Hospital & health services administration
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Hosp Health Serv Adm · Jan 1994
"How much do you get paid if I volunteer?" Suggested institutional policy on reward, consent, and research.
Pharmaceutical companies often ask practicing physicians to conduct phase IV or postmarketing research on new drugs. Companies pay physicians to enroll their patients and report dosage and side-effect information. ⋯ Improving investigators' financial status while increasing medical risks to phase IV subjects is ethically unsound, especially if subjects are unaware of investigators' rewards. We suggest a model policy and guidelines that affirm subjects' need for informed consent, investigators' need for recognition and support, and institutions' need to protect patients from undisclosed risk and relations.
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This article suggests that the community hospital can be an important key to health reform at the local level; that community benefit guidelines are acceptable to hospitals and community leaders in a 49-site national demonstration program; and that these guidelines can prove useful for communities in moving toward health reform. Types of community involvement by hospitals are categorized, and examples of each type are developed. Community benefit programs can be a promising approach to effectively respond at the local level to the problems of poor health status, lack of access to care, and increasing health care costs. Addressing financing of care without attention to changes in the delivery system will not lead to effective health reform.
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Hosp Health Serv Adm · Jan 1994
Supervisors matter more than you think: components of a mission-centered organizational climate.
A study was conducted in a medical center among a diverse sample of employees to examine whether components of organizational climate related to workers' knowledge of the organization's mission and mission-centered values. Findings supported a mediated relationship between supervisor behaviors, mission knowledge, and customer service orientation (the organization's key mission value). ⋯ Results suggest that supervisors are in an ideal position to disseminate a mission-centered climate. Practical applications of these findings for management wishing to develop mission-centered climates in health care organizations are discussed.