Tools for novice health care clinical administrators

With the face of health care changing at a blistering pace due to shrinking resources, advanced technology, and growing consumer demands, organizations, for-profit and nonprofit alike, have responded by flattening organizational hierarchies. Consequently, it is not an uncommon practice to promote "successful technical experts" to clinical administrator positions. Ill-prepared, rookie clinical administrators are often left struggling to manage an organization with little experience and training. Fortunately, there is help. This article will identify and apply internal and external tools that newly promoted clinical administrators can use to hurdle potential pitfalls.     

Consumer satisfaction: a model for health services administrators

Health care administrators should recognize that the economic quality and behavioral quality dimensions comprising consumer satisfaction are conceptually independent in nature and may be empirically independent as well.     

Competencies for health management practice: a practitioner's perspective

The current health care environment will require executive leadership with a new set of management competencies to effectively lead and manage the various components of a restructured health care delivery system. The traditional management skills of planning, organizing, directing, controlling, and staffing resources will remain relevant, but the true measure of professional success will be the development of conceptual skills. This means the ability to look at the health care enterprise as a whole, and recognize how changes in the environment shape your strategic mission, goals, and objectives. The successful health care leader will have a demonstrated ability to apply these conceptual skills to the development of information systems and integrated networks that position their organization to accept capitated risks. This paper examines the United States and Canadian health care systems from the perspective of both the more traditional hospital and the emerging medical care organizations. New importance of the team approach to leadership and management and all that entails is stressed.     

Orthopedic surgery in rural American hospitals: a survey of rural hospital administrators

Rural American residents prefer to receive their medical care locally. Lack of specific medical services in the local community necessitates travel to a larger center which is less favorable. This study was done to identify how rural hospitals choose to provide orthopedic surgical services to their communities. Methods: All hospitals in 5 states located in communities that met the criteria for a rural town according to the Rural Urban Commuting Area codes were included. A survey with topics including community and hospital demographics, orthopedic surgical workforce and demand, surgical services, and the perceived benefit of orthopedic services was sent to the hospital administrators. Results: Of the 223 rural hospitals surveyed, 145 completed the survey. Of those completing the survey, 30% had at least one full‐time orthopedic surgeon, 25% did not provide any orthopedic surgical services, 65% never had an orthopedic surgeon on ER call, 33% were recruiting an orthopedic surgeon, 52% stated that it is more difficult to recruit an orthopedic surgeon vs a general surgeon, and 71% of the administrators acknowledged a need for additional orthopedic surgical services in their community. For those hospitals that did not have a full‐time orthopedic surgeon, members of those communities traveled a mean distance of 55 miles for emergency orthopedic surgical care as reported by the hospital administrators. Conclusions: There are many rural communities that have limited access to orthopedic surgical services. While many of the rural hospital administrators feel that there is a need for additional orthopedic surgical services in their communities, it is difficult to recruit orthopedic surgeons to these areas.     

Emotional intelligence: a core competency for health care administrators

The contemporary concept of emotional intelligence (EI) as a critical set of management skills is traced through time to its current application for health care administration. EI is defined as proficiencies in intrapersonal and interpersonal skills in the areas of self-awareness, self-regulation, self-motivation, social awareness, and social skills. The contributions of EI to effective management are supported by empirical research in the field. The importance of developing these skills in health care organizations is further clarified with examples familiar to health care administrators. Training suggestions and assessment resources are provided.     

Nontraditional graduate training for administrators of neighborhood health centers.

Because of the shortage of qualified health care administrators who are members of minority groups, many neighborhood health centers, organized as a result of the Great Society legislation of the 1960''s, suffered from their staffs'' lack of administrative skills and from rapid turnover as staff members gained experience and moved upward to other jobs. To rectify this shortage, the National Association of Neighborhood Health Centers was funded to offer master''s degree programs at the University of Michigan and the University of Southern California. These on job/on campus programs, which began in 1972, allowed participants to work and study concurrently. At Michigan, students attended class 8 hours a day, 4 days a month, for 2 years. At U.S.C., they attended classes for 14 consecutive days 3 times a year for 2 years. Since the usual admission requirements of established graduate programs limit access of minority students, who frequently lack adequate educational backgrounds, admission criteria were modified for the 56 persons enrolled in the program. For example, the Graduate Record Examination scores were not considered in the program at Michgan. Findings in an independent evaluation conducted in 1974 indicated that the programs at both universities were successful in providing graduate education relevant to the special needs of the staffs of neighborhood health centers. Only four students were dropped for academic reasons. More special programs in health administration are needed in both graduate and undergraduate schools to train people in the effective administration of health care centers, particularly those serving communities of disadvantaged persons.     

Great expectations: Challenges for women as mental health administrators

Although women have made many strides in the area of leadership, stereotypes still exist that limit their power. Traditional concepts of femininity have not typically been associated with strength and competence. This article describes an inpatient unit at San Francisco General Hospital, University of California, San Francisco, which is led by a group of women. The unit houses a women-focused treatment team specializing in treating women who have serious mental illness with histories of severe trauma, including poverty and violence. The article describes the challenges and rewards available to women leaders in this type of setting. Four areas of women’s leadership are explored: the stereotypes women have about each other as leaders, the expectations and biases of staff and trainees, the projections of patients onto women leaders, and women’s leadership in relation to department administration. Strategies for addressing biases in these areas and developing women’s leadership conclude the article.