S. Robert Hernandez

Management Development and Succession Planning: Lessons for Health Service Organisations

In this article a definition of “succession planning” is given, outlining the potential benefits and problems of implementing a succession‐planning programme in a health service organisation, and factors critical for the success of such a programme are discussed. A case study is presented of one large health service organisation which recently implemented a succession‐planning programme. In this case study, a brief overview is given of the organisational setting, the philosophy and objectives of the programme are outlined and the programme′s implementation and early outcomes are described.

Review Article : Managing Change in Health Care Organizations

Change is pervasive in health care and for our purpose managing change in health care organizations means the alteration or modification of some aspect of organizational activity (Goodman and Kurke 1982). Successful change efforts require recognition of different levels of change, at the very minimum. This recognition helps managers and researchers define problems, identify variables critical to the problems, and apply different strategies within an appropriate time perspective. Three levels of organizational change are considered: change internal to the operations of the organization, change in the organizational structure vis-a-vis the external environment, and overall societal change (Tosi and Hammer 1977). At the internal level, attention focuses on the ongoing processes and interpersonal relationships affecting organizational performance. Attention is given to new programs and technology as well

Journal rankings and directions for future research in health care management: A global perspective

Despite the increasingly global nature of health care, much of the research about journal rankings and directions for future research in health care management is from a United States based viewpoint. There is a lack of information about influential journals and trends for health care management research from a global perspective. This exploratory study gathered the opinions of health care management researchers from 17 countries regarding which journals are considered most influential, popular research topics and areas needing more attention from the research community. An online survey was sent to individuals in high-income Organisation for Economic Co-operation and Development countries who were identified through author relationships, academic institution websites, editorial boards of international journals, and academic and practitioner associations in the countries of interest. Results indicate that journal rankings vary substantially from prior published studies evaluating health care management journals and international ranking lists, and the list of influential journals includes a much more diverse array of publications. Respondents also indicated a diverse number of topics for current and future research, highlighting the global complexity of the field. The implications of this study are valuable to scholars evaluating outlets for disseminating research, and highlighting areas for collaborative research in health care management globally.

The relationship between emergency department wait times and inpatient satisfaction

ABSTRACT This study examines patient perceptions of emergency department wait times and inpatient experiences. For many hospitals across the United States, the emergency department (ED) is now the “front door”; therefore, understanding the impact of ED experience on the inpatient experience is critical for leaders managing these complex settings today. Results showed statistically significant relationships between a very good ED experience and a very good inpatient experience. Perceived wait times in the ED, more so than actual ED wait times, served as a predictor of a very good ED rating as well as a very good rating of the inpatient experience.

A configurational view of executive selection behaviours: a taxonomy of USA acute care hospitals

Health-care organizations, particularly hospitals, are among the most complex organizations to manage. However, the executive selection processes these organizations have in place are poorly understood. The purpose of this study is to explore the executive selection processes employed by USA acute care hospitals and discern if such processes are related to environmental, structural and strategic organizational characteristics. We conceptualize this model using a configurational approach. We present an empirically derived taxonomy of hospitals based on executive selection processes, structural and environmental characteristics, and organizational strategy based on the Porter framework. Based on the analyses, three types of hospitals are identified: (1) small, rural, cost leaders with limited selection processes; (2) large, urban, differentiators, with a plan; and (3) small, rural, caught in the middle muddlers.

The relationship between technology and task design in hospital nursing units.

An empirical assessment of the use of the Hackman, Oldham, Janson, and Purdy (1975) implementing principles as a theoretical link between hospital nursing unit technology and job design is presented in this paper. While support for the implementing principles as an integrating mechanism was found to be weak, some insights into organization theory are noted and suggestions for future research resulting from this study are outlined.

Country of Origin and Brand Positioning for High-Involvement Health-Care Services: An Abstract

Country of origin and brand positioning are important factors to consider for high-involvement services such as health-care organizations competing for international patients. These factors become more important in high-involvement service industries because consumers do not have the information needed to evaluate service quality, and the cost to the patient of poor quality is high. Therefore, consumers may rely on country of origin and brand positioning signals more heavily relative to goods or hedonic services. This paper explores the relationship between country of origin and brand positioning in the context of the high-involvement service of health care. An analysis of brand positioning of health-care institutions using promotional materials from a large international health-care conference is presented using a sample of 170 health-care organizations located in 14 countries. The findings indicate that European and Middle Eastern health-care organizations most frequently employ foreign consumer culture positioning, while American institutions tend to use global consumer culture positioning. However, American organizations may be missing an opportunity to capitalize on the appeal of their country and cities and may not be appropriately considering their global competition in their market positioning. The findings are important for hospitals competing globally for patients seeking care abroad.

Determinants of physicians' career choices in Ukraine

Political and economic changes have created challenges for physician attrition rates in Ukraine. This study examined how a cross-section of Ukrainian physicians prioritised the factors hypothesised to influence decisions about continuing to work in medicine. A survey was conducted with 443 physicians in Ukraine. Latent class choice analysis (LCA) was used to model the heterogeneity in pair-wise comparisons of factors related to physician continued employment in medicine. The response rate was 70% (N = 310). Respondents, on average, were 45.4 years old, practiced 21.6 years. Four groups were identified on the basis of how they prioritised factors about work. Group 1 (47.7%) was ‘culture-focused’, group 2 (27.7%) was ‘advancement-focused’, group 3 (16.2%) was ‘routinisation-focused’, and group 4 (8.5%) was ‘externally-focused’. The use of a person-centred analytical approach represents an alternative for examining career decision issues that should be considered for subgroups within the workforce.

Primary care and local health departments: the initiation of a state-sponsored grant program.

This study examines factors that differentiate health service organizations that were successful applicants for a grant program to initiate primary-care services from a matched sample of organizations that did not apply for the program. Factors that were different between the two sets of organizations include the attitudes and behaviors of physicians in the local community, previous success of the organization in obtaining grant support, and employee perceptions of selected organizational and grant program characteristics. These findings suggest that factors both internal and external to the organization are influential in decisions to initiate activities sponsored through grant programs. Implications of these findings for the design of state block grant programs are discussed.