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8/3/2019 Managing the Family Medicine Practice
http://slidepdf.com/reader/full/managing-the-family-medicine-practice 1/39
MANAGING THE FAMILYMEDICINE PRACTICE
dr. Merry Tiyas A.
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THE FIVE STAR DOCTOR
C ARE PROVIDER
DECISION MAKER
COMMUNIC ATOR
COMMUNITY LEADER
MANAGER OF HEALTH C ARE
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MANAGING THE FAMILY MEDICINEPRACTICE
Managing People and Resources
Managing Facilities and Utilities
Managing Information
Managing Finance and Managed Care
Managing Quality
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MANAGING PEOPLE ANDRESOURCES
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Input 3M : manpower, money and
materials. Process operational work,
developmental work, and
organizational work.
Output technical care and patient
satisfaction
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BASIC FUNCTION OF A MANAGER
Planning
Process of setting objectives andformulating the steps which will be
necessary to attain these objectives.
Long term strategic planning
Short term operational planning
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Organizing
Process of getting activities, people,materials structured to meet organizational
objectives. It includes :
± setting of job description
± Authority to act
± departmentalization
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Leading
± process of influencing staff to meetpredetermined objectives.
± The skills to be an effective leader:
communication and feedback skills
motivation of staff
use appropriate leadership style.
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SKILL SET OF THE MANAGER
Conceptual skills skills of perceiving how
the part of the organization link together instructure and processes.
Human skills skills involved in working
with people.
Technical skills skills in managing things
rather than people and are often learned
through on the job training programs.
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MANAGING PEOPLE
From entry to exit of staff, there are many aspects in managingpeople :
± Recruitment ± Selection
± Induction training
± Motivation
± People handling
± Structure
± Leadership ± Personal effectiveness
± Change management
± Staff development delegation, appraisal, courses
± Separation
± promotion
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STRATEGIC MANAGEMENT
Basic of strategic planning five steps:
± Identification of current objectives and strategy ± Analysis of the external environment
± Analysis ot the organization¶s strengths and
weakness
± Strategic decision making to decide on services tointroduce, services to scale down
± Strategic implementation at functional levels.
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SWOT Analysis
Strengths, weaknesses, opportunities andthreats.
Opportunities and threats exist in the externalenvironment.
Opportunities are prospect to fill existing or newservice needs.
Threats come from competitors, policies andeconomic outlook,and changes in public.
Strengths, weaknesses are state of theorganization to sustain itself.
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MANAGING FACILITIES ANDUTILITIES
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SUPPLIES AND STORES
MANAGEMENT PRINCIPLES
Deals with ordering; receipt; maintenance;
and issue when required. The supplies can range from drugs and
pharmaceuticals to syringes and needles aswell as general use items like stationery.
Stocks of pharmaceuticals and medicalrequire close monitoring to ensure they donot deteriorate or reach expiry dates.
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MAINTENANCE AND STORAGE
Some rules are needed in the issue of drugs
and pharmaceuticals: ± Proper accounting of items issued
± Restriction of number of people having acces to
stores
± Regular inventory taking and action taken toexplain discrepancies.
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DRUGS.
The operations management principles are: ± Use principle of first in, first out (FIFO) its
important to avoid running of date.
± Circulate information on maintaining shelf life
through proper storage. ± Do spot checks and regular inventory taking
reduce wastage from date expiry, poor storage
and pilferage.
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VACCINES.
The operations management principles are : ± Maintain the ³ cold chain´. Transport to outlying
places must be carefully planned.
± Keep every one knowledgeable of the ³cold
chain´, down the driver. ± Review the ³cold chain´ regularly to ensure that
the ³cold chain´ works.
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MANAGING DISCREPANCIES
Discrepancies the differences between
recorded and actual quantity of money or inventory.
Reasons : ± Human error
± Machine counting error ± Incomplete recording
± Pilferage
± Fraud
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Action to be taken for all discrepancies
Take immediate action Parties involved to explain what they know of the
matter
Conduct the necessary investigation
Take uniform decision as has been laid down asstandard operating instructions.
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MANAGING INFORMATION
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MEDICAL RECORDS
Documentation of clinical details.
Properly kept and used, allow us to see the problemsolving process form which we can deliver better
care.
An effective record keeping system contributes to
the standard of care.
Attention paid to how medical records are organized,
filed and maintained is integral to effective practice.
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System of filling records :
Numeric Alphabetical
Address or company
Color coding
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MANAGING FINANCE ANDMANAGED CARE
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FINANCIAL MANAGEMENT
Keeping proper records of income, expenditure and
profit.
Preparing financial statements at the end of accounting
period.
Analyzing financial statements and taking the
necessary actions.
Implementing inventory and stock control processes.
Acting on discrepancies.
Ensuring that financial records are audited.
Developing financial plans.
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Income :
± Consultation
± Sale of medicine
± Fee for service
± House calls
± Investment from surplus revenue
Expenses : ± Staff cost as salary, bonus etc.
± Occupancy cost such as rents, repair, telephone, utilities.
Profit : difference between income and expenses.
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Financial Audit
The purpose of financial audits is to ensure
accountability in the use of financial andmaterial resources.
External audit
Internal audit
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MANAGED CARE
Refers to a variety of techniques for
influencing the clinical behavior of healthcare provider and/or patients, often byintegrating the payment and delivery of health care.
Aim : to place administrative control over cost, quality, or access to health careservices in a specific population coveredenrollees.
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Managed Care Systems
The prototype managed care system is the
Health Maintenance Organization (HMO). Capitation system of payment is key feature.
Capitation involves paying physicians a fixed,
prospective amount for each patient
regardless of the cost of caring for thepatient.
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Capitation is one example of managed care
practices that seek to control costs of healthcare.
Some managed care practices seek to
impact the quality of care.
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Managed care is structured around a variety
of incentives to encourage the practice of cost-effective medicine, and to minimize
variation in clinical practice pattern.
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In its ideal state, money is saved through
several mechanisms: ± Standardization of fees
± Reduced variations of care
± Cheaper alternatives without undue sacrifice of
quality or convenience ± Exclusion of non effective treatment
± Reduction of unnecessary tests and treatments
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MANAGING QUALITY
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QUALITY AND QUALITY ASSURANCE
QUALITY : care that meets or exceeds expectations.
Two aspects : ± technical
± patient satisfaction.
Evaluated by structure, process and outcome
indicators.
Based on the result of these indicators implement
improvement programs to close the quality gaps.
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QUALITY ASSURANCE is an attempt to
protect and enhance quality. Concerned with patient care that is high in
professional quality, and satisfying to the
patient.
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Quality holds the promise of being able to :
Deliver the most appropriate and up to datemedical care.
Reduce the chance of unsuitable treatment andcare, and an appropriate variation in carebetween doctors.
Encourage accountability between providers,consumers and founders of health care.
Save unnecessary costs by reducing waste,duplication and increasing efficiency.
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TUGAS INDIVIDUTUGAS INDIVIDU
Membuat resumeMembuat resume ³Asuransi³Asuransi
Kesehatan´Kesehatan´
Tugas ditulis tanganTugas ditulis tangan Dikumpulkan hari ini palingDikumpulkan hari ini paling
lambat jam 16.00 WIB.lambat jam 16.00 WIB.