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To navigate carefully through today's rough healthcare waters, healthcare financial managers need to: Plan for the unexpected. Realize that technology alone is not a solution. Refrain from being overconfident
This is part II of an analysis of world class practices adopted by model organisations known for their excellence in terms of people management and their superior competitiveness based on harnessing the potential of their employees. This paper continues by addressing best practices adhered to by organisations using the NASA framework, such as Rockwell Space Systems Divisions. In addition and quite comprehensively, the paper examines the personnel function and how it is managed in Japan. Finally, the paper describes two cases of model organisations and the human resource practices adopted and concludes by drawing some useful pointers that professionals who are in a healthcare setting and who are concerned with human resources can learn from.
The health care industry has experienced dramatic changes during the last 25 years and will likely undergo even more dramatic changes in the next 25 years. Many firms in the health care industry will thrive just as many firms have thrived during the last 25 years. The ultimate key to success will be management and their attention to the basics of good business management. Management has always been the key ingredient and will continue to be the most critical success factor.
Biotechnology will provide U.S. farmers with another green revolution. The United States Department of Agriculture has put together the Plant Genome Research Program as a coordinated multi-agency effort within the department to help develop the "new agriculture." The Cooperative State Research Service is managing the program's competitive research grants. Research topics include high- and low-resolution chromosomal maps; the isolation and transfer of economically important genes; and new technology developments. The Agricultural Research Service is the lead agency for the Plant Genome Research Program and coordinates data collection and information management resources for the program. Five species groups are collaborating in the database development effort for the program by defining the user needs for their species and collecting and evaluating their species data for the database. A central database for the Plant Genome Research Program is under development at the National Agricultural Library (NAL) and ultimately will contain data for as many as seventy-one different plant species. NAL will provide user access via Internet, dial-up modem, and, at a later date, a CD-ROM product.
Should we do away with HR? In recent years, a number of people who study and write about business--along with many who run businesses--have been debating that question. The debate arises out of serious and widespread doubts about HR's contribution to organizational performance. Dave Ulrich acknowledges that HR, as it is configured today in many companies, is indeed ineffective, incompetent, and costly. But he contends that it has never been more necessary. The solution, he believes, is to create an entirely new role for the field that focuses it not on traditional HR activities, such as staffing and compensation, but on business results that enrich the company's value to customers, investors, and employees. Ulrich elaborates on four broad tasks for HR that would allow it to help deliver organizational excellence. First, HR should become a partner in strategy execution. Second, it should become an expert in the way work is organized and executed. Third, it should become a champion for employees. And fourth, it should become an agent of continual change. Fulfilling this agenda would mean that every one of HR's activities would in some concrete way help a company better serve its customers or otherwise increase shareholder value. Can HR transform itself on its own? Certainly not--in fact, the primary responsibility for transforming the role of HR, Ulrich says, belongs to the CEO and to every line manager who works with the HR staff. Competitive success is a function of organizational excellence, and senior managers must hold HR accountable for delivering it.
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When the history of the 20th century is written, the chapter dealing with medical education will note that perhaps the 2 biggest factors affecting academic medicine occurred as the century was just getting under way and as it was winding down. First was the Flexner Report of 1910 that established the current system of medical education. Then came the 1990s and the emergence of managed care that is changing the way medical school administrators think, the way they run their schools, and the way they teach future generations of physicians.
Hate managed care? It's no picnic for doctors either. The big question is whether medicine's new order is making your doc treat you better or worse.
The last few years have been a period of transition not only for hospitals and their governance but also for post-graduate medical education in Hong Kong. Both trends have a direct impact on the information market place. This article starts by studying the provision of medical and health-related information in Hong Kong. The two university medical and dental libraries, together with the hospital and health sciences libraries in government hospitals and the Department of Health, house the major collections on medicine and health care. The demand for medical and health care information is increasingly felt with the takeover of 39 hospitals by the statutory Hong Kong Hospital Authority in 1991. The major problems and issues in planning for library information services are the historically uneven development of libraries, discrepancies in funding, the changes in organizational and management structure, and the competition with higher development priorities within the organization. In view of current technology and the availability of rich external resources, the adopted strategies tend towards the formation of 10 library service networks, development of integrated library information systems on the Health Authority-wide area network, and the devolution of management responsibilities. The future challenges in store for the information professional are examined.
