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Biomedical subjects

M D Fottler

Publications and source records attributed to M D Fottler.

At least 37 records · Page 2Linked to original sources
PubMed1994

The development of a state-level health manpower database using an employer-based survey: a pilot project.

State health care reform may provide a better approach to meeting the health care needs of rural communities than does federal reform because the planning is closer to the needs of local communities. However, state health reform requires a health manpower database (along with other data) that includes all health occupations and such databases are often nonexistent. This study reports on one element of such a database--a survey of a wide range of rural health care employers covering the full range of health occupations in Alabama. Information on current and future employment of the most significant health occupations is reported here. It was found that the greatest numbers of new health personnel employees needed in the future were, in descending order, nursing assistants, registered nurses, licensed practical nurses, radiological technicians, specialist physicians, nurse practitioners, physical therapists, primary care physicians, and respiratory care therapists. While an employer survey has limitations and should be supplemented by data on community needs and health status indicators, it does provide useful information for planning educational programs to prepare health personnel.

Alabama↗
PubMed1994

The process of managerial control in quality improvement initiatives.

The fundamental intent of strategic management is to position an organization with in its market to exploit organizational competencies and strengths to gain competitive advantage. Competitive advantage may be achieved through such strategies as low cost, high quality, or unique services or products. For health care organizations accredited by the Joint Commission on Accreditation of Healthcare Organizations, continually improving both processes and outcomes of organizational performance--quality improvement--in all operational areas of the organization is a mandated strategy. Defining and measuring quality and controlling the quality improvement strategy remain problematic. The article discusses the nature and processes of managerial control, some potential measures of quality, and related information needs.

Data Collection↗
PubMed1993

The impact of the changing healthcare environment on the attitudes of nursing staff: a longitudinal case study.

Attitude surveys of registered nurses were conducted in 1984 (just prior to implementation of prospective payment) and in 1989 (after implementation of changes responsive to prospective payment and increased competition) in an academic medical center. Results indicate more negative attitudes toward hospital administration, pay and promotional opportunities in 1989. However, overall job satisfaction, job variety, job market alternatives, participation in decision making, and intention to leave were unchanged while job variety and perceptions of job market alternatives were more positive in 1989. Implications for health-care management and future research are discussed.

Attitude of Health Personnel↗
PubMed1992

Determinants of HMO success: the case of Complete Health.

The health maintenance organization (HMO) industry has experienced a variety of difficulties and criticisms in recent years. Various hybrid models have been proposed to alleviate these problems. This article presents an in-depth case study of factors associated with the success of one such hybrid: an individual practice association (IPA)-model HMO affiliated with an academic health center. The major success factors identified include the plan design/structure, the strategic orientation/practices, and the stakeholder management orientation practices.

Academic Medical Centers↗
PubMed1992

Corporate structure and administrators' job stress: the case of nursing homes.

This paper examined the relationship between the job-related stress of nursing home administrators and the structure of their work setting. Multivariate analysis of covariance (MANCOVA) was used to test the hypothesis that nursing home administrators who are employed in multi-unit, corporate-owned facilities experience more job-related stress than do administrators employed in independent, free-standing organizations. The results indicated that, when controlling for other potential stressors, administrators in corporate-owned nursing homes reported more general job stress and greater role ambiguity than their counterparts in single-unit, autonomous organizations. Recommendations for management strategies and for future studies in this area are discussed.

Alabama↗
PubMed1991

Utilization and management of multiskilled health practitioners in U.S. hospitals.

This article examines the utilization and management of multiskilled health practitioners by U.S. hospitals. Results indicate such utilization is greatest for small hospitals as well as for other not-for-profit and government nonfederal hospitals. Flexibility, efficiency, and cost containment are the major reasons for utilizing such personnel. Secondary skills added to most multiskilled workers were of a parallel or lower level. Managerial issues and implications in utilizing multiskilled workers including training, compensation, evaluation, supervision, and competency assessment are also discussed.

Allied Health Personnel↗
PubMed1990

The case for hospital diversification into long-term care.

Since the market for long-term care (LTC) services is expected to grow rapidly in the years ahead, the case for hospital diversification into LTC is a strong one. This article discusses the major LTC diversification options, the cost of entry, potential profitability, potential problems, and recommendations for implementing them.

Alabama↗
PubMed1990

Improved stakeholder management: the key revitalizing the HMO movement?

In summary, our purpose has been to propose and to demonstrate that the survival of HMOs (in whatever form) depends on the proper identification and management of key stakeholder strategies. It is believed that identification and assessment of key stakeholders holds much promise for improving both HMO management and the future performance of HMOs.

Health Facility Administrators↗
PubMed1990

Achieving competitive advantage through strategic human resource management.

The framework presented here challenges health care executives to manage human resources strategically as an integral part of the strategic planning process. Health care executives should consciously formulate human resource strategies and practices that are linked to and reinforce the broader strategic posture of the organization. This article provides a framework for (1) determining and focusing on desired strategic outcomes, (2) identifying and implementing essential human resource management actions, and (3) maintaining or enhancing competitive advantage. The strategic approach to human resource management includes assessing the organization's environment and mission; formulating the organization's business strategy; assessing the human resources requirements based on the intended strategy; comparing the current inventory of human resources in terms of numbers, characteristics, and human resource management practices with respect to the strategic requirements of the organization and its services or product lines; formulating the human resource strategy based on the differences between the assessed requirements and the current inventory; and implementing the appropriate human resource practices to reinforce the strategy and attain competitive advantage.

Economic Competition↗
PubMed1989

Assessing key stakeholders: who matters to hospitals and why?

A key stakeholder perspective, informed by illustrative quantitative and qualitative data, is developed for hospital administrators. These data provide answers to the questions, Who matters to hospitals? and Why do they matter? A tool kit for assessing stakeholders also is presented to help hospital executives identify their institutions' key stakeholders, determine the power of these stakeholders and their core values, and define who within their institutions should be responsible for the routine management of different stakeholders. These tools facilitate the management of each key stakeholder, ensuring that each strategic decision is examined in terms of the likely reaction of key stakeholders and is supplemented with plans for gaining stakeholder acceptance. Managers should recognize that the answers to Who matters? and Why? will vary by type of hospital and by the specific issue being addressed.

Community-Institutional Relations↗
PubMed1988

HCFA release of hospital specific death rates: where are we and where are we going?

This article reviews the public release of hospital-specific death rates by the Health Care Financing Administration in 1986 and 1987 and makes projections for the future of such releases. Among the topics covered are the reasons for such public releases, the significant problems associated with the release in 1986, modifications which reduced such problems in 1987, strategies employed by hospitals to anticipate and/or respond to public release, future projections regarding public release,and implications for medical record professionals.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1988

Survival of the hospital emergency department: strategic alternatives for the future.

Diverse and pervasive environmental forces are reshaping hospital emergency services as hospitals strive to respond to consumer preferences related to cost and convenience. Complacency can no longer serve as a standard operating procedure for hospital emergency departments competing against lower-priced, consumer-oriented, free-standing facilities. Strategic alternatives, a five-step strategy for survival and growth, and a projection of future models of hospital emergency services are examined.

Economic Competition↗
PubMed1988

Attitudes of hospital executives toward product line management: a pilot survey.

This article reports results of a pilot survey of hospital executive attitudes toward product line management (PLM). Results indicate that the majority of respondents feel the concept is applicable to hospitals in general as well as to their own institutions. However, the respondents have not really internalized some of the key attributes of the concept and the likelihood of adopting PLM is higher for large, for-profit, and urban hospitals.

Alabama↗