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Chapter 7 Committees and Teams
The Nature of Committees
The Purposes and Uses of Committees
Limitations and Disadvantages of Committees
Enhancement of Committee Effectiveness
The Committee Chairperson
Committee Member Orientation
Minutes and Proceedings
Where Do Teams Fit In?
As Employee Involvement Increases
Employee Teams and Their Future
Exercise: Committee Structures
Case: The Employee Retention Committee Meeting

Chapter 8 Budget Planning and Implementation

The Revenue Cycle
The Budget
Uses of the Budget
Budget Periods
Types of Budgets
Approaches to Budgeting
The Budgetary Process
Capital Expenses
Supplies and Other Expenses
The Personnel Budget
Direct and Indirect Expenses
Budget Justification
Budget Variances
The General Audit
Sample Budget: Health Information Service
Exercise: Adjusting the Budget

Chapter 9 Training and Development: The Backbone of Motivation and Retention

Employee Development
Orientation
Training
Mentoring
Clinical Affiliation/Clinical Practice Program and Contract
Exercise: What to Do When Budget Cutting Threatens Training?
Case: The Department’s “Know-It-All”
 Appendix 9–A: Training Design: Release of Information

Chapter 10 Adaptation, Motivation, and Conflict Management

Adaptation and Motivation
Theories of Motivation
Practical Strategies for Employee Motivation
Appreciative Inquiry
Motivation and Downsizing
Conflict
Organizational Conflict
Discipline
The Labor Union and the Collective Bargaining Agreement
Labor Unions in Health Care: Trends and Indicators
Case: A Matter of Motivation: The Delayed Promotion
Case: Charting a Course for Conflict Resolution—“It’s a Policy”
Notes
Appendix 10–A: Sample Collective Bargaining Agreement

Chapter 11 Communication: The Glue That Binds Us Together

A Complex Process
Communication and the Individual Manager
Verbal (Oral) Communication
Written Communication
Communication in Organizations
Orders and Directives
Case: The Long, Loud Silence
Case: Your Word Against His
Notes

Chapter 12 The Middle Manager and Documentation of Critical Management

Processes
The Strategic Plan
The Annual Report
The Executive Summary
Major Project Proposal
Business Planning for Independent Practice
The Due Diligence Review
Exercise: Preparing Your Business Plan
Appendix 12–A: Newman Eldercare Services, Inc.: Strategic Plan
Appendix 12–B: Annual Report of the Health Information Services
 Appendix 12–C: Executive Summary: Annual Report of the Health
Information Services
Appendix 12–D: Sample Project Proposal for Funding

Chapter 13 Improving Performance and Controlling the Critical Cycle

Quality, Excellence, and Continuous Performance Improvement
The Search for Excellence: A Long and Varied History
The Management Function of Controlling
Benchmarking
Tools of Control
The Critical Cycle
Exercise: Choosing an Adequate Control Mechanism—What Fits Best?
Exercise: Promoting Total Quality Management
Note

Chapter 14 Human Resources Management: A Line Manager’s Perspective

“Personnel” Equals People
A Vital Staff Function
A Service of Increasing Value
Increase in Employee-Related Tasks
Learning about Your Human Resources Department
Putting the Human Resources Department to Work
Some Specific Action Steps
Further Use of Human Resources
Wanted: Well-Considered Input
Understanding Why as Well as What
Legal Guides for Managerial Behavior
An Increasingly Legalistic Environment
Emphasis on Service
Case: With Friends Like This ...
Case: The Managerial “Hot Seat”
Note

Chapter 15 Day-to-Day Management for the Health Professional-as-Manager

A Second and Parallel Career
Two Hats: Specialist and Manager
A Constant Balancing Act
The Ego Barrier
The Professional Managing the Professional
Leadership and the Professional
Some Assumptions about People
Style and Circumstances
The Professional and Change
Methods Improvement
Employee Problems
Communication and the Language of the Professional
An Open-Ended Task
The Next Step?
Case: Professional Behavior—The Bumping Game
Case: Delegation Difficulties—The Ineffective Subordinate
Notes

