BHA 3002, Health Care Management Course Syllabus Course Description Health Care Management contains an introduction to the field of modern healthcare management through a systematic analysis of the important areas of concern to the healthcare manager. Topics covered include the planning process and how planning is used in healthcare administration; the organizing process and job design; supporting and implementing decisions; building the quality of clinical service; and providing human resources and plant services. Course Textbook Safian, S. C. (2014). Fundamentals of health care administration. Upper Saddle River, NJ: Pearson. Course Learning Outcomes Upon completion of this course, students should be able to: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Explain the emergence of the modern healthcare organization. Describe how the design of healthcare organizations reflect their environment. Analyze the structure of governing boards for healthcare organizations. Outline the characteristics of the executive office. Categorize marketing procedures in a healthcare organization. Analyze the finance system in a healthcare organization. Examine information services in a healthcare setting. Evaluate ways to improve the quality and economy of patient care. Compare and contrast clinical support services. Explain how an effective human resource system operates. Credits Upon completion of this course, the students will earn three (3) hours of college credit. Course Structure 1. Study Guide: Each unit contains a Study Guide that provides students with the learning outcomes, unit lesson, required reading assignments, and supplemental resources. 2. Learning Outcomes: Each unit contains Learning Outcomes that specify the measurable skills and knowledge students should gain upon completion of the unit. 3. Unit Lesson: Each unit contains a Unit Lesson, which discusses lesson material. 4. Reading Assignments: Each unit contains Reading Assignments from one or more chapters from the textbook. 5. Discussion Boards: Discussion Boards are part of all CSU term courses. More information and specifications can be found in the Student Resources link listed in the Course Menu bar. 6. Unit Assessments: This course contains seven Unit Assessments, one to be completed at the end of Units I-VII. Assessments are composed of written-response questions. 7. Unit Assignments: Students are required to submit for grading Unit Assignments in Units II, V and VIII. Unit VIII contains two assignments. Specific information and instructions regarding these assignments are provided below. Grading rubrics are included with each assignment. Specific information about accessing these rubrics is provided below. BHA 3002, Health Care Management 1 8. Ask the Professor: This communication forum provides you with an opportunity to ask your professor general or course content related questions. 9. Student Break Room: This communication forum allows for casual conversation with your classmates. CSU Online Library The CSU Online Library is available to support your courses and programs. The online library includes databases, journals, e-books, and research guides. These resources are always accessible and can be reached through the library webpage. To access the library, log into the myCSU Student Portal, and click on \"CSU Online Library.\" You can also access the CSU Online Library from the \"My Library\" button on the course menu for each course in Blackboard. The CSU Online Library offers several reference services. E-mail (library@columbiasouthern.edu) and telephone (1.877.268.8046) assistance is available Monday - Thursday from 8 am to 5 pm and Friday from 8 am to 3 pm. The library's chat reference service, Ask a Librarian, is available 24/7; look for the chat box on the online library page. Librarians can help you develop your research plan or assist you in finding relevant, appropriate, and timely information. Reference requests can include customized keyword search strategies, links to articles, database help, and other services. LibGuides Click here for the LibGuide for this course. Think of a LibGuide (a Library Guide) as a mini-website to help you with your assignments. It has relevant information such as databases, ebooks, and websites specific to your courses. If you have any questions, please reach out to your friendly library staff. Unit Assignments Unit II Project Topic In Unit VIII, you are required to submit a management action plan (MAP). The details for this assignment are provided in the syllabus. This can be either a \"real world\" management problem within your own healthcare organization or one of the scenarios shown below. For this assignment, please present a one paragraph summary of the problem to your instructor for approval by submitting it here in Blackboard. