Ensayo escrito: Investigacion de enfermería basada en la evidencia

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As a manager of  Health Information Services, you must be able to organize your time in a fashion that reflects priorities, deadlines, and reasonable expectations. To-do lists, calendars, and delegation can help you organize time appropriately and effectively.

Objectives

Upon completion of this activity, you should demonstrate skill in

1. Managing time effectively in a given situation.
2. Prioritizing tasks in a logical manner.
3. Delegating tasks as appropriate.

Instructions

1. Read “Director Jones’ Monday Morning,” the case study below.  (Source:  AOE Case Study Manual, 1998)
2. Determine the priorityof each of the 10 items listed at the end. Decide on priority #1, #2, or #3. Write your answers in Microsoft Word and submit to the drop box as explained below.
   • #1 – the task should be handled immediately
   • #2 – the task should be delegated
   • #3 – the task can be resolved/scheduled for a later dat

1. For each item, list the action you will take and the rationale for the action.

Director Jones’ Monday Morning
Time Management Case Study

Introduction

For purposes of this case study, assume that you are J. R. Jones, the Director of the Health Information Department at University Hospital. The items that you face Monday morning must be prioritized (#1 – the task should be handled immediately; #2 – the task should be delegated or #3 – the task can be resolved/scheduled for a later date).  After prioritizing, you should decide how each task should be handled.

In a Word document, indicate the following:

• the priority of each of the 10 items (#1, #2, or #3)
• the action you will take for each item
• the rationale for the action

Your responsibilities

You are the Director of the Health Information Department at University Hospital.  You have been in this position for approximately six months. This is your first director position. You report to Carol Johnson, chief financial officer.

You have 42 employees in your department:

• One department administrative assistant—Susan Sweeney
• Two assistant directors—Carolyn Brown, RHIA and John Smith, RHIT
• Four supervisors—Mary Green, RHIT; Joan Wilson, RHIA, CCS; William Bass, RHIT; and Fern Bailey, RHIT
• Four coders
• Ten transcriptionists
• Five file clerks
• Six senior health information technicians
• Three abstractors
• Three release of information specialists
• One special project coordinator—Fran Dixon, RHIA
• One quality management coordinator—Jim Black, RHIA
• Two quality management assistants

As Director, you serve on the Health Information Committee and record minutes of their meetings. You coordinate committee meetings by sending out meeting notices, arranging refreshments, providing the records for review, and developing the agenda in conjunction with the committee chairman.

As Director, you also serve on the Quality Improvement Committee for the hospital, as does the quality management coordinator, Jim Black.  It is Mr. Black’s responsibility to record minutes at this meeting, prepare records for review and make meeting arrangements. 

Finally, you are a member of the hospital’s Computerization Task Force. 

Your other professional commitments are as follows: 

1. Vice-President of the advisory committee of the local HIA program,
2. Member of the board of directors of your state health information management association
3. Newsletter chairman for the regional professional association.

On this particular Monday, the Quality Improvement Committee meets at noon.  Lunch will be served during the meeting.  You also have an HIA Program Advisory Committee Meeting scheduled at 5:00 p.m. at the University.  You have not yet prepared a presentation that you will make to the Advisory Committee on a report from the subcommittee on curriculum, of which you are Chair.  This is also the first day of management affiliation for a student from out of state who will be spending six weeks in your department.

You will be out of the office for the next two days at a JCAHO seminar in another city.  Your flight leaves this evening at 8:30 p.m.

What happens Monday morning

On the way to work this Monday morning, you stop at the local printer’s office to pick up the draft of the regional association’s newsletter, which must go out tomorrow. It must be proofread and returned to the printer for any corrections and copying some time today. 

Upon leaving the printer’s office, you discover that your car is no longer where you parked it.  You had apparently parked in an illegal parking spot, and your car has been towed away.  When you call the local Police Department to find out where your car is, you are told that you can retrieve it from the auto storage facility for $50.00.  You call your administrative assistant, and then you call a taxi to retrieve your car.  You arrive at work at 9:45 am, rather than your usual starting time of 8:00 am. 

