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Biomedical subjects

John R Griffith

Publications and source records attributed to John R Griffith.

12 recordsLinked to original sources
PubMed2003

The impact of evidence on teaching healthcare management.

As healthcare management becomes more responsive to market demands, healthcare management education must prepare a more sophisticated and effective product. The author reviews the barriers to change in education and suggests that education will evolve to a new business model emphasizing "small bites" that are directly related to work needs and often learnable at the worksite, as well as integrative materialbest learned in a university environment. The ultimate model will have the following characteristics: 1. Managers' learning will be continuous, and will be recorded in individual certified "life transcripts" of mastery. 2. Learning will be performance driven, where performance is measured as contribution to the employer's goals and the patients' needs. 3. Learning will be flexible as to site, medium, and timing. 4. Managers' learning programs will emphasize recurring evaluation, celebration, and goal-setting.

Education, Continuing↗
PubMed2002

Structural versus outcomes measures in hospitals: a comparison of Joint Commission and Medicare outcomes scores in hospitals.

Outcomes performance measures are increasingly important in health care. The Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) continues to rely on structure and process measures based on accepted good practice. One of the first tasks in moving to a more outcomes-oriented approach is to compare the two measurement approaches. This article compares seven non-federal general hospital performance measures derived from Medicare against Joint Commission scores. Joint Commission measures are generally not correlated with outcome measures. The few significant correlations that appear are often counterintuitive. We conclude that a potentially serious disjuncture exists between the outcomes measures and Joint Commission evaluations.

Accreditation↗
PubMed2002

A framework for evaluating and continuously improving the NCHL transformational leadership initiative. National Center for Healthcare Leadership.

The National Center for Healthcare Leadership transformational leadership project is a broad and ambitious initiative that seeks to bring to the table top leaders from industry and academe. Their charge is to accomplish nothing short of resetting the course for health management education and practice in the coming decades. Four councils were recruited to launch the four major interventions: (1) recruitment and diversity, (2) core competencies, (3) the advanced learning institute, and (4) accreditation and certification. After describing intervention goals, we provide examples of baseline measures for tracking educational and performance outcomes longitudinally. We believe this transformation is only beginning, and it will take many years or decades. The transformation will be most successful if it is guided by data and systematic evaluation.

Accreditation↗
PubMed2002

Toward an understanding of competency identification and assessment in health care management.

Given the revolutionary changes occurring in the health care industry, there is increasing agreement that academicians and practitioners must collaborate to identify and prioritize major educational outcomes for health care management. Several competency initiatives have been undertaken or completed in health care and health care management in the last 5 to 7 years. Health care leaders who have undertaken such endeavors reveal that the task is most formidable. This article provides: (1) a summary of progress in competency identification for health management, (2) an historical overview on competency-based education and assessment, (3) a glossary of terms used in discussions on competency-based education and training, and (4) an outline of the challenges and benefits associated with competency modeling.

Competency-Based Education↗
PubMed2002

A new approach to assessing skill needs of senior managers.

Management of health care organizations must improve to meet the well-documented challenges of quality improvement and cost control. Other industries have developed the tools--entry education, mentoring, planned mid-career formal education and experience, and special programs for senior management. The purpose of this paper is to pilot test an alternative method to identify competencies and performance of health care executives. We propose using formal lists of technical, interpersonal, and strategic competencies and specific real events chosen by the respondent to identify and prioritize competencies. Results of a trial with 30 large health care system CEOs and 15 early careerists demonstrate that the method reveals useful depth and detail about managers' educational needs. The results suggest that current thinking about managerial education and learning patterns may be seriously inadequate in several respects. The continued improvement of U.S. health care is a pressing national concern. Quality of care is highly variable and substantially deficient in many institutions (Chassin and Galvin 1998; Committee on Quality of Health Care in America 2001). "Quality improvement should be the essential business strategy for healthcare in the 21st century (Kizer 2001)." Productivity improvements will be essential to balance cost pressures from an aging population and growing technology (Heffler, et al. 2002). Skillful management is necessary to improve quality and productivity. Teams of dozens of caregivers are often required to improve a patient's health. The organizations that provide care have grown larger in response to the greater cost, complexity of operation and finance, and evidence of the success of scale in other industries. While many small professional practices, hospitals, and nursing homes remain, consolidation has created a few dozen provider and intermediary organizations exceeding a billion dollars a year in expenditures. These large health care organizations are, or should be, modern corporate organizations at least as effective as their counterparts in manufacturing, retailing, or finance. To achieve that goal, they will require managers with comparable ability, motivation, and preparation. The National Summit on The Future Of Health Management and Policy Education emphasized the development of "evidence-based management education" by identifying, prioritizing, and measuring mastery of specific skills, knowledge, and abilities (Griffith 2001). Faculty of Association of University Programs in Health Administration (AUPHA) are working with practitioners to identify and prioritize specific learning competencies at the graduate degree level. Their effort focuses on skills teachable in the classroom, and it is expected to lead to measured performance of graduate school cohorts (Griffith 2001). The purpose of this paper is to pilot test an alternative method to identify competencies and performance of health care executives. Although it deliberately draws competency elements from academic sources, it supplements the teachable skills approach with a questionnaire that asks practitioner respondents to identify the skills and knowledge necessary to manage a specific management event and to evaluate the performance of an anonymous colleague against these skills and knowledge.

Attitude of Health Personnel↗
PubMedDate not supplied

Measuring comparative hospital performance.

Leading healthcare provider organizations now use a "balanced scorecard" of performance measures, expanding information reviewed at the governance level to include financial, customer, and internal performance information, as well as providing an opportunity to learn and grow to provide better strategic guidance. The approach, successfully used by other industries, uses competitor data and benchmarks to identify opportunities for improved mission achievement. This article evaluates one set of nine multidimensional hospital performance measures derived from Medicare reports (cash flow, asset turnover, mortality, complications, length of inpatient stay, cost per case, occupancy, change in occupancy, and percent of revenue from outpatient care). The study examines the content validity, reliability and sensitivity, validity of comparison, and independence and concludes that seven of the nine measures (all but the two occupancy measures) represent a potentially useful set for evaluating most U.S. hospitals. This set reflects correctable differences in performance between hospitals serving similar populations, that is, the measures reflect relative performance and identify opportunities to make the organization more successful.

Benchmarking↗
PubMedDate not supplied

The revolution in hospital management.

Five healthcare systems that have either won the Malcolm Baldrige National Quality Award in Health Care or been documented in extensive case studies share a common model of management: they all emphasize a broadly accepted mission; measured performance; continuous quality improvement; and responsiveness to the needs of patients, physicians, employees, and community stakeholders. This approach produces results that are substantially and uniformly better than average, across a wide variety of acute care settings. As customers, courts, and accrediting and payment agencies recognize this management approach, we argue that it will become the standard for all hospitals to achieve. This article examines documented cases of excellent hospitals, using the reports of three winners of the Baldrige National Quality Award in Health Care and published studies of other institutions with exceptional records.

Awards and Prizes↗
PubMedDate not supplied

Is anybody managing the store? National trends in hospital performance.

Nine standardized measures compiled from Medicare data show trends in the safety, quality, financial management, and efficiency for more than 2,500 community hospitals over five years ending in 2003. Although much public attention has been given to hospital performance, along with exhortations to improve, few measures show substantial positive trends, either in variance reduction or overall improvement. The authors conclude that environmental forces are not stimulating improvement and that the overall picture is one of randomness rather than management.

Efficiency, Organizational↗