Index
 Preface

This book is intended for healthcare professionals who regularly perform the classic
functions of a manager as part of their job duties—planning, organizing, decision making,
staffing, leading or directing, communicating, and motivating—yet have not had extensive
management training. Healthcare practitioners may exercise these functions on a continuing
basis in their roles as department directors or unit supervisors, or they may participate in only
a few of these traditional functions, such as training and development of unit staff. In any
case, knowledge of management theory is an essential element in professional training,
because no single function is ever addressed independently of all others.
In this book, emphasis is placed on definitions of terms, clarification of concepts, and, in
some cases, highly detailed explanations of processes and concepts. The examples reflect
typical practices in the healthcare setting. However, all examples are fictitious and none are
intended as legal, financial, or accreditation advice.
Every author must decide what material to include and what level of detail to provide. The
philosopher and pundit Samuel Johnson observed, “A man will turn over half a library to
make one book.” We have been guided by experience gained in the classroom, as well as in
many training and development workshops for healthcare practitioners. Three basic
objectives determined the final selection and development of material:
1. Acquaint the healthcare practitioner with management concepts essential to the
understanding of the organizational environment within which the functions of the
manager are performed. Some material challenges assumptions about such concepts as
power, authority, influence, and leadership. Some of the discussions focus on relatively
new concepts such as appreciative inquiry approaches to motivation and conflict
management, cultural proficiency and diversity training, changes in credentialing, and
job duties of technical support personnel. Practitioners must keep abreast of developing
trends in management, guarding against being “the last to know.”
2. Provide a base for further study of management concepts. Therefore, the classic
literature in the field is cited, major theorists are noted, and terms are defined,
especially where there is a divergence of opinion in management literature. We all stand
on the shoulders of the management “giants” who paved the way in the field; a return to
original sources is encouraged.
3. Provide sufficient detail in selected areas to enable the practitioner to apply the
concepts in day-to-day situations. Several tools of planning and control, such as budget
preparation and justification, training design, project management, special reports (e.g.,
the annual report, a strategic plan, a due diligence assessment, a consultant’s report),
and labor union contracts, are explained in detail.
We have attempted to provide enough information to make it possible for the reader to use
these tools with ease at their basic level. It is the authors’ hope that the readers will contribute
to the literature and practice of healthcare management as they grow in their professional
practice and management roles. We are grateful to our many colleagues who have journeyed
with us over the years and shared their ideas with us.
Joan Gratto Liebler
Charles R. McConnell
 About the Authors

Joan Gratto Liebler, MA, MPA, RHIA, is Professor Emerita, Health Information
Management, at Temple University, Philadelphia, Pennsylvania. She has more than 36 years
of professional experience in teaching and research in healthcare settings. In addition to
teaching, her work and consulting experience include engagement with community health
centers, behavioral health settings, schools, industrial clinics, prisons, and long-term care,
acute care, and hospice facilities. She has also been an active participant in area-wide
healthcare planning, end-of-life care coalitions, and area-wide emergency and disaster
planning.
Ms. Liebler is also the author of Medical Records: Policies and Guidelines and has
authored numerous journal articles and contributed chapters relating to health information
management.
Ms. Liebler holds the degrees of Master of Arts (concentration in Medical Ethics), St.
Charles Borromeo Seminary, Philadelphia, Pennsylvania, and Master of Public
Administration, Temple University, Philadelphia, Pennsylvania. She is a credentialed
Registered Health Information Administrator.
Charles R. McConnell, MBA, CM, is an independent healthcare management and human
resources consultant and freelance writer specializing in business, management, and human
resources topics. For 11 years he was active as a management engineering consultant with the
Management and Planning Services (MAPS) division of the Hospital Association of New
York State (HANYS), and he later spent 18 years as a hospital human resources manager. As
author, coauthor, and anthology editor, he has published more than 30 books and has
contributed several hundred articles to various publications. He is in his 35th year as editor of
the quarterly professional journal The Health Care Manager.
Mr. McConnell received a Master of Business Administration and a Bachelor of Science
degree in Engineering from the State University of New York at Buffalo.
 What’s New in the Seventh Edition