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Deciding on for-profit, not-for-profit, or public status for your hospital Managing third-party payer relationships in health care Implementing Healthy People 2020 standards in your community Implementing evidence-based medicine in your hospital Implementing CMS quality initiatives in your hospital Developing a workplace safety plan for your hospital Implementing telehealth services in your facility Conducting a complete risk assessment for your facility Developing an accountable care organization for your organization Developing a marketing plan for your healthcare facility Information about accessing the Grading Rubric for this assignment is provided below. Unit V Article Critique Using the CSU Online Library's Academic Search Complete database, please locate the following article: Morrill, P. W. (2013). Risk assessment as standard work in design. Health Environments Research & Design Journal (HERD), 7(1), 114-123. BHA 3002, Health Care Management 2 After reading the article and briefly summarizing the purpose for the study, answer the following questions: What is the author's main point? Who is the author's intended audience? Do the author's arguments support her main point? What evidence supports the main point? What is your opinion of the article? Do you agree with the author's findings? What evidence, either from the textbook or additional sources, supports your opinion? What benefits and challenges were associated with the hospitals' use of the failure modes and effects analysis (FMEA) process? Your paper should be a minimum of two pages, not counting the title page and references. Make certain that all references and in-text citations are formatted according to APA style. Information about accessing the Grading Rubric for this assignment is provided below. Unit VIII PowerPoint Presentation Imagine that you are the marketing manager for a healthcare organization. You and your team would like to create a marketing message to target the organization's primary market. It is your job to convince the governing board to give your team the funds it needs to produce the message. Create a PowerPoint presentation of no less than five slides (not including the title slide and reference slides) in which you explain the value of creating and implementing a marketing plan for the organization, provide an example of an effective marketing message, and discuss various appropriate marketing vehicles for your organization. Information about accessing the Grading Rubric for this assignment is provided below. Unit VIII Management Action Plan By the end of this course, you will need to prepare and submit a management action plan (MAP) addressing a specific healthcare problem or scenario. This can be either a \"real world\" management problem within your own healthcare organization or a scenario from the list in the Unit II Project Topic assignment. Please include documentation of all six steps shown below in your submission of the MAP assignment. I. Clarify the Problem or Opportunity for Improvement (OFI) Clearly describe the problem or OFI that you have selected for your MAP. Why is it important to resolve this problem right now? What are the consequences of not resolving this problem right now? II. Clarify your Measureable Goal Clearly describe the desired outcome from your MAP implementation. What are you trying to accomplish? How will successful MAP implementation be measured and assessed? What realistic constraints do you have as you begin creation of your plan? Consider limits on time, money, and other resources that are specific to your MAP. III. Prepare a List of Possible Actions Consider possible root causes of the OFI. Why do you believe the problem exists? Brainstorm and present a list of all possible actions that you may need to take in order to achieve your MAP goal. At this stage, focus on generating as many different options and ideas as possible. It is likely that not all of your ideas will make it into your final MAP. Write down your ideas just as they come to your mind, trying not to judge or analyze them at this stage. In your brainstorming, be sure to consider ideas* involving the following: leadership, governance, clinical performance, physicians, nurses, clinical support services, knowledge management, human resources, BHA 3002, Health Care Management 3 financial management, internal consulting, and marketing. *It is understood that some of these areas may not apply to your particular MAP, but all areas should at least be considered in this process. IV. Organize your Key Action Steps into a Management Action Plan Decide on the sequencing of your key action steps. For each key action step, what other steps must be completed before that specific action can be taken? Rearrange your key action steps into a sequence of ordered activity. Then, look at your plan once again. Are there any ways to simplify the plan further before presenting