 | The examples and perspective in this article may not represent a worldwide view of the subject.(April 2019) |
Health administration, healthcare administration, healthcare management or hospital management is the field relating to leadership, management, and administration of public health systems, health care systems, hospitals, and hospital networks in all the primary, secondary, and tertiary sectors.
Health systems management or health care systems management describes the leadership and general management of hospitals, hospital networks, and/or health care systems. In international use, the term refers to management at all levels. [1] In the United States, management of a single institution (e.g. a hospital) is also referred to as "medical and health services management", [2] "healthcare management", or "health administration".
Health systems management ensures that specific outcomes are attained that departments within a health facility are running smoothly that the right people are in the right jobs, that people know what is expected of them, that resources are used efficiently and that all departments are working towards a common goal for mutual development and growth[ citation needed ]
Hospital administrators are individuals or groups of people who act as the central point of control within hospitals. These individuals may be previous or current clinicians, or individuals with other healthcare backgrounds. There are two types of administrators, generalists and specialists. Generalists are individuals who are responsible for managing or helping to manage an entire facility. Specialists are individuals who are responsible for the efficient and effective operations of a specific department such as policy analysis, finance, accounting, budgeting, human resources, or marketing. [3]
It was reported in September 2014, that the United States spends roughly $218 billion per year on hospital's administration costs, which is equivalent to 1.43 percent of the total U.S. economy. Hospital administration has grown as a percent of the U.S. economy from .9 percent in 2000 to 1.43 percent in 2012, according to Health Affairs. In 11 countries, hospitals allocate approximately 12 percent of their budget toward administrative costs. In the United States, hospitals spend 25 percent on administrative costs. [4]
NCHL competencies that require to engage with credibility, creativity, and motivation in complex and dynamic health care environments. [5]
Health care management is usually studied through healthcare administration [6] or healthcare management [7] programs in a business school or, in some institutions, in a school of public health.
Although many colleges and universities are offering a bachelor's degree in healthcare administration or human resources, [6] a master's degree is considered the "standard credential" [8] for most health administrators in the United States. Research and academic-based doctorate level degrees, such as the Doctor of Philosophy (PhD) in Health Administration and the Doctor of Health Administration (DHA) degree, prepare health care professionals to turn their clinical or administrative experiences into opportunities to develop new knowledge and practice, teach, shape public policy and/or lead complex organizations. There are multiple recognized degree types that are considered equivalent from the perspective of professional preparation.[ citation needed ]
The Commission on the Accreditation of Healthcare Management Education (CAHME) is the accrediting body overseeing master's-level programs in the United States and Canada on behalf of the United States Department of Education. It accredits several degree program types, including Master of Hospital Administration (MHA), Master of Health Services Administration (MHSA), Master of Business Administration in Hospital Management (MBA-HM), Master of Health Administration (MHA), Master of Public Health (MPH, MSPH, MSHPM), Master of Science (MS-HSM, MS-HA), and Master of Public Administration (MPA).(Master of Hospital Management) (MHM)[ citation needed ]
There are a variety of different professional associations related to health systems management, which can be subcategorized as either personal or institutional membership groups. Personal membership groups are joined by individuals, and typically have individual skills and career development as their focus. Larger personal membership groups include the Healthcare Financial Management Association and the Healthcare Information and Management Systems Society. Institutional membership groups are joined by organizations; whereas they typically focus on organizational effectiveness, and may also include data sharing agreements and other medical related or administrative practice sharing vehicles for member organizations. Prominent examples include the American Hospital Association and the University Healthsystems Consortium.[ citation needed ]
A career in healthcare administration consists of organizing, developing, and managing medical and health services. These responsibilities are carried out at hospitals, clinics, managed care companies, public health agencies, and other comparable establishments. This job involves a lot of paperwork and minimal patient engagement. Healthcare administrators make sure to promote excellence in patient care, patient satisfaction, and relationships with their physicians. In order to do this they must make sure that their employees are willing to follow protocols and keep a positive attitude with their patients. The entire organization has a better experience when everything is organized and protocols are set into place. The dual role of physicians follows as both consumers of healthcare resources and controllers of organizational revenue with their ability to direct patients and prescribe care. This makes leader relationships with physicians fairly atypical in comparison with key stakeholder relationships in other industries. [9] Healthcare administrators might become overworked along with physicians feeling stressed from various protocols. However, both the parties of stakeholders and patients make up the backbone of a proper healthcare administration. These administrators make sure that the doctors, insurance companies, patients, and other healthcare providers have access to the files they need to provide appropriate treatments. Multiple hierarchies of professionals, on both the clinical and administrative sides of the organization, generate special challenges for directing and coordinating the healthcare organization. [9] A healthcare administrator has a long-term effect in improving the hospital's process operation systems. They play a vital role in the sustainability of the institution.
