Transcript problem solving - DR

POLICY AND PROCEDURE
• Policy – a simple clear statement of what
you should do (what)
• Procedure – a simple clear statement of who
should do what (when, where and how)
AUTHORITY
• This policy is promulgated under the
authority of the COO and the Director of
Infection Control. The Director of Infection
Control is responsible for administering the
policy.
POLICY
• All medical, nursing and laboratory
personnel who identify or suspect a case of
a reportable disease will report such case
promptly to the Louisiana Department of
Health in accordance with the Sanitary
Code of the State of Louisiana.
LAW IS NOT POLICY
• There is a term for disobeying the law as a
matter of policy.
• Who are the two most famous proponents of
this policy?
VIOLATION OF POLICY
• As with all formal policies of this hospital,
violation of this policy is grounds for
progressive discipline.
MALAPROPISM
• Mrs Malaprop in The Rivals by Sheridan
written in 1775
• infectious control nurse (infection)
• assess concerns (address)
• hold this nation hostile (hostage)
NONSENSE
• due to the feasibility of the department
• in the prevention of unlawful duty of care
continues to exist for individuals
• attend to our community in the utmost
fashion
TAKE A STAND
• You should think about considering whether
you perhaps should look into being in the
class room near or at the approximate time
that the professor or other instructor may or
may not present some information that
could possibly be of use to some or all of
you now or in certain circumstances in the
future. – COME TO CLASS!
MODIFIERS
• Sentences require a noun and a verb.
• Think carefully before adding an adjective
or an adverb.
• Do not modify an absolute. I am unique,
not more unique.
• Do not split infinitives.
PRONOUNS
• He and I want the books.
• Give the books to him and me.
• To whom did you give the books? To him?
PROBLEM SOLVING
STRATEGIC MANAGEMENT IN
HEALTHCARE
3 March 2008
GOALS AND OBJECTIVES
• GOALS
– ENDS - OUTCOMES
– VALUABLE IN THEMSELVES
• OBJECTIVES
– INTERMEDIATE STEPS - MEANS
– VALUABLE MEASURE OF PROGRESS
REASONING
• INDUCTIVE: REASONING FROM
PARTICULAR FACTS OR CASES TO A
GENERAL CONCLUSION
• DEDUCTIVE: REASONING FROM THE
GENERAL TO THE SPECIFIC
CONTINUOUS QUALITY
IMPROVEMENT
• PROACTIVE APPROACH THAT
ASSUMES ALL PROCESSES CAN BE
IMPROVED
• ASSUMES A REASONABLE LEVEL OF
QUALITY TO BEGIN WITH
• ASSUMES YOU ARE DOING THE
RIGHT THINGS ALREADY
PROBLEM SOLVING
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IDENTIFY THE PROBLEM
ANALYZE THE SITUATION
DEVELOP ALTERNATIVES
CHOOSE A SOLUTION
IMPLEMENT THE SOLUTION
EVALUATE THE RESULTS
PROBLEM RECOGNITION
• IT IS EASY TO BECOME SO FOCUSED
ON THIS THAT IT BECOMES THE
PROBLEM
• LEAD, FOLLOW OR GET OUT OF THE
WAY
PROBLEM STATEMENT
• STEM - OWNER - ACTION - GOAL
• “A QUESTION WELL PUT IS HALF
ANSWERED” - DO YOU AGREE?
OWNERSHIP/LEADERSHIP
ACTION ORIENTATION
• “ THE PSYCHOLOGICAL STIMULUS
PROVIDED BY AN ACTION
ORIENTATION SHOULD NOT BE
UNDERESTIMATED”
• THE VALUE OF A “HOLD” BOX
SHOULD NOT BE UNDERESTIMATED
EITHER
MILITARY MANAGEMENT
• STRATEGY: PLANNING AND
DIRECTING LARGE-SCALE
OPERATIONS
• TACTICS: MANEUVERING FORCES,
METHODS USED TO GAIN AN END
• LOGISTICS: PROCURING,
MAINTAINING, & TRANSPORTING
MATERIAL AND PERSONNEL;
MANAGING THE DETAILS
DECISION CRITERIA
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EFFECTIVENESS
FEASIBILITY
LEGALITY/ETHICS
ACCEPTABILITY
COSTS
SECONDARY GAINS
UNINTENDED CONSEQUENCES
INFLUENCING FACTORS
• SITUATION
• ENVIRONMENT
• PROBLEM SOLVERS
SITUATION
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URGENCY
MAGNITUDE/IMPORTANCE
RISK/UNCERTAINTY
COST/BENEFIT
ENVIRONMENT
• EXTERNAL
• INTERNAL
PROBLEM-SOLVERS
• EXPERIENCE, KNOWLEDGE,
JUDGEMENT
• PERSPECTIVE, PERSONALITY, BIASES
• VALUES, PHILOSOPHY
GROUP PROBLEM SOLVING
• GROUP PROBLEM SOLVING
PRODUCES BETTER QUALITY
DECISIONS
• GROUPTHINK IS A PRIMARY CAUSE
OF POLICY DEBACLES
• CONFLICT IS IMPORTANT TO
REACHING A GOOD DECISION
• NONE OF US IS AS STUPID AS ALL OF
US
EMPLOYEE PARTICIPATION
• QUALITY CIRCLES FAILED PARALLEL AND IRRELEVANT
• HEARINGS DO NOT EQUAL
PARTICIPATION - PATRONIZING
• SUGGESTION BOX - IMPERSONAL
AND GENERALLY IGNORED
CASE STUDY 4
• VOLUNTEER COORDINATOR IS
WORKING ONLY 6 HOURS A DAY
• FILLS OUT TIME CARD FOR 8 HOURS
• DOING A GOOD JOB
• GOES HOME WHEN HER WORK IS
DONE
• WHAT IS THE PROBLEM?
CASE STUDY 1
• WORK LOAD IN A NURSING UNIT IS
VERY HEAVY THIS MONTH
• FAMILY MEMBERS DOING PATIENT
CARE AT SUGGESTION OF MS
JOHNSON
• YOU HAVE SEEN JOHNSON SITTING
IN THE UTILITY ROOM FOR LONG
PERIODS OF TIME