Hospitals are developing their own healthcare networks and managed-care plans to take on the industry's giants. And, against seemingly long odds, they're finding some success as they see increases in the medical services performed at their facilities and capture bigger pieces of market share. Executives say the local plans have a cost advantage, enabling them to develop more competitive packages.
As in many areas of health care, the role of the nurse manager has changed dramatically. These changes have supported the evolution of a new role, nurse executive. The nurse executive is responsible for the delivery of patient care services, which will be cost efficient and will result in quality care acceptable to consumers (both physicians and patients). An effective nurse executive gives the organization a competitive advantage. The nurse manager requires both preparation and socialization to be successful. Development and support of the nurse executive must be a goal of the organization, so that as the organization increases in sophistication so does the nursing leadership.
Retail price structures are a critical part of the managed care contracting process because payers use local and national charge norms to compare hospitals and to determine negotiating targets. To successfully negotiate managed care contracts, and to be able to offer sensible discounts to payers that require them, a healthcare organization needs to determine its retail prices relative to the marketplace. By measuring their charge structure's variance from those of other providers in the same market, healthcare organizations can ensure that their retail prices are competitive.
Too many organizations descend into underperformance because they can't confront the painful gap between their strategy and the reality of their capabilities, their behaviors, and their markets. That's because senior managers don't know how to engage in truthful conversations about the problems that threaten the business--and because lower-level managers are afraid to speak up. These factors lie behind many failures to implement strategy. Indeed, the dynamics in almost any organization are such that it's extremely difficult for senior people to hear the unfiltered truth from managers lower down. Beer and Eisenstat present the methodology they've developed for getting the truth about an organization's problems (and the truth is always embedded within the organization) onto the table in a way that allows senior management to do something useful with it. By assembling a task force of the most effective managers to collect data about strategic and organizational problems, the senior team sends a clear message that it is serious about uncovering the truth. Task force members present their findings to the senior team in the form of a discussion. This conversation needs to move back and forth between advocacy and inquiry; it has to be about the issues that matter most; it has to be collective and public; it has to allow employees to be honest without risking their jobs; and it has to be structured. This direct feedback from a handful of their best people moves senior teams to make changes they otherwise might not have. Senior teams that have engaged in this process have made dramatic changes in how their businesses are organized and managed--and in their bottom-line results. Success that begins with honest conversations begets future conversations that further improve performance.
Negotiating hundreds of managed care contracts to protect market share may soon be a thing of the past for large California hospitals, according to an ongoing study by the Rand Corp., Los Angeles. But this doesn't mean that price competition is slowing down in the state, experts say.
Management services are thriving. They are realizing their promises of some years ago and seem to have established a well-deserved niche in the health care industry.
Academic health centers (AHCs) have supported their mission of patient care, education, and research through a complex system of cross-subsidies, many of which originate from patient care activities. The proliferation of managed care and health care reform initiatives, however, are threatening this traditional method of financing. This article begins by describing the financing of AHCs and the web of cross-subsidization that occurs at these institutions. The article then reviews the literature on the threats that AHCs are facing in the current health care market, how these threats are affecting their mission-related activities, and how they are responding to and managing these threats. The article concludes with a summary of our current understanding of AHCs and presents a research agenda of issues in need of further study.
Today's successful community hospitals should and will evolve into integrated health care organizations (IHCOs) that will share several common characteristics. IHCOs will have a community--not a membership--orientation, and this will be a distinguishing characteristic and a source of market appeal. The transition to IHCO will be a slow one, and to prosper, the IHCO will have to accommodate both price-oriented markets and traditional ones. Successful IHCOs will expand technical skills and capabilities to control costs and quality. New strategic competencies will have to be developed, and to do this, emerging IHCOs will improve the ability of managers to support decisions and sell them both to the buyers and the public at large. Excellent patient care will rest upon better trained, advised, and informed management teams. Making the change to an IHCO will take time and money, but organizations that make steady progress are likely to succeed.