Heinke Questions Flashcards
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What does CVPM stand for?
Certified Veterinary Practice Manager (CVPM)
What are the 4 components of The Management Process?
- Planning. Determining the goals of the business and developing the strategy and tactics to accomplish these goals
- Organizing. Communicating the plan to those who will carry it out and developing the team framework and resources required to successfully implement the plan
- Directing. Using personnel management skills to motivate people to accomplish various steps of the plan through appropriate allocation of resources
- Evaluating. Measuring and analyzing the success of the management process and providing the information required to adapt and modify management decisions
Of the four basic steps of the management process, Planning, the first step, involves Three general types of planning, what are they? Heinke pg 16
- Strategic planning:
-Long-range planning (five to ten years into the future).
-how the practice will be positioned down the road in relation to other practices and the marketplace…… envisions practice size and location, type and number of clients, level of veterinary service demand, and philosophy and style of animal-care delivery. - Tactical planning:
-Planning for the near future (one to three years ahead).
Tactical plans facility expansion, employee acquisition and training, identification of service specialization, budgeting, and the like. - Operational planning:
-Short-range planning (for the days and weeks immediately ahead).
Operational planning evolves from tactical planning. An operational plan identifies specific steps, indicates who will accomplish them, and ensures that resources are budgeted to achieve the various tactics. Once the operational plan is designed and implemented, a manager must monitor the results and adapt the plan as needed to keep the practice in line with the longer-range tactical and strategic plans.
Practice procedures and systems should be the direct result of ______ and not the result of random attempts at management. Successful businesses are ____ oriented rather than ________ oriented.
Planning
goal-
procedure-
Example of a tactical goal…..
Includes a date and reflects philosophy and practice aspirations…
Increase patients 25%, all doctors take a month off every year, increase income 15%
To produce best care for patients and prosper our organization to serve community and stakeholders is an example of what type of goal?
Heinke Pg 17… a strategic goal reflects the practice philosophy and forecasts a long term future.
The second management duty, ____, is founded in how well you, as practice manager, manage your team.
Organizing
Third step of the managment process, ______, calls upon your personnel management skills as you motivate your practice team to accomplish various stages of the plan.
Directing
These four attributes are cornerstones for marking the progress of business strategies in the final and fourth aspect of the management process termed _________.
Fourth aspect of management process….evaluating… includes these four attributes….
- The financial success of the business (financial success metric)
- The ability of the staff to work as a team (efficiency of internal processes metric)
- The level of motivation and contentment among employees (employee development metric)
- The level of client satisfaction as measured by new client referrals (client retention and loyalty metric) Heinke Pg. 18
THINK: the money, the efficiency, your people, the clients
Areas of management in a veterinary practice? (four) according to Heinke pg 19, Practice Made Perfect.
Personnel and human resources…people
Operations and maintenance…“gears” of the organization
Finance and economics…the money (and risks to it..legal)
Marketing and client relations……the clients attraction/retention
Of the office manager, the practice manager and the hospital administrator….who has the most absolute authority?
The hospital administrator
Heinke, pg 22
Owen McCafferty (1993, 4), who describe three key character styles in the business arena: name three types of individuals in a veterinary hospital….
The entrepreneur
The professional
The manager
What is EQ according to Heinke?
One’s awareness of other people’s emotions as well as one’s own and one’s ability to manage them and relate to people in positive ways.
Heinke Pg. 35
What six traits should a PM have per VHMA ?
- Ability to command respect
- Supervisory skills
- Ability to follow through on projects
- Ability to be self-motivated
- Communication skills
- Ability to control emotions
Strategic planning is a formal design of the practice’s future activities and is based on the answers of key stakeholders in the business to what three fundamental questions?
- What do we do?
- For whom do we do it?
- How do we excel?
Heinke pg 43
What is a vision statement?
The vision statement defines the practice’s purpose through its human values, and its audience is primarily clients and employees. It is typically inspirational and public facing and it helps shape how the clients view the practice and why they would want to do business with it.
Heinke Pg. 48 and Pg. 45
What is a mission statement?
The mission statement defines the practice’s primary objectives and purpose with an internally facing focus to leaders and owners, including key measures of success. Can include financial objectives.
Per Heinke what are core values?