Management Principles for Health Professionals, Seventh Edition continues to present

foundational principles of management in the context of contemporary health care. The
Seventh Edition reflects current issues by linking them to basic principles. Newly added
examples include corporate compliance, standards of conduct and mandatory reporting,
eHealth (its expansion, plus issues relating to reimbursement), revenue cycle considerations,
cultural competency and diversity training, and comparative effectiveness reviews. There is
continuing expansion of material relating to the Health Insurance Portability and
Accountability Act (HIPAA), electronic health records/personal health records, due diligence
reviews, and healthcare reform legislation.
Examples and exhibits have been updated throughout. Examples reflect a wide variety of
settings, including acute care, observation units, urgent care, rural critical access care
facilities, neighborhood health centers, secure personal care units, continuing care facilities,
and rapid treatment centers. These examples feature various patient groups, including the
frail elderly, at-risk youth, and homeless youths and adults. A full-scale plan, with 500-day
implementation schedule, is included to illustrate project management. Newly emerging
jobs/positions are included, such as compliance officer, privacy specialist, data quality and
analysis specialist, and contractual management teams.

SPECIFIC CHAPTER UPDATES

Chapter 1, “The Dynamic Environment of Health Care,” presents a template for analyzing
megatrends in health care with attention to clients, families as caregivers, professional
practitioners, the healthcare marketplace and settings, the impact of technology (including
eHealth and virtual health), data mining, the health information exchange, and social/cultural
factors. An expanded section on financing and reimbursement is included. The characteristics
of the effective manager are delineated.
Chapter 2, “The Challenge of Change,” includes detailed examples relating to the
continued implementation of the electronic health record (including outreach campaigns and
meaningful use initiatives), the organizational restructuring resulting from marketplace
forces, and continuing impact of healthcare reform legislation.
Chapter 3, “Organizational Adaptation and Survival,” includes expanded discussion of
competition and adversarial relationships. Extensive analysis of the effects of mergers, partial
or full closure of a facility, and the final stages in the organizational life cycle is made. The
main features of the manager’s concerns and activities during this phase are amplified.
Chapter 4, “Leadership and the Manager,” was formerly Chapter 12, “Authority,
Leadership, and Supervision.” The material concerned with knowing one’s own leadership
style has been expanded. Information presented on orders and directives has been moved to
Chapter 11, “Communication,” and the discussion of supervision and discipline has been
moved to Chapter 10, “Adaptation, Motivation, and Conflict Management.”
Chapter 5, “Planning and Decision Making,” adds material relating to the consequences of
delaying decision making or not making decisions at all, along with the second- and third-
order impact of decisions. More examples of the after-action report are included. Under the
topic of planning, project management is presented, including the role of the project manager
along with project evaluation through process and outcome reviews. A complete project,
coupled with a 500-day implementation plan, is provided to illustrate the extensive nature of
project delineation, activity description, and evaluation cycles.
Chapter 6, “Organizing,” provides additional discussion of the job analysis, classification,
and job description interrelationship. New/emerging/changing job titles and responsibilities
are included (e.g., corporate compliance officer, data quality specialist, privacy officer).
Standards of conduct and mandatory reporting are added to the orientation module. The role
and function of the external, contract management team is delineated. The changing
characteristics of the work force are highlighted. The management inventory to forecast
staffing needs is developed. The consultant report reflects current issues relating to transition
from hard copy to electronic health records, and the resulting legacy systems, changes in data
entries, studies relating to shorter stay admissions compared to balance-of-life admissions in
skilled care, the necessity of studies relating to patterns of readmission to acute care, and
studies about secure personal care units (including suspected elder abuse because of
