Guo, Kristina L.
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Item Educational interventions to increase cultural competence for nursing students(Emerald Group Publishing Limited, 2018) Young, Susan; Guo, Kristina L.Purpose The purpose of this paper is to analyze the study results conducted at a four-year university in Hawaii investigating the impact of providing nursing students with an educational intervention session aimed at improving cultural competence. Design/methodology/approach A descriptive-correlational research method was used to examine the correlations between a control group and experimental group using pre-and post-tests. The t-test for equality of means and Levene’s test for equality of variances were conducted for statistical analysis on pre-and post-test scores. In addition, a power analysis was conducted due to the small sample size. Findings The control group receiving no intervention scored lower on the post-test in overall competency by five points, while the experimental group increased their post-score by five points after receiving the intervention; however, this increase did not change the overall cultural competence score. The results indicate that the educational intervention of a two-hour didactic, discussion and presentation did not provide as robust as what was needed to increase domain scores for the experimental group. Further, the domains of awareness, skill, knowledge, encounter and desire cannot be taught by instruction alone and should be reinforced over time. Research limitations/implications The study was a convenience sample and limited by the small sample size. The sample may not be representative of all senior nursing students. The study is limited to one school of nursing in Hawaii; the results may not be generalized to other populations. Practical implications This research provides a foundation for future curriculum development and the evaluation of nursing programs. For instance, incorporating a value-added instructional project on cultural competence into each nursing class would increase cultural competence awareness and knowledge. Social implications This study also emphasizes the necessity of education in cultural competence for all health professionals, which has implications for improving quality, patient satisfaction and increased health outcomes. Originality/value This research is unique to examining and applying an educational intervention on cultural competence for nursing students in Hawaii. This research sheds light on studying the importance of culture competence for nursing students and other health professionals. This is not a skill that can be taught in one class or only even a single immersion experience and should be acquired over time where continuing education and encounters are necessary in order to become culturally competent; this will enable health professionals to provide meaningful and appropriate care to patients.Item Workplace Communication(Jones & Bartlett Learning, 2011) Guo, Kristina L.; Sanchez, YeseniaFundamental and vital to all healthcare managerial functions, communication is a means of transmitting information and making oneself understood by another or others. Communication is a major challenge for managers because they are responsible for providing information, which results in efficient and effective performance in organizations. Communication is the creation or exchange of thoughts, ideas, emotions, and understanding between sender(s) and receiver(s). It is essential to building and maintaining relationships in the workplace. Although managers spend most of their time communicating (e.g., sending or receiving information), one cannot assume that meaningful communication occurs in all exchanges (Dunn, 2002). Once a memorandum, letter, fax, or e-mail has been sent, many are inclined to believe that communication has taken place. However, communication does not occur until information and understanding have passed between sender and the intended receiver. To make oneself understood as intended is an important part of communication. A receiver may hear a sender but still not understand what the sender’s message means. Being constantly engaged in encoding and decoding messages does not ensure that a manager is an expert in communication. Understanding is a personal matter between people, and different people may interpret messages differently. If the idea received is not the one intended, communication has not taken place; the sender has merely spoken or written.Item The U.S. Long Term Care System(Springer Verlag, 2011) Guo, Kristina L.; Castillo, Richard J.The current U.S. health and long term care systems are inadequately prepared to meet the diverse and changing needs of the rapidly growing senior population. This paper describes the importance of naturally occurring retirement communities (NORCs) to promote the health and mental well being of older individuals through the collaborative efforts of formal and informal home and community based services and support. NORCs are considered a crucial model for aging in place since older adults prefer to remain in the comfort of their homes, and services can be provided in a much more efficient and cost effective manner. This paper examines the strengths, opportunities, and challenges of existing NORCs and discusses the need for the development and expansion of additional NORC programs as an innovative and viable solution for older adults aging in place.Item Entrepreneurship in Health and Human Services Organizations: A Symposium(Southern Public Administration Education Foundation, 2006) Guo, Kristina L.; Buss, Terry F.Item Introduction: A Symposium on Contemporary Entrepreneurship(2006) Guo, Kristina L.; Buss, Terry F.Item Roles of Managers in Academic Health Centers(Wolters Kluwer Health, Inc., 2002) Guo, Kristina L.This article addresses survival strategies of academic health centers (AHCs) in responding to market pressures and government reforms. Using six case studies of AHCs, the study links strategic changes in structure and management to managerial role performance. Utilizing Mintzberg's classification of work roles, the roles of liaison, monitor, entrepreneur, and resource allocator were found to be used by top-level managers as they implement strategies to enhance the viability of their