Health progress (Saint Louis, Mo.)
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The value of employee benefits depends largely on employees' perceptions of those benefits, rather than on any intrinsic value the benefits have. If employees do not value a benefit highly, the hospital is not getting its money's worth. Hospital management now faces the challenge of reallocating benefit dollars to best meet employees' perceived needs and have the maximum positive impact on employee morale, while holding the line on benefit costs. ⋯ Restructure benefits identified as being very important, but which produce little satisfaction. 3. Offer flexible, or "cafeteria," benefit plans so individual employees can increase the level of the benefits they value most and decrease the level of other benefits. 4. Offer educational activities, such as an annual benefits statement, to heighten the employees' awareness of the value of the benefits they are receiving.
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Hospital executives and even many attorneys frequently misunderstand the antitrust risks raised by hospital mergers and acquisitions. On one hand, until recently some people incorrectly believed that not-for-profit hospital mergers and acquisitions would not be subject to governmental scrutiny. On the other hand, many analyze hospital mergers and acquisitions by applying standard antitrust principles, without considering the unique features of, or recent developments in, the healthcare market. ⋯ Evidence that merging hospitals complement one another. 8. Examples of vigorous competition between hospitals and outpatient facilities. 9. Whether the parties involved must provide advance notice of the transaction to the government.
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A widely accepted new leadership approach concerns transactional and transformational leadership. Transactional leadership consists of planning, implementation, and evaluation. Transformational leadership consists of charisma, intellectual stimulation, and individualized consideration that can motivate followers. ⋯ The development of transformational leadership qualities during master's study primarily provides a foundation on which students can build. Health administration programs in cooperation with healthcare organizations have created three models for field experience: internships, residencies, and fellowships. Many master's programs deliver continuing education programs for both types of leadership, and research and consultation contribute to this education.
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The Healthcare Quality Improvement Act of 1986 (Public Law 99-660) offers immunity from monetary damages for peer review actions and protection for patients from incompetent physicians. Institutions may find, however, that its notice and hearing requirements are costly and offer no more than existing protections. "Deemed compliance" procedures may also differ greatly from facilities' current practices. ⋯ Burget decision already suggests. Facilities should examine costs and benefits of compliance and alternatives to the hearing process, as well as the effect on the national clearinghouse that the act will establish for reporting problem physicians.
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Decisions regarding life-sustaining treatment for incompetent patients are typically difficult and stressful for surrogate or proxy decision makers. Although substituted judgment and best interest provisions are helpful to next of kin or guardian and help replicate an incapacitated patient's wishes, a more definitive expression of treatment preferences is needed. Advance directives allow currently competent persons to express their wishes about medical treatment before a possible incapacitating situation. ⋯ Contribute to constructive debate in states without legislation. Include provisions for proxy decision making in states with existing patients' bill of rights. Consider legislation to protect physicians from litigation when patients' written directives are followed.