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Byline: Ginger Christ Travel nurses have held the upper hand for most of the pandemic, with providers willing to pay hundreds of dollars an hour for the temporary help needed [...]

Background: Information on hospital unit costs is valuable to health policy makers, managers, and researchers. Its importance is recognised internationally by the World Health Organization (WHO) and nationally by the South African Department of Health. Although some projects had attempted to introduce this concept in South Africa, none of them became sustainable. Objectives: To identify the cost centres in a large public hospital (Johannesburg Hospital) and to determine factors influencing its implementation and lastly, to provide future directions for successful and sustainable operation through transfer of skills. Methodology: Setting of the study was Johannesburg Hospital, a public sector hospital in South Africa. The study has used context analysis technique to analyze the operational environment of the hospital. Results: The study identified three types of cost centres: Overhead, Intermediate, and Final. The context analysis showed remarkable differences in comparison with Italian public hospitals. Various important factors were identified during this study, which may be classified into three broad categories: external, internal, and process. Discussion: Focus of hospital management should shift from cost minimisation. It should also consider other factors such as number of patients, levels of patients, clinical outcomes, clinical governance, organisational efficiency, and organisational culture, which might play a significant role. This requires expertise in clinical economics, which is not readily available in developing countries like South Africa. Training of hospital staff in the new way of thinking, internal communication, and regular feedback are probably other important factors to its success. Conclusion: A stepwise approach based on proper planning and a context analysis should be used for successful implementation of this type of activity in a public hospital setting. Key words: cost centre, public hospital., Information on hospital unit costs is valuable to health policy makers, managers, and researchers for at least three purposes: budgeting, the assessment of hospital efficiency, and economic assessment of different [...]

Like many hospitals in the United States, Orlando-based Florida Hospital is experiencing a significant increase in the diversity of its staff and patient base. This, combined with new requirements of [...]

[ILLUSTRATION OMITTED] Jason Gillam has been a physical therapist for more than five years and works for the Mat-Su Regional Medical Center in Palmer at its Outpatient Center in Wasilla. […]

Nurse staffing patterns have come under increased scrutiny as hospital managers attempt to control costs without harming service quality or staff morale. This study presents production function results from a [...]

Abstract. The human factor is central to healthcare, yet its proper management has remained beyond the reach of healthcare organizations. This qualitative study examines strategic human resource management (HRM) issues [...]

Million-dollar malpractice settlements. Rising labor costs. Slumping bond ratings. These are certainly trying times for hospital executives struggling to keep their institutions in the black. Yet many hospital executives, having [...]

Short on clinical coders these days? You're not alone. The national vacancy rate for clinical coding and billing personnel is nearly 20 percent, according to a 2001 American Hospital Association [...]

In examining the relationship among nurse staffing, quality of care, and financial performance, prior empirical studies used competing measures and applied different levels of analysis. Using longitudinal data from 1990 [...]

Days after assuming the CEO mantle at North Shore-Long Island Jewish Health System in January 2002, Michael Dowling told his 30,000 employees that they were LIJ's greatest assets. What Dowling [...]

THE BUSINESS CASE Health care organizations have stepped up efforts to improve patient safety and quality in response to the Institute of Medicine's report that up to 98,000 patients die [...]

Sign-on bonuses, free cars, concierge services--desperate hospitals are trying every trick in the book to attract nurses. That might be part of the problem; tricks can produce short-term recruiting results, [...]

Saint Joseph Health Center, Kansas City, Mo., periodically puts its Level II trauma center on bypass status because it has too few specialists to cover it. The University of Virginia [...]

* What should hospitals outsource? What's driving outsourcing? Hospitals are financially stressed; many struggle with operating margins of plus or minus 1 percent. The merger activity in the latter half [...]

EXECUTIVE SUMMARY Staffing and emergency department (ED) management experts say the nursing shortage will continue over the long term. They say that patient care could suffer as a result of [...]

Lisa Reed recently was promoted to a management position at one of our facilities in Wisconsin. Lisa is an African American who has worked at the organization for 14 years. [...]

Whether you liked Bill Clinton or not, you cannot argue that he relentlessly pursued a goal that was instrumental to his two-term presidency: improve the state of the U.S. economy. [...]

The state of California has recently mandated minimum nurse-staffing ratios, raising concerns about possible affects on hospital efficiency. In this study, we examine how market factors and quality were related [...]

In recent years, downsizing has become a ubiquitous phenomenon of organizational life, even though an increasing body of evidence suggests that it may produce few lasting benefits (Heenan 1989; Mentzer [...]

ORGANIZATIONAL INFORMATION The organization is a rural healthcare system with inpatient and ambulatory care services. The hospital is the sole hospital provider in a rural county with a population of [...]

An analysis of survey data offered by nurse administrators regarding productivity and nonproductivity of nurses employed by Los Angeles, CA-based hospitals is offered. Additional information on the key factors affecting productivity/nonproductivity of nurses functioning in a health care environment is included.

Survey data on physician-hospital integrated delivery systems are analyzed. Additional information on the emergent areas of physician-hospital integration process is included.

Health care managers will have to assess the organizational climate and the adverse psychological effects of staff reduction when facing staff after a reduction in force (RIF). During an RIF, managers should see to it that the credibility, employee productivity and morale are not compromised. They must recognize the trauma caused by RIF, present strategic factual information, maximize employees' feelings of control, suggest coping strategies and defuse hostility and tendency to blame.

Data gathered from 195 Israeli hospital physicians revealed that job satisfaction and autonomy have little or no impact on a physician's intent to remain with a hospital. Instead, primary predictors are years of hospital employment and tenure. Data collection used two sets of one questionnaire handed out and one mailed to physicians. Recommended modifications for U.S. studies are include an individual's turnover history and employment setting.

