Books & Journals

Buy HAP Books
Online Now!
  Books & Journals Links:
 
 

Volume 54, Number 6
November/December 2009

  • INTERVIEW
    Interview Kevin L. Unger, FACHE, President and Chief Executive Officer, Poudre Valley Hospital, Kyle L. Grazier

  • PHYSICIAN RELATIONS
    Innovation in the Face of the Economic Recession, Kenneth H. Cohn, and Philip A. Newbold

  • ARTICLES
    Strategic Performance Evaluation in Cancer Centers, Rigoberto I. Delgado and James R. Langabeer II
    The Relationship of Financial and Mission Factors to the Level of Uncompensated Care Provided in California Hospitals, Tae Hyun Kim, Michael J. McCue, and Jon M. Thompson
    Experiences That Develop the Ability to Think Strategically, Ellen Goldman, Terreence Cahill, and Rubens Pessanha Filho

Executive Summary

Strategic Performance Evaluation in Cancer Centers, Rigoberto I. Delgado and James R. Langabeer II

Most research in healthcare strategy has focused on formulating or implementing organizational plans and strategies, and little attention has been dedicated to the post-implementation control and evaluation of strategy, which we contend is the most critical aspect of achieving organizational goals. The objective of this study was to identify strategic control approaches used by major cancer centers in the country and to relate these practices to financial performance. Our intent was to expand the theory and practice of healthcare strategy to focused services, such as oncology.

We designed a 17-question survey to capture elements of strategy and performance from our study sample, which comprised major cancer hospitals in the United States and shared similar mandates and resource constraints. The results suggest that high-performing cancer centers use more sophisticated analytical approaches, invest greater financial resources in performance analysis, and conduct more frequent performance reviews than do low-performing organizations. Our conclusions point to the need for a more robust approach to strategic assessment.

Executive Summary
The Relationship of Financial and Mission Factors to the Level of Uncompensated Care Provided in California Hospitals, Tae Hyun Kim, Michael J. McCue, and Jon M. Thompson

Community hospitals in the United States have experienced a substantial rise in the burden of uncompensated care over the past few years. Debate continues, however, about whether hospitals, especially private not-for-profits, are providing sufficient levels of uncompensated care. Increased scrutiny regarding uncompensated care and the community benefit of not-for-profit hospitals may be fueled in part by the growing profitability of community hospitals. This study assesses how and whether a hospital’s financial performance, mission characteristics, or other significant factors influence its provision of uncompensated care.

The study sample consists of 193 short-term, private, acute care community hospitals in California. Results from multivariate regression suggest that free cash flow is positively associated with the provision of uncompensated care in not-for-profit hospitals, whereas a higher level of debt is related to a lower level of uncompensated care. Ownership type (for-profit versus private not-for-profit) does not make a significant difference in the provision of uncompensated care, and overall levels of uncompensated care in the local market are positively associated with a hospital’s level of uncompensated care.

Executive Summary
Experiences That Develop the Ability to Think Strategically, Ellen Goldman, Terrence Cahill, and Rubens Pessanha Filho

The ability to think strategically is an admired and a sought-after leadership requirement, yet we know little about how it develops. The purpose of this study is to identify specific experiences that contribute to the development of an individual’s ability to think strategically.
We identified eight work experiences, including different types of organizational projects, processes, and relationships, that contribute to an individual’s strategic thinking ability. We also delineate specific characteristics material to each experience. These characteristics indicate that considerable time and focus are required to develop the ability to think strategically. In addition, the experiences are not all accessed equally: Women are less likely to have nonrelational experiences, while chief executive officers are more likely to have the most challenging ones. In addition, we found differences regarding work-related continuing education activities. Respondents rated nonhealthcare conferences and reading behind all other identified experiences that contribute to strategic thinking ability.

Individuals can implement several strategies to improve their strategic thinking ability, including deliberately incorporating the requisite experiences into their development plans, ensuring that the experiences incorporate the required characteristics, and improving the benefit received from attending educational programs in nonhealthcare industries. Organizations can implement several strategies to ensure the experiences are as effective as possible, such as appraising gender differences across the experiences and reviewing the organization’s strategic planning processes for the characteristics that best encourage strategic thinking.