10.1 A Brief Introduction

Although I explored an array of different topics in this book, I focused on several key themes. As a first step, I looked at frontline healthcare supervisors. More specifically, I examined the roles they play within their organizations, their chief desires and obligations, and the best practices management strategies that they can use to oversee and motivate their employees. Next, I delineated some of the important features of continuous improvement (CI) methodologies and explained how healthcare executives and administrators might use CI techniques to help them reduce costs and improve the efficiency and effectiveness of their particular company’s (or department’s) processes, products, and services. I also discussed two popular CI systems—Lean and Six Sigma. I then drew upon my earlier conversations to aid me in positing suggestions that healthcare leaders could use to help them create and sustain corporate- and departmental-level cultures that are amenable to CI practices. Additionally, I presented readers who work at small or resource-challenged institutions with strategies that they could utilize to aid them in creating, implementing, and monitoring quality improvement (QI) initiatives. In the final series of chapters, I looked at some methods that frontline supervisors might use to help them make the right split-second decisions, to create vibrant office cultures, and to develop and enforce workplace-related rules and regulations.

In this final chapter, I will briefly examine some of the key takeaways from each section of the book. I will only cover the most important topics, as I do not have the space here to review every subject in detail. Readers who are interested in learning more about specific items can peruse the relevant chapters in this text.

10.2 The Typical Office-Level Healthcare Leader—An Important but Often Underappreciated Cog in the Corporate Wheel (Chapter 1)

In the early part of the book, I delineate office-level healthcare leaders’ roles and responsibilities. Although these individuals might work for a diverse array of company types and perform different tasks, they do share things in common. Most importantly, these administrators directly supervise frontline workers. Additionally, they possess at least some power to discipline, manage, and motivate their employees. Finally, these individuals must report to one or more superiors; they are not entrepreneurs or small business owners (Fallon & McConnell, 2007, p. 252).

office-level leaders play vital roles in virtually every healthcare company. For one thing, they directly manage the frontline staff who interact daily with patients and customers. Most healthcare organizations are labor-intensive operations (Sultz & Young, 2014, p. 299) and, therefore, would likely cease to exist if these administrators did not do at least an adequate job of overseeing first-line employees. At the same time, these supervisors “represent an all-important feedback loop that allows the CEO [and other executives] to stay abreast of the latest developments in the business” (Hassan, 2011, n.p.).

Given how important office-level healthcare leaders are to their companies, it might surprise some readers to learn that firms often do not focus enough attention on these individuals. For instance, in my experience, many healthcare executives will elevate an employee to a frontline leadership position based on seniority instead of as result of that person’s skills or job-related fit. As important, these organizations do not provide either experienced or new administrators with the education required to excel in their management-related roles. What training these corporations do offer to these people is often inadequate (Belker, McCormick, & Topchik, 2012, p. 5; Murray, 2010, loc. 110). Making matters worse, from what I have seen or heard, these entities overlook or even reward supervisors who utilize antiquated, ineffective leadership techniques.

One can point to several reasons why healthcare organizations have traditionally fostered environments that allowed and sometimes encouraged administrators to utilize suboptimal management techniques. For instance, executives might have felt that it did not make sense, from a cost–benefit perspective, to push their supervisors to use best practices leadership methods and to provide them with the training that would be necessary to employ these strategies. At the same time, some healthcare leaders may have believed that antiquated manage ment styles were more effective than best practices methodologies. From what I have seen, many healthcare corporations have tolerated frontline supervisors who utilized inefficient or ineffective leadership methods because these firms did not have the impetus to do anything differently. These institutions could get by with being, to borrow an old cliché, “just good enough.”

10.3 Healthcare Leaders—Becoming More Interested in Utilizing Best Practices Management and CI Methods (Chapter 1)

Until relatively recently, portions of the healthcare industry have traditionally been averse to adopting some types of best practices leadership methods. However, over the last few decades, they have slowly begun to alter their beliefs on this topic. This shift is at least partly due to external factors. For one thing, many healthcare companies, such as hospitals, have faced growing competition from other entities (Hopper, 2016, pp. 14–15). Additionally, both private and public third-party payers have become more aggressive in reducing reimbursements, limiting utilization rates, and doing other things to impinge upon clinical (and sometimes nonclinical) providers’ revenue streams (Bodenheimer & Grumbach, 2009, pp. 195–198; Diede, 2002). At the same time, federal, state, and accrediting agencies have begun to place an increasing emphasis on patient-related satisfaction and outcome metrics. Their focus on these topics has forced hospitals, physicians’ offices, nursing homes, and other care providers to devote more attention to quality-related issues (Hopper, 2016, pp. 11–12; Morrison, 2011, pp. 89–90; Singh, 2010, pp. 28–33; The Joint Commission, 2016).