involuntary seclusion).
Chapter 7, “Committees and Teams,” offers refined and expanded information concerning
employee teams and their legality and advice and guidance for building and maintaining a
departmental team.
Chapter 8, “Budget Planning and Implementation,” is essentially the same as the former
Chapter 7, “Budgeting: Controlling the Ultimate Resource.”
Chapter 9, “Training and Development: The Backbone of Motivation and Retention,”
includes new material that reflects diversity and cultural competence. New material has also
been added to address the mutual responsibilities, and the elements of an affiliation
agreement/contract between the healthcare organization and external academic programs for
clinical practice rotations. Additional aspects of the training design are included to reflect the
needs assessment for training, aspects of interpersonal skills, and challenges associated with
difficult client interaction.
Chapter 10, “Adaptation, Motivation, and Conflict Management,” includes an explanation
of motivational strategies for dealing with crisis incidents. The impact of downsizing is
explained in detail, including the environment created when layoffs occur, the effects on
employees who must be released, and the reactions of “survivors” who are expected to do
more with less at a time when morale and motivation have been adversely affected. Labor
union trends and issues are highlighted, and the sample labor contract has been updated.
Chapter 11, “Communication: The Glue That Binds Us Together,” formerly Chapter 14,
stresses plans and preparations for addressing communication during a crisis via the need for
disaster planning. Material concerning “the grapevine” and the manager’s role in rumor
control is presented, and information concerning orders and directives has been moved here
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from an earlier chapter.
Chapter 12, “The Middle Manager and Documentation of Critical Management
Processes,” includes full-scale examples of reports, strategic plans, and due diligence
reviews. Current points of emphasis, including regional health information exchanges,
telecommuting issues, upgrading job titles and content (including certifications and
qualifications), participation in clinical practice programs, and achievements related to
external rating reviews (e.g., Medicare Five-Star rating) are described.
Chapter 13, “Improving Performance and Controlling the Critical Cycle,” discusses ideas
for topics for studies that reflect current issues such as comparative effectiveness evaluation,
outcome measurement, Recovery Audit Contractor audits and payment error reviews,
American Health Information Management Association (AHIMA) governance principles,
issues specific to critical access/rural facilities (e.g., use of and reimbursement for telehealth,
swing bed usage, pattern of transfer to regional tertiary centers), no-show and cancelled
appointment patterns, and cultural and linguistic services. Seven categories of performance
improvement studies are also described. In addition, selected strategies of improvement
processes are noted, including rapid cycle improvement, waterfall/cascading impact reviews,
and root cause analysis. An application of dashboard reporting is given, reflecting its use in a
disaster situation. Three examples are given to reflect the unanticipated consequence of
planning: when an improvement fails and negative outcomes occur.
Chapter 14, “Human Resources Management: A Line Manager’s Perspective,” formerly
Chapter 13, is essentially unchanged from the previous edition, although laws applicable to
employment are reviewed for updates.
Chapter 15, “Day-to-Day Management for the Health Professional-as-Manager,” has been
slightly expanded to address the development and management of one’s own career.
 CHAPTER 1

The Dynamic Environment of Health Care

CHAPTER OBJECTIVES
• Describe the healthcare environment as it has evolved since the middle to late 1960s
with attention to the dynamic interplay of key factors.
• Examine megatrends in the healthcare environment with attention to:
○ Client characteristics
○ Professional practitioners and caregivers
○ Healthcare marketplace and settings
○ Applicable laws, regulations, and standards
○ Impact of technology
○ Privacy and security considerations
○ Financing of health care
○ Social and cultural factors
• Identify the role set of the healthcare practitioner as manager.
• Review the classic functions of the manager.
• Define and differentiate between management as an art and a science.
• Conceptualize the characteristics of an effective manager.

