Understanding Healthcare Management

1 UnderstandingHealthcare Management2 CHAPTER17 The prior chapter addressed growth in the health services industry andopportunities for Healthcare managers. By now the reader should appreci-ate that formal preparation in Healthcare Management can pay big divi-dends in terms of exciting Management jobs and positions with excellentcareer advancement. But just what do Healthcare managers do? And whatare their roles and responsibilities? Healthcare Management is the profession that provides leadership anddirection to organizations that deliver personal health services , and to divi-sions, departments, units, or services within those organizations.

2 Thischapter gives a comprehensive overview of Healthcare Management as aprofession. Understanding the roles, responsibilities, and functions carriedout by Healthcare managers is important for those individuals consideringthe field to make informed decisions about the fit. This chapter providesa discussion of key Management roles, responsibilities, and functions, aswell as Management positions at different levels within Healthcare organi-zations. In addition, descriptions of supervisory level, mid-level, and sen-ior Management positions within different organizations are 5/4/09 10:39 AM Page 17 Jones and Bartlett Publishers, LLC.

3 NOT FOR SALE OR NEED FOR Management AND THEIR PERSPECTIVEH ealthcare organizations are complex and dynamic. The nature of orga-nizations requires that managers provide leadership, as well as the supervi-sion and coordination of employees. Organizations were created to achievegoals that were beyond the capacity of any single individual. In healthcareorganizations, the scope and complexity of tasks carried out in provi-sion of services are so great that individual staff operating on their owncouldn t get the job done. Moreover, the necessary tasks in producing serv-ices in Healthcare organizations require the coordination of many highlyspecialized disciplines that must work together seamlessly.

4 Managers areneeded to make certain that organizational tasks are carried out in the bestway possible to achieve organizational goals and that appropriate resources,including financial and human resources, are adequate to support managers are appointed to positions of authority where theyshape the organization by making important decisions. Such decisions, forexample, relate to recruitment and development of staff, acquisition oftechnology, service additions and reductions, and allocation and spendingof financial resources. Decisions made by Healthcare managers not onlyfocus on ensuring that the patient receives the most appropriate, timely,and effective services possible, but also address achievement of perfor-mance targets that are desired by the manager.

5 Ultimately, decisions madeby an individual manager affect the organization s overall must consider two domains as they carry out various tasksand make decisions (Thompson, 2007a). These domains are termed exter-naland internal domains(see Table 2-1). The external domainrefers tothe influences, resources, and activities that exist outside the boundary ofthe organization but which significantly affect the organization. These fac-tors include community needs, population characteristics, and reimburse-ment from commercial insurers and Medicare and Medicaid. The internaldomainrefers to those areas of focus that managers need to address on adaily basis, such as ensuring the appropriate number and types of staff,financial performance, and quality of care.

6 These internal areas reflect theoperation of the organization where the manager has the most the dual perspective requires significant balance on the part ofmanagement and significant effort in order to make good 5/4/09 10:39 AM Page 18 Jones and Bartlett Publishers, LLC. NOT FOR SALE OR : DEFINITION,FUNCTIONS, AND COMPETENCIESAs discussed earlier, Management is needed to support and coordinate theservices that are provided within Healthcare organizations. Managementhas been defined as the process, comprised of social and technical func-tions and activities, occurring within organizations for the purpose ofaccomplishing predetermined objectives through humans and otherresources (Longest, Rakich, & Darr, 2000).

7 Implicit in the definition isthat managers work through and with other people, carrying out techni-cal and interpersonal activities, in order to achieve desired objectives of theorganization. Others have stated that a manager is anyone in the organi-zation who supports and is responsible for the work performance of oneor more other persons (Lombardi & Schermerhorn, 2007).While most beginning students of Healthcare Management tend to focuson the role of the senior manager or lead administrator of an organization,it should be realized that Management occurs through many others whomay not have manager in their position title.

8 Examples of some of thesemanagerial positions in Healthcare organizations include supervisor, coor-dinator, and director, among others (see Table 2-2). These levels of mana-gerial control are discussed in more detail in the next : DEFINITION, FUNCTIONS, ANDCOMPETENCIES19 Table 2-1 Domains of Health services AdministrationExternalInternalCommunity Demographics/NeedStaffingLicensureBudget ingAccreditationQuality servicesRegulationsPatient satisfactionStakeholder DemandsPhysician relationsCompetitorsFinancial performanceMedicare and MedicaidTechnology acquisitionManaged care organizations/InsurersNew service Thompson, Health services Administration in S.

9 Chisolm (Ed.), TheHealth Professions: Trends and Opportunities in Health Care, 5/4/09 10:39 AM Page 19 Jones and Bartlett Publishers, LLC. NOT FOR SALE OR implement six Management functions as they carry out theprocess of Management (Longest, Rakich, & Darr, 2000):Planning:This function requires the manager to set a direction anddetermine what needs to be accomplished. It means setting prioritiesand determining performance :This Management function refers to the overall design ofthe organization or the specific division, unit, or service for which themanager is responsible. Further, it means designating reporting rela-tionships and intentional patterns of interaction.

10 Determining posi-tions, teamwork assignments, and distribution of authority andresponsibility are critical components of this :This function refers to acquiring and retaining humanresources. It also refers to developing and maintaining the workforcethrough various strategies and :This function refers to monitoring staff activities and per-formance, and taking the appropriate actions for corrective action toincrease :The focus in this function is on initiating action in theorganization through effective leadership and motivation of, andcommunication with, 2-2 Managerial Positions, By Organizational SettingOrganizational SettingExamples of Managerial PositionsPhysician PracticePractice ManagerDirector of Medical RecordsSupervisor, Billing OfficeNursing HomeAdministratorManager, business OfficeDirector, Food ServicesAdmissions CoordinatorSupervisor, Environmental ServicesHospitalChief Executive OfficerVice President, MarketingClinical Nurse ManagerDirector, Revenue ManagementSupervisor.