Test Book - Hospitals: What They Are and How They Work, Fourth Edition. Edited by - Donald J. Griffin

Question 1

a. Define the term ALOS:

b. According to this author which trend resulted in significant decrease in hospital ALOS in the 1990s?

c. Look at table 2-2. Comment on the ALOS data for AHA-registered US Hospitals 1970-2008

d. Look up, state and provide a reference of the most current ALOS you can find online. Compare that to the 2008 value in Table 2-2.

Question 2

a. Define the term "Cultural competence" and its four components.

b. What is the "business case for diversity"? Said another way, when a healthcare organization embraces diversity and inclusion principles, how does it benefit?

c. Diversity is not . . . . . . .

Question 3

A patient may enter a hospital in a planned or unplanned manner. A planned entry into the hospital occurs when a physician with admitting privileges refers the patient to that hospital through the admissions office. Remember as a non-clinical healthcare manager you could head up the admissions department.

Unplanned admissions through the emergency department can also occur. The emergency department of a hospital, and how it well it operates, will influence the success of the dhospital. For example, if community physicians and patients trust the services provided in that ER, it becomes a HUGE source of admissions for that hospital. When beds are full, hospitals are financially healthy. OK - now on to the essay questions:

a. Patients entering through the ER are "triaged" what does this mean?

b. Distinguish between a trauma center and an emergency department.

Question 4

You are a CEO of a 200-bed community hospital who employs over 50% of the admitting physicians. You support the introduction of physician extender roles at your hospital:

Facts to consider: This hospital employs a full-time Medical Director, Dr. Smith, who serves as a top-level manager along with the C-Suite. (Medical director role defined in chapter 3 - The Medical Staff). The number of primary care physicians in the geography of the hospital is significantly below that of the national average. Dr. Smith has no experience working with physician extenders.

A. Describe what you will say to your medical director, Dr. Smith, to gain his support to hire nurse practitioners at your healthcare facility.

QUESTION 5

"GOOD nursing is crucial because its absence means a patient experience is on the verges of inhumane. When a nurse gets it right, we do no less than touch and transform people's lives at what is often their lowest ebb. Conversely, uncaring, negligent and "couldn't care less" nurses blight the lives, health and dignity of those who depend on them" (Darbywhire, 2011).
Nursing shortages have a major impact on the operation of a hospital. If a hospital is able to achieve recognition through the ANCC as

a desirable place to work, then high nurse retention rates, high job satisfaction levels, and high quality of patient care will be achieved.

a. Describe the Nurse Friendly program developed by the Texas nurse Association and its 12 criteria considered essential for a positive work environment for direct-care nurses. Please note this went global!

b. Do you agree or disagree with Scott et al - Article 1 - who implied that inadequate patient-nurse staffing ratios can result in patient death? Why or why not?

c. True or False: Nursing is a costly care resource that in hospitals and other health care settings must be used effectively and efficiently.

QUESTION 6

You are a graduate of the masters in HCA at WKU. You have held a mid-level management position in a hospital setting for the past 5 years. You are now interviewing for the position of Chief Operating Officer (COO) at a 120-bed Lifepoint-owned Hospital in Gallatin, Tennessee. One of several departments that will be under your responsibility, should you be selected, is the Department of Physical Therapy. The Director of the PT Department who recently received his doctorate degree in physical therapy from WKU will report directly to you.

How will you respond to the following questions posed by the Director of Human Resources during your interview?

Question 1: Tell me about your working knowledge of the role of physical therapists and physical therapy assistants and the services they provide in a hospital setting.

Question 2: Our PT department currently employs 10 FTEs (full time equivalents), in order to justify keeping this level of staffing going forward, describe how patient outcomes are affected by PT services.

QUESTION 7

Classify each Organizational Trait as either DESIRABLE (D) or UNDESIRABLE (U) according to the Executive View article:

Organizational Traits: (circle your answer)(not from individual traits section)

D   U   1.  Puts patient care first

D   U   2.  Minimizes focus on bottom line

D   U   3.  Retains talent

D   U   4.  Is a democracy

D   U   5.  Emphasizes process & procedure over performance & results

D   U   6.  Listens to internal stakeholders

D   U   7.  Exudes a sense of optimism

D   U   8.  Timelines on everything are longer

D   U   9.  Trust is high and the rumor mill is rather silent

D   U  10. Has visible and visionary leaders