THE DYNAMIC ENVIRONMENT OF HEALTH CARE

The contemporary healthcare environment is a dynamic one, combining enduring patterns of
practice with evolving ones to meet challenges and opportunities of changing times. The
healthcare organization is a highly visible one in most communities. It is a fixture with deep
roots in the social, religious, fraternal, and civic fabric of the society. It is a major economic
force, accounting for approximately one-sixth of the national economy. In some local
settings, the healthcare organization is one of the major employers, with the local economy
tied to this sector. The image of the hospital is anchored in personal lives: it is the place of
major life events, including birth and death, and episodes of care throughout one’s life.
Families recount the stories of “remember the time when we all rushed to the hospital ...” and
similar recollections. The hospital is anchored in the popular culture as a common frame of
reference. People express, in ordinary terms, their stereotypic reference to the healthcare
setting: “He works up at the hospital,” “Oh yes, we made another trip to the emergency
room,” or “I have a doctor’s appointment.” Popular media also uses similar references;
television shows regularly feature dramatic scenes in the acute care hospital, with the
physician as an almost universally visible presence. Care is often depicted as happening in
the emergency department.
On closer examination, one recognizes that, in fact, many changes have occurred in the
healthcare environment. The traditional hospital remains an important hub of care but with
many levels of care and physical locations. The physician continues to hold a major place on
the healthcare team, but there has been a steady increase in the development and use of other
practitioners (e.g., nurse midwife, physical therapist as independent agent, physician
assistant) to complement and augment the physician’s role. A casual conversation reflects
such change; a person is just as likely to go to the mall to get a brief physical examination at
a walk-in, franchised clinic as he or she would be to go to the traditional physician’s office.
One might get an annual “flu” shot at the grocery store or smoking cessation counseling from
the pharmacist at a commercial drug store. One might have an appointment for care with a
nurse practitioner instead of a physician. Instead of using an emergency service at a hospital,
one might receive health care at an urgent care service or clinic.
Although the setting and practitioners have developed and changed, the underlying theme
remains: how to provide health care that is the best, most effective, accessible, and
affordable, in a stable yet flexible delivery system. This is the enduring goal.
Those who manage healthcare organizations monitor trends and issues associated with the
healthcare delivery system in order to reach this goal. Thus, a manager seeks to have
thorough awareness and knowledge of the interplay of the dynamic forces. It is useful,
therefore, to follow a systematic approach to identify, monitor, and respond to changes in the
healthcare environment. The following template provides such a systematic approach. The
starting point is the client/patient/recipient of care. This is followed in turn by considerations
of the professional practitioners and caregivers; healthcare market place and settings;
applicable laws, regulations, and standards; impact of technology; privacy and security
considerations; financing; and social-cultural factors.

CLIENT/PATIENT CHARACTERISTICS
The demographic patterns of the overall population have a direct impact on the healthcare
organization. For example, the increase in the number of older people requires more facilities
and personnel specializing in care of this group, such as continuing care, skilled nursing care,
and home care. Clinical conditions associated with aging also lead to the development of
specialty programs such as Alzheimer’s disease and memory care, cardiac and stroke
rehabilitation, and wellness programs to promote healthy aging. At the other end of the age
spectrum, attention to neonatal care, healthy growth and development, and preventive care
are points of focus. Particular attention is given to adolescents and young adults who engage
in contact sports, where concussion, permanent brain injury, fractures, and sprains are
common. In all age groups, there is a rising rate of obesity; type 2 diabetes; and addictions to
substances, such as heroin, opioids, methadone, and assorted “street drugs.”
Diseases and illnesses are, of course, an ever-present consideration. Some diseases seem
to have been conquered and eliminated through timely intervention. Some recur after long
periods of absence. Tuberculosis, polio, smallpox, and pertussis are examples of successes in
disease management and prevention. Sometimes, however, new strains may develop or
compliance with immunization mandates may decrease so that these types of communicable
diseases reappear.
Decades of use of antibacterial medicines has given rise to superbugs, resistant to the
usual treatment. Another element of concern is the appearance of an almost unknown disease
entity (e.g., Ebola or a pandemic agent). New clinical conditions may also arise within
certain age groups, necessitating fresh approaches to their care. By way of example, consider
the rise in autism and childhood obesity.
Other characteristics of the client/patient population reflect patterns of usage and the
associated costs of care. The identification of superusers—patients who have high
readmission rates and/or longer than average lengths of stay or more complications—gives
providers an insight into practices needing improvement (e.g., better discharge planning or
increased patient education). The geographic region that constitutes the general catchment
area of the facility should be analyzed to identify health conditions common to the area.
Examples include rural farm regions, with associated injuries and illnesses; heavy industry,
with work-related injuries; and winter resort areas, with injuries resulting from strenuous
outdoor activity (e.g., fractures from skiing injuries).

