Health Services Management | Eastern North Carolina Now

    Publisher's Note: This post appears here courtesy of ECU News Services. The author of this post is Benjamin Abel.

Case study team members from the College of Allied Health Sciences pose before an award ceremony including Nina Thompson, from left, Claire Kraft, Robert Kulesher, Bradly Boaz and Gwendolyn Daniels.

    In late October, four East Carolina University students got gussied up and stood in a large, sun-splashed College of Allied Health Sciences conference room and presented their plan for how to decrease the incidence of hospital-acquired urinary tract infections.

    A host of medical providers and health care administration officials listened as the students detailed a series of bedside actions that research showed would save a hospital - and in turn patients - money while increasing the health outcomes for the region.

    The plan was solid. After peppering the students with questions about the program, audience members seemed satisfied that the strategy could be put into practice.

    This presentation wasn't a business improvement plan for a local heath care center. Rather, it was the warmup for a case competition - a sort of battle royale for undergraduate health service management majors - where research and planning for how to improve health care outcomes were graded by judges at the Medical University of South Carolina in Charleston.

    The program

    "We are the business of health care," said Robert Kulesher, a professor of health services and health information management in ECU's College of Allied Health Sciences.

    Kulesher, director of the undergraduate Health Services Management program, said that HSM is more related to public health, business and public administration than clinical medical delivery. One of the advantages of being in the College of Allied Health Sciences, Kulesher said, is proximity to physical and occupational therapy, speech language pathology and other clinical programs. Program students need an intimate understanding of how clinical medicine works to know how to manage a clinical practice.

    "Our prerequisites are science-based - anatomy and physiology, medical terminology, biostatistics - and it's a junior and senior major ... most of our students have a 3.0 (GPA) or better," Kulesher said.

    The undergraduate HSM degree is a foot in the door for entry-level management positions, but as with most career fields, opportunities to move up the ranks are available, Kulesher said. Graduate degrees, like a Master's in Health Administration or Master of Business Administration, are generally required for those interested in more advanced executive leadership positions.

    Kulesher said that his department puts extra effort into teaching students to be strong professional writers, creative thinkers and analysts. Those with particularly affinity for spreadsheets and social science statistics are valued for larger organizations that require business modeling and strategic planning.

    "The ability to get things done and be familiar with the health care environment," are the overall benefits that HSM students bring to the business end of health care management, Kulesher said. Being attuned to the nomenclature of health care and the hierarchy of the hospital from day one on the job is an intangible benefit, which Kulesher's students learn as part of the HSM program.

    "The job of the health care manager is to have the things that practitioners need, when they need it," Kulesher said.

    The things that practitioners might need, he added, aren't just sterile gloves and IV kits, but the most precious resources in health care: people and time.

    "It's making sure the surgery schedule is doable. You have to schedule for contingencies and emergencies. And you have to have a system for knowing what surgeries can wait," Kulesher said.

    During a recent lecture, ECU Health President and Chief Operating Officer Brian Floyd told HSM students that the health system's managers and analysts can predict, with great accuracy, the number of cardiac catheterizations based on the time of year and the weather, among other factors, which increases the manageability of the hospital's health care delivery.

    About half of the program's students are adults who have a two-year degree, are working in health care as, for example, an X-ray technician. As a part-time student, this track could take five or six years, Kulesher said, but his students are determined and persistent. The other half are true undergraduate students who, many times, are preparing themselves for graduate education in health services.

    Bradly Boaz, a junior from Wilmington, started his time at ECU as a nursing major but realized quickly that while nursing wasn't the right fit for him, he still wanted a career in health care. After some research he found health services management, which blends his dual interests of medicine and business.

    "The program is more than what I initially thought it would be," Boaz said. "It's a very tight-knit community with your professors, which builds a lot of connections that moving forward will benefit both parties. I like it a lot because I currently have a job in health care, so it helps me use my skills in the classroom to benefit my career outside of the classroom."

    Senior student Claire Kraft moved to North Carolina several years ago to be close to her brother, who was stationed at Fort Bragg. After working at a medical practice in Virginia and then classes at Pitt Community College, Kraft found the HSM program. While fascinated with clinical practice, Kraft said that her strengths are in administration, which allow her to create a trusted and positive environment for patients to receive hands-on care.

    "I've learned a lot, specifically change management processes - implementing new policies and procedures, which is probably the most difficult thing any practice manager is going to have to do," Kraft said, noting that health care is constantly changing, and not just for the doctors and nurses. "We often think about providers and patients as the most valued in a practice, but it's also staff. They should be valued just the same."

    Gwendolyn Daniels, a junior health services management major from Washington, D.C., had considered attending the University of Virginia, but they didn't have the major she wanted and something about ECU spoke to her.

    "I really fell in love with the people at ECU and the opportunities the university gives its students," Daniels said. "The program is better, and the opportunities are better."

    The competition

    The case competition at the Medical University of South Carolina was a special opportunity for health services management students - seniors Nina Thompson and Claire Kraft, and juniors Gwendolyn Daniels and Bradly Boaz - to consolidate the skills they had learned through their coursework and funnel that knowledge into a real-world example of the work they will do following graduation.

    Kulesher said case competitions are not typical for undergraduates, particularly in medical services concentrations.

    "Business schools and MBA programs do case competitions quite a bit," Kulesher said. "Participants are given a problem and they present their solutions to a jury, which scores them."

    The competition only accepted team entries from schools certified by the Association of University Programs in Health Administration, of which ECU is one of 50 in the nation.

    This was the second time a team from ECU entered the competition, and the first since 2019.

    "It's essentially a mini-course," Kulesher said. "We invited a physician and nurse from infection control at ECU Health and a professor of management from the College of Business to help us put the case together."

    While the team didn't finish in the top four, Kulesher is still heartened by the students' efforts and the opportunity to mine the final teams' presentations for best practices for next year's competition.

    One of the biggest lessons that Daniels took from the entire process is to think in terms of how the doctors, nurses and other clinical professionals would have to realize the recommendations she would make as a hospital administrator.

    "I learned to understand the clinicians' point of view, and not just my point of view for rule following in the perfect world, because not everything is ideal in healthcare," Daniels said. "Asking clinicians to wash their hands 800 times in a 12-hour span is a little much. So, it was more being realistic. It really made me understand the real-world application of everything I've been learning."

    Boaz said that the competition was a way to condense the team's classroom learning into a tight five-week period, which required teamwork, research and time management for the team to stay on top of their regular classwork.

    "We jokingly described it as a class without the credit," Boaz said. "It furthered a lot of my skills with time management and presentation, and it also improved my general knowledge of the health care field."

    All the students noted the advantages that the schools with Master's in Healthcare Administration programs had in the competition.

    "We got to see a lot of the skills that they from having a master's program at their school," Boaz said. "There was a lot of emphasis on presenting, that we'll take forward to next year. I'm optimistic that we can apply those lessons and hopefully score in the top four."

    Kraft values the entire process as a way to make her a better administrator after graduation.

    "This experience was much more than just winning," Kraft said. "It was also about enhancing our critical thinking skills, giving us the opportunity to improve operations and patient safety and outcomes, even if it's just a hypothetical scenario."
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