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The second of a three-part series of articles analyzing the results of the American Hospital Association's Nursing Personnel Survey, this article examines data about RN vacancies and turnover among community hospitals in general and community hospitals classified by bed size, control, and geographic region. It discusses the implications of the findings for nursing administrators.
There are two major models to save financially failing rural hospitals: (1) expanding through an affiliation or merger with other hospitals to increase the utilization and diversity of services, or (2) downsizing by employing the limited-service model and providing only emergency and primary care service with limited acute care. This study investigates hospital mergers and closures from 1990 to 1992 using the American Hospital Association's (AHA's) data from the Annual Survey of U.S. Hospitals. The presence of potential scale and scope economies among merging and closing hospitals prior to the merger or closure suggests that rural hospitals are operating at a size level that has great potential for achieving scope and scale efficiencies through mergers.
Mount Zion Hospital and Medical Center, a 290-bed institution in San Francisco, Calif., displayed a commitment to a mission of "caring, grounded in learning, supported by acts of personal kindness" to win the 1990 American Hospital Association's Foster G. McGaw Prize for community service. In the following interview with Health Care Strategic Management's editor and publisher Donald E.L. Johnson, Martin H. Diamond, the hospital's CEO, explains how the institution earned recognition for its community-based programs to aid disenfranchised groups.
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Gail L. Warden, president and CEO of Henry Ford Health System, Detroit, has been named chairman-elect of the American Hospital Association. He will become chairman of the board of trustees in January 1995. In many ways, Warden is the right man at the right time to head the AHA. His integrated system is described as light-years ahead of others in health care. This, plus his background as president and CEO of Group Health Cooperative of Puget Sound, Seattle, makes him one of the field's leading experts on managed care. Warden shared his vision of the future with Mary A. Grayson, Materials Management in Health Care's editorial director.
Corporate integrity is the topic du jour, and now it has emerged among the leadership of the American Hospital Association, where a divide exists over whether AHA board executives should serve concurrently on the boards of for-profit firms selling goods to hospitals. Fred Brown (left), AHA chairman in 1999, is one of several former AHA chair officers who served on the boards of privately held firms during their tenures.
For the third year in a row, the American Hospital Association's annual survey of more than 5,000 hospitals found little or no growth in hospital costs. The average length of stay for patients continued to drop, declining to an all-time low of 6.1 days. About 23% of hospitals were involved in developing an HMO insurance product independently or through a joint venture in 1997, up from 19% of hospitals in 1994.
The American Hospital Association has targeted 1994 for its national advocacy campaign, which is called "Health Care '94: Shaping Tomorrow Today." Health care educators have an important opportunity to participate in the AHA advocacy efforts and to play a role on the local level, perhaps by assisting their institutional campaigns. In order to be effective, they must be (1) informed about national issues and reform efforts, and (2) committed to participating. This article summarizes actions taken in the first half of 1994 and offers options for educators to consider in expanding their own roles in the advocacy effort.
This analysis describes hospitals that provide large amounts of uncompensated care and hospitals with sizable teaching programs, using data from the American Hospital Association. Despite current public financial support mechanisms, safety-net hospitals have a lower average total margin and a greater percentage with negative total margins than other groups of hospitals. For graduate medical education, however, the current public financial supports have assisted teaching hospitals with the largest training programs in maintaining their financial viability, although teaching hospitals' average total margins remain below those of nonteaching hospitals.
Fearing political backlash, the American Hospital Association is taking the offensive, crafting an image that shows hospitals are providing essential services despite the hefty price tag. In an attempt to rebrand itself, the AHA is touting a study on healthcare return on investment, has created an election card detailing "Seven Steps to a Healthier America" and debuted a new logo.
In this short piece, the author outlines the efforts the American Hospital Association (AHA) has made to uncover the issues associated with MRI. In March of 1983, as part of its Hospital Technology Series, the AHA published a 60-page report on MRI. In January 1985, it published a 240-page report entitled, "NMR Issues for 1985 and Beyond," that probes the questions of utilization, magnetic field strength, and the future of MRI in spectroscopy.
