This document discusses principles of organization and work planning in health information management. It covers topics such as organizational structure, management levels, team leadership, strategic planning, operational planning, budgeting, staffing, performance management, and quality improvement. The key points are hierarchical and modern organizational structures, levels of management including supervisory, middle, and executive, developing strategic and operational plans, managing budgets and finances, staff recruitment and development, and using a quality improvement process to identify and address problems.

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Chapter 18: Principles of Organization and
Work Planning
Health Information Management
Technology: An Applied Approach
Fourth Edition

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Principles of Organization
• Organization
o Hierarchy

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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 Management
• Levels of management
o Supervisory
o Middle
o Executive

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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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Organizational Tools
• Policies
• Procedures
• Organizational chart
• Mission statement
• Vision statement
• Values statement

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Developing Procedure
• Flowchart to document workflow
• Write down steps
• Define who performs steps
• Review periodically

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Human Resources
• Staff is most important asset

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Leadership Principles
• Leadership
• Key functions of leaders
o Authority
o Responsibility
o Accountability

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Team Leadership
• Should have vision
• Able to communicate vision to members

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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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Four Steps of Functional Team
• Forming
• Storming
• Norming
• Performing

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Teams
• Identify and work with stakeholders
• Executive sponsor
• Teams bring in different perspectives

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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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Team/Member Participation
• Team charge
• Regular meetings
• Dedicate to accomplish goals
• Be prepared for meetings

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Team Norms
• Rules that govern behavior

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Recruitment, Orientation, and Training
• Recruitment
• Retention

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Recruitment
• Advertising positions
o Internal
o External
• Resumes
• Job application
• Interview

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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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Job Training
• Specific training on job
• Position description

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Staff Retention
• Attempt to prevent turnover
• Satisfaction surveys
• Exit interviews

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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 Management
• Performance management
o Planning stage
o Monitoring stage
o Developing stage
o Rating stage
o Rewarding stage

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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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Disciplinary Actions
• Suspension from employment
• Demotion
• Termination

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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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Grievance Management
• Policies and procedures to handle employee
complaints
• Unions

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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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Fundamentals of Work Planning
• Strategic planning
• Operational planning

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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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Work Schedules
• Standard work week
• Compressed work week
• Flextime

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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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Work Distribution
• Based on staff’s capabilities and job
responsibilities

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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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Staffing Needs Driven By:
• Hours of coverage
• Understanding of workload

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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