Health care management review
-
Health Care Manage Rev · Jan 2014
ReviewUsing resource dependency theory to measure the environment in health care organizational studies: a systematic review of the literature.
Studies using the resource dependency theory (RDT) perspective commonly focus on one or more of the following environmental dimensions: munificence, dynamism, and complexity. To date, no one has reviewed the use of this theory in the health care management literature and there exists no consensus on how to operationalize the market environment in health care settings. ⋯ The RDT literature is limited to studies of hospitals, nursing homes, and medical practices. There is little consensus on how to measure or operationalize the environment in these studies. No previous studies have measured the environment for other health care settings such as ambulatory surgery centers, public health departments, or assisted living facilities.
-
Health Care Manage Rev · Jan 2014
ReviewUsing resource dependency theory to measure the environment in health care organizational studies: a systematic review of the literature.
Studies using the resource dependency theory (RDT) perspective commonly focus on one or more of the following environmental dimensions: munificence, dynamism, and complexity. To date, no one has reviewed the use of this theory in the health care management literature and there exists no consensus on how to operationalize the market environment in health care settings. ⋯ The RDT literature is limited to studies of hospitals, nursing homes, and medical practices. There is little consensus on how to measure or operationalize the environment in these studies. No previous studies have measured the environment for other health care settings such as ambulatory surgery centers, public health departments, or assisted living facilities.
-
Health Care Manage Rev · Jan 2011
ReviewEmergency department observation units: A clinical and financial benefit for hospitals.
There are nearly 120 million visits to emergency departments each year, one for every three people in the United States. Fifty percent of all hospital admissions come from this group, a marked change from the mid-1990s when the emergency department was a source of only a third of admissions. As the population increases and ages, the growth rate for emergency department visits and the resulting admissions will exceed historical trends creating a surge in demand for inpatient beds. ⋯ Observation units provide high-quality and efficient care to patients with common complaints seen in the emergency department. More frequent use of observation can increase patient safety and satisfaction while decreasing unnecessary inpatient admissions and improving fiscal performance for both emergency departments and the hospitals in which they operate. For institutions with the volume to justify the fixed costs of operating an observation unit, the dominant strategy for all stakeholders is to create one.
-
A prevailing blame culture in health care has been suggested as a major source of an unacceptably high number of medical errors. A just culture has emerged as an imperative for improving the quality and safety of patient care. However, health care organizations are finding it hard to move from a culture of blame to a just culture. ⋯ Organizational culture or human resource management practices play a critical role in the health care delivery process. Health care organizations need to develop a culture that harnesses the ideas and ingenuity of health care professional by employing a commitment-based management philosophy rather than strangling them by overregulating their behaviors using a control-based philosophy. They cannot simply wish away the deeply entrenched culture of blame nor can they outsource their way out of it. Health care organizations need to build internal human resource management capabilities to bring about the necessary changes in their culture and management systems and to become learning organizations.
-
Health Care Manage Rev · Jan 2000
ReviewThe paradox of physicians and administrators in health care organizations.
Rapidly changing times in health care challenge both physicians and health care administrators to manage the paradox of providing orderly, high quality, and efficient care while bringing forth innovations to address present unmet problems and surprises that emerge. Health care has grown throughout the past several centuries through differentiation and integration, becoming a highly complex biological system with the hospital as the central attractive force--or "strange attractor"--during this century. The theoretical model of complex adaptive systems promises more effective strategic direction in addressing these chaotic times where the new strange attractor moves beyond the hospital.