Transfer of ownership: antidote to closure

In the 1990s, many hospitals will continue to be confronted with financial, regulatory, and medical staff issues that threaten their survival. Inadequate reimbursement, HCFA certification problems, and aging medical staffs are just a few examples of the many difficult issues health care institutions face today and that have contributed to the phenomenal number of failing hospitals. Failing hospitals must consider all their options, such as turnaround process, modification of service mix, change to a specialty hospital, transfer to a new owner, or closure. Selection of the most appropriate option hinges on the hospital's goals and mission, its need in the community, and its owner's and sponsor's desire or ability to continue in the health care business. This article will discuss the transfer of ownership option.     

Hospital size determines department director policy

Early in 1990, the American College of Physician Executives undertook a survey of its hospital-based members to determine the extent to which hospitals had department directors and the roles, responsibilities, and compensation of those directors. The survey form was mailed to about 1,400 College members; responses were received from 734--approximately a 52 percent response rate. This article reports the results of the survey.     

Growth in medical director numbers continues.

A recent survey shows that nearly two-thirds of all hospitals have or are considering a medical director position. Comparative data show that the average bed size of hospitals with a medical director continues to decline as more and more institutions add the position. The reasons for the growth, according to the survey, are the increasing demands of administering a medical staff and responding to regulatory agencies.     

MANAGEMENT INFORMATION SYSTEMS CURRICULA: STATE-OF-THE-ART*

Business and business/management schools were surveyed to determine the characteristics of management information systems (MIS) curricula. All academic degree levels–Bachelors, Masters, and Doctorate–were investigated. An encouraging 82% response from 260 academic institutions queried lends credibility to findings reported. These survey results should provide insights for the development of new and/or revised MIS curricula. They also indicate opportunities for expanding enrollments. The MIS field, still in its infancy, has not yet stabilized. This is causing difficulties in planning curricula for this newly-evolving discipline. The MIS area within both the academic and business communities is undergoing constant and rapid change due to environmental and technological advancements. In order to insure curriculum relevance and properly trained personnel in this field, these areas must respond to these changes. Suggestions as to where and how this discipline should proceed must be based upon the currently existing situation.     

创新网络嵌入与高技术企业研发人员创新绩效关系研究

 创新驱动的实质是人才驱动,企业技术管理的重要核心之一是人员管理。研发人员是高技术企业的核心人力资本和主导资源,具有典型的稀缺性、创造性、主导性、体验性以及高信息需求等异质性特征,能否采取切实有效措施满足研发人员的异质性需求,激活其创新潜力和活力,是提升高技术企业创新绩效和管理技术人员的关键。        聚焦于高技术企业研发人员的异质性需求特征,运用创新网络嵌入理论,提出创新网络嵌入、创新效能感与创新绩效的关系假设模型;借鉴成熟量表,设计相关测量变量的调查问卷;利用Spss 19.0和Amos 21.0软件,对北京、上海、武汉、广州等地高技术企业研发人员的269个调查数据进行分析,考察创新网络嵌入对研发人员创新绩效的影响和作用机理,并验证创新效能感的中介作用。        研究结果表明,高技术企业研发人员的创新网络结构嵌入对创新过程和创新结果均具有显著正向影响,而关系嵌入仅对创新过程具有正向影响;创新网络结构嵌入和关系嵌入对创新效能感均具有显著正向影响,创新效能感对创新过程和创新结果具有显著正向影响;创新效能感在研发人员结构嵌入和关系嵌入对创新过程的影响中起完全中介作用,在结构嵌入对创新结果的影响中起部分中介作用。        从技术人员创新绩效管理的微观视角入手,探究高技术企业研发人员创新绩效的内涵、实质和影响因素,对高技术企业研发人员的创新网络嵌入与创新绩效的关系、创新效能感的中介作用以及创新网络嵌入与创新绩效的关系研究中关系嵌入悖论进行实证检验和解读,提出提升高技术企业研发人员创新绩效的创新网络嵌入式开发策略,包括聚焦产学研战略协同和集群创新、强化关系网络建设和位置管理、营造宽松氛围以提升创新效能感等。     

家族企业接班人的胜任—绩效建模——基于越商代际传承的实证分析

接班人的选择与培养对于家族企业的生存发展至关重要。本文通过文献回顾、深度访谈和问卷调查方式,采用探索性和验证性因子分析方法构建了家族企业接班人的胜任—绩效模型。结果显示,模型具有较好的拟合度,家族企业接班人胜任能力包括社会网络、政府关系、发现机会、承担风险、资源整合、战略决策、学习创新和科学管理八个因子,其中,前四个因子和后四个因子可以分别归属于管理素质和管理技能两个一级因子;家族企业的继承绩效包括客观绩效和主观绩效两个因子,其中,客观绩效包括人才结构、产品技术、品牌形象、市场份额、利润增长和企业规模六个二级因子,而主观绩效主要包括家族满意和员工满意两个二级因子;社会网络、学习创新、政府关系、资源整合等因子对于家族企业的继承绩效具有更显著的相关性关系,而社会网络和政府关系对于企业继承的影响颇具中国特色。     

