Healthcare

After looking at the Healthcare aspect of ACHE I find myself only having minimal
knowledge of the business aspect of the healthcare field. Looking at the sixteen objectives listed
under the Healthcare heading is a bit overwhelming. My competency has been more in the
hands-on aspect of healthcare versus the business aspect. Out of all of the objectives there are a
few that I have no knowledge of or do not feel I can provide an adequate amount of detail such
as latest trends and economics.
My strongest knowledge pertains to Nurse, Physician, and Allied Professionals scope of
practice; acronyms and terminology; patient perspective and community standards of care;
evidence based management practice. I have little knowledge of the interdependency, integration,
and competition among healthcare sectors as well as the interrelationships among access, quality,
cost, resources allocation, accountability, and community. At this point in my educational career I
am more a "jack of trades but master at none".
I would like to improve upon my working knowledge of the inner workings of the
business aspect of healthcare. I am able to work in the healthcare environment as a caregiver, but
a great caregiver knows the intimate details of how the "business" is ran in order to provide the
best quality of care for each patient.
Business and Management
I know some text book information about business. I can give you the strategic planning
principles and explain how they should work in the perfect world, but my limited experience
does not allow me to be able to know if it can be used in the real world. I do understand the basic
business contracts and some of the legal contracts as I have dealt with some of those in my
personal life. There are always loopholes for these contracts -- they are designed to protect.
When it comes to marketing I do not know anything other than what I like and what draws me
into a specific company. I am a visual person, for myself, I like marketing styles that allow me
to see what the target is and what I am getting myself into. So for marketing strategies that allow
for the imagination to be used are useless on myself. It is not that I do not have an imagination, I
have a very vivid one actually, it is that what I picture is not necessarily the market strategy the
company is advertising for. I have seen marketing analysis and have done very little marketing
research. Marketing analysis allow companies to see what is working to draw people in so they
may make improvements in their marketing styles. I have done some marketing research for an
organization I am part of. As an organization we help public safety personnel when they need
help. We raise money so they may pay their bills when some type of catastrophe touches their
lives. I research our marketing area and how to touch those lives that need us the most. As the
business administrator for this same organization I have also developed business plans,
implementation, and making assessments on how they are working for us and what changes need
to be made.
I have done some public affairs and community relations as that is the whole basis for our
organization. I am not the public affairs person. The founder is a phenomenal example of what a
public relations person should be like. He is loved by everyone he comes into contact with. He

likes working with people and is great at getting the donations needed to help those in need. We
have policies and procedures that need to be followed in order to help those that need it the most.
We know as an organization we cannot help everyone therefore we have a set of guidelines and
policies that allow us to help those that need us the most. As heartbreaking as it is to turn
someone away or only be able to help them minimally there is only so much we can do with the
resources that we have.
I feel more comfortable with the management side of our organization than I do with the
PR aspect. I love people and I want to help people but I am the type of person that is very
organized and can keep a team on track with my management skills. That is why the founder of
our organization and myself get along so well. He has many great ideas but he needs me to keep
them on track and focused. Implementation planning and contingency planning are important to
have in any company or organization. Operational plans are needed so the company/organization
know what they are doing. We would not be good at working on vehicles or teaching a class as
our organization helps provide needs to those that are not able to provide them at that moment.
Trying to do it all will destroy our organization instead of helping it; this is why there are
different companies for various reasons. Emergency contingency plans are needed for when
those types of cases come up. Every company or organization should have a backup plan.
Of all of the management knowledge for me to have my best qualities above all else so
far have been team building skills because I work great with people and I am organized. I can
work with any team, I work better when we are in-person face-to-face than online as I found out
last semester. I have the ability to pick out great qualities within each person on the team and
utilize those abilities to the best of our capability. I use my life experiences and my academic
experience to bring forth a great team. I have also been known to be able to bring out the best in
people even when others do not think there are the "best" in them. My ambition is contagious, or
at least it has been thus far in my experiences.
When I was younger I was taught great mediation skills. I have used them throughout my
life even in times that I did not know I was using them. This allows me to be a great negotiator
even in times where it may not seem to be the best of situations. Making lists has helped me
with negotiating, mediating, and also decision making. I try to write all the pros and cons of each
situation that I am faced with even if it is an emergent situation. This worked great for me when I
worked in the emergency room and this will continue to work great for me in the future. I
process information fairly quickly and have great intuition. Though these are great qualities
about myself I also know there are times when I need to sit back and review the tougher
decisions instead of making split-second choices every time. What helps me with this is my
option to never regret any choice I make in life. I choose to use them as learning experiences and
because of that choice I know it makes me a great leader.
Governance and Organizational Structure
I understand the governance theory of business. Each business needs to have a mission
and values. Mission statements is the core value of a business. It is the promise the business
gives to the public or to their clients. Values are set to establish the beliefs of the business. Each

