Hospital administration is a phrase used to describe those professionals who choose to be a part of upper management in organized hospitals.
In addition to traditional hospitals and medical centers, hospital administrators provide leadership for psychiatric and mental health facilities, alcohol and/or drug rehabilitation centers, and long term care and nursinghome-type agencies. Job qualifications for a career in hospital administration include a college degree and often a master's degree in either business, public administration, or in organizational administration/management. Occasionally a physician, registered nurse, pharmacist, social worker, or an individual in another health-related profession employed within the hospital setting will choose the upward mobility route of the hospital administrator. Job titles for individuals in these roles include Administrator, Director, Executive Director, Chief Operating Officer, and Chief Executive Officer. Hospital administrators tend to be at the top of the organizational pay scale and are often considered to be the top-level leaders within the facility, answering to the Board of Directors or the Board of Trustees. The salary
There are multiple skills needed for effective hospital administration. Knowledge of basic leadership skills and organizational management is required along with an understanding of organizational culture, i.e., the unwritten rules that determine how an organization operates as a separate system. The hospital administrator provides leadership and strategic directions within the organization to insure continuity and targeted growth over time. People-skills is a phrase used to describe someone who interacts positively with others at all levels. Administrators use people-skills along with an effective communication style to deal with issues in human resources, negotiation, and conflict resolution. Ability to interact positively with the Board of Directors/Trustees, the varied specialty physician groups, allied health care providers, paid staff in general, and the public is essential. Intermixed with the above skills, an administrator uses marketing expertise to ensure that the organization is meeting its market share in providing care. Administrators often interact with patients and families to determine if the organization is meeting patient/family expectations. Also, the administrator must be concerned with maintaining a positive image for the organization and must be able to maintain effective public relations within the community.
Practical business skills are a strong asset for the hospital administrator. Being able to deal with concepts such as overhead, costs, charges, fund asset replacement, capital availability, joint ventures, and how group purchasing arrangements benefit the organization are often a requirement for effective administrators. Financial management skills are critical. The use of financial systems, computer applications, consolidation of services, and network development are needed to achieve positive outcomes and insure quality of care and optimal performance of all employees. Job expectations for hospital administrators demand current knowledge of reimbursement policy within the state as well as an in depth understanding of the way the hospital is reimbursed for services under Medicare, Medicaid, managed care organizations, and other insurance carriers such as Blue Cross and Blue Shield. The ability to articulate the role the institution plays in the delivery of charity care and more importantly implementing corrective measures as needed for the percentage of charity care provided is crucial to overall organizational outcomes. Hospital administrators spend a significant amount of time addressing legal issues including contracts, partnerships, joint ventures, joint operating agreements, group purchasing, and management contracts.
A working knowledge of health care policy such as the balanced budget act and new regulations dealing with medical record confidentiality are beneficial to the hospital administrator. Administrators should possess a comprehensive view of regulatory requirements mandated by the city, regional, and/or state health departments. A cursory understanding that each specialty group within the hospital setting has its own national board with an accompanying set of requirements that divisions or departments within hospitals are required to meet is also an expectation. A specific example is the National Voluntary Laboratory Accreditation Program that visits hospitals to evaluate the standards in clinical laboratories. And finally inherent in this concept of policy is the hospital administrator's ability to understand what needs to be done for the facility to meet the requirements of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). All hospital administrators should have a working knowledge of coding requirements of medical records, national patient classification systems in common use, and the use of diagnostic related groups (DRGs), which is a classification system used to identify specific medical diagnoses. These varied systems are used to report all sorts of data to the regulatory agencies and must be understood to use the data provided by state or federal agencies when communicating with the hospital about things like patient mix or staffing ratios.
Perhaps one unique aspect of role expectations for hospital administrators is learning to identify and keep current with health care issues of regional and national interest. Access to information about changes in reimbursement and managed care regulations, as well as new laws effecting the hospital, is needed. Awareness that many large hospitals are difficult to manage is important. Knowing that the Baby Boomers will shortly be demanding care in hospitals and that this will increase the demand for senior services and put pressure on already scarce resources is beneficial to the administrator. And finally, understanding the impact a nursing shortage has on the hospital is vital to survival.
Effective strategies for success within the role are multifaceted. Management-by-walking-around is a phrase that describes the principle that effective leadership and management is best achieved by directly observing and seeing for oneself the services provided and the overall milieu of the organization. Future outlook includes consideration and understanding of the pros and cons of developing an Internet site for the hospital that provides health information for patients and interested visitors to the web address is an emerging reality. Being able to change with time, evaluating the evolution of the hospital organization, and avoiding the overflow of new
Readers interested in the field of hospital administration are encouraged to explore the web site of the American Hospital Association or related sites listed below to increase personal knowledge about issues that are current and highly significant for hospitals.
Degeling, P., J. Kennedy, and M. Hill. "Mediating the Cultural Boundaries Between Medicine, Nursing and Management—The Central Challenge in Hospital Reform." Health Service Management 14 (February 2001): 36-48.
DeJohn, P. "Hospital of the Future to Replace Aging Facility." Hospital Materials Management 26 (May 2001): 8-9.
Hanna, E. "Thriving in a Changing Environment." Healthcare Management Forum 14 (Spring 2001): 29-34.
Harris, J.A. "Medicare's New Hospital Outpatient Prospective Payment System." Bulletin of the American College of Surgeons 85 (July 2000): 8-12, 64.
"Hospital Aims for Savings Under More Benign HCA." Hospital Materials Management 26 (May 2001): 10-11.
Kaufman, N.S. "What Makes a Winner? Key Characteristics of Peak Performing Hospitals." Trustee 54 (April 2001): 14-7.
Kirchheimer, B. "A Baby Boomer Boom: Hospital Executives are Pinning Growth on Consumer-oriented Age Group." Modern Healthcare 31 (January 15, 2001): 28, 32.
Meliones, J. "Saving Money, Saving Lives." Harvard Business Review 78 (November-December 2000): 57-62, 64, 66-7.
Spurgeon, M. "Transforming Toward Outpatient Care." Fund Raising Management 32 (March 2001): 20-3.
Taylor, M. "Sizing Up the Industry. New Report Shows Nation's Small Hospitals are Still the Most at Risk." Modern Healthcare 31 (April 2001): 42, 44.
Tieman, J. "Status Quo in the Executive Suite: Hospital CEO Turnover Rate Stable; Most Change Seen in D.C., Southwest States." Modern Healthcare 31 (June 4, 2001):10.
American Hospital Association. <http://www.aha.org>.
American Hospital Directory. <http://www.ahd.com>.
Health Care Financing Administration (HCFA). <http://www.hcfa.gov/>.
Health Forum (hospital statistics). <http://www.healthforum.com>.
The Hospital Web. <http://neuro-www.mgh.harvard.edu/hospitalweb.shtml>.
Carole Birdsall, R.N., A.N.P., Ed.D.