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Volume 50, Number 1
January/February 2005

I. INTERVIEW

Interview with Mary Stefl, Ph.D., professor and chair, Department of Health Care Administration, Trinity University, San Antonio, Texas, Kyle Grazier

II. PHYSICIAN-EXECUTIVE RELATIONS

The Five Stages of Physician Reaction to Change, Barbara LeTourneau

III. REPLACEMENT FACILITIES

Lessons Learned: Seven Keys to a Successful Replacement Hospital Project, James E. Hosking

IV. FUNDING

Overview of Investment and Financing Trends in the Hospital Industry, William O. Cleverley and James O. Cleverley

V. COMMUNICATIONS

Teams as the Key to Organizational Communication, Paul Preston

VI. ARTICLES

  • Marketing Telehealth to Align with Strategy, Kathryn H. Dansky and Jeffrey Ajello
  • Predicting the Effect of Extrinsic and Intrinsic Job Satisfaction Factors on Recruitment and Retention of Rehabilitation Professionals, Diane Smith Randolph
  • Building an Understanding of the Competencies Needed for Health Administration Practice, Richard M. Shewchuk; Stephen J. O’Connor, David J. Fine

VII. FELLOW PROJECT

Achieving Statistically Significant Improvements in Patient Satisfaction Scores in
a Community Hospital Through the Development of a Service Excellence Model, Adrienne Kirby

Executive Summary
Marketing Telehealth to Align with Strategy, Kathryn H. Dansky and Jeffrey Ajello

Telehealth is a twenty-first century solution to an old problem—how to deliver quality health services with shrinking resources. Telehealth enables healthcare providers to interact with and monitor patients remotely, thus adding value to service delivery models. On occasion, telehealth can substitute for live encounters, saving time and resources. Furthermore, as the geriatric population increases, telehealth will support independent living by supplementing the existing network of care. To be used most effectively, however, telehealth services must be carefully planned and executed.
This study investigated management practices used to promote telehealth services, focusing on strategic goals for adopting telehealth. Interviews with senior managers from 19 home health agencies identified three strategic goals for adopting telehealth: (1) cost containment, (2) clinical excellence, and (3) technological preeminence. Organizational documents were analyzed to determine the extent to which the telehealth program was featured in marketing materials. Documents included the organization’s brochure, newspaper ads and articles, and each home health agency’s web site. Results showed that marketing practices vary widely but are correlated with motivations to adopt telehealth. The organizations with the highest marketing scores emphasize clinical excellence as a major reason for using telehealth, whereas those with the lowest marketing scores tend to focus on cost containment.
Although this study focused on management practices in home health agencies, results are applicable to hospital and outpatient services as well as to other community-based programs. Using a strategic management framework, the authors offer recommendations to help organizations develop effective marketing approaches for telehealth programs.

Executive Summary
Predicting the Effect of Extrinsic and Intrinsic Job Satisfaction Factors on Recruitment and Retention of Rehabilitation Professionals, Diane Smith Randolph

The purpose of this study was to ascertain which extrinsic and intrinsic job satisfaction areas are most predictive of career satisfaction and desire to stay on the job for rehabilitation professionals. This article discusses the results of a survey conducted on practicing occupational therapists, physical therapists, and speech-language pathologists regarding factors that contribute to career satisfaction and desire to stay on the job. Five hundred surveys were mailed to each profession; 463 were returned, of which 328 were able to be analyzed. Results from regression analysis showed that intrinsic factors such as professional growth and having a work environment in line with personal values are more significant in predicting career satisfaction than extrinsic factors such as pay and continuing education. These same intrinsic factors are also significant in predicting the rehabilitation professional’s desire to stay on the job. These findings are significant to healthcare managers desiring to recruit and retain qualified occupational therapists, physical therapists, and speech-language pathologists. In addition to extrinsic benefits such as pay, healthcare managers need to focus on provision of intrinsic factors such as opportunities for professional growth, recognition of accomplishments, and opportunities for departmental input in order to motivate rehabilitation professionals.

Executive Summary
Building an Understanding of the Competencies Needed for Health Administration Practice, Richard M. Shewchuk; Stephen J. O’Connor, David J. Fine

Rapid change in the healthcare environment has pressured healthcare organizations, health management professional associations, and educational institutions to begin examining more carefully what it means to be a fully competent health executive. As a result, interest in healthcare management core competencies has increased.
Most competency development initiatives seek to build consensus and typically result in the generation of five or six broad competency domains—but consensus around what? Most competency initiatives are based on literature reviews and consensus-building efforts. Typically, such efforts in healthcare management have involved defining general competency domains and attempting to specify representative behavioral exemplars that demonstrate mastery of the general competency domain.
This study describes an approach that used a purposeful sample of ACHE affiliates who represented different geographical regions and health industry segments to construct a framework composed of critical healthcare issue clusters. A panel of healthcare executives then specified five sets of entry-level behavioral competencies that would be required to address the clusters of critical issues. Although the behavioral competencies identified by the executives in this study are anchored to a framework, their empirical association with performance has not been tested. Before implementing broad curriculum redesign, the effect of these competencies on performance should be established. Additionally, competencies should be examined in the context of potential moderating influences such as specific educational program focus, educational delivery format, and type and preparation of students entering healthcare management educational programs.