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Article
Publication date: 5 October 2015

Lee Revere, Arlin Robinson, Lynn Schroth and Osama Mikhail

The purpose of this paper is to present a case study which details the successful development, design and deployment of a leadership course for academic medical department…

Abstract

Purpose

The purpose of this paper is to present a case study which details the successful development, design and deployment of a leadership course for academic medical department chairs. The course provides a needed local and contextual alternative to the lengthy and often theoretical MBA/MHA.

Design/methodology/approach

Faculty developers used a multi-tiered methodology for developing the physician leadership course. The methodology consisted of literature findings, needs assessment, stakeholder input and structured interviews with administrative leaders.

Findings

The research, stakeholder input and interviews revealed an increasing number of physician leaders with a general lack of fundamental administrative leadership skills. These shortfalls are largely because of underexposure to core management competencies during medical school and limited contextual knowledge outside their organization. There is an urgent need for leadership development opportunities aimed at current and future academic medical department chairs.

Research limitations/implications

This research is limited by the assumptions that the curriculum meets the ever-changing needs of health-care leaders, the course’s focus on academic medical department chairs within the Texas Medical Center and the lack of long range follow-up data to substantiate the effectiveness of the curriculum content and course structure.

Practical implications

The Academic Medical Department Leadership course offers valuable management skills training which complements standard medical training. Much of the course structure and content is adaptable to physician administrative and leadership positions in all settings.

Originality/value

Although the Academic Medical Department Leadership course is a response to a local concern, the study offers a generalizable approach to addressing the demand for skilled physician leaders.

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Book part
Publication date: 29 July 2009

Jay A. Fishman

The healthcare system is undergoing rapid change as medical centers are confronted with constricted reimbursements for healthcare services while adapting to growth in…

Abstract

The healthcare system is undergoing rapid change as medical centers are confronted with constricted reimbursements for healthcare services while adapting to growth in medical knowledge, major technological advances in medical practice, and a changing regulatory environment. Academic medical centers thought themselves immune to the forces that shape most service enterprises but are forced to compete based on customer service and the efficiency, quality, and safety of medical care, while continuing to compete in the academic world. These challenges are not unique to academic medicine, but these institutions are, perhaps, least suited to the leadership challenges posed by this environment. Certain attributes of these centers raise barriers to successful adaptation to the changing healthcare environment. The need for systemic change in academic medicine requires commitment to programs that create change agents willing to assume leadership roles and to guide institutional evolution. In academic medicine, traditional one-on-one relationships between mentors and trainees do not provide the breadth of guidance needed in the complex environment of research, medical practice, and teaching. A structured system of “matrix mentorship” and structured evaluation will advance institutional values, provide leaders with an essential set of skills and values consistent with institutional goals, and provide competitive advantage for medical centers in academic healthcare.

Details

Biennial Review of Health Care Management: Meso Perspective
Type: Book
ISBN: 978-1-84855-673-7

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Article
Publication date: 5 June 2007

Leah Krevit and Linda Crays

The purpose of this paper is to examine a pilot program implemented by the Houston Academy of Medicine‐Texas Medical Center Library and The University of Texas School of…

Abstract

Purpose

The purpose of this paper is to examine a pilot program implemented by the Houston Academy of Medicine‐Texas Medical Center Library and The University of Texas School of Nursing at Houston to design the multi‐institutional repository for the Texas Medical Center.

Design/methodology/approach

The steps involved in the program are outlined and the lessons learned from the implementation are analyzed.

Findings

The success of the institutional repository depends on appropriate communication with faculty, a deep understanding of the publishing process, identifying appropriate partners, designing a flexible technology infrastructure, and engaging in active collaboration with key players. The Library is the logical center for this activity.

Practical implications

The paper should assist libraries with the unique activities involved in creating a viable multi‐institutional repository in a research‐intense academic medical environment.

Originality/value

This paper analyzes the challenges inherent in introducing institutional digital repositories to the academic medical community. Currently, institutional repositories are being developed in only a small percentage of the academic medical centers in the USA.

