ACHE
A Reflection of Ethnic Group Achievements Within the ACHE Structure
The American College of Healthcare Executives (ACHE) has prided itself on its forward-thinking nature as well its strong commitment to tolerance, acceptance, and diversity. Diversity is an especially strong priority within the ACHE and refers not only to ensuring that ethnic minorities are given a fair opportunity to achieve and succeed in the job market, but also to ensuring that representatives with differing but ultimately complimenting skill sets are employed as well.
Diversity, or rather the conspicuous absence of it, has been an issue that has plagued the healthcare system for some time now, and this woeful state of affairs was brought to the light of day by means of a study conducted in 2008 which sought to determine the number of ethnic groups actually in a healthcare executive post.
The study identified that it was whites who predominantly held the upper ranks, although this discrepancy was explained with the rationalization that this was due to ethnic members possessing lower rates of years of service within the relevant sectors. On a more positive note was the identification that there was little discrepancy among both white and minority females in terms of the proportion that held CEO posts.
This would further support the argument cited earlier that the lower rates of ethnic minority males being promoted and holding higher positions is due to lack of experience as opposed to something more sinister at play.
The figures for upper-level positions for women also unearthed interesting developments. Hispanic women enjoyed the highest proportion, clocking in at 37%, with white women actually trailing behind at 31%. Furthermore, when it came to general management roles, again Hispanic women enjoyed a stronger dominance in these roles than other ethnic groups.
http://www.ache.org/PUBS/research/Report_Tables.pdf
An Article for ACHE Members, Both Actual and Potential
The ACHE (American College of Healthcare Executives) Code of Ethics is utilized in precisely the same manner as the code of ethics of any other professional body in that it is designed to lay down a series of rules and regulations by which the reputation, professionalism, and good name of the organization as a whole can be better protected, served, and enhanced as the case may be. The code of ethics helps guide the ultimate decisions of the healthcare executives, providing them with a focal point of reference to which they can rely upon in all times of doubt, difficulty, and moral ambiguity. A healthcare executive will have to make tough, emotionally draining decisions and there will be times when such choices may run counter to the personal feelings or politics of the healthcare executive in question.
The ACHE Code of Ethics is broken down into a number of different niches and subcategories, all of which seek to address specific issues that may arise during the commission and performance of the health care executive’s duties and functions. The Code imposes obligations upon the healthcare executive to be responsible for their own actions and decisions as the following excerpt shows:
“Disclose to the appropriate authority any direct or indirect financial or personal interests that pose potential or actual conflicts of interest.”
The Code also imposes a further duty upon the executive and that is to ensure that they supervise the actions and conduct of their subordinates in order to promote accountability and personal responsibility for their decisions:
“A member of the College who has reasonable grounds to believe that another member has violated this Code has a duty to communicate such facts to the Ethics Committee.”
The code is intended to be more than just a checklist for proper procedure, but also to promote the fundamental rights of the patients under their care:
“Work to ensure that all people have reasonable access to healthcare services.”
http://ethics.iit.edu/indexOfCodes-2.php?key=13_375_1321
Hospital of the Future: The Staffing Challenge
In 2006, a roundtable of healthcare experts convened to examine the many critical issues facing hospitals today. Among these issues are the growing elderly population, greater demand for emergency care, increased numbers of those suffering from chronic conditions, increased costs, and the need for access to care.
The roundtable’s goal was to examine current healthcare issues such as socioeconomic trends, the physical care environment, technology, patient-centered care values, staffing challenges, and how those issues impact the hospital of the future. Following is a summary of the discussion and conclusion on the topic of the staffing challenge:
Workforce Shortages
Though the healthcare industry has contributed more jobs to the U.S. economy than any other industry in the past few years, the demand for certain health professionals still outstrips supply. According to the American College of Healthcare Executives, the shortage of staff has ranked among the top five issues facing hospital CEOs.
