This paper reports on the status of the implementation of the national health planning program mandated by Congress in the National Health Planning and Resources Development Act of 1974 (P.L. 93-641). The law created ...
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This paper reports on the status of the implementation of the national health planning program mandated by Congress in the National Health Planning and Resources Development Act of 1974 (P.L. 93-641). The law created and financed a two-tiered planning network of more than 260 local and state planning agencies. The paper gives a very brief history of previous efforts in health planning and describes some of the environmental factors — rampant cost inflation and proliferation and redundancy of high cost technology and facilities — which triggered interest in controlling capital investment in the health sector. The major structural features of the statute and the progress made by 1977 in constructing the program are described. The rationale and the requirements related to particular Plan documents are explained, as are the Certificate of Need law provisions and Appropriateness Review. The authors argue that this program is different from previous planning efforts in several fundamental respects including who the major actors are, the importance given to an empirical, population-based, systems approach to planning, the availability of technical assistance and the emphasis on plan implementation. While there is evidence of progress in health planning, some persistent policy problems such as unrealistically high expectations, the inadequacy of the knowledge base, insufficient time and patience to allow for agency maturation, conflicts in governance, assuring public accountability, and the desirability of further regulation of the health industry still remain unresolved. The authors conclude that, compared to the apparent alternatives, this health planning program is the best way to go and should succeed.
Building community participation into the operation of a mental health center may be difficult, but staff and community residents can gain from the process
Building community participation into the operation of a mental health center may be difficult, but staff and community residents can gain from the process
Although the planning operation is regarded by some observers as unrealistic in conditions of rapid change and increasing competition, the discipline of strategic thinking and the need for strategic leadership continu...
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Although the planning operation is regarded by some observers as unrealistic in conditions of rapid change and increasing competition, the discipline of strategic thinking and the need for strategic leadership continue to be of vital importance. The author examines the purpose of the Board of Directors and its role in the management of strategy.
Major companies devote considerable effort to communicating corporate visions and missions. Yet three recent surveys suggest that much of this effort has been counter-productive. A gap has emerged between rhetoric and...
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Major companies devote considerable effort to communicating corporate visions and missions. Yet three recent surveys suggest that much of this effort has been counter-productive. A gap has emerged between rhetoric and reality. Arenas of confrontation have arisen between directors and managers, head offices and business units, holding companies and their subsidiaries, and between specialists and generalists. A widespread desire for corporate transformation is not matched by understanding of how to bring it about. The lack of top management commitment and of communication skills are major barriers to change. More competent directors and more effective boards are needed. The article suggests key roles for the chairman and the chief executive. It examines how best to share a compelling vision, and identifies a requirement for new attitudes and approaches to communication.
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