequency of recurrence of the same kinds of errors.
How are quality control and assurance alike?
Catch errors after the fact
Benchmarking defined:
A continuous, systematic, management process for measuring work processes, products, and services for the purpose of organizational comparison and improvement.
How are benchmarks set?
Two ways: internally for own institution using literature and past practice, externally using top 100 best hospitals for example.
How is benchmarking used?
id the best practices in the industry or in your field. Set goals based on knowing what others have achieved and what’s realistic in your situation. Compare your institution with the best. When your department’s performance falls below the benchmark, set goals for improvement. When you consistently exceed the benchmark, apply for an award and raise the bar.
In what areas are benchmarks set?
They are all in quantitative terms;you have a number for comparison. Operational performance. Financial. Customer service. HR - % of turn over, staff : patient.
Gantt Chart
a visual control device sometimes referred to as a scheduling and progress chart. It emphasizes the work-time relationships necessary to meet a desired goal.
With what management functions is the Gantt Chart associated?
Planning and controlling
How is a Gantt Chart created?
1 Estimate how long it should take to perform an activity. Use days, weeks, or months as well as calendar dates to show time across the top of the chart. 2 Along the side of the chart put the names of your people involved in the work. 3 Use symbols to show beginning time and estimated finish time of each person’s involvement in the project. 4 As work is finished, color in the chart so that everybody can see if the work is on schedule, ahead of schedule, or behind schedule.
Flow Chart
a graphic representation of an ordered sequence of events, steps, or procedures that take place in a system. Flow charts are used to analyze, plan and control work flow.
Procedures flow chart
Commonly used in allied med. Showing the flow of work activities such as a food from delivery of ingredients to serving a dish in the cafeteria.
Systems flow chart
Commonly used in allied med. Shows how a form makes its way through the system, such as a purchase order or the flow of operations from a physician’s order to completion of the procedure.
How can the flow chart by used in the management functions of planning and controlling?
Develop a procedure. Illustrate and emphasize key points in a written procedure. Compare present and proposed procedure.
How can the flow chart be used as a control device?
Compare actual workflow with that originally planned. Audit workflow - The chart will help pinpoint delays, investigate the legitimacy of delays, and determine how to shorten or eliminate delays.
Run Chart
A simple line graph used in Total Quality Management. Allows teams to study observed data (a performance measure of a process) for trends or patterns over a specified period of time (days, weeks, months).
How do you develop a Run Chart?
- Decide what you want to track over time (number of patient treatments, number of lab tests, percent patients screened for malnutrition) 2. Gather the data. Best if this data collection is part of usual practice, such as staff work logs. 3. Create a graph with an x (time or sequence) and a y axis (measurement). 4. Plot the data. Because data will go up and down, calculate a mean value and draw a line on the graph showing the average.
Histogram
Is usually a bar graph that shows in pictorial form the distribution of data collected over a period of time. Displays large amounts of data that is difficult to interpret in tabular form.
Scattergram
is a graph with numerous dots showing the relationship between two different sets of variables or factors. A scattergram can show a positive correlation, no correlation, or a negative correlation.
Cause and Effect Chart
is also known as fishbone diagram or Ishikawa diagram. The diagram that looks something like a fishbone, created by a team to identify, explore, and graphically display, in great detail, all of the possible causes related to a problem to discover its root causes. Possible causes to a problem are clustered into categories: people, procedures, equipment, and policy.
Quality Control Charts
Like a run chart, except, they show UPPER CONTROL LIMIT (UCL) and LOWER CONTROL LIMIT (LCL). The upper control limit and the lower control limit are usually placed three standard deviations from the mean value – that’s why they are called “statistical quality control charts.” These charts are used to monitor, control, and improve performance over time by studying variation and its source.
Pareto Chart
Used to determine priorities by showing which factors make the greatest contribution to a problem. The Pareto chart is a bar graph that shows which factor offers the greatest potential for improvement of a problem by showing the relative frequency or size of factors in descending order.
Bar Chart or Bar Graph
A simple illustration using bars to compare outcomes in one or more areas of activity. For example, bar graphs are often used to compare average length of stay (ALS) for different DRG groups or patient units, or percent patients with malnutrition on different medical services (medical, surgical, bone marrow transplant, renal, etc), or comparing actual performance with target performance (such as percentage of stat tests performed within 20 minutes).
Traditionally, what is the focus of quality control?
Finding defects
Why did quality assurance evolve into a better process?
QA placed emphasis on counting deviations from standards
What is the basis of total quality management or continuous quality improvement?
Avoid making errors in the first place
In essence, what are quality circles or a self-directed work teams?
Team oriented problem solving groups
What is the common driving force of Total Quality Management?
Strong commitment of top management
What is the role of a supervisor in TQM?
Foster employee commitment to excellence
Which of the following is a measure of productivity?
Minutes per treatment completed
What is an example of how to improve productivity?
12% increase in treatments with no increase in personnel hours
In the health professions, what is the basis for measuring quality?
Practice guidelines
According to the QA guru, what is responsible for poor quality?
Inadequate systems
When are quality control tools useless?
When no steps are taken to correct deviations
What is another term for methods improvement?
work simplification
What is the primary purpose of methods improvement?
to accomplish a task with less effort, in less time, at lower cost.
What characteristics are present for both methods improvement and TQM?
Multidisciplinary involvement. Team engagement in problem solving. Solution are generated.
What is an appropriate management philosophy regarding methods improvement?
Almost every task can be improved. People who do the work should help improve the processes. Participative management enhances effective member involvement
What would be a clue that there is a task that would lend itself to methods improvement?
Excess cost. Bottlenecks. Evident confusion. Poor morale of the workers. Excess walking, handling, and other non-productive activities.
What is an essential step of gathering facts for the methods improvement process?
Find out how the task is currently being performed.
Which step in the process lies at the heart of methods improvement?
Challenging every detail of a task
What common human problem arises at the implementation stage?
Resistance to change
Why is it important to involve employees in the entire process of methods improvement?
Employees know best how a job can be improved.
What is a flow process chart?
Tool to track and record steps in a process
The flow process chart can be used to follow either…
the steps of a person or the flow of material.
What is a flow process diagram?
Layout drawing of a department or unit
Who has greatest impact on employee attitude toward methods improvement?
The supervisor
What is a good definition of reengineering in a health care institution?
Systematic redesign of the hospital’s core processes
What is the first essential step when reengineering a hospital?
Identify mission
Why is reengineering necessary in today’s healthcare environment?
Circumstances are ever changing
What are some major barriers to hospital reengineering?
Existing processes. Traditional divisions of work. Normal resistance to change.
What is the most common goal of organizational restructuring?
Reduce the number of staff
Why are health care workers upset by a Reduction in Force? Because they feel that
money is more important than people.
What are immediate responses of health care employees to a Reduction in Force?
Eroded commitment to the hospital. Increased absenteeism. Reduced morale. Excess compassion toward laid off workers.
What is the major challenge to health care supervisors following a Reduction in Force?
Unite the survivors into a forward moving team.
After a Reduction in Force, what must employees do to attain the intended purpose of restructuring?
Pursue cost control and continuous quality improvement
What key skill will a manager use to help employees understand their role after a Reduction in Force?
Communication
What are some immediate effects of a Reduction in Force?
Drop in productivity. Increased absenteeism
What is the most potent source of employee motivation after a Reduction in Force?
Challenging and rewarding work
What is one thing managers can do after RIF to boost employee motivation?
Create incentive programs
What must a manager focus on especially after a Reduction in Force?
Staff advocacy. Productive work teams. Communication. Employee involvement.