城市劳动力市场中的人员流动及其决定机制——兼析大城市的新二元结构

本研究借用了劳动力市场阶层化研究的思路和方法,利用专项调查获取的大量数据,实证分析了城市劳动力市场中的流动及其决定机制。本文的理论假说如下:第一,中国的城市劳动力市场包含了外劳和本地居民两大部分,但这两部分从业人员所属的市场阶层以及在市场阶层之间的流动状况是不相同的。第二,从非正规部门流向正规部门的上升移动会带来工资收入的增加,但本地居民和外劳,以及外劳中的民工与城镇居民实现流动的机会是不均等的。第三,在求职过程中选择什么性质的部门、以何种方式在不同部门之间流动,主要取决于以户籍为代表的制度因素,而不是个人的教育水平、工作经历等人力资本。本文的结论是:通过劳动力市场的竞争机制,人力资本的利用状况明显改善,但由于还存在制度歧视,劳动力市场依旧是二元性质的。消灭城市内部的新二元结构是下一步改革的重要目标。     

Coaching für Führungskräfte im Krankenhaus Baustein einer Strategie zum Total Quality Management

Coaching of managers in hospitals as component of a total quality management strategy The author delineates the changed conditions of hospitals at the beginning of the new millenium. In order to be up to date with the growing challenges and the need for change a Total Quality Management (TQM) is necessary. This TQM sees the satisfaction of clients and of employees as crucial for all reorganization processes. The realization in everyday hospital life requires a total personnel development concept, with special regard to the managers and their specific needs for support by supervisors resp. coaches.     

Risk management in an IPA setting--Part I

Over the past several years, HMO enrollment has grown the most in independent practice association (IPA) and network models. HMOs in general have expanded as a means to control the cost of health care. Key customers, including large employers and government agencies such as the Health Care Financing Administration (HCFA), require such control. IPA and network models retain a greater sense of choice on the part of participating physicians and patients than do closed-panel group- or staff-model programs. As physician and patient choice increases, however, the HMO's control over health care diminishes. Thus, customers require HMOs to manage health care. The HMO must market, develop delivery systems, meet regulatory requirements, and make profits. It must control both the quality and the cost of health care. Doing so without the level of control found in staff-model HMOs has created unique challenges for IPA HMO managers. IPA-model HMOs adapt quality improvement programs to this lesser level of control. Staff-model HMOs and hospitals closely link quality assurance to risk management. Programs designed to improve quality will naturally also reduce the risk of providing care below standards. This relationship is less clear in IPA- and network-model HMOs, in which the HMO does not provide the care. Thus, IPA-model quality improvement programs often do not address their risk management implications. This two-part article examines the differences between staff-model and IPA-model HMOs in liability and in ability to manage risk. In the first part, the nature of the risks is described. In the next issue of the journal, the management of those risks will be discussed.     

Personnel turnover in health care organizations: Test of a predictive model based on work assessments by employees

It is predicted that institutions in Dutch intramural health care will be increasingly confronted with problems in personnel supply. Instead of making great efforts to keep the inflow of new personnel on the desired level, control of turnover is an alternative solution. In this paper, an explanatory model is constructed, based on previous theories and research findings. It is hypothesized that the more employees have positive attitudes concerning their work and work situation, the greater their satisfaction and commitment and hence the less their intention to leave and the lower actual turnover. This model was tested using a large scale employee questionnaire. The instrument turned out to be reliable (internal consistencies above .70). The questionnaire was administered in eight institutions in four health care sectors (n = 1456). Results indicate that attitudes about work content and personnel management are relevant in predicting intention to leave. All in all, 8 work-related aspects predicted 21% of intention to leave. Aspects with the most predictive value were career guidance, work safety, responsibilities and job discretion. Furthermore, general satisfaction was shown to play an intermediary role in predicting intention to leave. It is concluded that improvements in work content and personnel management can reduce intention to leave and hence the demand for new personnel.     

Utilization management in Alberta's new funding environment

Although physicians have the greatest influence on the resource utilization of hospital patients, Canadian hospitals have not been too successful in bringing physicians into the resource planning and decision-making processes. This is because most hospitals have been unable to provide the information needed by physicians to participate in resource management in a meaningful way. With the introduction of a new system in the Canadian Province of Alberta that fundamentally changes the way hospitals are funded, it has become even more important to involve medical staffs in the utilization management process. This article describes the new funding system and highlights some of the ways in which Wetaskiwin Health Care Centre has leveraged information technology to support the utilization management process in this new environment.     

An Empirical Study of the Relations Between Hospital Volume,Teaching Status,and Service Quality

This paper contributes to research on quality drivers in healthcare settings by examining the relationships between patient volume, teaching mission, and process quality in US hospitals. To develop a model that accurately assesses the impact of patient volume and teaching status on quality, we draw on three related research streams pertaining to the volume–quality relationship, the comparative quality of care in teaching and non‐teaching hospitals, and quality drivers in service institutions. We propose the impact of patient volume on process quality varies across hospitals with different teaching intensities. The test of this proposition uses a large data set that measures process quality for treatments for heart attacks and heart failures in all major US hospitals. Our results suggest that, as hospital teaching intensity increases, greater patient volume is associated with decreased process quality. Never before was such a relationship uncovered. This initial finding has important practical implications. First, the regionalization policy of hospitals should be re‐evaluated in light of their teaching function. Second, the root causes for the lower quality scores of large, high resident‐to‐bed ratio teaching hospitals, compared with smaller versions, must be found.     

