Healthcare Management Forum

The Caldwell Partners Amrop International, in the course of conducting executive search, are often in contact with business executives across Canada, many of whom serve as hospital trustees.

Because of the concerns being expressed informally by these trustees, it was decided to conduct a formal survey. The University of Toronto's Department of Health Administration was involved in designing the survey instrument and tabulating the results.

The survey's findings cover many governance issues, such as board size, composition, terms, representation, roles, mergers, evaluation, quality of care, research institutes, fiscal issues and government relations.

Lors du recrutement de cadres supérieurs, The Caldwell Partners Amrop International a souvent l'occasion d'entrer en contact avec de nombreux responsables canadiens d'entreprise qui sont également membres d'un conseil d'administration hospitalier.

En raison des inquiétudes exprimées spontanément par ces gestionnaires, il a été jugé opportun de mener une enquête en bonne et due forme. Le Département d'administration de la santé de l'Université de Toronto a été chargé de mettre au point le questionnaire et de compiler les résultats.

Les constatations de l'enquête portent sur de multiples aspects de la gestion: taille du conseil, composition, durée des mandats, représentation, rôles, fusionnements, évaluation, qualité des soins, instituts de recherche, questions financières et rapports avec le gouvernement.

A comprehensive assessment of the Health Program Guidelines (HPG) in Canada was undertaken between January and September 1992. This review examined the strategic effectiveness and operational efficiency of the guidelines under the auspices of the Federal, Provincial and Territorial Committee on Institutional and Medical Services. To assess the perceived needs for the guidelines, over 185 structured mail questionnaires were sent to a sample of health care agencies, institutions and organizations across Canada; the response rate was over 80.5%. A key informant approach was also used to assess the perceived effectiveness and efficiency of the guidelines. Based on the results of the questionnaires, over 45 interviews and an extensive content analysis of key documents, recommendations were made that may be relevant to the Canadian health system community.

Many organizations are implementing programs and services to manage the human and economic costs of stress. A mail survey was conducted of 500 randomly selected Canadian organizations having at least 500 employees. The survey tapped four major areas: organizational policies and procedures for managing stress; programs and services offered; perceived benefits and constraints for the organization; and projected future directions in this area. Analyses of returns from 210 organizations — 43 health and 167 non-health — revealed various findings. For example, over half of health care organizations have policies and procedures as opposed to less than half of non-health care organizations. Also, health care organizations place greater emphasis on smoking cessation, weight control programs and on stress management training. Although some Canadian organizations are addressing stress, much more could and should be done, especially by organizations that do not yet recognize the impact of stress on employees and their work performance.

The authors describe Total Quality Management (TQM) as an organizational change strategy. Health care leaders who implement TQM only as a “program” may achieve limited success. Leaders who respond to incentives that motivate personal change, understand the dynamics of socioeconomic transformation and put people (especially employees) first can positively influence organizational culture leading to successful change. A leader self-examination is recommended to evaluate personal readiness for the change that TQM represents.