Murder Past Due: Up Close with the Author

A fund-raiser with fellow librarian and mystery author, Dean James at The TMC Library. Proceeds go to the Friends Anderson Fund which support professional development for HAM-TMC Library staff.

Dr. William Gorgas and his style of management against yellow fever during the construction of the Panama Canal: A historical case study

This study describes the style of management of Dr. William Gorgas as he led the public health effort to reduce diseases to a level that permitted the completion of the Panama Canal construction. Initially, Gorgas was skeptical of the mosquito vector theory. He fully accepted this theory after participating in Walter Reed’s massive cleanup of Havana, Cuba during the Spanish American War of 1898. During 1905 to 1914, Gorgas was selected to lead the sanitary effort during the construction of the Panama Canal. The lessons learned from this historical case study provide public health administrators with guidance to effectively lead current and future infectious diseases threats. Understanding styles of management within the context of disease control is essential in tackling epidemics like yellow fever and other infectious diseases. ^

COMPARISON OF THE ORGANIZATIONAL STRUCTURES AND EFFECTIVENESS OF THE INVESTOR-OWNED AND VOLUNTARY MULTIHOSPITAL SECTORS

Objectives. The central objective of this study was to systematically examine the internal structure of multihospital systems, determining the management principles used and the performance levels achieved in medical care and administrative areas.^ The Universe. The study universe consisted of short-term general American hospitals owned and operated by multihospital corporations. Corporations compared were the investor-owned (for-profit) and the voluntary multihospital systems. The individual hospital was the unit of analysis for the study.^ Theoretical Considerations. The contingency theory, using selected aspects of the classical and human relations schools of thought, seemed well suited to describe multihospital organization and was used in this research.^ The Study Hypotheses. The main null hypotheses generated were that there are no significant differences between the voluntary and the investor-owned multihospital sectors in their (1) hospital structures and (2) patient care and administrative performance levels.^ The Sample. A stratified random sample of 212 hospitals owned by multihospital systems was selected to equally represent the two study sectors. Of the sampled hospitals approached, 90.1% responded.^ The Analysis. Sixteen scales were constructed in conjunction with 16 structural variables developed from the major questions and sub-items of the questionnaire. This was followed by analysis of an additional 7 structural and 24 effectiveness (performance) measures, using frequency distributions. Finally, summary statistics and statistical testing for each variable and sub-items were completed and recorded in 38 tables.^ Study Findings. While it has been argued that there are great differences between the two sectors, this study found that with a few exceptions the null hypotheses of no difference in organizational and operational characteristics of non-profit and for-profit hospitals was accepted. However, there were several significant differences found in the structural variables: functional specialization, and autonomy were significantly higher in the voluntary sector. Only centralization was significantly different in the investor owned. Among the effectiveness measures, occupancy rate, cost of data processing, total manhours worked, F.T.E. ratios, and personnel per occupied bed were significantly higher in the voluntary sector. The findings indicated that both voluntary and for-profit systems were converging toward a common hierarchical corporate management approach. Factors of size and management style may be better descriptors to characterize a specific multihospital group than its profit or nonprofit status. (Abstract shortened with permission of author.) ^