Assignment: Staffing and Controlling Issues

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Assignment: Staffing and Controlling Issues

Assignment: Staffing and Controlling Issues

Assignment: Staffing and Controlling Issues

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Week 3 – Assignment: Analyze Staffing and Controlling Issues

Assignment: Analyze Staffing and Controlling Issues Instructions

Personnel are the single greatest and largest resource available to healthcare administrators. As a group, personnel and staffing represent the largest cost, but are also the means by which a healthcare organization can fulfill its mission.

Imagine that you are a clinical department manager for a large hospital system. Leadership has decided that a service line is needed in a new medical area. One example of a newer medical field is medical genetics, but others exist. Select one or create your own for this assignment. Regardless of the field, leadership is anxious to better understand the staffing needs—including management, physicians, nursing, support staff, and others—that will be needed for this new area of service.

Prepare a PowerPoint presentation for leadership that reviews the overall role of staffing and for specific needs, such as those mentioned above. Explain how you will determine what and how many staff members will be required. Note that you do not need to provide actual numbers, but an understanding of your approach is needed. Describe the staff reporting structure in the new department and why you feel the proscribed structure will be effective. Finally, indicate how you will recruit for these new positions. Assignment: Analyze Staffing and Controlling Issues

Incorporate appropriate animations, transitions, and graphics as well as speaker notes for each slide. The speaker notes may be comprised of brief paragraphs or bulleted lists.

Support your presentation with at least three scholarly resources. In addition to these specified resources, other appropriate scholarly resources may be included.

Length: 12-15 slides (with a separate reference slide)

Notes Length: 100-150 words for each slide

Be sure to include citations for quotations and paraphrases with references in APA format and style where appropriate. Assignment: Analyze Staffing and Controlling Issues

Please watch following videos:

Nursing Shortage

produced by Nancy Kramer, fl. 2001, Columbia Broadcasting System; interview by Lesley Stahl, 1941-, in 60 Minutes (New York, NY: Columbia Broadcasting System, 2003), 12 mins

Building a Magnetic Culture: How to Attract Top Employees, Engage Them, and Make Them Want to Stay

produced by Briefings Media Group, in Retaining Great Employees: Tactics for Hanging on to Your Best Talent (Bethesda, MD: Columbia Books, 2013, originally published 2013), 1 hour 26 mins

Week 3 Assignment Title: Analyze Staffing and Controlling Issues

Grading Rubric

CriteriaContent (12 points)

Characterized an example of a clinical service line (2 points).

Analyzed the staffing model to be used in an understandable manner (4 points).

Illustrated the proposed staff reporting structure (4 points).

Reviewed the manner of recruitment for the various roles (2 points).

Included speaker notes for each slide, animations, transitions, and graphics. Included a minimum of three scholarly references, with appropriate APA formatting applied to citations and paraphrasing. Presentation is 12-15 slides long (3 points).

(Total points 15)

inter v ie w Interview With Wayne M. Lerner, DrPH, FACHE, Past President and Chief Executive Officer, Holy Cross Hospital W ayne M. Lerner, DrPH, FACHE, was president and CEO of Holy Cross Hospital in Chicago, Illinois, from 2006 to 2013. He spent the first 17 years of his career at Rush–Presbyterian–St. Luke’s Medical Center, where he rose to the position of vice president for administrative affairs and chair of the Department of Health Systems Management. During the early 1990s, Dr. Lerner served as president of Jewish Hospital of St. Louis, Missouri, and as a senior executive officer within the BJC Health System, where he was a key executive behind the merger of Jewish and Barnes hospitals as well as the creation of the BJC Health System. From 1997 to 2006, Dr. Lerner was president and CEO of the Rehabilitation Institute of Chicago, an organization distinguished by its designation as the best rehabilitation hospital in the United States since 1991 by U.S. News & World Report. In 2006, Dr. Lerner became interim president and CEO of Holy Cross Hospital, an inner-city, faith-based, disproportionate-share hospital in Chicago. In 2007, he assumed the role on a full-time basis and stepped down from that position in 2013. Dr. Lerner is a Fellow of the American College of Healthcare Executives and of the Institute of Medicine of Chicago. He holds a bachelor’s degree from the University of Illinois and MHA and DrPH degrees from the University of Michigan. In 2013 he was the recipient of ACHE’s Gold Medal Award in the healthcare delivery organization category. The Gold Medal Award is the highest honor bestowed by the American College of Healthcare Executives on outstanding leaders who have made significant contributions to the healthcare profession. Dr. O’Connor: Congratulations on receiving the 2013 Gold Medal Award! The variety of organizations (academic medical center; rehabilitation facility; large, integrated system; inner-city, faith-based hospital) in which you have worked and the breadth of activities you have managed are noteworthy. Similarly, you have filled many different types of leadership roles. How have you been able to adapt to the different role demands and differences in organizational context, culture, governance, resources, and so on, as you moved among these various settings? What did you learn from working in these different types of organizations and roles? Dr. Lerner: First, we should establish a contextual baseline for this question. The delivery system roles were important, but so were the many external roles in which I also participated. I always tell people that I’ve had an atypical career, in that it has not followed any type of linear trajectory. I have always been motivated by opportunities that are intellectually demanding and professionally exciting. If an opportunity meets those criteria, then I tend to say yes. Those are the qualities that have driven Photocopying or distributing this PDF is prohibited without the permission of Health Administration Press, Chicago, Illinois. 245 For permission, please contact the Copyright Clearance Center at For reprints, please contact [email protected] Journal of H ealt hcare M anage ment 58:4 J uly /A ugust 2013 me to follow a career path not considered to be the norm for someone with my background. I’m not sure I have a great secret here. I first became a hospital president when I was about 40 years old. It was the biggest transition I had ever made. I tell students that the best job you will ever have is when you’re number two or three in an organization, because you can be yourself, you don’t have ultimate responsibility for the direction of the institution, and you can relate to people on a more humanto-human basis than you can in a higher position. When you become number one, you assume a role for which you may have been prepared but you’re not really ready for, as it can be very isolating in terms of personal interrelationships. People look to you to provide the last word on whatever is going on in the institution. I finally realized the true implications of being a CEO when I understood the need to change my approach slightly.