Healthcare administrators are in charge of hospital finances and advocate various strategies to improve their facilities and resources. Hospitals provide funding for assets like marketing, charity events, equipment, medicine, payroll, etc. At the same time, an institution should not be all things to people; it has its own limitations. [10] The management administration carefully manages these funds due to a spending limitation. The healthcare administrators control the expenditures that the hospital allows in order to meet profits. Sometimes hospitals are limited on what they can do for patients. Administrators that run these hospitals strive to achieve goals within their financial limitations. This study examines the causes of healthcare employment growth and workforce composition in the US and evaluates the labor market's impact on healthcare spending and health outcomes. [11] When healthcare spending reduces, employment growth will start reducing as well. The healthcare administration is critical to the lives of the people in hospitals. It contributes to cost saving practices and making sure that the necessities are brought to the institution. Healthcare management makes sure that protocols and funds are properly organized for each department. They are responsible for keeping the healthcare industry afloat. Many hospitals host charity events and donate to them as well.[ citation needed ]
The fundamental goal of a hospital administrator is to create a positive work environment where patients are treated in the most efficient and cost-effective way possible. The United States leads the world in high quality and advanced level healthcare. [10] Everyone is working towards a common goal thanks to these mission statements. This improves the organization's efficiency and productivity. The mission statement establishes the organization's purpose and provides employees a sense of belonging and identity. This encourages management and stakeholders to put in more effort in order to obtain success. The ultimate purpose of health care is to help individuals regain their overall health and wellbeing.[ citation needed ]
Health policy and systems research (HPSR) is a field of inquiry that studies "how societies organize themselves in achieving collective health goals, and how different actors interact in the policy and implementation processes to contribute to policy outcomes". [12] HPSR is interdisciplinary and brings together expertise in a variety of biomedical and social sciences such as economics, sociology, anthropology, political science, public health and epidemiology.
The Commission on Health Research for Development [13] and the Ad Hoc Committee on Health Research [14] both highlighted the urgent need for focusing research methods, funding and practice towards addressing health inequities and embracing inter-disciplinary and intersectoral thinking. These reports and other academic and activist voices linked to them argued for greater voice and participation of developing countries in defining research priorities. [15] Since then creation of the Alliance for Health Policy and Systems Research in 2000 and that of Health Systems Global in 2012 have consolidated the practice community of HPSR.
Early hospital administrators were called patient directors or superintendents. At the time, many were nurses who had taken on administrative responsibilities. Over half of the members of the American Hospital Association were graduate nurses in 1916. Other superintendents were medical doctors, laymen and members of the clergy. In the United States, the first degree granting program in the United States was established at Marquette University in Milwaukee, Wisconsin. By 1927, the first two students received their degrees. The original idea is credited to Father Moulinier, associated with the Catholic Hospital Association. [16] The first modern health systems management program was established in 1934 at the University of Chicago. [17] At the time, programs were completed in two years – one year of formal graduate study and one year of practicing internship. In 1958, the Sloan program at Cornell University began offering a special program requiring two years of formal study, [18] which remains the dominant structure in the United States and Canada today (see also "Academic Preparation").[ citation needed ]
Health systems management has been described as a "hidden" health profession [19] because of the relatively low-profile role managers take in health systems, in comparison to direct-care professions such as nursing and medicine. However the visibility of the management profession within healthcare has been rising in recent years, due largely to the widespread problems developed countries are having in balancing cost, access, and quality in their hospitals and health systems. [20]
Health care reform is for the most part governmental policy that affects health care delivery in a given place. Health care reform typically attempts to:
A health system, health care system or healthcare system is an organization of people, institutions, and resources that delivers health care services to meet the health needs of target populations.
