ABSTRACT
Public hospitals face mounting challenges posed by the rise of managed care, increasing hospital competition, growing responsibilities in indigent care, and stagnant public sector revenues. Privatization exists as a viable strategy for reengineering the structure and operation of public hospitals to meet the new demands of quality and efficiency imposed by a rapidly changing health care environment.
Subject(s)
Hospital Restructuring , Hospitals, Municipal/organization & administration , Privatization/organization & administration , Delivery of Health Care, Integrated/organization & administration , Economic Competition , Efficiency, Organizational , Hospitals, Municipal/trends , Humans , Models, Organizational , New Jersey , Organizational Culture , Power, Psychological , Total Quality ManagementSubject(s)
Continuity of Patient Care , Health Services for the Aged/organization & administration , Long-Term Care/organization & administration , Primary Health Care , Aged , Chronic Disease , Female , Health Services for the Aged/trends , Humans , New York City , Personality Disorders/therapy , Time Factors , United StatesSubject(s)
Facility Regulation and Control , Hospitals, Municipal/economics , Hospitals, Public/economics , Medicaid/legislation & jurisprudence , Utilization Review/legislation & jurisprudence , Cost Control/legislation & jurisprudence , Hospital Bed Capacity, 500 and over , Insurance, Health, Reimbursement , New York , New York City , Professional Review OrganizationsSubject(s)
Admitting Department, Hospital , Emergency Service, Hospital , Hospital Departments , Aged , Female , Humans , Male , Middle Aged , Time FactorsABSTRACT
The experience of functional program planning, in addition to facilitating the planning process for a new emergency unit, has had additional benefits. It has given the staff a common conceptual framework for analyzing patient care as provided and for identifying areas where improvements can be made. Also, a new approach has been developed for communicating with other departments and with hospital administration about day-to-day operating problems which may be useful for addressing other resource allocating and operating room time schedules. By developing a planning framework, it is possible to integrate the expertise of various services, while retaining an integrated overall orientation within which the efficacy of different proposals can be judged. This approach is critically important in helping to avoid the adverse effects of fragmented planning.
Subject(s)
Emergency Service, Hospital , Hospital Design and Construction , Adult , Child , Emergency Medical Services , Hospital Administration , Humans , Task Performance and AnalysisABSTRACT
Consumer participation in the planning and management of health care programs is prescribed as a method for increasing provider responsiveness to the goals and needs of users of services. However, issues related to the nature of mandates to implement consumer participation has not had the impact on policy development proposed for it. While structural changes can be identified which might enhance the consumer role in decision making, it will also be necessary for the consumer sector to develop a strategy which will prompt major rather than incremental movement.
Subject(s)
Community Participation , Delivery of Health Care , Decision Making , Economics , Education, Continuing , Evaluation Studies as Topic , Health Planning , Humans , United StatesABSTRACT
A retrospective evaluation of training provided to six hospital consumer advisory groups is described. The training program was designed to provide information and decision-making skills to consumers of services and community representatives serving on voluntary hospital advisory boards. The evaluation, initiated after the end of the training program, demonstrates different effects of training depending on the stage of development of the consumer board. All but one of the six boards studied showed positive changes in the number and type of activities following training.
