E-service learning: A pedagogic innovation for healthcare management education

This paper proposes an innovation in service learning that we identify as e-service learning. By adding the "e" to service learning, we create a service learning model that is dynamic, mediated by technology, and delivered online. This paper begins by examining service learning, which is a distinct learning concept. Service learning furnishes students with opportunities for applied learning through participation in projects and activities in community organizations. The authors then define and conceptualize e-service learning, including the anticipated outcomes of implementation such as enhanced access, quality, and cost effectiveness of healthcare management education. Because e-service learning is mediated by technology, we identify state of the art technologies that support e-service learning activities. In addition, possible e-service learning projects and activities that may be included in healthcare management courses such as finance, human resources, quality, service management/marketing and strategy are identified. Finally, opportunities for future research are suggested.     

Teaching and learning teamwork: competency requirements for healthcare managers

This paper addresses an essential element of postgraduate health service management education - development of individual competencies to enhance teamwork among health service managers. A survey of qualified health service managers in the state of Victoria, Australia revealed a set of individual competencies that the managers felt made a positive contribution to the success of workplace teams. The identified competencies included skills in leadership and communication; clinical knowledge and knowledge of organizational goals and strategies; motives such as commitment to the organization, to quality, to working collaboratively and to a consumer focus; and respect for others as a trait. Building on acknowledged teaching and learning theories, a teamwork teaching and learning model was successfully introduced into the postgraduate health services management curriculum at La Trobe University in Melbourne.     

Successful healthcare programs and projects: organization portfolio management essentials

Many healthcare organization projects take more time and resources than planned and fail to deliver desired business outcomes. Healthcare IT is a major component of many projects and often undeservedly receives the blame for failure. Poor results are often not a result of faulty healthcare IT or poor project management or poor project execution alone. Many projects fail because of poor portfolio management--poor planning and management of the portfolio of initiatives designed to meet an organization's strategic goals. Because resources are limited, portfolio management enables organizations to more strategically allocate and manage their resources so care delivery, service delivery, and initiatives that advance organizations toward their strategic goals, including healthcare IT initiatives, can be accomplished at the levels of quality and service desired by an organization. Proper portfolio management is the essential foundation for program and project success and supports overall organization success. Without portfolio management, even programs and projects that execute flawlessly may not meet desired objectives. This article discusses the essential requirements for porfolio management. These include opportunity identification, return on investment (ROI) forecast, project prioritization, capacity planning (inclusive of human, financial, capital, and facilities resources), work scheduling, program and project management and execution, and project performance and value assessment. Portfolio management is essential to successful healthcare project execution. Theories are drawn from the Organizational Project Management Maturity Model (OPM3) work of the Project Management Institute and other leading strategy, planning, and organization change management research institutes.     

An experiential learning simulation exercise for healthcare management students

Preparing competent administrators to work in today's dynamic healthcare environment is a challenging task for contemporary educators. Experiential exercises in the classroom can contribute significantly to student training. This paper reviews the benefits to students of actively participating in simulations and role-plays, as well as the challenges in running such exercises. A simulation designed specifically for healthcare administration students is presented with details and implementation instructions. The intent of this article is to impart to other educators the learning experiences in running this particular simulation to inspire dialogue and program improvement. Readers are encouraged to create simulation exercises with optimum relevance for their students. Information to obtain e-mail versions of the simulation is also provided.     

The balanced scorecard: a potent tool for energizing and focusing healthcare organization management

The current environment for healthcare organizations contains many forces demanding unprecedented levels of change. These forces include changing demographics, increased customer expectations, increased competition, and intensified governmental pressure. Meeting these challenges will require healthcare organizations to undergo fundamental changes and to continuously seek new ways to create future value. This article provides explanation of a potent new management tool-the balanced scorecard-that can be used by healthcare organizations to meet these challenges. The article also presents the opinions of many high-level healthcare administrators that the balanced scorecard can be highly beneficial to healthcare organizations. It also summarizes these administrators' suggestions regarding the goals and measures that can make up an effective scorecard for a hospital as a whole, as well as for a specific subunit of a hospital. Interestingly, while no published report of balanced scorecard implementations in healthcare organizations exists, a number of administrators stated that they had fully implemented systems similar to the scorecard. These actions can be considered support for the scorecard's potential usefulness; at the same time, they suggest that some sharing of experiences will likely be available in the future. As all administrators are well aware, moving from concept to practice is often difficult. While the article includes some suggestions for scorecard development and implementation, each organization must engage in the full range of activities, from defining its mission to the selection of goals and strategies, and develop its own unique scorecard to assist progress toward the selected goals. As a starting point, Table 3 provides a timeline of some general events that may be common to all organizations during this process.     

Matrix analysis of the client's voice: QFD applied to healthcare management

OBJECTIVE: To apply quality function deployment (QFD) methodology to identify clients' needs by relating complaints with perceived quality domains. SETTING: A hospital within the Public Health Service of Madrid. METHODS: Matrix analysis based on the QFD model was performed, using the surveys (1998-2002) conducted in the hospital with the Servqhos questionnaire and a sample of 363 complaints made in 2002. The complaints analyzed were selected using a non-probabilistic sampling method. RESULTS: QFD methodology was highly useful, allowing complaints to be related to the results of a perceived quality questionnaire and identification of the attributes with the greatest influence on patient satisfaction. It also allowed us to identify areas for improvement according to clients' needs.     

