From the Editor THE VISIBLE MANAGER
activities, some vital aspects of the management task are likely to go unaddressed. Visibility and availability will forever reIn a small hospital, an employee opinion main among the important elements of a mansurvey was conducted at the same time the ager’s job, most especially for those first-line employees were experiencing a flurry of changes managers who supervise the people doing the related to the hospital’s merger with another hands-on work. Despite the ever-changing eminstitution. In the written responses accompaphasis on the mix of tasks that should comnying the checked-off levels of opinion, 1 emmand management’s attention, the fact remains ployee commented on a department’s shared that certain aspects of a department’s functionmanagement as follows: ‘‘We now have a sining are better served by the manager’s presence gle manager over the departments in 2 places. than by the manager’s absence. Some may beHe comes here, he goes there, and half the time lieve that appropriately empowered employees he’s at some place called the system. Even need not have the manager close at hand at all when he’s here he’s always meeting with the times. True, but empowerment goes only so higher-ups, so we hardly ever get to see him. far. There are decisions to be made that are the How are we supposed to get an answer from province of the manager only. Also, the manthe boss when we really need one?’’ ager’s all-important coaching, counseling, and Few if any readers of this journal are uninstructing functions are not served in the aware of the sweeping changes that continue manager’s absence. to plague health care. Most working managers The manager who may now be spread thinhave probably been exposed to some aspect of ner than before, who may actually oversee mul‘‘merger mania,’’ have gone through ‘‘reengitiple groups in multiple locations, will have to neering’’ or an undisguised reduction in force, make a conscious effort to remain equally visior have seen their organizations’ structures ble and available in all necessary places. There ‘‘flattened’’ such that layers of management will always be demands that necessitate being and some specific management positions have here or there or elsewhere at any given time. It been eliminated, leaving the survivors with may be wise, therefore, to consider simple vismore than ever to manage. ibility and availability as demands in themThe changes in some managers’ roles have selves; sometimes you may have no specific had the effect of reducing their day-today presreason for being present in the work group ence in the work group. The pressures to face except for your presence itself. That is more toward higher management, to spend more than enough real reason for being there. time on organizational issues, on strategic planThis issue of The Health Care Manager ning and such, are undeniable. Some managers (34:2, April-June 2015) offers the following readily give way to these pressures, perhaps articles for the reader’s consideration. believing that these higher-level involvements ‘‘Using a Facilitation Model to Achieve should take precedence in this era of rapid change. However, while the manager is particPatient-Centered Medical Home Recognition’’ ipating in what are perceived to be high-level describes how a facilitation model that included a partnership between a Community Care of North Carolina network and undergraduates at a regional univerThe author has no conflict of interest. sity supported rural primary care practices in transforming their practices to become DOI: 10.1097/HCM.0000000000000050 91 Copyright # 2015 Wolters Kluwer Health, Inc. All rights reserved.
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
THE HEALTH CARE MANAGER/APRIL–JUNE 2015
92
National Committee for Quality Assurance– recognized patient-centered medical homes. ‘‘Has Competition Increased Hospital Technical Efficiency?’’ demonstrates how use of the hospital efficiency score as a dependent variable facilitates analysis of the effects of hospital competition on hospital efficiency, concluding that when a hospital is located in a less competitive market in 2003, its technical efficiency score is lower than those in a more competitive market. ‘‘Manager-Employee Interaction in Ambulance Services: An Exploratory Study of Employee Perspectives on Management Communication’’ presents an exploratory study of how paramedics experience challenges in communication with station leaders, addressing the issue from a dialogue perspective by way of interviews in both one-to-one encounters and focus group settings. ‘‘International Classification of Diseases, 10th Revision Coding for Prematurity: Need for Standardized Nomenclature’’ describes the importance of the need for specificity of the codes and emphasizes the role of training in preparing for implementation of the ICD-10 coding system; an example is made for the need for accuracy in ICD-10 codes for prematurity as regards defining the premature population using standardized nomenclature. ‘‘Robotic Joint Replacement Surgery: Does Technology Improve Outcomes?’’ reports on a study undertaken to examine whether component misalignment leads to failure of total joint replacement and concludes that although computer navigation enhances the precision of component alignment, the addition of robotic guidance can provide a higher level of accuracy. Case in Health Care Management: ‘‘Where Does the Time Go?’’ asks the reader a com-
mon management concern: the effective use of time and what individual practices can be changed to improve one’s employment of this unrenewable resource. ‘‘Health Care Leader Competencies and the Relevance of Emotional Intelligence’’ reports on a study undertaken to develop a better understanding of what relationship, if any, can be identified between health care leader competencies and emotional intelligence. Community Health Needs Assessment: A Pathway to the Future and a Vision for Leaders’’ stresses the need to implement evidencebased public health practices that integrate targeted and specific strategies and actions with community preferences to improve the health of populations via the community health needs assessment. ‘‘Hospital Budget Increase for Information Technology During Phase 1 Meaningful Use’’ reports on a study of nonfederal hospital information technology budgets during the years 2009 to 2011, finding that increases in the percentage of operating budgets allocated to information technology in the years leading up to federal incentives were most pronounced among hospitals receiving high proportions of their reimbursements from Medicaid and Medicare, suggesting a possible budget shift toward more information technology spending to achieve ‘‘meaningful use’’ policy guidelines. ‘‘The Manager and the Merger: Adjusting to Functioning in a Blended Organization’’ suggests that as a result of organizational combinations such as mergers, affiliations, and the creation and expansion of health care systems, areas of responsibility are becoming broader, the groups overseen by individual managers are becoming larger, and many of the older ‘‘principles’’ of management are being tested and strained.