A LARGE-SCALE PERSONNEL ASSIGNMENT MODEL FOR THE NAVY*

The U.S. Navy has been trying for years to develop a model to automate its personnel assignment process The requirement of rotating navy personnel frequently between sea duty and shore duty in accordance with multiple policies makes modeling efforts difficult. However, without a model to optimize assignments with regard to multiple policies, navy managers do not know the real impact of personnel assignments. This limits their ability to make effective decisions. This paper summarizes our effort to develop a large-scale network model for the navy's assignment problem. The navy has accepted this model for implementation, replacing the current manual assignment process. The approach in this paper can be generalized to a wide variety of perosnnel assignment problems.     

Coaching- und Beratungsanliegen von Hochschullehrenden

In the last few years, there has been an increase in coaching and training for teaching staff at institutions of higher education??universities and colleges??to provide them with the skills to develop their roles and meet professional demands upon them. These services are usually provided by the institution??s own human resource department or external higher education institutions with teaching services. This article focuses on the typical concerns of the target group of lecturers teaching at academic institutions about teaching and the higher education system. It has been structured chronologically, to provide a frame of reference for coaching and guidance counseling services and serves as a guideline for such services in general.     

Computerization of a medium-sized hospital without an internal DP department

The conventional approach to computerization in a large hospital is to establish an internal data processing (DP) department and DP professionals then begin to develop computer-based information systems (CBIS). For medium-sized hospitals, however, this approach is doubtful. The limitation of financial resources and the lack of skilled systems professionals force the medium-sized hospital to consider different approaches. In this paper, we present a conceptual framework for the computerization of a medium-sized hospital based upon the viewpoint of top management. Based on the conceptual framework presented, a PC-based application software package has been developed, tested, and implemented at Cheng-Ching Hospital in Taiwan. Our study shows that a medium-sized hospital can initiate and conduct computerization in very short time with low cost and without an internal DP department.     

Personnel turnover in health care organizations: Test of a predictive model based on work assessments by employees

Abstract

It is predicted that institutions in Dutch intramural health care will be increasingly confronted with problems in personnel supply. Instead of making great efforts to keep the inflow of new personnel on the desired level, control of turnover is an alternative solution. In this paper, an explanatory model is constructed, based on previous theories and research findings. It is hypothesized that the more employees have positive attitudes concerning their work and work situation, the greater their satisfaction and commitment and hence the less their intention to leave and the lower actual turnover. This model was tested using a large scale employee questionnaire. The instrument turned out to be reliable (internal consistencies above .70). The questionnaire was administered in eight institutions in four health care sectors (n = 1456). Results indicate that attitudes about work content and personnel management are relevant in predicting intention to leave. All in all, 8 work-related aspects predicted 21% of intention to leave. Aspects with the most predictive value were career guidance, work safety, responsibilities and job discretion. Furthermore, general satisfaction was shown to play an intermediary role in predicting intention to leave. It is concluded that improvements in work content and personnel management can reduce intention to leave and hence the demand for new personnel.     

From knowledge to decision – a case study of sales and operations planning in health care

One of the most important challenges in health care management is balancing resources with fluctuating and uncertain demand. This study examines whether introducing a standardised process for sales and operations planning at a large university hospital improved specialty department managers’ knowledge of planning conditions and if so, whether decisions were made based on this knowledge. Using responses from a survey of 30 specialty department managers at Sahlgrenska University Hospital in Sweden, the analyses indicate that operational knowledge strengthens insights about the needs for strategic decisions, and vice versa. Moreover, knowledge is a necessary, but not sufficient, condition for making decisions at the department level. An overall planning and decision structure is required and should be implemented first at the hospital level to effectively allocate resources.     

Technology selection in the absence of standardised materials and processes: a survey in the UK composite materials supply chain

Composite materials is an industry where technology selection has major consequences as there is not a standard manufacturing process, nor are there standardised materials with defined or proscribed properties for companies to select as multiple solutions are technically viable. This research aims to identify key factors for manufacturing technology selection in the UK composite materials supply chain. Literature review and managers’ opinions were used to identify 18 factors affecting manufacturing technology selection. This was followed by a survey comprising the multi-tier supply chain of the composite materials industry. The results of the survey show ‘on time deliveries/service level to customers’, ‘improve quality’ and ‘reduce cycle time’ received the highest average ratings. In this study a correlation analysis was performed to identify the underlying dependencies between the factors investigated. The identification and use of underlying dependencies rather than highest average provided a more comprehensive picture of the factors that affect technology selection in the composite materials industry. For this study, experts in composite materials were asked to comment on the findings of the survey and their value to the industry. The results presented may assist companies in the composite materials industry with technology selection decision-making processes.