Question

Based on the Case below, Write a brief explanation that explains why the case represents its particular ACHE competency domain. (Be sure that the explanation justifies the assigned competency domain based upon the facts and circumstances of the case.)

Case:

Case 4: Knowledge of the Healthcare Environment

A new administrator in a large suburban healthcare system was hired to work in the corporate offices as a patient service coordinator for the five hospitals, one rehabilitation hospital and one skilled nursing facility for the system. Her major role and responsibilities included the overall coordination of patient services for these facilities so that each organization was offering similar services and doing so with similar levels of quality and effectiveness.

The initial charge for this person was to inventory current patient service practices throughout the system and determine what was the existing baseline for such services that would provide a platform for future development and change. For the first two months on the job, the systems coordinator visited facilities, talked to key people in these organizations and tried to determine what precisely was being done for patient services and what the level of quality and effectiveness this work was. Things appeared to be going well for several weeks. The information seemed fairly straight forward despite the fact that it was obvious there were major differences in what each of these organizations was doing in the name of patient care coordination. By week 6, the systems coordinator was ready to visit the long term care nursing facility and the acute care rehabilitation hospital. The appropriate meetings with key folks in these organizations were scheduled and the site visits began. But it quickly became clear from her perspective that what these two organizations were offering as patient care coordination services were significantly different and not at all what she expected they should be in comparison with what was being done at the five acute care hospitals in the system.

Her vice president of systems operations for the healthcare system expected her report on baseline services within four weeks and the fact that she was experiencing such discrepancies in these service agendas was disturbing. But her data collection through interviews, meetings, and related sources had been completed and there was no other options but to report on what she had found. Over the next two weeks she compiled her report on system-wide patient care service coordination. In brief, it suggested that all five acute care hospitals were relatively similar in their activities related to such services. There were noticeable differences in the overall quality of services among the five institutions and that range of performance was a concern but at least, all five places were on the same page. But her interpretation of what was happening in the skilled nursing facilities and in the acute care rehabilitation facility was far different. For both of these organizations, she reported missing services or services that hardly reflected what was so obvious with the acute care hospitals. By the time the report was completed and ready for submission to the vice president, the systems coordinator was sure that the situation she was reporting represented job security for several years into the future.

She submitted the report and was told that the VP would set up a meeting to discuss it in the next several days. On Thursday after submitting the report, she and the vice president met. What she anticipated would be a positive reaction from the VP and an indication that she was doing a good job as a new member of the administrative team turned out to be an embracing response suggesting that she had seriously misinterpreted the information collected from the nursing and rehabilitation facilities. The VP asked how she could have so badly gaged this material and misjudged what was happening in terms of patient care services. The meeting was a major blow to her and she was asked to revisit the patient care services for these two facilities and resubmit her report in three weeks.

Despite feelings of complete failure, she quickly started reassessing what she had learned from the nursing facility and from the rehab hospital. It’s hard to know exactly why she began to understand her errors in judgment, but she came to realize that the fundamental issue was in how she misunderstood the mission, role, and work of these two organizations. She had applied the same criteria for patient care coordination services to these two places that she had done for the five acute care hospitals. It was true there was some overlap, but in many ways the work of the skilled nursing facility and that of the rehabilitation hospital were quite different from that of the acute care hospitals. The patient and family member expectations were different. How patient care coordination of services was assessed was also much different, and how those performing this work assigned their measures of quality was significantly different. Overall, she had severely misunderstood what it meant to offer patient care coordination across a healthcare system with the diversity of organizations it represented.

Her revised report was submitted by the three week deadline and she had a follow-up meeting with the VP. But this error in judgment so early on in her career with this healthcare system proved to be a difficult issue to overcome. Within two years, she decided to seek employment with another healthcare company since her chances for upward advancement with the current health system appeared to be slim.

Answer 1

Let me explain the meaning of knowledge of the healthcare environment competency domain it is the understanding of the healthcare system and the environment in which healthcare managers and providers function it includes healthcare systems and organizations, healthcare personnel, the patients perspective, the community and the environment. According to this case the new administrators main role is to assess the overall coordination of patient services and assure that the organization offers similar level of quality and effectiveness. The coordinator gather the data needed by visiting the facilities, interviewed the patient and the medical staff to learn what kind of healthcare environment the medical facilities are having. Her mistake was not realizing that each medical facilities have different mission, role and work. So it is really important to know first the criteria needed before you can properly assess the standard of care the facility is giving. Each medical personnel should have a proper knowledge of the healthcare environment they are working in to be able to provide a good quality care to the patients.