business should have values that they will follow and hold themselves accountable.
Accountability is important in business--the business holds itself in high esteem. The mission
and values are the foundation of every business. Every business needs to have a board of
directors that employees must answer to. The board of directors keep the business on track and
running the way it should be. The governing board and management keep the other employees
on the task at hand. They insure the daily tasks are performed according to the standards set forth
by the board of directors. I know the general idea of each of the items listed above. My plan for
improvement is to experience what it is like to be in each of the positions listed above, even if it
is just through knowledge and not in the actual role.
Every healthcare business needs to have governance structure. This is also the foundation
in which the company is founded. These are the limitations or rules expected to be followed. The
bylaws are the statements in which the company plans to succeed. These can be changed or
added to, based on the companys growth and need at that particular time though it may not be
easy to change or extend the bylaws but it is not impossible. I do not know much more than that
about governance structure. The business aspect I have not experienced other than in the
classroom. I can give you the definitions but in the real world that is not going to get me very
far. I would improve by learning more hands-on than in the text book format; studying and being
guided through the structure in person. I learn better hands-on than by just reading about it.
Having worked in the medical field has given me great insight into the medical staff
structure and its relationship to governing body and facility operations. Each type of facility must
meet their own credentialing criteria but they must meet the same health standards across the
board. For example a nursing home will not have the same credentialing as a hospital. But both
must meet JCAHO standards in order to be a JCAHO certified. The medical staff structure is like
a pyramid of sorts with the board of directors on the top and the "hands-on people" on the bottom
(such as CNA's, MA's, RN's, etc.) Each section of the pyramid are imperative to keeping the
pyramid in the best shape. If at any point one of the levels were to be removed then the whole
structure would fall. The disciplinary process is different depending on the facility but each level
of the pyramid holds the next level accountable for their actions. Discipline is necessary to keep
the company running efficiently and effectively. To improve my lack of knowledge I can study
the credentialing process of the specific facility I will be working for. I will also need to
familiarize myself with the disciplinary policies of the same facility.
Healthcare is always changing -- meaning there are public policies, and legislative and
advocacy processes. Not everyone working in the healthcare field will participate in the legal and
government aspect of healthcare. Public policies are important to know because they affect
everyone not just those in the healthcare field such as ACA. It is important to know the latest
policies because information is powerful. The legislative and advocacy processes are done to
create a better healthcare. The government can make the healthcare system function more
efficiently or it can create more chaos as we have seen in the past with Medicare and ACA. Some
medical staff are used as experts to pass legislation. I can improve by learning more about public
policies and keeping up with legislation especially in my state.

Laws and Regulations

I am a little familiar with human resources laws and regulations. I know what the
minimum wage in the state of Michigan is, $8.50 per hour. By law you must pay an employee
minimum wage and no less. There are laws about providing employees breaks for certain hours,
if you work for 8 hours you must provide employees with a half hour break. FMLA is the Family
Medical Leave Act, this allows anyone to take 12 weeks of leave to have a baby, provide for an
immediate family member and still be able to come back to a job. However, the 12 weeks are
unpaid, therefore most employees try not to take all 12 weeks unless absolutely necessary. This
has helped family members, such as pregnant mothers, soon-to-be dads, leave their job without
the fear of losing it. FLSA establishes minimum wage, overtime pay, employment records, and
standards. This helps the employees feel protected from employers taking advantage of them.
Employees will get paid for the time they put into their work versus working them "to the bone"
for little wages. Workman's Compensation is the wage provided by the employer to the employee
during the time they are off due to an injury on the job. I am not as familiar with EEOC and
ERISA. I have not had the opportunity to study these as in-depth as some of the others. My plan
for improvement would be to study more human resource laws and regulations especially those
that I will need in the near future. If I understand them better then I can help those that may not
completely understand the help that is out there for them. The Human resource department is
there to protect the employer but also the employee. They play the mediator between the two.
Confidentiality laws and principles I am not as familiar with. I do know that every patient
must be kept confidential as well as their information, demographic and clinical. I know that if
confidentiality is not kept then the employee, and possibly, the employer may be prosecuted.
There are a few circumstances that allow the confidentiality to be broken, such as death of the
patient or when knowing something about one patient may endanger another patient. I do not
know specific laws so I do need to improve upon the actual laws. Confidentiality principles are
in everything we do in the medical field. I need to improve by keeping up-to-date with current
laws and principles.
I know very little about corporate compliance laws and regulations. I need to improve my
knowledge about physician contracts, antitrust, fraud and abuse. I am familiar with billing and
coding practices. I am aware that you can only bill a patient for services that are provided. Each
billing item has a medical code that is submitted to health insurances. Overall I do not know
much about this aspect.
Medicare sets the standards with which other insurance companies must follow. If
Medicare accepts a certain practice then more than likely other insurance companies will also
accept it. Medicaid follows the same guidelines the difference is Medicare is for those 65 and
older. Medicaid are for low-income families that cannot afford health insurance. Every
healthcare facility must meet certain criteria and regulations in order to renew their
accreditations. OSHA provides the regulations and standards for safety and health
administrations. OSHA keeps hospitals safe for all involved: patients, employees, employers, etc.
The FDA determines the regulations for food and drugs. They ensure that the healthcare facilities
are disposing of medications properly, administrating medications properly, and making sure all
food served are within proper holding limits. The CDC is the disease control center. This ensures