AHCs. Based on these new roles, the study recommends improving management practices through education and training as well as changing organizational culture to support management decision making and foster the continued growth of managers and their AHCs.Item A Study of the Skills and Roles of Senior-Level Health Care Managers(Wolters Kluwer Health, Inc., 2003) Guo, Kristina L.This study identifies the most essential skills and roles of senior-level health care managers. The study first reviews the literature to describe major forces in the health care environment that impact management and then discusses the skills and roles of managers. From this, a descriptive list of skills and roles is created. Ten senior-level managers were interviewed to reveal six roles and associated skills necessary for managing in the current health care environment.Item Roles, Skills, and Competencies of Middle Managers in Occupational Therapy(Wolters Kluwer Health, Inc., 2007) Guo, Kristina L.This article describes the most essential roles, skills, and competencies needed by middle managers in occupational therapy organizations. Middle-level managers are responsible for a specific segment of the organization. They are uniquely positioned to foster changes in the department. Because of the challenges in the health care environment, it is important to discuss the roles that middle managers need to bring out the viability and growth of their departments and organization. These roles include planner, strategic planner, coordinator, leader, problem solver, and negotiator. To conduct these roles, skills and competencies that are closely linked to the effective performance of those roles are also described. Skills include human relations, marketing, and conceptual skills. Competencies include being able to manage attention, meaning, trust, and self, as well as being competent when conducting utilization reviews, program evaluations, documentation of services for quality and reimbursement purposes, and fiscal management. With these outlined roles, skills, and competencies, middle managers should be able to promote the mission of their organizations, support their employees, and navigate successfully in the competitive and ever-changing health care environment.Item DECIDE: A Decision-Making Model for More Effective Decision Making by Health Care Managers(Wolters Kluwer Health, Inc., 2008) Guo, Kristina L.The purpose of this article is to describe a step-by-step process for decision making, and a model is developed to aid health care managers in making more quality decisions, which ultimately determines the success of organizations. The DECIDE model is the acronym of 6 particular activities needed in the decision-making process: (1) D = define the problem, (2) E = establish the criteria, (3) C = consider all the alternatives, (4) I = identify the best alternative, (5) D = develop and implement a plan of action, and (6) E = evaluate and monitor the solution and feedback when necessary. The DECIDE model is intended as a resource for health care managers when applying the crucial components of decision making, and it enables managers to improve their decision making skills, which leads to more effective decisions.Item Core Competencies of the Entrepreneurial Leader in Health Care Organizations(Wolters Kluwer Health, Inc., 2009) Guo, Kristina L.The purpose of this article is to discuss core competencies that entrepreneurial health care leaders should acquire to ensure the survival and growth of US health care organizations. Three overlapping areas of core competencies are described: (1) health care system and environment competencies, (2) organization competencies, and (3) interpersonal competencies. This study offers insight into the relationship between leaders and entrepreneurship in health care organizations and establishes the foundation for more in-depth studies on leadership competencies in health care settings. The approach for identifying core competencies and designing a competency model is useful for practitioners in leadership positions in complex health care organizations, so that through the understanding and practice of these 3 areas of core competencies, they can enhance their entrepreneurial leadership skills to become more effective health care entrepreneurial leaders. This study can also be used as a tool by health care organizations to better understand leadership performance, and competencies can be used to further the organization’s strategic vision and for individual improvement purposes.Item Consumer-Directed Health Care(Wolters Kluwer Health, Inc, 2010) Guo, Kristina L.The purpose of this article is to describe the importance of consumer-directed health care as the essential strategy needed to lower health care costs and support its widespread adoption for making significant strides in health care reform. The pros and cons of health care consumerism are discussed. The intent is to show that the viability of the US health care system depends on the application of appropriate consumer-directed health care strategies.Item Consumer-Directed Health Care(Wolters Kluwer Health, Inc, 2010) Guo, Kristina L.This article uses a pyramid model to illustrate the key components of consumer-directed health care. Consumer-directed health care is considered the essential strategy needed to lower health care costs and is valuable for making significant strides in health care reform. Consumer-directed health care presents new challenges and opportunities for all health care stakeholders and their managers. The viability of the health system depends on the success of managers to respond rapidly and with precision to changes in the system; thus, new and modified roles of managers are necessary to successfully sustain consumerism efforts to control costs while maintaining access and quality.Item Cultural Diversity Training: The Necessity of Cultural Competence for Health Care Providers and in Nursing Practice(Wolters Kluwer Health, Inc, 2016) Guo, Kristina L.; Young, SusanThe purpose of this article is to discuss the need to provide culturally sensitive care to the growing number of diverse health care consumers. A literature review of national standards and research on cultural competency was conducted and specifically focused on the field of nursing. This study supports