Code Blue Health Science Edition Four T HE B OARD C HAPTER
2
Slide 3
Topics Covered in Chapter 2 The beginning chapters of Code Blue
focus on some of the administrative issues facing a community
hospital.The beginning chapters of Code Blue focus on some of the
administrative issues facing a community hospital. Medical and
technical issues will be addressed in more detail in subsequent
chapters.Medical and technical issues will be addressed in more
detail in subsequent chapters.
Slide 4
Topics Covered in Chapter 2 Since most health occupations
students are looking for careers outside of administration, some
wonder why it is important to understand the business side of
hospitals and other healthcare organizations.Since most health
occupations students are looking for careers outside of
administration, some wonder why it is important to understand the
business side of hospitals and other healthcare organizations.
Slide 5
Why Study Administration? Nurses, doctors, respiratory
therapists, and so on do not operate in a vacuum.Nurses, doctors,
respiratory therapists, and so on do not operate in a vacuum. It is
necessary to work with and relate not only to other departments,
but also to the administration of the hospital.It is necessary to
work with and relate not only to other departments, but also to the
administration of the hospital.
Slide 6
Why Study Administration? Many students may become department
supervisors and must, therefore, work with administration in
preparing budgets, hiring and firing employees, and in managing the
department.Many students may become department supervisors and
must, therefore, work with administration in preparing budgets,
hiring and firing employees, and in managing the department.
Slide 7
Why Study Administration? Some students may eventually move
into administration as the hospital administrator or assistant
hospital administrator.Some students may eventually move into
administration as the hospital administrator or assistant hospital
administrator.
Slide 8
Why Study Administration? Since the mid 1960s, hospitals have
increasingly been managed by administrators with backgrounds in
business, rather than patient care.Since the mid 1960s, hospitals
have increasingly been managed by administrators with backgrounds
in business, rather than patient care. While this has made
hospitals more cost effective, this increased efficiency may have
come at a cost.While this has made hospitals more cost effective,
this increased efficiency may have come at a cost.
Slide 9
Why Study Administration? The health care industry is currently
undergoing a major redesign.The health care industry is currently
undergoing a major redesign. If the healthcare industry is to
regain its focus on quality, compassion, and accessibility,
clinical personnel must assume a greater role in the planning and
implementation of the new programs that will be needed to meet the
healthcare demands of today.If the healthcare industry is to regain
its focus on quality, compassion, and accessibility, clinical
personnel must assume a greater role in the planning and
implementation of the new programs that will be needed to meet the
healthcare demands of today.
Slide 10
Chapter Two The Board Storyline
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The Characters Edward Wycoffchairman of the finance
committeeEdward Wycoffchairman of the finance committee What kind
of person is Edward Wycoff? Dr. Ashton AmosNewly elected president
of the medical staffDr. Ashton AmosNewly elected president of the
medical staff What kind of a person is Dr. Amos?
Slide 12
Board of Trustees The highest governing body in the hospitalThe
highest governing body in the hospital Functions: Hires and fires
the hospital administratorHires and fires the hospital
administrator Approves the annual hospital budgetApproves the
annual hospital budget Approves the annual strategic planApproves
the annual strategic plan Appoints doctors to the medical
staffAppoints doctors to the medical staff Approves physician
privileges (procedures physicians are allowed to perform)Approves
physician privileges (procedures physicians are allowed to
perform)
Slide 13
Brannan Community Hospital Organizational Structure
Slide 14
Executive Committee Conducts business on behalf of the board
between board meetingsConducts business on behalf of the board
between board meetings Membership: Chairman of the Board of
TrusteesChairman of the Board of Trustees Hospital
AdministratorHospital Administrator President of the Medical
StaffPresident of the Medical Staff Chairman of the Finance
CommitteeChairman of the Finance Committee
Slide 15
Finance Committee Advises the board on financial mattersAdvises
the board on financial matters The budget The accounting system
Financial reports Edward Wycoff is chairman of the finance
committeeEdward Wycoff is chairman of the finance committee
Slide 16
Medical Staff Consists of all physicians who practice medicine
in the hospitalConsists of all physicians who practice medicine in
the hospital Dr. Ashton Amos has been elected president of the
medical staff.Dr. Ashton Amos has been elected president of the
medical staff. He represents the interests of the medical staff to
the administrator and the board of trustees.
Slide 17
Hospital Departments Hospitals are grouped into departments.
Examples include: surgery, administration, nursing, radiology,
laboratory, housekeeping, finance, etc.
Slide 18
Department Heads The supervisor of a department in a hospital
is referred to as a department head. Department heads report
directly to the hospital administrator, or,in the case of larger
hospitals, to an assistant administrator.
Slide 19
Other Terminology Attending Physician: The physician who is in
charge of a patient admitted to the hospital.
Slide 20
Other Terms Used in Chapter 2 Prospective Reimbursement: This
is an important principle that we will discuss in some detail later
in the book.Prospective Reimbursement: This is an important
principle that we will discuss in some detail later in the book. It
has dramatically changed the way that medicine is practiced in the
United States. It is also one of the reasons Brannan Community
Hospital is in financial trouble. For the time being, that is all
we need to know about the topic.For the time being, that is all we
need to know about the topic.
Slide 21
Other Terms Used in Chapter 2 Dietary Department: The
department that plans and delivers meals to hospital patients.
