Health care management review
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Health Care Manage Rev · Jan 2000
ReviewThe paradox of physicians and administrators in health care organizations.
Rapidly changing times in health care challenge both physicians and health care administrators to manage the paradox of providing orderly, high quality, and efficient care while bringing forth innovations to address present unmet problems and surprises that emerge. Health care has grown throughout the past several centuries through differentiation and integration, becoming a highly complex biological system with the hospital as the central attractive force--or "strange attractor"--during this century. The theoretical model of complex adaptive systems promises more effective strategic direction in addressing these chaotic times where the new strange attractor moves beyond the hospital.
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The history of total hip replacement in the U. S. demonstrates that health care providers can reduce costs while improving quality. Nationwide, the cost of total hip replacements has declined dramatically while quality has improved. This article describes 14 clinical and management innovations ranging from patient education to competitive bidding.
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Health Care Manage Rev · Jan 1997
Best practices for managing surgical services: the role of coordination.
Growing evidence exists that patient outcomes are related to how effectively health care organizations coordinate work responsibilities among their staffs. However, information is lacking on actual practices that can be used to achieve effective coordination. This article reports on a National Veterans Affairs Surgical Risk Study, in which the authors studied the coordination practices of 20 surgical services that, based on risk-adjusted mortality and morbidity rates, occupied different ends of the patient outcomes continuum.
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Health Care Manage Rev · Jan 1997
ReviewStrategic leadership: a view from quantum and chaos theories.
Viewing health care from the perspective of chaos and quantum theories offers new insights into management techniques for effective and efficient delivery of health care services. This article introduces these concepts and gives specific prescriptions for managerial action.