I. General Information

1. Course Title:
Healthcare Management and Organization

2. Course Prefix & Number:
HINS 2148

3. Course Credits and Contact Hours:

Credits: 3

Lecture Hours: 3

4. Course Description:

This course will provide an introductory understanding of healthcare management and organization; its major functions, roles and responsibilities. The course will cover performance improvements, technologies, cost and revenue management, ethics, law, fraud and abuse, and skills for working in teams.

5. Placement Tests Required:

Accuplacer (specify test):

No placement tests required

Score:

6. Prerequisite Courses:

There are no prerequisites for this course.

9. Co-requisite Courses:

There are no corequisites for this course.

II. Transfer and Articulation

III. Course Purpose

1. Program-Applicable Courses – This course is required for the following program(s):

Healthcare Administrative Specialist, AAS 
Healthcare Technology AAS

IV. Learning Outcomes

1. College-Wide Outcomes

College-Wide Outcomes/Competencies	Students will be able to:
Apply ethical principles in decision-making	Use case scenarios and identify the law(s) and ethical isssues related to the case and provide solutions for prevention.
Work as a team member to achieve shared goals	Participate in small teams and demonstrate the steps required in establishing team guidelines and processes.

2. Course Specific Outcomes - Students will be able to achieve the following measurable goals upon completion of the course:

• Demonstrate an understanding of the different healthcare facility organizational structures.
• Define quality and the quality standards in healthcare;
• Demonstrate an understanding of a quality and performance improvement plan and list the key quality improvement concepts;
• Demonstrate an understanding of the characteristics of health insurance and its role in financial viability of the healthcare organization;
• Demonstrate an understanding of the roles of various healthcare professionals employed at the different healthcare facilities;
• Demonstrate the tools and methods for managing a team of healthcare professionals;
• Demonstrate an understanding of the cultural competency and diversity in healthcare management;
• Demonstrate their ability to apply healthcare legal and ethical process using the state and federal resources to specific scenarios; and
• Demonstrate the responsibility of managing compliance and internal controls to their specific field of study.

V. Topical Outline

Listed below are major areas of content typically covered in this course.

1. Lecture Sessions

1. Leadership and Management
• Introduction
• Healthcare facility ownership
• Healthcare facility organizational structure
• Integrated health system
• Ambulatory care facility
• Acute care facility
• Behavioral healthcare facility
• Home care and hospice
• Long-term care
• Managed care
• Federal, state, and local healthcare
• Governance
• Roles of healthcare management
• Licensure, regulation, and accreditation
2. Organizational Behavior
   • Organizational behavior issues in health organizations
3. Strategic Planning
   • Purpose and importance of strategic planning
   • Mission, vision, and values
   • Organizational volume forecast
   • Financial condition
   • Strategic performance
   • Strategic planning and execution
4. Performance Improvement in Healthcare
   • Defining quality in healthcare
   • Brief history of quality and performance improvement
   • Quality assurance
   • The end results system
   • The flexner report
   • The Joint Commission
   • QA essentials
   • QA assumptions and actions
   • Peer review to quality improvement organizations
   • Professional standard review organization
   • Quality improvement organization program
   • Continuous Quality Improvement (CQI)
   • The concept of CQI in healthcare
   • Applying CQI
   • Leading quality improvement models
   • Key quality improvement concepts
   • Healthcare as high hazard industry
   • Approaches to system improvement
   • Assessing healthcare system improvement
   • Healthcare system improvement challenges
   • Developing a national information technology infrastructure
5. Information Technology
   • Health information and its users
   • Health information technology and applications
   • The role of the health manager
6. Financing Healthcare and Health Insurance
   • National health spending
   • Paying for health care
   • Introduction to health insurance
   • Brief History of health insurance
   • Characteristics of health insurance
   • Private health insurance coverage
   • Consumer-driven health plans
   • Evolution of social insurance
   • Convergence of political opportunity and leadership
   • Statistics on health insurance coverage and costs
   • Uninsured
7. Managing costs and revenues
   • Ten major objectives of financial management
   • Tax status of healthcare organizations
   • Financial governance and responsibility structure
   • Managing reimbursement from third-party payers
   • What are the primary methods of payments used by Medicare and Medicaid
   • Reimbursement by individuals with no health insurance
   • Controlling costs and classifying costs
   • Break-even analysis
   • Setting charges
   • Other determinants of setting charges
   • Managing budgets
8. Managing Healthcare Professionals
   • Physicians
   • Registered nurses
   • Licensed practical nurses/licensed vocational nurses
   • Nursing, psychiatric, and home health aids
   • Midlevel practitioners
   • Allied health professionals
9. Teamwork
   • What is a team?
   • The challenge of teamwork in healthcare organizations
   • The benefits of effective healthcare teams
   • The costs of teamwork
   • Who’s on the team?
   • Team communication
   • Methods of managing teams of healthcare professionals
10. Cultural Competency and Diversity
    • Cultural frameworks in healthcare management
    • Cultural competency and diversity staff training
    • Cultural competency at the workplace
11. Ethics and Law
    • Introductions
    • Elements of a contract
    • Malpractice
    • Patient and provider rights and responsibilities
    • Legal/ethical concerns in managed care
      • Biomedical concerns
      • Beginning- and end-of-life care
      • Research in healthcare setting
12. Fraud and Abuse
    • Social Security Act and the criminal-disclosure provision
    • Emergency medical treatment and Active Labor Act (EMTALA)
    • Hospital compliance with EMTALA
    • Management responsibility for compliance and internal controls
    • Corporate compliance programs
13. Healthcare Management Guidelines and Cases
• "Oops" is not an option
• Managing healthcare professionals
• Merger of two competing hospitals
• Electronic medical records in a rural family practice
• Medication error reporting