More Related Content Similar to HIMT 4e Ch18 (20) HIMT 4e Ch181. © 2011
Chapter 18: Principles of Organization and
Work Planning
Health Information Management
Technology: An Applied Approach
Fourth Edition
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Nature of Organization
• Humans are social creatures
• Groups
o Informal
o Formal
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Organizational Structure
• Traditional views
o Hierarchical
o Bureaucracy
• Chains of command
• Modern management systems
o Sharing authority
o Teamwork
o Interdisciplinary
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Supervisory Managers
• Supervise small workgroups or teams
• May perform hands-on functions
• Direct daily work, work schedules, quality, and
productivity
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Middle Management
• Facilitate work of supervisory, staff-level, and
executives
• Responsibilities
o Developing, implementing, and revising policies and
procedures
o Executing organizational plans developed at board
and executive levels
o Providing operational information needed for
planning
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Executive Management and Governance
• Two entities
o Executive management
o Governing board
• Role of executive managers
o Set future direction/strategic plan
o Oversee departments
o Work with community leaders
o Lead quality and compliance
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Executive Management and Governance
• Role of governing board
o Ultimately responsible for organization
o Board made up of
• Chairperson
• 10 to 20 board members
• Roles of teams and committees
o Used to address problems that cross traditional boundary
lines
o Standing committee
o Ad hoc committees
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Successful Team Facilitator Provides
Leadership By:
• Creating purpose and framework for project prior to first
meeting
• Encourage team to fully discuss opportunities and
potential pitfalls
• Encouraging all members to participate and reach
consensus on purpose
• Establishing specific goals and measurable objectives
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Successful Team Facilitator Provides
Leadership By:
• Ensuring decisions and plans are consistent with
purpose and goals
• Building trust among team members through
emphasizing unique role and importance of each
member
• Functioning as cheerleader, reminding members of
purpose and goals, celebrating achievements and
recognizing efforts of members
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Team Leaders
• Ensure each member has opportunity to
contribute
o Flowcharts
o Brainstorming
• Good interpersonal skills
• Act as role model for team
• Set ground rules
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Ineffective Teams
• Lack of clear purpose
• Lack of participation by team members
• Insufficient expertise
• Unconcerned with success
• Not supporting decisions
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Team Selection
• Need to understand challenges
• Need to understand skills required
• Not based on job title
• Stakeholders should be part of team
• Size of team depends on charge
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Purpose of Interview
• Obtain information from application about past work
history and future goals
• Give information to the applicant about the
organization’s mission and goals and nature of
employment opportunity
• Evaluate work experience, attitudes, and personality as
potential fit
• Evaluate organization as potential fit for employment
goals
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Interviews
• Competency-based questions
• Scenario-based questions
• Sample interview questions
o Why are you looking for job?
o What has been your biggest mistake at work and what did you
learn from it?
o What criticisms would your previous manager have about
you?
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Illegal Questions
• Nationality
• Religion
• Age
• Marital and family status
• Sexual orientation/gender
• Data of birth
• Anything about children or childcare
• Health and physical abilities
• Is applicant a member of the National Guard or Reserves
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Orientation and Training
• New employee orientation
o Human resources
o General orientation
• Employment policies
• Employee conduct
• Communication
• Confidentiality
o Department orientation
• Rules to follow
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Department Orientation
• Mission and vision
• Goals
• Structure
• Communication policies
• Procedure for requesting
time off
• Person to notify in case
of absence
• Tour
• Introductions
• Confidentiality policies
• Evaluation process
• Schedules
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Delegation of Authority and Empowerment
• Delegation of authority
• Job description
• Delegating responsibilities
o Frees team leader to perform more important or
complex tasks
o Increase the leader’s capacity and productivity
o Reduce delays in decision making
o Develops staff’s capacity and abilities
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Prepare Staff to Succeed By:
• Explaining exactly what needs to be done
• Describing clear expectations
• Setting clear deadline
• Granting authority to make relevant decisions
• Ensuring appropriate communication and
reporting
• Providing resources needed to complete task
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Performance Evaluation
• Annual performance reviews:
o Assess employee’s performance compared to
performance standards or previous goals
o Develop job-related goals for following year
o Developing plan for professional development
• May include self-assessment
• May be basis of pay increases
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Periodic Performance Reviews
• Information collected regularly
• Information is shared with employee
• Addresses performance issues
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Performance Counseling and Disciplinary
Action
• Disciplinary action
• Performance counseling
o Informal counseling or verbal warning
o No record kept in file
• Progressive discipline
o Formal documentation of problem and steps taken
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Supervisor’s Steps
• Be clear and direct with employee about problems and
consequences
• Support efforts to improve or resolve issues
• Document steps taken to improve performance
• Follow all organizational policies
• Consult with human resources
• Keep performance issues confidentiality
• Be consistent with all employees
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Conflict Management
• Problems that result from conflict:
o Waste time
o Reduce productivity
o Decrease morale
o Lead to harmful behavior
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Causes of Conflict
• Poor communications
• Lack of openness by management or other
members of team
• Weak leadership
• Interpersonal interactions
• Lack of resources
• Desire for more power
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Actions for Minimizing Conflict
• Clearly define job responsibilities
• Job descriptions and procedures reviewed
regularly
• Build trust between team members
• Regular reports from staff
• Regular training on interpersonal communication
and conflict management
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Conflict Management Strategies
