The Sisters of Charity Health Care System (SCHCS), Inc., Cincinnati, undertook a systemwide board evaluation project to support and enhance effective aspects of governance and to deal with obstacles that often arise due to differing beliefs and role confusion. A task force of chief executive officers developed the questionnaire, which was then administered to members of individual facilities' boards and the system's board. The documented highlighted value issues important to SCHCS's ministry and business activities: overall board responsibilities, financial responsibilities, strategic planning, the board's role, committee structures, the board's operating process, board education, and overall board effectiveness. The responses from each member were returned to the local boards, who analyzed them and developed an action plan. A summary of each facility's responses and action plans were forwarded to the system's corporate office. The CEO committee critiqued the process and reported on significant issues and action plans. In general, survey results revealed a strong influence of mission and philosophy in decision making, support for current processes, and effective interaction among board members. The system's corporate office will use the responses to respond to a dynamic environment and strengthen their role in the delivery of Catholic health care services.

Many of the criticisms of American hospitals are implicitly charges of governing board failures. Boards cannot solve all the problems, but they can accept a mandate to guarantee quality and act more effectively to control costs. To succeed, they must stiffen their willpower (perhaps by better selection of their own members), broaden their knowledge base, and improve their decision processes. A clearer, more specific mission is a good start, backed by more reliance on the CEO, more collaborative relations with the medical staff, and more rigorous processes for planning and budgeting.

The search for effective administrative patterns in health service organizations has heightened in the United States. The organized anarchy model depicting these organizations suggests an emphasis on certain CEO roles, and this emphasis is different from that expected of a CEO in a "rational" organization. The degree of internal influence and coherence of coupling are two indicators of CEO effectiveness within a health service organization.

The selection of a CEO is one of the most important- and risky-events in the life of any company. Yet the way CEOs are chosen remains little discussed and little understood. The succession process has traditionally unfolded behind closed doors--some observers have even likened it to the election of a pope. To shed light on what works and what doesn't in CEO succession, the authors lead a roundtable discussion with five distinguished corporate directors: Philip Caldwell, George D. Kennedy, G. G. Michelson, Henry Wendt, and Alfred M. Zeien. Collectively, the five directors have participated in dozens of successions, either as board members or as CEOs. In a lively and frank exchange of views and experiences, the roundtable participants explore a broad range of questions: What can a company do to ensure a successful succession? How should management-development and succession processes be managed? How should the board work with the sitting chief executive during the process? What makes for a strong CEO candidate? When should outside candidates be considered? How much competition should be encouraged among potential CEO candidates? What role should executive search firms play? What role should former CEOs play after they are succeeded? Their conversation illuminates a corporate challenge that is as difficult as it is important.

Energy loss spectra from fluorite-structured ZrO(2), CeO(2), and UO(2) compounds are compared with theoretical calculations based on density functional theory (DFT) and its extensions, including the use of Hubbard-U corrections (DFT + U) and hybrid functionals. Electron energy loss spectra (EELS) were obtained from each oxide using a scanning transmission electron microscope (STEM). The same spectra were computed within the framework of the full-potential linear augmented plane-wave (FLAPW) method. The theoretical and experimental EEL spectra are compared quantitatively using non-linear least squares peak fitting and a cross-correlation approach, with the best level of agreement between experiment and theory being obtained using the DFT + U and hybrid computational approaches.

The resolution-limiting aberrations of round electromagnetic lenses can now be successfully overcome via the use of multipole element "aberration correctors." The installation and performance of a hexapole-based corrector (CEOS GmbH) integrated on the probe-forming side of a JEOL 2200FS FEG STEM/TEM is described. For the resolution of the microscope not to be severely compromised by its environment, a new, specially designed building at Oak Ridge National Laboratory has been built. The Advanced Microscopy Laboratory was designed with the goal of providing a suitable location for aberration-corrected electron microscopes. Construction methods and performance of the building are discussed in the context of the performance of the microscope. Initial performance of the microscope on relevant specimens and modifications made to eliminate resolution-limiting conditions are also discussed.

In the 1980s, many CEOs and senior management teams operated in isolation. A reimbursement system designed to encourage competition led to a "survival-of-the-fittest" mentality that prompted many managers to develop "competitive strategies" and look for "niche opportunities." In many cases, the end result was a fragmented delivery system with--in some instances--gaping holes. Now, CEOs are looking for ways to put the pieces back together. The first part of this cover story examines the issues surrounding the rapidly emerging trend of regional delivery systems; the second part, which begins below, looks at four case histories of different types of integrated systems at various stages in their development.

