POLICY AND PROCEDURE

• Policy – a simple clear statement of what you should do (what)

• Procedure – a simple clear statement of who should do what (when, where and how)

AUTHORITY

• This policy is promulgated under the authority of the COO and the Director of Infection Control. The Director of Infection Control is responsible for administering the policy.

POLICY

• All medical, nursing and laboratory personnel who identify or suspect a case of a reportable disease will report such case promptly to the Louisiana Department of Health in accordance with the Sanitary Code of the State of Louisiana.

LAW IS NOT POLICY

• There is a term for disobeying the law as a matter of policy.

• Who are the two most famous proponents of this policy?

VIOLATION OF POLICY

• As with all formal policies of this hospital, violation of this policy is grounds for progressive discipline.

MALAPROPISM

• Mrs Malaprop in The Rivals by Sheridan written in 1775

• infectious control nurse (infection)

• assess concerns (address)

• hold this nation hostile (hostage)

NONSENSE

• due to the feasibility of the department

• in the prevention of unlawful duty of care continues to exist for individuals

• attend to our community in the utmost fashion

TAKE A STAND

• You should think about considering whether you perhaps should look into being in the class room near or at the approximate time that the professor or other instructor may or may not present some information that could possibly be of use to some or all of you now or in certain circumstances in the future. – COME TO CLASS!

MODIFIERS

• Sentences require a noun and a verb.

• Think carefully before adding an adjective or an adverb.

• Do not modify an absolute. I am unique, not more unique.

• Do not split infinitives.

PRONOUNS

• He and I want the books.

• Give the books to him and me.

• To whom did you give the books? To him?

PROBLEM SOLVING

STRATEGIC MANAGEMENT IN HEALTHCARE

3 March 2008

GOALS AND OBJECTIVES

• GOALS – ENDS - OUTCOMES– VALUABLE IN THEMSELVES

• OBJECTIVES– INTERMEDIATE STEPS - MEANS– VALUABLE MEASURE OF PROGRESS

REASONING

• INDUCTIVE: REASONING FROM PARTICULAR FACTS OR CASES TO A GENERAL CONCLUSION

• DEDUCTIVE: REASONING FROM THE GENERAL TO THE SPECIFIC

CONTINUOUS QUALITY IMPROVEMENT

• PROACTIVE APPROACH THAT ASSUMES ALL PROCESSES CAN BE IMPROVED

• ASSUMES A REASONABLE LEVEL OF QUALITY TO BEGIN WITH

• ASSUMES YOU ARE DOING THE RIGHT THINGS ALREADY

PROBLEM SOLVING

• IDENTIFY THE PROBLEM

• ANALYZE THE SITUATION

• DEVELOP ALTERNATIVES

• CHOOSE A SOLUTION

• IMPLEMENT THE SOLUTION

• EVALUATE THE RESULTS

PROBLEM RECOGNITION

• IT IS EASY TO BECOME SO FOCUSED ON THIS THAT IT BECOMES THE PROBLEM

• LEAD, FOLLOW OR GET OUT OF THE WAY

PROBLEM STATEMENT

• STEM - OWNER - ACTION - GOAL

• “A QUESTION WELL PUT IS HALF ANSWERED” - DO YOU AGREE?

OWNERSHIP/LEADERSHIP

ACTION ORIENTATION

• “ THE PSYCHOLOGICAL STIMULUS PROVIDED BY AN ACTION ORIENTATION SHOULD NOT BE UNDERESTIMATED”

• THE VALUE OF A “HOLD” BOX SHOULD NOT BE UNDERESTIMATED EITHER

MILITARY MANAGEMENT

• STRATEGY: PLANNING AND DIRECTING LARGE-SCALE OPERATIONS

• TACTICS: MANEUVERING FORCES, METHODS USED TO GAIN AN END

• LOGISTICS: PROCURING, MAINTAINING, & TRANSPORTING MATERIAL AND PERSONNEL; MANAGING THE DETAILS

DECISION CRITERIA

• EFFECTIVENESS

• FEASIBILITY

• LEGALITY/ETHICS

• ACCEPTABILITY

• COSTS

• SECONDARY GAINS

• UNINTENDED CONSEQUENCES

INFLUENCING FACTORS

• SITUATION

• ENVIRONMENT

• PROBLEM SOLVERS

SITUATION

• URGENCY

• MAGNITUDE/IMPORTANCE

• RISK/UNCERTAINTY

• COST/BENEFIT

ENVIRONMENT

• EXTERNAL

• INTERNAL

PROBLEM-SOLVERS

• EXPERIENCE, KNOWLEDGE, JUDGEMENT

• PERSPECTIVE, PERSONALITY, BIASES

• VALUES, PHILOSOPHY

GROUP PROBLEM SOLVING

• GROUP PROBLEM SOLVING PRODUCES BETTER QUALITY DECISIONS

• GROUPTHINK IS A PRIMARY CAUSE OF POLICY DEBACLES

• CONFLICT IS IMPORTANT TO REACHING A GOOD DECISION

• NONE OF US IS AS STUPID AS ALL OF US

EMPLOYEE PARTICIPATION

• QUALITY CIRCLES FAILED - PARALLEL AND IRRELEVANT

• HEARINGS DO NOT EQUAL PARTICIPATION - PATRONIZING

• SUGGESTION BOX - IMPERSONAL AND GENERALLY IGNORED

CASE STUDY 4

• VOLUNTEER COORDINATOR IS WORKING ONLY 6 HOURS A DAY

• FILLS OUT TIME CARD FOR 8 HOURS

• DOING A GOOD JOB

• GOES HOME WHEN HER WORK IS DONE

• WHAT IS THE PROBLEM?

CASE STUDY 1

• WORK LOAD IN A NURSING UNIT IS VERY HEAVY THIS MONTH

• FAMILY MEMBERS DOING PATIENT CARE AT SUGGESTION OF MS JOHNSON

• YOU HAVE SEEN JOHNSON SITTING IN THE UTILITY ROOM FOR LONG PERIODS OF TIME