You begin to go through the notes and phone messages on your desk. In addition, while you are trying to do your work, people come in an interrupt you. Following is the list of 10 action items—both from messages and from people coming into your office. You need to find the time to take care of all 10 items. According to the instructions above, identify the priority, the action, and the rationale for each item.

Time for Ten?

1. A telephone message from Ms. Johnson regarding the proposed plan for the new file space that you have requested.  Ms. Johnson wants to know what the impact on the department will be if the Health Information Department gets only 1800 square feet of additional file room space instead of the 2000 square feet requested.  She needs an answer by tomorrow.
2. Carolyn Brown, your Assistant Director, has stopped by and left a note to tell you that the management affiliation student arrived at 8:30 as scheduled and is waiting in her office.  She has not been able to find the schedule that was prepared for the student’s first week.
3. A second telephone message tells you that Jim Black, the Quality Management Coordinator, will not be in today because he has strep throat.  The records are ready for review by the committee today, but he will not be able to present the final report on the study from last month.  The report is on Mr. Black’s desk.  Mr. Black cannot be reached since he has a doctor’s appointment this morning.
4. A third telephone message is from Mary Green.  She will be late today because she has an emergency dental appointment.  Her tooth abscessed last night.  She hopes to be here by noon.
5. Susan Sweeney, your assistant, has left a message which she has marked “URGENT.”  Ms. Rosemary Mays, the Director of Nursing, called at 8:20 am and left a message regarding a possible breach of confidentiality on one of her employees, a nursing supervisor, who was recently a patient.  It seems that one of the Health Information Department employees left part of the nurse’s record in the copy machine overnight and one of the other nurses, who entered the Health Information Department to retrieve a record, found it.  She discussed the record with some of the other nurses.  Ms. Mays was extremely upset and wants to talk to you as soon as possible.
6. The fourth phone call message is from Ann Shoemaker, a friend of yours whose husband is a patient in the hospital.  Ann knows that you are the director of the Health Information Department and that you have access to the medical records in the facility.  Her husband has an alcohol problem and she wants to know if he can find out if the attending physician has mentioned it in the record.  She is afraid the hospitalization will not be covered by insurance if it is documented that her husband is an alcoholic.  She has explained this to Susan Sweeney. She would like you to call her as soon as you get in.
7. At 10:15 am, Joan Wilson, the Coding Supervisor, stops by and asks if you have a minute to talk to her.  You stop what you are doing and ask her what the problem is.  She says that she cannot stand the pressure put on her regarding accounts receivable.  She knows that there is $2 million presently outstanding for the hospital, but it is not all the fault of coders.  She says they absolutely must have more help in order to get the coding backlog caught up.  She indicates that she has been thinking about looking for a job where there is less stress.
8. You find a memo from the assistant director, Carolyn Brown, indicating that there is a problem with supplies in the department.  They have been disappearing, and she suspects that some of the people on second shift are taking them home. How should this be handled?
9. It is now 11:30 am.  Fern Bailey, supervisor of the incomplete area, mentions to you as you walk through the department that one of her techs has come back late from break AGAIN and Ms. Bailey is nearly ready to terminate her. The employee has already received a verbal and written warning concerning this chronic problem.  The tech is the niece of the hospital CEO.
10. It is 11:45 am. You have closed the door to your office so that you can work on your presentation for the 5:00 pm Advisory Committee meeting. Soon there is a knock on the door.  It is Susan Sweeney, who tells you that one of the cardiac doctors is demanding to see you.  He is saying that after dictating a discharge summary, which he says took an hour, he discovered that he had already dictated it last week. He claims that the list of delinquent records indicated that he still needed to dictate the particular discharge summary, when it turned out to have been dictated before. He is angry and wants to discuss this problem immediately.