Management

A moral compass for management decision making: a healthcare CEO's reflections

A moral compass for management decision making: a healthcare CEO's reflections
Frontiers of Health Services Management. 2013; 30(1): 14-26.

John Donnellan
09/12/2013

Ethical behavior is good for business in any organization. In healthcare, it results in better patient care, a more committed and satisfied staff, more efficient care delivery, and increased market share. But it requires leaders who have a broad view of the role that ethics programs--and an effective, sustained ethical culture--play. Ethical organizations have integrated and shared ethical values and practices, an effective ethics infrastructure, ongoing ethics education for staff at every level, ethical and morally courageous leaders, and a culture that is consistent with the organization's values. The mission, vision, and values statements of these organizations have been successfully translated into a set of shared values--a moral compass that guides behavior and decision making.

Beyond Foundation Funding: Revenue-Generating Strategies for Sustainable Social Change

Beyond Foundation Funding: Revenue-Generating Strategies for Sustainable Social Change
RCLA Report; February 2013

Jennifer Dodge, Amparo Hofmann-Pinilla, Angela Beard and Caitlin Murphy
02/05/2013

As social change organizations diversify their funding to be less reliant on foundations, they are finding creative ways to adapt traditional strategies and experiment with new ones. This report from RCLA and the Mertz Gilmore Foundation offers specific revenue-generation strategies and examples of nonprofits putting them into practice to offer immediate, actionable guidance for social change organizations, funders and technical assistance providers.

101 Careers in Healthcare Management

101 Careers in Healthcare Management
Springer Publishing Company

Friedman, Leonard and Anthony R. Kovner (eds.)
11/20/2012

Careers in health administration continue to grow despite an overall downturn in the economy. This is a field that offers tremendous job opportunities across the spectrum of healthcare delivery and payment organizations. 101 Careers in Healthcare Management is the only comprehensive guide to careers in health administration, ranging from entry-level management positions to the most senior executive opportunities. The guide clearly explains the responsibilities and duties of each of these careers and how they differ from other management jobs. It describes the integral role of healthcare administrators in creating and sustaining the systems that allow healthcare clinicians to do their best work.

The book covers educational requirements, opportunities, traditional and nontraditional career pathways, and helps students assess whether they are temperamentally and intellectually suited to a career in healthcare management. Based on the most current data from the U.S. Department of Labor and professional societies in healthcare management, the guide describes careers in 14 different healthcare and related settings. These include long-term care, physician practices, commercial insurance, consulting firms, pharmaceuticals, medical devices, information technology, and biotechnology. Additionally, the book offers numerous interviews with health administrators, from those in entry-level positions to CEOs, to more vividly portray potential careers.

Performance Measurement and Evaluation Systems: Institutionalizing Accountability for Governmental Results in Latin America

Performance Measurement and Evaluation Systems: Institutionalizing Accountability for Governmental Results in Latin America
In S. Kushner & E. Rotondo (Eds.), Evaluation voices from Latin America. New Directions for Evaluation, 134, 77–91.

Cunill-Grau, N., & Ospina, S. M.
06/08/2012

Results-based performance measurement and evaluation (PME) systems are part of a global current in public administration. In the Latin American context, this trend is also a reflection of the broader processes of reform of the latter half of the 20th century, including the modernization of public administration, as well as broad processes of decentralization and democratization, both of which are dimensions of development in Latin America, regardless of the political and ideological orientation of specific governments. This chapter documents the development of such evaluative approaches to organizational quality and raises some issues for further discussion.

Debt, Donors, and the Decision to Give

Debt, Donors, and the Decision to Give
Journal of Public Budgeting, Accounting, and Financial Management, volume 24, no. 2: 221-254