Creating a learning health care organization for participatory management: a case analysis

PURPOSE: This paper aims to define a theory of practice in successfully implementing management-communication practices in the service of organizational learning. DESIGN/METHODOLOGY/APPROACH: A combination of research methods, both quantitative and qualitative, was used in gathering and analyzing data. FINDINGS: Three principles in creating a supportive environment conducive to employee empowerment and participative decision making enable organizational learning. RESEARCH LIMITATIONS/IMPLICATIONS: The study provides empirical findings in support of current theoretic knowledge in organizational learning and empowerment. ORIGINALITY/VALUE: The paper partly rectifies that little research has investigated the enabling structures and processes to manage the environment that surrounds and supports employee participative decision making and new learning to occur at the individual and collective level within a health care setting.     

Sustainability of healthcare improvement: what can we learn from learning theory?

ABSTRACT: BACKGROUND: Changes that improve the quality of health care should be sustained. Falling back to old, unsatisfactory ways of working is a waste of resources and can in the worst case increase resistance to later initiatives to improve care. Quality improvement relies on changing the clinical system yet factors that influence the sustainability of quality improvements are poorly understood. Theoretical frameworks can guide further research on the sustainability of quality improvements. Theories of organizational learning have contributed to a better understanding of organizational change in other contexts. To identify factors contributing to sustainability of improvements, we use learning theory to explore a case that had displayed sustained improvement. METHODS: Forde Hospital redesigned the pathway for elective surgery and achieved sustained reduction of cancellation rates. We used a qualitative case study design informed by theory to explore factors that contributed to sustain the improvements at Forde Hospital. The model Evidence in the Learning Organization describes how organizational learning contributes to change in healthcare institutions. This model constituted the framework for data collection and analysis. We interviewed a strategic sample of 20 employees. The in-depth interviews covered themes identified through our theoretical framework. Through a process of coding and condensing, we identified common themes that were interpreted in relation to our theoretical framework. RESULTS: Clinicians and leaders shared information about their everyday work and related this knowledge to how the entire clinical pathway could be improved. In this way they developed a revised and deeper understanding of their clinical system and its interdependencies. They became increasingly aware of how different elements needed to interact to enhance the performance and how their own efforts could contribute. CONCLUSIONS: The improved understanding of the clinical system represented a change in mental models of employees that influenced how the organization changed its performance. By applying the framework of organizational learning, we learned that changes originating from a new mental model represent double-loop learning. In double-loop learning, deeper system properties are changed, and consequently changes are more likely to be sustained.     

Marketing healthcare globally: make it work for your organization

Geographic location and good patient care alone will not guarantee a successful international program. Organizations attracting foreign patients talk about weighing the chances of successfully launching a program, making sure the system is ready to provide customized patient services and--instead of advertising their services--marketing one-on-one.     

三级管理组织架构应用于医院医保指标管理中的效果分析

目的：探究三级管理组织架构应用于医院医保指标管理中的效果。方法：选取2018年1月至2019年12月无锡市第五人民医院医保患者的医保住院费用数据,2018年实施常规医保管理,2019年后开始实施三级管理组织架构,对比两年内医保患者住院指标情况、医保患者住院费用结构占比情况及医保查房与培训次数。结果：2019年医保患者住院指标情况优于2018年,差异有统计学意义（P＜0.05）;2019年医保患者住院费用结构占比情况与2018年相比,差异无统计学意义（P＞0.05）;2019年医保人员医保查房及培训次数分别为24次和10次,相较于2018年的15次和5次均有明显提升。结论：三级管理组织架构应用于医院医保指标管理中,可有效改善医保患者住院指标,增加医保工作者的医保查房与培训次数,对于改善住院医保患者的预后效果具有重要意义。     

Diversity management: an imperative for healthcare organizations

Historically, white males have represented the ideal manager in appearance, values, and behaviors, resulting in overt or subtle discrimination in selection, evaluation, and promotion practices in corporate America. Because women and minorities could not meet this ideal, they were often passed over for advancement. The author discusses key areas of diversity management for healthcare administrators to consider: the elements of diversity, the reasons behind diversity management, and solutions for addressing many of the issues involved.     

Championship management for healthcare organizations

Stakeholders will put increasing pressure on integrated health systems (IHS) for measured performance, demanding data on quality and patient satisfaction, while simultaneously pressing for lower cost. The changes to Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) and the growing importance of the National Committee on Quality Assurance (NCQA) are simply forerunners of an intensifying trend. Quality of care in particular will face increasing scrutiny. Achieving competitive targets in these areas will also require measures addressing demand and worker satisfaction. "Balanced scorecard" approaches will allow IHS and their accountable work groups to track performance on several dimensions and establish integrated goals or targets. Those with consistently good scores will be labeled "champions." Champions will support the multidimensional measures with improved decision processes. About eight major processes will be central--governance/strategic management, clinical quality, clinical organization, financial planning, planning and marketing, information services, human resources, and plant services. It is possible to map these processes to the criteria of the Joint Commission, NCQA, and Malcolm Baldrige Quality Award. The processes themselves can be measured and common weaknesses identified and corrected. Champions share some common characteristics that seem to arise from the combination of processes and measures. Among these characteristics are service line orientation, extensive partnering with other organizations, and the possibility of outsourcing organizational components.