These guidelines were developed by the American Hospital Association's Committee on Hospital Governing Boards to suggest to hospitals ways of achieving physician participation in governing board activities and to identify the decisions that must be made in doing so. The guidelines take into consideration the responses of 2,900 nongovernmental not-for-profit hospitals to a 1976 AHA survey among all hospitals. The document was approved by the AHA's House of Delegates on February 1, 1978.
The American Hospital Association and the Joint Commission on Accreditation of Healthcare Organizations are at it again. The AHA once more is scourging the JCAHO for too much work outside of its accreditation role, and this time AHA President Richard Davidson (left) is accusing the commission of becoming a government regulator of hospital business and clinical practices. But the JCAHO maintains that its mission remains intact.
In an earlier article, Berry published the results of a study that examined possible relationships among hospital facilities and services. In general, Berry found that hospitals behaved in a reasonably consistent fashion; that is, hospitals added facilities and services in a well-defined order, and these facilities and services were added in distinct groups. Berry defined five such groups and hypothesized that each group represents an increasing level of case-mix complexity. Given the current interest in using Berry's results to measure hospital case mix, this study attempted to replicate Berry's results using recent data from the American Hospital Association. Using a number of statistical methodologies (including cluster analysis and Guttman scale analysis), we found that hospitals continue to add facilities and services in a well-defined order (although this order contains some notable differences from the order found by Berry). However, our results indicate that hospitals no longer add facilities and services in well-defined groups but in a more continuous fashion. Thus, it would appear that hospitals have become more differentiated.
One long-standing problem of social work departments in acute care hospitals has been their diverse patterns of staffing. The lack of a standard or guide has tended to diminish the utilization of social work services in hospital settings. Over a period of six years, the Society for Hospital Social Work Directors of the American Hospital Association developed and revised a guide for inpatient staffing. The guide is designed to assist hospital and social work administrators establish an inpatient line staffing plan which is based on the number of hospital beds, the number of patients to be served and the number of functions carried. The logic of the inquiry and the findings can serve as a base for future research in inpatient, ambulatory care and other settings which serve special populations.
The mission of every hospital in America is to serve the health care needs of individuals in their communities, 24 hours a day, seven days a week. Their task, and the task of their medical staff, is to continually care for and to cure their patients. American health facilities are said to provide the best, most sophisticated, and most beneficial health care in the world. However, a hospital's ability to care for each patient who walks through their doors is continuously challenged on numerous fronts--the shortage of key hospital personnel, the increased cost of caring for the uninsured, the continued problem of medical errors, and the growth of niche and specialty hospitals. As of 2002, there were 5,794 registered hospitals in the United States, according to the most recent data available from the American Hospital Association (AHA). The AHA also states that there are 4,927 community hospitals, which includes nongovernmental, non-profit hospitals, investor-owned (for-profit) hospitals, and hospitals owned by state and local governments. The AHA defines community hospitals as all non-federal, short-term general and other specialty hospitals. Specialty hospitals include obstetrics and gynecology, rehabilitation, orthopedic and other individually described specialty services. Statistics provided by the AHA indicate that the number of rural and urban community hospitals is approximately equal--2,178 rural hospitals compared to 2,749 urban hospitals.
Carolyn C. Roberts--researcher, health care administrator, American Hospital Association board member--is a role model for women health care executives. As president of Copley Hospital in Morrisville, Vermont, Carolyn has provided national leadership on health care reform and the management of small and rural hospitals. Her creative and positive approach to life coupled with her sensitivity to serving patients and the community with quality service provides inspiration to many health administrators, physicians, and community leaders. The following interview is a tribute to a dear friend and a great lady.
CEOs have always played an important role in influencing health policy legislation. But in these times many CEOs view it as an essential part of their jobs. "It's terribly important to educate and sensitize legislators to the indigent care problem and hospital problems in general," says James Mongan, M.D., executive director of the Truman Medical Center, Kansas City, MO. Mongan, who has testified several times at the federal level on behalf of the American Hospital Association, believes that advocacy on the part of patients is a legitimate, constructive way to contribute to the public policy debate. "My sense is that there is a certain amount of hunger to talk to the people who are running the hospital facilities." Activity at the state level is also an important legislative arena for CEOs. Lobbying efforts at the state and local level pay dividends, according to executives who are actively involved in shaping state legislation.