Cultivating next generation leadership: preceptors' rating of competencies in post-graduate administrative residents and fellows

Substantial national attention is being directed at enhancing the competency levels of early careerists in healthcare management. In this study, we examined preceptors' ratings of administrative resident/fellow competencies in multiple domains, and we compared those to our previous results of self-rated competency by residents/fellows. In this national sample of preceptors (n=61) of administrative residency/fellowship program listed with the American College of Healthcare Executives, competency in the information management domain was ranked highest, with more than half of preceptors (55.7%) giving their residents/fellows an "A" rating. Fewer preceptors (between 30.0% and 39.2%) gave their residents/fellows an "A" rating in domains of interpersonal and emotional intelligence, analytic and conceptual reasoning, and clinical operations. Less than 20% of preceptors rated competencies as "A" level in the domains of human resources/marketing/public affairs, financial management, fund raising, and facilities management. There were significant differences in preceptor ratings compared with resident/fellow self-ratings, with preceptors often providing lower ratings than provided by resident/fellows. The findings highlight the need not only to enhance competency levels of graduates but also to address the potential mismatch in early careerists' and preceptors' views about required and attained competency levels.

Accreditation across cultures: a case study

Accreditation of academic programs is one of the most significant developments in the evolution of professional education in the United States. Efforts in several fields to extend programmatic accreditation to institutions outside the United States have had mixed results. This report describes such an accreditation experience in health services administration, its pitfalls, and the lessons that the site visit team (the authors) learned. The authors hope that others undertaking such tasks can benefit from this experience.

On teaching governance

Great governance is an effective and efficient process to develop policies that set the strategic directions for the healthcare enterprise, and then help assure that resources are assembled and allocated for the successful implementation of the plans, in compliance with the ethical and regulatory framework of the industry. Given the growing legal and political emphasis on governance, it is crucial that undergraduate and graduate health administration programs adequately prepare students in the fundamental aspects of governance. This paper will present the ten building blocks of effective governance as well as other theories and frameworks applicable to teaching governance in a healthcare management program.

Active engagement in health services administration survey courses through problem-based learning

Problem-based learning (PBL) seeks to engage students in an active process of individual and cooperative learning of interrelated themes. As applied, it has been shown to develop better reasoning processes, critical thinking, communication skills, and an increased motivation to learn. A PBL learning modality, with a unique content approach, was incorporated into an introductory healthcare delivery systems course geared toward freshman and sophomore students. The students were engaged in groups to work on real-world problems faced by the healthcare system under conditions that assure both positive interdependence and individual accountability.

Evidence-based healthcare management competency evaluation: alumni perceptions

An ongoing concern of healthcare educators is how well students are prepared for practice after they are graduated. Curriculum design and pedagogical methods are central components for developing healthcare management and leadership competencies. Various stakeholders have identified competency domains and typologies that outline the requisite skills and expertise to manage and lead healthcare organizations. This study analyzes survey data over a ten-year period from alumni one-year post graduation to compare self-reported assessment of competency development. Trends across two graduate professional programs tailored to different students of healthcare administration are compared. A total of 302 alumni responded to the survey. A factor analysis is performed to evaluate how the skills, knowledge, and abilities of graduates fit into identified competency domains. Fourteen competencies on the survey load into four factor domains: leadership, communication, business skills, and technology.

Reading One Flew Over the Cuckoo's Nest in an undergraduate, US healthcare course

One Flew Over the Cuckoo's Nest, a modern classic in American literature by Ken Kesey, was used to complement conventional assignments in Healthcare USA, an undergraduate survey of the American healthcare system at George Mason University. The book contrasts perceptions of reality between a group of psychiatric patients and the institutional staff. It also depicts a power struggle between patients and staff and illustrates how patients can be enslaved by the healthcare system itself. The purpose of the assignment was to prompt student reflection upon both the contrasting realities and the power conflicts between patients and staff. Several examples of student responses are presented.

Bridging the gap: academic and practitioner perspectives to identify early career competencies needed in healthcare management

Healthcare organizations, health management professional associations, and educational institutions have begun to examine carefully what it means to be a fully competent healthcare executive. As a result, an upsurge in interest in healthcare management competencies has been observed recently. The present study uses two critically important groups of informants as participants: health management practitioners and faculty. Using the nominal group process, health administrators identified critical environmental issues perceived to have an impact on healthcare executives today. These issues were employed in a card-sort assessment and a survey was administered to a nationwide sample of health administrators. These data were used to create a map and five clusters of the environmental landscape of healthcare management. These clusters of environmental issues provided a framework for having groups of administrators and faculty members generate and rank perceived behavioral competencies relative to each cluster. Implications for healthcare management practice, education, and research are discussed.