Assignment: Staffing and Controlling Issues

I had to modify my sense of humor, and in general I didn’t feel free to relate to people in exactly the same way I had previously—I began playing the role of president. That adjustment included acknowledging that now I’m responsible for, say, 10,000 lives, 1,200 staff, 100,000 people in my community, and the strategic direction of the organization. The other major insight I gained from shifting roles or positions, whether staying within an institution or moving on outside of it, was that the lens through which you see things changes. For example, when I became chair of the Illinois Hospital Association board, all of a sudden, how I perceived and related to situations and people, and how I managed my personality within the context of these organizations, changed, because I now had a responsibility and an obligation to people outside of my organization, or outside of my immediate circle. As my situation changed by becoming a CEO, so did my orientation to the position and to those with whom I interacted. Ultimately, if you assume that you can apply a single template that will work in all organizations and role responsibilities encountered in a career, you have made a big mistake. Culturally and strategically, every organization is different. The one constant is who you are. Dr. O’Connor: Born and raised in Chicago, you spent most of your professional career there (with the exception of six years in St. Louis). Could you have achieved the same level of success and variety of activities if you had moved to a different city for each subsequent professional position? In other words, are there unique career path prospects and opportunities embedded within a city such as Chicago that are not available in other places? Dr. Lerner: I think it’s happenstance or serendipity that I ended up spending my whole life in Chicago except for the time in St. Louis. It never was my plan to stay; in fact, I was more than willing to move for an opportunity. I started at Rush– Presbyterian–St. Luke’s Medical Center working with Gail Warden, LFACHE, which was a great way to begin a career, and ended up having five different jobs there over 17 years. I decided to leave Rush because there was no place for me to grow at that point and I didn’t know if I had the wherewithal to be a president. I was not the kind Photocopying or distributing this PDF is prohibited without the permission of Health Administration Press, Chicago, Illinois. 246 For permission, please contact the Copyright Clearance Center at For reprints, please contact [email protected] I nterv iew of person who always wanted to be a president. There is no camp to attend to see if you can or should become a president. You have got to do it, decide if you like it, and see if the expectations of the position are those that you can meet or exceed. For personal reasons, I drew an hour’s flight time around Chicago. I was lucky enough to get an interview at The Jewish Hospital in St. Louis and even luckier to be selected as its president. Six years later, after essentially merging myself out of a job, I became a consultant back in Chicago, reinvigorated myself with my family, and started to consider whether I wanted a lifelong career in consulting or other possible opportunities. Again, serendipity or karma was at play when I learned of a unique opportunity in Chicago: serving as president and CEO of a specialty hospital—the Rehabilitation Institute of Chicago—whose specialty was the same area in which my wife worked. I never really thought about location, perhaps because the societal demands and cultural differences between the roles I had at Rush and Jewish were very different than those at the Rehabilitation Institute, which was a very high-profile role. I don’t believe location makes much difference when considering job opportunities for healthcare executives. The key factor is how well you adapt to the demands of a particular job, how well you relate to the people for whom you work, and how well you relate to your employees and the community. For example, despite their relative proximity, St. Louis is very different than Chicago in terms of culture, local dynamics, politics, and other factors. If you are attuned to such factors, you are likely to make those transitions easier. I have always maintained that it doesn’t matter where you go for your job. What makes the difference is what the environment is like where you are going to work and learn, and who your boss is. The job could be located in Alaska, Antarctica, or Chicago; if you have a great environment, good support and people, and a supportive boss or board, then theoretically you should be able to apply your talents anywhere. Dr. O’Connor: The need for clinicians and administrators to work effectively together has never been greater, yet the majority of today’s physicians, nurses, and administrators are educated in isolation from each other—in silos, if you will, that don’t address the roles or functions of other hospital occupations. What can our educational programs do to begin overcoming this problem? Dr. Lerner: This issue is near and dear to my heart. I had never taken an epidemiology