Biomedical subjects
Publications and source records attributed to G S Bilchik.
Unions are becoming more attractive to nurses who feel increasingly unappreciated and disenfranchised from the decisionmaking process. But unions can cause big headaches for management and the board. The best way to keep unions off your doorstep is to listen to what your nurses want.
Illegal immigration is on the rise and Congress has restricted access to health coverage for legal immigrants. Those factors combine to create a large pool of uninsured patients, and hospitals once again are left to foot the bill--to the tune of millions of dollars a year. And the problem is no longer restricted to border states and big cities.
For the three winners of this year's Circle of Life Award--Beth Israel Medical Center, New York City; St. Joseph's Manor, Trumbull, Conn.; and Hospice of the North Shore, Evanston, Ill.--life and death are points on a continuous thread. The award is created by the American Hospital Association to recognize innovations in end-of-life care.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
The first group of Baby Boomers will start receiving Medicare in about 10 years. These patients will be savvier and more demanding than any group before them. Moreover, the changing demographics mean a major shift from acute to chronic care.
The jury is still out on whether a recent spate of hospital de-mergers and system break-ups represents a trend or a natural readjustment. But one thing is for sure--advice from trustees who have been through a hospital divorce can save you from repeating their emotionally wrenching experiences.
The age of oversight dawns in health care, bearing down on mergers and other big-picture moves. Still, there's a long way to go. "We still haven't completely outgrown the old volunteer-fireman mentality," says one consultant. "Trustees who should know better still take off their MBA hats at the door and replace them with social-worker hats."
Trend watchers stop short of calling it a groundswell, but broader board membership is gaining support. "Traditionally, governance on behalf of a community has meant governance by the community," says one consultant. "Changing circumstances are challenging that convention." Driving the trend are changes often initiated by trustees themselves.
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Doubters may deride them as boondoggles--and with some justification--but the management retreat is a staple among high-performance organizations of all types. It's no longer a hyped-up name for a weekend fishing trip for the inner circle. From a walk in space to walks in the woods, retreats offer ways to build up you management team and break down barriers to good ideas and smoother relations.
Three of the major issues affecting health care today are global in nature: poverty, violence and the aging of the American population. In the absence of a concerted national effort to deal with them, communities across the country are experimenting with their own local solutions. The Valencia County Coalition in New Mexico, for instance, is breaking down the barriers between low-income residents and the state's Medicaid managed care program. Another example: The DeKalb Medical Center in Decatur, Ga., opened a unit to treat elderly patients' acute medical problems and keep them functional so they can go straight home from the hospital rather than to subacute or skilled nursing care.
Religious groups have laid thousands of hospital cornerstones, but today's business bent is forcing hard choices about how best to minister to the poor and sick. Hospitals owned by religious communities are both numerous and endangered, with as many as half expected to change hands.
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Explore the source record for details and available documents.
Fred Brown, recently named the AHA's new chairman-elect, balances idealism with pragmatism. He likes to delegate and doesn't micromanage, but Brown is direct and tough when necessary. And having presided over the three-way merger that created BJC Health System in St. Louis, he's no stranger to politics and consensus-building.
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