Hospital development plans: a new tool to break ground for strategic thinking in Tanzanian hospitals

Tanzanian hospitals suffer from underfunding and poor management. In particular, planning and strategic thinking need improvement. Cultural values such as subordination, risk aversion, and high time preference, together with a long history of socialist government, result in lack of responsibility, accountability, and planning. This has been addressed by the health sector reform with its focus on decentralization, strengthened by the introduction of basket funding facilitated by the Comprehensive Council Health Plans. As a consequence of this the next logical step is to improve the authority of regional and district hospitals in the use of their resources by introducing hospital development plans. These strategic plans were introduced as tools of strategic planning in 2001 by the Kreditanstalt für Wiederaufbau in close collaboration with the Tanzanian Ministry of Health, binding the release of rehabilitation funds to presentation of a strategic hospital plan. This study examines the rationale and content of hospital development plans. Initial experiences are discussed. The quality of presented plans has steadily improved, but there is a tendency for hospitals with a close connection to development partners to present well prepared reports while other hospitals have severe problems fulfilling the requirements. For many hospitals it is in fact the first time that they have had to define their functions and future role, thus breaking ground for strategic thinking.

Healthcare ethics: a pedagogical goldmine

The author explores how a well designed and delivered course in healthcare ethics can meet multiple curricular goals in a health administration program. The basic philosophy, content, and methods of instruction are presented along with discussion of the effectiveness of using ethics as a platform for development of critical analysis and decision-making skills. The author illustrates how the course meets specific curricular criteria for program accreditation by the Commission on Accreditation of Healthcare Management Education (CAHME). Finally, a number of specific challenges related to the design and delivery of an effective course in healthcare ethics are addressed including course design, materials of instruction, and faculty.

Educating future healthcare managers: meeting contemporary challenges

University programs must work to keep curricula sufficiently dynamic to assure knowledge content remains relevant, appropriate skills are developed, and standards of academic rigor are maintained. This paper describes a curriculum analysis for a healthcare management program conducted in 1997 and the subsequent steps taken to enhance the program through more formalized links with healthcare organizations. In describing the curriculum analysis, a special emphasis is placed on data compiled in 1996 from a small exploratory study conducted to identify which content areas, skills, and experiences healthcare employers in the state of Maryland noted to be most important for a new hire from an undergraduate program. The program was recently granted Full Certified Undergraduate membership in the Association of University Programs in Health Administration (AUPHA). The paper concludes with a discussion of the changes to the curriculum implemented since 1997 and the process initiated to continually assess the quality of the revised program.

Articulation of undergraduate and graduate education in health administration: barriers and strategies for the future

The initiation of the hospital administration degree at the master's level and not the baccalaureate level was an intentional decision. Unfortunately, during this formative half-decade, the baccalaureate programs developed in a vacuum, isolated from one another and from the long-established graduate programs. While there is not a clear professional consensus that the lack of undergraduate degree articulation with graduate education is a problem, the authors believe this to be the case and believe that many faculty agree. This paper will address the history of health administration education, current academic pathways to careers in health administration, and detailed barriers and strategies to academic degree articulation. The paper concludes that discussion of health administration degree articulation has received modest attention and discussion for more than twenty years, and neither formal relationships nor certification/accreditation has addressed the issue. The authors believe that creation of articulated degrees is desirable and call for AUPHA and CAHME to develop a task force to address barriers and strategies for articulation. Concurrently, while national policy would facilitate more rapid change, we recommend that individual undergraduate and graduate degree programs explore individual relationships as a means to achieve models for the profession as an alternative to the status quo.

Preparing for diversity management strategies: teaching tactics for an undergraduate healthcare management program

This paper reports the processes used by faculty in the Bachelor of Science in Health Sciences (BSHS) Program at the University of Alabama at Birmingham to increase diversity knowledge for the faculty and to incorporate diversity management issues and skills development into the program curriculum using a structured plan.

Teaching healthcare marketing via community research: the LifeFlight project

Undergraduate students in Healthcare Administration programs may benefit from cooperative learning strategies such as participation in community research. Collaborating with local healthcare facilities on class projects also encourages more active engagement between the academic and practice communities. This purpose of this paper is to briefly describe one collaborative venture undertakenby undergraduates in a Marketing for Healthcare Organizations class and a LifeFlight program at a local hospital. The students carried out a survey of members in the program, conducted a SWOT analysis, and made relevant recommendations. Student evaluations of this experience were positive, as was the hospital's assessment.

The Latino Healthcare Professionals Project: responding to the diverse needs of the 21st century

The Latino Healthcare Professionals Project (LHPP) is a privately-funded initiative to provide healthcare management training to first-generation educated Latino bilingual and bicultural upper division university students planning careers in healthcare. This unique curriculum, scholarship, and mentorship program is based in the Health Care Administration (HCA) Program at California State University Long Beach (CSULB). Initially funded by The Sisters of St. Joseph Healthcare Foundation, LHPP has been sponsored by several organizations, including Kaiser Permanente and the Health Care Foundation for Orange County, with a shared commitment to increase the diversity of trained Latino managers in the healthcare field. Since its inception in 1995,168 students have participated in LHPP, with demonstrated success in improved student performance, retention, participation in the health professional work force, and continuing educational achievements. This article discusses the need for Latino healthcare professionals, current issues facing the Latino population with regard to higher education and family involvement, and barriers affecting Latino students' ability to complete a four-year baccalaureate degree. Information on the projectincludes a description of the LHPP mission and goals, curriculum and core components, as well as the project's structure, process, and outcomes.

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Hospital-based palliative care has been found to decrease the length of stays, ease transitions between care settings and increase patient and family satisfaction.