Question

Assignment 7.1: Top Issues Confronting Hospitals: 2020 Name: Issue Confronting Hospitals Financial challenges Governmental mandates Patient safety and quality Personnel Shortages Behavioral health/addiction issues Patient satisfaction Access to care Physician-hospital relations Technology Population health management Reorganization (eg mergers, acquisitions, restructuring partnerships) 2020 2018 2 4 5 10 In 100 words or less, provide a supporting rationale for your top issue In 100 words or less, explain how your top issue might impact the role of the health care manager in 2020 Reflect back on the leadership principles and applications (ie, evidence based management managerial control, organizational design, accountability, adaptability, and professional integration) you have learned throughout this course. Choose one principle and in 250 words or less, describe how the application of the leadership principle might differ in 2020 for your top concern. Provide supporting rationale and include one outside professional or peer- reviewed source Reference

1. Rank the list of issues from the viewpoint of a 2020 hospital CEO.
2. In 150 words or less, provide a supporting rationale for your top issue.
3. In 100 words or less, explain how your top issue might impact the role of the evidence-based health care leader in 2020.
4. Reflect back on the leadership principles (e.g., evidence-based management, managerial control, organizational design, accountability, adaptability, and professional integration). Choose one principle, and in 250 words or less, describe how the application of the leadership principle might differ in 2020 for your top concern. Provide. supporting rationale and include one outside professional or peer-reviewed source.

Answer 1

1. Rank the list of issues from the viewpoint of a 2020 hospital CEO.

Issues Confronting Hospital	2020	2018
Financial challenges	1	1
Governmental mandates	2	2
Access to care	3	7
Patient safety and quality	4	3
Behavioral health or addiction issues	5	5
Patient satisfaction	6	6
Physician-hospital relations	7	8
Population health management	8	10
Reorganization	9	11
Technology	10	9
Personnel shortages	11	4

2.Within financial challenges
1. Medicaid reimbursement (69 percent)
2. Bad debt (67 percent)
3. Decreasing inpatient volume (63 percent)
4. Medicare reimbursement (57 percent)
5. Competition from other providers (of any type) — 55 percent

Within governmental mandates
1. CMS audits — 80 percent
2. ICD-10 implementation — 68 percent
3. CMS regulations — 64 percent
4. State regulations — 34 percent
5. Increased government scrutiny — 32 percent

3. Evidence-based healthcare makes a positive difference for patients and their families; excellence in providing that care is a pressing need. Adoption of evidence-based practice (EBP) leads to important improvements in outcomes for patients and their families as well as for clinicians and organizations. Healthcare-acquired conditions and complications are reduced, patient symptoms are improved, and the cost of care is less. As part of their daily work and as members of interprofessional teams, nurses can lead the way in advancing EBP.

As the branch(in all aspects) of Medicine calls for 90 percent of healthcare to be evidence-based by 2020. To move the needle in that direction, nursing leaders must communicate a clear vision for EBP within their organizations.

A well-defined vision for EBP combined with a strong and well-designed infrastructure create a supportive organizational culture that promotes a climate in each clinical area for providing evidence-based care. When an organization focuses on inquiry and safety, frontline nurses are encouraged to ask important questions, such as why, how, and what.

4.Strong leadership is critical if the vision of a transformed health care system is to be realized. Yet not all nurses begin their career with thoughts of becoming a leader. The nursing profession must produce leaders throughout the health care system, from the bedside to the boardroom, who can serve as full partners with other health professionals and be accountable for their own contributions to delivering high-quality care while working collaboratively with leaders from other health professions.

A leadership approach that aims to achieve a collective goal rather than a multitude of individual goals and aims to transform all workers both managers and staff in pursuit of the higher collective purpose can be the most efficient and effective means of achieving widespread and fundamental organizational change. In practicing transformational leadership, leaders need to engage managers and staff in an ongoing relationship based on the commonly held goal of patient safety, and communicate with and teach managers and staff about this higher collective purpose.

The concept of evidence-based practice first emerged in clinical medicine and now suffuses the language, decision making, and standards of care of health care clinicians, managers, policy makers, and researchers throughout the world. Evidence-based clinical practice is defined as the conscientious, explicit, and judicious integration of current best evidence—obtained from systematic research—in making decisions about the care of individual patients (Sackett et al., 1996).

Evidence-based management, however, is a newer concept not yet as widely embraced, but just as important (Axelsson, 1998; Hewison, 1997; Kovner et al., 2000; Walshe and Rundall, 2001).

Evidence-Based Management is a systematic application of the best available evidence to the evaluation of managerial strategies for improving the performance of health services organizations. Evidence-based management means that managers, like their clinical practitioner counterparts, should search for, appraise, and apply empirical evidence from management research in their practice. Managers also must be prepared to have their own decisions and actions systematically recorded and evaluated in a way that will further add to the evidence base for effective management practices (Axelsson, 1998)

The empirical evidence on effective management practices that do exist is difficult to locate. Management literature is poorly indexed for practical applications and is not easily reviewed and synthesized (Walshe and Rundall, 2001).

Many managers are not trained or experienced in the use of such evidence in making management decisions (Kovner et al., 2000). While physicians are trained in a strong professional model with fairly uniform educational preparation, managers come from a variety of very different professional backgrounds and training. Some management training comes more from long-term practical experience in the workplace, as opposed to formal professional education (Axelsson, 1998; Walshe and Rundall, 2001).

*Steps in Decision Making Process:

1. Identification of a problem
2. Identification of decision criteria
3. Allocation of weights to criteria
4. Development of alternatives
5. Analysis of alternatives
6. Selection of an alternative
7. Implementation of the alternative
8. Evaluation of decision effectiveness

*Step Process to apply Evidence to the Assessment of Alternatives and the Selection of a Best Alternative:

1. Formulating the research question
2. Acquiring the relevant research findings and other types of evidence
3. Assessing the validity, quality, and applicability of the evidence
4. Presenting the evidence in a way that will make it likely that it will be used in the decision process
5. Applying the evidence in decision making

All the health care professionals will deliver innovative evidence-based, cost-effective, quality care across an integrated health and social care contexts. They will have the capacity to initiate and to respond to change. The definition of quality should be further enhanced to take account of all six dimensions of quality: person-centredness, safety, effectiveness, efficiency, equity, and timeliness, together with patient experience and satisfaction with care. Equity should be included in a measure of quality to ensure that safety, effectiveness and the experience of women and their partners do not vary as a result of factors such as age, ethnicity, the area of residence or socioeconomic status.

For individual professionals, the provision of quality care and quality improvement should be supported by

• Appropriate education, training, and continuing professional development
• Use of evidence-based guidelines to improve practice
• Use of reflective practice
• The system of statutory supervision of professionals
• Feedback of information collected about the care from each professional

*Marcel Schwantes, A leadership philosophy that's been around for centuries is only practiced by a few wildly successful global leaders. Founder and Chief Human Officer, Leadership From the Core