Organizational Leadership and Health Care Reform

Organizational Leadership and Health Care Reform

T. Ray Ruffin (University of Phoenix, USA & Colorado Technical University, USA & University of Mount Olive, USA & Wake Technical Community College, USA), Joyce Marie Hawkins (Wake Technical Community College, USA) and D. Israel Lee (Southern Illinois University, USA & University of Phoenix, USA)
DOI: 10.4018/978-1-4666-9970-0.ch003
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Abstract

Policies, health, and government regulations affect various Health Care organizations and their members. One such policy, the Health Information Technology for Economic and Clinical Health (HITECH) Act, attempts to improve the performance of health care systems through the use of technology, such as Electronic Health Records (Bluementhal, 2010). The most critical task of leadership is to establish a mindset at the top of the organization and function to infuse a culture of excellence throughout the organization (Bentkover, 2012). Health organizations can only progress if their members share a set of values and are single-mindedly committed to achieving openly defined objectives (Bentkover, 2012). This chapter investigates organizational leadership in relation to health care reforms to include trends in health care leadership, Stratified Systems Theory (SST), Systems Thinking, and regulators perspectives. The chapter will consist of the following sections: background; issues controversies, and problems; solutions and recommendation; future research directions; and conclusion.
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Background

Prior to 1994, the standards were comprised of chapters on management, governance, regulators, medical staff, and nursing services. Basically, each division in the health organization essentially had their own standards. These standards were based on individual divisions; and all related policies and procedures complied with that division (Schyve, 2009). Essentially each division was operating as an organizational silo for the good of that individual division’s, governance, accountability, ethical conduct. These regulators have their own threshold languages (SB853) that cover about 20 different languages. However, the languages covered are primarily Spanish and Chinese in health care (Wu, 2015). These threshold languages are anticipated to guarantee the success of the division and better patient understanding (Schyve, 2009).

Key Terms in this Chapter

TDK Technologies: Vendor for Technology and Management for e-commerce.

World Health Organization WHO: A health system for profit and non-profit organizations.

National Committee of Quality Assurance (NCQA): A non-profit organization to improve quality in health plans.

Patient Protection and Affordable Care Act (PPACA): This is an act created by Obama Care to maximize quality and affordability of insurance plans.

Quality Improvement (QI): The main goal is to make sure that all policies and regulations are implemented in health plans.

Department of Management Health Care (DMHC): A health plan regulator for High Maintenance Organizations plans.

Appointment of Representation (AOR): A form of power of attorney.

Health Insurance Portability and Accountability Act (HIPAA): Makes the ability to transfer and continue health insurance coverage for patient care to millions of citizens and families that lose their jobs, and protects the patients’ privacy.

Emotional Intelligence (EI): Motivates individuals with a collective vision of the future to communicate well.

Medicare Urban (MU): A program that covers hospitals in urban areas.

Independent Medical Reviewers (IMR): An Independent Medical Reviewer that works along with the DMC to regulate health plans.

Australian Commission on Safety and Quality in Health Care (ACSQHC): A commissioner agency that leads and coordinates health care improvements across Australia.

Centers for Medicare & Medicaid Services (CMS): Medicare and Medicaid Services.

Systems Thinking: A holistic approach analysis to leadership and decision making.

Senate Bill 853 (SB853): This Senate Bill provides various threshold languages and making language barriers to more understandable.

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