Application of diffusion of innovations models in hospital knowledge management systems: lessons to be learned in complex organizations.

The authors identify a number of lessons to be learned regarding implementing a knowledge management system in hospitals. Building on the diffusion of innovations model, the authors address the development and implementation of a staffing productivity system designed to anticipate future hospital staffing needs. They describe the methodology behind the daily staff management system, efforts to market the system, and the implementation process and subsequent discontinuance of the system in a few early adopter hospitals. The authors address a number of principles of diffusion of innovations in the context of a complex adaptive system and provide insights into why some knowledge management systems fail.

Long term care: an essential element of health administration education.

Long-term care represents a career opportunity of choice for many healthcare executives and an education essential for the comprehensive management responsibilities of many others. Yet formal educational programs for health administrators include little academic attention to long-term care. This paper reports on an examination of the curricula and courses of undergraduate health administration educational programs certified or recognized by the Association of University Programs in Health Administration (AUPHA) and graduate programs accredited by the Commission on Accreditation for Health Management Education (CAHME). The results show that long-term care plays a minor role in the curriculum for most university programs in health administration, that there are few students enrolled in long-term care concentration or certificate offerings, and that courses in long-term care vary widely in their content and focus. We suggest that university health administration programs include specific training about long-term care services in their established core health management educational requirements so that all students in health management programs receive at least a basic education about long-term care.

A somewhat unorthodox explanation for the rise and fall of physician practice management companies: the application of Gaia theory.

PURPOSE: The purpose of this article is to present an alternative theory to why publicly-traded physician practice management companies in the US were popular and successful for a limited number of years and then essentially self-destructed. DESIGN/METHODOLOGY/APPROACH: The short history of publicly-traded practice management companies suggests that they had limited value and utility in the US healthcare industry. It is the premise of the paper that the sudden appearance these for-profit companies upset the natural order within the healthcare industry and created a disequilibria which ultimately resulted in their demise. While Gaia theory is most commonly applied to the natural sciences, it has been applied to a number of interdisciplinary issues. FINDINGS: Physicians gravitated to these for-profit companies either out of fear of encroaching managed care or out a desire to sell their practice to the highest bidder. Physician practice management companies, on the other hand, saw a way to entice stockholders to invest in a growth industry. The paper suggests that the physician practice management companies added little new value to the health care industry and applies Gaia theory as a possible explanation for this phenomena. Gaia theory was first postulated in 1979 to address the evolution of the material environment and corresponding organisms as a tightly coupled system which attempt to manipulate the environment for the purpose of creating biologically favorable conditions. ORIGINALITY/VALUE: The paper is one of the first to suggest that the laws of nature, as understood from the perspective of Gaia theory, may have applicability to the US health care industry.