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A methodology for developing hospital standards is comprised of components having characteristics of several hospital systems including the cost accounting system, the budget process, and staffing assessments. The methodology is developed for labor, supply, and equipment standards. The cost accounting system requires standards for variable labor, fixed labor, variable supplies, fixed direct other supplies, and fixed direct equipment for cost allocation purposes. Outside of the cost accounting system, variable labor and fixed labor standards are required for determining workload assessment for staffing studies and evaluation of hospital projects. Both perspectives of standards requirements are incorporated into this methodology for developing hospital standards. A consistent approach for developing standards establishes a foundation for a Standards Maintenance System and the basis for analysis. Because standards are systematically developed according to this methodology, maintenance of standards is more efficient and routine. When standards are current and accurate, integrity of standards is maintained and system outputs derived from standards are meaningful and easily interpreted. This methodology also permits standards information to be instrumental in analysis of labor, relationships among standards, and potential process improvements. The use of standards in a Standards Maintenance System becomes a tool for analysis across departments within the hospital and for eventual comparative analyses across hospitals. / Master of Science

<p>Organisational culture has been one of the most studied and theorised concepts in organisational development. New ways of working, globalisation, increased competition and change in technology have created a greater need for strategic innovation and co-ordination and integration across units (Schein, 1992). Culture is the single most important factor for success or failure and has the greatest potential to effect organisational improvements or hold it back (Deal &amp / Kennedy, 1982 / Fowler, 2002). Research suggests that organisational culture, its assessment and management is increasingly viewed as a necessary part of healthcare improvements (Scott, Mannion, Davies &amp / Marshall, 2003). In the health care environment, organisational culture has been associated with several elements of organisational experience and initiatives that contribute to quality, such as nursing care, job satisfaction and patient safety (Boan &amp / Funderburk, 2003).</p> <p>In order to implement strategic initiatives or performance improvement interventions, it is important that an organisation understands the current status of its organisational culture. The best way to gain understanding of the culture is by assessing it (Davidson, 2004).&nbsp / he aim of the research was to assess the organisational culture of a private hospital in the Western Cape. For the purpose of this study a quantitative methodology adopted used utilising purposive sampling. The sample (n = 221) was inclusive of males and females and comprised of permanent and contract employees extending across the following departments: Human Resources, Patient Administration, Pharmacy, Technical, Support Services and Nursing. The nursing department was the largest representative group of the sample. The sample also included of medi-staff, management and an additional small hospital that reports to the management team. The Denison Organisational Culture Survey was used to gather data for the study. The Survey measures four culture traits, namely, involvement, consistency, adaptability and mission. Descriptive and inferential statistics were used to analyse the data. Results indicated that employees perceived involvement, consistency, adaptability and mission positively. Furthermore, there were no significant differences found for consistency and sense of mission by employees in different departments. There were several limitations of the study. Amongst others, the results cannot be generalised to the broader population of all private hospitals as the findings are unique to the particular organisation. Secondly, the Denison Organisational Culture Survey has only been validated in a financial organisation in South Africa. A recommendation for further research would be to utilise quantitative as well as qualitative methodology to add to the existing body of knowledge.</p>

Thesis (M.Dev) --University of Limpopo, 2011

Given the need to ensure the best use of scarce resources, increasing emphasis is being placed on hospital efficiency measurement. In the literature about hospital efficiency measurement, there is an absence of a well-defined framework to select the most appropriate set of input and output variables. Variables used in hospital efficiency studies predominantly reflect a narrow view of hospital functions with a little attention to quality variables. This implies that the hospital goal and its full range of functions in efficiency measurement are poorly understood. While numerous studies have been undertaken in developed countries, there have been only a few attempts at measuring hospital efficiency in developing countries. However, there has so far been no systematic attempt, using frontier-based techniques, to measure the efficiency of Iranian hospitals, and to identify factors affecting efficiency and remedial actions to improve efficiency. By focusing on the above two issues, this thesis makes three arguments. First, by undertaking an in-depth investigation regarding the multi-product nature of hospitals, considering a fuller range of hospital functions, and the values of various stakeholders including patient, staff, and community, this study has proposed a health-oriented framework with a focus on the Iranian hospitals to select the most appropriate variables for measuring hospital efficiency. I argue that both variables (existing in the literature, and discussed for addition) should be taken into account in order to enhance the validity of hospital efficiency studies. Second, two types of techniques (simple ratio analysis and data envelopment analysis) were used for measuring the technical efficiency of hospitals owned by the Iranian Social Security Organization (SSO). The benefits and shortcomings of each method were discussed. For example, considering major surgery rates, which implicitly provide information about the case-mix, has revealed that all high-turnover, high-occupancy outlying hospitals as well as the majority of hospitals falling in the relatively well-performing quadrant in the Lasso diagram had a low major surgery rate. This suggests that simple ratio analysis can only measure the performance of hospitals over a single dimension ignoring their multi-input and multi-output nature of hospitals. Using Data Envelopment Analysis (DEA), I measured technical efficiency, scale efficiency, and types of returns to scale for the SSO hospitals. In addition to studying their overall and relative efficiency, I analysed the magnitude of the inefficiency for each individual hospital. The results revealed that 22 of the 53 hospitals were deemed to be efficient. Inefficient hospitals had an average score of 78%, implying a potential reduction in all inputs on average by about 22% with no impact on output levels. The comparison of DEA results and simple ratio analysis has revealed that hospitals with an exceptional performance on individual variable even though less valuable compared with other variables can gain a full efficiency score. This critical analysis of the study strongly suggests that the findings obtained from unconstrained DEA should be interpreted with caution. Finally, in addition to simply measuring efficiency, it was felt that a better understanding of the factors affecting hospital efficiency and remedial actions to improve efficiency is needed. Using qualitative methods, a complex mix of organisational factors such as hospital financing, political influences such as political pressures in determining hospital location, and the training and experience of the managers were argued to be influential factors in hospital efficiency. The interviews also provided a great insight into remedial actions such as reforms in the regulatory framework and corporatization. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1297532 / Thesis (Ph.D) -- University of Adelaide, School of Population Health and Clinical Practice, 2007