Details

OCLC Systems & Services: International digital library perspectives, vol. 23 no. 2
Type: Research Article
ISSN: 1065-075X

Keywords

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Abstract

Details

Advances in Librarianship
Type: Book
ISBN: 978-0-12024-618-2

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Article
Publication date: 1 June 2002

Andrew Jameton and Catherine McGuire

Sustainable health care combines three key factors: quality patient care, fiscally responsible budgeting and minimizing environmental impact. Although pollution is well…

Abstract

Sustainable health care combines three key factors: quality patient care, fiscally responsible budgeting and minimizing environmental impact. Although pollution is well understood as a health problem, US health planners have not fully recognized the need to reduce health‐care pollution. Minimizing health‐care pollution, moreover, requires reducing the throughput of energy and materials. Ultimately, sustaining healthy ecosystems requires that health‐care material and energy utilization be limited. However, traditional conceptions of health‐care ethics maintain a philosophy of rescue that makes limiting life‐saving resources, except at a patient’s request, morally worrisome. Moreover, the media image of health care as technologically intensive, together with the common medical view that nature is the enemy, render suspect philosophical perspectives respectful of Earth’s limits. Nevertheless, academic medical centers have advantages as sites for pursuing sustainability: students often uphold environmental ideals, a public health perspective, and an interest in providing services universally; basic biomedical research on campus permits innovative research combining health and environmental considerations; opportunities exist for including environmental concerns in health professional education; some academic medical centers have already stated environmental criteria for purchasing contracts; and health‐care professionals and institutions are increasingly addressing such environmental concerns as mercury use, latex allergies, dioxin pollution, and waste volume. To address these challenges, a visioning process is proposed, designed to formulate a practical plan by means of public, local, and professional participation in the process of articulating creative and morally sound proposals for change.

Details

International Journal of Sustainability in Higher Education, vol. 3 no. 2
Type: Research Article
ISSN: 1467-6370

Keywords

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Book part
Publication date: 15 January 2021

Jessica Herling

Purpose: This chapter examines the implementation of lesbian, gay, bisexual, transgender, and queer (LGBTQ) health curricula in medical education, focusing on how this…

Abstract

Purpose: This chapter examines the implementation of lesbian, gay, bisexual, transgender, and queer (LGBTQ) health curricula in medical education, focusing on how this content is presented to students to understand if these curricula can fulfill goals of achieving healthcare equity for LGBTQ populations.

Methodology: This research draws on data from six months of participant observation of an academic medical center and school and 28 interviews with medical faculty, students, community members, administrators, and LGBTQ Health Center employees.

Findings: This research has three findings: (1) this medical school has variable definitions for LGBTQ health, making it a hybrid form of knowledge based in (a) understanding the unique health needs of; (b) being culturally competent to; and (c) being a (structural) advocate for LGBTQ patients; (2) LGBTQ health is integrated into multiple courses in the curriculum; and (3) LGBTQ health is becoming a medical specialty frequently delivered to students by LGBTQ health experts.

Research limitations and implications: This research used snowball sampling to recruit participants engaged in LGBTQ health at the institution; it therefore risks self-selection bias. Findings from this study are not generalizable.

Originality: This research argues that LGBTQ health experts engage in a new kind of diversity and inclusion work because (1) these health experts are not always LGBTQ identified; (2) this work is not necessarily unpaid or involuntary; and (3) it involves a hybrid knowledge requiring an understanding of LGBTQ identity, medical knowledge, and social science. Because these LGBTQ health experts opt into this work, and broadly define it, a message available to other physicians and students is that LGBTQ health remains elective.

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Book part
Publication date: 15 December 2016

Wyoma vanDuinkerken, Nancy Burford, Joanne Romano, Richard Wayne and John Weed

The use of high-density remote storage facilities helps alleviate competing space needs in academic medical libraries while they continue to support core services and…

Abstract

Purpose

The use of high-density remote storage facilities helps alleviate competing space needs in academic medical libraries while they continue to support core services and supply service copies of resources.

Methodology/approach

Four academic medical libraries in the Texas A&M University System and the University of Texas System will highlight their participation in a regional collaborative storage facility using the Resource in Common (RIC) model.

Findings

Results will show how library services and facilities changed since moving some or all of print collections to JLF.

