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Nowadays, the importance of a health care manager in achieving effective and efficient service is constantly growing. This person plays one of the central roles in the organizations providing health care service. This essay will provide thorough explanations of the health care manager`s role and the factors which can affect his/her high quality performance. Additional attention will be paid to the discussion of stakeholders’ perspectives in the high quality rendering of care services. The final part of this essay will present the report concerning the current issue and the potential directions of its improvement in the ‘Seven Kings.’ The analysis of the role of the health care management and the inherent factors of high quality performance will be used for the presentation of the relevant and reliable discussions of the problems in the chosen organization.
The primary aim of the health care manager is providing leadership, supervision, and coordination of employees for enabling the institution to achieve its goals and provide the high quality services (Graham, McCann & Allen 2013). Additional attention should be paid to the fact that the role of managers in health care institutions is extremely important due to the distinct character of the work of these institutions. The care givers have numerous tasks and the enormous responsibility for the health and life of their patients. At the same time, their work requires “coordination of many highly specialized disciplines that must work together seamlessly” (Thompson, Buchbinder & Shanks 2016, p.2). Managers in these institutions help to guarantee that the organizational tasks are performed in the best possible way for achieving the goals in the most effective manner. Besides, they assure that both human and financial resources are adequate and used in the appropriate manner for the supporting of the company.
Shaping the employees’ actions, their behavior, and the overall organizational performance is made by taking special managerial decisions from the position of the authority (Slipicevic & Masic 2012). Such decisions usually have several directions; those are the assurance the patients obtain appropriate, effective and timely treatment, and achieving the performance targets desired by the managers and the company. Hence, such decisions have the considerable effect on the overall performance of the company.
It is notable that the work of the managers is closely connected with both external and internal domains (Thompson, Buchbinder & Shanks 2016). The external domain is represented by the resources, influence, and activities which lie outside the institution’s boundary yet have the considerable effect on it. This domain is driven by needs of the community, government plans, etc. The internal domain refers to the aspects which lie inside the institutional boundary and should be addressed every day. It is represented by the assurance that the institution has the appropriate amount of employees of certain qualification, the highest possible level of the quality care and necessary resources. The effective and efficient performance of the institution is impossible without dealing with both of these domains as all of them influence on its work. Consequently, the managers are required to keep the dual perspective.
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The effective performance of managerial functions is closely connected with the ability to set a direction to the further institutional development and determine the needs that should be accomplished (Al- Abri 2007). Such planning actions will help to set priorities and determine the performance targets enabling to create the understanding of the services and operations which the manager is responsible of. Additional attention should be paid to the designation of the reporting relationships and patterns of interaction for the elimination of any issues in sharing of the information among the employees. Successful organizing is based on the clear “determining positions, teamwork assignments, and distribution of authority and responsibility” (Thompson, Buchbinder & Shanks 2016, p.5). Managers should also pay attention to the acquisition and retaining of human resources which have the sufficient level of experience and professionalism for the providing of high quality services. The work of the employees should be thoroughly monitored for the prevention and identification of any issues and their timely rectification. The managers should act as leaders and motivators who both control the work of the staff and inspire the employees to improve their professionalism and put more effort on reaching organizational goals (Al-Sawi 2013). The final activity that forms the foundation of the successful management is reflected in the ability to make “effective decisions based on consideration of the benefits and the drawbacks of alternatives” (Thompson, Buchbinder & Shanks 2016, p.5).
Health care managers can also perform some specific functions which are directly and indirectly connected with the quality of the work of health care providing organizations. The example of such functions is the financial management of the resources. It enables reasonable distribution of resources directed on the coverage of the most important needs of the patients.
Besides, health care managers can be obliged to take part in the involvement of finance directors, chief executives and board members into the discussion and realization of the patient safety programs (Al- Abri 2007). It is necessary for the promotion of further improvement of the quality of health care provided by the institution.
This short explanation of the work of a healthcare manager provides the understanding that this person should be directed to the effective and efficient service delivery for the assurance of the high quality treatment of patients and reaching the institutional targets.
The stakeholders of the health care providing institutions are individuals and institutions which have vested interests in the performance of these institutions. Those are the patients and patient advocacy organizations, caregivers, clinicians, and their professional associations, health care providing institutions, public and private insurers, manufacturers, health care policymakers on the federal, state and local levels, and health care researchers (Pierre, Liegh & McGinnism 2010). It is notable that they have both unique and shared perspectives regarding the quality of the work of the institutions.
