The Doctor of Health Administration: an educational innovation for healthcare executives

This article describes the development and implementation of an innovative doctoral program designed to enhance the knowledge and skills of healthcare executives. The program is a Doctor of Health Administration (D.H.A.) Degree with a specific focus on leadership. This sets the program at the Medical University of South Carolina apart from all others in being the first D.H.A. offered in the United States and the only program at the time to place its primary emphasis on leadership.     

Assessing the educational needs of community sexual healthcare practitioners

There is wide variation in the quality and nature of community sexual health service delivery in the UK, which has led to a number of professional and Government-led directives to improve service provision. One key target is the provision of appropriate training and updating of staff in order to maintain an appropriate skill level. To identify the educational development needs of community sexual health nursing and medical staff, preparatory to commissioning appropriate educational provision, a training needs analysis survey was conducted. This involved using a customised psychometrically valid and reliable instrument, which was administered to all relevant staff for self-completion. Fifty-four (67.5%) of all doctors and nurses working in a community sexual health directorate responded. For the whole sample, the following categories of development need were identified: professional development; research; legal issues; clinical practice; and communication/interpersonal skills. When the nursing and medical subsamples were analysed separately, the same generic training needs emerged, although the nurses and doctors identified 22 and 25 significant training needs, respectively. The reported skills deficits cluster into super-ordinate groups which resonate with other available literature. This suggests that each category could be reliably used to inform a short course or series of modules, either for the whole sample or for each professional group. The results also suggest that the instrument is viable for use with healthcare professionals working in this specialty. Consequently, if this approach to identifying skill deficits was adopted, limited educational budgets could be used to provide courses which would meet the real training needs of staff, and if offered as a shared learning opportunity, could promote multidisciplinary team-working. In this way, improved local healthcare provision could be readily realised, with the potential for reducing current variations in the quality of community sexual health provision.     

Characteristics and educational needs of senior health service managers in Australia.

A conflict between perceived management skill and educational deficiencies led to a survey of Australian hospital chief executive officers, directors of medical services, directors of nursing, and other managers of equivalent status in an effort to improve the caliber of senior health officials in the future. The results are outlined and analyzed in this article. Although measurement of their characteristics is mainly of interest to Australians, the information on the background, process, and education for management has much wider relevance.     

Ethics and impaired healthcare executives

Healthcare executives are not expected to poorly manage their own health. When they do, they do more than diminish their own public image: They can also damage the public image of their organizations of employment.     

An exploratory study of healthcare strategic planning in two metropolitan areas

Little is known about empirical variation in the extent to which healthcare organizations conduct formal strategic planning or the extent to which strategic planning affects performance. Structural contingency and complexity science theory offer differing interpretations of the value of strategic planning. Structural contingency theory emphasizes adaptation to achieve organizational fit with a changing environment and views strategic planning as a way to chart the organization's path. Complexity science argues that planning is largely futile in changing environments. Interviews of leaders in 20 healthcare organizations in the metropolitan areas of Minneapolis/St. Paul, Minnesota, and San Antonio, Texas, reveal that strategic planning is a common and valued function in healthcare organizations. Respondents emphasized the need to continuously update strategic plans, involve physicians and the governing board, and integrate strategic plans with other organizational plans. Most leaders expressed that strategic planning contributes to organizational focus, fosters stakeholder participation and commitment, and leads to achievement of strategic goals. Because the widespread belief in strategic planning is based largely on experience, intuition, and faith, we present recommendations for developing an evidence base for healthcare strategic planning.     

The importance of middle managers in healthcare organizations

In the 1990s, the turbulent environment continued to exert pressure on the management of cost, access, and quality of healthcare provision. To strengthen financial and market positions, mergers and acquisitions became popular strategies along with the reengineering of internal structures. Since this trend of restructuring and reengineering, an understanding of the value of middle managers has been misplaced. Their importance in strategic formulation and implementation has largely been overlooked. They have been perceived as intermediaries that slow organizational efficiency without adding much measurable value. Some researchers have since challenged the accuracy of this assumption and the helpfulness of removing middle managers. They have reexamined the role of middle managers and discovered that they are key agents of change. Middle managers make significant contributions across the healthcare organization in their roles of entrepreneur, communicator, therapist, and stabilizer.     

Career patterns of healthcare executives.

This research examines the job and career changes of healthcare executives and managers working in different segments of the healthcare industry in the western United States. The results suggest that the job and career patterns in the healthcare delivery sector are undergoing significant transformation. One third of the respondents reports that at least one of their last four job changes was involuntary or unplanned. One half of those attempted to make a career change. This study identifies four different executive and management career patterns. The most common was one of multiple career changes. The second pattern was that of a single career change, followed by a 'traditional' career in which one did not seek a career change. The final pattern was characterized as a movement back and forth between two different segments of the healthcare industry. Age, gender, marital status and education were not associated with any specific career pattern. The need to achieve results early in the respondent's career had a strong influence on career patterns. This study confirms the fluidity of career movement and the changing permeability between the various segments of the healthcare industry. It also suggests that career success increasingly will require broad management experience in those different segments.     

Placing the cornerstone for healthcare professionals' risk management education: An educational needs assessment

The risk manager's performance of an educational needs assessment to assist in determining related training and development elements supports a solid, proactive risk management program designed to motivate healthcare professionals. Environmental scanning, needs assessment tool design and development, tool validation, organizational commitment and ethical considerations are examined. A sample needs assessment tool is provided.