Health care, or healthcare, is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health professionals and allied health fields. Medicine, dentistry, pharmacy, midwifery, nursing, optometry, audiology, psychology, occupational therapy, physical therapy, athletic training, and other health professions all constitute health care. The term includes work done in providing primary care, secondary care, and tertiary care, as well as in public health.
The healthcare industry is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, and palliative care. It encompasses the creation and commercialization of products and services conducive to the preservation and restoration of well-being. The contemporary healthcare sector comprises three fundamental facets, namely services, products, and finance. It can be further subdivided into numerous sectors and categories and relies on interdisciplinary teams of highly skilled professionals and paraprofessionals to address the healthcare requirements of both individuals and communities.
The Master of Health Administration, Master of Healthcare Administration (MHA), or Master of Health Management (MHM), is a master's-level professional degree granted to students who complete a course of study in the knowledge and competencies needed for careers in health administration, involving the management of hospitals and other health services organizations, as well as public health infrastructure and consulting. Programs can differ according to setting; although practitioner-teacher model programs are typically found in colleges of medicine, health professions, or allied health, classroom-based programs can be found in colleges of business or public health.
The Edward J. Bloustein School of Planning and Public Policy of Rutgers University serves as a center for the theory and practice of urban planning, public policy and public health/health administration scholarship. The school is located in New Brunswick, New Jersey, and was named in honor of the former Rutgers University president, Edward J. Bloustein. Through its academic programs and research centers, the Bloustein School engages in instruction and research, combined learning and application. The school's strengths and the specializations of its faculty are vast and many of its faculty members are the founders of theories or practices that are now commonplace in urban planning and policy. Areas of expertise for Bloustein faculty members include transportation planning and the environment, urban and community health, workforce development, and social justice.
A Patient Safety Organization (PSO) is a group, institution, or association that improves medical care by reducing medical errors. Common functions of patient safety organizations are data collection, analysis, reporting, education, funding, and advocacy. A PSO differs from a Federally designed Patient Safety Organization (PSO), which provides health care providers in the U.S. privilege and confidentiality protections for efforts to improve patient safety and the quality of patient care delivery
Health information management (HIM) is information management applied to health and health care. It is the practice of analyzing and protecting digital and traditional medical information vital to providing quality patient care. With the widespread computerization of health records, traditional (paper-based) records are being replaced with electronic health records (EHRs). The tools of health informatics and health information technology are continually improving to bring greater efficiency to information management in the health care sector.
Health advocacy or health activism encompasses direct service to the individual or family as well as activities that promote health and access to health care in communities and the larger public. Advocates support and promote the rights of the patient in the health care arena, help build capacity to improve community health and enhance health policy initiatives focused on available, safe and quality care. Health advocates are best suited to address the challenge of patient-centered care in our complex healthcare system. The Institute of Medicine (IOM) defines patient-centered care as: Health care that establishes a partnership among practitioners, patients, and their families to ensure that decisions respect patients’ wants, needs, and preferences and that patients have the education and support they need to make decisions and participate in their own care. Patient-centered care is also one of the overreaching goals of health advocacy, in addition to safer medical systems, and greater patient involvement in healthcare delivery and design.
