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Clinical Corner

Part 7: Thoughts on Budgeting
June 19, 2008 11:40 AM by Carol Kleinman
The operations budget, while based in part on expenses, is also based on revenue projections. Clearly we would not knowingly budget to spend more than we expect to earn from a product or service and so we budget accordingly. In general, we do not expect Read More...
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Part 6: Management Tip - Staff Buy In
June 5, 2008 4:24 PM by Carol Kleinman
One of the things I had ongoing on all my units was a wish list in the staff lounges on which anyone could put a request for something they wished to have purchased. I always did my best, at every administrative level, to acquire as much as I could of Read More...
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Part 3: Fiscal reality and length of stay
April 18, 2008 12:07 PM by Carol Kleinman
As I reflect upon the massive changes in health care in the last couple of decades, one of the most profound relates to our focus on length of stay and the ever-present need to reduce hospitals stays until they are so short I wonder sometimes how patients Read More...
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Part 2: Prospective Payment Systems: An Historical View
April 14, 2008 12:58 PM by Carol Kleinman
What happens with Prospective Payment Systems (PPS) is that we are paid a flat rate for each Diagnostic Related Group (DRG), rates that were determined after extensive research into the cost of treatment for specific diagnoses. What the PPS system did Read More...
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Part 1: Sharing Financial Information with Staff
April 14, 2008 12:53 PM by Carol Kleinman
One of my pet issues relates to the level of knowledge of nurse managers and administrators about financial operations. I even believe strongly in the importance of beginning to educate staff nurses in the fiscal realities of health care operations! I Read More...
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Noncompliance
March 7, 2008 3:09 PM by Carol Kleinman
Few situations challenge and frustrate us as the need to deal with residents who are noncompliant with treatment protocols. In a world in which health care dollars are increasingly scarce, we must carefully allocate the resources we have to those who Read More...
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Change, Part 5
February 28, 2008 12:34 PM by Carol Kleinman
Parable: Millions of years ago people lived in extended families—often with their farm animals—in houses made of wood and thatch. One day, one of these houses caught fire and burned down. A pig was inside and burned along with the house, which was reduced Read More...
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Change, Part 4
February 19, 2008 2:25 PM by Carol Kleinman
I thought I would share an online article by Rosabeth Kanter called "The Enduring Skills of Change Leaders." The abstract in the Harvard Business Review states, “Leaders use seven leadership skills in conceiving and managing change projects, whether innovations Read More...
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Change, Part 3
February 8, 2008 10:32 AM by Carol Kleinman
Change is ever-present in our lives, both personal and professional. There are many theories of change and in an earlier posting I suggested a website that presents many such theories. One that I like very much was developed by Rosabeth Kanter, called Read More...
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Change, Part 2
January 29, 2008 4:10 PM by Carol Kleinman
The nature of organizations is that success in one area inevitably produces problems in another. Organizations, whatever their specific purpose, facilitate the production of problems and dilemmas; therefore there is always a need for change and change Read More...
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Change, Part 1
January 22, 2008 10:38 AM by Carol Kleinman
In adopting change, often the primary goal is increased revenue or significant cost savings, a first order effect. Revenue generated or savings realized create resources that can be used in other areas, a second order effect that also influences the decision Read More...
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Time to Change
January 3, 2008 11:46 AM by Carol Kleinman
Some older models of change suggest that current practices be eliminated and new processes and systems be designed from scratch. In reality, few organizations have the luxury of redesigning their processes or organizations from the ground up as people, Read More...
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Holiday Tips for LTC Residents
December 20, 2007 2:21 PM by Carol Kleinman
When we think of the holiday season, we think of parties, music, and happy family get-togethers. However, the hustle and bustle of the holiday season does not always fill people with Christmas spirit. This is the time of year where many people suffer Read More...
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Leadership Development in Long-Term Care
December 6, 2007 5:56 PM by Carol Kleinman
The long term care industry reflects the rapid changes experienced by the entire healthcare industry. A new generation of nurse leaders is desperately needed, leaders who are able to respond as we are being asked to become more cost-conscious and understand Read More...
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Nurse Leaders
November 12, 2007 3:29 PM by Carol Kleinman
An organization is only as strong as its leadership and in long-term care facilities all registered nurses are leaders. Some are directors or assistant directors of nursing, others are nurse managers and supervisors, some lead a team providing daily care Read More...
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