Our healthcare system follows the recommendations of this section.  One of the things we struggle with is involving ancillary departments and holding them accountable.  The directors and supervisors of these departments are held accountable to the overall patient satisfaction scores.  The problem for ancillary departments is that we do not get a specific score reflecting our results.  I wonder if anyone has any recommendations for helping ancillary staff members to understand that their interactions can influence the patient's stay.  We can really help make the experience positive. 

The mission, vision, ownership, scope of services, location, and partners of the organization defines its:

A.  Strategy;

B. Scenario;

C.  Strategic Postion;

D.  Business Philosophy;

Answer:  C   Well Managed Healthcare Organization page 607

    I have a quesion first not related - what is the difference between community discussion and exam discussion areas ?

Now on question 6 antitrust laws I am not certain why the answer excludes physician contracts it does pertain to physician contracts and there needs to be clear evaluation any contracts to make sure stark laws are not compromised.

I do not have much experience with writing business plans.  Does anyone have tips to share regarding writing a business plan?  Are there any recommended resources that would help guide me through the process step-by-step?  I appreciate any experiences you can share.

With Sarbanes-Oxley in place, I am wondering just how involved non-profits are in comparison to public companies.  For example, it seems to me that in healthcare directors and executives have always been underpaid for what is expected of them.  Is this something actively scrutinized with the enactment of Sarbanes-Oxley?  Do non-profit organizations follow the requirement to have separate audit committees?  I am curious about the extent that Sarbanes-Oxley truly influences non-profit institutions.  I appreciate any comments on this area of discussion from week 10. 

This is more of an observation than question, however the ethics involved in managed care seems quite complicated.  Throughout the presentation the discussion was that, the Provider was only interested in helping to keep patients well enough until they could be passed on to another responsible party, which may be Medicare or another HSO.  This is the first time I heard that physicians or LIPs have to sign “gag” orders in some circumstances.  How can this be ethical? Does anyone have more information to share related to “gag” orders?

During the course of a patient's stay, the patient and/or family may request a change in provider related to a dissatifsying experience, complaint or a personal preference.  Provider is intended to be used in a broad sense and can include any associate providing service to the patient, ie physician, nurse, therapist.

Occasionally, the astute clinician may identify that the therapeutic relationship with the patient has either not been effectively established or has deteriorated.

What is the providers moral, ethical and professional obligation to honor the request or remove themselves and request reassignment?

Does a patient have the right to change providers for any reason?

Does the type of provider change the right or circumstance under which a change in provider should be honored?

Are there situations or events that would be exceptions to assigning a different provider?

I am interested in entertaining how other HCO have handled these request.  Our ethics committee is currently discussing this issue and we have found that there are varied and in some instances extreme differences in opinion.