it? V. Accountability For each key action step, assign a responsible party or group within your organization (by position, department, or team name, not by individual name), and assign a suspense date by which the key action step must be completed. Then, based upon all of your key action steps and their suspense dates, provide a realistic completion date for the entire MAP. VI. Measurement and Monitoring Now, explain in detail how you will measure the success of your MAP following implementation and how you will monitor ongoing performance to prevent regression and loss of the positive change that has taken place. Your plan should consist of no less than four pages, and any outside sources should be cited and referenced using APA formatting. Information about accessing the Grading Rubric for this assignment is provided below. APA Guidelines The application of the APA writing style shall be practical, functional, and appropriate to each academic level, with the primary purpose being the documentation (citation) of sources. CSU requires that students use APA style for certain papers and projects. Students should always carefully read and follow assignment directions and review the associated grading rubric when available. Students can find CSU's Citation Guide in the myCSU Student Portal by clicking on the \"Citation Resources\" link in the \"Learning Resources\" area. This document includes examples and sample papers and provides information on how to contact the CSU Success Center. Grading Rubrics This course utilizes analytic grading rubrics as tools for your professor in assigning grades for all learning activities. Each rubric serves as a guide that communicates the expectations of the learning activity and describes the criteria for each level of achievement. In addition, a rubric is a reference tool that lists evaluation criteria and can help you organize your efforts to meet the requirements of that learning activity. It is imperative for you to familiarize yourself with these rubrics because these are the primary tools your professor uses for assessing learning activities. Rubric categories include: (1) Discussion Board, (2) Assessment (Written Response), and (3) Assignment. However, it is possible that not all of the listed rubric types will be used in a single course (e.g., some courses may not have Assessments). The Discussion Board rubric can be found within Unit I's Discussion Board submission instructions. The Assessment (Written Response) rubric can be found embedded in a link within the directions for each Unit Assessment. However, these rubrics will only be used when written-response questions appear within the Assessment. Each Assignment type (e.g., article critique, case study, research paper) will have its own rubric. The Assignment rubrics are built into Blackboard, allowing students to review them prior to beginning the Assignment and again once the Assignment has been scored. This rubric can be accessed via the Assignment link located within the unit where it is to be submitted. Students may also access the rubric through the course menu by selecting \"Tools\" and then \"My Grades.\" Again, it is vitally important for you to become familiar with these rubrics because their application to your Discussion Boards, Assessments, and Assignments is the method by which your instructor assigns all grades. BHA 3002, Health Care Management 4 Communication Forums These are non-graded discussion forums that allow you to communicate with your professor and other students. Participation in these discussion forums is encouraged, but not required. You can access these forums with the buttons in the Course Menu. Instructions for subscribing/unsubscribing to these forums are provided below. Click here for instructions on how to subscribe/unsubscribe and post to the Communication Forums. Ask the Professor This communication forum provides you with an opportunity to ask your professor general or course content questions. Questions may focus on Blackboard locations of online course components, textbook or course content elaboration, additional guidance on assessment requirements, or general advice from other students. Questions that are specific in nature, such as inquiries regarding assessment/assignment grades or personal accommodation requests, are NOT to be posted on this forum. If you have questions, comments, or concerns of a nonpublic nature, please feel free to email your professor. Responses to your post will be addressed or emailed by the professor within 48 hours. Before posting, please ensure that you have read all relevant course documentation, including the syllabus, assessment/assignment instructions, faculty feedback, and other important information. Student Break Room This communication forum allows for casual conversation with your classmates. Communication on this forum should always maintain a standard of