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Patients are highly affected regarding the quality of the obtained services since these activities have influence on their treatment, health, and life. The interrelation of the work of health care providers and the quality of the provided services is based on the unrelenting competition in this sector and the “imperative of competitive labor costs” (Pierre, Liegh & McGinnism 2010, p. 34). Currently, they are demanded to be accountable for the value of health care expenditures due to the high impact of employer innovations and existing limits to employee cost shifting (“for example, pay-for-performance and total health management to address chronic conditions such as diabetes and the exploding epidemic of obesity”) (Pierre, Liegh & McGinnism 2010, p.34). Hence, rendering the high quality work increases the value of labor in some particular healthcare providing institution and makes this institution (and its employees) more competitive on the market, reduce health care spending and avoid unemployment.
Both patients and caregivers are interested in the determination of concerns of illnesses for the development of the effective treatment procedures. They also pay attention to the distinct features of various treatment procedures for the determination of the most effective one.
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Clinicians are considered to form the separate stakeholders group because they take an active part in the medical decision making processes. Consequently, these individuals are highly interested in the obtaining of the relevant data concerning the diagnostics and treatment of patients (both successful and unsuccessful). They also need the reliable and evidence-based information for providing recommendations to patients and caregivers (Stefi, 2008).
Health care institutions are also highly interested in the receiving of the reliable information concerning the diagnostics and treatments of patients for making effective decisions on the institutional level in order to improve health outcomes. Moreover, they pay much attention to the supporting of the positive image of the institution by the successful passing of surveys and elimination of any issues in the operational performance.
Public and private insurers and purchasers play the considerable role in the shaping of the personal decisions concerning the diagnostic and treatment choices of patients. Hence, they need clear and definite evidences related to the quality of the provided services for making decisions to pay for these activities. These individuals and organizations pay the additional attention to the availability of new equipment and technologies which can raise the standards of provided health care. Moreover, the clear identification of the causations and consequences of success and failure of any interventions can help this group of stakeholders to make grounded decision related to the further funding of researchers. Hence, they are interested in the high quality documentation and analyses of all interventions. This information is also very useful for the manufacturers of medication and equipment for the improvement of their commodities and for researchers for the increasing the quality and the variety of treatment options.
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The perspectives of policymakers are reflected in the necessity to gather the best available evidence about the effectiveness of researchers and patient-centered outcomes and to make the analysis of this information. The quality of treatment, collecting of the information, analyzing it, and presenting in the appropriate manner is rather important for this group of stakeholders; this information would be used as the background for the planning of public health and advocacy programs, and for the establishment of the insurance coverage.
The quality of delivered care is influenced by the great variety of factors such as skills, attitudes, knowledge and behavior of health care providers, the structure of the health care system, number and the professionalism of the personnel, deployment, and distribution of employees, “the pace at which change is occurring, the availability of technology needed to deliver quality care, and the expertise and style of health care resource management” (Woodward 2000, p. 14). Generally, these factors may be divided into three categories which are patient, provider and environment related (Mosadeghard 2014).
The first category is closely connected with the patient`s behavior; it contains patient socio-demographic variables, patient cooperation and types of illnesses. The variables and distinct characteristics of the patients have the considerable effect on the interaction between the patient and healthcare provider and, consequently, on the quality of rendered services. Hence, the employees should clearly understand this distinction and know how to deal with it. The quality of treatment can be lowered due to the patient’s financial status and inability to afford it, and the irresponsibility towards the fulfillment of the prescriptions. Patients should be involved into their designation and treatment, cooperate with care givers and provide the information concerning their status on time. The absence of the cooperation and trust between patients and doctors can not only lower the quality of the treatment but also endanger the patient’s life, if the person would not provide some extremely relevant information. The additional attention should be paid to the fact that the types of patient illness can also affect the effectiveness of treatment since it “influences personnel job stress” (Mosadeghard 2014, p. 81).
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The provider related factors include provider socio-demographic variables, their competency, motivation, and satisfaction. The quality of health care services can be affected by the personality of employees and their ability to develop good rapport with patients by using such characteristics as helpfulness, intelligence, reliability, respect, and confidence. However, these types of behavior can be negatively influenced by the private problems of the health care providers and the lack of motivation due to the low salary, discrepancy between their efforts, and the obtained income. Among other factors which may lower the motivation are working environment (support and quietness), organizational policies, leadership behavior of managers, recognition, relationships with co-workers, job identity and security, and opportunity for further promotion (Mosadeghard 2014). The absence of these factors can lower the employees’ desire to reflect due diligence and perform their responsibilities in appropriate manner. This can lead to the employee turnover and cause insufficient professionalism and skillfulness of the new personnel. At the same time, low motivaton and dissatisfaction can lower the personal desire to improve its knowledge and technical skills despite the availability of developmental opportunities and educational facilities.
