The health care systems

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The health care systems

  1. 1. The Health Care Systems<br /><ul><li>A System is a set of elements that are so related that a change in any element causes any changes in other element within the system
  2. 2. Types of SYSTEM
  3. 3. Rational
  4. 4. A collectively oriented to the pursuit of the relatively specific goals and exhibiting a relatively formalized social structure
  5. 5. Represent most of the organizations that we deal with today
  6. 6. Natural
  7. 7. A collectivity where participants are little affected by the formal structure of official goals but who shares a common interest in the survival of the system and who engage in collective activities to secure this end.
  8. 8. Usually seen as an agreement among individuals in an organization
  9. 9. Open
  10. 10. A coalition of shifting interest that develop goals by negotiation
  11. 11. In physical therapy services, organizations are found in rational system.
  12. 12. A system is represented by input, throughput, output, feedback and the environment
  13. 13. In a healthcare system:
  14. 14. Input = ill person/patient
  15. 15. Throughput = clinical environment (tests, hospital stays, consultations, diagnosis and treatment)
  16. 16. Output = outcome to the patient
  17. 17. Feedback = quality assessments, improvement activities, reimbursements
  18. 18. Environment = community, state, region or the larger world</li></ul>Organizational Structure<br /><ul><li>Organization depends on the following:
  19. 19. Activities
  20. 20. Decisions
  21. 21. Relationships
  22. 22. Its function is always determined by its structure
  23. 23. Interaction is one of the most integral part of an organization
  24. 24. Lines in an organizational diagram:
  25. 25. Horizontal line – span of control
  26. 26. Vertical lines – line of authority
  27. 27. The organizational charts depicts not only the relationship of each members on the systems but also activities that must be performed
  28. 28. Physical therapy departments are built according to the output of the systems</li></ul>Owner<br />Physical TherapistSecretaryBookkeeper<br />PTABilling Clerk<br />PT Aide<br />Owner<br />Senior PT/ Chief PT<br />Physical TherapistSecretaryBookkeeper<br />PTABilling Clerk<br />PT Aide<br /><ul><li>SMALL PHYSICAL THERAPY SETTING
  29. 29. Physical Therapy in Complex Systems
  30. 30. Fee-for-Service Settings/HMO
  31. 31. Considered as a free market
  32. 32. Patient was free to seek a healthcare provider
  33. 33. This is the model under which health care was originally established.
  34. 34. No insurance, no policies
  35. 35. Payments were often made in terms of service, and it is being given directly to the professional.
  36. 36. During the industrial revolution, factory owners provide injury-related health care facility and offer it to the employee.
  37. 37. During the post-industrial phase, healthcare organizations (HMO) have grown to corporation size and that most of it is being dominated by the government regulations and interventions.
  38. 38. Physical therapy was a part of the healthcare organization as early as 1917.
  39. 39. Physical therapy was not considered as a profession before and was well thought-out as an ancillary service.
  40. 40. They report directly to the physicians and was being paid on an hourly basis.
  41. 41. In 1965, physical therapy was considered as a fee-for-service profession.
  42. 42. Under this medical legislation, PT services secure a reimbursable position for a non-physician professional under the traditional health care systems.</li></ul>Community Hospitals<br /><ul><li>These are healthcare within the community which most people have become familiar with.
  43. 43. Majority of these hospitals are non-profit institutions and are being run by the government.
  44. 44. Community hospitals are also often referred to as voluntary hospitals.</li></ul>Hospitals/Multihospital Systems<br /><ul><li>The primary goal of this system is to build a system that provides continuous care for its patients.
  45. 45. It may be age related or procedure oriented
  46. 46. Hospitals have developed a regional cooperating systems (departments) in which there are agreements of cooperation between facilities and each components agrees to focus service in certain ways that will promote the system and allow the easy flow of the patients between facilities</li></ul>School Systems Practices<br /><ul><li>School systems have always been an attractive setting for physical therapist who specializes in pediatric care; because it is a setting which child can be observed and treated in a natural environment.
  47. 47. In the US, Physical therapist have become an integral part of the public school team to plan an appropriate educational plan for each handicapped child
  48. 48. HUMAN DEVELOPMENT THEORIES
  49. 49. Maslow’s Hierarchy of Needs
  50. 50. Postulated by Abraham Maslow in 1940 which underlay’s human motivation.
  51. 51. Physiological Needs
  52. 52. The most basic human need that represents warmth, breathing elimination, shelter and food.
  53. 53. These needs motivate employees to work for a wage that will satisfy his physiological needs and that of his family.