appropriateness and respect for your fellow classmates. This forum should NOT be used to share assessment answers. Grading Discussion Boards (8 @ 2%) Unit Assessments (7 @ 6%) Unit II Project Topic Unit V Article Critique Unit VIII PowerPoint Presentation Unit VIII Management Action Plan Total Course Schedule/Checklist = 16% = 42% = 2% = 13% = 13% = 14% = 100% (PLEASE PRINT) The following pages contain a printable Course Schedule to assist you through this course. By following this schedule, you will be assured that you will complete the course within the time allotted. BHA 3002, Health Care Management 5 BHA 3002, Health Care Management Course Schedule By following this schedule, you will be assured that you will complete the course within the time allotted. Please keep this schedule for reference as you progress through your course. Unit I Introduction to Healthcare Management Review: Read: Discuss: Submit: Unit Study Guide Chapter 1: The Balance of Good Administration Chapter 2: Types of Facilities and Services Discussion Board Response: Submit your response to the Discussion Board question by Saturday, 11:59 p.m. (Central Time) Discussion Board Comment: Comment on another student's Discussion Board response by Tuesday, 11:59 p.m. (Central Time) Assessment by Tuesday, 11:59 p.m. (Central Time) Notes/Goals: Unit II Financing and Quality for Health Care Review: Read: Discuss: Submit: Unit Study Guide Chapter 3: Financing the Provision of Care Chapter 4: Quality of Care Discussion Board Response: Submit your response to the Discussion Board question by Saturday, 11:59 p.m. (Central Time) Discussion Board Comment: Comment on another student's Discussion Board response by Tuesday, 11:59 p.m. (Central Time) Assessment by Tuesday, 11:59 p.m. (Central Time) Project Topic by Tuesday, 11:59 p.m. (Central Time) Notes/Goals: Unit III Healthcare Safety and Technology Review: Read: Discuss: Submit: Unit Study Guide Chapter 5: Workplace Safety Chapter 6: Health Care Technology Discussion Board Response: Submit your response to the Discussion Board question by Saturday, 11:59 p.m. (Central Time) Discussion Board Comment: Comment on another student's Discussion Board response by Tuesday, 11:59 p.m. (Central Time) Assessment by Tuesday, 11:59 p.m. (Central Time) Notes/Goals: BHA 3002, Health Care Management 6 BHA 3002, Health Care Management Unit IV Healthcare Food Services and Compliance Review: Read: Discuss: Submit: Notes/Goals: Unit Study Guide Chapter 7: Institutional Food Services Chapter 8: Compliance Plans Discussion Board Response: Submit your response to the Discussion Board question by Saturday, 11:59 p.m. (Central Time) Discussion Board Comment: Comment on another student's Discussion Board response by Tuesday, 11:59 p.m. (Central Time) Assessment by Tuesday, 11:59 p.m. (Central Time) Unit V Strategic Planning and Risk Management in Health Care Review: Read: Discuss: Submit: Course Schedule Unit Study Guide Chapter 9: Strategic Planning Chapter 10: Risk Management Discussion Board Response: Submit your response to the Discussion Board question by Saturday, 11:59 p.m. (Central Time) Discussion Board Comment: Comment on another student's Discussion Board response by Tuesday, 11:59 p.m. (Central Time) Assessment by Tuesday, 11:59 p.m. (Central Time) Article Critique by Tuesday, 11:59 p.m. (Central Time) Notes/Goals: Unit VI Crisis Management and Performance Improvement in Health Care Review: Read: Discuss: Submit: Notes/Goals: Unit Study Guide Chapter 11: Crisis Management Chapter 12: Performance Improvement Discussion Board Response: Submit your response to the Discussion Board question by Saturday, 11:59 p.m. (Central Time) Discussion Board Comment: Comment on another student's Discussion Board response by Tuesday, 11:59 p.m. (Central Time) Assessment by Tuesday, 11:59 p.m. (Central Time) BHA 3002, Health Care Management 7 BHA 3002, Health Care Management Unit VII Audits, Inspections, and Legal Issues Review: Read: Discuss: Submit: Notes/Goals: Course Schedule Unit Study Guide Chapter 13: Audits and Inspections Chapter 14: Legal and Ethical Issues Discussion Board Response: Submit your response to the Discussion Board question by Saturday, 11:59 p.m. (Central Time) Discussion Board Comment: Comment on another student's Discussion Board response by Tuesday, 11:59 p.m. (Central Time) Assessment by Tuesday, 11:59 p.m. (Central Time) Unit VIII Marketing and Advertising Review: Unit Study Guide Read: Chapter 15: Health Care Marketing, Advertising, and Public Relations Discussion Board Response: Submit your response to the Discussion Board question by Saturday, 11:59 p.m. (Central Time) Discussion Board Comment: Comment on another student's Discussion Board response by Tuesday, 11:59 p.m. (Central Time) PowerPoint Presentation by Tuesday, 11:59 p.m. (Central Time) Management Action Plan by Tuesday, 11:59 p.m. (Central Time) Discuss: Submit: Notes/Goals: BHA 3002, Health Care Management 8 UNIT II STUDY GUIDE Financing and Quality for Health Care Course Learning Outcomes for Unit II Upon completion of this unit, students should be able to: 6. Analyze the finance system in a healthcare organization. 