RÉSUMÉ
To improve its efficiency and effectiveness, Alexandria Hospital, Alexandria, VA, has developed a strategy of participatory management: the management advisory board. The board, made up of 16 middle managers elected for six-month terms, is a problem-solving, idea-generating forum that may get involved in almost any aspect of hospital operations. Project ideas, which must be aimed at increasing the morale, efficiency, and effectiveness of the hospital and employees, can come from any employee at any level. Once a project has been accepted, it is assigned to a project committee, made up of at least three members who are given much latitude and are encouraged to use their individual and group talents and creativity. After the project has been completed and approved by the full board, it is submitted to the administration for approval and implementation. The board's results have led to a number of new policies and programs at the hospital, including "employee-of-the-year" recognition, standardized uniforms, disaster plans, quality circles, and management orientation. The board is now developing a physician orientation program, identifying outpatient service opportunities, investigating ways to control the use of copying machines, and studying the feasibility of using one particular travel agency for hospital travel.