Core values are the ultimate standards, those which the owners consider to be inviolate. They steer the veterinary practice as guiding principles of practice
conduct, and they are the basis for the rules by which the principals and the rest of the practice team live and make daily decisions (Nyland and Heinke 2006).
Usually, core values come down to four or five deeply held principles that are
independent of the current business environment and management fads. Pg. 46
THE STRATEGIC PLANNING PROCESS has what five components?
- Vision
- Situational Analysis
- Strategy Formulation
- Strategy Implementation
- Evaluation and Control
Core purpose? Definition?
How financial and ethical commitments relate to each other.
What is a veterinary practice act?
The legal statute that guides what each licensed and non-licensed employee of the practice can and cannot do.
The written practice vision and mission statements collate four areas, which are…..
(1) the visionary goals of the practice stakeholders
(2) their core values
(3) the core purpose and supporting primary objectives of the practice
(4) applicable laws and professional ethical codes
What is a SWOT analysis?
- Strengths
- Weaknesses
- Opportunities
- Threats
Analysis - this strategic planning technique analyzes the practice’s internal strengths and weaknesses and identifies external opportunities and threats (good and bad risk)
What is environmental scanning?
Evaluating the practices situation, a step in strategic planning that involves evaluating internal and external factors includes SWOT Analysis, analyzing external factors (tech, economy, etc.).
Pg. 52 Heinke
What are examples of EXTERNAL PRACTICE FORCES?
- Competitors
- Sales market (clients)
- Supplier market
- Labor market
- Technology
- The economy
- The regulatory environment
What are 3 sources of competitive advantage in the veterinary marketplace that should be considered when you analyze external forces?
3 sources of competitive advantage include
- Cost
- Differentiation
- innovation
Differentiation is what in reference to an external factor in the veterinary marketplace
?
Perceived quality of care, type of service, price levels,
and image of your practice. This perception is driven by marketing.
As an external factor in the vet marketplace what does innovation describe?
innovation is the competitive advantage a practice has when others cannot keep up with the new ideas and methodologies it has successfully implemented
A useful approach to external pressure analysis was developed by Michael Porter (1980).
Porter’s five-force analysis…. What are the 5 forces….
Porter’s five forces are:
- Threat of new entrants to the industry
- Threat of substitutes
- Buyer (client) power
- Intensity of rivalry among established practices
- Supplier power….pg 54 Heinke
PEST analysis is a strategic planning analysis framework using four factors in the external microenvironmt in which a practice operates ….what are those factors?
political,
economic, sociocultural, and technological.
Value chain management is an example of a internal or external force on your practice organization and define value chain model?
Internal….
The overriding emphasis of the value chain model is client satisfaction.
evaluate what the practice team does from a value chain–
strategy perspective. If employees are doing things that do not add value to the client’s
experience, they should not be doing them. Your primary objective as a manager is to cause the practice to make money. By focusing
on excellent service, your team drives client perception of value and willingness to pay for
that value (this is called the value proposition) One management objective is to focus on what
your practice does well and keep doing it well. Such effort drives quality and value, thus
ensuring client satisfaction and loyalty.
In value chain analysis you divide the practice into what 2 activity areas
- The primary operating activities, or those that show the progress of client and patient interaction with the practice
- The support activities, or those governance or managerial activities required to sustain a well-organized and efficiently managed practice
The VPS recognizes the financial measures that assure an adequate economic base to
drive excellent veterinary care….. Describe this tool and the 4 perspectives it uses
Veterinary Practice Scorecard (VPS)..... • The patient care perspective • The client perspective • The learning and growth perspective • The financial perspective
Policy or protocol drift…. What is it and how does it apply to VPS analysis and setting goals
Lapses in policy or protocol where processes have clearly lapsed….such as waiting to see the doctor after arriving, missed appointments, arriving late for appointments HEINKE pg 60 Process or protocol drift causes a weakening in the value chain.. This can be used in VPS analysis.
SMART goals in each of the
balanced scorecard (VPS) quadrants will lead to action and incremental improvement.
