Code Blue

Trip to McCallChapter 1

Code BlueHealth Science Edition Four

1Note to Instructor: Chapters 1 and 2 are short enough to be covered in one classroom session.

Instructor Comments: The story begins with a hospital administrator (Hap Castleton) who has decided to take a hospital accountant (Del Cluff) on a fishing trip. The hospital is having financial difficulties, changes in the accounting department are being discussed by the board, and Cluff is being considered for a new job.

Hap Castleton and Del Cluff do not have a good relationship. Part of the problem is that they have very different personality types. This may be the primary motivation that Hap has for getting Del out of the hospital and into a more informal setting where they can build a better relationship.

In the real world of work, communication is an issue that all supervisors and employees grapple with. How does one work and communicate with people who may have different values, and who may view the world differently?

One of the concepts introduced in this chapter is the importance of understanding those with whom you wish to communicate. Otherwise, you may wind up talking past each other as is happening with Hap and Del in Chapter One.Be sure that you are viewing this in presenter mode or that you have previously printed out the presenter notes to go along with each slide. Also, check your audio to make sure your volume is up for a few fun sounds throughout the presentation.The CharactersHap CastletonadministratorWhat kind of person is Hap?An introvert or an extrovert?A detail person or someone who is concerned with the big picture?Del Cluffassistant controllerWhat kind of a person is Del? An introvert or an extrovert?A detail person or someone who is concerned with the big picture?

Click to reveal bullet one and read text. Establish the expectation that students will participate in these discussions, that their ideas are valued, and that, in many situations, there is not one right answer.Click to reveal bullet two and read question. Get responses from students, Instructor Comments: Many leaders of large corporations are extroverts, as is Hap Castleton. Leaders work with many people whom they must inspire and direct. Most leaders of large organizations are also, by necessity, generalists, as is Hap Castleton. They must know a little about a lot of things. Consider a hospital with 40 departments. The hospital administrator, for example, must understand something about the operation of each department (such as radiology, nursing, laboratory and so on), as he or she is the boss and the person the heads of those departments will come to for advice. The administrator simply does not have time to get involved in much detail.Click to reveal bullet three and read question. Get responses from students. Ideas the instructor might wish to make at the end of the conversation follow. Del Cluff is an accountant, a job that requires little creativity, little contact with people, but a great deal of attention to detail. Del is an introvert (although not all accountants are introverts) and a detail person.It is apparent that Del does not understand the reasons that Hap is so people oriented, and so general in his approach to management. Hap probably does not understand the demands of the job of accountant either. The amount of detail required to be a successful accountant would probably drive Hap crazy.

We will discuss more about these two individuals in a moment.

2TerminologyThroughout the textbook/novel we will be introduced to new terminology.Terms are defined in the sidebar of the page where they first appear.Terms are listed again in the glossary of medical and administrative terms on page 289.Abbreviations used in the text are explained on page 287.There is an index of topics discussed on page 314.Click to reveal bullet one and read the text. You may wish to have the students turn to pages with sidebars, to the glossary, abbreviations and index in their books as you review the format of the book.Instructor Comments: One of the objectives of Code Blue is to build vocabulary. Not all of the terms listed in the sidebars are medical terms, some relate to the administrative operation of the hospital, others are simply terms people need to communicate in the real world.As a side note: Code Blue is actually used in some English classes to build vocabulary.3Board of TrusteesThe board of trustees:hires and fires the administratorapproves the budgetapproves applications for doctors to be members of the medical staffapproves physician privileges (the procedures they are allowed to perform within the hospital)

Click to reveal bullet and discuss text. All legal authority for the operation of the hospital resides with the board of trustees (not doctors). The board of trustees hires and fires the administrator. They also admit physicians to the medical staff, so that they can practice in the hospital, and determine what procedures physicians can and cannot do within the confines of the hospital. The board is, of course, advised by the medical director in issues involving medical staff membership and privileges, but it alone has the final authority. It delegates this authority to the hospital administrator.

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Hospital AdministratorWhat is a hospital administrator?The person responsible for the entire operation of the hospitalSometimes he or she is called the presidentSometimes he or she is called the chief executive officer (CEO)He or she is the boss

Click to reveal bullet and read text. Instructor Comments: Some of you may not understand why it is important to understand a little about the business end of the hospitals, as you may be focusing solely on a desired technical career (such as a doctor or nurse). Like it or not, hospitals and other healthcare organizations are business organizationseven the not-for-profits. Doctors, nurses, laboratory techs, etc. must work with in an organization and must deal on a daily basis with both administrative and technical personnel. Understanding what these people do will help you be more effective in healthcare jobs.5Hospital AdministratorMany people dont realize that it is not the doctors who run the hospital, it is the hospital administrator.The hospital administrator is responsible for everything that takes place within the hospital.The administrators authority comes from the board of trustees.Click to reveal bullets and read text. In military hospitals, physicians are the commanders that all employees report to. This is not the case in civilian hospitals. The hospital administrator is essentially the president (often called the chief executive officer) that all employees report to. Physicians report to the administrator, who reports to a board of trustees. Many students have trouble getting this concept. The medical staff works within the hospital, but they do not run hospitals, except where they are employed as departments heads and so on, and even they report to the hospital administrator.6Typical Organization Chart of a Community HospitalBoard of TrusteesAdministratorPresident of the Medical StaffMedical DepartmentsSupport DepartmentsMedical StaffInstructors Comments: This is a simplified organization chart of a community hospital. You might want to ask students if they can name some examples of medical departments. Examples include Nursing, Laboratory, Radiology, Physical Therapy, and so on. Examples of Support Departments include Medical Records, Accounting, Admissions, the Dietary Department, Housekeeping, and so on.7Assistant ControllerDel Cluff is being considered for the job of controllerThe controller is the person who has responsibility for the finances of the hospital.A controllers responsibilities include budgeting, accounting, and running the business office.