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
activities, some vital aspects of the management task are likely to go unaddressed. Visibility and availability will forever reIn a small hospital, an employee opinion main among the important elements of a mansurvey was conducted at the same time the ager’s job, most especially for those first-line employees were experiencing a flurry of changes managers who supervise the people doing the related to the hospital’s merger with another hands-on work. Despite the ever-changing eminstitution. In the written responses accompaphasis on the mix of tasks that should comnying the checked-off levels of opinion, 1 emmand management’s attention, the fact remains ployee commented on a department’s shared that certain aspects of a department’s functionmanagement as follows: ‘‘We now have a sining are better served by the manager’s presence gle manager over the departments in 2 places. than by the manager’s absence. Some may beHe comes here, he goes there, and half the time lieve that appropriately empowered employees he’s at some place called the system. Even need not have the manager close at hand at all when he’s here he’s always meeting with the times. True, but empowerment goes only so higher-ups, so we hardly ever get to see him. far. There are decisions to be made that are the How are we supposed to get an answer from province of the manager only. Also, the manthe boss when we really need one?’’ ager’s all-important coaching, counseling, and Few if any readers of this journal are uninstructing functions are not served in the aware of the sweeping changes that continue manager’s absence. to plague health care. Most working managers The manager who may now be spread thinhave probably been exposed to some aspect of ner than before, who may actually oversee mul‘‘merger mania,’’ have gone through ‘‘reengitiple groups in multiple locations, will have to neering’’ or an undisguised reduction in force, make a conscious effort to remain equally visior have seen their organizations’ structures ble and available in all necessary places. There ‘‘flattened’’ such that layers of management will always be demands that necessitate being and some specific management positions have here or there or elsewhere at any given time. It been eliminated, leaving the survivors with may be wise, therefore, to consider simple vismore than ever to manage. ibility and availability as demands in themThe changes in some managers’ roles have selves; sometimes you may have no specific had the effect of reducing their day-today presreason for being present in the work group ence in the work group. The pressures to face except for your presence itself. That is more toward higher management, to spend more than enough real reason for being there. time on organizational issues, on strategic planThis issue of The Health Care Manager ning and such, are undeniable. Some managers (34:2, April-June 2015) offers the following readily give way to these pressures, perhaps articles for the reader’s consideration. believing that these higher-level involvements ‘‘Using a Facilitation Model to Achieve should take precedence in this era of rapid change. However, while the manager is particPatient-Centered Medical Home Recognition’’ ipating in what are perceived to be high-level describes how a facilitation model that included a partnership between a Community Care of North Carolina network and undergraduates at a regional univerThe author has no conflict of interest. sity supported rural primary care practices in transforming their practices to become DOI: 10.1097/HCM.0000000000000050 91 Copyright # 2015 Wolters Kluwer Health, Inc. All rights reserved.
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
THE HEALTH CARE MANAGER/APRIL–JUNE 2015
92
National Committee for Quality Assurance– recognized patient-centered medical homes. ‘‘Has Competition Increased Hospital Technical Efficiency?’’ demonstrates how use of the hospital efficiency score as a dependent variable facilitates analysis of the effects of hospital competition on hospital efficiency, concluding that when a hospital is located in a less competitive market in 2003, its technical efficiency score is lower than those in a more competitive market. ‘‘Manager-Employee Interaction in Ambulance Services: An Exploratory Study of Employee Perspectives on Management Communication’’ presents an exploratory study of how paramedics experience challenges in communication with station leaders, addressing the issue from a dialogue perspective by way of interviews in both one-to-one encounters and focus group settings. ‘‘International Classification of Diseases, 10th Revision Coding for Prematurity: Need for Standardized Nomenclature’’ describes the importance of the need for specificity of the codes and emphasizes the role of training in preparing for implementation of the ICD-10 coding system; an example is made for the need for accuracy in ICD-10 codes for prematurity as regards defining the premature population using standardized nomenclature. ‘‘Robotic Joint Replacement Surgery: Does Technology Improve Outcomes?’’ reports on a study undertaken to examine whether component misalignment leads to failure of total joint replacement and concludes that although computer navigation enhances the precision of component alignment, the addition of robotic guidance can provide a higher level of accuracy. Case in Health Care Management: ‘‘Where Does the Time Go?’’ asks the reader a com-
mon management concern: the effective use of time and what individual practices can be changed to improve one’s employment of this unrenewable resource. ‘‘Health Care Leader Competencies and the Relevance of Emotional Intelligence’’ reports on a study undertaken to develop a better understanding of what relationship, if any, can be identified between health care leader competencies and emotional intelligence. Community Health Needs Assessment: A Pathway to the Future and a Vision for Leaders’’ stresses the need to implement evidencebased public health practices that integrate targeted and specific strategies and actions with community preferences to improve the health of populations via the community health needs assessment. ‘‘Hospital Budget Increase for Information Technology During Phase 1 Meaningful Use’’ reports on a study of nonfederal hospital information technology budgets during the years 2009 to 2011, finding that increases in the percentage of operating budgets allocated to information technology in the years leading up to federal incentives were most pronounced among hospitals receiving high proportions of their reimbursements from Medicaid and Medicare, suggesting a possible budget shift toward more information technology spending to achieve ‘‘meaningful use’’ policy guidelines. ‘‘The Manager and the Merger: Adjusting to Functioning in a Blended Organization’’ suggests that as a result of organizational combinations such as mergers, affiliations, and the creation and expansion of health care systems, areas of responsibility are becoming broader, the groups overseen by individual managers are becoming larger, and many of the older ‘‘principles’’ of management are being tested and strained.
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
