Hospital administration and revolution: the economy of Pennsylvania Hospital, 1775-1782.
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This study describes selected characteristics of hospital administrators in Utah, who are implementing a market strategy of cost containment. A mail survey was used to query hospital administrators concerning their personal backgrounds, professional practice patterns, and perceived role performance. The questionnaire elicited a 75.6 percent return from a limited universe sample. Analytical results disclose that Utah hospital administrators are relatively young, professionally dynamic, well educated, and subject to frequent career-motivated moves. Using Mintzberg's ten administrative roles, respondents identified two as key: "Leader" ranks as the role performed best, the role second most critical to survival, second best prepared for, second most time-consuming, and second most satisfying. "Entrepreneur" ranks as the role most critical to survival, most satisfying, most deserving of improvement, second least prepared for, and second best performed. Suggestions for innovative ways in which administrators can develop their skills to be better prepared to meet future challenges are listed.
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In most rural areas, specialist nonprimary care, when available, is provided by "itinerant" physicians and surgeons who periodically visit from a distant home base. Little is known about current usage and acceptability of itinerant specialists in rural communities. Administrators of hospitals in rural and frontier Kansas counties were asked to report the frequency of itinerant care in their facilities, the home base of each specialist and a listing of procedures performed during specialist visits. Administrators were also asked to respond on a Likert scale to six questions inviting their assessment of itinerant care. Responses were received from 53 of 56 hospitals. All offered at least one monthly session of itinerant medical or surgical care. The most common specialties represented were cardiology (in 87 percent of hospitals), urology (68 percent), orthopedics (68 percent) and radiology (60 percent). General surgeons consulted in over 80 percent of responding hospitals. Psychiatrists, dermatologists and neurologists were rarely available in the hospitals surveyed. Administrators generally rated itinerant care highly, though some expressed concern about revenue lost when specialists performed procedures in their home-base office or hospital. No associations were found between amount of care offered and potential explanatory variables such as hospital size, distance from subregional centers, or percentage of patients hospitalized locally. Further study is needed to better understand differences in itinerant specialist utilization and acceptance among rural Kansas hospitals. Because Kansas demographics are similar to those of many other American rural areas, such study may offer insights applicable to other regions.
Hospital pharmacy directors and administrators in Wisconsin were surveyed to determine their perceptions of the responsibilities, skills, postgraduate education, training, and experience necessary for hospital pharmacy directors during the next 10 years. Packages containing two identical questionnaires were mailed in April 1985 to the pharmacy directors at all 159 hospitals in Wisconsin. The pharmacy director and his or her immediate supervisor were asked to use a 5-point Likert-type scale to rate the importance of various responsibilities and skills and also to rank the most important responsibilities, skills, and issues. In addition, respondents answered forced-choice questions about postgraduate education and training and an open-ended question about academic coursework. All responses were compared by respondent characteristics and hospital size. There was a response rate of 48.1% to the questionnaire, representing 60.7% of the pharmacy directors (n = 96) and 34.6% of the administrators (n = 55). Both groups agreed on which responsibilities and issues will be very important (mean importance rating of greater than 4) for future pharmacy directors. However, administrators rated clinical and technical skills as significantly more important than did pharmacy directors. Only 48% of pharmacy directors believed that a residency is essential and preferred either a general or administrative residency coupled with an advanced degree, whereas more than 50% of the responding administrators favored residencies not affiliated with a degree program. The majority of pharmacy directors and administrators believed that both general staff and administrative experience is necessary for future pharmacy directors.(ABSTRACT TRUNCATED AT 250 WORDS)
The objective of the present study was to investigate hospital administrator's expectations about the administrative role played by nurses, utilizing functions proposed by the Neoclassical Theory of Administration: planning, organization, direction, and control as theoretical references. An instrument established in TREVIZAN (1989) was applied to 11 hospital administrators. The results showed they expect the four functions to be done by nurses. Therefore, the interaction between nurses and hospital administrators is critical to improve the patient's assistance.
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