SMART goals are:
SMART goals are: • Specific •Measurable • Attainable • Relevant • Time-bound
What are the 4 VPS perspectives and give an example of each
- patient perspective EX. measure time of client arrival, time of exam room admit, and time of doctor
to patient. Our goal will be to have every client and patient with a technician and/or
veterinarian within five minutes of arrival. - Client perspective EX. we will employ a three-question exit survey to determine satisfaction with
appointment timeliness. - Employee perspective…ex… At the end of each shift, each employee will write down any
issues they came across that were challenging to work through. - Financial perspective ex. increased
revenue generated per client and increased average patient visits per year.
gross revenues, profitability percentage, client numbers, client satisfaction measures, patient numbers, employee longevity, and/or satisfaction measures…. Are examples of what type of measurement used for long term planning
KPI’s
Common pitfalls to a strategic plan
failure to communicate VISION
passive management NO plan or idea or inadequate detail IN THAT plan lack of motivation and personal ownership
Central planning is important in strategic planning for 2 reasons
- budgeting helps managers measure progress toward goals…. 2. Good planning and budgeting are needed to fund each part of the strategic plan
Innovative budgeting tools that can help businesses become more nimble in a changing economy
. Some examples are rolling budgets, rolling forecasts, flexible budgets, and event-driven budget plans. Be aware of the pros and cons of these financial tools and
how they can be used in financial planning.
Budgeting can be broken down into 3 sections?
Target setting, forecasting, and resource allocation…
management style that is primarily directive or achievement-oriented is commonly
known as _______or authoritarian leadership. A management style that is primarily
supportive or participative is known as ________ leadership.
Autocratic
Democratic
Theory ____ assumes that people prefer to be directed, are not interested in assuming responsibility, and are motivated primarily by money, fringe
benefits, and the threat of punishment.
theory X
Theory ____ postulates that employees can be self-directed and creative at work if they are properly supported and motivated. Motivation can come from individual desire for recognition, from a sense of self-worth and pride, and from an interest in work well done.
Theory Y
self awareness, self control, self motivation, empathy and effective management of relationships are 5 levels of competence in the study of what behavioral theory?
EQ
What are 4 basic leadership styles?
Directive, supportive, participative, and achievement oriented
Define chief characteristics of each of the 4 leadership styles….
Managers primarily use four basic leadership styles to varying degrees: directive, supportive,
participative, or achievement oriented. The directive style is task oriented. The supportive
style is more concerned with people’s individual needs than with tasks. The participative
style involves consulting with the group in decision making. And achievement-oriented
leadership focuses on setting challenging goals.
Emotional intelligence is often described by five levels of competence in which to focus
personal improvement:
self awareness, self control, self motivation, empathy, effective management of relationships
List the Marston 4 behavioral types
Dominance, inducement, submission, and compliance
D and C are __ oriented whereas I and S are ___oriented and D/C see the world as ___ and S and I see the world as ___ using behavioral instruments to predict how teams can be built is called _______.
task, people/relationship
unsafe/adversarial
safe/benevolent
instrumented learning
What is the difference between a hospital manual and an employee manual?
The employee
policies and guidelines manual gives employees information pertinent to their employment
with the practice. The hospital operations manual presents information about how to
perform duties associated with client service, animal care, facility maintenance, and other
business protocols. pg 95 Heinke
In the employment cycle, these four stages exist mirroring closely those of the management process
these stages translate roughly into planning employee acquisition, hiring, conducting orientation and training, and engaging in performance evaluation….Heinke pg 102
Two key ingredients in a complete plan for staff acquisition are the ___ and the ___.
the budget and the job description
What is negligent referral
When a past employer refuses to give negative information about a former employee even though they know that they committed violent or illegal acts under their employ
In the United States one form that an employee must complete and documentation that the employer must collect includes a federal income tax holding document which is also called ____….. What other form for tax purposes should an employer also collect
w-4
state income tax withholding forms
In the United States the forms to complete and the documentation to collect when an employee is on board include
w-4, state income tax withholding form, I-9, medical retirement forms, personal information including full name permanent address telephone number and phone number for person to contact in an emergency
what is an I-9 form, what is it used for and what do you need to fill it out
I-9 is it employment eligibility verification form used to establish an employee’s eligibility to legally work in the United States passport drivers license or ID card Social Security card birth certificate
Which document completed upon employment must be kept separately from the rest of the employees personnel file
I-9
What does OSHA stand for and why is it important in the veterinary workplace per Dr. Heinke….
