Health Care

Posted: October 23rd, 2013





Health Care

Describe the process of medical membership, granting of privileges and process of medical staff quality monitoring in an HCO

            The process of validating a professional’s eligibility for medical staff membership and/or privileges to be granted based on academic preparation, licensing, training, certifications and performance is called credentialing (White 187). This process is also used to ensure medical staff quality monitoring in an HCO.

The HCO can validate the caregiver’s competence and proficiency through credentialing. The competence is validated by examining the knowledge and skill obtained through formal education and experience, which is regulated by, licensure and certification bodies while the proficiency is validated by examining the evidence that the clinician’s education and experience are current (White 101).

The role of medical staff, management and governance in the credentialing process

            The role of the medical staff is to meet all the credentialing and re-credentialing criteria. This entails obtaining valid credentials that include licenses and certificates issued by the government. This is usually after a certain level of education, training or experience is attained. In addition, the medical staff has an obligation to provide treatment by practicing good medicine within their training, experience and the capabilities.

The role of the management is to verify the validity of all the certificates and licenses issued by the medical staff. This verification process focuses on the medical school, internship and residency completion, board certification, work history and criminal history.

The role of governance in credentialing is to set and monitor both the credentialing criteria and process. After the process, the governance grants the professional privileges to the medical staff, which allows them to participate in the physician organization.

Describe the differences, duties and key points of management versus governance in an HCO.           

The difference between the management and the governance of an HCO is that the governance deals with strategic duties of the HCO while the management deals with operational duties of the HCO. That is the governance is responsible for policymaking, decision making and providing oversight for the HCO while the management is responsible for the operational leadership in organizational activities such as financing of the HCO (White 107).

The duties of governance include mission and strategic planning, monitoring and assessment of the HCO’s progress, making strategic decisions, executive management, offering financial oversight and providing strategic protection of the HCO from risks. An example of governance performing a task in an HCO, is when the governing board establishes a senior management compensation program that reviews compensation and bonuses for all managers

On the other hand, the duties of management include providing fact base for all goal setting and decision-making activities of the governance, financial management of the HCO, human resource management, marketing and internal consultation (White 108).

The key points in governance are that governance is responsible for the strategic activities of the HCO. These strategic activities include policymaking, decision making and providing oversight. The key points in management are that the management is responsible for the operational activities of the HCO. These activities include operational management and goal achievement activities.

Discuss the expectations and cultural issues with today’s recently graduated physicians and how an HCO can recruit/retain them. 

            Studies have suggested that recently graduated physicians may have different expectations from the preexisting ones that may influence their decision to leave or remain in a community (White 194). Some of the factors that may influence their decision include the collaborative nature of the practice, the organizational culture of the institution and the political environment.

The HCO can retain them by using incentives, theories of interpersonal relations like the Peplau’s theory and the application of other organizational behavior theories (White 195). These methods can help the employees understand and appreciate the existing organizational culture.

Discuss how an HCO monitors and improves quality.

The governance board and the senior management are responsible for monitoring of the quality of health care (White 115). For instance, excellent HCOs that operate under the evidence-based management systems have the ability to retain an accountability hierarchy that aids in monitoring of performance.

Improving of the quality of health care is accomplished by research conducted by the ethics committee. This ethics committee is complimented by an institutional review board, which monitors and approves research protocols for involving patients or associates. It is through this research and continuous assessment that health care is improved (White 169).

Discuss various external and internal factors affecting HCOs today and explain how the organization can successfully deal with them.

            One internal factor facing Health care organizations is bad organizational culture. This includes interpersonal relationships, training material, philosophical statements and organizational policies. Bad organizational culture often affects an organization’s productivity by weakening the internal communication links. This can be solved by establishing a good organizational culture that enables the employees to identify with the goals and missions of the organization.

Another internal factor is unethical management practices that affect the operational activities of the HCO. These unethical activities include mismanagement of funds, which affect the operating costs of the organization. The HCO can deal with the unethical management practices by formulating an ethics committee whose primary goal is identifying and dealing with unethical management practices (White 65).

In addition, technological change is also a factor affecting the HCOs. The increased revolution of technology and its integration into the processes of HCO is a new phenomenon that requires the readjustment of the attitude of the HCO. However, this can be managed by properly preparing the employees for the technological change after critical assessment of the change by the management.

An example of an external factor is the presence of strict legislative requirements. The presence of new legislations presents with it drastic changes in patient information disclosure, documentation and record keeping systems. The HCOs can successfully deal with the new legislations by revising their policies and organizational structures to satisfy the provisions by law.

Another example of an external factor affecting HCO’s is the increasing diversity among population in the community served which is further supplemented by staff shortages. There has been an increase in the demand for medical care from the community with very little personnel to satisfy the supply. However, this issue can be dealt with by practicing better recruitment and retention practices that ensure there are adequate and qualified personnel.

What makes up the well-managed community hospital?

A well-managed community hospital is a hospital that has the ability to recruit and satisfy the needs of the medical practitioners while at the same time meet the needs of their local patients at manageable costs. This implies that the hospital is capable of providing financial resources, human resources such as nurse and physicians and any other resources that are necessary to meet the needs of the locals in the community.

The factors that characterize such a hospital include a well-defined organizational culture that promotes shared values, empowers associates, supports service excellence and encourages success (White 39). Another factor is a strong cultural, operational and strategic foundation, which enable high performance (White 14). This is usually supplemented by a well-defined operational leadership system that is accountable and sustains improvement in the operational structure (White 69).

It should have foundations on clinical performance that ensure accurate diagnosis, excellent care, good implementation of protocols, individualization of patient care, good planning and treatment, improved community health and improved clinical performance (White 141). This should be supported by clinical support services that are responsible for providing excellent health care (White 250).

Finally, it should have a human resource management system that is aimed at workforce planning, work force development, workforce maintenance, workforce empowerment and workforce compensation (White 346).

If you were planning an initial discussion about goal setting and capital budgeting for newly appointed first line supervisors, what would be the topics you would include?

I would include topics like feasibility assessment, resource allocation, capital sources, financial management, risk management and decision-making.

Work cited

White, Kenneth R, and John R. Griffith. The Well-Managed Healthcare Organization. Chicago, IL: Health Administration Press, 2010. Print.





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