These factors, among others, have also led many healthcare executives and administrators to embrace CI methodologies, such as Lean and Six Sigma. In some of the proceeding chapters, readers will learn how they can utilize best practices leadership techniques and CI-related philosophies to help them improve their particular department’s efficiency and effectiveness. They will also discover strategies for creating vibrant workplace cultures that energize staff and are amenable to CI methodologies.

10.4 Key Factors That Motivate Healthcare Administrators (Chapter 2)

I believe that one must be cognizant of the key factors that motivate most healthcare supervisors if that person is going to provide individuals with the best advice on leadership and process improvement strategies. With that fact in mind, I begin Chapter 2 by analyzing the core drivers of the typical healthcare administrator’s workplace and career decisions. I argue that the important influences on the average office-level leader’s actions center on his or her self-interests, obligations, ethical beliefs, and desire to leave a legacy. The first two aspects play a prominent role in the development of the latter two elements.

It goes without saying that almost all individuals, even seemingly altruistic ones, are self-interested to some degree. Following that logic, I delineate four key types of desires that influence office-level healthcare leaders’ decisions. They include:

• Material Self-Interests: Most healthcare administrators are motivated to some degree by material wants, including the desire for tangible items (e.g., monetary rewards) and intangible ones (e.g., added leisure time) (Prasch, 2000, pp. 679–689).
• Family-Related Desires: A majority of the office-level healthcare leaders who I have worked with or talked to consider their families’ interests when making business-oriented decisions, especially ones related to career moves.
• Desire for Amicable Relationships: Most healthcare supervisors likely want to work in amicable environments in which conflict is minimal. As part of this process, they usually desire to maintain good relationships with their peers and subordinates (Iqbal, Khan, & Fatima, 2013, pp. 18–19; Morrison, 2011, p. 17; Shanks & Dore, 2012, p. 47).
• Yearning for Personal Autonomy: I believe that almost all human beings have an innate desire to maintain at least some control over their own decisions and actions. In my experience, healthcare administrators’ office- and career-related choices are influenced to some extent by this self-interest.

I believe that the typical office-level healthcare leader also considers his or her obligations to key stakeholders when making work-related decisions. These duties include:

• Loyalties to Family and Friends: The typical healthcare administrator might not directly rely on his or her obligations to family and friends to guide this person’s day-to-day workplace-related decisions. However, in my experience, these beliefs do influence this supervisor’s core ethical principles. As such, this individual’s perceived duties to these stakeholders have some impact on his or her office-related choices.
• Obligations to Subordinates: From what I have seen, even the most self-interested healthcare administrator feels like he or she has some obligations to staff.
• Responsibilities to One’s Company: While each administrator’s views on this topic will differ considerably, I think almost everyone would agree that he or she needs to fulfill contractual obligations, follow corporate rules and regulations, keep certain pieces of company-related information private, and treat the organization’s stakeholders with respect.
• Duties to Society: In my experience, the typical office-level health-care leader will also rely upon his or her duties to society when making workplace-related decisions. For instance, an individual might ensure that his or her department follows all federal and state regulations, not just out of a sense of self-preservation (e.g., avoiding being fired) but also because he or she feels the need to honor the community’s laws.

The typical office-level healthcare leader’s self-interests and duties not only directly influence that person’s workplace-related choices but also help to shape his or her core ethical principles. In some cases, an administrator might intentionally use these beliefs to help craft his or her moral ideals. At other times, the process is subconscious (Andre & Velasquez, 2015; Velasquez, Andre, Shanks, & Meyer, 2015).

In my experience, the typical healthcare administrator also wants to leave a legacy behind, and this desire, to some extent, influences his or her workplace-related decisions. Each individual might define this phrase slightly differently, and many people may have a hard time describing it all. However, almost everyone would say that, as part of this legacy, he or she wants to be remembered by someone or something (Matthiessen, n.d.). From what I have seen, the average office-level leader draws upon this need to “leave something behind” when making some day-to-day and career-related choices.