Occupational Safety and Health Administration important personal safety training in the veterinary practice setting relates to the employees ability in handling and being around animals and maintaining good training resources about normal animal postures and body language as well as hazardous materials and ergonomic risks in the workplace are important to compliance…. according to HEINKE indoctrination and training should begin immediately for new hires and should be documented
What questions can you not ask or areas that you cannot discuss in an interview
Discussing age is acceptable only to know if they are the age of majority arrests and convictions are acceptable only if it relates specifically to the performance of the position for example handling controlled drugs there are no legal questions regarding marital or family status and disability has to be handled by asking how a person would perform a function as opposed to how they might be different national origin race color religion sex birthplace` discharge from the military clubs or societies or a photograph
Payroll summated with ancillary employment costs, such as employer payroll taxes, qualified benefit programs, and workers’ compensation coverage, can easily consume 50 percent of every revenue dollar earned true or false.
true
The ancillary elements of employee compensation other than salary may add as much as __
to __ percent to the total cost of hiring an employee.
25-35
Employee compensation can be 45 to 55% of total gross revenue… T/F
TRUE
Define at-will employment
At-Will Employment
In most states in the United States, employment is considered to be “at-will employment.”
This means that unless a specific provision in an employment contract states an agreed upon
duration of employment, employees may quit and employers may terminate
employees “at will,” according to their own preferences
WHAT ARE express exceptions to at will employment?
• Collective bargaining agreements (labor contracts between unionized workers and
employing companies)
• Specific contracts that indicate a definite period of employment
• Dismissals based on race, sex, color, creed, or national origin, prohibited by the Civil
Rights Act
• Dismissals based on age if over forty years old, prohibited by the Age Discrimination in
Employment Act
• Dismissal because of pregnancy, prohibited by the Pregnancy Discrimination Act
• Dismissals that occur because employees refuse to work in a workplace that they
consider unsafe or because they have exercised other rights under the Occupational
Safety and Health Act
• Dismissal of an employee because he has filed for bankruptcy, prohibited by the
Bankruptcy Reform Act
• Dismissal of an employee because of service on a federal jury, prohibited by federal law
What is COBRA
The Consolidated Omnibus Budget Reconciliation Act of 1986
(COBRA) allows for the extension of group insurance coverage to former employees and
their dependents. COBRA requires employers to cover former employees whose medical
conditions would prevent them from immediately getting coverage under a new employer
plan. This is done at the employees expense.
What 5 separate record keeping systems related to employees should employers keep
employers should maintain five essentially separate record-keeping systems related to its employees.
These include personnel files, medical record files, equal employment opportunity data, I-9 records, and payroll and benefits data.
employers should maintain A separate personnel file for each hospital employee that contains relevant materials related to the person employment and excludes unnecessary personal information should be kept in a locked secured cabinet that is accessible only to specific personnel that need access to them true or false
true
A ____record should include the following application, letters of qualification, contacts, references, resume, federal and state mandated form I-9, which should be managed separately, an employee record form showing the date of hire original salary records, of raises and promotions, demotions, performance evaluations, education and training records, awards, recommendations, disciplinary records, attendance, vacation, corrective action feedback, layoff, termination records, resignation, exit interview
Employee personal record
Federal I-9 records support federal law that requires an employer to verify that an employee is eligible to work in the United States and to keep records of the verification process why must these records be kept separate?
These forms should be kept separate from other employee records for a number of reasons, including the fact the employers are not to use information on
national origin in employment decisions in accord with nondiscrimination laws. Segregated record-keeping is one protection against the implication that nationality might have been a factor in any aspect of the employment cycle.
Medical records should be segregated from other employee personnel records. Access must be carefully limited only to those who need to know the information, such as the employee’s supervisor for purposes of identifying work limitations. Medical-record files
contain information such as:
• Pre-employment drug screen results
• Post-employment physical exam results
• Family and Medical Leave Act Documentation
• Return-to-work releases
• Documentation of corrective-action feedback or other discussions related to
performance of duties
• Documentation regarding disability and/or accommodation thereof
• Workers’ compensation documentation
• Insurance claims documents
• Physician notes (Crook n.d.)
