Explain how performance measurement fits into the quality continuum, and identify sources of comparative performance data for health services organizations.

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MEASURING PROCESS AND SYSTEM PERFORMANCE

Learning Objectives
After completing this chapter, you should be able to
• Describe how managers use measurement for performance management purposes,
• Distinguish types of measures and comprehensive measurement sets,
• Explain how performance measurement fits into the quality continuum, and
• Identify sources of comparative performance data for health services organizations.

Describe the importance of purposeful team design on organizational results, and identify evidence-based strategies for improving collaboration and teamwork.

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FOSTERING A CULTURE OF COLLABORATION AND TEAMWORK

Learning Objectives
After completing this chapter, you should be able to
• Describe why a supportive culture, collaboration, and teamwork are essential to quality health services delivery;
• Recognize mental models about teams and the manager’s role in team effectiveness;
• Describe the importance of purposeful team design on organizational results; and
• Identify evidence-based strategies for improving collaboration and teamwork.

Distinguish the relationships between purpose, desired results, measures of results, interventions, and improvement goals and compare the concepts of mental model and context as they are used in organizations.

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ESTABLISHING SYSTEM DIRECTION

Learning Objectives
After completing this chapter, you should be able to
• Link the role of mission, vision, and context to organizational results;
• Appreciate how the purpose principle can aid managers in problem solving;
• Distinguish the relationships between purpose, desired results, measures of results, interventions, and improvement goals; and
• Compare the concepts of mental model and context as they are used in organizations.

Recognize the benefit of viewing system components when managing quality. Explain how parts of the health services delivery system are interconnected.

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VISUALIZING SYSTEM RELATIONSHIPS

Learning Objectives
After completing this chapter, you should be able to
• Recognize the benefit of viewing system components when managing quality,
• Explain how parts of the health services delivery system are interconnected,
• Contrast four different models for illustrating system relationships, and
• Describe the management implications of different system relationship models.

Identify three factors described by Dr. Berwick that are the most difficult for healthcare organizations to overcome and explain why. For the three factors you select, describe actions that managers can take to eliminate or minimize the factor so it no longer inhibits operations improvement.

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Applying Quality Management in Health

Instructions: Read the following article:

Berwick, D. 2003. “Improvement, Trust, and the Healthcare Workforce.” Quality & Safety in Health Care 12 (supplement 1): i2–i6. www.ncbi.nlm.nih.gov/pmc/articles/PMC176576/pdf/v012p000i2.pdf.

In this article, Dr. Berwick describes several historical and present-day “below the waterline” factors that inhibit healthcare quality improvement. For example, he observes that improvement is limited when the workforce is not encouraged to actively participate in reinventing the system.

• Identify three factors described by Dr. Berwick that are the most difficult for healthcare organizations to overcome and explain why.
• For the three factors you select, describe actions that managers can take to eliminate or minimize the factor so it no longer inhibits operations improvement.

Explain systemic structure from the perspective of the iceberg metaphor. Describe how an understanding of systemic structure guides managerial questions about performance problems.

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UNDERSTANDING SYSTEM BEHAVIOR

Learning Objectives
After completing this chapter, you should be able to
• Explain systemic structure from the perspective of the iceberg metaphor;
• Describe how an understanding of systemic structure guides managerial questions about performance problems;
• Identify the influence of mental models on managerial behaviors, decisions, and effectiveness; and
• Apply learning strategies to better understand how systemic structures affect performance.

Why is this person a candidate for hearing aids in the first place? You have some information about the person’s hearing loss. Is this enough for you to be able to fit hearing aids effectively?

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CASE STUDY #1 QUESTIONS

1. Why is this person a candidate for hearing aids in the first place?
2. You have some information about the person’s hearing loss. Is this enough for you to be able to fit hearing aids effectively?
3. What other kinds of information would you like to be able to help this person?
4. What style of hearing aid do you recommend this patient use, based on her hearing loss?
5. Find information from one or more of the websites of hearing aid manufacturers that will reassure you that the style of hearing aid you have chosen is appropriate for this person’s hearing loss and describe what you found.
6. What controls and features (volume control, remote control, telecoil, etc..) would this person need or enjoy?
7. For the hearing aid you recommend, do you need to make an impression of the person’s ear?
8. Now that hearing aids are almost all digital, what benefits will this client receive from having a digital circuit in the hearing aid?
9. Will the hearing aid you recommend have a directional microphone? Do directional microphones help and how do they help?
10. What size of battery will be in the hearing aid?
11. What do you need to tell the person about the batteries so they can use them both safely and effectively?
12. How well does a hearing aid do in overcoming a hearing loss?
13. How do you take care of hearing aids?
14. Why do hearing devices cost so much?

Describe system characteristics that contribute to dynamic complexity, and explain the influence of dynamic complexity on managerial decision making.

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CHARACTERISTICS OF COMPLEX SYSTEMS

Learning Objectives
After completing this chapter, you should be able to
• Discuss how a systems perspective can explain recurrent organizational problems,
• Recognize different types of systems and the role of systems thinking,
• Describe system characteristics that contribute to dynamic complexity, and
• Explain the influence of dynamic complexity on managerial decision making.

Describe the types of oversight organizations that influence healthcare quality. Recognize how public and private policies encourage quality improvement at the organizational, community, and national levels.

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ROLE OF POLICY IN ADVANCING QUALITY

Learning Objectives
After completing this chapter, you should be able to
• Describe the types of oversight organizations that influence healthcare quality;
• Recognize how public and private policies encourage quality improvement at the organizational, community, and national levels; and
• Identify resources to maintain current knowledge about policy changes, new initiatives, and updates on current initiatives.

Did your experience fit with the listed outcomes of the course? Why or why not? What was successful? Why? What would you do differently? Why?

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DISCUSSION QUESTION

  • What did you learn from this course? About yourself? About working in the field?
  • Did your experience fit with the listed outcomes of the course? Why or why not? What was successful? Why? What would you do differently? Why?