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The giving and receiving of gifts, funeral attendance, post-discharge babysitting, usurping Of parental roles, indiscriminate sharing of personal information, and other issues prompted a pediatric tertiary care facility in the [...]

Consumer groups and other critics of the Illinois Dept of Professional Regulation maintain the agency is too hesitant in disciplining doctors who are incompetent or negligent. The agency has a sizable staff, but Illinois ranks 40th among states in taking serious action against physicians.

When Rockford Memorial Hospital decided its unscheduled absences were taking too big a bite, it took a look at paid time off (PTO). The new system gave the hospital a [...]

Besieged with fiscal and political constraints in acute care, the addition or substitution of less expensive nursing personnel is quickly gaining popularity. The evolution of nursing care delivery systems in the acute care setting, the factors associated with the increased use of unlicensed assistive personnel, examination and evaluation of the current literature surrounding unlicensed assistive personnel, and recommendations for a future strategy are described., Because nurses are the largest proportion of patient care providers, the redesign and restructuring of nursing care are two of the most challenging issues for the future of health care [...]

This quasi-experimental study examined the effects of shared governance on nurse/non-nurse perceptions of work and work environment. Initiating shared governance did not significantly influence job satisfaction, anticipated turnover, and perceived effectiveness. Increases in autonomy were not sustained over time., Nurses and non-nurses recognize shared governance as a structural framework in which job-related activities can be effectively organized. Shared governance provides an organizational framework that offers workers maximal participation in [...]

Mercy Health Services offers a case history of how to create an integrated health care network. A team of administrators and clinicians spearheaded the effort. The goal was providing a seamless continuum of quality care. Year 1 encompassed foundational activities; year 2 focused on building infrastructure and relationships; and year 3 is centering on continuing integration, implementation, and evaluation. Activities have included developing a common language, choosing a data collection system, and developing a system-wide formulary.

Downsizing and restructuring initiatives in hospitals are causing employee morale to decrease. Layoffs and uncertainty over healthcare reform are the main causes of the morale problems, according to an Oct 1995 Deloitte & Touche study of 681 hospitals. Changes in job duties, competitive pressure and a lack of communication are also contributing to the decreasing morale.

Economic credentialing refers to the evaluation of medical staff so that they can be appointed, reappointed and given the privileges commensurate to their positions. This practice, largely controlled by medical staffs, was first used in hospitals in the early 1990s, generating much controversy because criteria other than quality of care or professional competency was used to evaluate medical staffs. The use of economic credentialing in an environment teeming with new managed care practices is evaluated., This article deals with the application of economic measures to the appointment, reappointment, and delineation of medical staff privileges, the so-called practice of economic credentialing. The concept of economic credentialing [...]

The effects of age, tenure, perceptions of interactional justice, affective and continuance commitment and the perceived practice of absenteeism are analyzed in relation to an employee's level of absenteeism. Data was gathered from 166 nursing and food services personnel in a medium-sized chronic care hospital. Data on the frequency of absences were gathered within a year after an employee survey. Evidence gathered supported hypotheses of the study.

There is a need to improve the quality of nursing care in rural hospitals amidst growing concerns for the health of rural citizens. Response to this need depends to a large extent on the ability of rural hospitals to develop programs to advance professional rural nursing practice. A research and demonstration project to improve nursing practice in a rural hospital is presented.

Late last October, an advertisement appeared in several national and California newspapers. Alongside pictures of nurses standing at the bedside of actutely ill patients was the following statement: 'Hospitals and [...]

Thirty-eight percent of hospitals surveyed by Deloitte & Touche in 1994 are cutting staff to cope with the increased competition generated by managed care. Most are laying off less than 10% of total staff, but cutbacks are as high as 30%. The most assiduous trimmers are nonprofits, particularly religious institutions. The most heavily targeted occupational group is registered nurses.

Hospital administrators, including financial managers, should come up with a formal transition and succession planning process for members of the medical staff. This responsibility is crucial since a growing number of physicians are in their retiring age. Succession and transition planning should be incorporated in the hospital's medical staff development. The duration of the transition process, the role that incumbent physicians will play in the practice during transition and the value of the practice should be primary considerations in succession and transition planning.