10.5 Comparing Strict Autocratic Methods to Best Practices Management Styles (Chapter 2)

In this part of the chapter, I compare strict autocratic management styles to more participatory ones. I start out by delineating some of the key features of strict authoritarian leadership methodologies, including the belief that the supervisor is the absolute boss, the focus on hierarchy, and the tendency of individuals who work in these types of environments to rely on paternalistic ideals (Fallon & McConnell, 2007, pp. 373–374). I note that, until relatively recently, a large majority of healthcare administrators, as well as their peers working in other fields, utilized these management techniques (Fallon & McConnell, 2007, p. 97). I assert that, in most instances, office-level leaders should no longer use strict autocratic tactics to motivate and manage staff. As part of this discussion, I denote some key problems with authoritarian oversight methods.

Next, readers learn about participatory (best practices) management styles, which, in contrast to many strict authoritarian methodologies, value workers as individuals and call for them to be treated with dignity and respect (Alexander, 2013; Ferral, 2010; Shanks & Dore, 2012, p. 43). I delineate some of the important tenets that are part and parcel of these philosophies. I then discuss ways in which supervisors might employ best practices leadership techniques to help them better manage and motivate staff.

I believe that healthcare administrators will have more success using the best practices management techniques, which I talk about in this chapter, if they have strong emotional intelligence (EI) skills. With that fact in mind, I briefly discuss EI and list the key traits that an office-level leader should want to possess. I end the narrative by asserting that supervisors who employ best practices management strategies will find it easier to foster workplace cultures that are accepting of CI methodologies.

10.6 Defining and Describing CI (Chapter 3)

In the first part of this chapter, I delineate the general aspects that CI methodologies have in common with each other. First, I discuss some of the key elements that are part and parcel of most CI systems, including the belief that a process rarely works flawlessly; the corresponding view that one can improve this process; the use of systematic methods for enhancing a service, product, or workflow; the desire to continuously look for ways to enhance a process; and the assertion that an individual or group needs to monitor these improvements to ensure that they stick (Chapman, 2007, pp. 40–41; Jha, Noori, & Michela, 1996, pp. 27–28; Linich & Bergstrom, 2014, pp. 6, 8; Spath, 2009, pp. 12, 14–19, 107; Williams, Savage, & Stambaugh, 2012, pp. 122–123).

A healthcare administrator and his or her team might potentially use any of several different CI systems to help them identify and correct issues in products, services, or processes. Regardless of which CI methodology these people utilize, they will almost always follow some of the same basic steps when undertaking CI-related projects, including (Louisiana Department of Children and Family Services; Kelly, Johnson, & Sollecito, 2013; Spath, 2009):

• Identifying the Problem
• Coming Up with a Plan of Action
• Analyzing the Existing Practice or Process
• Designing and Executing Improvements
• Evaluating and Reevaluating

I describe each of these steps in more detail in Section 3.4.

In this part of the narrative, I also, among other things, delineate six reasons why healthcare organizations and departments might want to adopt and use CI methodologies. For brevity’s sake, I will not review that discussion here. Interested readers can find my commentary on this topic in Section 3.6.

10.7 Comparing and Contrasting Lean and Six Sigma (Chapter 3)

As I note in Chapter 1, numerous factors are pushing healthcare organizations to become more efficient and effective. With this fact in mind, many healthcare executives and administrators have begun to use CI methodologies such as Lean and Six Sigma to improve their organization’s or office’s processes, services, and products. In this part of the narrative, I briefly denote important characteristics of these two CI philosophies and demonstrate some of the important ways in which they differ from each other. More specifically, I focus my attention on Lean’s and Six Sigma’s somewhat distinct end goals, the tools that each system’s proponents favor, and the differences in these two philosophies’ methods and techniques.

Next, I look at Lean in more detail. I start offby discussing this CI methodology’s focus on eliminating “waste.” I delineate the different types of waste that Lean practitioners might seek to reduce or remove from a process. I then try to help readers discern some of the core principles of Lean theory by reviewing the Five S’s—one of the CI philosophy’s key process-improvement techniques. As part of this conversation, I go over each of the S’s—sort, store, shine, standardize, and sustain—in brief detail. I then demonstrate several of the charts and diagrams that Lean practitioners utilize to help them identify and fix process-related problems. I include graphical aids to help readers better understand each of these tools. From there, I turn my attention to Six Sigma.

In this section, readers learn about Six Sigma by seeing how this CI philosophy’s principles are embedded in its methods and tools. With that fact in mind, I analyze the DMAIC process. I go over each of the steps in this system, which include define, measure, analyze, improve, and control. I then look at several charts and diagrams that Six Sigma practitioners tend to employ in identifying and improving process-related issues. As with my discussion on Lean, I include graphical aids to help readers better understand each of these Six Sigma–related tools.