diseases are not spread from one person to the next and that proper precautions are used to
prevent illness and spreading of disease. I am not an expert on all of these regulations and laws
but I do know the basics especially those that deal with the patient.
Patients rights and laws are extremely important in the healthcare field. HIPPA insures
privacy acts are being enforced as well as all medical standards are being standardized among all
patients. Medical records are to have a copy of the HIPPA signed form stating the patient is
aware of their privacy acts. Patient records cannot be released without the patients consent. All
patients have the right to access of care that will stabilize the patient. It is within the hospitals
rights to release the patient after he or she is stabilized. Many healthcare facilities are trying to
provide their patients with a chance to provide advanced directives. It is important for patients to
deem someone in control of their decisions in case they are unresponsive or cannot make those
decisions for themselves. All patients should know their rights and the laws are always changing.
I need to improve myself by keeping up to date on the latest laws and patients rights so I may be
the best advocate for my patients.
Human Resources & Professionalism and Ethics
I have worked in a few different places that have varying performance management
systems. One business used the reward system, they would have incentive charts to get their
employees to work harder for the goal the company set forth. It created friendly competition to
see who could reach the goal first. The employees seemed to enjoy it and there was no animosity
amongst them. I have also worked in an environment where they used performance based
evaluation. Each employee receives an evaluation on their own performance; things they are
good at and ways they can improve. Many times I have found employees can take the
suggestions given to them but many do not like being criticized especially when they believe
they are doing a great job. Another complaint with performance evaluations is the person doing
the evaluations is not the same person that is working with the employees. It is someone behind
the lines and not on the actual floor. I believe this does not give a great evaluation review. Each
business should have disciplinary policies and procedures for when employees break the rules set
forth. This is essential for keeping employees honest and on track with how the company wants
to operate. I would like to improve by learning other performance management systems
especially those that have been known to work.
I have not had the pleasure of being on the inside of a company and going through their
recruitment techniques. However, I have been recruited by a few companies. The most recent
company went through a job website, found my resume and proceeded to contact me for
interviews. I have also been recruited through school job fairs, off-campus job fairs, etc. As the
person being recruited, I have had to sell my qualities to companies -- networking. The recruiter
would need to decide in those few moments if the person they are interviewing is going to be the
right person for their company. I would like to improve by knowing recruitment techniques used
by recruiters in determining who would be best for their company. To go hand in hand, I would
need to improve my knowledge of selection techniques. I know recruiters cannot pick the perfect
person every time but there must be ways in determining the best person most of the time.

Many companies are interested in employee satisfaction measurements and improvement

