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Hospital administrators as professionals: a study of occupational role identity.

This study set out to examine how hospital administrators see themselves in relation to their occupational role, that is, do they see themselves primarily as professionals, as organizational men and women, or as some combination of both. The determinants of their perceptions of occupational role identity were also examined. Canadian hospital CEOs numbering 361 were surveyed with a 72 percent response rate showing wide variation in education and length of work experience. Findings indicate these CEOs manifest a combination of professional and organizational role identities with no apparent conflict between these identities and no systematic differences in role identity by type of education or by length of work experience. The structure of this integrated model of professionalism and its potential impact on the leadership role of the CEO is examined in this article.

Canada↗

Supervisor personal liability for ADA discrimination. Emerging issues for hospital administrators and physicians.

This article discusses emerging and conflicting trends in recent Americans with Disabilities Act discrimination legal decisions in which plaintiffs seek compensatory or punitive damages directly from supervisors and their employers, creating potential issues of personal liability for physicians or hospital administrators, for example. Also addressed in the article are potential problems employers face if supervisors are held personally liable for Americans with Disabilities Act discrimination.

Persons with Disabilities↗

Quality control circles in the Veterans Administration hospital.

In response to residents' reports of inefficiencies in the Veterans Administration (VA) system, a temporary task force of quality control circles was implemented at a VA hospital. A total of 25 internal medicine residents, on rotation at the VA, were subdivided into four groups. Each group was presented with a different problem, given the components and constraints of the problem, and asked to identify possible solutions. Program results were submitted to the hospital administration. Efforts are now being made to improve the working environment for medical residents.

Efficiency, Organizational↗

[Validation of colorectal cancer diagnostic codes in a hospital administration data set].

OBJECTIVES: To validate the ability of a hospital administration data set (minimum data set [MDS]) to detect incident cases of colorectal cancer using the Murcia Cancer Registry (MCR) as the gold standard and to measure agreement between the MDS and registration of colorectal cancer. MATERIAL AND METHOD: A cross sectional validation study of the MDS of the main hospital in the region of Murcia (Spain) was conducted. The study population consisted of incident cases of colorectal cancer in 2000 obtained from the MCR and cases in the MDS of the above-mentioned hospital for the same year with an ICD-9 diagnostic code between 153.0 and 154.1, eliminating readmissions. During the process, two analyses were performed: one analysis with the principal diagnosis only and another with all the diagnostic codes. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and agreement was calculated with their 95% confidence intervals (CI). RESULTS: With the first diagnosis only, the MDS detected 80% of the incident cases of colorectal cancer with a PPV of 75%. With all the diagnoses, the MDS detected 85% of the cases with a PPV of 64%. The agreement in codification was high at three digits (kappa 88% [95% CI, 0.79-0.97] first diagnosis, 89% [95% CI, 0.80-0.97] all diagnoses) as well as at four digits (kappa 77% [IC, 0.68-0.85] first diagnosis, 78% [95% CI, 0.70-0.86] all diagnoses) in both analyses. CONCLUSIONS: Because of its high sensitivity, the MDS is a good source for detecting incident cases of cancer. The high agreement found in the site of colorectal cancer helps to consolidate the MDS as a data source for cancer registration.

Colorectal Neoplasms↗

Stress and the hospital administrator: sources and solutions.

Each day, more is learned about the nature and impact of executive stress. Only recently, however, has there been concern about the specific causes of stress faced by managers in different organizational settings. This article presents the findings of a study designed to identify sources of stress associated with the tasks, roles, and social relationships of hospital administrators. Seventy-one administrators of general short-term hospitals completed extensive questionnaires reflecting factors influencing stress in their work and diseases related to those factors. In addition, in-depth interviews with ten administrators provided further insights into the hospital work environment and its relation to stress. Although numerous conditions were reported by administrators to heighten stress levels on the job, other factors not readily recognized as stress producing appeared to be related to physical and psychological disorders. Implications of the findings for administrative practice are also presented.

Data Collection↗