Calabrese, Thad, Grizzle, C.
06/01/2012

There has been a significant amount of work done on the private funding of nonprofits. Yet, despite the enormous size of the nonprofit sector as a whole, the importance of private donations to the sector, and the significance of the sector to public finances, there has been very little empirical research done on the capital structure of nonprofit organizations, and none has examined the potential effects of borrowing on individual contributions. Debt might affect donations because programmatic expansion might “crowd-in” additional donors, the use of debt might “crowd-out” current donors since expansion is undertaken at the behest of the organization (and not due to donor demand for increased output), donors might have a preference for funding current output rather than past output, or because of concerns that the nonprofit will be unable to maintain future programmatic output. These potential effects of debt on giving by individuals have not been the focus of research to date. The primary data for this paper come from the “The National Center on Charitable Statistics (NCCS)-GuideStar National Nonprofit Research Database” that covers fiscal years 1998 through 2003. The digitized data cover all public charities required to file the Form 990. The final sample contains 460,577 observations for 105,273 nonprofit entities. The results for the full sample support a “crowding-out” effect. The analysis is repeated on a subsample of nonprofits more dependent upon donations, following Tinkelman and Mankaney (2007). The restricted sample contains 121,507 observations for 36,595 nonprofit organizations. The results for the subsample are more ambiguous: secured debt has little or no effect, while unsecured debt has a positive effect. The empirical analysis is then expanded to test whether nonprofits with higher than average debt levels have different results than nonprofits with below average debt levels. The results suggest that donors do remove future donations when a nonprofit is more highly leveraged compared to similar organizations.
Nonprofits may fear that the use of debt signals mismanagement or bad governance, worrying that donors will punish the organization by removing future donations. The results presented here suggest a more complicated relationship between nonprofit leverage and donations from individuals than this simple calculus. On the one hand, increases in secured debt ratios (from mortgages and bonds) seems to reduce future contributions, possibly because donors are wary of government or lender intervention in the nonprofit’s management, or possibly because of the lack of flexibility inherent in repaying such rigid debt. On the other hand, unsecured debt, while more expensive, seems to crowd-in donations, even at increasingly higher levels when compared to similar organizations. There are at least two important conclusions from this analysis. First, during times of fiscal stress, nonprofits are often tempted to use restricted funds in ways inconsistent with donor intent simply to ensure organizational survival. Rather than violate the trust of certain donors, the results here suggest that nonprofits would be better off utilizing unsecured (possibly short-term) borrowing to smooth out cash flow needs. This option, however, assumes that nonprofits have access to some type of borrowing which is not true for many organizations. A second conclusion one might draw, therefore, is that policy considerations should be made to expand access to debt for nonprofits. The results here suggest that certain types of unsecured debt might in fact draw in additional resources, allowing nonprofits to leverage these borrowings for additional resources. By encouraging this type of policy option, nonprofits would not only gain access to increased revenue sources, but might be able to maintain programmatic output during times of fiscal stress.

Resource Allocation, Emergency Response Capability and Infrastructure Concentration Around Vulnerable Sites

Resource Allocation, Emergency Response Capability and Infrastructure Concentration Around Vulnerable Sites
First published on: 14 April 2011, forthcoming 2011, Journal of Risk Research, 18pp. doi:10.1080/13669877.2010.547257

J. S. Simonoff, C. E. Restrepo, R. Zimmerman, Z. S. Naphtali, and H. H. Willis.
04/14/2011

Public and private decision-makers continue to seek risk-based approaches to allocate funds to help communities respond to disasters, accidents, and terrorist attacks involving critical infrastructure facilities. The requirements for emergency response capability depend both upon risks within a region's jurisdiction and mutual aid agreements that have been made with other regions. In general, regions in close proximity to infrastructure would benefit more from resources to improve preparedness because there is a greater potential for an event requiring emergency response to occur if there are more facilities at which such events could occur. Thus, a potentially important input into decisions about allocating funds for security is the proximity of a community to high concentrations of infrastructure systems that potentially could be at risk to an industrial accident, natural disaster, or terrorist attack. In this paper, we describe a methodology for measuring a region's exposure to infrastructure-related risks that captures both a community's concentration of facilities or sites considered to be vulnerable and of the proximity of these facilities to surrounding infrastructure systems. These measures are based on smoothing-based nonparametric probability density estimators, which are then used to estimate the probability of the entire infrastructure occurring within any specified distance of facilities in a county. The set of facilities used in the paper to illustrate the use of this methodology consists of facilities identified as vulnerable through the California Buffer Zone Protection Program. For infrastructure in surrounding areas we use dams judged to be high hazards, and BART tracks. The results show that the methodology provides information about patterns of critical infrastructure in regions that is relevant for decisions about how to allocate terrorism security and emergency preparedness resources.

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