Shared leadership empowers all departments in the hospital.
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The trade-offs between quality of care, operational efficiency, convenient patient access, physician productivity, and initial capital costs should be considered in evaluating functional relationships, dedicated versus shared facilities, and the creation of decentralized, satellite services. With rapidly changing technology, new payment initiatives, and uncertainties about various healthcare reform measures, planning for the healthcare campus of the future should involve an integrated process of clinical program planning, operations planning, and facility planning to ensure that new or renovated facilities are both flexible and promote operational efficiency well into the twenty-first century.
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Those of us who have chosen to embark on this journey into the world of Patient Focused management sometimes refer to our experience as a wild roller coaster ride. It is probably an accurate analogy since many of us have found the amplitude of the highs and lows to be quite extreme. Most of us came prepared with what we thought was a great deal of knowledge about management and leadership in an acute care setting. As we have moved through this process, we have found ourselves starting over and beginning to accept completely new paradigms. Although this has been, for many of us, the greatest challenge of our careers, I believe it has also been the greatest opportunity for growth.
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In summary, any communications plan must meet two critical requirements if it is to successfully rally professional support for your patient focused care program. First, it must explicitly present a "vision" of the future role of professionals within your patient focused hospital. Neither your program nor these professionals benefit from them having to deduce their own future roles. Second, it must reorient the way in which these professionals view their roles. Today's almost demeaning, task-oriented view needs to be replaced with one attuned to the unique contributions professionals make now and in the future. By helping professionals "see" their future contributions, effective communications can keep your patient focused care program out of the grave and in perfect health for years to come.
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The patient-centered care model needs to retain a central focus on the patient. Process and system interfaces are key areas where alignment on behalf of the patient is required. Often, the current system is out of control. Departmental infrastructure and the need for resource reallocation must be assessed. No blueprint exists for implementing patient-centered care, although many incremental patient-focused initiatives are already underway. Impact on patients must be the balancing factor.
This article defines a process to reconfigure and streamline patient care services in an acute care hospital. Multidisciplinary teams use quality improvement methods and team process to challenge and redefine current work activity in order to achieve financial savings and service improvements.
Patient-centered care may have the pharmacists and technicians reporting either directly or in a matrix to other than pharmacy administration. The pharmacy administrative people will need to be both effective leaders and managers utilizing excellent human resource management skills. Significant creativity and innovation will be needed for transition from departmental-based services to patient care team services. Changes in the traditional methods of recruiting, interviewing, hiring, training, developing, inspiring, evaluating, and disciplining are required in this new environment.
In summary, the slow, participative change process worked well. The power of the staff's involvement overcame the hospital's mistakes. The Steering Team "finessed" the problem of resistance to multi-skilling by creating a system that encouraged the desired behaviors without demanding them. By setting more realistic boundaries and acting more decisively, the Steering Team could have made the process even smoother.
Anticipating health care reform and seeking a marketing edge over competitors, hospitals are forming alliances with other providers.
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