course until I was working on my doctoral degree at the University of Michigan. I had been working at Rush, whose organizational structure was based on a tripartite relationship among doctors, nurses, and administrators. In other words, each operating unit had a doctor, a nurse, and an administrator at the top, who were expected to work together. I was always amazed to think how we were all educated differently, how we talked differently, how we didn’t even relate to the variable of time in the same way and were then thrown together around this entity called the patient where we were expected to make everything better. And this occurred in an organization that employed a matrix management model, which by its nature is the most difficult model to operate within. Photocopying or distributing this PDF is prohibited without the permission of Health Administration Press, Chicago, Illinois. 247 For permission, please contact the Copyright Clearance Center at For reprints, please contact [email protected] Journal of H ealt hcare M anage ment 58:4 J uly /A ugust 2013 Organizational behavior and organizational theory have always been my great interests, and it is always fun for me to think about these topics. So when I went to Michigan, I wrote a paper that my professor called turgid and irksome. I still have it; she was right, my writing was not great. But the theory was good. The paper examined how we have no common language among doctors, nurses, and administrators and how we are educated in silos and then thrown together and expected to work together effectively. I thought it would be nice if we at least had a common language. I wrote that we all ought to be forced to take epidemiology, and we all should conduct a joint epidemiologic project as a way to break down barriers and find at least one core vehicle by which to communicate with one another. I believe our educational programs should reach across the campus and find ways to get students together and collaborate, not just from medicine, nursing, and administration but from the other health professions as well. With the Affordable Care Act in place, we have to deliver services across a continuum to a defined population in an effort to maximize both individuals’ health and their functional status. If you don’t incorporate an understanding of primary prevention with the acute and postacute models, how do you intervene to ensure this population is healthy? Now add to the mix patient navigators, ombudsmen, insurance professionals, lawyers, and others, all of whom are engaged in this effort to maximize health. Some may see a complex morass that will never come together. But wouldn’t it be fun to work collaboratively on a project that helps a community achieve its potential? Dr. O’Connor: What is the future for urban, safety net hospitals in the United States? Dr. Lerner: Over the next 7 to 10 years, the entire healthcare landscape will change. That transformation is one reason the Sisters of St. Casimir at Holy Cross Hospital were encouraged to look at such options as selling the hospital to a forprofit firm, merging with one of the bigger Chicago-area systems, or becoming part of a new initiative by creating a private safety net system. I worry that stand-alone safety net hospitals will not survive once patients have more choices that come with their new health insurance. It is likely that we will begin to see unusual affiliations and relationships develop for both public and private safety net hospitals, as I do not see the need for safety nets ever going away. In the end, the safety nets remaining will need to find ways to reduce expenses, control costs, and increase revenue while improving the health of their populations, which will be a most challenging task, indeed. I believe that over the next decade, the roles and points of focus of the private practice of medicine, the stand-alone community hospital, and the urban and rural safety net hospitals all will change. Those changes will come about not so much by what the institutions choose to do as by what happens with the other entities they work with. In fact, we may find these hospitals participating in multi-institutional systems that include federally qualified health centers, private clinics, medical groups, and perhaps even insurance companies. Photocopying or distributing this PDF is prohibited without the permission of Health Administration Press, Chicago, Illinois. 