TRENDS RELATING TO PRACTITIONERS AND

CAREGIVERS
The trends and issues relating to practitioners and caregivers cluster around the continuing
expansion of scope of practice, with the related increase in education and credentialing. The
traditional attending physician role has given way to the inpatient physician, the hospitalist.
The one-to-one physician–patient role set continues to shift from solo practice to group
practice and team coverage. Licensed, credentialed nonphysician practitioners continue to
augment the care provided by the physician. These physician-extenders often specialize—for
example, the physical therapist in sports-related care, the occupational therapist in autism
programs, the nurse practitioner in wellness care for the frail elderly, the nurse midwife, the
nurse case manager in transition care, and the physician assistant in emergency care.
Educational requirements include advanced degrees in the designated field.
There is a related shift in the practice settings for these various practitioners. The move
away from inpatient-based care leads to an increase in independent practice. Sometimes the
franchise model is favored over self-employment. Regional and national franchises provide a
turnkey practice environment with the additional benefits of a management support division.

The Family as Caregiver

Although the provision of care by family members is a practice that long predates formal
healthcare models, these caregivers are the focus of renewed attention. As shorter stays for
inpatient care, or subacute care to reduce inpatient care, become the norm, the role of the
family caretaker intensifies. The patient care plan, with emphasis on the discharge plan,
necessarily includes instruction to family members about such elements as medication
regimen, wound care, infection prevention, and injection processes. If the patient does not
have a family member who is able to assist in these ways, or if the patient (often a frail,
elderly person) lives alone, coordination of services with a community agency or commercial
company is needed. This gives rise to related issues. Can family members be reimbursed by
insurance providers? If so, what is needed by way of documentation and billing? And there is
yet another related issue: how can employers assist workers to meet the demands of work as
well as help the family member? Practices such as flexible work hours and unpaid leave
become both desirable and necessary elements.

Changes in Management Support Services

Behind the scenes, there is the wide network of management support services within the
healthcare organization. The trend toward specialization increases within these ranks, with
new job categories being developed in response to related trends. With regard to finances and
reimbursement, chief financial officers (or similar administrators) augment their teams with
clinical reimbursement auditors, coding and billing compliance officers, physician coder-
educators, and certified medical coders. The regulatory standards manager specializes in
coordinating the many compliance factors flowing from laws, regulations, and standards. The
chief information officer augments that role with specialized teams, including nurse
informaticians, clinical information specialists, and information technology experts.

Patterns of Care
Improvements in patient care services, the utilization of advanced technologies such as
telemedicine, and the financial pressures to reduce the length of stay for inpatient care have
resulted in shorter stays, more transitional care, and (possibly) a higher readmission rate. To
offset a high readmission rate, additional attention is given to the discharge plan. The
increased use of the observation unit in the emergency department also helps reduce
admission and readmission rate. These issues and trends lead to a discussion of the healthcare
setting.

THE HEALTHCARE SETTING: FORMAL

ORGANIZATIONAL PATTERNS AND LEVELS OF CARE
Each healthcare setting has a distinct pattern of organization and offers specific levels of
care. Characteristics include ownership and sponsorship, nonprofit or for-profit corporate
status, and distinct levels of care. These elements are specified in the license to operate as
well as in the corporate charter. Ownership and sponsorship often reflect deep ties to the
immediate community. A sector of the community, such as a fraternal organization, a
religious association, or an academic institution, developed and funded the original hospital
or clinic, almost always as nonprofit because of their own nonprofit status. These
organizations purchased the land, had the buildings erected and equipped, and provided
continued supplemental funding for the enterprise. Federal, state, city, and county units of
government also own and sponsor certain facilities (e.g., facilities for veterans, state
behavioral care facilities, county residential programs for the intellectually disabled). For-
profit ownership and sponsorship include owner-investor hospital and clinic chains; long-
term care facilities; franchise operations for specialty care (e.g., eye care, rehabilitation
centers, retail clinics in drugstores and big-box retailer stores). Over the past several decades,
sponsorship by religious or fraternal organizations has diminished, with the resulting sale of
these healthcare facilities to other entities. The original name is often retained because it is a
familiar and respected designation in the community.