While Lean and Six Sigma might be different in some ways, they do share important aspects in common. I discuss some of these similarities in the final part of Chapter 3. For instance, I note that proponents of both systems “manage by fact” because they put their trust in observable or objective data to arrive at valid, reliable conclusions (Pojasek, 2003; Summers, 2007, pp. 24, 128–133, 152, 348). At the same time, supporters of Lean and Six Sigma try to keep each step in the process, as well as the presentation of their findings, as simple as feasible. By doing so, they can efficiently identify problems and disseminate improvement suggestions to all key stakeholders in a way that these people understand (Stark, 2016; Summers, 2007, pp. 289–291, 329–330). Finally, I argue that an administrator likely needs to have engaged, flexible, and adaptive workers on staff if he or she is going to successfully incorporate Lean or Six Sigma methods into the workplace culture. I discuss this topic in more detail in Section 3.17.3.

10.8 Key Attributes of Organizational Cultures That Support CI (Chapter 4)

I contend that a healthcare company needs to develop and sustain a certain type of organizational culture if it wants to incorporate CI-related methodologies into its workplace routines (Fried & Carpenter, 2013, p. 137). In this part of the narrative, readers will discover several key reasons why these corporate environments are more amenable than their peers to CI philosophies. These factors include aspects related to staffing, the development of team-centered ideals, work ethics, and employee-satisfaction metrics.

10.9 Suggestions for Fostering CI-Supportive Organizational Cultures (Chapter 4)

In Chapter 4, readers will learn about strategies that they can employ to help them foster CI-supportive organizational cultures at their respective companies. I touch on several key themes in this part of the narrative. For instance, I discuss the ways in which a leader can leverage his or her firm’s mission, vision, and values statements to create and maintain a corporate atmosphere that is centered on a set of shared ideals and focused on “us” and not “I.” As part of this process, I posit some techniques that a healthcare executive or an administrator can use to encourage his or her staff members to inculcate their institution’s mission, vision, and values. I also go over topics relating to employee bonding, building an amicable work environment, answering staff-related questions, focusing on the system and not the person, convincing employees to embrace health information technologies (HITs), and imbuing the corporate culture with a sense of optimism. I rely on my own experiences in the field as well as on my research to help me in formulating these arguments.

10.10 From a CI-Related Perspective—A Look at the Key Features of Dysfunctional Departmental Cultures (Chapter 5)

If a healthcare organization wants to incorporate CI methodologies into its work-place routines, it needs to ensure that most if not all units possess CI-supportive cultures. In my experience, a firm’s executives and administrators will often have difficulty in developing, implementing, and sustaining interdepartmental CI projects if even one group is hostile to any CI-related changes in work-related protocols. A supervisor will also encounter these problems when trying to incorporate Lean, Six Sigma, or a similar process-improvement strategy into office routines unless the departmental environment is amenable to these philosophies.

To help readers better understand these issues, I delineate some of the key aspects of dysfunctional office cultures (environments that are not CI-supportive). They include:

• Disengaged Employees: As one group of healthcare researchers noted, “[E]ven the most technically precise quality management program will fail if employees are unmotivated and lack commitment to the program’s success” (Lam, O’Donnell, & Robertson, 2015, p. 212).
• Disruptive Workers: In my experience, an administrator will have significant difficulty in developing, implementing, and sustaining CI initiatives if a critical mass of the department’s employees is disruptive.
• Self-Interested Staff Members: A department’s CI projects will often run aground if its employees consistently put their interests over those of the unit and its stakeholders.
• A Dearth of Trust: As both my experiences in the field and my research attest, a supervisor will have trouble incorporating CI protocols into the workplace’s routines if his or her employees lack faith in the administrator or in each other (De Leede & Kees, 1999, pp. 1198–1199; Elliott, 2008, p. 58).
• Misaligned Incentives: Dysfunctional office cultures fail to incentivize workers to buy into CI methodologies. Sometimes, these departments’ overt and embedded inducement systems even encourage employees to attempt to derail CI projects (Sollecito & Johnson, 2013, p. 64; Upshaw, Steffen, & McLaughlin, 2013, p. 300).
• A Lack of Know-How: It goes without saying that a healthcare department usually needs to contain a critical mass of people who have certain technical skills if that unit is going to successfully utilize CI methodologies. However, in my experience, these employees also need to possess a range of nontechnical abilities and mind-sets (I focus on this topic in more detail later in Chapter 5). In many cases, staffwho work in a dysfunctional departmental culture will have difficulty in developing these traits.

