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Volume 47, Number 6
November/December 2002

Volume 47, Number 6
November/December 2002

I. INTERVIEW
Interview with Greg Van Pelt, FACHE, vice president and chief executive, Providence Health System, Washington Region, Seattle, Kyle Grazier

II. QUALITY AND SAFETY
Healthcare Reform: One Coalition's Efforts at Effecting Change, Alan E. Cudney and Brian Klepper

III. STAFFING
The Inclusive, Diverse Workplace: We Are Not There Yet, Steven M. Barney

IV. ARTICLES

  • Sustaining the Edge: Factors Influencing Strategy Selection in Academic Health Centers, Anne M. Walsh and Kathryn Szabat
  • Community Health Center-Led Networks: Cooperating to Compete, Christine Baxter, Rebecca Levin, Marie M. Legaspi, Barbara E. Bailey, and Christie L. Brown
  • Healthcare Managers' Roles, Competencies, and Outputs in Organizational Performance Improvement, William G. Wallick

V. Fellow Project
Eliminating Night Hours for a Community's Sole Urgent Care Clinic,
Gale S. Pollock

VI. Survey of Postgraduate Fellows, ACHE's Division of Research and Development

Executive Summary
Sustaining the Edge: Factors Influencing Strategy Selection in Academic Health Centers
Anne M. Walsh, D.S.W, associate professor, Health Administration Program, La Salle University, Philadelphia, Pennsylvania, and Kathryn Szabat, Ph.D., assistant professor, Management Department, La Salle University, Philadelphia, Pennsylvania

Competition within the acute care sector as well as increased penetration by managed care organizations has influenced the structure and role of academic health centers during the past decade. The market factors confronting academic health centers are not dissimilar from conditions that confront other organizations competing in mature industries characterized by declining profitability and intense rivalry for market share. When confronted with intense competition or adverse external events, organizations in other industries have responded to potential threats by forming alliances, developing joint ventures, or merging with another firm to maintain their competitive advantage. Although mergers and acquisitions dominated the strategic landscape in the healthcare industry during the past decade, recent evidence suggests that other types of strategic ventures may offer similar economic and contracting benefits to member organizations. Academic health centers have traditionally been involved in network relationships with multiple partners via their shared technology , collaborative research, and joint educational endeavors. These quasi-organizational relationships appear to have provided a framework for strategic decisions and allowed executives of academic health centers to select strategies that were competitive yet closely aligned with their organizational mission. The analysis of factors that influenced strategy selection by executives of academic health centers suggests a deliberate and methodical approach to achieving market share objectives, expanding managed care contracts, and developing physician networks.

Executive Summary
Community Health Center-Led Networks: Cooperating to Compete
Lieutenant Commander Christine Baxter, MSC, USN, CHE, doctoral candidate, Department of Health Policy Administration, Pennsylvania State University, University Park; Rebecca Levin, student, Schreyers Honors College, Pennsylvania State University, University Park; Marie M. Legaspi, network coordinator, field offices VII-X, Health Resources and Services Administration, Bureau of Primary Healthcare, Bethesda, Maryland; Barbara E. Bailey, Ph.D., chief, Policy Assistance and Development Branch, Health Resources and Services Administration, Bureau of Primary Healthcare, Bethesda, Maryland; and Christie L. Brown, ISDI network coordinator, field offices I-IV, Health Resources and Services Administration, Bureau of Primary Healthcare, Bethesda, Maryland

The primary mission of community health centers (CHCs) is to provide primary and preventive healthcare for the underserved and vulnerable populations, including the uninsured, underinsured, and Medicaid beneficiaries. Economic and regulatory challenges have placed these safety net providers in a precarious position, forcing some to respond using cooperative strategies. This article focuses on seven CHC-led networks, delineating their integrative efforts in the core areas of managed care, clinical, administrative, information, and finance. Interviews with key representatives from each network highlight the networks' accomplishments and the critical success factors and outcomes of their integrative efforts. Several underlying themes emerged from this study that are consistent with findings of previous studies conducted in other organizational settings. Specifically participants in CHC-led networks site the following factors as contributors to success: reciprocity, communication, trust, and long-standing relationships among key individuals. This is the first study to provide a rich depiction of CHC network activities.


Executive Summary
Healthcare Managers' Roles, Competencies, and Outputs in Organizational Performance Improvement
William G. Wallick, Ph.D., assistant professor and director, Undergraduate Human Resource Studies Program, Department of Health Administration and Human Resources, University of Scranton, Scranton, Pennsylvania

Healthcare CEOs recognize that managers are under increasing pressure to work smarter and more efficiently with fewer available resources. Jobs in the healthcare industry are in a constant state of change, requiring a workforce that is not only prepared to adjust quickly to the changing environment but to simultaneously maintain or improve overall organizational performance. Traditionally, trainers were viewed as the people with the primary responsibility for improving organizational performance. Today some CEOs believe healthcare managers should own that responsibility, and other CEOs believe the responsibility should be shared among healthcare managers and trainers. This shift in how accountability is viewed poses at least two important questions. Are managers aware of the various roles they need to enact to achieve successful organizational performance improvement? Do managers possess the competencies associated with those roles?
The seven most contemporary trainer roles, now referred to as workplace learning and performance roles, are examined in this article to help managers increase their knowledge of the roles, competencies, and outputs expected of them. Based on findings of a study conducted to examine CEOs' perceptions of managers' roles in the performance improvement process, this article provides theoretical backgrounds, includes verbatim study comments, and offers practical recommendations or tips for managers.