Provider Growth: Mergers, Joint Ventures, and Collaborative

Partnerships
Healthcare organizations periodically change or augment their service offerings, with a
resulting change in corporate structure. This restructuring may take the form of a merger, a
joint venture, or a collaborative partnership. Why do healthcare organizations seek
restructuring? The reasons are several:
• The desire to express an overall value of promoting comprehensive, readily accessible
care by shoring up smaller community-based facilities, keeping them from closure
• The need for improved efficiencies resulting from centralized administrative practices
such as financial and health information resource streamlining or public relations and
marketing intensification
• The desire and/or need to penetrate new markets to attract additional clients
• The desire and/or need to increase size so as to have greater clout in negotiations with
managed care providers who tend to bypass smaller entities
As cost-containment pressure began to grow, providers—primarily hospitals—initially
moved into mergers mostly to secure economies of scale and other operating efficiencies and
sometimes for reasons as basic as survival. The growth and expansion of managed care plans
provided further incentive to merge among hospitals, which seems to have inspired health
plan mergers in return. Each time a significant merger occurs, one side gains more leverage
in negotiating contracts. The larger the managed care plan, the greater the clout in negotiating
with hospitals and physicians and vice versa.

Clarification of Terms
The term merger is used to describe the blending of two or more corporate entities to create
one new organization with one licensure and one provider number for reimbursement
purposes. One central board of trustees or directors is created, usually with representation
from each of the merged facilities. Debts and assets are combined. For example, suppose a
university medical center buys a smaller community-based hospital. Ownership and control
is now shifted to the new organization. Sometimes the names of the original facilities are
retained as part of public relations and marketing, as when a community group or religious-
affiliated group has great loyalty and ties to the organization. Alternatively, a combined name
is used, such as Mayfair Hospital of the University Medical System.
The joint venture differs from a merger in that each organization retains its own standing
as a specific legal/corporate entity. A joint venture or affiliation is a formal agreement
between or among member facilities to officially coordinate and share one or more activities.
Ownership and control of each party remains distinct, but binding agreements, beneficial to
all parties, are developed. Shared activities typically include managed care negotiations,
group purchasing discounts, staff development and education offerings, and shared
management services. Each organization keeps its own name with the addition of some
reference to its affiliated status, as in the title: Port Martin Hospital, an affiliate of Vincent
Medical Center.
A collaborative partnership is another interorganizational arrangement. As with the joint
venture, each organization retains its own standing as a specific legal–corporate entity. The
purpose of the collaborative partnership is to draw on the mutually beneficial resources of
each party for a specific time period associated with the completion of agreed-on projects. An
example from research illustrates this point: a university’s neuroscience and psychology
departments and a hospital pediatric service combine research efforts in the area of autism. A
formal letter of agreement or mutual understanding is exchanged, outlining the essential
aspects of the cooperative arrangement.
Such restructuring efforts, especially the formal merger, are preceded by mutual due
diligence reviews in which operational, financial, and legal issues are assessed. Federal
regulations and state licensing requirements must be followed. Details of the impact of the
restructuring on operational levels are considered, with each manager providing reports;
statistics; contractual information, leases (as of equipment); and staffing arrangements,
including independent contractors and outsourced work.
In the instance of a full merger, practical considerations constitute major points of focus.
Examples include redesigning forms, merging the master patient index and record system
into one new system, merging finance and billing processes, and officially discharging and
readmitting patients when the legally binding merger has taken place.
Present-day mergers and joint ventures can have a pronounced effect on the health
professional entering a management position. Consider the example of a laboratory manager
who must now oversee a geographically divided service because a two-hospital merger
results in this person’s having responsibility in two sites that are miles apart. There is far
more to consider in managing a split department than in managing a single-site operation.
The manager’s job is made all the more difficult. Overall, however, mergers, joint ventures,
and collaborative partnerships are an opportunity for the professional-as-manager with
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 Machine Learning - Teaching Resources
Fall 2023 - Program