Originality/value

The RIC model has proven to be a success in recovering user space without losing access to resources.

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Book part
Publication date: 16 July 2015

Laura Senier, Matthew Kearney and Jason Orne

This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin.

Abstract

Purpose

This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin.

Methodology/approach

We show the geographic distribution, funding patterns, and utilization trends for outreach clinics over a 20-year period. Interviews with program planners and outreach clinic staff show how external and internal constraints limited the program’s capacity. We compare clinic operations to the conceptual models guiding program design.

Findings

Our findings show that state health officials had to scale back financial support for outreach clinic activities while healthcare providers faced increasing pressure from administrators to reduce investments in charity care. These external and internal constraints led to a decline in the overall number of patients served. We also find that redistribution of clinics to the Milwaukee area increased utilization among Hispanics but not among African-Americans. Our interviews suggest that these patterns may be a function of shortcomings embedded in the planning models.

Research/Policy Implications

Planning models have three shortcomings. First, they do not identify the mitigation of health disparities as a specific goal. Second, they fail to acknowledge that partners face escalating profit-seeking mandates that may limit their capacity to provide charity services. Finally, they underemphasize the importance of seeking trusted partners, especially in working with communities that have been historically marginalized.

Originality/Value

There has been little discussion about equitably leveraging genetic advances that improve healthcare quality and efficacy. The role of State Health Agencies in mitigating disparities in access to genetic services has been largely ignored in the sociological literature.

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Book part
Publication date: 4 September 2013

Christopher R. Freed, Shantisha T. Hansberry and Martha I. Arrieta

To examine a local primary health care infrastructure and the reality of primary health care from the perspective of residents of a small, urban community in the southern…

Abstract

Purpose

To examine a local primary health care infrastructure and the reality of primary health care from the perspective of residents of a small, urban community in the southern United States.

Methodology/approach

Data were derived from 13 semistructured focus groups, plus three semistructured interviews, and were analyzed inductively consistent with a grounded theory approach.

Findings

Structural barriers to the local primary health care infrastructure include transportation, clinic and appointment wait time, and co-payments and health insurance. Hidden barriers consist of knowledge about local health care services, nonphysician gatekeepers, and fear of medical care. Community residents have used home remedies and the emergency department at the local academic medical center to manage these structural and hidden barriers.

Research limitations/implications

Findings might not generalize to primary health care infrastructures in other communities, respondent perspectives can be biased, and the data are subject to various interpretations and conceptual and thematic frameworks. Nevertheless, the structural and hidden barriers to the local primary health care infrastructure have considerably diminished the autonomy community residents have been able to exercise over their decisions about primary health care, ultimately suggesting that efforts concerned with increasing the access of medically underserved groups to primary health care in local communities should recognize the centrality and significance of power.

Originality/value

This study addresses a gap in the sociological literature regarding the impact of specific barriers to primary health care among medically underserved groups.

Details

Social Determinants, Health Disparities and Linkages to Health and Health Care
Type: Book
ISBN: 978-1-78190-588-3

Keywords

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Article
Publication date: 1 September 2004

Wally R. Smith, Mindy E. Wyttenbach, Warren Austin and Shantaram Rangappa

The use of hospitalists in the care of in‐patients is a relatively new phenomenon in the USA – hospitalists are delivering medical care to patients in private practice…

Abstract

The use of hospitalists in the care of in‐patients is a relatively new phenomenon in the USA – hospitalists are delivering medical care to patients in private practice, public hospitals, and academic medical centers. Several obstacles hinder understanding of the characteristics of academic medical center‐based hospitalists. These include differences in definitions and nomenclature, differences in job descriptions, roles and administration across hospitalist programs, and in qualifications and credentialing of hospitalists versus other physicians. These differences derive from the heterogeneity of AMCs by bed size, level of local and regional competition, and cultural, utilization and referral patterns. The field needs an agreed definition of the term “hospitalist”. Assuming a good definition, one could take advantage of already good descriptive data on AMCs to quantify hospitalists within AMCs and to study how hospitalist programs vary by AMC characteristics.

Details

Clinical Governance: An International Journal, vol. 9 no. 3
Type: Research Article
ISSN: 1477-7274

Keywords

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