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Several trends converge around the teaching of entry level managers for healthcare provider organizations (HCOs):

1. Competencies: Most of the accrediting agencies for professional degrees have moved to “competencies”. CAHME is included. “Competency” is defined as:

   Effective application of available knowledge, skills, attitudes and values (KSAV’s) in complex situations. The essential knowledge, skills, and other attributes (KSO’s) that are essential for performing a specific task or job. (CAHME Self Study Handbook, http://www.cahme.org/)

   Key words in this definition are “skills,” “application,” and “performing”. They rule out knowledge alone. Our students must be trained to act.

2. The move from “volume” to “value” in health insurance incentives: Tomorrow’s HCOs will be pushed to higher performance in their traditional jobs—births, trauma, surgery, strokes, etc.—and to expand their role in chronic disease management. The immediate implications require revised HCO operations, improved effectiveness and a substantial shift in the relationship with caregivers.
3. The rapid development of interactive learning: The “flipped classroom” eliminates lectures and substitutes active participation learning, particularly with teams. It is rapidly becoming a student expectation; the traditional lecture format may become unsaleable.
4. The emergence of evidence-based management: well-documented successful models for HCO operation. There is a growing list of implementations. Among the most rigorous are the descriptions filed by winners of the Baldrige Award in healthcare. They suggest that continued high performance requires a comprehensive structure addressing strategy, leadership, and culture as well as carefully designed programs for managing patient relations, information technology, human resources, and clinical activities. (See “Documenting Evidence-Based Management,” below.)

The bottom line is that what we did in 2012 is no longer good enough. Text books, reading assignments, and lectures don’t make it. We need an expanded set of tools to support a new approach. Let’s collaborate to build one. My colleagues, Ken White at UVA and Christy Lemak at UAB and I will start the effort. With substantial assistance from our publisher, ACHE, we have created a Learning Suite accessible by most learning management systems. Version 1.0 is organized around the text, The Well-Managed Healthcare Organization, 8^th edition, but it’s open to all faculty. The text provides a convenient set of categories around which to organize information. (See Topics for Training HCO Managers, below.) We want to offer tools to improve the creation of healthcare managers.

Documenting Evidence-Based Management

Baldrige Excellence Framework, 2015-2016, Baldrige Performance Excellence Program, National Institute of Standards and Technology (NIST) • United States Department of Commerce

 Charlier SD, Brown KG, Rynes SL. Teaching evidence-based management in MBA programs: what evidence is there? Acad Manag Learn Educ. 2011;10(2):222-236. doi:10.5465/AMLE.2011.62798931.

 Khurana, R. (2010) From Higher Aims to Hired Hands: The Social Transformation of American Business Schools and the Unfulfilled Promise of Management as a Profession, Cited 367 times.

 Kovner, Anthony R . Fine, David J. DR, ed. Evidence-Based Management in Healthcare. Chicago: Health Administration Press; 2009.

 Rousseau DM. Envisioning Evidence-Based Management. Carnegie Mellon Univ. 2013:19-85. doi:10.1093/oxfordhb/9780199763986.013.0001.

 Smith, M, R. Saunders, L. Stuckhardt, J. Michael McGinnis, Editors; 2013 Best Care at Lower Cost: The Path to Continuously Learning Health Care in America Committee on the Learning Health Care System in America; Institute of Medicine

 Walshe K, Rundall TG. Evidence-based management: from theory to practice in health care. Milbank Q. 2001;79(3):429-457, IV - V. doi:10.1111/1468-0009.00214.

White, K.R., Lemak, C.H., Griffith, J.R. Improving Healthcare Management Education Using Principles from Baldrige and Evidence-Based Management The Journal of Health Administration Education Vol. 28, Issue 3. Date: 07/01/2011

Topics for Training Managers

Two sets of questions—300 for automated student use in learning management systems and 75 for classroom or team discussion—are designed to reflect real issues for managing HCOs and to show “best practice” solutions drawn from Baldrige winners’ applications and other published sources. They are organized around the major processes of HCOs:

1. Stakeholder relations, mission, and values
2. Transformational culture
3. Continuous Improvement
4. Governance
5. Foundations of Clinical Excellence
6. Physician and Licensed Practitioner Organization
7. Nursing
8. Clinical Support Services
9. Community Health
10. Knowledge Management Systems
11. Human Resources Management
12. Environment of Care
13. Finance
14. Internal Consulting
15. Marketing and Strategy