History of Management Flashcards
Group Think:
informal groups-> subculture
Not always negative. You can have positive ones. The management theory looked at was the effect of the negative groups.
Pareto Principle:
80% of the effect or outcome comes from 20% of causes or work: Pay attention to that 20% for a more effective program. Focus on the 20.
Peter Principle:
promoting competent employee to a new job could cause person to be less competent => need to assure training at every level. As you move up in career, if the training isn’t appropriate, the employee will not be good at that job.
Medical model practice settings in OT
Acute hospital (medical or psychiatric)
Acute rehab
Sub-acute rehab
Home health
Nursing home
Free standing outpatient or outpatient at hospital
Private physician office
Medical Model: short term
includes history and physical, diagnosis, and treatment to alleviate or cure an underlying medical condition.
Educational Model:
services are aimed at adaptation and performance within the educational setting
OT practice settings in Education Model
School system
Preschool
Day Care
Early intervention home health
Early intervention outpatient clinic
Public Health Model:
achieve health of populations through
prevention of disease (prevention)
e.g., eating nutritious foods to prevent obesity and other-related diseases;
slow progress of disease to prevent disability and complications (secondary prevention)
e.g., people with high blood pressure exercising and eating well to forestall CVA; or
tertiary prevention used in advance levels of disease to limit disability and other complications
[e.g., energy conservation techniques to prevent stroke]
OT Practice Settings Public Health Model
Community Education
Health insurance company
Public health agency (CDC, APHA)
Underserved or high incidence
Private industry
Research
National Institute for Health
Not directly under and OT model
Community Model (Social Model):
longer term maintenance and episodic restorative services (health promotion and prevention of further decline)
clients with stable health conditions at risk from social isolation, reduced family support, physical frailty, or other similar characteristics
Focus is on social barriers to prevention (Scaffa, 2001)
not necessarily OT
Ot Practice settings community / social model
Senior center
Group home, independent living center
Retirement center
Sheltered workshop
Prevocational programs
Community mental health center
not necessarily OT
Challenges in US healthcare
- Rising Costs
- Emphasis on outcomes and accountability
- Lack of services to meet specific needs
- Imbalance in services available to different populations
- Frequent advances in medical technology
- Increase government scrutiny of practices
- Increase public scrutiny of care available
Blue cross blue shield is
the first commercial insurance available started by roosevelt for injuries to worker on railroads.
Legislation under President Franklin D. Roosevelt (Term 1933-1945)
Ethical responsibility of an industrialized nation
First Modern Insurance Company (1930’s)
Blue Cross & Blue Shield
Roosevelt’s Economic Bill (1944)
Set forth fundamental social and political rights part of which was the right to health.
Health insurance Now an employee benefit
Healthcare legislation in the 40’s and 50
Hill-Burton Act (1946): promoted building hospitals & free-standing health facilities
later control over-growth and duplication of services (in 70’s and 80’s)
Taft Hartley Act (1947) Required Health benefits become a condition of employment
70% had health care by 1960
1950’s funds to encourage more schools for training medical personnel
focused on physicians
healthcare legislation in 60-70’s
1965: national insurance established
Medicare (for elderly)
Medicaid (for poor)
Based on Fee for Service (FFS)
Indemnity Plan: 80/20 with no limit to costs
= 80% paid by insurance company & 20% paid for by patient
1966: Allied Health Professionals Personnel Training Act
Funding -> increased number of OT Programs
1972: Amendment to the Social Security Act:
Drove focus toward professional standards review to monitor and control costs and quality of care
1970’s & 80’s Laws Changed due to spiraling costs of Fee For Service (FFS)
Medicare is for
elderly
medicaid is for
low income
medicaid and medicare is 80/20 - what does that mean
80% by insurance, 20% by patient. often 20 is picked up by the hospital.
medicare and medicaid is funded by whom
federally funded.
1970’s & 80’s Laws Changed due to
spiraling costs of Fee For Service (FFS)
seeing your primary before you see a specialists
Established Managed Care
Integrated delivery system between payor (insurance company) and care provider (physician or hospital)
Uses gate keepers
i.e physicians that limit referral to specialists or case managers that monitor and approve usage of services
HMO (Health Maintenance Organization):
Medical care provided ONLY within their network (often in same building) of providers or no coverage
