Evaluation and Decision Making for Health Services

Evaluation and Decision Making for Health Services
By James E. Veney and Arnold D. Kaluzny

2005/01 - Beard Books
1587982307 - Paperback - Reprint - 444 pp.
US$34.95

Stresses the importance of evaluation as a tool for improved decision making for health services organizations and practitioners.

Category: Healthcare

This title is part of the Healthcare Administration list.

Of Interest:

Competitive Strategy for Health Care Organization

Health Care Risk Management: Organization and Claims Administration

Hospitals, Health and People

Hospital Turnarounds: Lessons in Leadership

Partners: Forming Strategic Alliances in Health Care

The White Labyrinth: Guide to the Health Care System

This is a book that health services organizations and practitioners have been relying on since its first publication in 1984. Its popularity led to two subsequent revisions in 1991 and 1998. This reprint of the 1998 version, with an updated preface, brings the issues into focus in today's context. The book begins with a framework for decision making that stresses the importance of evaluation in the entire managerial process of program planning, implementation, and control.

There are five major evaluation techniques: monitoring, case studies, survey research, trend analysis, and experimental design. The authors explain the methodology behind each approach. Exploring how and by whom evaluation is carried out and how best to use the results of evaluation efforts, they focus on the measurement of utility; sampling; operations research techniques and interpretation; cost benefit, cost effectiveness, and cost utility analysis.

Now in its fourth printing, Evaluation and Decision Making for Health Services has proved instructive and relevant to healthcare management since its original publication in 1984. Revised printings came out in 1991 and 1998. This is a reprint of the 1998 revision.

Veney and Kaluzny do not present a whole new structure or method of management; nor do they give guidance on how to adapt to or undertake change. Their book refines and substantiates the processes management uses to make significant decisions affecting the soundness of the healthcare organization.

The key principle recommended for refining and substantiating management decisionmaking is cybernetics. First cited as a term in 1948, cybernetics has become “popular as a way of defining a methodological approach to a wide variety of scientific and management endeavors and is closely linked with general systems theory and its application in the social organization,” say the authors. But it is only in more recent years that cybernetics has been applied to scientific work and business management to make these more efficient, dependable, and germane. Cybernetics has also been applied to the area of self-improvement.

Veney and Kaluzny apply the concept of cybernetics specifically to the healthcare field. With backgrounds in healthcare administration and thus the particular problems, considerations, circumstances, and ends of a healthcare organization, the authors describe how management applies cybernetics in a variety of areas to make decisions in five main areas. These areas are monitoring, case studies, survey research, trend analysis, and experimental design. These are not new to well-trained managers — there could be no substantive or relevant management without attention to or practice of them. But in discussing and demonstrating how the exceptionally informative principle of cybernetics works in these key areas, Veney and Kaluzny bring a new, fresh perspective to them for managers.

The authors identify two components of cybernetics that make it of particular relevance and value to managers. One is that, in any system, there are the interrelated variables of inputs, throughputs, and outputs responsible for “a process of accomplishing an end.” The authors note that this process is not intended to replace any healthcare management system, but to improve or refine one in place by making it more informed and pertinent.

Some of the aspects of these three main types of variables are “regulated and controlled by decisions made on the basis of feedback of information about the state of the system.” As further explained, cybernetics is largely, though not completely, a monitoring of the “communication of information in any system.” This can be done in such a way that intended outcomes can be compared with actual outcomes. With this comparison afforded by the cybernetic’s methodology, the gap between intended outcomes and actual outcomes can be closed as much as is possible in the real world of management with its inevitable pressures of decisionmaking, employee changes, effects of new technology and government regulations, and constant competition.

The large, 8-1/2" x 11" format of Evaluation and Decision Making for Health Services gives the appearance of a workbook. Some of the interior matter and formatting contribute to this workbook-like feel of the book. There are many charts and graphs and tables. Sections, titles of the varied visual matter, and sometimes the “illustration” of a chapter section are provided in the wide margins. Fairly complex formulas are also provided in the margins. And, at the end of the chapters are discussion questions. But although it may first seem to be an interactive workbook, Evaluation and Decision Making for Health Services is actually one of the leading textbooks in the relatively specialized field of healthcare management. The plentiful visual matter, including the formulas, serves the educational purpose of helping the reader to learn how to apply the general concepts and methods of cybernetics to both the daily and ongoing concerns and operations of a healthcare organization. The authors do this in a comprehensive way, not only meticulously treating every significant subject of interest to management from the standpoint of understanding and applying cybernetics, but also making use of varied visual tools and actual and hypothetical scenarios from the healthcare workplace.

