A tale of two systems: a personal account of a successful consolidation

"It was the best of times, it was the worst of times." This isn't a "tale of two cities." It's a tale of two Catholic health care systems in one city. For nearly a century, we were vigorous competitors. We were forced to consolidate our operations in 1987 as a result of the consolidation of our national Health Care sponsors. This is a detailed account of how that consolidation was achieved.     

Skills needed by physician CEOs. Interview by Barbara J. Linney

How do you transition from physician executive to physician CEO? Three physician CEOs were interviewed to explore the skills they needed to land in the top position. They share their views on what it takes to be a successful CEO. They describe the skills that they needed when they moved into the CEO role and how they acquired them. Some of the qualities it takes to be a CEO include the ability to: Articulate your values; use your people skills; describe a vision; solve problems; listen; walk around; and use analytical skills.     

Analysis of Uncertainties in Interactive Probabilistic Safety Analysis (PSA) Models

Probabilistic safety analysis (PSA) has been used in nuclear, chemical, petrochemical, and several other industries. The probability and/or frequency results of most PSAs are based on average component unavailabilities during the mission of interest. While these average results are useful, they provide no indication of the significance of the facility's current status when one or more components are known to be out of service. Recently, several interactive computational models have been developed for nuclear power plants to allow the user to specify the plant's status at a particular time (i.e., to specify equipment known to be out of service) and then to receive updated PSA information. As with conventional PSA results, there are uncertainties associated with the numerical updated results. These uncertainties stem from a number of sources, including parameter uncertainty (uncertainty in equipment failure rates and human error probabilities). This paper presents an analysis of the impact of parameter uncertainty on updated PSA results.     

Medical staff make-up facing shake-up

With financial, occupational and political pressures rising, hospital medical staffs will eventually be forced to change in order to meet the demands of today's health care market.     

Author Index

Authors Index

Author Index     

No pattern seen in survey for overreader qualifications

A survey was conducted in the fall of 1989 to determine how hospitals handle the task of overreading of computer-generated electrocardiograms. All hospital-based members (1,451) of the American College of Physician Executives were sent questionnaires. Responses were received from 413 physician executives, a response rate of about 28 percent. The results of the survey are summarized in this article.     

Due process key element of physician grievance.

The concept of grievance procedures, when applied to physicians, has a foreign ring to it. We ordinarily associate grievance procedures with unions and labor relations activities unrelated to professional conduct and behavior. As described in the preceding article, grievance procedures usually are extremely limited, having been created to resolve very specific violations of collective bargaining agreements in a unionized company or of conflict resolution policies in a nonunion environment. In health care organizations, "due process provisions" are designed to resolve specific conflicts in the relationship between the medical staff and individual medical practitioners.