Health services research (HSR) became a burgeoning field in North America in the 1960s, when scientific information and policy deliberation began to coalesce. Sometimes also referred to as health systems research or health policy and systems research (HPSR), HSR is a multidisciplinary scientific field that examines how people get access to health care practitioners and health care services, how much care costs, and what happens to patients as a result of this care. HSR utilizes all qualitative and quantitative methods across the board to ask questions of the healthcare system. It focuses on performance, quality, effectiveness and efficiency of health care services as they relate to health problems of individuals and populations, as well as health care systems and addresses wide-ranging topics of structure, processes, and organization of health care services; their use and people's access to services; efficiency and effectiveness of health care services; the quality of healthcare services and its relationship to health status, and; the uses of medical knowledge.
The emerging field of Health administration informatics is concerned with the evaluation, acquisition, implementation and day-to-day operation of information technology systems in support of all administration and clinical functions within the health care industry. The closely related field of biomedical informatics is primarily focused on the use of information systems for acquisition and application of patients' medical data, whereas nursing informatics deals with the delivery, administration and evaluation of patient care and disease prevention. What remains unclear, however, is how this emerging discipline should relate to the myriad of previously existing sub specializations within the broad umbrella of health informatics - including clinical informatics, bioinformatics and healthcare management informatics - particularly in light of the proposed "fundamental theorem" of biomedical informatics posed by Friedman in early 2009.
The Dartmouth Institute for Health Policy and Clinical Practice (TDI) has garnered significant accomplishments since its inception. Established in 1988 by John Wennberg as the Center for the Evaluative Clinical Sciences (CECS) and later reorganized in 2007 to its current form as TDI, the institute has made substantial strides in the realms of healthcare education, research, and policy
Healthcare in Georgia is provided by a universal health care system under which the state funds medical treatment in a mainly privatized system of medical facilities. In 2013, the enactment of a universal health care program triggered universal coverage of government-sponsored medical care of the population and improving access to health care services. Responsibility for purchasing publicly financed health services lies with the Social Service Agency (SSA).
The Office of the National Coordinator for Health Information Technology (ONC) is a staff division of the Office of the Secretary, within the U.S. Department of Health and Human Services. ONC leads national health IT efforts, charged as the principal federal entity to coordinate nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information.
The National Center for Healthcare Leadership (NCHL) is an American 501(c)(3) nonprofit organization that promotes evidence-based best practices within the healthcare leadership, organizational development, and international healthcare spaces. NCHL operates three organizational membership programs – the Leadership Excellence Networks (LENS), the National Council on Administrative Fellowships (NCAF), and the US Cooperative for International Patient Programs (USCIPP) – that in total comprise over 160 US hospitals and health systems and nearly 40 graduate health management programs at US institutions.
Examples of health care systems of the world, sorted by continent, are as follows.
The Canadian Foundation for Healthcare Improvement is a non-profit and non-partisan organization based in Ottawa, Ontario, Canada that collaborates with governments, policy makers, researchers, front-line clinicians, patients and practice leaders, as well as non-profit and professional organizations to accelerate healthcare improvements and transform Canada's healthcare systems.
Health policy and management is the field relating to leadership, management, and administration of public health systems, health care systems, hospitals, and hospital networks. Health care administrators are considered health care professionals.
Nursing is the largest healthcare profession in the United States, with more than 3.1 million registered nurses. Between 2012 and 2022, employment for nurses is projected to grow by 19 percent, which is more than any other profession. Nurses make up the largest component of staff in hospitals but are also able to provide care in clinic settings, patient's homes, schools, nursing homes, public health agencies, and mental health centers. In addition, nurses can be found in the military, in industry, nursing education, and do health care research. Nurses in these various roles and settings can provide direct patient care and case management, but also develop and establish nursing practice and quality standards within complex healthcare systems. As each degree can provide a different level of care for patients and function in vastly different roles, it is important to differentiate between them. The levels of nursing degrees have different educational requirements, licensure, and credentialing that can vary state to state.
Elizabeth Howe Bradley is the eleventh President of Vassar College, a role she assumed on July 1, 2017. Bradley also holds a joint appointment as Professor of Political Science and Professor of Science, Technology, and Society.
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