Biomedical subjects

Barbara Bigelow

Publications and source records attributed to Barbara Bigelow.

3 recordsLinked to original sources

PubMed2006

Toward the creation of an institutional logic for the management of hospitals: efficiency in the early nineteen hundreds.

This research focuses on the creation of an institutional logic--efficiency--and on its organizing principles of standardization and business practices through a study of the American Hospital Association and its publication, the Modern Hospital. In the early years of the 20th century, efficiency began to emerge as a first institutional logic for the management of hospitals. The term was defined broadly, encompassing not only economy but also quality and breadth of services, as well as access to care. This early emphasis on efficiency foreshadowed three issues that affect health policy and hospital management to this day: the pressure on hospitals to introduce new technology while containing cost, the assumption that hospitals should act like businesses, and the practice of offering large hospitals as the model for other providers.

American Hospital Association↗

PubMed2005

Transformational change in health care: changing the question.

The authors' purpose of this article was to explore the experience of hospitals with transformational change. Transformational change is defined as radical change introduced by visionary leaders at the level of the organization. Using reengineering as an example, this article examined transformational change, and questioned what it means for hospitals. The authors argue that transformational change has been illusive because it has, at best, offered new solutions to a century-old question: How can hospitals be made more business-like?

Adaptation, Psychological↗

PubMed2003

Teaching evidence-based management: where do we go from here?

Recently we talked with executive directors of healthcare organizations about the sources of information they use when conducting research. The responses were very similar. They preferred "googling," reading trusted trade journals, and reading more generic business literature such as Harvard Business Review. When asked if they ever read and used healthcare management research, they said the articles were often inaccessible. First, as CEOs faced with the responsibility for their organization's performance, they want to know whether there is anything in the research that will help them run their organizations better. Unfortunately, as observed by Gary Mecklenburg in this issue, the focus in healthcare research is too frequently on research implications, not on what a CEO wants and needs to know. As a result, the research is not always relevant. Further, by the time the research is conducted and published (it is not infrequent for more than a year to elapse from submission to actual publication in a journal, and by then the data may be two or more years old), executives have moved on to other decisions. As one of the CEOs observed, there is a gap between what she needs to know and what the health management literature has to say. Second, managers have limited time, and information needs to be succinct and to the point if it is to be useful. Research articles are very time consuming to read, and as the CEOs commented, time is a precious resource. Research articles frequently devote considerable space to conceptual development and methods, and even when managerial implications are addressed, managers

Attitude of Health Personnel↗