the theory that cultural competence is learned over time and is a process of inner reflection and awareness. The domains of awareness, skill, and knowledge are essential competencies that must be gained by health care providers and especially for nurses. Although barriers to providing culturally sensitive care exist, gaining a better understanding of cultural competence is essential to developing realistic education and training techniques, which will lead to quality professional nursing practice for increasingly diverse populations.Item Using a Social Entrepreneurial Approach to Enhance the Financial and Social Value of Health Care Organizations(Journal of Health Care Finance, 2014) Guo, Kristina L.; Liu, Sandra S.; Lu, Jui-fen R.In this study, a conceptual framework was developed to show that social entrepreneurial practices can be effectively translated to meet the social needs in health care. We used a theory-in-use case study approach that encompasses postulation of a working taxonomy from literature scanning and a deliberation of the taxonomy through triangulation of multilevel data of a case study conducted in a Taiwan-based hospital system. Specifically, we demonstrated that a nonprofit organization can adopt business principles that emphasize both financial and social value. We tested our model and found comprehensive accountability across departments throughout the case hospital system, and this led to sustainable and continual growth of the organization. Through social entrepreneurial practices, we established that both financial value creation and fulfilling the social mission for the case hospital system can be achieved.Item Market-focused management(Emerald Group Publishing, Limited, 2003) Guo, Kristina L.Abstract This paper describes managed care, competition and high health care costs and reductions in funding as the major market forces that affect US academic health centers. .As academic health centers continue to preserve their missions of providing patient care, educating and training health professionals and conducting research, they are negatively impacted by these market changes, thus, resulting in increased expenses and lowered revenue. A key component to surviving in difficult times is market-focused management. This paper develops a model to show the path of senior level management teams in their decision making. Through the performance of essential managerial roles, senior level managers are responsible for strategies that result in the long-term viability and growth of academic health centers.Item Organizational and management strategies in response to US market trends(Emerald Group Publishing, Limited, 2004) Guo, Kristina L.This paper describes major trends in the health care market. They include increased health care costs, the growth of managed care, emphasis on quality of care, consumer choice and the growth of the elderly and uninsured populations. The relationship between cost, quality, managed care and choice are explored in the Medicare and Medicaid programs. A clearer understanding of these trends enables managers in health care organizations to make strategic decisions resulting in organizations’ survival and growth.Item Quality improvement techniques to improve patient satisfaction(Emerald Group Publishing, Limited, 2004) Guo, Kristina L.; Torres, E.J.This paper describes several approaches for implementing quality improvement initiatives to improve patient satisfaction, which enables health-care organizations to position themselves for success in today's global and increasingly competitive environment. Specifically, measuring the views of patients, improving patient satisfaction through a community-wide effort, and using a Six Sigma program are discussed. Each of these programs can be an effective mechanism for quality improvement. A key component to quality improvement techniques involves collaborative efforts by all health-care professionals and managers as they seek to increase patient satisfaction.Item Leadership processes for re-engineering changes to the health care industry(Emerald Group Publishing, Limited, 2004) Guo, Kristina L.As health care organizations seek innovative ways to change financing and delivery mechanisms due to escalated health care costs and increased competition, drastic changes are being sought m the form of re-engineering. This study discusses the Wader’s role of re-engineering in health care. It specifically addresses the reasons for failures in re-engineering and argues that success depends on senior level leaders playing a critical role. Existing studies lack comprehensiveness in establishing models of re-engineering and. management guidelines. This research focuses on integrating re-engineering and leadership processes in health care by creating a step-by-step model Particularly, it illustrates the four Es: Examination, Establishment, Execution and Evaluation, as a comprehensive re-engineering process that combines managerial roles and activities to result in successfully changed and reengineered health care organizations.Item The new health care paradigm(Emerald Group Publishing, Limited, 2005) Guo, Kristina L.; Anderson, DawnThe purpose of this paper is to discuss the need for the service line management approach in health care. Service line management is increasingly utilized by US health care organizations as an innovative method for providing the needed stimulus to increase viability and profitability for the ailing health care sector. Design/methodology/approach - Using current literature, this study describes a paradigm shift from traditional health care management approaches to focus on the importance of a service line management approach with its specific emphasis on competencies of leaders. Research limitations/implications - Four essential competencies - conceptual, participation, interpersonal, and leadership - must be gained by leaders to bring about organizational growth. Practical implications - Health care managers must understand and practice these four key competencies to become effective health care leaders. Originality/value - This paper provides useful information on the need for the service line management approach in health care.Item Re-engineering changes to the healthcare industry(Emerald Group Publishing, Limited, 2006-07) Guo, Kristina L.