Cybernetics is not simply a fad that has found its way into the popular culture for a time. Nor is cybernetics another one of the latest management principles or systems that has come and gone over recent decades. As the two authors convincingly demonstrate, cybernetics is an essential management methodology with applicability across the entire range of management responsibilities. From employee morale to financial goals to prospective new products or services, cybernetics offers the best means for exceptionally informed, clear-sighted, concrete, and productive management.

James E. Veney and Arnold D. Kaluzny are both professors of Health Policy and Administration at the School of Public Health of the University of North Carolina-Chapel Hill. And both have wide-ranging experience in the health field as published authors and consultants to private, government, and international organizations.

Specialists in health policy and administration (U. of North Carolina- Chapel Hill) describe techniques for making management decisions about new or existing programs and services designed to help health-care organizations compete better in terms of efficiency and quality. No dates are noted for earlier editions; the third updates examples, illustrations, and references and includes new information on cost- utility measures, operations research, total quality management, applying quantitative methods, and experimental design and sampling. The glossary does not indicate pronunciation. Book News, Inc.®, Portland, OR

From Doody's Review Services, Kimberly A. Galt, PharmD, FASHP (Creighton University Medical Center):

Description: This book provides a practical description of contemporary methods useful for health services program evaluation and decision making. The theme of each of its seven sections is the presentation of integrated basic research design and measurement methods, along with program evaluation principles and strategies. A logical progression of research method approaches is presented. The authors, who are experienced, well respected professionals, are consultants in program evaluation and instructors for post-graduate health services managers.

Purpose: The intent is to give health professions managers a better understanding of the problems frequently encountered when providing health services, as well as the tools to evaluate and work with these problems. This is a highly relevant objective in the development and advancement of contemporary health services management.

Audience: Both health professions managers and health services scientists will find this publication beneficial. It blends the key elements of both disciplines, and provides an appealing balance between scientific rigor and practical management decision making.

Features: The specific research techniques described in the book include the use of monitoring, case studies, descriptive and analytic surveys, trend analyses, and various experimental designs. Many case examples are provided to illustrate how the scientific method is applied in program evaluation. The examples are representative of common questions and are efficient and pragmatic. Clear illustrations of cause-effect diagrams, flow charts, and decision analysis models are provided. Relevant formulas for calculations are included. A well selected glossary of terms is helpful to anyone studying this area. The book is written for high-quality instruction at the post-graduate level. The writing style is also suited to life long learners in self-study.

Assessment: This is a successful publication that provides the practical interface of research principles with program evaluation strategies to assist both the health services researcher and the health professions manager.

Should your healthcare organization implement a new service or program? Was an implemented program successful? In the face of stiff competition, the answers to these questions are critical. This book provides you with the tools and techniques for making sound management decisions about new or existing programs and services.

This book covers a lot of different evaluation topics and is a great book for someone new to the topic or as a reference book for people experienced in evaluation. I wish they'd included more on how to calculate certain formulas in excel.

James E. Veney is Professor of Health Policy and Administration, School of Public Health, University of North Carolina at Chapel Hill. He has served as a consultant to a number of private research organizations and various international, federal, and state agencies, including the World Health Organization, the World Bank and the United States Agency for International Development. He is the author and co-author of numerous publications and most recently the author of an innovative statistical text designed for health care managers entitled Statistics for Health Policy and Administration Using Microsoft Excel.

Arnold D. Kaluzny is Professor of Health Policy and Administration, School of Public Health and a Senior Research Fellow at the Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill. He has served as a consultant to a number of private research organizations and various international, federal, and state agencies, including Project HOPE, the World Health Organization, the National Cancer Institute, the Joint Commission on the Accreditation of Healthcare Organizations, the Department of Veteran Affairs, and the Agency for Health Care Policy Research. He is the author and co-author of numerous articles and books including Health Care Management 4th Edition with Steve Shortell, and Managing a Health Care Alliance: Improving Community Cancer Care with Richard Warnecke.