10.11 Key Aspects of High-Performing Office Cultures (Chapter 5)

After briefly discussing office environments that are not amenable to CI principles and delineating some of their key aspects, I turn my attention to high-performing departmental cultures. I use this term to refer to workplace environments that are supportive of CI methodologies. Ironically, I begin the narrative by noting that these types of cultures do embrace some employee-related inefficiencies. I explain, from a cost–benefit perspective, why healthcare administrators should tolerate and even promote these “flaws.” I then review the important features of a high-performing office environment.

For the remainder of the chapter, I highlight the key aspects of high-performing office cultures, while at the same time delineating reasons why the employees who work in these environments are more likely to buy into CI ideals and accept any CI-related changes to their work routines. Along the way, readers can discover techniques that they can use to help them foster these types of workplace cultures. I try to accomplish these goals by looking at the key abilities and mind-sets that at least some of the employees in a department need to possess if that unit’s administrator is going to successfully incorporate CI-related methods into the office’s routines. These traits include:

• Self-Confidence
• Possessing a Degree of Autonomy
• Job Satisfaction
• A High Level of Motivation
• A Team Player
• A Sense of Loyalty to the Company and Its Stakeholders
• Bonds of Trust
• A Willingness to Accept Change

I rely both on my experiences in the field and my research to help me examine each of these abilities or mind-sets. I end the chapter by discussing a few additional employee-related skills that CI-focused administrators should covet.

10.12 Some General Tips for Improving a Department’s Efficiency and Effectiveness (Chapter 6)

I begin the chapter by providing readers with some tips that they can use to make their departments more efficient and effective. For instance, I note that many healthcare companies use printers and copiers that are not capable of handling these organizations’ workloads. As a result, employees “waste” valuable time in trying to fix these machines or in finding someone else to do so. These issues might also negatively impact staffmembers’ productivity by requiring them to make multiple trips to copy/print documents or in forcing them to delay key tasks (Morgan & Brenig-Jones, 2012, p. 162; Simplicated, 2012). I also posit other suggestions, including ones related to the creation of digital-based decision-support tools, training on how to use computer-based shortcuts and hotkeys, and ways to reduce shadow systems.

10.13 A Guide for Office-Level Leaders Who Are Working Solo—Suggestions for Developing, Implementing, and Monitoring QI Initiatives (Chapter 6)

I start out by denoting some of the struggles that healthcare administrators at small or resource-challenged companies face in developing, implementing, and monitoring QI projects. I then discuss the process that I have used when working on QI initiatives for these types of firms. My system, which I call IPPIM, consists of:

• The Ideas Generation Stage
• The Presentation Stage
• The Planning Stage
• The Implementation Stage
• The Monitoring Stage

I discuss each step in the process in some detail. I also touch on other topics, including ones related to how to develop and implement project plans, ways to win over key stakeholders, and the best presentation methods.

10.14 A Healthcare Administrator’s “In-the-Moment” Decisions Can Have a Significant Impact on His or Her Office-Related Metrics (Chapter 7)

In the first part of Chapter 7, I note that the typical administrator’s workday is often frenetic and somewhat unpredictable. As a result, this individual will likely need to make numerous ad hoc decisions on a daily basis. I list some of the types of unplanned interactions that this supervisor may have to handle while on the job, including ones that involve other employees; problems with office-related equipment; and conversations with vendors, customers, or patients. Next, I discuss ways in which an office-level leader’s “in-the-moment” actions might impact the department’s efficiency and effectiveness-related metrics, as well as affect key stakeholders. As part of this conversation, I argue that, as administrators become more reliant on technology, they might be more prone to making suboptimal ad hoc choices (Benjamin, 2016, p. 4; Harmon, 2013, pp. 70–71; Twenge, 2013, pp. 13–16).

10.15 Suggestions for Office-Level Healthcare Leaders Who Want to Make Good Ad Hoc Decisions (Chapter 7)

In this part of the chapter, readers will discover strategies that they can use to help them become better at handling office-related ad hoc situations. I begin this process by delineating some mental maps that healthcare administrators can call upon to aid them in making the correct “in-the-moment” decisions. As part of this conversation, I discuss methods that supervisors can utilize to enable them to develop and enhance these internal knowledge centers. Additionally, I provide office-level leaders with advice on how to craft game plans for dealing with the most common unplanned events that might occur during a work-day. I identify a four-step process that one can take to create and enrich these guides. I also touch on other ways in which readers can improve their chances of successfully managing ad hoc circumstances, including by enhancing their interpersonal skills and via getting to know their subordinates’ and coworkers’ interests, inclinations, and needs.

