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Executive
Summary:
Assessing the Implementation
of Clinical Process Innovations: A Cross-case Comparison
Clinical
process innovations (CPI) are central to the ability of organizations
to negotiate the challenges of cost containment and quality improvement,
yet many CPI have not met expectations. Perhaps most alarming I that the
dissemination and the implementation of CPI is not well understood.
This is the second of two articles addressing the dissemination and use
of CPI in integrated delivery systems. This article discusses those factors
that have been identified s either facilitating or impeding the various
stages in implementing CPI and suggests some intervention strategies to
enhance opportunities for continuous CPI.
Identifying the process and the factors driving the implementation of
CPI is only part of the challenge. The development of CPI adequate to
fully meet current challenges will require managers to re-examine existing
paradigms and values influencing their actions to date. Within this context,
the necessary staging of the innovation process within the life cycle,
developing partnerships both within and outside the organization to gather
the necessary resources and support, and multidimensional performance
monitoring and feedback can prepare organizations and managers to better
face the reality of managing the innovation process.
For more information on this article, please contact Dr. Savitz at lucy_savitz@unc.edu.
Executive
Summary:
Getting Off the Bandwagon:
An Academic Health Center Takes a Different Strategic Path
Focusing
on one state university academic health center (AHC) located in a rural
setting in the southeastern United States, this case study investigates
the strategic response to the increasingly turbulent and competitive environment
in the healthcare industry. The qualitative research reported here involved
a review of pertinent documents and archival data and interviews with
key informants including AHC executives and staff, community leaders,
and others. Additional information was obtained from published sources,
including a literature review that covers a five year period ending in
1997 and searches conducted using the key words "academic medical or health
center."
The AHC in this case study demonstrates how it is possible to respond
proactively to changes in the environment without sacrificing the multiple
missions of the institution. This AHC implemented strategies that ensure
access for both inner city and rural underserved populations while providing
venues for primary care training and educational programs. In addition,
the AHC positioned itself to compete more effectively by implementing
a continuous quality improvement program that is aimed at maximizing quality
while controlling costs. Administrators in not only AHCs but also other
healthcare organizations, such as community hospitals and competing systems,
should consider the findings from this case study useful in evaluating
existing strategies and possible alternatives. In particular, the use
of an affiliation strategy of growth in a resource-poor environment may
encourage organizations located in rural areas to consider innovative
expansion strategies to develop integrated systems of care.
For more information on this article, please contact Dr. Malvey at: dmalvey@hsc.usf.edu.
Executive
Summary:
Organizational Characteristics Associated with Hospital CEO Turnover
Using
a Probit regression model, this study examines organizational factors
contributing to hospital chief executive officer (CEO) turnover. The study
concludes that some organizational environments are more conducive to
turnover. Hospitals that are smaller, are on the West Coast, are investor
owned, are church related, offer many services, have high service usage,
and larger hospitals with female CEOs are more likely to experience turnover.
For more information on this article, please contact Dr. Wilson at: nwilson@unf.edu.
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