Vacancy rates for physical, occupational, and speech therapists exceeded 11% by the end of 2006, and have been increasingly difficult to recruit. Registered nurses, pharmacists, nursing assistants, license practical nurses, and laboratory and imaging technicians have vacancy rates from 6% to 8% for technicians and RNs, respectively. Physician shortages are a problem in several states already, with expectations that it will worsen. There is a high turnover of hospital executives as well, with as many as 50% of nurse executives and 14-18% of CEOs leaving their jobs within their first year.
The ability of hospitals to perform even the most basic functions is challenged by staffing issues. According to studies, there is an association between RN staffing and hospital-related mortality, failure to rescue, and an increased risk of complications. Beds that are not staffed cannot be filled, thereby decreasing the number of admissions, particularly those from emergency departments. The top-cited reason for diversion–a hospital closed to incoming ambulances–is a lack of staffed critical care beds.
Staffing shortages also lead to job dissatisfaction. Hospital-based nurses express job dissatisfaction at rates three to four times the national average for U.S. workers. Those employed in Magnet status hospitals, those facilities recognized by the American Nurses Credentialing Center (ANCC), report increased satisfaction. Those facilities also enjoy strengthened nursing recruitment and retention. In addition, patients in Magnet hospitals have lower mortality rates, shorter lengths of stay, and higher satisfaction.
The average voluntary turnover rate of new hospital nurses is 27% during the first year on the job. This may be a reflection of inadequate educational preparation for the realities of hospital practice as well as work environment issues. Included in those issues are long hours and persistent fatigue, lack of empowering leadership, unavailability of supportive technologies, and lack of innovation in improving the role of the nurse.
Almost one-third of a medical-surgical nurse’s time is spent on documentation and only one-fifth is spent on direct patient care, which also contributes to job dissatisfaction. This indicates a need to examine the role of the nurse and the inherent processes of the job.
An increasing shortage of nurse faculty is increasing the gap between supply and demand in the nursing workforce. In 2007 alone, over 30,000 qualified applicants were denied entry into baccalaureate nursing programs due to lack of capacity.
The Food and Drug Administration (FDA) has approved more than 500,000 new medical devices since the late 1990s, while concurrent technological developments in pharmaceuticals, biologics, and genomics are increasing the knowledge demands of practitioners. The addition of new developments in robotic preparation and automated distribution has had an effect on the hospital pharmacist and the level of technological expertise now required. In answer to this, the profession raised the entry-level degree for a pharmacist to a doctorate. The negative aspect of the higher standard is a roadblock created for new pharmacy students, resulting in an 8% vacancy rate for pharmacists in 2006.
Team-Based Care
To address the issue of staffing shortages, hospitals are faced with accomplishing more with less. Studies have shown that well-functioning teams can accomplish more with fewer errors than individuals, with a positive impact on patient safety.
The team-based care models may be expanded by the potential payment model proposed by the Medicare Payment Advisory Commission (MedPAC), which advocates a bundled Medicare payment approach. At present, hospitals and physicians are paid separately under different payment schemes. It is thought that a bundled approach, one that pays hospitals and physicians a fixed payment, will reduce cost variations and encourage joint accountability. This concept is being tested, as of January 2009, with its Acute Care Episode demonstration, offering bundled payments in 4 states for 28 cardiac care and 9 orthopedic inpatient surgical services. The expectations include influencing physicians and hospitals to more closely integrate their services, which is required to accept bundled payments.
A Consideration of the Quality and Access of Educational Opportunities for ACHE Members
The ACHE (American College of Healthcare Executives) has introduced a radical new licensing system which, while entirely voluntary at the time that this publication is written, is no mere bureaucratic exercise: it is intended to act as a refining tool to sharpen the mind and test the skill set of the respective ACHE member. The licensing scheme actively requires that its members re-accredit themselves on a 3-year basis in order to continually ensure that the employee is indeed able to maintain the exemplary standards expected and demanded by the ACHE organization.
There have been some who have regarded the licensing and accreditation system operated by the ACHE as too arbitrary and draconian, that it imposes an unnecessary and indeed unfair level of strain upon the member of the organization. In reality, the member will be amply rewarded for their diligence as it provides them with a significant competitive edge over their peers in the industry and, given the current turbulent nature of the economy, every little bit helps.