Chief Dietician: The head of the dietary department. Dietician: An
individual trained in the practical application of diet in the
treatment of hospital patients.
Slide 22
Career Opportunity There are good career opportunities for
those interested in hospital dietetics. A number of universities
offer degrees for hospital dieticians.
Slide 23
Other Terms Used in Chapter 2 Double Bypass: An operation where
two veins or internal mammary arteries are grafted between the
aorta and a coronary artery branch to shunt blood beyond an
obstruction.
Slide 24
Other Terms Used in Chapter 2 Coronary Care Unit (CCU): The
medical unit where patients with coronary (heart) diseases are
treated and housed.
Slide 25
Other Terms Used in Chapter 2 Critical Condition: The most
serious classification of patient illness.
Slide 26
Other Terms Used in Chapter 2 Emergency Call: Physicians at
some hospitals are required to provide coverage of the emergency
room.Emergency Call: Physicians at some hospitals are required to
provide coverage of the emergency room. These hospitals do not have
full-time emergency physicians. When a patient presents himself (or
herself) at the emergency center, the doctor is called to the
emergency center.
Slide 27
Other Terms Used in Chapter 2 Life Flight: In Code Blue, a
helicopter that transports patients from an accident to a hospital,
or from a hospital to a more specialized hospital.
Slide 28
Other Terms Used in Chapter 2 Managed Care: A philosophy and
system of reducing healthcare costs.Managed Care: A philosophy and
system of reducing healthcare costs. MBA: Acronym for Masters of
Business Administration a general masters degree in business.MBA:
Acronym for Masters of Business Administration a general masters
degree in business. Medicare: A Federal program to pay for
healthcare costs of certain groups, including those 65 years of age
or older.Medicare: A Federal program to pay for healthcare costs of
certain groups, including those 65 years of age or older. Payer:
The individual or organization that pays the healthcare bill.
Insurance companies, Medicare and Medicaid are payers.Payer: The
individual or organization that pays the healthcare bill. Insurance
companies, Medicare and Medicaid are payers.
Slide 29
Other Terms Used in Chapter 2 President of the medical staff:
An individual elected by the medical staff to represent them to
administration and the board.
Slide 30
Other Terms Used in Chapter 2 Rounds: In Code Blue, a morning
visit by a physician to his or her patients within the hospital.
The term originated at Johns Hopkins Hospital, where all patient
wings radiated off a central, circular hall.
Slide 31
Other Terms Used in Chapter 2 Transportation Aide: An
individual who is responsible for transporting food, supplies,
and/or patients throughout the hospital.Transportation Aide: An
individual who is responsible for transporting food, supplies,
and/or patients throughout the hospital.
Slide 32
Power and Politics In this chapter, we learn the reaction of
the board to the death of the hospital administrator.In this
chapter, we learn the reaction of the board to the death of the
hospital administrator. We also are introduced to power and
politics in the hospital. Financial problems facing the board are
also briefly discussed.We also are introduced to power and politics
in the hospital. Financial problems facing the board are also
briefly discussed.
Slide 33
Power and Politics Selecting a new administrator may be a
difficult task. The board of trustees has at least the following
five options:
Slide 34
Option 1 Select an administrator who has been formally trained
by an accredited program in healthcare administration and has prior
experience in hospital management.Select an administrator who has
been formally trained by an accredited program in healthcare
administration and has prior experience in hospital management. If
the board of trustees of Brannan Community Hospital selects this
alternative, they will not be able to fill the job immediately,
since most experienced hospital administrators must provide several
weeks notice to their current employer.
Slide 35
Option 2 Select someone who has business experience, but no
hospital experience, perhaps a local businessman or
businesswoman.Select someone who has business experience, but no
hospital experience, perhaps a local businessman or businesswoman.
The problem with this alternative is that the issues involved in
running a hospital are very different from those involved in
running a retail, manufacturing, or construction firm. By the time
the new administrator learns the rules, the game may be over.
Slide 36
Option 3 Choose someone from within the hospital to succeed the
old administrator. This individual would have the advantage of
understanding the problems of the hospital. Department heads dont
always make the best hospital administrators, however. Many come
from technical backgrounds and are inadequately trained in
administration or finance.
Slide 37
Option 4 Recruit a local physician to fill the job. A
non-competitive salary and a lack of business training are the
major problems of this alternative.
Slide 38
Option 5 Select an interim administrator to guide the hospital
through the current crisis and provide the board of trustees time
to find a permanent replacement.Select an interim administrator to
guide the hospital through the current crisis and provide the board
of trustees time to find a permanent replacement. The advantage of
this alternative is that the hospital will have someone immediately
to address the financial problems the hospital is having. The
disadvantage is that the interim administrator might not be as
qualified as a permanent replacement, and the hospital staff will
have to adjust to two administrators (the interim administrator and
the interims replacement).
Slide 39
Discussion Question 1 What are the advantages and disadvantages
of selecting an interim administrator to run Brannan Community
Hospital?
Slide 40
Discussion Question 2 Why did Edward Wycoff summon Dr. Ashton
Amos to discuss the appointment of a new administrator prior to the
board meeting?Why did Edward Wycoff summon Dr. Ashton Amos to
discuss the appointment of a new administrator prior to the board
meeting? What does Wycoff want from Amos?What does Wycoff want from
Amos? Why did Dr. Amos agree to Wycoffs proposal?Why did Dr. Amos
agree to Wycoffs proposal?
