Governance in multihospital systems: an assessment of decision-making responsibility.
This study examines decision-making responsibility in multihospital system governance. The investigation focuses on the division of decision-making authority between local (hospital) and corporate boards. Fifteen decision areas were considered, including strategic planning, allocation of financial resources, appointment and evaluation of hospital CEOs, and controlling medical staff privileges. Results suggest moderately high levels of corporate (centralized) decision making in multihospital systems. Findings also indicate that type of decision determines whether control is centralized or decentralized. Most centralized decisions were related to resource allocation, formation of new companies, and changes in by-laws of a system hospital. Most decentralized decisions were related to medical staff privileges, service changes, and hospital strategic planning.
D000704:Analysis of Variance; D002201:Capital Expenditures; D003657:Decision Making; D006075:Governing Board; D006740:Hospital Administrators; D008504:Medical Staff Privileges; D009096:Multi-Institutional Systems / Q000458:organization & administration*; D010934:Planning Techniques; D014481:United States