Partnership for front-line success: a call for a national action agenda on workforce development.

Despite more than a decade of dialogue on the critical needs and challenges in public health workforce development, progress remains slow in implementing recommended actions. A life-long learning system for public health remains elusive. The Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry in collaboration with other partners in federal, state, local agencies, associations and academia is preparing a national action agenda to address front-line preparedness. Four areas of convergence have emerged regarding: (1) the use of basic and crosscutting public health competencies to develop practice-focused curricula; (2) a framework for certification and credentialing; (3) the need to establish a strong science base for workforce issues; and (4) the acceleration of the use of technology-supported learning in public health.

The impact of CQI on human resources management.

If CQI is to become a mind-set and not simply a management fad, adjustments need to be made in all aspects of management, especially human resources management. This article will consider the impact of CQI on human resources philosophy and practice in health services organizations. The effects will be illustrated by the experiences of a group of human resources managers and the organizations in which they work.

The effects of hearing impairment on health services utilization.

The objective of this study was to examine the effects of hearing impairment on the utilization of physician and hospital services in the U.S. adult population. Andersen's behavioral model of health services utilization served as the conceptual framework for the study, and data used for the analyses were taken from two years (1971, 1977) of the Health Interview Survey. Hearing impaired persons used significantly more physician services than hearing persons. Hearing impairment had no effect on the number of hospitals days used but had a significant, positive effect on hospital contact and hospital episodes. In addition, neither the type nor the severity of the impairment had a consistent effect on utilization. These findings were consistent for both years of study data. The study's findings, implications, and suggestions for future research are discussed.

Leadership: implications of the literature for health services administration research.

In reviewing the literature and research on leadership, as conceptualized in the rational and natural system perspectives, we identified major trends and issues in the organizational literature on leadership. Our discussion of the implications of this literature for the study of health services organizations raised several questions, and identified them for future research.

Management education focuses on new leadership ideas.

A widely accepted new leadership approach concerns transactional and transformational leadership. Transactional leadership consists of planning, implementation, and evaluation. Transformational leadership consists of charisma, intellectual stimulation, and individualized consideration that can motivate followers. The six orientations that characterize the Catholic healthcare ministry imply both types of leadership. Fundamental values, knowledge, and skills required for healthcare organization management are acquired through health administration education. The themes prevalent in today's Catholic healthcare ministry and the leadership qualities they imply are addressed by all aspects of such education: degree programs, field experience, continuing education, and research and consultation. Much of a master's degree program concentrates on transactional leadership because its content is better formulated and easier to teach. The development of transformational leadership qualities during master's study primarily provides a foundation on which students can build. Health administration programs in cooperation with healthcare organizations have created three models for field experience: internships, residencies, and fellowships. Many master's programs deliver continuing education programs for both types of leadership, and research and consultation contribute to this education.

Who picks the hospital: practitioner or patient?

This article presents the findings of a survey on consumer versus physician selection of a hospital. Forty-one percent of respondents reported that they or the affected household member selected the hospital. In addition, the perception of who chose the hospital was related to: 1) demographic (age and marital status); sociocultural (number of times moved in the past five years), and psychological (willingness to change physicians) factors which predispose hospital selection; 2) differences in individual resources (type of insurance coverage) which influence decision making; and 3) medical conditions (inpatient vs. outpatient status and the reason for the hospital utilization) which imply specific needs. Knowledge of these factors permits the correct classification of 70.2% of the cases, as opposed to 59.5% without such knowledge. The implications of these findings for healthcare marketing are discussed.

How the public chooses and views hospitals.

This article examines factors people consider important in choosing a hospital, as well as their feelings toward hospitals. It begins with a brief discussion and overview of the literature on how people choose doctors and hospitals. The literature on factors involved in people's choices of new physicians is discussed primarily because of the lack of data in this area. After reviewing the issues, we describe the data used in this study and the context in which they were gathered. The analysis is divided into two sections: the first examines the salient issues in choosing a hospital, while the second examines the public's attitudes toward hospitals. Finally, we present a summary of the results and conclusions.

Who engages in health protective behaviors? A replication.

The purpose of this article is to replicate Berkanovic's study suggesting that general health orientations are weak mediators of the relationship between sociodemographic characteristics and health protective behaviors, and thus, health education campaigns attempting to alter health orientations in target populations would have little effect on health protective behaviors. Our methodology is similar to that used by Berkanovic although additional sociodemographic factors as well as measures of general health orientations are included in the analysis of the three types of health protective behaviors (i.e., voluntary life style change, physician recommended life style change, and physician recommended treatment). Our results support Berkanovic's earlier view. The effect of attitudes toward physicians on asymptomatic life style change is also considered, and the implications for health education are discussed.