Assuntos
Catolicismo , Comportamento Cooperativo , Prestação Integrada de Cuidados de Saúde/organização & administração , Hospitais Religiosos/organização & administração , Sistemas Multi-Institucionais/organização & administração , Afiliação Institucional/normas , Prestação Integrada de Cuidados de Saúde/normas , Conselho Diretor , Guias como Assunto , Liderança , Missouri , Sistemas Multi-Institucionais/normas , Negociação , Técnicas de Planejamento , Integração de Sistemas , Estados UnidosRESUMO
The traditional functions of the hospital board are affected significantly when the institution is part of a multiunit system. The local board in multiunit systems often does not have the unrestricted ability to define its mission and goals and typically does not have total responsibility and authority for selecting, appointing, and evaluating the performance of the hospital's CEO. Some type of system-level involvement in shaping and/or approving the local institution's strategic plan and budget is common. Local boards generally have retained the principal role in the appointment and credentialing of medical staff members. In general, the continuing growth of multiunit systems has profound implications for the present and future role of local-level governance, but that role continues to have great importance and must be defined carefully.
Assuntos
Conselho Diretor/organização & administração , Sistemas Multi-Institucionais/organização & administração , Orçamentos , Administradores Hospitalares/normas , Planejamento Hospitalar/organização & administração , Privilégios do Corpo Clínico , Papel (figurativo) , Estados UnidosRESUMO
The growth of multiunit hospital systems (organizations that include two or more acute-care hospitals owned, leased, or managed by a single corporate entity) and their impact on health care are described. In 1970, there were fewer than 50 nongovernmental multiunit hospital systems in the United States. By 1981, this figure increased to 256; 53% of the systems included only two or three hospital units, while 13% included 11 or more units. Approximately one third of all nongovernmental hospitals in 1981 were included in multiunit systems. About 12% of the systems, which included 39% of the hospitals, were owned or operated by investor-owned firms. Multiunit hospital systems can improve the hospital industry's overall effectiveness and efficiency by achieving economies of scale and by developing hospital performance criteria and standards. In the future, the number and size of U.S. multiunit hospital systems most likely will continue to increase. The nation's multiunit hospital systems vary enormously in size and composition, as well as in their mission, goals, values, and approaches to governance and management.
Assuntos
Sistemas Multi-Institucionais/tendências , Atenção à Saúde , Estados UnidosRESUMO
By the mid-1980s, the structure of governing boards and the nature of hospital governance are likely to be considerably different from what they are today. Trends such as the development of multiple-unit systems and the growing authority of regulatory agencies will result in smaller and more professionalized boards with stricter requirements and standards of conduct.
Assuntos
Conselho Diretor/tendências , Administração Hospitalar/tendências , Estados UnidosRESUMO
The Virginia Hospital Association's trustee education program is a statewide approach to board development whose cornerstone is individualized seminars provided in the local community. This article reviews the events that led to development of the program and describes the program's goals, organization, and results during its first year of operation.
Assuntos
Conselho Diretor , Sociedades Hospitalares , Sociedades , Curadores/educação , Educação Continuada/organização & administração , VirginiaRESUMO
Conscientious efforts by boards of directors to assess and improve their own effectiveness, as well as that of the chief executive officer, are increasingly necessary to ensure sound board leadership and decision making. The literature on governance published during 1977 indicates that considerable attention is being given to the board's responsibility for performance assessment.
Assuntos
Conselho Diretor/normas , Administradores de Instituições de Saúde/normas , Administradores Hospitalares/normas , Humanos , LiderançaRESUMO
When compared with the results of a statewide study conducted in 1968, these data indicate that the utilization of Virginia's emergency departments has increased substantially both in absolute numbers and on a per capita basis. Consistent with the national pattern, the results of this study suggest that a large proportion of patients who utilize the hospital emergency department are actually seeking care for non-acute conditions. Thus the hospital emergency department and its staff are confronted with the complex and often contradictory task of responding appropriately to growing demands for primary medical care while, concurrently, trying to improve the level of care for patients with acute illness or injuries. The development of workable ways to resolve this dilemma and still ensure that the public has ready access to appropriate medical care at a reasonable cost is one of the major challenges in the health industry today.
