Chapter 7

Healthcare Organizations

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Objectives

Identify and compare characteristics that are used to differentiate healthcare organizations.

Classify healthcare organizations by major types.

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Objectives (Cont.)

Analyze economic, social, and demographic forces that drive the development of healthcare organizations.

Describe the impact of the evolution of healthcare organizations on nursing leadership and management roles.

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Characteristics and Types of Organizations

Institutional providers Types of services Length of direct care services Teaching status Accreditation Ownership

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Not-for-Profit vs. For-Profit Healthcare Organizations

How does ownership impact healthcare organizations?

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Not-for-Profit Healthcare Organizations

Controlled by voluntary boards or trustees Provide care to a mix of paying and

nonpaying patients Excess revenue over expenses is redirected

into the organization for maintenance and growth.

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For-Profit Healthcare Organizations

Operate with the specific intent of earning a profit by providing healthcare services to individuals who can afford to pay

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Characteristics and Types of Organizations (Cont.)

Accountable Care Organizations Consolidated systems and networks

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Characteristics and Types of Organizations (Cont.)

Other organizations Community services Subacute facilities Home health Long-term care and residential facilities Hospice Nurse-owned and nurse-organized services Self-help voluntary organizations

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Characteristics and Types of Organizations (Cont.)

Supportive and ancillary organizations Regulatory agencies Accrediting bodies Third-party financing organizations Pharmaceutical and medical equipment Professional, educational, and training

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Characteristics and Types of Organizations (Cont.)

Organizational relationships Integration Acquisitions and mergers

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Forces That Drive Organizations

Economic Social Demographic

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Theoretical Perspective

Systems theory Structure Technology People Environment

Chaos theory Universe filled with unpredictable and random

events

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Economic Forces Influencing Health Care

Increasing numbers of uninsured patients Decreasing reimbursement Regionalization Focus on pay for performance

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Social Factors Influencing Health Care

Focus of society that is changing from illness to health (wellness)

Increasing demand by individuals that they participate in designing their own customized care plans

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Demographic Factors Influencing Health Care

Increasing percentage of society that is composed of elderly individuals

Increasing percentage of uninsured Inability of communities to provide access to

needed health services

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The Spectrum of Health Care

Primary Care Purpose

• Early detection and prevention of disease • Maintenance of health and wellness• Management of common health problems and chronic

illnesses Examples of Organizations

• Healthcare provider practices• Community and neighborhood clinics• School and occupational health offices

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The Spectrum of Health Care (Cont.)

Secondary (Acute) Care Purpose

• Diagnosis and treatment of disease and injury Examples of Organizations

• Acute care hospitals• Long-term care facilities

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The Spectrum of Health Care (Cont.)

Tertiary Care Purpose

• Diagnosis and treatment of complex disease and injury Examples of Organizations

• Acute care hospitals with specialty units such as coronary care or transplant units

• Specialty hospitals such as psychiatric facilities

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The Spectrum of Health Care (Cont.) Respite Care

Purpose: To provide caregivers of chronic care patients a short-term period of relief

Restorative Care Purpose: To provide routine follow-up for acute

conditions (e.g., nursing home care), or for conditions such as drug rehabilitation (e.g. half-way house)

Continuing Care Purpose: To provide ongoing care for those who

need assistance with activities of daily living (e.g., geriatric care centers)

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Understanding the type of healthcare organization in which you practice helps you understand the populations served, the availabilities of healthcare providers, the concerns of owners or taxpayers, and how forces are likely to change the organization in the future.

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