  54. 54. Safety Needs
  55. 55. These arise from the normal anxieties associated with the individual’s personality.
  56. 56. Maybe represented by fear such as safety of the work environment, location of the business, security of the job, etc.
  57. 57. Belonging Need
  58. 58. Also referred to as Social Need or the need to be accepted in the group or at society at large
  59. 59. Self- esteem Needs
  60. 60. This is the need to be recognized for a unique or special contribution to the group or organization motivated employees to excel or specialized within the group.</li></ul>Self<br /> Actualization<br /> Esteem<br /> Belongingness<br />Safety<br /> Physiological<br /><ul><li>Locus Control
  61. 61. The concept of locus control relates to the degree to which individual believe that they have the power to control or change a given situation.
  62. 62. Control can be: internal or external
  63. 63. In physical therapy, locus control means the degree to which they see the control of the disease to be within or outside of their control.
  64. 64. Adult Development
  65. 65. Erikson identified the 8 levels of development from birth to old age.
  66. 66. This transition of periods will make feel adults to make decisions regarding issues such as accepting a new identity as an adult during early adult transition.
  67. 67. When these decisions are made, the individuals move into a stable period of life and solidify changes that results from the decisions.
  68. 68. Erikson’s Stages of Development
  69. 69. StagesDevelopmental PhaseTrust vs. MistrustInfancyInitiative vs. GuiltEarly childhoodAutonomy vs. ShameEarly childhoodIndustry vs. InferiorityChildhood and adolescenceIdentity vs. ConfusionAdolescenceIntimacy vs. IsolationYoung adulthoodGenerativity vs. StagnationAdulthood and middle ageIntegrity vs. DespairOld age
  70. 70. </li></ul>Management Theories Related to Managing People<br /><ul><li>Herzberg’s Theory of Motivation
  71. 71. This theory is based on 2 sets of factors:
  72. 72. Those that motivates the individual to work
  73. 73. These motivators cause the individual to be excited about the job.
  74. 74. If these motivators are not present, people will not necessarily leave their job or even complain
  75. 75. Examples are: achievements, recognition, advancement and visibility within the organisation, possibility for growth and promotion, autonomy, appraisals and fringe benefits
  76. 76. Those that leads to dissatisfaction with the job
  77. 77. If these motivators are not present, individuals will feel that their talents are not being fully utilised therefore they will not excel.
  78. 78. McGregor’s Theory X and Theory Y
  79. 79. Introduced by Douglas McGregor in the early 1960’s
  80. 80. He perceived that:
  81. 81. Employers thinks that workers are basically lazy, unmotivated to work; seek security and needs closer supervision in order to accomplish task. These represent the THEORY X.
  82. 82. Employers should change these perception of workers to be more in line with maximizing the workers human potentials which means that employees should be the opposite of Theory X. These represent the THEORY Y.</li></ul>Recruitment and Retention<br /><ul><li>Recruitment and retention of physical therapist is one of the major problems facing mangers in the hospital settings therefore several programs have been instituted in hospital PT programs to enhance motivation and remain in this setting.
  83. 83. Shortage in PT had caused starting salaries to increase dramatically. At the same time that compensation of salaries for more experienced PT is leading to low morale.
  84. 84. Incentive Programs are designed
  85. 85. This Incentive Programs attract workers because they can pace themselves and know the financial rewards that they will earn with specific level of output on their part.
  86. 86. Several type of incentive programs are as follows:
  87. 87. Individual worker
  88. 88. In these systems target productivity levels within a set of quality a guidelines are established and the individual workers are paid predetermined variable amounts of money for achieving specific targets.
  89. 89. This is the most easily administered and he most common incentive program
  90. 90. Profit sharing
  91. 91. Determined by a pre-arranged formula.
  92. 92. Does not focus on productivity.
  93. 93. Individuals received a specified share on the profit after all the other expenses are paid and the profit are determined
  94. 94. Group Incentive plans
  95. 95. Develop for group of workers that should achieve a specific target.
  96. 96. Aside from the monetary incentives, managers consider self-actualization and self-esteem needs such as:
  97. 97. Expanded educational leaves
  98. 98. Sabbaticals
  99. 99. Development of educational programs that are seeking certifications or advance degree (loans, scholarships, trainings)
  100. 100. Cultural exchange programs to other countries
  101. 101. Clinical ladders and mentoring programs for the level of staffs to recognise contribution, refine and gain more skills
  102. 102. Staff Recognition

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