Prepared by: Prof. Jones

Date: August 12, 2025

Abstract 1: Research findings and conclusions

Learning Objective 1: Comparative analysis and synthesis
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Learning Objective 2: Statistical analysis and interpretation
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Learning Objective 3: Case studies and real-world applications
• Case studies and real-world applications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Learning Objective 4: Case studies and real-world applications
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Learning Objective 5: Case studies and real-world applications
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 5: Ethical considerations and implications
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Best practices and recommendations
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Interdisciplinary approaches
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Practical applications and examples
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 9: Diagram/Chart/Graph]
Practice Problem 9: Case studies and real-world applications
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Abstract 2: Comparative analysis and synthesis
Note: Problem-solving strategies and techniques
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Remember: Literature review and discussion
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 12: Practical applications and examples
• Case studies and real-world applications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 13: Diagram/Chart/Graph]
Definition: Research findings and conclusions
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Assessment criteria and rubrics
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Note: Statistical analysis and interpretation
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 16: Ethical considerations and implications
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Study tips and learning strategies
• Case studies and real-world applications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Remember: Problem-solving strategies and techniques
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 19: Diagram/Chart/Graph]
Note: Key terms and definitions
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Background 3: Experimental procedures and results
Remember: Learning outcomes and objectives
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Theoretical framework and methodology
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 22: Diagram/Chart/Graph]
Key Concept: Literature review and discussion
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 23: Diagram/Chart/Graph]
Definition: Assessment criteria and rubrics
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Study tips and learning strategies
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 25: Critical analysis and evaluation
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Key Concept: Literature review and discussion
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Research findings and conclusions
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Important: Experimental procedures and results
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Study tips and learning strategies
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Lesson 4: Experimental procedures and results
Key Concept: Current trends and future directions
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Fundamental concepts and principles
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Literature review and discussion
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 33: Best practices and recommendations
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Statistical analysis and interpretation
• Study tips and learning strategies
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Remember: Ethical considerations and implications
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 36: Diagram/Chart/Graph]
Definition: Practical applications and examples
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
[Figure 37: Diagram/Chart/Graph]
Remember: Critical analysis and evaluation
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Theoretical framework and methodology
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Note: Practical applications and examples
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 40: Diagram/Chart/Graph]
Topic 5: Theoretical framework and methodology
Practice Problem 40: Key terms and definitions
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 41: Diagram/Chart/Graph]
Example 41: Ethical considerations and implications
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Case studies and real-world applications
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Note: Research findings and conclusions
• Study tips and learning strategies
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Case studies and real-world applications
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Example 45: Experimental procedures and results
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Example 46: Study tips and learning strategies
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 47: Current trends and future directions
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Comparative analysis and synthesis
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Theoretical framework and methodology
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Unit 6: Statistical analysis and interpretation
Example 50: Comparative analysis and synthesis
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Statistical analysis and interpretation
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Example 52: Study tips and learning strategies
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 53: Literature review and discussion
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Note: Historical development and evolution
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 55: Problem-solving strategies and techniques
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Learning outcomes and objectives
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Definition: Fundamental concepts and principles
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 58: Diagram/Chart/Graph]
Important: Experimental procedures and results
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 59: Historical development and evolution
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Discussion 7: Practical applications and examples
Remember: Historical development and evolution
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 61: Problem-solving strategies and techniques
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Learning outcomes and objectives
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Interdisciplinary approaches
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Critical analysis and evaluation
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 65: Literature review and discussion
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 66: Diagram/Chart/Graph]
Remember: Key terms and definitions
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 67: Assessment criteria and rubrics
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Statistical analysis and interpretation
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Research findings and conclusions
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
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