Health care is a business and, like every business, it needs good management to keep it running smoothly. Medical and health services managers, also referred to as health care executives or health care administrators, plan, direct, coordinate, and supervise the delivery of health care. These workers are either specialists in charge of a specific clinical department or generalists who manage an entire facility or system.
The structure and financing of health care are changing rapidly. Future medical and health services managers must be prepared to deal with the integration of health care delivery systems, technological innovations, an increasingly complex regulatory environment, restructuring of work, and an increased focus on preventive care. They will be called on to improve efficiency in health care facilities and the quality of the care provided.
Large facilities usually have several assistant administrators who aid the top administrator and handle daily decisions. Assistant administrators direct activities in clinical areas such as nursing, surgery, therapy, medical records, or health information.
In smaller facilities, top administrators handle more of the details of daily operations. For example, many nursing home administrators manage personnel, finances, facility operations, and admissions while also providing resident care.
Clinical managers have training or experience in a specific clinical area and, accordingly, have more specific responsibilities than do generalists. For example, directors of physical therapy are experienced physical therapists, and most health information and medical record administrators have a bachelor's degree in health information or medical record administration. Clinical managers establish and implement policies, objectives, and procedures for their departments; evaluate personnel and work quality; develop reports and budgets; and coordinate activities with other managers.
Health information managers are responsible for the maintenance and security of all patient records. Recent regulations enacted by the Federal Government require that all health care providers maintain electronic patient records and that these records be secure. As a result, health information managers must keep up with current computer and software technology and with legislative requirements. In addition, as patient data become more frequently used for quality management and in medical research, health information managers ensure that databases are complete, accurate, and available only to authorized personnel.
In group medical practices, managers work closely with physicians. Whereas an office manager might handle business affairs in small medical groups, leaving policy decisions to the physicians themselves, larger groups usually employ a full-time administrator to help formulate business strategies and coordinate day-to-day business.
A small group of 10 to 15 physicians might employ 1 administrator to oversee personnel matters, billing and collection, budgeting, planning, equipment outlays, and patient flow. A large practice of 40 to 50 physicians might have a chief administrator and several assistants, each responsible for different areas.
Medical and health services managers in managed care settings perform functions similar to those of their counterparts in large group practices, except that they could have larger staffs to manage. In addition, they might do more community outreach and preventive care than do managers of a group practice.
Some medical and health services managers oversee the activities of a number of facilities in health systems. Such systems might contain both inpatient and outpatient facilities and offer a wide range of patient services.
Work environment. Some managers work in comfortable, private offices; others share space with other staff. Most medical and health services managers work long hours. Nursing care facilities and hospitals operate around the clock; administrators and managers be called at all hours to deal with problems. They also travel to attend meetings or inspect satellite facilities.
| 1. | Direct, supervise and evaluate work activities of medical, nursing, technical, clerical, service, maintenance, and other personnel. |
| 2. | Establish objectives and evaluative or operational criteria for units they manage. |
| 3. | Direct or conduct recruitment, hiring and training of personnel. |
| 4. | Develop and maintain computerized record management systems to store and process data such as personnel activities and information, and to produce reports. |
| 5. | Develop and implement organizational policies and procedures for the facility or medical unit. |
| 6. | Conduct and administer fiscal operations, including accounting, planning budgets, authorizing expenditures, establishing rates for services, and coordinating financial reporting. |
| 7. | Establish work schedules and assignments for staff, according to workload, space and equipment availability. |
| 8. | Maintain communication between governing boards, medical staff, and department heads by attending board meetings and coordinating interdepartmental functioning. |
| 9. | Monitor the use of diagnostic services, inpatient beds, facilities, and staff to ensure effective use of resources and assess the need for additional staff, equipment, and services. |
| 10. | Maintain awareness of advances in medicine, computerized diagnostic and treatment equipment, data processing technology, government regulations, health insurance changes, and financing options. |
| 11. | Manage change in integrated health care delivery systems, such as work restructuring, technological innovations, and shifts in the focus of care. |
| 12. | Prepare activity reports to inform management of the status and implementation plans of programs, services, and quality initiatives. |
| 13. | Plan, implement and administer programs and services in a health care or medical facility, including personnel administration, training, and coordination of medical, nursing and physical plant staff. |
| 14. | Consult with medical, business, and community groups to discuss service problems, respond to community needs, enhance public relations, coordinate activities and plans, and promote health programs. |
| 15. | Inspect facilities and recommend building or equipment modifications to ensure emergency readiness and compliance to access, safety, and sanitation regulations. |
| 16. | Review and analyze facility activities and data to aid planning and cash and risk management and to improve service utilization. |
| 17. | Develop or expand and implement medical programs or health services that promote research, rehabilitation, and community health. |
| 18. | Develop instructional materials and conduct in-service and community-based educational programs. |
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