Because the Internal Revenue Code and Fair Labor Standards Act (FLSA) require employers to keep detailed payroll and benefits data, access should be limited. Keeping this information segregated from other personnel data is advised:… Which of the following would qualify to be kept separate in this way?
Employee’s full name and Social Security number
• Address, including zip code • Birth date, if employee is a minor • Work schedules • Pay rates • Earnings records • Wage deductions • Benefit records • Hours worked daily and weekly • Time records for each pay period, documenting the hours the employee has worked
What is the IRCA
The Immigration Reform and Control Act (IRCA) of 1986 affects all employers regardless of size. Intended to prevent illegal aliens from obtaining employment in the United States, the IRCA requires employers to take steps to verify that a newly hired employee is eligible
for employment in the United States. All employers must verify that every new hire is either a U.S. citizen or is authorized to work in this country. The IRCA applies to all employees: full-time, part-time, temporary, or seasonal. It does not apply to contract workers, so you do not need to obtain or verify information about independent contractors or their employees. 2Verification of employee eligibility is documented on U.S. Citizenship and Immigration
Services (USCIS) Form I-9
What time frame does the employer have to ensure that the I - 9 is completed?
The
employer is responsible for ensuring that this attestation is properly completed by the time
of hire, even though the proof-of-identity documents must be presented and examined up
to three business days from the hire date.
Is the sole proprietor required to have an I-9
no…. Every other employee is … Even practice owners
How long are verification of employment forms mandated to be retained by the employer?
The verification forms must be retained for three years from the date of hire or one year
from the date of termination, whichever is longer.
What is the fair labor standards act of 1938
The Fair Labor Standards Act (FLSA), passed by Congress in 1938, sets basic minimum
wage and overtime pay standards and record-keeping requirements and regulates the
employment of minors. The FLSA can apply to employees in one of two ways: enterprise
coverage or individual coverage.
What businesses do the FSLA apply to?
applies to a business if it is engaged in interstate
commerce, has at least two employees, and has annual sales or business volume of at least
$500,000.
what are the minimum wage requirements under the FLSA?
The FLSA generally requires covered employers to pay their nonexempt employees at least
the federal minimum wage and overtime premium pay of one-and-one-half times the
normal rate of pay for all hours in excess of 40 in a workweek, or, in some states, it is for all
hours in excess of 8 in a work day. Each workweek stands alone.
what is the work week according to FLSA… And when would straight time and overtime apply in that work week?
A workweek is defined as 7 consecutive,
regularly recurring, 24-hour periods totaling 168 hours. For the first 40 hours worked in
any given workweek, each employee must be paid at least the minimum wage.
The overtime pay premium (1.5 times the regular rate) applies to all hours worked
above 40 in a given workweek.
What activities are considered hours worked that might not intuitively be considered on the clock according to the FLSA
Hours an employee worked that were not expressly requested by the employer include waiting time when even when unable to use the time to do other things on call time when the employee has to stay on the premises or close to the premises, a rest period of 5 to 20 minutes training time travel time between job sites sleep time if the employee is on duty and is allowed to sleep
Who is exempted under FLSA
- Executive employees
- Administrative employees
- Professional employees
- Employees engaged in outside sales
- Employees doing computer-related work
Are you required to post the minimum wage in your place of business
yes….FLSA.. in a prominent place in the workplace
If an employee must wear a uniform, the financial burden of furnishing and maintaining
the uniform (including laundry and repair) may not be imposed on the employee if the
resulting wage would be below the minimum wage or overtime compensation required by
the FLSA. T/F?
TRUE
to determine regular rate of pay under FLSA…T/F?
TRUE
The three tests for exemption from FLSA minimum wage and overtime provision are related to ______. The ultimate burden of supporting exemption rests on the employer.
salary level, salary basis, and job duties.
Under the first test, the minimum requisite exempt salary level is $____ per week for most
employees.
455.00
under FLSA the second test for exemption resides in salary payment…. citing guideline for how salary must be paid to an exempt employee
compensation cannot be reduced because of variations in the quality or quantity of the work performed. The full salary must be paid for any week in which the employee performs any work, but need not be paid for any workweek when no work is performed. If the employee is ready, willing, and able to work, deductions may not be
made for time when work is not available….
