Controlling Variation

How do you control variation to improve outcomes? How might health care administration leaders implement approaches to control for variation for their health services organization?
Within a health services organization different processes and workflows contribute to the overall aim of delivering health services. Not surprisingly, when resources become constrained—for example, with influxes of new patients or even changes in health care policy and law—these changes may result in differences, that is, variation in how these workflows and processes are executed for health care delivery. As a current or future health care administration leader, you may encounter the need to control for variation to maximize the efficiency and effectiveness of health care delivery for your health services organization.

For this Discussion, reflect on the approaches health care administration leaders may use to control for variation. Then, select a health process or outcome that might benefit from variance reduction and consider how you might measure the effectiveness of variation reduction for this health process or outcome. Reflect on the McWilliams, Chernew, Landon, & Schwartz (2015) article and consider how accountable care organizations (ACOs) may compare in relation to non-ACOs.

Post, a description of the health process or outcome you selected and explain why. Then, explain variance reduction measures that might be appropriate for improving performance for this health process or outcome. Explain how you would measure the process or outcome to ensure that variance reduction measures worked. Then, explain how well accountable care organizations (ACOs) performed in comparison to non-ACOs as suggested by the McWilliams, Chernew, Landon, & Schwartz (2015) article. Explain whether you believe that ACOs will be effective in controlling cost, quality, and access variation. Then, explain whether you, as a health care administration leader, would encourage a health organization to move toward the ACO model. Why or why not?

Sample Solution

velopment world, bears often cross through private lands in search of food and secure habitat. Attractants such as bee yards, garbage, fruit trees, chicken coops, livestock and bird feeders often lure bears close to homes and habituate them, or help them become used to human activity. Nearly 3 million of Yellowstone Park’s annual 4 million visits occur in June, July and August. More than 30,000 people a day visit in the peak summer season   and they all want to see bears. Bear jams keep rangers busy directing traffic and protecting tourists and bears. Seeing a black bear is great, but spotting a grizzly is an even greater, rarer thrill. Tourists who search for bears with binoculars and cameras won’t appreciate having them shot for sport. A grizzly hunting season would hurt the state’s reputation far outside its borders and potentially damage our tourism industry.

Climate change poses new and little understood challenge to the bears. There is evidence suggesting that bears are denning later, and staying on the landscape longer in the fall when unintended shooting by hunters are most common. Most importantly, a changing climate can also impact food resources for grizzlies.

For example, whitebark pine seeds are major food source for grizzly bears in the Yellowstone Ecosystem. Blister rust (an exotic species) and mountain pine beetle infections, exacerbated by climate change, are major threats to changing food conditions. Grizzly bears that choose to adapt to human-generated food resources often die as a result. What a grizzly bear’s environment and diet will look like in the face of climate change is still uncertain, and as habitats are altered we will have to continually assess the impacts to grizzly bears.

Changes in climate and extreme weather events have already begun to affect biodiversity across the globe and mostly what negatively affect not only grizzly bears but also impacts on wildlife. Humans and wild animals face new challenges for survival because of climate change. More frequent and intense drought, storms, heat waves, rising sea levels, melting glaciers and warming oceans can directly harm animals, destroy the places they live, and wreak havoc on people’s livelihoods and communities. Sea levels are rising and oceans are becoming warmer. Longer, more intens

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