248 For permission, please contact the Copyright Clearance Center at For reprints, please contact [email protected] I nterv iew Dr. O’Connor: What topics and issues would you like to see addressed by authors in the Journal of Healthcare Management? Dr. Lerner: I would like to see authors address the changing face of healthcare leadership in terms of education, experience, and background. What does it mean for our field and those we serve if the traditional master’s degree–prepared individual no longer is the gold standard for CEO positions? How will clinically educated executives change the way care is provided to populations—not just patients—and what does this change in orientation mean for the graduate education system? What roles will be assumed in the future by those coming from graduate programs? Who will mentor them if the CEO does not have that orientation in her background? How will the role, function, and expectations of the governing boards change as we migrate our system to one that maximizes a population’s health and links payment to health and functional status outcomes? Finally, how should our educational system change in recognition of the contributions of clinical and nonclinical executives in the organization and delivery of health services? If we are to assume risk for a population’s health, then we will need expertise across a wide continuum. Leading such a multidisciplinary team while engaging the community will present our field’s leadership with new and daunting challenges. Photocopying or distributing this PDF is prohibited without the permission of Health Administration Press, Chicago, Illinois. 249 For permission, please contact the Copyright Clearance Center at For reprints, please contact [email protected] Copyright of Journal of Healthcare Management is the property of American College of Healthcare Executives and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder’s express written permission. However, users may print, download, or email articles for individual use. Developing a Pediatric Burn Treatment Program in a Community Hospital Pamela Jennings, Marc Cullen, Roseanne Mark, Mary Ellen Meloche, Sandra Jaeger, and Tammy Lile T here are 120,000 pediatric burn injuries annually in the United States (Center for Research Injury and Policy [CRIP], 2010). According to CRIP (2010), pediatric burns result in 2,500 deaths and over 100,000 emergency room visits every year. Burns are the fourth leading cause of death in children under the age of 15 years and the number one cause of accidental death occurring in the home. Burn injuries are also a major source of pediatric disability and are associated with significant national health care resource utilization (CRIP, 2010). Serious burns are resource intensive, costing hundreds of thousands of dollars per patient (Miller, Latenser, Jeng, & Lentz, 2009). Many pediatric thermal injuries are not severe; however, referral to a burn unit for any burn regardless of depth, size, location, or severity is common. These patients are routinely transported long distances and at great expense for treatment (Vercruysse, Ingram, & Feliciano, 2011). Pamela Jennings, DNP, PNP, RN, is a Pediatric Clinical Nurse Specialist, St. John Hospital, Detroit, MI. Marc Cullen, MD, MPH, FACS, is Division Chief–Pediatric Surgery, St. John Hospital, Detroit, MI. Roseanne Mark, MA, RN, is a Clinical Nurse Manager, St. John Hospital, Detroit, MI. Mary Ellen Meloche, BSN, RN, is a Pediatric Surgery Nurse, St. John Hospital, Detroit, MI. Sandra Jaeger, BSN, RN, is a Pediatric Nurse, St. John Hospital, Detroit, MI. Tammy Lile, ADN, RN, is a Nurse Preceptor, St. John Hospital, Detroit, MI. Acknowledgment: The authors would like to thank Susanna M. Szpunar, PhD, Senior Medical Researcher, for providing statistical analysis. There are 120,000 pediatric burn injuries annually in the United States (Center for Research Injury and Policy [CRIP], 2010). Although many pediatric thermal injuries are not severe, referral to a burn unit for any burn regardless of depth, size, location, or severity is common. Many patients with smaller burns can be effectively managed in a community hospital, which allows children and their families to remain close to home, reducing costs and some stress associated with hospital stays. This article describes the process of creating a community pediatric burn care program at St. John Hospital in Detroit, Michigan, and initial outcomes of the program. Patients with large burns (greater than 15% body surface area for young children, and greater than 20% for older children and adolescents) develop systemic responses to vasoactive mediators released from damaged tissue after a burn injury (Joffe, 2010). These patients are likely to require aggressive, resource-demanding management available in a regional burn center. However, most burns treated in burn units within the United States are superficial, partial thickness burns that would heal without burn unit referral (Vercruysse et al., 2011). Many patients with smaller burns (less than 15% body surface area) can be effectively managed in a community hospital when a knowledgeable and experienced staff establish and maintain a coordinated burn program. When Vercruysse et al. (2011) considered the problem of overutilization of regional burn centers for pediatric patients, they noted that communitybased care eliminates the need for children with less-severe burn injuries to be transferred, and allows children and their families to remain close to home, reducing costs and some stress associated with hospital stays. St. John Hospital in Detroit, Michigan, part of St. John Providence Health System (SJPHS), is an 800-bed, not-for-profit community hospital with a 40-bed pediatric unit, an 8-bed pediatric intensive care unit, and a pediatric emergency room, and holds a Level 2 Pediatric Trauma Certi- PE …

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