6.1 Examine key differences between for-profit, not-for-profit, and public healthcare facilities. 6.2 Explain the process of creating and balancing a healthcare facility budget. 8. Evaluate ways to improve the quality and economy of patient care. 8.1 Describe the process of quality review and privileging for physicians. 8.2 Discuss the importance of quality initiatives, quality equipment and supplies, and quality regulations. 8.3 Identify a management problem in a healthcare organization. Reading Assignment Chapter 3: Financing the Provision of Care Chapter 4: Quality of Care Unit Lesson Evidence-Based Performance Measures One of the hottest topics in healthcare administration today is evidence-based performance, and you certainly need a solid understanding of this process in order to function effectively as a healthcare leader moving into the future. American health care needs to improve. There is no doubt about that. Americans deserve more bang for the buck that they spend on medical services. One of the most important initiatives to make that happen is a move to more evidence-based practice. What evidence-based performance is truly all about, first and foremost, is the patient (UT Health, 2015). In particular, it is all about making sure that the patient receives care based upon the best and latest research that is available for the patient's own particular health problem or set of health problems. It is about giving the right care, every time, for every patient. Other benefits of a solid evidence-based medicine program include the ability to assure your own community that your hospital provides high quality care and that you are doing your own quality review studies to make sure of this. Finally, evidence-based medicine makes sense because the Centers for Medicare Services (CMS) demands it of us. They will actually pay us more for our services if we meet evidence-based performance criteria and goals, and they will financially penalize us if we do not meet evidence-based goals. In short, there are many good reasons to implement evidence-based medicine in your own medical facility. Currently, there are several national focus areas for evidence-based medicine programs. These are heart failure (HF), acute myocardial infarction (AMI), pneumonia (PN), and the surgical care improvement project (SCIP). Let's consider these four very important projects here separately. BHA 3002, Health Care Management 1 Heart Failure UNIT x STUDY GUIDE Title Congestive heart failure accounts for more than 700,000 hospitalizations each year in America (UT Health, 2015). It is one of the most common reasons people over the age of 65 are hospitalized each year (UT Health, 2015). The reason that so many people are showing up at the hospital with congestive heart failure today is actually pretty easy to understand. We are simply living longer in this country, and more people are now living long enough to encounter chronic illnesses such as heart failure. Additionally, the American lifestyle and diet make us susceptible to heart problems as we age. So, taking excellent care of heart failure patients and keeping them well to avoid readmissions, becomes an important part of our role in community hospitals. Acute Myocardial Infarction Acute myocardial infarction, heart attack, is also a major reason for admission to hospitals in our nation. As you probably know, cardiovascular disease is the single leading killer in America today (Centers for Disease Control and Prevention [CDC], 2015a). Each year in America, a little over one million people have heart attacks, and almost two-thirds of them do not make a complete recovery from the heart attack (UT Health, 2015). We need and want to do better for heart attack victims in this country, and there are some very specific steps that doctors and hospitals can take to make that a reality with better outcomes for our patients. We will discuss those steps below. Pneumonia Also very important as a quality-focus measure is pneumonia. Even with modern antibiotics, vaccines, and high technology respiratory therapy, pneumonia and influenza continue to be among the leading causes of death in patients over age 65 (UT Health, 2015). Pneumonia generally does not kill younger patients, but in patients over age 65, the risk is very real. About 90% of pneumonia deaths are in patients over 65 years of age (Cassiere, 1998). Surgical Care Improvement Surgical care improvement is also a major goal for medical care in the United States. According to UT Health, the most alarming current statistic is that 22% of preventable deaths in U.S. health care are due to postoperative