1. For a hospital to operate efficiently and effectively, the three important influences in its governance, medical staff, board of trustees, and administration, must work together in reasonable harmony. What factors might contribute to tensions among these groups?2. As the nursing profession has expanded through advanced degrees, specialization, and clinical practice, nurses’ salaries and responsibilities have also increased. Now, hospitals substitute non-nurses for nurses to perform all but the most technical tasks. What are the implications for the nursing profession? Have nurses lost their traditional role of hands-on patient care and, if so, is that to their advantage or disadvantage? 3. The traditional management style of hospitals has been hierarchical and internally focused. What are three important challenges that face hospitals to accommodate new payer and consumer expectations?4. The availability of hospital insurance removed an important cost constraint from hospital services and charges. What were some positive and negative consequences of that development?5. The organization and practices of modern hospitals reflect the promotion of specialization and sub-specialization by academic health centers. What were the advantages and disadvantages to patients of increasing the number of physicians who limit their activities to narrower fields of practice? 6. With significant oversupply of hospital beds in the U.S. what is the rationale for taxpayer support of the separate and costly hospital system of the Department of Veterans Affairs?
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