Hospitals should develop recruitment programs which can effectively address issues relating to the supply/demand for physicians and the changing requirements and characteristics of young physicians. Such programs should be concerned not only with finding the ideal candidate, but also with retaining them after they are hired. Healthcare provider organizations can best attend to all these considerations by developing an integrated system, since this setup can offer physicians security, employed status, a decent lifestyle and a sense of belonging, in addition to other benefits., IT IS COMMON knowledge that physicians are independent, autonomous, re-active personalities who thrive on instant gratification. It's equally well known that hospital administrators are planned, organizational types who accept delayed [...]

Hospital employees may be expected to introduce innovative methods in spite of pressure to conform. Non-managerial employees were studied to show the influence of positive and negative factors on likelihood of innovation. Factors considered include role conflict or clarity, involvement in the organization, job satisfaction and willingness to resign. Requirements for conformity need not stifle innovation in an atmosphere of open communication., Summary Two factors characterize innovative organizational climates as perceived by nonmanagerial hospital employees. The first, innovation, comprises perceptions about the consequences or contingencies (e.g., punished, ignored, rewarded) of such proactive [...]

Nursing shortages ease during periods of economic recession, but economic factors alone do not account for nurses' decisions to accept employment. Also, financial pressure on hospitals resulted in shorter hospital stays for more seriously ill patients who require more nursing services. Registered nurses fear that employment of unlicensed nurses to save money may lower standards and morale. Nurse executives should plan to create a supportive environment to retain registered nurses and attract qualified persons to the field., Summary The recent economic recession and slow-paced recovery have contributed to dampening out the shortage of hospital-employed registered nurses (RNs), a shortage that has persisted since the mid-1980s. While national [...]

The move towards health care reform has taken its toll on acute care hospitals. To remain competitive and to increase employee productivity at reduced costs, these hospitals introduced the gain-sharing program. Under this program, employees are given regular cash bonuses for participating in the cost reduction and quality improvement programs of hospitals. An evaluation of the program showed that in general, hospital-based gain-sharing programs increased employees' productivity. In cases wherein the program did not measurably increased productivity, it provided lasting improvements in labor and management relations.

The Performance Review and Development System designed by St. Luke's Hospitals MeritCare strengthens the company's corporate commitment by actively involving the reviewer and the reviewee in the performance review process. The Fargo, ND-based tertiary care hospital redesigned the review system and integrated behavioral measures into all performance appraisals. The resulting system thus distinguishes and rewards high quality performance., St. Luke's Hospitals MeritCare developed an appraisal system that reinforces its corporate commitment by actively involving the reviewer and reviewee. As corporate change accelerates, organizations may measure and reward behaviors [...]

The annual Hay/Modern Healthcare survey of the remuneration of hospital employees reveals that pay raises for nurses have declined for the second straight year and that more hospitals are using incentive programs in their pay schemes. The survey collected data from 910 hospitals with 255,000 employees. The survey revealed that the average base salary for staff registered nurses was $36,700, a 5.7% increase over 1993. The percentage of hospitals using incentive pay increased from 6% in 1992 to 10% in 1993.

Training of new employees in hospital systems and laboratories will be more efficient with the use of detailed checklists and in-services. The laboratory manager is tasked by the Occupational Safety and Health Administration with the burden of orienting and training new employees especially with regard to safety topics. The orientation checklist would contain the general laboratory policy, laboratory safety guidelines and lab section information on equipment and supplies. The new employee would just tick off which items have been presented. Feedback is also necessary to refine the training program., Detailed checklists and in-services for new employees at a hospital system's four sites provide thorough, consistent training that exceeds OSHA's and other standards. DO YOU REMEMBER when you were the [...]

Work force diversity can be the cause of conflict and maltreatment of people in hospitals. As such, hospital administrators must be able to anticipate problems associated with diversity and must know how to effectively deal with these problems. They must develop various discrimination control strategies and prejudice reduction approaches. Essentially, changing work force demographics in hospitals has become a well-accepted reality in multi-ethnic American society.

The NLRB in 1989 promulgated a rule giving eight standard collective bargaining units for acute care hospitals, which the US Supreme Court affirmed in American Hospital Ass'n v NLRB. The eight units are registered nurses, physicians, professional employees, technical employees, skilled maintenance employees, clerical employees, guards and nonprofessional employees. Hospital management's fear that this rule will facilitate union organizing may have some justification.

