Journal of Healthcare Management - January/February 2014 - (Page 5)

I ntervIew And we still do not really know how much the current forms of clinical practice cost. Patient care needs to be designed, scheduled, and delivered on the basis of not only cost but also the most effective use of health professionals. How can we best use all clinicians-nurse practitioners, physical therapists, physicians, and so on- according to time-driven, activity-based costing (which, by the way, is not used much in healthcare)? Dr. O'Connor: What are the key challenges nurses confront when working with administrators? How can these two disciplines find greater synergy? Dr. White: This has been my soapbox topic for 20 years. When I was at VCU, I spent a lot of time redesigning the curriculum for health administration students, who typically did not have a clinical background. I have always believed that if they are to truly understand this business, students must understand it from the patient's perspective as well as the perspective of bedside clinical care providers. In the redesigned curriculum, starting on day one of the first semester, students were assigned to interprofessional teams. They interviewed patients, followed medical residents for 24 hours, and spent time on nursing units with assignments at the bedside. I think it has made all the difference in the world for them to get that exposure early on-at least that is the feedback I've received from students and their employers. The languages are also very different. Clinicians speak one language, business folks another, and even though their goals are similar, they have difficulty communicating about those goals with each other. For example, administrators speak of cost, staffing, and acuity levels, whereas nurses make statements such as, "My patient needs more of me," "My patient needs more education," or "My patient needs more resources." In reality, everyone is trying to do the best for patients-at least I hope so-and they should be focused on the organization's mission, vision, and values. Interprofessional teamwork allows that focus to be demonstrated. Interprofessional education has to begin prior to licensure-in the college classroom-and we need to add health administration students to that mix. A patientcentered curriculum for health administration students is one way to do so, as is providing nursing students with exposure to health economics-the financial side of the business, how patient care is paid for, and so on. A nursing model called the clinical nurse leader (CNL) approach (Begun, Tornabeni, & White, 2006) is now being taught to nursing students at U.Va. They are gaining knowledge about the legal environment, risk management, patient safety, financial outcomes, and cost-effective care while learning to be clinicians. These students will be valuable resources once they enter the profession. They will be the clinicians whom hospital administrators can tap as champions for the business side of care on the nursing units. Nurses like to know that administrators care about patients. Administrators who demonstrate that they make decisions in the best interest of patients are in alignment with clinicians. Once nurses also shift their mind-set to doing what is best for the patient in cost-effective ways, synergies will develop and strengthen. 5

Table of Contents for the Digital Edition of Journal of Healthcare Management - January/February 2014

Journal of Healthcare Management - January/February 2014
Contents
Interview With Kenneth R. White, PhD, FACHE, Associate Dean for Strategic Partnerships and Innovation and the University of Virginia Medical Center Professor of Nursing, University of Virginia School of Nursing
Team-Based Care at Mayo Clinic: A Model for ACOs
The Management Springboard: Eight Ways to Launch Your Career as a Healthcare Leader
The Role of a Public–Private Partnership: Translating Science to Improve Cancer Care in the Community Donna M. O’Brien and Arnold D. Kaluzny
The Value of Patients’ Handwritten Comments on HCAHPS Surveys John W. Huppertz and Robert Smith
Can Inbound and Domestic Medical Tourism Improve Your Bottom Line? Identifying the Potential of a U.S. Tourism Market
Success Factors for Strategic Change Initiatives: A Qualitative Study of Healthcare Administrators’ Perspectives

Journal of Healthcare Management - January/February 2014