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Volume 52, Number 3
May/June 2007

  • INTERVIEW
    Interview with Douglas Hawthorne, FACHE, president and chief executive officer, Texas Health Resources, Kyle L. Grazier
  • TECHNOLOGY
    Regional Health Information Networks and the Emerging Organizational Structures,
    Christina Beach Thielst
  • DIVERSITY
    The Role of Leadership in Creating a Diversity-Sensitive Organization, Janice L. Dreachslin
  • ARTICLES
    Management Development: A Study of Nurse Managerial Activities and Skills, Li-Min Lin, Jer-Her Wu, Ing-Chung Huang, Kuo-Hung Tseng, and John J. Lawler
    Real Options Reasoning in Healthcare: An Integrative Approach and Synopsis, David R. Williams and Paul H. Hammes
    Hospital Patient Safety: Characteristics of Best-Performing Hospitals, Daniel R. Longo, John E. Hewett, Bin Ge, and Shari Schubert
  • FELLOW PROJECT
    Establishment of a Communitywide EMS First-Responder Program,Thomas H. Gee
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Executive Summary

Management Development: A Study of Nurse Managerial Activities and Skills, Li-Min Lin, Jer-Her Wu, Ing-Chung Huang, Kuo-Hung Tseng, and John J. Lawler  

This study discusses an activity competency model that may be used to investigate the perceived importance of managerial activities and skills required by three levels of nurse managers (top, middle, and supervisory management). Our findings indicate that the importance of nurse managerial activities differs significantly according to the level of nurse management. A set of critical managerial activities and skills/knowledge needs for each level of nurse managers was identified in the study. These findings provide guidelines for nursing-management development programs, training, and career planning. They also can serve as a guideline for recruiting and selecting an effective nurse manager.

Executive Summary

Real Options Reasoning in Healthcare: An Integrative Approach and Synopsis, David R. Williams and Paul H. Hammes

For the past 40 years, practitioners and researchers alike have been grappling with the natural shortcomings associated with the net present value approach to strategic decision making and capital budgeting. Work by scholars in option pricing theory has evolved into an alternative perspective on strategic capital investments, called “real options.” Proponents of real options argue that this is a superior way of approaching decision making and capital budgeting, compared with other approaches, as it allows for greater strategic flexibility and encourages exploration, experimentation, and innovation. Within the healthcare literature, articles on real options have focused on pricing these options. The current article is unique to the healthcare literature as it emphasizes the cognitive or strategic aspects of real options. Additionally, this article integrates two techniques for applying the real options approach for interested practitioners using a hospital’s imaging department as an example, while providing scholars with additional applications and questions for future research. For practitioners, the implications are that thinking of and planning for capital investments as real options may create greater strategic and operating flexibility than other, more traditional approaches.

Executive Summary

Hospital Patient Safety: Characteristics of Best-Performing Hospitals,
Daniel R. Longo, John E. Hewett, Bin Ge, and Shari Schubert

Hospitals have made slow progress in meeting the Institute of Medicine’s patient safety goals, and implementation of safety systems has been inconsistent. The next logical question is this: What organizational characteristics predict greater implementation of patient safety systems, in terms of both extent of systems and progress over time?

To answer this question, a survey was administered to 107 hospitals at two points in time. Data were consolidated into 7 latent variables measuring progress in specific areas. Using the overall measure, Joint Commission–accredited hospitals showed statistically significant improvement, as reflected in the sum score (p =.01); nonaccredited hospitals did not show statistically significant improvement (p =.21). Joint Commission accreditation was the key predictor of patient safety systems implementation. Management type and urban-rural status were secondary predictors.

Several factors may account for the strong association between accreditation and patient safety system implementation. In 2003, the Joint Commission began tying accreditation to patient safety goals. Also, Joint Commission data are now widely available to the public and may stimulate hospitals to address safety issues. Healthcare executives, hospital trustees, regulators, and policymakers should encourage Joint Commission accreditation and reward hospital efforts toward meeting Joint Commission standards . The Joint Commission should continually strive to maintain evidence-based and state-of-the-art standards that advance the aim of providing the best possible care for hospitalized patients.