The human factor is central to healthcare, yet its proper management has remained beyond the reach of healthcare organizations. This qualitative study examines strategic human resource management (HRM) issues in a university and a community hospital. The findings indicate that the two hospitals lacked a clear understanding of their strategic intent and objectives; as a result, their human resource (HR) practices lacked coherence and direction. Whereas the community hospital understood the interrelationship between culture and HRM, the university hospital did not. Moreover, the university hospital showed only a modest understanding of competencies needed in managing HR function, which hampered its ability to identify competent HR managers and employees. The community hospital made significant gains in the past few years in managing its culture and people by recruiting a competent HR manager. The relationship between HR practices and clinical outcomes was much less clear in the university hospital than it was in the community hospital.

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A filing system of cumulative patient record cards is described for use by large or active blood banks. Cards are retrieved for review of patient identification, past transfusion history, and legally necessary documentation of test results. Information on the cards is handwritten (as is required in most blood banks) only once, reducing transcription error. Card acquisition depends on an electromechanical delivery system, which is selectively activated by a programmed key-stroke sequence. Cards are filed and accessed randomly so that records cannot be lost. A backup system for delivery permits certainty of retrieval of records. The system contains 40,000 complete patient records on line, can easily be expanded, may be linked to off-line files or a computer, and is simple to operate.

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