A particularly commendable perk offered by the ACHE are the so-called “clusters,” which are annual events typified by a series of educational seminars devoted to a particular issue and topic within the healthcare industry. These allow the member to further cultivate their skills and finesse their clinical experience. Provisions have also been made to provide educational and learning resources on the Internet in the interests of cost saving for members and also to reach out to a far wider audience than initially intended.
In addition, there has been the introduction of online seminars which allow a member who is interested to fill out forms and take a brief examination which, if successfully completed as required, will entitle that particular member to earn additional credits toward their current degree. This in turn helps professionals to quickly and easily specialize within a niche.
http://chppm-www.apgea.army.mil/qso/cert/bche2.htm
An Explanation of the ACHE and How It Can Benefit Your Hospital
Currently within the United States of America, there are no legal provisions (either at state or federal level) requiring a healthcare manager to have any sort of license at all, which has caused a significant amount of concern given that healthcare managers are directly responsible for the allocation of resources, both in terms of manpower and finances. They work in partnership with frontline healthcare providers such as physicians, nurses, and physical therapists in order to more readily identify the priorities and requirements that currently remain outstanding.
The ACHE, or American College of Healthcare Executives, is a professional-based body which has implemented a voluntary licensing system for healthcare managers. It has done so in an attempt to provide a stopgap solution until legislation on this issue is modified. This licensing system, dubbed FACHE (the Foundation of ACHE), will make the identification and ultimate selection of qualified, experienced staff members far more easy as all the administrator has to do is look at the presence (or conspicuous absence as the case may be) of the FACHE license and base their judgment from there.
The benefits of the FACHE pilot scheme are numerous, as the hospital can rest assured that they are employing dedicated personnel who not only have the requisite skill base to successfully perform the job but also that the personnel that they take possess the drive, ambition, and ethics to learn and strive. The FACHE system is useful not only for ensuring that a hospital attracts quality and talent, but also that they get to keep it over the course of the lifetime of the employee.
Given that our healthcare system is governed by the principles of free market economics, ensuring that you operate as competitively as possible is crucial indeed.
http://www.sru.edu/pages/3312.asp
The Goals and Objectives of the ACHE, and How They Benefit the Service Provider
The ACHE (American College of Healthcare Executives) and its objectives are plain to see. They are fiercely committed to ensuring universal and affordable healthcare for all and seeing that the delivery of healthcare will be governed and maintained by competent, licensed, and qualified staff who in turn are also committed to the ethics of the organization. The ACHE has already implemented a series of bold plans, the most radical and commendable of these being the introduction of the FACHE (Foundation of ACHE), a voluntary licensing and professional accreditation system which has provided significant benefits for both hospital recruiters and the healthcare executives who have been prepared to get involved in the process.
If we take a look at Part 4 of the ACHE Code of Ethics, which is conveniently named “Healthcare Executive’s Responsibilities to Community and Society,” we have an eloquent demonstration of the ethics and primary objectives of the organization:
“Work to identify and meet the healthcare needs of the community;”
“Work to ensure that all people have reasonable access to healthcare service;” and
“Consider the short-term and long-term impact of management decisions on both the community and on society.”
A praise that can be clearly stated about the ACHE is that it is certainly committed to accounting for and making sufficient provision to accommodate current and prospective social trends. In particular, the significant shift in the labor market pyramid which is now typified by a sharp increase in the geriatric population and a steady decline in the working age generation has meant that there is a strong need for forward-thinking people who are flexible enough to keep up with the changes.
The qualities and demands of the ACHE program have always been met by the people involved in them. As an example, a July 2009 newsletter of the Mississipi Healthcare Executives reported that “Colin O’Sullivan, Chief Executive Officer of Regency Hospital in Meridian, was the recipient of the 2009 Early Careerist Award. Mr. O’Sullivan was responsible for the transformation of increased morale, decreased turnover, and higher physician satisfaction with the capabilities and outcomes achieved by Regency Hospital’s Meridian team.”
http://mhanewsnow.typepad.com/ache/
http://ethics.iit.edu/indexOfCodes-2.php?key=13_375_1321