Background: The Hong Kong Hospital Authority (HA) has adopted the Australian Council on Healthcare Standards (ACHS) scheme for their public hospital accreditation program. Continuous improvement is a vital aspect of the ACHS criteria and facilitates the movement from status quo to the desired state; therefore, change is necessary, and change management may be useful. Objectives: To identify the current level of evidence regarding change management with respect to hospital accreditation and to identify the common change management tools that may be relevant to hospital accreditation. Methods: The primary method was a search of MEDLINE and PubMed for articles published between January 2001 and April 2011. Grey literature was identified via a Google search. Unpublished data was retrieved from an on-going qualitative study of hospital accreditation in Hong Kong. Results: No literature with the keywords “change management” and “hospital accreditation” were found in MEDLINE or PubMed. By adjusting these keywords to identify articles about change management in healthcare, 84 citations were identified, 18 of which were included for review. The majority of the literature described increased communication as a change management intervention. Change management framework and tools were also found in the grey literature review. Results: No literature with the keywords “change management” and “hospital accreditation” were found in MEDLINE or PubMed. By adjusting these keywords to identify articles about change management in healthcare, 84 citations were identified, 18 of which were included for review. The majority of the literature described increased communication as a change management intervention. Change management framework and tools were also found in the grey literature review. / published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

This study of Indiana hospital public relations professionals investigated factors predicting a person's participation in management decision-making. A telephone survey was conducted of professionals directing public relations activities in Indiana hospitals, yielding 55 usable responses.Each respondent was asked the likelihood he or she would be called on by top hospital management to help solve hospital problems, and the likelihood that his or her advice would be seriously considered when making major decisions about programs or policies. Each of the seven questions was answered using a Likert-type scale, with values assigned from 1.0 (highly unlikely) to 5.0 (highly likely). Values were averaged for a total "influence" score.A stepwise multiple regression measured the relationship between influence scores and eight variables: age, gender, salary, department size, education, manager score, technician score, and use of research and evaluation. Only the manager score, research score, and department size were found to be related to influence. / Department of Journalism

<p>Organisational culture has been one of the most studied and theorised concepts in organisational development. New ways of working, globalisation, increased competition and change in technology have created a greater need for strategic innovation and co-ordination and integration across units (Schein, 1992). Culture is the single most important factor for success or failure and has the greatest potential to effect organisational improvements or hold it back (Deal &amp / Kennedy, 1982 / Fowler, 2002). Research suggests that organisational culture, its assessment and management is increasingly viewed as a necessary part of healthcare improvements (Scott, Mannion, Davies &amp / Marshall, 2003). In the health care environment, organisational culture has been associated with several elements of organisational experience and initiatives that contribute to quality, such as nursing care, job satisfaction and patient safety (Boan &amp / Funderburk, 2003).</p> <p>In order to implement strategic initiatives or performance improvement interventions, it is important that an organisation understands the current status of its organisational culture. The best way to gain understanding of the culture is by assessing it (Davidson, 2004).&nbsp / he aim of the research was to assess the organisational culture of a private hospital in the Western Cape. For the purpose of this study a quantitative methodology adopted used utilising purposive sampling. The sample (n = 221) was inclusive of males and females and comprised of permanent and contract employees extending across the following departments: Human Resources, Patient Administration, Pharmacy, Technical, Support Services and Nursing. The nursing department was the largest representative group of the sample. The sample also included of medi-staff, management and an additional small hospital that reports to the management team. The Denison Organisational Culture Survey was used to gather data for the study. The Survey measures four culture traits, namely, involvement, consistency, adaptability and mission. Descriptive and inferential statistics were used to analyse the data. Results indicated that employees perceived involvement, consistency, adaptability and mission positively. Furthermore, there were no significant differences found for consistency and sense of mission by employees in different departments. There were several limitations of the study. Amongst others, the results cannot be generalised to the broader population of all private hospitals as the findings are unique to the particular organisation. Secondly, the Denison Organisational Culture Survey has only been validated in a financial organisation in South Africa. A recommendation for further research would be to utilise quantitative as well as qualitative methodology to add to the existing body of knowledge.</p>