Transparency initiatives will require vigorous, interdisciplinary efforts to address the systemic and pervasive nature of the problem. Several ethical and social-psychological barriers suggest that medical schools and hospitals should collaborate to establish continuity in education and ensure that knowledge acquired in early education is transferred into long-term learning. At the institutional level, practical and cultural barriers suggest the creation of supportive learning environments and private discussion forums where physicians can seek moral support in the aftermath of an error. To overcome resistance to culture transformation, incremental change should be considered, for example, replacing arcane transparency policies and complex reporting mechanisms with clear, user-friendly guidelines.
The fast-paced change in today's health care environment presents an unsettling organizational climate within which managers must make important decisions that affect key stakeholders. This ambiguousness has resulted in the proliferation of health care organizations that are bundling together to find a sense of environmental stability in which they can achieve common goals. This means that health care managers need to view stakeholders as parts of larger bundles rather than only as individual organizations.
Bioterrorism, once a subject of fantasy and speculation, has become all too real in a world turned upside down by the September 11, 2001. series of events. An essential, but as yet unanswered, question has become a crucial topic for discussion on the nightly news and in living rooms across the United States: How much of a terrorist threat do we face, and what must be done to control its potential for mass destruction? This article seeks to both answer this question and explore proper plans of preparedness for the eventuality of the unthinkable.
Emergency departments (EDs) represent a critical entryway into America's health care delivery system and are under significant pressure. This study seeks to understand why insured patients use EDs rather than more appropriate medical alternatives available to reduce the strain they are placing on this critical portal of entry. This exploratory research study surveyed insured patients presenting to 1 of 4 Central Florida EDs. Factor analysis and cluster analysis were used to identify groups of insured ED users defined by motivating factors. This study found that there exists a disconnect between insured individuals and the primary care system.
The debate over which health care providers are most capably meeting their responsibilities in serving the public's interest continues unabated, and the comparisons of not-for-profit (NFP) versus for-profit (FP) hospitals remain at the epicenter of the discussion. From the perspective of available factual information, which of the two sides to this debate is correct? This article is part II of a 2-part series on comparing and contrasting the performance records of NFP health care providers with their FP counterparts. Although it is demonstrated that both NFP and FP providers perform virtuous and selfless feats on behalf of America's public, it is also shown that both camps have been accused of being involved in potentially willful clinical and administrative missteps. Part I provided the background information (eg, legal differences, perspectives on social responsibility, and types of questionable and fraudulent behavior) required to adequately understand the scope of the comparison issue. Part II offers actual comparisons of the 2 organizational structures using several disparate factors such as specific organizational behaviors, approach to the health care priorities of cost and quality, and business-focused goals of profits, efficiency, and community benefit.
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