New role for managers: increasing the amount of bad news.
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Biomedical subjects
Publications and source records attributed to K Darr.
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Every day seems to bring new demands for health services managers, even though none of the existing expectations seems to end. But, an effective pain management program is basic to meeting patient needs and is driven by patients' judgments and demands. It remains for HSOs and their managers to determine the means by which patients' judgments and demands will be met.
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Hospital boards and executives must resist the pressure to become all things health in the community. Hospital executives must educate their boards about the importance of concentrating on their core business and avoiding entangling and potentially risky ventures in peripheral and unrelated activities. They can and should participate in community health initiatives, but such efforts should, at most, be incidental to delivery of acute care services. The Drucker quote at the beginning of this column should be a warning to all who would venture even a short distance from their core business.
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It has been suggested that widespread use of advance directives might encourage systematic rationing of healthcare, especially to the elderly. If a right to die becomes a duty to die, the living will and its progeny have become a Frankenstein monster. Indeed, public statements by state and federal officials that the elderly should be required to have living wills raised a storm of protest in the past. Regardless of true motives, such suggestions tend to be seen by the public as motivated by economics. The organization must be alert to the issues raised by advance directives. Managers are obliged to obey the law. Beyond that, however, they should work to enhance patient autonomy by facilitating preparation and availability of advance directives and surrogate decision making, should that become necessary.
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