Staffing cuts and skill-mix reductions do not necessarily translate to hospital cost savings. It should be noted that the quality of hospital care rather than the volume of medical personnel exact a significant toll on payroll expense. The patients' severity of illness as well as the level of skill of caregivers are other variables which impact the cost of care. Understaffing may minimize expenses in the short run but will ultimately cost the company.

Hospital administration problems such as unclear and ineffective mission statements, divisiveness of efforts, difficulties of supplementing external advocacy with internal reconciliation in the senior manager's job as well as the lack of open communication with board members can be surmounted provided hospital staff undertake a change in mindset. Effecting lasting and genuine change is possible not through a rearrangement of authority but rather through specific actions geared toward improving personal responsibility.

The growth of managed care, the resulting unsteadiness of physicians' salaries plus the fact that physicians are most comfortable working solo or in small groups have spurred the growth of physician practice management companies (PPMCs). The success of PPMCs, however, would largely depend on the managerial skills of its administrators and whether they could actually integrate healthcare delivery. It is also imperative that these PPMCs be able to add real value to physicians' practices in terms of practice administration and reduced administrative hassle.

The nursing departments of Allegheny General Hospital in western Pennsylvania conducted research to compare staffing levels and patterns with comparable hospitals. This benchmarking led to the formation of a team to visit a similar hospital and then to determine the appropriate (higher) intensive care staff-to-patient ratio. The goal was increased efficiency while maintaining high-quality patient care.

Employee motivation can best be effected by managers by their treatment of employees rather than how these employees are organized within the corporate structure. Managers can effect better performance of employees by catering to their self-worth and image, and how managers can effect a feeling that the needs of employees are satisfied without having to compromise corporate goals. A good manager studies what the specific needs of employees need to be satisfied and from there, works on motivating techniques which may be a combination of tried and tested approaches.

As hospitals continue to face intense pressure to control operating costs, many have resorted to staff reductions and other redesign efforts. The remaining employees are frequently asked to do more with less. In these uncertain times, it is important that hospital administrators understand the concept of organizational citizenship behavior (OCB) and attempt to attract and retain those employees capable of exhibiting such behaviors. This study examined the relationships between three organizational commitment components, as well as job satisfaction (including specific facet measures) and two separate forms of OCB. Usefulness analyses indicated that satisfaction with coworkers and affective commitment were the two most important predictors of one dimension of citizenship behavior, as each construct contributed unique variance in the dependent variable. Implications for future research and practice are provided., Hospitals struggling to function with reduced staff should focus on achieving satisfaction among coworkers and employee committment in order to meet organizational demands, according to one study. The importance of employee attitude and satisfaction on organizational success was studied and results conclude there is a definite relationship between the two. Hospital administrators have an interest in striving to find employees willing to work towards the hospital's goals and objectives., The hospital industry continues to face strong pressures to control costs and, at the same time, improve the quality of care delivered. Needless to say, this task is difficult but [...]

Our Lady of the Way Hospital, like most hospitals in the late 1980s and early 1990s, exemplified the bureaucratic organization represented by the traditional 'line and box organization chart.' Additionally, as in most small hospitals, the CEO of Our Lady of the Way Hospital--a 39-bed, JCAHO accredited, general, acute care hospital in Martin, Kentucky--had direct management responsibility for several functional departments. In 1992, administration replaced the traditional, hierarchical organization chart with a circular structure that reflected its increased reliance on team processes throughout the organization. The new structure also significantly reduced the number of reporting assignments to the CEO. This article describes the hospital's transition to a team-based organization, illustrates the application of a circular organization chart, and assesses its value and limitations., A circular organization chart can be used effectively to promote team-based organization in a hospital. The circular organization plan allows for integration of all hospital employees and encourages managers to increase leadership within their department. One hospital used this approach to implement its mission of redesigned services, improved quality and integrated services, and a focus on health-care continuum. The circular structure is limited in its ability to create distinct reporting relationships between administration and department managers., The traditional organization chart has no customer focal point. All communications must be channeled through upper-level management where managers acting in a customer relations capacity refer complex problems through the [...]

Clinical competence in health care can be developed based on guidelines established by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) in 1996. Healthcare administrators need to define who a facility's customers are, what they want, and how meeting those desires can be measured. Competencies can be developed empirically or non-empirically, and need to be periodically assessed., In 1996, JCAHO required hospitals to assess, prove, track, and improve the competence of all employees. This article is the second part of a review of the concept of competency [...]

Service line organization is a business concept that can provide a model for a team-based approach to outcomes management of health care delivery. Outcomes management utilizes an interdisciplinary team to develop and implement enhanced practice. The collaborative team includes roles for the service line manager, advanced practice nurse, nurse manager, staff nurse, physician and administrator. The advanced practice nurse functions as outcomes manager.

Medical care managers can enhance job satisfaction among nurses by influencing hospitals' ethical climate. The types of ethical climate may be characterized by professionalism, caring, rules, instrumental, efficiency or independence. Job satisfaction covers satisfaction with pay, promotion, coworkers, supervisors and work. Survey shows that 36% of respondent nurses were dissatisfied with supervisors, while 62% were dissatisfied with promotion opportunities.

Hospital managers in Utah are satisfied with their jobs but are concerned with future conditions. Although managers rate achievement, responsibility and subordinate-superior relations as satisfactory, areas of lower satisfaction include personal growth, job security and salary. Hospital executives should monitor these problem areas to enhance long-term retention of skilled managers., In a survey of managers in Utah hospitals, 85 percent responded overall satisfaction with their jobs. Surprisingly, women in the survey reported significantly greater satisfaction with their jobs than other [...]