Reinventing the American hospital.
The American hospital is being reinvented to conform with the forces that are replacing the acute, inpatient-oriented illness model of health care with a disease-prevention, health-promotion, primary-care one. Although hospitals will no longer conduct the "core business" of American health care, they can play a key role by empowering others and facilitating the integration of health services across the continuum of care. New management and governance structures will be required, as will population-based health status needs assessments, new relations with physicians, re-engineering of the clinical processes, organization-wide commitment to improving quality, information systems that link patients and providers, and creation of an overall community care management system. Despite major barriers, there are examples of progress.
Shortell
S M
SM
J.L. Kellogg Graduate School of Management, Northwestern University, Evanston, IL 60208-2007, USA.
Gillies
R R
RR
Devers
K J
KJ
D018672:Community Health Planning / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000639:trends; D006293:Health Promotion; D006301:Health Services Needs and Demand; D006754:Hospital Restructuring / Q000639:trends*; D018578:Hospital-Physician Relations; D006801:Humans; D017146:Models, Organizational; D009096:Multi-Institutional Systems; D012922:Social Change; D018511:Systems Integration; D017749:Total Quality Management; D014481:United States