The third test for exemption from minimum wage and overtime provision relates to which job duties?
practice:
1. Executive duties 2. Administrative duties 3. Professional duties
Under the FLSA, employers are required to keep records on wages, hours, and other
information for at least —___years?
3
do you have to pay a student worker minimum wage?
Other exceptions to the FLSA’s minimum wage requirements include full-time students,
student learners, and disabled workers.
The Wage and Hour Division of the U.S. Department of Labor issues certificates of exemption. The employer must apply for these in order to pay wages that are less than the minimum to these workers.
Who enforces the FLSA?
Can an employee lodge a complaint?
The wage and hour division of the US Department of Labor….yes and It is a violation of the FLSA to fire or in any way discriminate against an employee for filing a complaint or participating in a legal proceeding involving
any of the provisions of the act.
Do child labor restrictions fall under FLSA?
yes
Holiday bonus pay is covered by FLSA?
no… State laws may cover this and the other following matters• Vacation, holiday, severance, or sick pay
• Meal or rest periods, holidays off, or vacations
• Premium pay for weekend or holiday work
• A discharge notice, reason for discharge, or immediate payment of final wages to
terminated employees
• Any limit on the number of hours in a day or days in a week that an employee at least
sixteen years old may be required or scheduled to work
• Pay raises or fringe benefits
What are some common errors to avoid in employment law
Here are some common errors to avoid:
• Confusing federal law and state law
• Assuming that all employees paid a salary are not due overtime
• Improperly applying an exemption
• Failing to pay for all hours an employee is “suffered or permitted” to work
• Limiting the number of hours employees are allowed to record
• Failing to include all pay required for calculating the regular rate of overtime
• Making improper deductions from wages that cut into the required minimum wage or
overtime (e.g., shortages, drive-offs, damage, tools, uniforms)
• Treating an employee as an independent contractor
EMPLOYEES AND INDEPENDENT CONTRACTORS
Whether an individual is classified as an employee or an independent contractor is an important factor in determining the responsibilities of your practice under a variety of acts and regulations. These include:
• The FLSA
• The Federal Insurance Contribution Act (FICA)
• The Federal Unemployment Tax Act (FUTA)
• Internal Revenue Code (IRC) regulations determining income tax withholding responsibilities
• IRC regulations determining the requirement for providing benefits to an individual under evolving sections of the IRC
• IRC regulations determining the employer’s responsibility regarding the many other
laws related to “employees”
The FLSA protects employees but not contractors true or false?
TRUE
What are the 6 elements of control exercised by practice over an individual as described by the economic reality FLSA test to determine independent contractor versus employee…there are 20 common law factors to determine if an employer employee relationship exists what 3 categories did they fall in to?
The degree of control exercised by the practice over the individual’s work performance
- control over work hours, appointments and assignments, priority of work, hourly payment arrangement).
- The extent of the relative investments by the practice and the individual in equipment and supplies used (for example, drugs and medical supplies).
- The individual’s opportunity for profit and loss through managerial skill (if the practice provides the opportunities and bears the risk of profit and loss, it is more likely that the individual is an employee).
- The skill and initiative required by the work. Lower skill requirements weight toward employee status, but this does not necessarily mean that more skilled individuals, such as veterinarians, will qualify as independent contractors.
- The permanence of the relationship. Longer work relationships imply employee status, especially when the nature of the work assignments does not vary much.
- The extent to which the worker’s services are an integral part of the practice.
They fall into three main categories: behavioral control, financial control, and relationship of the
parties.
what is an example behavioral control, financial control, and relationship of the parties as it pertains to determining employment versus contractor status
behavioral control exists when you can tell an employee where and when and how to do their work, an example of financial control is the employer sets an employees hours, an employee can terminate his or her relationship anytime without incurring liability but an independent contractor is usually responsible for the satisfactory completion of the job - there also might be a written contract with a contractor
Civil Rights Act of 1964 Title VII makes it an unlawful employment practice for an employer to fail or refuse to hire or to discharge any individual, or otherwise to discriminate against any individual with respect to his
compensation, terms, conditions, or privileges of employment, because of such individual’s____
race, color, religion, sex, or national origin