• Positive ways to address conflict
o Compromise
o Control
o Constructive confrontation
• Management behaviors to avoid
o Avoiding
o Accommodating
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When Facing Confrontation:
• Speak calmly
• Private location
• Listen to other person’s argument or point of
view
• Pay attention to other
• Acknowledge points of agreement and
disagreement
• Try to build consensus
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Employee Development
• Drivers of health care employee development
o Rate of change in healthcare
o Introduction of new technology into the workplace
o Increased demand on maximizing productivity
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Super’s Stages of Employee Development
• Exploration and trial
• Establishment and advancement
• Midcareer growth, maintenance, and decline
• Disengagement
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Strategies for Developing Staff Skills
• On-the-job training
• Information presentation
• Action-based methods
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Job Redesign
• Aligning needs of organization with skills and
interests of employee
• Reasons to redesign job
o Introduce new tools or technology
o Improve process
o Use employee skills more effectively
o Provide better customer service
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Career Planning and Lifelong Learning
• Career planning
o Supervisor’s role
• Lead by example
• Create a supportive environment
• Provide career counseling
• Create a partnership
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Strategic Planning
• How organization will respond to changes in
external environment
• Ongoing activity
• Responsibility of board of directors
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General Steps of Strategic Planning
• Conducting environmental assessment
• Developing and/or revising mission and vision
statement
• Developing and/or revising values statement
• Developing and/or revising strategic plan for the
upcoming year
• Revising strategic plan for the succeeding years in light
of changes
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General Steps of Strategic Planning
• Discussing the proposed strategic plan with the board of
directors and making changes as a result
• Officially documenting board’s approval of plan
• Communicating strategic plan to administrators and
managers
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General Steps of Strategic Planning
• Developing operation plans for the upcoming year on
the basis of the action steps and future direction
documented in the final strategic plan
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Operational Planning
• Annual operational plan
• Normally tied to budget
• Department managers play key role
• Establish short-term goals
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Expense Budgets
• Financial control
• Plan for the period of the budget
• Budget year
• Compare actual to budget
• Should support goals of organization
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Revenues and Expenses
• Revenues
• Expenses
o Mixed costs
o Fixed costs
o Variable costs
o Direct costs
o Indirect costs
• Capital budget
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Budgeting Process
• Developing goals for department
• Budget assumptions
• HIM is generally expense based
• Approaches
o Historical projections
o Zero-based budget
o Combination
• Budget review
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Financial Control
• Monitoring expenses and revenues
• Manager should
o Understand what caused variances
o Determine if variable is one time or ongoing
o Determine actions needed to stay on target
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Supply Management
• Purchasing process
o Supply catalog
o Request for proposal
• Inventory control
o Just in time inventory
o Centralized purchasing
• Supplier relationships
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Staffing
• Staffing tools
o Position descriptions
o Performance standards
o Work schedules
o Written policies and procedures
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Considerations in Developing Work
Schedule
• Is the job dictated by equipment they use?
• Is the job dictated by external entities?
• Should there be overlapping shifts?
• Should there be job sharing?
• Will anyone be on vacation?
• Will there be a significant increase in workload?
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Position Descriptions
• Outlines work performed
• Used in recruitment and interviewing
• Used in establishing wages
• Clarify tasked to be performed
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Performance and Practice Standards
• Define acceptable execution
• Set for quantity and quality
• Should be objective and measurable
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Developing Standards
• Benchmark against industry standards
• Collect data on current performance
• Share standards with employees who perform
that task
• Determine a collection process
• Feedback
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Work Analysis and Design
• Workflow analysis
• Workplace design
o Placement of staff
o Flow of traffic
o Noise
o Privacy
• Space and equipment
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Work Analysis and Design
• Aesthetics
• Ergonomics
o Consequences of bad design
• Headaches
• Eye strain
• Fatigue
• Neck and back pain
• Repetitive stress injuries
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Work Patterns
• How work is done in organization
• Includes
o Time performing tasks
o Breaks
o Lunch
• Should be performed in most efficient way
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Staffing Analysis
• Most efficient mix of staff
• Time and motion studies
o Limitations
• Does not address if effective and efficient for organization
• If individuals work at appropriate levels
• Could other processes be more beneficial
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Performance and Quality Improvement for
HIM Functions
• Model for quality improvement
o Established approach to quality improvement
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Quality Improvement Process—Problem
Identification
• Identify current and future key performance measures
• Measure current performance
• Create flowchart of current process
• Brainstorm problem areas within the current process
• Research all regulatory requirements related to current
process
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Quality Improvement Process—Problem
Identification
• Compare current process to performance standards
and/or national standards
• Conduct survey to gather customer input on needs and
expectations
• Prioritize problem areas for focused improvements
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Quality Improvement Process—Process
Redesign
• Incorporate findings or changes identified in research
phase
• Collect focused data from prioritized problem areas
• Create flowchart of redesigned process
• Develop policies and procedures that support the
redesigned process
• Educate involved staff on the new process
• Measure for success
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Change Management
• Making improvements happen
• Change management
o Becoming change agent
o Being available to listen to staff
o Holding on to the vision
o Continuing to delegate
o Measuring and celebrating success