Search

The financial difficulties encountered by Martinique hospitals has led to restructuring of the territory's medical project with the merger of three healthcare facilities. These new constraints impacting the work environment with organizational consequences in services.A management experiment was attempted in a geriatric day care hospital based on the use of health promotion concepts. After an overview of the unit's activity based on the perceptions of staff, patients and private physicians, a one-day research-action structural seminar was organized.Group dynamics, unit functioning, shared values, success factors, and improvement strategies were discussed. This seminar resulted in the development of a business model based on five values (respect, professionalism, cohesion, empathy, communication). Three operational working groups were established to implement the conclusions of the seminar in the unit.This experiment focused on an alternative approach to the management of small health care services by the use of health promotion.

International audience; No summary

The merging of two intensive care units is a time of profound change, and constitutes a risk of mishaps. We report some aspects of such a project in our institution. The evaluation of various indicators reflecting the activity, patient's hospital pathways, mortality, as well as the use of specific techniques, has shown that no particular problem was observed during the first 9 months. Improvements in performance or productivity have not been demonstrated so far. The follow-up will permit to demonstrate long-term benefits. We believe that these observations may be of interest for other departmental or hospital reorganisations.

More and more, corporate culture is being recognized as an important determinant of organizational effectiveness. This article describes how the Centre for Addiction and Mental Health proactively focused on rebuilding its culture after a mandated merger. The long-term effects of this effort need to be monitored. However, commitment is strong to the ideas articulated in the Statement of Desired Culture that was developed by a staff task force and approved by the Centre's Board.

The following article aims at giving some informations about the solutions that have been launched by the american hospitals in order to improve their situation. These measures appear in the context of a tougher competition. But there are a lot of uncertainties on the future on the american hospitals.