Use of bar coding technology to flag ER patients on metformin-containing drugs.

Sixty percent of Jennie Edmundson Hospital's inpatients are admitted through the emergency room. Type II diabetes accounts for 90-95% of all diagnosed cases of diabetes. There were about 1.6 million new cases of diabetes diagnosed in people 20 years or older in 2007. Consequently, we should expect to see an increase in Americans on metformin-containing drugs in the future. Jennie Edmundson Hospital's goal was to develop a hardwired process to identify patients on the medication metformin and who had a CT scan with contrast in the ER and were then admitted as an inpatient.

Computer assistance in the structured, behavioral based interview process.

*It is estimated that it costs a facility at least 150% of a person's base salary to replace a vacated position. *The most effective way for facilities to guard against hiring employees with counterproductive behavior is the systematic measurement of those personality characteristics during the assessment process. *Since the introduction of computer based assistance in the structured, behavioral interview process, Jennie Edmundson Memorial Hospital (JEMH) in Council Bluffs, Iowa has seen a reduction in turnover of 6.5%.

Managing change within the healthcare environment.

In the healthcare environment, there are many catalysts for change, including federal and state regulations, increased utilization, patients' expectations, competition, declining reimbursement and the technologist shortage. Regardless of what organization you work in, change creates pressure internally. This is especially true of organizations that have not had to deal with much change. The three most common responses are: 1) senior managers tend to isolate themselves from the effects of change on staff members; 2) middle managers tend to feel squeezed between the need to implement change and the need to support staff members; and 3) employees tend to feel attacked and betrayed by change. The following five steps will help you work with your staff as you introduce and implement change: prepare your employees, plan thoroughly, develop a transitional line of authority, stay flexible during implementation, and encourage self-management, acknowledging those who helped make the change work. When change is implemented, it is important to understand that people will move through four stages of reaction: denial, resistance, exploration and commitment. As a general rule, individuals will go through all four stages, but the speed at which they move through them will be different. Managers need to assist employees who get stuck in certain stages. To implement change as successfully as possible, follow these four steps: communicate about change, deal with resistance, increase team involvement, and use visionary leadership.

Conflict resolution in healthcare management.

Conflict causes decided tension in the workplace and often produces poor professional outcomes. A manager dealing with conflict can experience a crisis of confidence and often ends up second-guessing himself or herself, regardless of how a situation has been handled. In some organizations, conflict is not viewed positively or as an opportunity for improvement. In these organizations, most individuals will see conflict as being unproductive, unpleasant, and a waste of time and energy. Yet, conflict provides employees with critical feedback on how things are going. When viewed in a positive context, even personality conflicts may provide information to the healthcare manager about what is not working in the organization. If conflict is not directed and controlled, it can have damaging effects in the workplace, stifling the growth of departments and deflating employee morale. Our job as healthcare managers is to deal with conflict so that it does not decrease productivity or detract from the provision of patient-centered care. There are 4 general sources for interpersonal conflict: personal differences, informational deficiency, role incompatibility, and environmental stress. There are 5 common responses used in dealing with conflict: forcing, accommodating, avoiding, compromising, and collaborating. Healthcare managers should become comfortable with using all of these approaches.