As health care organizations expand and move into global markets, they face many leadership challenges, including the difficulty of leading individuals who are geographically dispersed. This article provides global managers with guidelines for leading and motivating individuals or teams from a distance while overcoming the typical challenges that "virtual leaders" and "virtual teams" face: employee isolation, confusion, language barriers, cultural differences, and technological breakdowns. Fortunately, technological advances in communications have provided various methods to accommodate geographically dispersed or "global virtual teams." Health care leaders now have the ability to lead global teams from afar by becoming "virtual leaders" with a responsibility to lead a "virtual team." Three models of globalization presented and discussed are outsourcing of health care services, medical tourism, and telerobotics. These models require global managers to lead virtually, and a positive relationship between the virtual leader and the virtual team member is vital in the success of global health care organizations.

Saint Elizabeths Hospital in Washington D.C. implemented a treatment mall in 2002. The authors place the mall's development within the context of the Hospital's problems associated with ward-based treatment. They describe objectives in developing the mall, steps taken to prepare staff and hospitalized persons, and the mall's structure and programs. Providing treatment in a mall setting increased active treatment, expanded opportunities for trainees and staff, and improved monitoring of treatment activities.