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Health professionals and hospital administrators in organ procurement: attitudes, reservations, and their resolutions.

The responses of hospital administrators, directors of nursing, intensive care unit nurses, and neurosurgeons are reported to a range of inquiries designed to measure their commitment to organ procurement and thereby identify impediments limiting their cooperation with organ procurement efforts. Descriptive and multivariate statistical techniques are used to analyze data collected from each group. We find general approval for organ procurement but serious hesitation about dealing with donor families, particularly among physicians. Physician support for donation, moreover, is the strongest predictor of other professionals, attitudes toward donation. Neurosurgeons and intensive care unit nurses who believe organ procurement is a professional responsibility have the fewest reservations about facilitating organ donation.

Attitude of Health Personnel↗

A look at the hospital administrator.

The key individual in health care management in the new multidimensional health care system will be the hospital administrator, the person responsible for the overall management and direction of a single health care institution in a community. This person will have to deal with a vertically integrated institution and changing delivery and financing mechanisms.

Consumer Behavior↗

Assessing hospital administrators' responses to prospective payment. A case study in New Mexico.

Few studies have assessed the relationship between hospital administrators' efforts at planning and subsequent performance of health care organizations. Nonetheless, planning is viewed as an important mechanism for aligning health services delivery efforts with community needs and operating constraints. When prospective payment (PPS) was first introduced, hospital administrators had little choice other than to plan how they would respond to the new reimbursement policies. However, it is unclear whether they actively undertook planning in an effort to address prospective payment and related pressures. This article presents a case study of rural New Mexico hospital administrators' efforts to respond to prospective payment. Two dimensions of planning effort by administrators--intensity and formality--are analyzed within rural hospitals during the PPS transition (i.e., 1983 to 1987) and after its full implementation (i.e., since 1988). The findings suggest that planning intensity during the PPS transition is associated with higher performance; notably, higher net patient care revenues, lower costs per patient day, higher operating margins, higher net income, and higher planning effectiveness. However, the strength of these associations weakened as PPS was fully implemented. Given the exploratory nature of this evaluative case study, the results should be viewed as preliminary until confirmed by larger studies. The implications for research that evaluates planning-performance relationships in the health care field are discussed.

Attitude of Health Personnel↗

Hospital administrators' tolerance of staff needlestick injuries.

OBJECTIVE: To survey hospital administrators regarding their opinions of an acceptable frequency of staff needlestick injury and the frequency that would prompt additional preventive action. DESIGN: A simple anonymous questionnaire sent to 960 administrators with one reminder. Data were collected regarding hospital size and community role, whether human immunodeficiency virus (HIV)-infected patients had ever been treated, presence of an infection control practitioner, estimation of the proportion of staff vaccinated against hepatitis B, and opinions as to the acceptable frequency of needlestick accidents and the accident frequency, requiring additional action. SETTING: 240 public hospitals in New South Wales, Australia. PARTICIPANTS: The executive officers, directors of medical services, directors of nursing, and safety officers of the hospitals surveyed. RESULTS: The response rate was 50%. Administrators' opinions of acceptable accident frequency increased with hospital size and (independently of size) with experience with HIV-infected patients, and with the presence of a full-time infection control practitioner. Accident frequencies judged to require additional preventive action were higher than injury frequencies regarded as acceptable. CONCLUSIONS: The hospital administrators surveyed accept staff needlestick injuries as inevitable, the more so in hospitals that have treated known HIV-infected patients and that have full-time infection control practitioners.

Accidents, Occupational↗

Hospital power structure and the democratization of hospital administration in Quebec.

In 1973, the Canadian Province of Quebec 'democratized' its hospital boards of directors by replacing the previous 'elite' boards by boards representative of the hospitals' major interest groups. This study looks at the impact of these participatory boards on the distribution of power within hospitals, particularly their effect on the hospital administrators' position of control in relation to their boards of directors and medical staff. Findings include a deterioration in the administrators' sense of organizational control, a weakening of the boards' authority over physicians, and a concentration of decision-making outside of the boardroom.

Community-Institutional Relations↗

Marketing orientation: how do hospital administrators compare with marketing managers?

A recent study shows that the marketing orientation of hospital administrators is similar to that of marketing practitioners but that hospital administrators have an underdeveloped sense of market segmentation and market aggressiveness regarding their patients and physicians. Studies such as this one can be helpful in applying marketing techniques to today's hospitals.

Aggression↗