Management of Hospitals and Health Services: Strategic Issues and Performance

by Schulz, Rockwell

• ISBN13: 9781587981746
• ISBN10: 1587981742
• Edition: 3rd
• Format: Paperback
• Copyright: 2003-05-01
• Publisher: Lightning Source Inc

Table of Contents

PART I HOSPITAL AND HEALTH SERVICES MANAGEMENT OBJECTIVES IN A RAPIDLY CHANGING ENVIRONMENT
The Growing Importance of Management to Institutional, Patient, and Community Health	3	(14)
Stages in health services management	4	(1)
Public health period: into the 1920s	4	(1)
Physician period: 1930s into 1960s	5	(1)
Hospital period: 1960s into 1990s	6	(3)
Framework for a strategic management role to improve patient outcomes and community health	9	(6)
Conclusions	15	(2)
Health and the Health System	17	(18)
Inputs to health	17	(4)
The health system	21	(4)
Personal health care system	25	(2)
Physician services	27	(4)
Hospital services	31	(1)
Conclusions	32	(3)
Environmental Pressures from Cost Controls and Consolidation	35	(22)
Are health care costs too high?	35	(1)
Why are costs rising?	36	(1)
Who pays and how do they try to control costs and quality?	36	(2)
How are physicians paid?	38	(2)
How are hospitals paid?	40	(1)
How do payers control costs and quality of care?	41	(5)
Future prospects for cost controls	46	(1)
Implications of cost control on management of health services	46	(1)
Consolidation of health services	47	(2)
Investor-owned health systems	49	(2)
Are horizontal, vertical, and for-profit consolidations beneficial?	51	(1)
Implications of consolidation on management of health services	51	(6)
PART II STRATEGIC MANAGEMENT
Strategic Management Defined	57	(11)
The concept of ultrastable equilibrium	58	(2)
The strategic management process	60	(1)
The major components of the strategic management process	61	(2)
The role of the strategic manager	63	(1)
Competencies	64	(3)
Summary	67	(1)
Strategy Formulation	68	(15)
Determining the mission, goals and objectives	69	(3)
Social responsibility	72	(1)
Competitive position	73	(2)
The SWOT analysis	75	(1)
Strategies	76	(1)
The strategy plan	76	(1)
Grand strategies	76	(5)
Summary	81	(2)
Implementation Processes	83	(23)
Change	83	(4)
Management initiatives/styles	87	(8)
Training	95	(1)
Structure	96	(1)
Resource deployment	97	(2)
Policies	99	(2)
Culture	101	(3)
Summary	104	(2)
Changing Roles of the Chief Executive Officer with Special Emphasis on the Evaluation/Control Process	106	(23)
Role models---an overview	107	(3)
Roles/processes	110	(7)
Monitoring/evaluating/controlling	117	(8)
Conclusions	125	(4)
PART III HEALTH SERVICES ORGANIZATION ISSUES
Organizational Arrangements of Health Services Delivery Systems	129	(13)
Health service functions and the patient care systems	133	(3)
Organizational design	136	(4)
Joint ventures	140	(1)
Conclusions	140	(2)
Governance of Health Services Organizations	142	(15)
Functions of governing boards	142	(1)
Structural characteristics of a governing board	143	(6)
Who really controls hospitals and health services?	149	(1)
Hospital performance seems to relate to accountability	150	(1)
How does consumerism relate to governance?	151	(2)
Board decision processes	153	(1)
Conclusions	154	(3)
Physicians	157	(20)
Barriers to physician/management relationships	158	(1)
Who are physicians?	159	(1)
Who become physicians?	159	(1)
What is the conditioning process of medical education?	160	(1)
The physician surplus	161	(1)
Organized medicine	162	(2)
Hospital medical staff organization	164	(1)
Corporate integration of physician services	165	(3)
Management and physicians	168	(9)
Nursing	177	(16)
Nursing in transition	177	(5)
Issues in nursing	182	(5)
Implications for management	187	(6)
PART IV MANAGERIAL FUNCTIONS AND ISSUES
Other Health Professionals and Programs	193	(15)
Other health professionals	193	(10)
Management of professional services to patients	203	(5)
Functional Managers	208	(23)
Functional managers	210	(4)
Computer systems---medical and management information systems---decision support systems	214	(2)
Marketing	216	(3)
Planning	219	(1)
Human resources management	220	(1)
Materials management	221	(1)
Risk management	222	(3)
Public relations and volunteer services	225	(1)
Consultants	226	(1)
Management contracts	227	(1)
Factors that might improve effectiveness of functional specialists	227	(2)
Conclusions	229	(2)
Management of Access: an Epidemiological Approach to Marketing	231	(14)
Marketing and demarketing health services	232	(1)
An epidemiological approach to marketing	233	(1)
Marketing	233	(5)
Epidemiology	238	(3)
Managing access to care: balancing community and institutional health needs	241	(4)
Management of Quality and Costs	245	(16)
Forces for more attention to quality	248	(1)
Approaches to evaluating quality of care	248	(2)
Methods for managing quality of physicians' services	250	(3)
Management of quality or cost?	253	(2)
The bottom line and the rational manager	255	(6)
The Management of Human Resources	261	(19)
The nature of the human resources function	262	(9)
Management's human resources tools	271	(7)
Summary	278	(2)
Managing Conflict and Labor Management Relations	280	(25)
The nature of conflict	281	(1)
Individual conflict	281	(1)
Interpersonal conflict	281	(1)
Group conflict	282	(1)
The status factor	283	(1)
Client/organization conflict	283	(1)
Mitigation of conflict	284	(1)
Win/win strategies	285	(1)
Action program for mitigation of conflict	285	(2)
Participative management	287	(1)
Managerial/organizational stress	287	(2)
Collective bargaining	289	(1)
Changing philosophies regarding unions	289	(2)
Employees, managers, and unions	291	(2)
Collective bargaining process	293	(2)
Contract administration	295	(4)
Summary	299	(6)
PART V FUTURE CHALLENGES, STRATEGIES, AND ETHICS
Managerial Performance and Ethics for Hospitals and Health Services into the Twenty-first Century	305	(1)
Organization and management strategies for meeting future challenges to management	306	(2)
Diseases of health services management	308	(1)
Management of organizational decline	309	(1)
An ethical framework for health services management	310	(9)
Personal approaches to management	319