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PubMed1993

The role of executive and physician representative calling programs in TQM/CQI.

Many hospital Total Quality Management/Continuous Quality Improvement programs focus on the patient as the ultimate consumer of the hospital's service. Recent research utilizing data provided by Hospital Corporation of America has shown that "quality, as measured by patient satisfaction, is associated with financial strength as measured by earnings, net revenues, and return on assets ... Relatively small increases in the level of patient satisfaction are associated with millions of dollars in year-end earnings for the average hospital. "However, there are other significant customer groups on which hospitals need to focus. Chief among these are physicians, who still play a major role in determining which hospital a patient will utilize. It is reasonable to assume that the positive financial impact that has been demonstrated for the patient market also exists for the physician market.

Consumer Behavior↗
PubMed1993

Alternative dispute resolution and the physician--the use of mediation to resolve hospital-medical staff conflicts.

The use of adversarial methods to resolve disputes arising out of medical staff matters can be time-consuming, costly, and disruptive to the hospital-medical staff relationship. As this article suggests, mediation is the preferred method of alternative dispute resolution for reaching mutually acceptable solutions with minimal harm to relationships.

Hospital Administration↗
PubMed1993

Partnership--the term of the '90s? Building a network of middle management.

In her latest column, Ms. Sjolseth describes how a group of middle managers at a hospital where she worked began holding regular, interdepartmental meetings. The partnership broke down departmental barriers, fostered teamwork and enabled the managers to identify and resolve problems more quickly than before. After recounting the group's accomplishments, Ms. Sjolseth provides tips on how radiology administrators can create middle management teams in their own facilities.

Decision Making, Organizational↗
PubMedDate not supplied

Informal networks: the company behind the chart.

A glance at an organizational chart can show who's the boss and who reports to whom. But this formal chart won't reveal which people confer on technical matters or discuss office politics over lunch. Much of the real work in any company gets done through this informal organization with its complex networks of relationships that cross functions and divisions. According to consultants David Krackhardt and Jeffrey Hanson, managers can harness the true power in their companies by diagramming three types of networks: the advice network, which reveals the people to whom others turn to get work done; the trust network, which uncovers who shares delicate information; and the communication network, which shows who talks about work-related matters. Using employee questionnaires, managers can generate network maps that will get to the root of many organizational problems. When a task force in a computer company, for example, was not achieving its goals, the CEO turned to network maps to find out why. He discovered that the task force leader was central in the advice network but marginal in the trust network. Task force members did not believe he would look out for their interests, so the CEO used the trust map to find someone to share responsibility for the group. And when a bank manager saw in the network map that there was little communication between tellers and supervisors, he looked for ways to foster interaction among employees of all levels. As companies continue to flatten and rely on teams, managers must rely less on their authority and more on understanding these informal networks. Managers who can use maps to identify, leverage, and revamp informal networks will have the key to success.

Communication↗
PubMed1993

Teaching tomorrow's health care leaders.

Business school curricula have traditionally emphasized functional skills for people who will work in functional departments and general management skills for people who will organize interdepartmental work. Recently, some business schools have begun to develop programs that teach cross-functional work and team skills to functional specialists. Students educated in such programs will be well prepared to meet the new challenges that health care organizations will face.

Commerce↗
PubMed1994

Getting along with the "difficult" physician.

Satisfactory relationships between physicians and nurses are of vital importance to effective patient care. In fact, physician-nurse relationships even have been related to numbers of patient injuries in the hospital. Understanding the etiology of physician-nurse communication patterns and having a working knowledge of strategies to utilize when a "difficult" physician is encountered can facilitate physician-nurse communication. Positive communication can promote the development of healthy physician-nurse relationships.

Adaptation, Psychological↗
PubMed1994

The joy of doctoring.

What makes doctoring joyful? Important issues may involve the organization and management of the practice setting; the physician needs to focus on the human aspects of doctoring as well.

Humans↗
PubMedDate not supplied

Interdisciplinary collaboration in the special care unit--Part I.

Quality improvement (QI) activities in special care units can serve as a model of interdisciplinary problem identification and resolution for organizations that are moving from service-specific QI activities to organizational-wide activities. The transition from distinct unit-based QI activities to an interdisciplinary collaborative model at the Carl T. Hayden Veterans Administration Medical Center began with recognition of problems that were identified during a Joint Commission survey of the special care units. Process improvements were made that resulted in improved interdisciplinary collaboration between the special care units, and a successful follow-up Joint Commission survey.

Accreditation↗
PubMed1995

In pursuit of physician/organization linkage.

A friend of mine once said that medical staff/administrative relationships are the Bermuda Triangle of health care management. The Bermuda Triangle, as I recall it, is an area of the Atlantic Ocean into which ships and planes disappear without a trace, for no apparent reason. Sometimes, especially late at night on reruns of "Twilight Zone," these planes reappear years later, crew intact and youthful. Sometimes, salt and sharks get the ships, planes, and voyagers. In a like manner, problems in medical staff/administrative relations draw consultants into a vortex. Sometimes, the consultants and their reports float to the surface a long afterward. Sometimes, they are digested by the organization and become a part of its mythology. Sometimes, they vanish forever. This is the story of three consultations. All were intended to make recommendations concerning the structural relationship of management to the physicians and their groups in our HMO: How to link the physician organization to the corporate structure. Like any narrative, this story is constructed to provide a context for reflection and is not intended to question the value of the contribution of specific individuals or companies.

Consultants↗