Correlates of hospital leadership team effectiveness: results of a national survey of board chairmen

To examine hospital leadership team effectiveness, analyses the responses of 540 randomly sampled board chairmen of US hospitals. Reports findings regarding board chairmen's evaluation of their hospitals' productive outputs and of the adequacy of their communications with the CEO and medical staff president (MSP) in their hospitals. Notes that over one-quarter of board chairmen found communications with the MSP to be only sometimes productive and notes means whereby positive communications are promoted. Offers suggestions for board chairmen recruitment.     

CEO turnover in rural northwest hospitals

This study examines rates of and reasons for turnover among administrators from 148 rural hospitals in four northwestern states. Data were obtained from a survey of CEOs who left their positions between 1987 and 1990 and from a survey of board members from those same hospitals. During the study period, 85 CEO turnovers occurred at 78 hospitals. High-turnover hospitals were generally smaller than those facilities with fewer turnovers. The annual rate of CEO turnover was 15 percent in 1988 and 16 percent in 1989. The reasons for turnover most often cited by those in their positions for less than four years were due to: seeking a better position elsewhere, an unstable health care system, conflict with hospital board members or with medical staff, and inadequate salary. High levels of self-reported job satisfaction and job performance by turnover CEOs contrasted to the much lower performance evaluations reported by hospital board members. Nearly three out of four board members indicated they would not rehire their departed CEOs. CEOs perceived their professional weaknesses to center on deficiencies in leadership and financial skills as well as problems with physician, hospital board, and community relations.     

The challenge of contributing to policy making in primary care: the gendered experiences and strategies of nurses

This paper explores nurses’ experiences as members of primary care organisations set up to develop and commission health services for local communities. Nurses, alongside GPs and other health professionals, were given a place on the governing bodies (boards) of Local Health Groups – a move widely welcomed by the nursing profession as long overdue recognition of the important contribution nurses and nursing could bring to the policy arena. Nurse board members faced a number of challenges in their attempts to contribute to and influence local health policy. This ethnographic study (which involved non‐participant observation of 33 board meetings and interviews with 29 board members including nurses) suggests that medical authority and control, and hierarchical power relations between doctors and nurses on the board, were seen by nurses as significant obstacles to their participation in this new policy arena. In response to their perceived lack of power and subordinate status, nurses employed a number of strategies to negotiate their participation as board members – these included ‘getting it right’, ‘achieving the right balance’, ‘self‐presentation’ and ‘unassertiveness’. These strategies reflected and reproduced gendered identities and relations of power and raise important questions regarding the influence of nurses and nursing within policy making.     

Hospital board effectiveness: relationships between governing board composition and hospital financial viability.

OBJECTIVE. Two theories--agency and managerialism--are compared with respect to their usefulness in explaining the role of insiders on the hospital board: whether their participation enhances or impairs board financial decision making. DATA SOURCES/STUDY SETTING. The study used 1985 hospital financial and governing board data for a representative sample of acute care California hospitals. STUDY DESIGN. Relationships were examined cross-sectionally between the presence or absence of insiders on the board and measures of hospital financial viability while controlling for the organizational factors of system affiliation, ownership, size, region, and corporate restructuring. PRINCIPAL FINDINGS. Multiple regression analysis found significant relationships between insider (CEO, medical staff) participation and hospital viability. CONCLUSIONS. These results support the managerial theory of governance by suggesting that the CEO and medical staff provide informational advantages to the hospital governing board. However, the cross-sectional design points to the need for future longitudinal studies in order to sequence these relationships between insider participation and improved hospital viability.     

The Role of Consumers in Health Care Decision Making

This paper focuses on the results of a survey of chief executive officers and consumer board members of Ontario hospitals and community health centres regarding the role of consumers in health care decision making. The opinions of both the chief executive officer and consumer board member respondents were elicited regarding the value of consumer input in decision making for the organizations studied. Results indicate that consumer board members feel that their input into organizational decision making is valued, chief executive officers value the input of consumers, and consumer involvement in decision making is increasing. More women are now involved on boards of the organizations studied, but visible minority representation remains low on hospital boards. Consumer board members feel that their decision making is influenced by providers on the board.     

Education needs of hospital governing boards

Hospital governing board members serve voluntarily, however they are integral to their hospitals' operations. This article investigates if there is a discrepancy between board members' knowledge of healthcare issues and how important they perceive these issues to be in their hospitals' operations and direction. In addition, it offers preliminary steps on how to ensure that board members are kept well-informed and up-to-date on issues for strategy planning in the healthcare marketplace.     

American Hospital Association: Prospective Reimbursement Debated; Delegates Request Revised Proposal

Hospital governing board members serve voluntarily, however they are integral to their hospitals' operations. This article investigates if there is a discrepancy between board members' knowledge of healthcare issues and how importanf they perceive these issues to be in their hospitals' operations and direction. In addition, it offers preliminary steps on how to ensure that board members are kept well-informed and up-to-date on issues for strategy planning in the healthcare marketplace.     

