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Volume 48, Number 6
November/December 2003

I. INTERVIEW
Deborah M. Lee-Eddie, CHE, Sr. VP, Operations, Catholic Health Initiatives, Kyle Grazier

II. CAREERS
Six Steps to Creating a Personal Career-Decision Framework, Mike Broscio and Jay Scherer

III. STRATEGIC MARKETING
Market Management: A Concept Worth Exploring, Howard J. Gershon

IV. ARTICLES

  • An Assessment Tool For Developing Healthcare Managerial Skills and Roles, Kristina L. Guo
  • Integrating Six Sigma with Total Quality Management: A Case Example for Measuring Medication Errors, Lee Revere and Ken Black
  • Effects of High-Involvement Work Systems on Employee Satisfaction and Service Costs in Veterans Healthcare, Joel Harmon, Dennis J. Scotti, Scott Behson, Gerard Farias, Robert Petzel, Joel H. Neuman, and Loraleigh Keashly

V. FELLOW PROJECT
A Pragmatic Approach to Quality Training, Kathryn Walker Zavaleta

Executive Summary
An Assessment Tool For Developing Healthcare Managerial Skills and Roles, Kristina L. Guo

This article is based on a study to identify, and by doing so help develop, the skills and roles of senior-level healthcare managers related to the needs of the current healthcare environment. To classify these roles and skills, a qualitative study was conducted to examine the literature on forces in the healthcare environment and their impact on managers. Ten senior managers were interviewed, revealing six roles as the most crucial to their positions along with the skills necessary to perform those roles. A pilot study was conducted with these senior managers to produce a final assessment tool. This assessment helps managers to identify strengths and weaknesses, develop in deficient areas, and promote competence in all areas as demanded by the market and organization. This tool can be used by organizations in the recruitment process and in the training process.

Executive Summary
Integrating Six Sigma with Total Quality Management: A Case Example for Measuring Medication Errors, Lee Revere and Ken Black

Six Sigma is a new management philosophy that seeks a nonexistent error rate. It is ripe for healthcare because many healthcare processes require a near-zero tolerance for mistakes. For most organizations, establishing a Six Sigma program requires significant resources and produces considerable stress. However, in healthcare, management can piggyback Six Sigma onto current total quality management (TQM) efforts so that minimal disruption occurs in the organization. Six Sigma is an extension of the Failure Mode and Effects Analysis that is required by JCAHO; it can easily be integrated into existing quality management efforts. Integrating Six Sigma into the existing TQM program facilitates process improvement through detailed data analysis. A drilled-down approach to root-cause analysis greatly enhances the existing TQM approach. Using the Six Sigma metrics, internal project comparisons facilitate resource allocation while external project comparisons allow for benchmarking. Thus, the application of Six Sigma makes TQM efforts more successful. This article presents a framework for including Six Sigma in an organization's TQM plan while providing a concrete example using medication errors. Using the process defined in this article, healthcare executives can integrate Six Sigma into all of their TQM projects.

Executive Summary
Effects of High-Involvement Work Systems on Employee Satisfaction and Service Costs in Veterans Healthcare, Joel Harmon, Dennis J. Scotti, Scott Behson, Gerard Farias, Robert Petzel, Joel H. Neuman, and Loraleigh Keashly

Two strong imperatives for healthcare managers are reducing costs of service and attracting and retaining highly dedicated and competent patient care and support employees. Is there a trade-off or are there organizational practices that can further both objectives at the same time? High-involvement work systems (HIWS) represent a holistic work design that includes interrelated core features such as involvement, empowerment, development, trust, openness, teamwork, and performance-based rewards. HIWS have been linked to higher productivity, quality, employee and customer satisfaction, and market and financial performance in Fortune 1000 firms. Apparently, few prior studies have looked at the impacts of this holistic design within the healthcare sector. This research study found that HIWS were associated with both greater employee satisfaction and lower patient service costs in 146 Veterans Health Administration centers, indicating that such practices pay off in both humanistic and financial terms. This suggests that managers implementing HIWS will incur real expenses that are likely to be more than offset by more satisfied employees, less organizational turmoil, and lower service delivery costs, which, in this study, amounted to over $1.2 million in savings for an average VHA facility.