Hospital Management Model Research Articles

Correlation between psychophysiological response and hospital management model for nurses involved in medication errors

Because hospitals in Taiwan now place a lot of emphasis on hospital accreditation, leading to a heavy workload for nurses, nurses are unintentional involved in patient medication errors (MEs). In this research, we explore the possible correlation between psychophysiological responses of nursing staff and a hospital management model regarding MEs. We conducted a cross-sectional study design in one hospital in central Taiwan. A total of 345 nurses at Tali Jen-Ai Hospital l were selected. A questionnaire was chosen as the study instrument. The questionnaire asked the following information: basic data, classification of MEs, frequency and severity of psychophysiological responses, and information about the hospital’s management model and support system. We found that the hospital management model had a significant negative correlation with the frequency of physiological symptoms (r = -0.14, p < .01). Likewise, the support system also had a substantial negative correlation with the scores of the physiological symptom, behavioral responses, and psychophysiological responses. Using multiple regression analysis adjusted for work duration, job title, and degree of injury, we found that the support system was significantly correlated with the nurses’ psychophysiological responses. Both the hospital management and the support system decreased the psychophysiological responses of the nurses. Therefore, we recommend that supervisors implement a management strategy to deal specifically with MEs. When nurse managers have frequently empathy and no-blame attitude to replace disrespectful or skeptical ways to nurse with ME, they will empower their enthusiasm and responsibility to improve the reduction of ME.

Public private partnerships for hospitals

Despite the growing prevalence of Public–Private Partnerships in healthcare, scholars have paid little attention to their consequences for the workforce. Public–Private Partnerships may have important consequences in labour-intensive services such as healthcare, since staff reductions and higher working loads may lead to a decrease in service quality and patient safety. In this paper, we analyse the extent to which Public–Private Partnership schemes have influenced employment in Madrid, one of the most enthusiastic adopters of Public–Private Partnership models in Spain. To do so, we compare clinical staff employment levels across three types of hospital management models, including two types of Public–Private Partnerships. Our findings illustrate that clinical staff employment levels seem to be substantially lower in Public–Private Partnership hospitals than in directly managed public hospitals, particularly as regards nursing staff, and in those types of hospitals where the private sector manages both clinical and non-clinical staff.

Outcomes analysis of hospital management model in restricted budget conditions

ABSTRACTFacing conditions of market economy and financial crisis, the head of any healthcare facility has to take adequate decisions about the cost-effective functioning of the hospital. Along with cost reduction, the main problem is how to maintain a high level of health services. The aim of our study was to analyse the quality of healthcare services after the implementation of control over expenses due to a reduction in the budgetary resources in Military Medical Academy (MMA, Sofia, Bulgaria). Data from the hospital information system and the Financial Department about the incomes and expenditures for patient treatment were used. We conducted a retrospective study on the main components of clinical indicators in 2013 to reveal the main problems in the hospital management. In 2014, control was imposed on the use of the most expensive medicines and consumables. Comparative analysis was made of the results of the medical services in MMA for 2013 and 2014. Our results showed that despite the limited budget in MMA over the last year, the policy of control over operational costs succeeded in maintaining the quality of healthcare services. While reducing the expenses for medicines, consumables and laboratory investigations by ∼26%, some quality criteria for healthcare services were observed to be improved by ∼9%. Financial crisis and budget reduction urge healthcare economists to create adequate economical instruments to assist the normal functioning of hospital facilities. Our analysis showed that when a right policy is chosen, better results may be achieved with fewer resources.

The impact of hospital organization in the ethical act of hospital management

Objective: There are different levels of decision and clinical, administrative and management procedures in a hospital organization. The exercise of management and bioethics should be seen as an interconnected operation by anyone committed to an ethical conduct. This article is based on a larger study under a PhD in Bioethics and was conducted in 25 Portuguese hospitals. The objective of the article is to determine whether hospital organization is predictive of the ethical act of its managers.Methods: We have developed a correlational study using the Questionnaire of Ethicity in Hospital Management (QEHM). It was conducted with a sample of 421 professionals with management positions in Care Units/Services, Management Departments/Units, Boards of Directors of the National Health Service and hospitals connected to the Ministry of Health. The sample is also composed of different management models, representative of the Public, Private and Social sectors.Results: A significant association/correlation was discovered in the following dimensions: Accountability and quality, Ethical weighing and Costs and ethics within the management models; Ethical weighing and Ethical decision within the management level; Costs and ethics and Economical and ethical restriction within age.Conclusions: The ethical act of hospital managers, besides being associated with the hospital management model, is not independent of the managers’ age, being influenced by the organizational structure, particularly at management level. This means that hospital organization has an impact in the ethical act of hospital management. Given the correlational nature of the study and the current health sector reforms in Portugal, we suggest an observational study to examine the implications of the organization in the ethical act of managers and their impact on health care users, which was not included in this study.

The Translation of Hospital Management Models in European Health Systems: A Framework for Comparison

In this paper we develop a framework for comparing changes in the management of public hospitals across different national health systems, drawing on insights from institutional theory. Using a range of secondary sources we show how one particular form of hospital management, pioneered originally at the Johns Hopkins Hospital in Baltimore, has been translated differently in four health systems: England, Denmark, Italy and France. This analysis builds on the notion of editing rules, which derive from the institutional context, and illustrates how these rules broaden our understanding of variable translations of global templates for hospital management. The paper concludes by highlighting wider implications for theory and policy.

Modeling and discussion of hospital management models specialized for innovation

Modeling and discussion of hospital management models specialized for innovation

A Simulation Model of Hospital Management Based on Cost Accounting Analysis According to Disease

Since a little before 2000, hospital cost accounting has been increasingly performed at Japanese national university hospitals. At Kumamoto University Hospital, for instance, departmental costs have been analyzed since 2000. And, since 2003, the cost balance has been obtained according to certain diseases for the preparation of Diagnosis-Related Groups and Prospective Payment System. On the basis of these experiences, we have constructed a simulation model of hospital management. This program has worked correctly at repeated trials and with satisfactory speed. Although there has been room for improvement of detailed accounts and cost accounting engine, the basic model has proved satisfactory. We have constructed a hospital management model based on the financial data of an existing hospital. We will later improve this program from the viewpoint of construction and using more various data of hospital management. A prospective outlook may be obtained for the practical application of this hospital management model.