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It is notable that the healthcare providing and competency of workers are closely connected with the system of obtaining education of employees, since it forms the basic knowledge, skills and understandings of workers (Woodward 2000). It facilitates permanent improvement of the workers’ skills, for example, through distance courses, and knowledge, and forms the background for the models of multi-disciplinary cooperation.
Among environmental factors which may have an influence on the quality of healthcare providing is the existing system of healthcare, its availability, cost, insurance, etc. The excessive demand on the health care providing that cannot be covered by the current resources of health care providing institutions, or staff shortages directed on the lowering of institution’s expenses can lead to the overworking of the staff, weariness, lowering of attention to the needs of customers, and providing services of poorer quality (Mosadeghard 2014). In such conditions, physicians may be forced to transfer patients to paramedical departments without proper examination and accurate diagnosis. In consequence, such treatment can be ineffective or even dangerous. Moreover, the productivity of employees depends greatly from the availability of new equipment and resources. They enable to provide better services and to eliminate staff’s stresses caused by its shortages.
This report will provide the analysis and discussion of the issue of one of the healthcare providing institutions called the Seven Kings. Only the issue that is supported by the reliable evidence in the form of the report of the Care Quality Commission, also known as CQC, will be assessed in this work. This institution performs the recognized checking of the quality systems, procedures and policies of various health care providing institutions. The employees of this commission also develop grounded reports which can help to understand the existing challenges and determine the actions which should be taken for their rectification.
The safety of the provided services requires improvement. This statement is based on the outcomes of the inspections of the CDC held on 15 May 2014 (Care Quality Commission 2014). The registered managers of the Commission found out that the management of medication was at inappropriate level. In 2014, there were instances that the prescribed medication “has been administered but not assigned for” (Care Quality Commission 2014, p. 9). There were some missing signatures on personal Medication Administration Record chart (MAR chart) used for the identification of the patients who obtained medication. This founding formed the assumption that the “procedure on administration of medication were not being followed” (Care Quality Commission 2014, p. 9).
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The environmental analysis of this issue is based on the model presented in the work Strategic Planning in Healthcare Organizations (2012). This model was chosen, because it provided the information concerning the relevant events in health organizations and enabled to assess the organizational performance form different aspects, such as resources, the legal situation, power groups within the institution, and clinical care analysis. The above mentioned issue is closely connected with the work of the staff that is responsible for keeping the medication administration records. These employees did not perform their work with due diligence and this caused the above described situation. This can be connected with the insufficient skillfulness, knowledge, and motivation. It is notable that no any additional training concerning the work with MAR charts were performed in the institution before. At the same time, no any regulations or the interference of the power groups, which may cause the above mentioned problem, was found during the inspection. Hence, this analysis forms the understanding that the stated issue was purely internal because it had characteristics peculiar to this environment, like resource management (performance of additional trainings and proper motivation) and employee capability (Noh and Kwon 2011). This understanding is rather useful for the consideration of the potential development of the service as it shows that strategies directed on the rectification of the determined issue should address the internal environment, especially management of employees and their skills. This statement is also supported by the prescriptions of the Commission to hospital to perform the additional training of the staff (Care Quality Commission 2014). This prescription to the healthcare providing institution aligns to the theory of respondent superior, under which “a hospital can be held vicariously liable for the actions of its employees” (Carroll 2009, p.135). Hence, the administration of the hospital is responsible for taking the relevant actions for the rectification of the determined issue. This can be made after the understanding of the reasons of poor performance. According to the counseling theory, the actions of the employees are determined by their behavior (Mayberry 2007). Thus, health care managers should develop and realize various strategies for the modeling and improvement of the employees’ behavior, for example, by establishing the special trainings or increasing the control or motivation of workers.
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This paper demonstrates that health care managers play a crucial role in the achieving effective and efficient service delivery as they perform leadership, supervision and coordination of the staff and forcing the development and realization of strategies directed on the improvement of the work of hospitals. It is notable that all the stakeholders of these institutions are highly interested in the effective performance. These stakeholders are represented by patients, care givers, public and private insurers, manufacturers, researchers, and policymakers. However, the effective work of these institutions depends greatly not only on the will, the actions of stakeholders and the healthcare managers but also on the external and internal environment. This is shown on the example of the Seven Kings. This health care providing institution currently is obliged to deal with the issue of the inappropriate management of medication.
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