10.16 Defining and Describing a Vibrant Office Culture (Chapter 8)

I define a vibrant office culture as one that allows the unit’s employees to efficiently and effectively meet stakeholder needs over the long term. By fostering this type of work environment, the supervisor will not only satisfy the demands of his or her superiors and customers but will likely also meet his or her obligations to the staff. At the same time, the office-level leader who creates and maintains this type of departmental culture can achieve his or her own goals, including those related to building a legacy (see also Chapter 2).

Next, I discuss some of the key aspects that are part and parcel of a vibrant office culture, including:

• Employees Treat Each Other with Respect and Dignity
• Staff Buy into Their Organization’s Mission, Vision, and Values
• Workers Think in Terms of “Us”
• Employees Trust Their Administrator and Coworkers
• StaffFeel Free to Share Relevant Information with Their Fellow Employees

I rely on my own experiences in the field as well as my research to help me elaborate on each of these features.

After describing the key aspects of a vibrant office culture, I discuss some of the benefits that a healthcare administrator might realize when he or she oversees this type of workplace environment. These advantages include satisfied employees, cooperative workers, engaged staff, committed personnel, and subordinates who are willing to accept change. I note that each of these “benefits” is not only a product of a healthy departmental culture but also a component of this environment. As such, every one of these advantages influences the other items in the list (Sarwar & Abugre, 2013, p. 23).

10.17 Strategies for Successfully Managing Habitual Complainers, Cheerleaders, and Fence Sitters (Chapter 8)

I divide the typical office’s staff into three groups—habitual complainers, cheerleaders, and fence sitters. The habitual complainers are apt to be pessimistic about their particular department’s future and are quick to criticize their supervisors, coworkers, and other stakeholders for perceived slights or foibles. By contrast, the cheerleaders come to work energized and engaged. They generally focus on the positive aspects of their workplace. The fence sitters, at least in my experience, represent the largest cohort of employees in most offices. These people come from different backgrounds and might exhibit a range of behaviors. However, these individuals share one key thing in common: They readily respond to changes in their department’s routines and/or culture. I devote a significant amount of time to discussing each of these employee types. As part of this process, readers will learn how to manage and motivate these staff members.

10.18 Five Additional Strategies That Healthcare Administrators Can Use to Help Them Cultivate Vibrant Office Cultures (Chapter 8)

In the final part of the chapter, readers will learn about five additional strategies that they can use to help them cultivate vibrant office cultures. For brevity’s sake, I will only list the headers for each of these suggested tactics. Individuals who are interested in reviewing these methods in more detail can find them in Section 8.9. These techniques include:

• Interacting with Employees on a Routine Basis
• Serving as an Advocate for Staff
• Routinely Reaffirming Core Values and Beliefs
• Putting in the Effort to Create a Family and Not a Fiefdom
• Continuously Learning

10.19 Developing and Enforcing Departmental Rules and Regulations (Chapter 9)

I have rarely come across business or healthcare-related texts that provide administrators with detailed advice on how to develop, implement, and enforce departmental rules. In Chapter 9, I seek to remedy that lacuna. I start out by identifying four types of mandates, including departmental-level policies, externally created directives, written rules, and unwritten regulations. Next, I discuss some of the important ways in which an office’s (or organization’s) edicts help to define and influence its culture. In this part of the chapter, readers will learn how to enforce externally created regulations. I then focus on pinpointing strategies that healthcare administrators can utilize to help them create fair and effective office-level directives. At the end of the narrative, readers can learn about methods for successfully implementing and applying these rules.

10.20 Summing Things Up

In this chapter, readers discovered summaries of many of the important themes in my book. For instance, I defined and briefly described the office-level health-care leader position. I also touched on these people’s desires and obligations and identified best practices strategies that they could use to manage and motivate their employees. Additionally, I highlighted some of the key features of CI method ologies, such as Lean and Six Sigma, and I discussed reasons why health-care executives and administrators might want to use these process-improvement methods. I then looked at ways in which supervisors could foster organizational-and departmental-level environments that are supportive of CI philosophies. At the same time, I provided readers who work at small or resource-challenged institutions with information that they could utilize to help them create, implement, and monitor quality-improvement initiatives. Finally, I provided a quick synopsis of the final part of my book, which included sections on making the right split-second decisions, creating vibrant workplace cultures, and developing, implementing, and enforcing departmental rules and regulations.