MnO x -CeO₂-Al₂O₃ powdered and preformed catalysts were prepared through self-propagating high-temperature synthesis (SHS) and impregnation methods. Compared to the traditional impregnation method, the SHS method has a shorter catalyst preparation cycle and simpler preparation process. The characterization results showed that mixed crystals of cerium, aluminum, and manganese oxides were formed through the SHS method, the binding energy of Mn⁴⁺ increased, and the active components were distributed uniformly. The MnO x -CeO₂-Al₂O₃ powdered catalyst had an extensive pore structure, with a Brunauer-Emmett-Teller surface area of approximately 136 m²/g, a pore volume of approximately 0.17 cm³/g, and an average pore diameter of approximately 5.1 nm. Furthermore, the MnO x -CeO₂-Al₂O₃ powdered catalyst achieved a NO x conversion higher than 80% at 100-250 °C. Coating liquids with identical metal-ion concentrations were prepared using the catalysts, and the preformed catalyst obtained through the SHS method had a higher loading capacity after one coating. The MnO x -CeO₂-Al₂O₃ preformed catalyst achieved a NO x conversion higher than 70% at 200-350 °C.

Advancing anything requires change and a new method. It can be a challenge to bring about the change that you believe in. This change however requires you to plan and say no to the old way of doing things. Fortunately there is a positive way to say no whereby important needs are met. As Ury suggests, we need to focus on how the two opposing forces need to be addressed. There is your internal focus of what's important to you and the opposing external focus of others--what's important to them. We can't lose sight of this because when we do, we risk disrespecting others. As technicians we are in a unique position as perfusionists whereby we work closely with physicians and on occasion will direct them to perform tasks. Additionally, many other non-physicians are not familiar with our responsibilities. We need to make others knowledgeable of the education, skill, and passion we possess. I really enjoy what I do as a perfusionist and I am proud to be recognized for my team's contribution and of having received the Gibbon award. Bob Parsons, the CEO and founder of The Go Daddy Group, Inc., said "We're not here for a long time, we're here for a good time!" This all has been a real good time. Thank you. My Perfusion Team is currently: Barbara Elmer, Marie Kilcullen, Jim McVey, Marie Zanichelli, Junli Liu, Anthony Lamonica, Karen Hussey, Lilia Voevidko, Haleh Ebrahimi, Sergey Savy, Akilah Richards, Diana Froehlich.

BACKGROUND

Predictive models for earlier diagnosis of Alzheimer's disease and related dementias (ADRD) that rely on variables requiring assessment during an office visit, such as cognitive function, body mass index, or lifestyle factors, may not be broadly applicable, since that level of data may be inaccessible or inefficient.

OBJECTIVE

To build a predictive model for earlier diagnosis of ADRD using only administrative claims data to enhance applicability at the health care-system level. Building on the strength of this approach and knowledge that health care utilization (HCU) is increased before dementia diagnosis, it was hypothesized that previous HCU history would improve predictive ability of the model.

METHODS

We conducted a case-control study using data from the OptumLabs Data Warehouse. ADRD was defined using ICD-9-CM codes and prescription fills for antidementia medications. We included individuals with mild cognitive impairment. Cases aged ≥ 18 years with a diagnosis between 2011-2014 were matched to controls without ADRD. HCU variables were incorporated into regression models along with comorbidities and symptoms.

RESULTS

The derivation cohort comprised 24,521 cases and 95,464 controls. Final adjusted models were stratified by age. We obtained moderate accuracy (c-statistic = 0.76) for the model among younger (aged < 65 years) adults and poor discriminatory ability (c-statistic = 0.63) for the model among older adults (aged ≥ 65 years). Neurological and psychological disorders had the largest effect estimates.

CONCLUSIONS

We created age-stratified predictive models for earlier diagnosis of dementia using information available in administrative claims. These models could be used in decision support systems to promote targeted cognitive screening and earlier dementia recognition for individuals aged < 65 years. These models should be validated in other cohorts.

UNASSIGNED

This research was supported by AstraZeneca, Global CEO Initiative, Janssen, OptumLabs, and Roche. Albrecht was supported by Agency for Healthcare Quality and Research grant K01HS024560. Perfetto is employed by the National Health Council, which accepts membership dues and sponsorships from a variety of organizations and companies. The authors declare no other potential conflicts of interest.

The nursing profession must continue to cement recognition as a powerful and innovative force in health care by first "caring for themselves" at the bedside for the goal of patient continuity of care. The negative effects of stress, both internal and external, major, minor, and adaptive, are rooted in the nurses occupational stress level, and how that level influences the continuity of care. Stress assessments and unit specific stress management sessions need to become ingrained within the health care environment by instituting "comprehensive" stress management programs. Communicative "healing" needs to flow from the bedside to the CEO and back down again.

