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The Role of the Administrator In looking at the role of the administrator, it is first necessary to look briefly at some of the recent trends in administration, particularly hospital administration. The most significant development affecting the administrative process is the increased size and complexity of the hospital organisation and the bureaucratisation of all sectors of modern industrial society. Related to these developments are such other changes as the advances in science and technology with increased specialisation, extended lines of communication, and new language, related to growth and specialisation. In addition, the presence of unions, the progress in transporting methods, and finally, new discoveries and innovations in science and technology resulting in new material, plus new techniques and equipment to improve functions, have all had their impact on the process.

Doctors are seen as key to embedding health improvement and patient safety initiatives and there has been much international debate over how best to engage doctors in healthcare leadership and management. This paper explores the current focus on leadership development programmes for doctors through taking a comparative approach to initiatives in New Zealand and the UK. It also considers the challenges to embedding leadership development programmes at all levels of training, education and continuing professional development and highlights some of the implications arising from the two approaches.

The purpose of this paper is to address the research question using qualitative research methods: how and why medically trained managers choose to undertake postgraduate management training?

This research used two qualitative methods to gather data. Both methods used purposeful sampling to select interviewees with appropriate management expertise, qualifications and experience. The first stage utilised convergent interviews and was exploratory. The five interviewees were managers and academics. The second stage used case research methodology and was confirmatory. The fifteen interviewees were medically qualified chief executives and chief medical officers. In total, 20 in-depth interviews were carried. Rigorous content analysis of data collected showed emergent themes.

The first theme that emerged was that doctors move into management positions without first undertaking training. The second theme was that doctors undertake such training in the form of a masters-level degree and/or a specialist fellowship. The third theme was that effective postgraduate management training for doctors requires a combination of theory and practice. The fourth theme was that clinical experience alone does not lead to required management competencies. The fifth theme was that doctors choose to undertake training to gain credibility.

This research was exploratory and descriptive in nature and limited to analytical rather than statistical generalisation.

This research has provided insights into the importance of understanding how and why doctors undertake postgraduate management training, and may assist policy makers and training providers in the development of such training for doctors.

Hospitals consume the largest share of government health resources, yet, until recently, they have not been a focus of health policy and research in developing countries, where the resources are in negative proportion to the demands placed on services of health care institutions, and where the possibility of resources being increased in the short run is very remote, the only hope for the increase in the effectiveness of the health care system being the effective management of hospitals. A professional administrator with multidisciplinary training would ensure the optimal use of resources. We live in the age of perfection at all levels. Hence, professional training is the basic requirement for the personnel to function effectively in a hospital. Professional training is required to be imparted by the institutions specialised in professional training. Professional management has an immense scope and a bright future market on account of the increasing demand for specialised and quality health care. Better management or lack of it will determine the future of health service. This paper focuses on development of management and the requirement for professional administrators in India.

Medication management is a complex process, at high risk of error with life threatening consequences. The focus should be on devising strategies to avoid errors and make the process self-reliable by ensuring prevention of errors and/or error detection at subsequent stages. The purpose of this paper is to use failure mode effect analysis (FMEA), a systematic proactive tool, to identify the likelihood and the causes for the process to fail at various steps and prioritise them to devise risk reduction strategies to improve patient safety.

The study was designed as an observational analytical study of medication management process in the inpatient area of a multi-speciality hospital in Gurgaon, Haryana, India. A team was made to study the complex process of medication management in the hospital. FMEA tool was used. Corrective actions were developed based on the prioritised failure modes which were implemented and monitored.

The percentage distribution of medication errors as per the observation made by the team was found to be maximum of transcription errors (37 per cent) followed by administration errors (29 per cent) indicating the need to identify the causes and effects of their occurrence. In all, 11 failure modes were identified out of which major five were prioritised based on the risk priority number (RPN). The process was repeated after corrective actions were taken which resulted in about 40 per cent (average) and around 60 per cent reduction in the RPN of prioritised failure modes.

FMEA is a time consuming process and requires a multidisciplinary team which has good understanding of the process being analysed. FMEA only helps in identifying the possibilities of a process to fail, it does not eliminate them, additional efforts are required to develop action plans and implement them. Frank discussion and agreement among the team members is required not only for successfully conducing FMEA but also for implementing the corrective actions.

FMEA is an effective proactive risk-assessment tool and is a continuous process which can be continued in phases. The corrective actions taken resulted in reduction in RPN, subjected to further evaluation and usage by others depending on the facility type.

The application of the tool helped the hospital in identifying failures in medication management process, thereby prioritising and correcting them leading to improvement.

