Local hospital systems: fact or fancy?

In summation, Luke's article presents a series of concepts and tools that provide insight into local system building. Most of the material holds up well to the "reality test." Additional studies should be undertaken that include ambulatory, aging, and social services. The regional system of the future will likely include a range of services from wellness to hospice. We need to know how to bundle such services and provide them within the capitation payments. Such service offerings must be easily accessible to the consumer. We have our work cut out for us!

Renewal and change for health care executives.

Health care executives must consider renewal and change within their own lives if they are to breathe life into their own institutions. Yet numerous barriers to executive renewal exist, including time pressures, fatigue, cultural factors, and trustee attitudes. This essay discusses such barriers and suggests approaches that health care executives may consider for programming renewal into their careers. These include self-assessment for professional and personal goals, career or job change, process vs. outcome considerations, solitude, networking, lifelong education, surrounding oneself with change agents, business travel and sabbaticals, reading outside the field, physical exercise, mentoring, learning from failures, a sense of humor, spiritual reflection, and family and friends. Renewal is a continuous, lifelong process requiring constant learning. Individual executives would do well to develop a framework for renewal in their careers and organizations.

Caring for the aged requires communication, trust, and appropriate services.

This special report discusses different strategies management and the board should explore to gain a better understanding of the health care needs of the elderly in their community, to establish a cooperative relationship with senior citizen groups, and to provide appropriate services for an aging population.

Corporate cultures and business strategy: a health management company perspective.

This article develops a framework of analysis for understanding corporate cultures, and applies available analytical tools to the cultural study of four health management organizations. A distillation of the relevant literature was performed to establish working definitions, tools of analysis, and various caveats. Examples of corporate cultural studies follow, and an attempt was made to identify the cultural dimensions, typology, and anticipated strategies for the four multis. The author emphasizes that healthcare companies which want sustained changes in their business lines must examine and carefully alter their firms' culture to support and reinforce such changes.