Draft Syllabus for Undergraduate Course Fall 2014
Managing innovation in Health Care
Professors Kovner and Sendach
This is a 14 week course for undergraduates aimed at students intending to work
as clinicians or as managers in the health care industry. There are no prerequisites.
Learning Objectives:
 Understand how health care organizations operate, the contexts they face.
 Understand the opportunities and constraints facing those who wish to
innovate in health care organizations.
 Understand how healthcare organizations are governed and managed.
 Examine successful innovations implemented in healthcare organizations.
 Understand how to motivate workforce in healthcare organizations
 Improve writing, presenting, and listening skills
Course Texts and Required and Recommended Readings:
Required:
 Kovner and Knickman, Health Care Delivery in the United States, 10th
edition
 McAlearney and Kovner Health Services Management: Cases, Readings and
Commentary
 Christensen, The Innovator’s Prescription
Recommended:
 Kenney C, 2010, Transforming Health Care: Virginia Mason Medical
Center’s Pursuit of the Perfect Patient Experience. New York: Taylor and
Francis
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 Berry and Saltman, 2008. Management Lessons from Mayo Clinic. New
York: McGraw Hill
 Studer, Q, 2003. Hardwiring Excellence, Gulf Breeze FL, Firestarter Press.
All assigned readings that are not included in the required textbooks will be
posted on NYU Classes.
Course Sessions
1
Course Expectations, Impact of ACA and Evidence-Based Management
Disruption in Health Care: Impact of ACA
Move toward more scientific management
What does “innovation” mean”?
What “better outcomes are we talking about?”
Readings: The Current USA health system (K & K)
What is Evidence-Based Management? (Rousseau)
Effects of Change Interventions (Barends et al)
2
How Organizations Measure Performance.
Cost, quality and patient behavior metrics
How do HCOs measure managerial performance?
How does North Shore measure performance?
Readings: Cost, Quality and Health Behavior (K&K)
2
Financial Reporting to the Board (Kovner)
How Intermountain Trimmed health Care Costs and Improved Quality
James and Savitz)
3
Constraints to Producing Better Outcomes
What are key external factors influencing HCO performance?
How do managers adapt to external pressures?
What incentives affect managerial performance?
Readings:
Griffith on Frontiers of Hospital Management (M&K)
Millenson, 2013. The Long Wait for Medical Excellence (Health Affairs 17571760)
4
Governance and Management of HCOs.
Hospitals
Physician organizations
Suppliers
Readings:
Kovner, Governance and Managers of HCOs, in (K & K)
Case: Sparks Medical Center and the Board (M & K)
3
5
Disrupting the Hospital Model
How hospitals are currently organized
Problems and issues
Readings:
Christensen, Hospitals Chapter (C)
Case: Hand-offs in the ED (M & K)
NSHS organizational chart
6
Disrupting the Business Model of Physician Practice
How Physician Practice is Currently Organized
Problems and Issues
Readings:
Christensen chapter (C)
Case: Implementing an Accountable Care Organization (M & K)
7
Disrupting Solutions for the Care of Chronic Disease
How is chronic care currently organizaed.
Problems and Issues
Examining community benefit
The challenge of obesity solutions
Readings:
4
Christensen chapter (C)
Case: Examining the North Shore Community Benefit Plan
Case: How is obesity managed at NSHS
8
A Physician and a Nurse (Guest speakers) discuss their work
Education of doctors and nurses
Impact of education on Managing innovation in HCOs
e.g. Physician management of ambulatory care
e.g. Nurse management of inpatient care units
Readings:
Workforce chapter (K & K)
9
Class presentations
(see Class Assignments)
10
Class Presentations
(see Class Assignments)
11
Innovative Solutions
Virginia Mason: Ambulatory Care Breakthrough
Intermountain: Lowering Pre-elective surgery rates before 39 weeks
North Shore : Forming an Insurance Company
5
Readings:
Kenney, Ambulatory Care Chapter pp 69-92
Intermountain
North Shore
12
Two Managers (not in inpatient hospital care) discuss their work
What do managers do?
Work relationships between managers and clinicians
Readings:
Interview with Patrick Charnin (M & K)
Tucker and Edmonson, Why Hospitals Don’t Learn from Failures (M & K)
Case Study: Kovner: Where the Rubber Hits the Road (M& K)
13
Managing Your Career
200 different health occupations
How choose between them?
How get to Square One and Beyond
Clinicians as Managers and Clinician Managers
Readings:
Readings: 101 Careers in Health Care Management (Friedman and Kovner).
6
14
Motivating the Work Force
Managing Up and Down
Getting the Elusive Buy-In
Culture Change in HCOs
Readings:
Case Study: Taking Care of your nurses. (M & K)
Case Study: Buy-in for the Patient Care Medical Home model? (M & K)
Case Study: Staff support and buy-in for a new lift system? (M & K)
Assignments
Assignment 1 HCO Performance paper (due week 4)
Select an HCO which you would like to work in or about which you would like to
learn more about. See what you can learn from their web site about
organizational performance. Interview a manager, a clinician or a human
resources manager. How does their HCO perform on metrics of cost, quality and
service? How does the interviewee(s) say that people achieve these metrics? How
does the organization set these metrics? How does top management review unit
performance?
3-5 double-spaced pages in 12 point font. Please cite sources as appropriate. An
appendix may be included but is not required.
Note: If you need assistance in contacting a specific organization, contact one of
us, and we shall try and assist you making contact.
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Presentation (due week 7 or week 8)
The class will be divided into teams. Six teams will present during weeks 7 and 8.
Presentations will be limited to 10 minutes each. Hand out to the class a one page
summary of what you are going to say. The topic is either about HCO
performance or managing innovation in an HCO. Discuss the current situation,
problems or opportunities to improve performance or manage innovation, and
explain the rationale behind your conclusions. The presentations will be graded
by the class, and these ratings considered by the professor before grading each
team’s presentation. All members of the presenting team get the same grade. The
professor will return a written evaluation and grade to each team presenting. The
audience evaluations will also be graded and comprise part of the class
participation grade.
#2 Managing Innovation Paper (due week 12)
Select a health care organization (this can be the same organization that you
selected in assignment #1). Interview a manager, clinician of human resources
manager. Interview at least one different (a second) manager for assignment #2.
What encourages the interviewee(s) to innovate to improve unit performance? Is
there any innovation the interviewee(s) would like to see made now? What has
he or she done to try and get the innovation accomplished? If nothing, how could
he or she push to get the innovation implemented now? What are some
innovations that could be considered (e.g. to contain costs, improve quality, or
improve access?)
3-5 double-spaced pages in 12 point font. Please cite sources as appropriate. An
appendix may be included but is not required.
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Class Participation
Class participation is an important part of the course. You will be asked to submit
a resume at the beginning of the course and to share with the professor during
the last class what you have learned in taking this course. Students will also be
evaluated on attendance, engagement in the classroom, and on constructive
contributions to class discussion. Students will receive a mid-year grade on class
participation when they receive the presentation evaluation during weeks 8 and
9.
Grading
25% Assignment 1
Due Week 4
25% Presentations
Week 7 and Week 8
25% Assignment 2
Week 12
25% Class Presentation Throughout (Includes resume)
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