Hospital & health services administration
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Hosp Health Serv Adm · Jan 1993
ReviewRestructuring military health care: the winds of change blow stronger.
The Military Health Services System is an enormously complex enterprise, consisting of more than 400,000 personnel in the active, reserve, and civilian workforce, operating 148 hospitals and over 800 medical and dental clinics worldwide, and serving nearly 9 million beneficiaries. Expenditures on military health care activities will exceed $15 billion in 1993. ⋯ One of the most pressing challenges facing military health care managers is how to best organize resources to provide timely access to quality care and achieve economies at a time when civilian health care is itself in turmoil. This article provides a long-awaited update on the spirited debate over the need to reorganize the Military Health Services System--and the prescriptions ordered so far to cure the system's perceived organizational ills.
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Because the 1990 accreditation standards of the Joint Commission on Accreditation of Healthcare Organizations call for the establishment of patient grievance procedures, this study examines the possibility of patient representatives serving in that capacity. Members of the National Society of Patient Representation and Consumer Affairs were surveyed to examine current roles of patient representatives--in particular, their handling of complaints, the types and sources of their power, the potential for conflict of interest as an institutionally employed advocate, and requirements for and barriers to successful job performance. The study reveals a great variation in the activity profiles of patient representatives. Additionally, it shows that the staff in place is professionally capable of moving in many directions and that departments have become the patient grievance mechanisms called for by the Joint Commission, depending on the hospital's management philosophy as reflected in allocation of authority and resources.