The Culture of Healthcare SettingsThe Places Where Care

The Culture of Healthcare Settings–The Places Where Care is Delivered Lecture b This material (Comp 2_unit 3 b) was developed by Oregon Health and Science University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU 24 OC 000015.

Unit Title Learning Objectives 1. Differentiate the range of care delivery organizations, including primary care, specialty care, tertiary care, inpatient and outpatient facilities, long-term care hospitals, and long-term care facilities (Lecture a) 2. Analyze the organization of healthcare delivery from the perspective of a “continuum of care”, such as ambulatory services, in-patient care, long-term care, and end-of-life care (Lecture a) 3. Evaluate the similarities and differences of community hospitals, teaching hospitals, and community health clinics (Lecture a) Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 2

Unit Title Learning Objectives (continued) 4. Describe the various departments and services offered by an outpatient clinic, community hospital, academic medical center, and long-term care facility (Lecture b) 5. Explain the ways in which these departments interact and the services relate (Lecture b) 6. Speculate on the data and information that are created and used by people in these departments (Lecture b) 7. Describe ways in which medical and/or information technology has improved interdepartmental communication and how that has improved the patient experience (Lecture b) Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 3

The Structure and Function of Health Care Organizations • Departments and functions of health care organizations • How these organizations interact • Types and use of data by the departments • Technology’s impact on interdepartmental communication and patient experiences Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 4

Healthcare Organization: Organization Chart 3. 2 Chart: Example of a healthcare organizational structure (Hickman 2012, CC BY-NC-SA 3. 0). Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 5

Management (Longecker et, 2007) • • • Chief Executive Officer Chief Operating Officer Chief Financial Officer Chief Medical Officer Chief Information Officer Chief Medical Information Officer Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 6

Medical Staff • Usually has an elected Chief of Staff • Manages – Physician privileges – Medical polices – Governance of medical staff – Continuing medical education Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 7

Nursing (University of Rochester Medical Center, 2011) • Chief Nursing Officer • Nursing Units • • Ambulatory Inpatient Critical Care Other – Education and Professional Development – Research Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 8

Clinical Support Services • Management Varies • Diagnostic – Radiology – Cardiology • Therapeutic – Physical Therapy – Pharmacy • Social Service Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 9

Ancillary Services • Management varies • Examples – Laboratory – Transportation – Food Services Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 10

Information (United Hospital Fund, 2008; Medicare Payment Advisory Committee, 2004) • Management varies • Examples – Admitting – Medical records – Information technology Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 11

Facilities Management • Senior Manager • Examples – Housekeeping – Maintenance – Security Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 12

Organizational Structure by Institution • Core functions • Size • Type Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 13

Data Types (Shortliffe EH, Barnett GO, 2006) • • • Narrative, textual Numerical measurements Recorded signals Drawings Photographs and images Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 14

Communication • • Verbal Paper Film/Analog Digital Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 15

Patient Experience • History • Testing • Information access Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 16

Healthcare Settings—The Places Where Care is Delivered Summary – Lecture b • Range and “Continuum of Care” • Unique types of health care organizations and relationships between organization • Organizational structure and function • Relationship and communication between departments • Effect of technology on the patient experience Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 17

Healthcare Settings—The Places Where Care is Delivered―Summary 1. Differentiate range of care delivery organizations 2. Analyze the organization of healthcare delivery from the perspective of a “continuum of care” 4. Evaluate similarities and differences of community hospitals, teaching hospitals, community health clinics 5. Describe departments and services offered 6. Explain how departments and services interact 7. Discuss data and information 8. Describe impact of medical and/or information technology Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 18

Healthcare Settings—The Places Where Healthcare is Delivered References – Lecture b References • Longnecker DE, Patton M, Dickler RM. (2007). Roles and responsibilities of Chief Medical Officers in member organizations of the Association of the American Medical Colleges. Academic Medicine, 82(3), 258 -263. Retrieved Jan 2012 from http: //journals. lww. com/academicmedicine/Fulltext/2007/03000/Roles_and_Responsibilities_of_Chief_Medical. 9. as px. • Medicare Payment Advisory Committee. (2004). Chapter 7: Information technology in health care. In Report to the Congress: new approaches in Medicare. Retrieved Jan 2012 from: http: //www. medpac. gov/publications%5 Ccongressional_reports%5 CJune 04_ch 7. pdf. • Scribd. (2011). Organizational structure of a hospital. Retrieved Jan 2012 from http: //www. scribd. com/doc/20884108/Organizational-Structure-of-a-Hospital. • Shortliffe EH, Barnett GO. (2006) Biomedical data: their acquisition and use In: Shortliffe EH, Cimino JJ, eds. Biomedical Computer Applications in Health Care and Biomedicine. 3 rd ed. New York, NY: Springer; 2006: p 403443. • United Hospital Fund. (2008). Family care giver guide. Hospital admission: how to plan and what to expect during the stay. Retrieved Jan 2012 from http: //www. nextstepincare. org/uploads/File/Hospital_Admissions. pdf. • University of Rochester Medical Center. (2011). Strong Memorial Hospital organizational chart. Retrieved Jan 2012 from http: //www. urmc. rochester. edu/strong-nursing/about/documents/Nursing. Org. Chart. pdf. Images • 3. 2 Chart: Example of a healthcare organizational structure (Hickman 2012, CC BY-NC-SA 3. 0). Health IT Workforce Curriculum Version 3. 0/Spring 2012 The Culture of Healthcare Settings—The Places Where Care is Delivered Lecture b 19