The salient aspects of the iCARE philosophy implemented by nurses at Yeovil District Hospital to improve quality of care provided to patients and interactions with patients' relatives and carers, while also boosting employee morale, are discussed. Based on the concept of every employee's involvement in providing appropriate communication, care, respect and environment, the ongoing iCARE initiative has changed the working of the hospital staff drastically for the better.

A public safety director describes how Forsyth Medical Center redesigned its expensive training program for public-safety officers. The training program was restructured to include communications technicians and its four phases were designed to impart only relevant information. The courses are either completed online or taught in-house by employees trained to teach the subjects.

A survey conducted by Modern Healthcare in collaboration with Deloitte & Touche found that a human resource departments at hospitals are starting to play an important role in strategic planning. 52% of the 1,241 acute-care hospitals included in the survey said that human resource executives are members of their planning teams. 17.4% of respondents have instituted human resource plans that analyze staffing requirements and provide programs for staff development.

Researchers present a model for dealing with shortages of registered nurses in hospitals through optimal deployment of existing staff, rather than recruitment. Data was obtained from the British Columbia Health Association centralized payroll system. Three factors that determine nurse deployment requirements are workforce stability, average paid hours and full-time employee ratio. The size of the full-time nursing staff is not the major consideration in every case. Instead each facility should try innovative approaches appropriate to the problems in its own situation., Arminee Kazanjian is Assistant Professor, Department of Health Care and Epidemiology, and Associate Director, Centre for Health Services and Policy Research, University of British Columbia, Vancouver. Indra R. Pulcins is [...]

A newly promoted lab manager scrambled to find workers for the 3-11 shift and to fill her own former position as evening supervisor. Her solutions were driven by flexibility and [...]

There are many legal considerations for hospitals when recruiting medical staff. The inurement provisions of IRS regulations covering hospital tax-exemption specifically limit the inducements hospitals may offer to physicians. Federal Medicare and Medicaid fraud and abuse laws contain safe harbor provisions on business arrangements. Hospitals should evaluate their physician recruiting practices very carefully to ensure compliance with these laws., Summary This article identifies and discusses the legal problems and pitfalls associated with the implementation of a physician recruitment program. Careful structuring is necessary to strike a balance meeting the [...]

Jim Knutson knows the value that Aircraft Gear Corp. receives for its health care dollars is often difficult to pin down. "We are seeing cases where we pay a lot [...]

Facilitators are explained the best methods of implementing the Productive Ward program initiated by the NHS. The program consists of 11 modules that helps empower staff to make necessary changes in wards and incorporate new management ideas smoothly and successfully.

Swedish Medical Center, one of the biggest hospitals in Washington's Seattle area, has cut back four vice presidents and 22 directors and is planning to lay off additional 175 staff. Unemployment insurance claims from hospital staff in Washington have risen from 2,400 in 2007 to 2,600 in 2008, and more hospitals are expected to cut staff.

Douglas B. Matey is an undergraduate in the Department of Health Management and Policy, School of Health and Human Services, University of New Hampshire, Durham. Leadership continues to be a [...]

Stephanie Lin Bloom is Special Projects Coordinator, Greater Baltimore Medical Center, Baltimore, Maryland. A cohesive medical staff provides a solid foundation for the acute care hospital. As an organized body, [...]

David S. Hames is Associate Professor, Department of Management, College of Business and Economics, University of Nevada, Las Vegas. Summary Prospective pricing, the proliferation of alternative delivery systems, and the [...]

Changes in reimbursement, medical practice, demographics and lifestyles are altering profoundly the way physicians relate to hospitals. Some of these trends are still emerging, but experts urge hospital executives to [...]

Not long ago, the nursing shortage prompted hospitals to woo job applicants with impressive-sounding bonuses and benefit packages. Our latest survey of fringe benefits, however, shows there's been little real [...]

Designing an in-house phlebotomy training program A structured course provides a community hospital with a steady source of well-trained phlebotomists. We used to train phlebotomy personnel at our 195-bed community [...]

Although the shortage of registered nurses has deservedly received much publicity, local hospital personnel managers are dealing as well with a dire shortage of 'allied health professionals,' such as physical [...]

Urban public hospitals have many of the defining characteristics of Lipsky's (1980) street-level bureaucracy, but relatively little is known about what problems these characteristics produce for hospital employees, professionals in […]

No hospital wants to face a court battle against a disgruntled terminated employee. To deter this type of grievance from ever reaching the courtroom, some administrators are considering two human [...]