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Executive
Summary:
CEO Performance
Appraisal: Review and Recommendations
John F. Newman, Ph.D., CHE, associate professor, Institute of Health Administration,
J. Mack Robinson College of Business, Georgia State University, Atlanta;
Larry Tyler, FACHE, president, Tyler & Company, Atlanta; and Davis M.
Dunbar, MBA, MHA, Gill/Balsano Consulting, Atlanta
CEO performance
appraisal (PA) is very valuable to an organization, but the chances of
obtaining a PA of high quality decrease as executive responsibility increases.
The realities of CEO PA are that it: (1) is inevitable; (2) is creative
and complex; (3) involves politics; and (4) has a significant effect on
the organization and the executive. PA is conducted for legal and social
requirements, to enhance communication, to provide opportunities for improvement,
and to relate performance to compensation.
This
article discusses several problems with chief executive officer (CEO)
PA and the contemporary approaches that seek to improve it. Three fundamental
areas for evaluation are identified: (1) organizational success; (2) areawide
health status; and (3) professional role fulfillment. These provide an
outline for successful healthcare PA. In addition to a discussion of the
strategic considerations behind a successful CEO PA system, several recommendations
are offered for the implementation of the annual evaluation process.
The final
goal of CEO PA is to link its results to CEO incentive compensation. It
is strongly recommended that some portion of the CEO's salary directly
hinge on his performance in two critical areas: organizational effectiveness
and community health status.
For more
information on this article, please contact Dr. Newman at: hadjfn@langate.gsu.edu.
Executive
Summary:
Spirituality
and Healthcare Organizations
David R. Graber, Ph.D., M.P.H., associate professor, Medical University
of South Carolina, Charleston, and James A. Johnson, Ph.D., professor,
Medical University of South Carolina, Charleston
In recent
years, the place of spirituality in organizations has become increasingly
discussed and advocated. On a personal level, this may involve achieving
personal fulfillment or spiritual growth in the workplace. In the broader
sense, spirituality is considered by many to be essential in an organization's
interactions with employees, customers, and the community.
This
article describes a possible role for greater spirituality in healthcare
organizations, whose cultures in recent decades have largely excluded
spirituality or religiousness. This is the consequence of an analytical,
scientific perspective on human health; a reductionist paradigm in biomedical
research; and the inevitable bureaucratization occurring in large healthcare
organizations. However, in recent decades, numerous scientific articles
supporting a connection between faith or religiousness and positive health
outcomes have been published. Because individuals seek meaning when experiencing
severe illnesses, and humans universally respond to compassion and caring,
spirituality among healthcare workers and managers appears highly appropriate.
The article
describes organizational barriers to the greater inclusion of spirituality
in healthcare and presents several approaches to developing a more caring
organization. These include eliciting extensive input from all staff and
clinicians in identifying core or common values, ethics, and a philosophy
of caring. Programs should ensure that the views of nonreligious staff
and patients are respected and that clear guidelines are established for
the extent and nature of affective or spiritual support for patients.
For more
information on this article, please contact Dr. Graber at: graberd@musc.edu.
Executive
Summary:
Better
Information for the Board Anthony R. Kovner, Ph.D., professor, Robert
F. Wagner Graduate School of Public Service, New York University
Healthcare
managers are making quicker, riskier decisions in an increasingly competitive
and regulated environment. Questions have been raised regarding the accountability
and performance of boards of these organizations, as board members are
not always selected based on their competencies to guide such decisions.
Adapting mission and strategy and monitoring organizational performance
require information that boards get mostly from management. The purpose
of this study was to examine the information that boards regularly get
to carryout their functions.
I obtained
board documents from four not-for-profit hospitals and health systems
in different boroughs of New York City. At each institution, I conducted
one-hour interviews with at least three board members and three top managers.
I also attended at least one board or executive committee meeting and
one additional meeting, usually of the finance committee. Principal findings
were that the boards get too much data, the same data that management
gets, and little comparative data on performance of similar benchmarked
organizations. Board members and managers are satisfied with the information
that board members get and have no plans to improve their system of shaping,
or the quality of, information.
Key recommendations
to boards and managers are: (1) boards must take greater responsibility
for identifying the information that they get and how they wish to get
it, (2) managers must ensure that measurable objectives are developed,
against which organizational performance can be evaluated, (3) boards
must get information that is targeted and shaped to better fit board functions,
(4) managers must develop information sets for main service lines, (5)
boards must get information on the expectations and satisfaction levels
of key stakeholders, (6) boards must get better and more focused information
on performance of benchmarked institutions, and (7) boards must get less
hospital operating data on a monthly basis.
For more
information on this article, please contact Dr. Kovner at: anthony.kovner@nyu.edu.
This study was supported through a grant from the United Hospital Fund
of New York.
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