Board engagement in quality: findings of a survey of hospital and system leaders

Hospital governing boards assume an important role in improving delivery of quality care in the hospital. More knowledge about the prevalence and impact of particular board activities can help them perform this role more effectively. This study draws from a survey of hospital and system leaders (presidents/chief executive officers [CEOs]) that was conducted in the first six months of 2006 with a total of 562 respondents. The survey contained 27 questions on various aspects of board engagement in quality. More than 80 percent of the responding CEOs indicated that their governing boards establish strategic goals for quality improvement, use quality dashboards to track performance, and follow up on corrective actions related to adverse events. The adoption of other practices was reported less frequently. Only 61 percent of the respondents indicated that their governing boards have a quality committee. The existence of a board quality committee was associated with higher likelihoods of adopting various oversight practices and lower mortality rates for six common medical conditions measured by the Agency for Healthcare Research and Quality's Inpatient Quality Indicators and the State Inpatient Databases. Hospital governing boards appear to be actively engaged in quality oversight, particularly through use of internal data and national benchmarks to monitor the quality performance of their organizations. Having a board quality committee can significantly enhance the board's oversight function. Other potentially useful activities-such as board involvement in setting the agenda for the discussion on quality, inclusion of the quality measures in the CEO's performance evaluation, and improvement of quality literacy of board members-are currently performed infrequently.     

Board development. A clearer picture

--Non-executive board members often take up their positions with little or no previous experience of the NHS. --The NHS Appointments Commission's acclaimed training programme for employees new to the NHS has been running for two years. Along with formal training, board chairs are also offered access to mentors.     

Governing board structure, business strategy, and performance of acute care hospitals: a contingency perspective.

Contingency theory suggests that for a hospital governing board to be effective in taking on a more active role in strategic management, the board needs to be structured to complement the overall strategy of the organization. A survey study was conducted to examine the strategies of acute care hospitals as related to the structural characteristics of their governing boards. After controlling for organizational size and system membership, results indicated a significant relationship between the governing board structure of 109 acute care hospitals and their overall business strategy. Strategy also accounted for more of the variance in board structure than either organization size or system membership. Finally, the greater the match between board structure and hospital strategy, the stronger the hospitals' financial performance.     

Symptoms, airway physiology and histology of workers exposed to medium-density fiber board.

Medium-density fiber (MDF) board was recently introduced in the furniture industry. In this pilot study health complaints, physiology, and histology of the upper airways were evaluated for two groups of workers, one handling MDF board for at least one-third of their work week (MDF group) and another handling traditional fiber board. Civil servants served as a reference group. The frequency of health complaints concerning the airways was higher, the sense of smell was poorer, and the frequency of nasal obstruction measured with rhinomanometry was higher for the MDF group, while mucociliary activity was lower in the group handling traditional board. In both groups forced vital capacity was low when compared with expected values. Histological specimens from the middle turbinate of the nose showed, in a few cases, nasal epithelial dysplasia in the traditional board group, but histological changes in terms of scoring did not differ significantly between the groups.     

Advocacy to action: addressing coordinated school health program issues with school boards

As the need for Coordinated School Health Programs (CSHP) increases, so does recognition of the importance for advocating with local school boards for their support. Identifying the diversified make up of school board members and implementing effective strategies to advocate for coordinated school health can help facilitate the successful inclusion of such a program. With increasing emphasis placed on standardized testing and the "basic" curriculum, school board members need to become aware of specific benefits a CSHP can provide their district. With the relationship between health status and academic achievement confirmed in scientific research, school boards may begin paying more attention to providing high-quality health services and health instruction for students. This article presents items to consider and steps to take before, during, and after addressing a local school board for their support in implementing a CSHP.     

Unique governance for a national ministry. Catholic Health Initiatives' board structure empowers laity, supports mission

The three original founding healthcare systems and 10 sponsoring religious institutes of Catholic Health Initiatives (CHI) have developed an unprecedented governance model to support their vision of a national Catholic health ministry in the twenty-first century. The new organization spans 22 states; annual revenues exceed $4.7 billion. Religious institutes choose either active or honorary status before consolidating with CHI, depending on their desired involvement in the organization. Currently, nine are active and two are honorary. CHI's civil corporation comprises one representative from each active congregation. These representatives approve major changes in mission or philosophical direction. They control board membership by appointing three to five congregation representatives as sponsorship trustees, who are responsible for approving the remaining members of the Board of Stewardship Trustees. This half-religious, half-lay governing board is responsible for leading CHI. CHI has only two levels of governance, a national board and boards of market-based organizations, for instance a network of facilities with one management structure, or a community board of an individual facility. This avoids multiple administrative layers and approval processes. The organization has a civil identity as CHI and a canonical identity as a public juridic person of pontifical right, called Catholic Health Care Federation (CHCF). The governing board members of CHI, as members of CHCF, serve as the religious sponsors for all CHI health facilities. Some facilities have already been "alienated" (turned over) to CHI by their religious institutes; others will be alienated in the future. CHI's recent consolidation with Sisters of Charity of Nazareth Health System added an 11th sponsor, a sixth geographic region, and two members--one religious and one lay--to the governing board. The governance model assists such growth through the appeal of an equal religious-lay partnership and a flexible sponsorship model.     

