Senior Manager Roles and Skills in Eldercare Organizations

Introduction: The Role of Senior Manager in Eldercare

Eldercare organizations can exhibit various organizational structures depending on their role in the community, their size, mission and vision, and strategic objectives. Most eldercare institutions will, like other healthcare organizations, have hierarchical organizational structures with senior or executive leadership at their zenith. The purpose of this paper is to show that senior managers in healthcare organizations encompass a wide range of specific skills and competencies, including those related to coordination, strategic planning, capital budgeting and cost accounting, marketing, advocacy, and interfacing with policymakers, community allies, and stakeholders.

The role of the senior manager is multifaceted and varied, and may shift on an almost daily or even hourly basis. At times, the senior manager will function as a visionary leader who devises strategies for planned organizational change. At other times, the senior manager embodies a transformational style of leadership to empower colleagues and subordinates, particularly in an institution with departmental divisions. The senior executive in an eldercare organization may also work with financial planning and accounting teams to make strategic planning decisions and decisions linked to the allocation of resources, methods of managing or cutting costs, and effective human resources policies. Ultimately, the senior management team aims to "foster an environment that can provide necessary and quality health care at maximum profit" (Locsin, n.d., p. 1).

All executive decisions made in the eldercare facility need to reflect the organization's core vision, values, and mission. Therefore, the senior manager must ensure that all department leaders are on track and that patient or resident outcomes meet stated objectives. The senior manager also receives regular updates on healthcare policy at the state or federal level, while responding to local contingencies stemming from relations with community stakeholders and strategic allies. Particularly in the realm of eldercare, politicians are "closely in touch with and aware of the attitudes and beliefs of the public about their local health service" (Walshe & Smith, 2006, p. 2). Senior executives are in the unique position of needing to systematically balance the pressures of public opinion with the economic expediencies of the organization. Additionally, the senior manager works with the marketing department to promote the products and services being offered to target audiences. Executives in eldercare facilities frequently serve as spokespeople for the entire institution, implying an additional role in public relations.

Key Administrative Processes

Key administrative processes that need to be managed in an eldercare facility include human resources, marketing and outreach, public relations, advocacy, reimbursement policies and procedures, and financial management. Strategic planning and quality improvement are also critical administrative processes. Unlike supervisors or managers, executives or senior administrators will not necessarily be working directly with patients or managing nursing teams. However, the senior manager of the eldercare organization does need to understand the fundamental principles of organizational culture and behavior in order to interface effectively with the human resources department. Human resources managers will implement policies and programs that are passed down and supported by senior leadership, which is why an executive needs to provide visionary guidance that aligns human resources policies with the values of the organization.

Issues related to finances, budgeting, fee scheduling, and reimbursement will also require strong leadership. Dunn (2010) points out the challenges that managed care presents to the eldercare facility, noting that reimbursement declines have been on the rise (p. 3). Challenges and concerns like these affect administrative processes, requiring creative solutions, concerted efforts at devising temporary or even ad hoc management teams, and clear communication with relevant staff and stakeholders.

Role of Communication and Coordination

Communication is the cornerstone of effective leadership in every sector, but particularly in healthcare, where so many disparate interest groups and parties compete for attention. Senior leaders will also have a coalition or team within the eldercare organization, as well as beyond it, helping to guide visionary activities, assess risks, and plan for change. To achieve their goals, executive leaders in eldercare organizations must recognize and assess available resources and "leverage resources and assets at will" (Stack, 2014, p. 31). Leveraging resources and assets requires sustained communication and coordination. Communication strategies include the use of traditional and new media for internal communications and inbound marketing, as well as leveraging the interconnectivity of the healthcare sector.

Because senior administrators work in a collaborative environment, "healthcare leaders must try to engage others in the process of making their own changes" (Porter-O'Grady & Malloch, 2015, p. 11). Those changes need to be evidence-based and driven by empirical needs assessments. Likewise, a senior manager in the eldercare organization remains dedicated to achieving results that are measurable and attainable. Communication with various departments allows the senior manager to coordinate all efforts focused on reaching specific patient outcomes or budgetary outcomes. Parand, Dopson, Renz, et al. (2016) conducted a systematic review of literature and found "evidence that managers' time spent and work can influence quality and safety clinical outcomes, processes and performance" (p. 1). Therefore, senior managers should spend additional time with staff to cultivate core competencies in key areas, including the implementation of new technologies, new guidelines for best clinical practices, renovations to the physical structure, and methods of attracting new clients.

Conclusion

Executive leadership guides best practices within the eldercare organization. Working with a team of departmental managers, a senior manager performs various interrelated functions that help promote the mission and values of the organization. Although communication and coordination remain the most important functions of the senior manager, executive leadership also requires astute awareness of healthcare policy and the needs of community stakeholders.

References

Dunn, R. T. (2010). Dunn & Haimann's healthcare management. Health Administration Press.

Groves, K. S. (2006). View from the top. The Journal of Health Administration Education, Winter 2006.

Locsin, A. (n.d.). The role of managers in health care. The Chronicle. http://work.chron.com/role-managers-health-care-16590.html

Parand, A., Dopson, S., Renz, A., et al. (2014). The role of hospital managers in quality and patient safety: a systematic review. BMJ Open, 4, e005055. https://doi.org/10.1136/bmjopen-2014-005055

Porter-O'Grady, T. & Malloch, K. (2015). Quantum leadership (4th ed.). Jones & Bartlett.

Stack, L. (2014). Execution IS the strategy. Berrett-Koehler.

"Understanding Healthcare Management." Chapter 2. http://samples.jbpub.com/9780763759643/59643_CH02_5289.pdf

Walshe, K. & Smith, J. (2006). Introduction: the current and future challenges of healthcare management. In K. Walshe & J. Smith (Eds.), Healthcare Management. McGraw-Hill.