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Why would a university renowned for its school of medicine ever sell its teaching hospital? In his newest book, Dr. John A. Kastor presents an insider’s view of why university medical centers decide to sell teaching hospitals, why the decision might be a good one, and how such transitions are received by the faculty and administration. Kastor tells the story of two universities that, under financial duress for more than a decade, chose to sell their teaching hospitals. George Washington University sold to a national, for-profit corporation, Universal Health Services, Inc., and Georgetown University sold to a not-for-profit, local company, MedStar Health. Through interviews with key players involved in and affected by these decisions, Kastor examines the advantages and disadvantages of selling and describes the problems that can afflict medical schools that separate from their faculty practice plans. For the current leaders of medical schools facing similar financial challenges, Kastor analyzes how much it costs to teach clinical medicine and offers valuable advice on how to reduce expenses and increase surpluses.
What forces lead to changes in governance among medical schools and their associated teaching hospitals? To what extent do such changes affect how well those schools and hospitals do their work? In this book, John A. Kastor, M.D., focuses on the academic medical centers of the University of Pennsylvania and the Johns Hopkins University, two institutions that underwent dramatic change in governance during the late 1990s. Drawing on extensive interviews with more than three hundred administrators, physicians, and other medical professionals at Penn, Hopkins, and elsewhere, Kastor identifies the factors that influenced changes in governance at these two institutions. Chief among these, he finds, are structure, personality conflicts, and current events. This book will be of interest to administrators of teaching hospitals as well as professionals in health policy and management.
Without new ways to think and manage itself strategically, academic healthcare faces terminal deterioration. Heightened competition and changing dynamics have brought turbulence to teaching hospitals, and the main impact has been financial. Langabeer and Napiewocki give health care executives the tools and concepts of strategic management they need and ways to strengthen analytic skills, all based on up-to-date empirical research, cast in language they can grasp and relate to, and specially tailored to help teaching hospital administrators cope successfully with today's marketplace challenges. Board members, trustees, and others with decision- and policy-making responsibilities will also find the book essential, as well as their teaching colleagues and students on their way up in the hospital industry. The authors maintain that if nonprofit teaching hospitals are to compete successfully with private for-profit hospital chains, not only must they learn the terrain of the playing fields, they must also learn how the game itself is played. Langabeer and Napiewocki offer that knowledge, and in doing so have written the first book of its kind to address comprehensively the entire realm of strategic management aimed clearly at teaching hospitals and major academic medical centers. With findings from primary empirical research into a large sample of teaching hospitals and focusing on the statistical relationships to economic performance, they provide crucial insights into why certain hospitals are more effective than others. Their book will also help healthcare executives relate strategy research on industrial organizations to their own teaching hospital environments. In doing so, their book fills a void in the literature on business strategy that for too long has caused consternation among healthcare administrators and aspirants alike.
The implementation of the Information Systems (IS) Architecture is one of the steps in the construction of the Enterprise Architecture (EA), according to The Open Group Architecture Framework (TOGAF), and can bring notable benefits in supporting the management and governance of Information and Communication Technology (ICT) in organizations, including of health. However, this task is usually followed by several challenges, even more so when we refer to University Hospitals (HU), which are hospitals dedicated to teaching, research, and extension. The purpose of this book is to disseminate an empirical research whose methodological course was carried out in three phases: 1- an extensive Systematic Literature Review, based on 9 specific research questions, to explore the state of the art of the application of EA in health. 2- proposed the 5tep Model, with five well-defined steps to help the implementation of the IS Architecture in HUs. 3- practical application of the 5tep Model together with TOGAF 9.2 and the Archi tool to build and deliver the IS Architecture of a large HU which seeks to improve the provision of services to the population through investments in ICT. As result, in addition to relevant data to the literature on EA and IS through the SLR and the 5tep Model, the delivered IS Architecture for this UH offers a holistic view of the entire ICT, in which identified problems, challenges, possible solutions, and critical success factors for the hospital business.
Investigates the conditions that have led some of the nation2s top teaching hospitals to merge with each other. The three case studies in this book describe mergers among some of the nation's best known hospitals. In addition to citing published articles and books, the author also includes information obtained from numerous personal interviews with more than two hundred faculty members, administrators, trustees, and invested observers who shared their experiences with and knowledge of the mergers. Throughout the book, the author not only presents a picture of the events and conditions that have led to the recent drop in funding for teaching hospitals and why these mergers came about, but he also investigates how the organizations have fared since joining together. The mergers are analyzed and compared in order to identify various methods of merger formation as well as ways in which other newly formed hospitals might accomplish a variety of important goals.