Prior research suggests that having a baby face is negatively correlated with success among White males in high positions of leadership. However, we explored the positive role of such "babyfaceness" in the success of high-ranking Black executives. Two studies revealed that Black chief executive officers (CEOs) were significantly more baby-faced than White CEOs. Black CEOs were also judged as being warmer than White CEOs, even though ordinary Blacks were rated categorically as being less warm than ordinary Whites. In addition, baby-faced Black CEOs tended to lead more prestigious corporations and earned higher salaries than mature-faced Black CEOs; these patterns did not emerge for White CEOs. Taken together, these findings suggest that babyfaceness is a disarming mechanism that facilitates the success of Black leaders by attenuating stereotypical perceptions that Blacks are threatening. Theoretical and practical implications for research on race, gender, and leadership are discussed.

Herein a case of retained perfluorocarbon liquid beneath the macula, following surgical repair of a complicated retinal detachment, is reported. The ocular coherence tomography findings were helpful in distinguishing retained perfluorocarbon liquid from residual subretinal fluid, macular cyst or cystoid macular oedema.

In the summer of 2001, Saskatchewan Health asked Dr. Peter Glynn, Health Care Consultant, Dr. Mark Taylor, the Deputy Head of General Surgery at St. Boniface General Hospital in Winnipeg and Dr. Alan Hudson, a Toronto-based neurosurgeon and former CEO of the University Health Network, to advise on the creation of a provincial surgical wait list management strategy to address growing concerns about waiting times for many non-emergent surgical procedures. Although the work was focused on Saskatchewan, this is a common issue across the country.

In January 2005, the University of Texas Medical Branch (UTMB) School of Nursing and the UTMB Hospitals and Clinics launched the first phase of a project to improve perceptions of patient care on the part of nursing faculty and nursing clinicians. A finding on the UTMB annual employee satisfaction survey that nursing faculty and clinicians tended to rate quality of UTMB patient care lower than other UTMB employees provided the impetus for the initiative. When UTMB colleagues noticed the findings, various entities including human resources and the Faculty Senate called for explanations from the dean of the School of Nursing, the chief nursing officer, and the CEO for the hospitals and clinics. In the process of attempting to give reasons for the findings, each of us determined we would take definitive action to address the situation. This article describes our accomplishments for Phase 1 of the initiative. Beginning with a vision for a productive professional community characterized by a pedagogical partnership between nursing education and practice, we share the processes we followed to (1) achieve mutual understanding among task force members, (2) obtain input on perceptions from nursing colleagues, (3) identify the clinical and nursing education aspects of the perceptions, (4) reach consensus on target perceptions for Phase 2 of the project, and (5) outline the next steps for the project.

In an effort to battle soaring Medicaid costs, Oregon is experimenting with coordinated care organizations with the hopes of saving $11 billion over 10 years. Dr. George Brown, president and CEO of Legacy Health, says, "My prediction is that we will be successful. It will be a lot of hard work, but if we're not, it will be much worse."

This study focuses on career aspirations of executive-track health care administrative personnel and their perceptions of the competencies required to become hospital chief executive officers (CEOs). This article examines these topics using the results of a 1994 survey of 162 junior- and mid-level healthcare managers who work in hospitals in a western state. Respondents included 34 CEO aspirants and 128 CEO nonaspirants. The majority of both groups reported high satisfaction with several work-related activities. Significantly more CEO nonaspirants than CEO aspirants perceived a need for additional self-development in several work areas. CEO aspirants reported that CEOs five years from now would need improved strategy formulation and negotiation skills. CEO aspirants also perceived that in the future, successful CEOs will have to be more proficient in several areas, such as interpersonal skills and medical staff relations. Three lists of academic subject matter considered important to career preparation were generated from (1) the Association of University Programs in Health Administration (AUPHA) undergraduate standards, combined with curriculum graduate standards of the Accrediting Commission on Education for Health Services Administration (ACEHSA); (2) study participants' responses; and (3) professional literature. When compared for relatedness, the contents of the three lists were not significantly different statistically. The implications of these findings for health administration education are discussed.

Because of the need of focus on their financial survival, hospitals and health systems are not the popular community-oriented institutions they once were--too many have set aside their mission to promote and protect the health of their communities. By conducting on-site interviews with CEOs, other executives, board members, and community partners in seven hospitals across the nation, we discovered 25 management and governance practices used by hospitals that excel in relating to their communities. We have grouped these practices for promoting community health into six functions: (1) identifying community needs; (2) setting goals; (3) allocating financial and human resources; (4) educating leaders, staff, and community members; (5) measuring outcomes; and (6) sustaining the mission. Specific examples are given that describe what we learned. Ultimately, we hope to engender a dialog about other management and governance practices that have proven successful in promoting hospitals' involvement in community health.

Hospitals face very dynamic environments and must meet diverse needs in the communities they serve and respond to multiple expectations imposed by their stakeholders. Coupled with these variables, the fact that leadership in these organizations is a shared phenomenon makes organizational leadership in them very complicated. An integrative overview of the organizational leadership role of CEOs in hospitals is presented, and determinants of success in playing this role are discussed.