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If you were asked to manage an occupational therapy delivery service, occupational therapy educational program, or a professional organization, would you consider yourself competent for the job(s)? Given the complexity of issues in today's marketplace for almost any health care entity, management is not an easy role to fill. This issue of Occupational Therapy in Health Care (OTHC)therefore, was planned to provide a practical guide for those people in our field who are struggling at being managers. Little did any of us think, as students, that we would soon occupy managerial jobs. Many occupational therapists must supervise others; staff and plan units; develop, market and evaluate programs; and teach not only their own personnel but also clinical students. We must also insure quality, accountability and coordination of services. Many occupational therapists today do these things without feeling knowledgeable about the whys and hows of management. This issue of OTHC, accordingly, has gathered a series of practical case srudies which illustrate situations not new to today's occupational therapy manager. Further, the case material in the papers follows a common format to facilitate study and use in either classroom groups, staff discussions or in workshops. These papers thus offer to those who seek to acquire managerial skills and knowledge a timely method for learning how to address some of the more com. . Q 1988 by The Haworth Press, Inc. All rights reserved.


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The Occrrprrrional &mpy Manager's Survival H a n d h k

mon tasks and problems today's manager faces. Many of them also include valuable resource materials as well. While there may be dangers in having most of this collection in the same form, the advantages for the teacher or learner outweigh the disadvantages. Further, given the diversity of topics that are being addressed it seemed prudent to ask writers to follow the format briefly described below. Each case will include:

1. Overview: This section provides a short summary of what the situation was, the focus of the case, when and where it took place and a brief glimpse at its character. 2. The Participants: Next, key figures are introduced and readers are given some of the history, skill, philosophy and motivation of these people. 3. The Organization:This section gives a concise overview of the organizational context in which the situation takes place (a department, division, unit, free-standing operation, etc.). 4. Chronology of Events: A list of the key events follows, in chronological order, leading up to the problem situation about which a decision needs to be made. 5.. Contex?: This section discusses the interrelated conditions in which the situation exists. It might include demographic, economic, regulatory and social trends as well as developments in the professional disciplines that were the determining factors in the situation. 6. Choices: Here are described the strategic choices facing the participants in the situation, alternatives considered and the particular causes of action selected. 7. Risks and Constraints: Next comes the descriptions of the professional, personal, organizational andlor financial risks facing the dedision make;. The regulatory, bureaucratic, political and other constraints that influenced the situation are also briefly discussed as they might apply. 8. Outcomes:This section tells briefly what ultimately happened. Some authors have added a "summary" section to close off their case(s). 9. Questions: Here authors have provided questions for reader/ student consideration that will assist them to focus on analysis

Frvm the Co-Ediror


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and judgement factors, either to reach decisions, critique choice(s) made by the case writer, andlor to show the reasoning for choice(s) made.' Obviously no one collection of cases can be totally comprehensive. Yet we feel this issue has indeed tapped some of the major problems/situations in which occupational therapy managers find themselves today. Burt and Rasmussen start us off with discussions of two key concerns: how to justify more therapist staff and then, how to evaluate their performance effectively. Since income is critical to any operation, Dennis and Ledet take a look at how one better collects and analyzes cost data to establish fees; Kolodner and Novey tell us ways to gather and use data of all kinds to make better decisions. Planning is the focus of two papers: Tovar considers how to make changes in existing programs for better quality; Harnish and Schmidt tackle an enormous planning job and share their results. Jaffe describes the consultant role, one which more and more therapists are called upon to undertake; Gilkeson and colleagues describe situations in which marketing proves itself as an important strategy in decision making. Gray and Welles, in two separate papers, address important operational elements which any manager must be prepared to handle, conflict among personnel and ethical and liability concerns. In the final paper in the theme section of the issue, Fazio helps all of us who try to teach students about their future responsibilities as managers by describing how one institution developed a course on personnel and resource management. Absolute answers? No. But certainly the issue will provide practical and useful material for any therapist who wishes to examine and strengthen her role as a manager, regardless of level. We the editors hope you will enjoy the ideas presented. And as editors we certainly thank the authors for their willingness to share their experiences with us, since each writer was asked to recount situations 'Note: The editors wish to acknowledge the source from which the above format has been developed: Young, Dennis R, Casebook for Management for N o n - h f u Organizations: Enrrepreneurship and Orgnnizntionul Change in the Human Services. ( A monograph supplement to Administration in Social Work). New York: The Hawonh Press, Inc., 1984.


The Occupatwnal Therapy Manager's Survival Handbook

which actually had happened, sometime, somewhere. Identities are changed in some papers to protect participants.

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Chestina Brollier, PhD, OTR, FAOTA

From the co-editor.

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