Click to reveal bullet and read text.8

Other Terms Used in Chapter 1

Code Blue: A distress code word broadcast over the hospital intercom announcing to physicians that there is a cardiac arrest within the hospital and that aid is required.Click to reveal bullet and read text.9CommunicationIt takes two to communicate the person who sends the message and the person who receives it.When formulating a message it is important to consider the education and personality of the receiver.Perhaps communication is an area in which Del is weak.

Instructor comments before clicking on bullet. Lets come back and talk about the communication problems that Hap Castleton, the hospital administrator, and Del Cluff, the accountant, are having. Lets discuss first what it takes to have effective communication.Click on the first bullet and read text. Then do the same for bullets two and three.10CommunicationIt takes two to communicate: the person who sends the message and the person who receives the message.

Message is created in mind of senderMessage is communicatedMessage is received and interpretedReceiver provides feedbackClick on the communication steps one at a time and read text. 11It takes more than words to communicate

It takes more than words to communicate. Ask students what else is required.12Communication is Influenced byBody languageThe beliefs, cultures, education, values, and perceptions of the sender and receiverHow people process information and make decisionsThe personality profile of the senders and receivers

Click on bullet one. Studies have shown that body language plays an important part in communication. Facial expressions, posture, tone of voice, eye contact, and so on communicate feelings. What one says can actually be contradicted by body language. Ask students if they can think of any examples from personal experience.Click on bullet two. We all sort what we see through a lens that may distort our observations of what we are seeing. This is an interesting topic if the instructor wishes engage the students in additional discussion.Click on bullet three. Studies have shown that the way people process information and make decisions varies greatly from person to person. Some people, for example. gather a great deal of information before making a decision and analyze the data in detail. Other make decisions on the basis of emotion or feeling.Click on bullet four. Psychologists have studied the personality profiles of people to determine how they react to information and make decisions. We are going to apply some of their findings now to Hap Castleton and Del Cluff.

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Discussion Question 1

From what you have read in Chapter 1, complete the following personality profile for Hap Castleton and Del Cluff by checking the appropriate column for the individual whose personality most closely fits the attribute listed.Click to reveal text. This personality profile is adapted from many tools, including Myers-Briggs.14Discussion Question 1AttributeHap CastletonDel CluffFocuses primarily on detail Focuses primarily on the big pictureMotivated by factsMotivated by feelingsFocuses on the possibleMotivated by dreams

Click to retrieve table. Have students verbally classify each action.15

Discussion Question 1AttributeHap CastletonDel CluffAnalytic SympatheticInterested in thingsInterested in peopleApt to gather more information before making a decision Apt to make a quick decision based on emotion Click to reveal table.16

Discussion Question 2

Why is it important to understand the value system, personality style and decision-making model of those with whom you work in a healthcare setting?Click to reveal bullet. Ask question.Answer: Because all of those factors play an important part in the communication process, etc.17

Discussion Question 3It is obvious that Del has not established a good rapport with his boss, Hap. To what do you attribute this problem?

Click to reveal bullet oneread question.Possible answers include:Del does not understand what motivates Hap.Del does not understand how Hap makes decisions.Neither Del, nor Hap, properly understand the importance of the jobs of the other individual.18

Discussion Question 4What are the differences in the ways Del Cluff and Hap Castleton process information and, therefore, make decisions?

Click to reveal bullet. Read the question.Hap is more interested in the big picture; he probably doesnt care much about details. He is motivated by feelingshe is a dreamer. Del is motivated by logic. He likes figures, and is a details person.Ask the students: if you were Del Cluff and wanted to persuade Hap to buy new fetal heart monitors for the newborn nursery, should you share figures, such as return on investment, profitability etc.? After having completed the proceeding exercise, most students will answer no, since Hap makes decision not based on facts, but on emotion. Ask them how Del should approach him then? The most logical solution would be to talk about issues like saving babies, improving employee morale, making the community proud of the hospital, etc. Del should appeal more to Haps emotions than his analytic skills.Emphasize that supervisors need to understand their employees, and employees need to understand the differences in their supervisors when crafting communications.Any additional thoughts the students have might be made here.19Discussion Question 5How could Del Cluff be more effective in communicating his concern about the hospitals financial condition to his boss, Hap Castleton?

Click to reveal bulletread question. Solicit input from students. Since Hap is influenced more by feelings than facts, Del probably wont be effective in influencing Hap if he only gives him figures. He can motivate his boss to pay more attention to the budget, for example, by talking about the impact a bankruptcy would have on the employees. Emotional appeals work better with Haps personality profile than analytical approaches.

20Writing Exercise

Assume you are Del Cluff. Using what you know about Hap Castleton, prepare a written memo explaining your concerns about the hospitals losses. Explain why you will not oppose Edward Wycoffs efforts to cut the hospital budget.Click to reveal bullets and read questions. Give this assignment or, if you have already given it, have the students read their memos to the class.21End of Chapter 1

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