Describes a methodological study to evaluate the quality of care for an elderly population in the treatment of hypertension from a fairly simple analysis of medical records in primary care, with or without the use of additional information from patients, and shows how this type of data can be used to point out shortcomings in primary care. The data derive from a community survey of elderly people in one area of Jerusalem and relied on personal interviews, blood pressure measurements and an analysis of medical records over a period of four years. The measures used are: the percentage of persons without blood pressure (BP) measurement in a given year; the maximum “gap” between consecutive BP measurements in a given year; the rate of BP measurement per clinic visit; the percentage of hypertensives treated; and the percentage of hypertensives under control. The prevalence rates for hypertension in this elderly population vary between 40 per cent and 59 per cent according to the definition used. Using a simple and straightforward analysis of sick‐fund records several shortcomings in the surveillance and control of hypertension were detected. Calculation of the percentage of untreated hypertensives required a separate information source ‐ the screening. A BP survey is an important complement to an analysis of records. An ongoing evaluation of the quality of care of hypertensives in an elderly population should be based on screening, interviews with patients and analysis of the physician′s records. These provide an overall picture of the care in each medical practice enabling the physician to improve the quality of care provided to his or her patients.

This paper aims to show the impact of service failure and to shed light on the vengeance of consumer in the health-care service.

A qualitative research through a retrospective study based on individual interviews was conducted. As this study is a sensitive topic, projective techniques were used to complement individual interviews, especially with care consumers who are reluctant subjects who prefer methods which preserve confidentiality. Practically, drawing interpretations method was used. The use of these drawings is to encourage reluctant interviewee to discuss on the study’s sensitive theme.

Empirical findings allowed first to approach care service failure in Tunisia that is an emerging post-revolutionary country-owned MENA. In this context, a comparison between the public and private sectors was proposed. Moreover, the results helped to understand service failure’s consequences related to patient’s reaction.

The Ministry of Health in collaboration with managers of public and private medical institutions will have to work on capitalization of knowledge, especially those learned from unsuccessful experiences.

Medical service failure can have multiple sources. The care consumer’s reaction to these failures can sometimes be extreme in form of revenge.

The purpose of this paper is to consider organisational climate as the vehicle to get an understanding, map and enhance the appropriate organisational culture for good clinical governance (CG). Based on this assertion, the purpose of this research is fourfold: to investigate CG attributes embedded in Greek hospitals' climate; to test the validity and reliability of the Clinical Governance Climate Questionnaire (CGCQ) and highlight the dimensions of CG climate in the Greek context; to illuminate the “red flag” aspects of hospital's climate and areas shaping the perceptions of the quality of the provided services; and to explore the influence of hospital's legal status on CG climate and service quality.

Empirical research using the CGCQ was conducted in three Greek NHS hospitals. A total of 214 usable questionnaires completed by the hospitals' personnel were gathered.

The validity and reliability tests proved that the study's five‐dimension structure of CGCQ is capable of conceptualising the basic elements of CG climate in the Greek context. Hospital's climate was found to be not supportive to successful CG implementation, and areas that demand attention were illuminated. Hospital's legal status seems to mediate CG climate and service quality.

CGCQ proved to be a useful tool for managers and policymakers to trace “problematic” areas of hospital's climate and develop strategies for successful CG initiatives.

The paper contributes to the field of health care management, since it demonstrates that CG climate can be used as a “gauge” of the prevailing CG culture. CGCQ is revealed as a valid, reliable and flexible tool.

With U.S. health care costs increasing at three times the rate of inflation and Americans spending 50 percent more on health care than any other nation, health care practitioners will most certainly continue to focus upon cost containment and budgets (Guthrie, 1991). However, as suggested by some experts (e.g. Lytle and Mokwa, 1992), managerial approaches preoccupied with containing costs and financial budgeting are no longer sufficient for success, or maybe even survival, in today's intensely competitive marketplace. The major transformations in structure that have taken place in the health care industry throughout the 1980s call for more proactive and strategic approaches to planning and managing if health care organizations are to be successful in today's highly competitive environment.

Qualitative methods are not suitable to process high volumes of policy texts for exploring policy evolution. Therefore, it is hard to use qualitative methods to systematically analyze the characteristics of complex policy networks. So the authors propose a bibliometric research study for exploring policy evolution from time–agency–theme perspectives to excavate the rules and existing problems of China's medical informatization policy and to provide suggestions for formulating and improving the future medical informatization policies.

Initially, 615 valid samples are obtained by retrieving related China's medical informatization policy documents, and the joint policy-making agency network and the co-occurrence network models of medical informatization policies are defined, and then the authors research China's medical informatization policies from single-dimension and multi-dimension view.

The analysis results reveal that China's medical informatization policy process can be divided into four stages; the policy-making agencies are divided into four subgroups by community detection analysis according to the fast unfolding algorithm; the core policy theme keywords are identified based on the eigenvector centrality of the nodes in those networks; the focuses of theme terms are varied in different stages and the correlations between agencies and themes are gradually decentralized.

These findings provide experience and evidence on leveraging informatics in the medical and healthcare field of China. Also, they can help scholars and practitioners better understand the current status and future directions of medical and healthcare informatics development in China and provide a reference to formulate and improve China's future medical informatization policies.

This study proposes a quantitative bibliometric-based research framework to describe transitions and trends of China's medical informatization policy.