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Volume 52, Number 4
July/August 2007

  • INTERVIEW
    Interview with Jack O. Bovender, Jr., FACHE, chairman and chief executive officer, Hospital Corporation of America, Kyle L. Grazier
  • TECHNOLOGY
    Effective Management of Technology Implementation,
    Christina Beach Thielst
  • DIVERSITY
    A Systems Approach to Culturally and Linguistically Competent Care, Janice L. Dreachslin and Valerie L. Myers
  • ACHE ESSAYS
    -Retail Medicine: The Cure for Healthcare Disparities? Alicia Gallegos
    -Hospital-Physician Informed Consent: New Use for an Old Doctrine, Gerry Ibay

    Errata: In the July/August 2007 issue of the Journal, the article entitled "Retail Medicine: The Cure for Healthcare Disparities?" failed to cite two sources of information--MinuteClinic's website and an article in Disease Management journal. The author regrets these oversights.

    Page 228 of the published article, line 30, the source for the following statement: "Those first clinics treated a very limited number of illnesses and conditions and only accepted cash for services" is as follows:

    Hansen-Turton, T., S. Ryan, K. Miller, M. Counts, and D. Nash. 2007. "Convenient Care Clinics: The Future of Accessible Health Care." Disease Management 10 (2): 61-73.

    Pages 230-31 of the published article, the source for the bulleted list is as follows:
    www.minuteclinic.com/en/USA/About/Quality/Qualified-Clinicians.aspx

  • ARTICLES
    The "New Economics" of Clinical Quality Improvement: The Case of Community-Acquired Pneumonia, Kurt Grote, Edd Fleming, Edward Levine, Russell Richmond, Saumya Sutaria, Francine C. Wiest, and Jennifer Daley
    Mentoring Junior Healthcare Administrators: A Description of Mentoring Practices in 127 U.S. Hospitals, Frances R. Finley, Lana V. Ivanitskaya, and Michael H. Kennedy
  • FELLOW PROJECT
    Government-Sponsored Health Plan Acquisition Integration: Decisions and Dynamics, Sara Horning Szabla

Executive Summary

The “New Economics” of Clinical Quality Improvement: The Case of Community-Acquired Pneumonia, Kurt Grote, Edd Fleming, Edward Levine, Russell Richmond, Saumya Sutaria, Francine C. Wiest, and Jennifer Daley

Hospitals and health systems have developed substantial infrastructure, at significant expense, to improve care quality and support the collection and distribution of quality metrics. Yet providers often have little understanding of what return, if any, they have earned on the investment because they typically view quality improvement efforts simply as a cost of doing business. After analyzing data from 10,512 patients with community-acquired pneumonia, we found that better performance on two quality measures was associated with shorter length of stay and improved financial performance. For example, a one-day decrease in the time until patients were shifted from intravenous to oral antibiotics was associated with a 0.8-day reduction in length of stay and a nearly 60 percent increase in margins. Providers can adapt the methods we used to derive these findings to identify other quality metrics that simultaneously increase care quality and generate economic value. To derive maximum clinical and financial benefit, however, providers must ensure that clinical quality staff members are adequately supported and skilled to set priorities and to implement effective initiatives.

Executive Summary

Mentoring Junior Healthcare Administrators: A Description of Mentoring Practices in 127 U.S. Hospitals, Frances R. Finley, Lana V. Ivanitskaya, and Michael H. Kennedy

A survey instrument about mentoring junior healthcare administrators was mailed to 485 senior-level executives—chief executive officers, hospital administrators, and presidents. Completed surveys were returned by 127 senior executives (26 percent response rate). On average, the respondents were 53 years old, had nine years of organizational tenure in their current position, and had 16.5 years of career tenure as a senior healthcare executive. The mean age of when the respondents first had a mentor was 28 years old. The average length of the respondents’ relationship with their mentor was 3.56 years. Although healthcare executives believed mentoring benefits the healthcare industry as a whole, they reported that the benefits are even greater for the hospital where mentoring is done. Personal satisfaction was cited as the primary reason for serving as a mentor. In the 127 organizations represented by the respondents, informal mentoring programs were more prevalent than formal mentoring programs.

Our findings suggest that h ealthcare executives in formal mentoring programs may be more likely to support mentoring than individuals who entered informal mentoring relationships. Those who reported being mentors or engaging in mentoring-supportive activities had a longer job tenure and career tenure than did individuals who had not served as mentors. The study suggests that mentoring—in particular, informal mentoring—is a popular activity in U.S. hospitals and is carried out by experienced healthcare executives whose primary motivation is personal satisfaction.