techniques in order to retain employees over the years. Human resources job is to acquire
employees and retain them. Companies can do this by using satisfaction questionnaires and tools.
They can analyze what keeps the employees in that company and what makes them want to leave
or consider leaving. I can improve by learning the satisfaction measurements and improvement
techniques of the companies that have high retention rates.
Compensation and benefits practices are very important to every employee and every
company. Employees cannot demand any compensation and benefit package regardless if they
deserve it or not. Companies must keep compensation and benefits down as low as possible in
order to not bankrupt themselves but they must still pay enough to retain great employees.
Compensation is determined based on skill, education, and/or a combination of both. Benefits are
based on what the company can afford to pay for each employee. Now days benefits are mostly
paid on the employees end; leaving companies with less overhead. I would like to improve my
knowledge on benefit packages that are beneficial to both the company and the employee.
Worker safety, job security, and employee health issues are all combined into one area of
knowledge. Companies must provide a safe work environment for every employee as a result
every employee is expected to follow safety guidelines and regulations. By having both factors
in place this allows for a safe environment. Employees also want to know they have job security.
Insuring job security allows employees to work harder and better for the company because they
feel safe and secure. Those two qualities are important in retaining employees. I can improve my
knowledge by understanding what makes employees feel secure and how companies view job
security and its relation to worker safety.
There are various ways of conflict resolution depending on the conflict at hand. Each
conflict resolution includes grievance procedures. If there are conflicts involving two co-workers
usually the manager handles the conflict. If there is a conflict between an employee and manager,
usually the managers boss is the mediator. Grievance procedures usually occur when one party
does not agree with the discipline decision against them. The grievance allows them to appeal the
company's decision without the fear of retaliation. I can improve by understanding varying
conflict resolutions and looking into grievance procedures.
Ethical behavior and ethics is very important to have in the healthcare profession. We
need to know patient rights and responsibilities. It is important to teach patients their own rights
and responsibilities. Ethics committees are set up to ensure patients rights are not violated. They
also ensure that those in care of the patients do not hurt or take advantage of patients. I would
improve by knowing exactly how ethics committees are set up, how they operate, and who is
involved in them as I do not know much about the actual process.
Many schools are teaching cultural and spiritual diversity for patients and staff. It is
important to keep the integrity of the patients as well as the staff. It helps bring an understanding
between the patients and those that have interaction with them. Understanding and appreciating
the cultural differences between all of us allow us to grow as a society. I can improve by
remembering cultural and spiritual differences in all of us is what makes us a great society. I
need to be aware of those around me at all times.

Every unethical action deserves a consequence to match the unethical behavior. There are
some professionals that are unethical or have unethical behaviors. Each company has their own
consequences to unethical behaviors. In some cases the professional can lose their license and
ability to work in the healthcare field. It could be their first and last mistake...choice. I need to
improve my knowledge of ethics in the healthcare field. I understand that the number one ethical
choice is to do no harm to patients. I cannot know every possible ethical issue out there but the
more I am aware of the more I can make better choices.
Finance
I know the basics in financial management and financial analysis principles. I have taken
a couple of accounting classes during my early higher education years. I can manage through
balance sheets, income and cash flow statements, and ratio analysis. For improvement I would
like to take a couple more accounting classes because it has been 16 years since I took an
accounting class. I understand everything has changed with all of the technological advances.
I do not have any experience with operating budget principles (fixed or flexible) or
capital budgeting principles. I was supposed to job shadow with a Director of Operations and she
was going to go over operating budgets and capital budgets. I will have that opportunity to go
over budgets with her after her maternity leave or with one of her co-workers. I look forward to
this major improvement and the ability to learn from a seasoned professional.
I know very little about reimbursement methodologies and ramifications. It will depend
on the facility and their principles of reimbursement methodologies. I plan on improving by
keeping an open-mind and learning from seasoned professionals. They can teach me a lot about
how to gain knowledge about reimbursements.
I have dabbled in fundamental productivity measures throughout my career. I have seen
spreadsheets that measure costs per day, units of service per man hours, and how a slight change
can affect or throw these spreadsheets off balance. I plan on improving by studying productivity
measures more even if that means taking more business classes to understand.
I do not know much about financial controls, capital funding sources, and auditing. I can
always learn more in the finance arena. I have studied math but I am aware that finances are
completely separate. I plan on improving by taking more business classes and reaching out to
those experts that know what they are doing.
I do know some about revenue generation. I can always learn more, but I am more
comfortable in this category than previous categories. I have learned some about asset
management through the tax office I used to work for. I would ask questions and learn more with
the process they go through. This may not be the exact same thing but may be similar in style.
Overall finance is my weakest point and I can always improve by expanding my
horizons. I can ask questions, study more, and take classes so finances make more sense. I am
aware finances is one of the most important aspects of business so it is important that I improve.