医院内医疗器械电路板故障的判断与维修

本文介绍了作者在医院工作中总结出的一些有关医疗器械故障维修的实践经验,主要分析如何判断电路板是否出现故障以及在医院里通过有限的资源对故障电路板进行维修,对于维修各种医疗器械以延长使用寿命和降低维修成本具有很好的参考作用。     

Better information for the board

Healthcare managers are making quicker, riskier decisions in an increasingly competitive and regulated environment. Questions have been raised regarding the accountability and performance of boards of these organizations, as board members are not always selected based on their competencies to guide such decisions. Adapting mission and strategy and monitoring organizational performance require information that boards get mostly from management. The purpose of this study was to examine the information that boards regularly get to carry out their functions. I obtained board documents from four not-for-profit hospitals and health systems in different boroughs of New York City. At each institution, I conducted one-hour interviews with at least three board members and three top managers. I also attended at least one board or executive committee meeting and one additional meeting, usually of the finance committee. Principal findings were that the boards get too much data, the same data that management gets, and little comparative data on performance of similar benchmarked organizations. Board members and managers are satisfied with the information that board members get and have no plans to improve their system of shaping, or the quality of, information. Key recommendations to boards and managers are: (1) boards must take greater responsibility for identifying the information that they get and how they wish to get it, (2) managers must ensure that measurable objectives are developed, against which organizational performance can be evaluated, (3) boards must get information that is targeted and shaped to better fit board functions, (4) managers must develop information sets for main service lines, (5) boards must get information on the expectations and satisfaction levels of key stakeholders, (6) boards must get better and more focused information on performance of benchmarked institutions, and (7) boards must get less hospital operating data on a monthly basis.     

医院内医疗器械电路板故障的判断与维修

本文介绍了作者在医院工作中总结出的一些有关医疗器械故障维修的实践经验,主要分析如何判断电路板是否出现故障以及在医院里通过有限的资源对故障电路板进行维修,对于维修各种医疗器械以延长使用寿命和降低维修成本具有很好的参考作用。     

Suit alleges Chicago schools denied job based on HIV

In 1996, the Lambda Legal Defense and Education Fund persuaded the Chicago Board of Education to revoke a policy that demands applicants to disclose their HIV status. The Board promised to revise the policy, but on March 27, 1997 Lambda filed suit in U.S. District Court against the school board on behalf of an applicant who says he continues to be denied a teaching job because of his positive HIV status. The lawsuit claims that the board of education's requirement for any job applicant to provide a complete medical history and to submit to a medical examination is tantamount to requiring HIV status disclosure. The lawsuit states that the board is violating the Americans with Disabilities Act (ADA), the Rehabilitation Act, and Federal and State constitutional guarantees to privacy and equal protection under the law. The suit also says the board lacks procedural safeguards to ensure confidentiality of applicants' medical information.     

中文科技期刊编委会结构优化策略

【目的】 探讨中文科技期刊编委会结构设置特点,提出进一步优化编委会以促进期刊发展的策略。【方法】 统计分析9种耳鼻咽喉科学核心期刊编委会的结构设置、编委数量、换届频率等,总结存在的问题及对期刊发展带来的不良影响,提出优化策略。【结果】 中文科技期刊编委会存在组织结构设置名称多样、规模差异较大、编委兼职明显、编委会换届频率差异显著等问题。建议提高编委遴选标准,合理控制编委会规模,弱化行政考评对担任期刊编委的要求,定期更新编委会。【结论】 合理的编委会结构与规模、严格的编委遴选标准及适时更替将有助于中文科技期刊的可持续发展。     

Effect of board game activities on cognitive function improvement among older adults in adult day care centers

Stimulating leisure activities are considered as possible protective factors against dementia and cognitive decline in older adults, particularly due to the enhancement of cognitive reserve. This study tested the effectiveness of board game activities improving the cognitive function of older adults in adult day care centers. This was a quasi‐experimental study. A purposive sampling strategy was used to select 82 subjects who were aged 65 and above with intact mental functions and currently residing in adult day care centers. 41 subjects who participated in a selection of 12 board game activities were assigned to the experimental group and 41 subjects who adhered to their ordinary activities were allocated to the control group. Structured questionnaires of the board game programs were used for data collection. The board game programs showed promising effects in the cognitive function of older adults living in adult day care centers. A possible beneficial effect of board game playing on the risk of dementia could be mediated by a less cognitive decline in older adults. Board game activities may benefit the cognitive function of older adults. Incorporating board game activities into social work care may help develop long‐term care into a more diverse, unique and innovative direction.     

Selecting consumers for neighborhood health center boards

During the winter of 1978, a study of board members of 13 neighborhood health centers was conducted in which consumers were found to have parity of influence with non-consumers. Organized group sponsorship and backing of consumers, rather than their election or appointment, were partially responsible for this parity. Despite literature reports that organized group backing would increase the chances of "vested interest" conflicts on the board, consumers who were affiliated with organized groups were not found to be more competitive than those who were not thus affiliated. In contrast, nonconsumers with organized group backing did have a tendency to feel competitive on their boards.