complications (2015). Patients who develop surgical site infections have about twice the mortality rate of those who avoid them after surgery (UT Health, 2015). Additionally, patients who develop postoperative infections are about 60% more likely to spend time in the intensive care unit during their admissions (UT Health, 2015). UT Health (2015) states that these patients are about five times more likely to be readmitted to the hospital after discharge. In short, there is plenty of reason for us to work hard and avoid postoperative complications. Surgical patients are also much more likely than other patients to experience deep venous thrombosis (DVT), and sometimes pulmonary embolism (PE), which is an immediately lifethreatening complication (UT Health, 2015). PE and DVT result in 60,000 to 100,000 hospital deaths per year (CDC, 2015b). It is generally considered to be the most serious type of postoperative complication. Key Performance Measures So, the information presented above should make it clear that these are health problems worth studying and worth working to improve. Let us share the actual measures for these major health problems. Heart Failure Measures Complete discharge instructions must be provided. Left ventricular function assessment must be performed. An ACE inhibitor or ARB medication must be prescribed at discharge. Smoking cessation instruction counseling must be provided (UT Health, 2015). BHA 3002, Health Care Management 2 Acute Myocardial Infarction Measures UNIT x STUDY GUIDE Title Aspirin must be given at time of arrival. Aspirin must be prescribed at time of discharge. ACE inhibitor or ARB medication must be prescribed at discharge. Smoking cessation instruction counseling must be provided. Beta blockers must be given at time of arrival. Beta blockers must be prescribed at time of discharge. Thrombolysis (clot busters) must be given within 30 minutes of arrival. Percutaneous coronary artery intervention (cardiac catheterization with angioplasty) must be done within 90 minutes of arrival (UT Health, 2015). Pneumonia Measures Oxygenation assessment must be performed. Blood cultures must be performed within 24 hours of arrival. Blood cultures must be performed before the first dose of antibiotic is given in the hospital. Smoking cessation instruction counseling must be provided. Antibiotics must be started within six hours of arrival. An appropriate antibiotic must be selected for the patient. Influenza vaccination must be provided before discharge. Pneumococcal vaccination must be provided before discharge (UT Health, 2015). Surgical Care Improvement Antibiotics must be given within one hour prior to surgery. An appropriate antibiotic must be given. Appropriate surgical prep hair removal must be performed. Normothermia must be achieved for colon surgery patients. Glucose control must be achieved for cardiac patients. Venous thromboembolism prevention must be provided. Patients on beta blockers prior to admission must receive beta blockers in the hospital (UT Health, 2015). Conclusion The interesting thing about these measures is that none of them are particularly difficult to achieve, and most of them are not very expensive. However, our track record in making certain that these simple steps are taken for all patients has not been very good. There have been significant gaps and significant delays in treatment for many patients in U.S. hospitals. What all American hospitals are working toward today is a system of care in which every patient receives these fundamental diagnostics and therapeutics and has the best possible chance for survival and full recovery from these serious medical problems. Notes As you know, by the end of Unit VIII you will need to submit a Management action plan (MAP) for grading. The MAP does comprise a significant portion of your overall course grade and deserves considerable planning and effort on your part. During Unit II, you will need to select your management action plan topic. You will either present an actual management problem from your own organization for instructor approval (just a one paragraph summary), or you will choose your topic in the Unit II Project Topic assignment. BHA 3002, Health Care Management 3 References UNIT x STUDY GUIDE Title Cassiere, H. A. (1998). Severe pneumonia in the elderly: Risks, treatment, and preventions. Retrieved from http://www.medscape.com/viewarticle/722306_1 Centers for Disease Control and Prevention. (2015a). Heart disease. Retrieved from http://www.cdc.gov/heartdisease/facts.htm Centers for Disease Control and Prevention. (2015b). Venous thromboembolism (blood clots). Retrieved from http://www.cdc.gov/ncbddd/dvt/data.html UT Health. (2015). CMS core measures: Evidence-based performance measurement. Retrieved from http://uthealth.utoledo.edu/depts/quality/docs/CMS%20Core%20Measures-%20basic.pdf BHA 3002, Health Care Management 4