Healthcare Technology and Information Management

The first and most important thing I know about technology and information management
is there are trained IT professionals that know more about this topic than I do. The role and
function of information technology in operations is that in our day and age everything relies on
information technology. It plays a very important role in the daily operations of any healthcare
environment. The function is to link all of the other facilities within the hospital system so all
employees have access to each others patients. It is the virtual expressway of the healthcare
system. I can improve by learning about the information technology of the healthcare system I
will be employed at. I can work with the IT professionals to learn more about the system.
My knowledge about technology trends and clinical applications is even less than the
actual role of technology and information management. Clinical applications are the applications
used throughout the healthcare system that allows the various departments to communicate
within their specific department as well as the various departments so that they may help the
patients without leaving a paper trail. I would improve by learning the current technology trend
and the clinical applications used within the department I would be working.
Knowledge of technology security requirements are needed to maintain the anonymity of
the patients. HIPPA protects patients rights to be able to discuss any of their conditions or
ailments without the fear of prosecution from their employer and their family and friends. HIPPA
keeps employees from talking or spreading "rumors" about someone they may know or someone
their friends or family members may know. Organizational policies are in place to keep
healthcare workers and patients safe. It is easy in our society to send information out into the
World Wide Web -- leaving information at everyone's finger tips. Organizations are aware of this
and must create policies to keep patients safe. Essentially organizations keep employees in
check. Local governmental policies are in place to keep organizations in place. It is not just to set
more laws for companies to follow. There are checks and balances that need to be followed for
the protection of the patients, employees, and organizations. I can improve by learning local
government healthcare policies by knowing those that pertain to my job specifically. I can also
remember to keep HIPPA in the forefront of mind in order to protect patients.
Health information is obtained through various routes such as data equipment, decision
support, and interoperability standards. Each of these routes are used in specific cases to obtain
the information needed to keep the flow of personal information of patients running smoothly.
Data equipment could be anything from the EKG machines, radiology machines, to the
computers used to type information. All of these pieces of equipment work together to design
health information. Understanding the companys policies about health information and how it is
used to optimize patient care is the best way to improve my abilities.
Information systems continuity is one system I do understand. While working in the
emergency department we were the ones who trained other employees in emergency situations.
We knew how to plan for disasters, anticipating natural disasters, and knowing how to back up
our technological systems. We would practice "downed systems" and how to have backup
systems in place when some disaster does occur, whether it is natural or created. I can improve

by practicing the techniques I have been taught and teaching those techniques (as well as better
ones) to others.

Quality and Performance Improvement

I have seen benchmarking techniques used but I have never implemented them myself.
According to Dr. Jay FL Kay, benchmarking techniques are used to show the strengths and
weaknesses within a health care system. It could be strengths and weaknesses within the staff,
the supplies, book keeping, and processes. It also helps hospital staff to know how to satisfy
customer needs by knowing what appeals to their customers. A way I can improve in this process
is to experience it firsthand. I have seen some examples in the classroom setting but never
watched how it is actually implemented.
I have participated in medical staff reviews. The physician's office I worked at had peer
reviews and it included the physicians also. Each of us would provide information based on
performance on ourselves as well each person. We had to rate performance, cleanliness,
attendance, what we wanted to improve and what we performed well. We had to evaluate each
other on what we thought the others did well and one recommendation for improvement. It had
to be professional we could not attack a co-worker if we did not like them. The system worked
really well as we did it once a year because our staff was small it was not needed more than that.
We did not see who the comments belonged to as the office manager typed it up and handed
them out. I would improve my implementing this kind of constructive criticism in my future
endeavors. The system worked in a small setting I would need to make some changes to make it
work for a larger setting.
Risk management principles and programs is used to reduce the incidence of
organizational loss. This can be seen with insurance, education, and safety. Insurance loss could
be something like a patient contracting a hospital acquired illness that insurance companies will
not pay for. This is huge loss for a health care facility as all costs to get the patient healthy is now
being absorbed by the facility. Education is important in risk assessments because a staff that is
ill trained causes patient harm and those costs are absorbed back into the facility. Safety
measures are in place to keep the staff and patients safe. I have been through risk management
training in the facility I have worked at previously. I know that not all departments are required
to do this training but since we worked in the Emergency Department it was required of us. I can
improve my knowledge in the risk management by learning how to develop programs for risk
management.
Customer satisfaction principles and tools are important in the healthcare field because if
our customers are not satisfied they will choose a different healthcare system to use. Losing a
few customers does not seem like a big deal in the grand scheme of things, but word of mouth is
huge in customer service. One bad experience and the customer tells 30-40 people they know of
the terrible experience. When a customer has a great experience they tell an average of 10-15
people. It is important to keep customers happy as much as we possibly can. I have sixteen years
of customer service, I have learned over the years that no matter how hard a company tries they
cannot please everyone all the time. It is important to know that concept because when you try

too hard then it is just as much of a put off as the original offense. I can always improve in my
customer satisfaction skills but the one skill I am currently working on is the ability to anticipate
what the customer wants ahead of time. Being realistic I know this is not going to happen all the
time but knowing what makes people tick is important. Having compassion is huge in customer
satisfaction.
Quality and performance improvement is always being done in the health care field. Most
health care facilities look for improvements especially with evidence based practices. It allows
them to have the best research facilities and be able to be known for their customer service.
When the staff is trained to be the best and are willing to put their heart and soul into their work
because they believe in what they are doing, it makes all the difference to the customer.