Health care management review
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Health Care Manage Rev · Jan 1991
Analyzing the health care environment: "You can't hit what you can't see".
The health care environment of the 1990s promises to be every bit as dynamic and complex as the environment of the 1980s. Health care managers must identify emerging issues and incorporate these issues into the strategic management process. This article discusses a five-step process for analyzing the changing environment facing health care organizations.
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The article describes a case in which dysfunctional teamwork was threatening patient care on medical units. Various team-building techniques were used by trained facilitators. Survey results showed that the interventions resulted in improved communication, morale, and working relationships.
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A medical director has enormous influence on medical cost and quality in managed care organizations. Little empirical work has been done on the attributes of an effective HMO medical director. ⋯ The factors that emerged as significant were communication and interpersonal skills, clinical credibility, ego strength, concern about quality, motivation, data orientation, and leadership qualities, along with organizational/systemic variables. Implications for hiring and physician education are drawn.
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Continued debate over who should pay for the increasingly unaffordable U. S. health care system has failed to yield a consensus solution. Shifting attention to how to reduce health care costs may be more productive. Strategies for achieving this goal include drastically reducing costly quality deficiencies, eliminating higher cost care options that add no demonstrated value, recognizing that responsibility for clinical and cost consequences cannot be divided, and acknowledging that rationing available resources is superior to other allocation alternatives.