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Hospital Governance - Examples of Changes

  1. Multiple comparisons: Overviews, statistics, and case studies
  2. Denver Health. "Making a Public Hospital Work."
  3. Grady Memorial, Atlanta, Georgia. "Best Practices for Public Hospital Governance"
  4. Hillsborough County Hospital Authority and Tampa General Hospital
  5. Middle Tennessee Medical Center, Murfreesboro, Tennessee
  6. Privatization of Public Hospitals, prepared for the Henry J. Kaiser Family Foundation
  7. "Shared Governance at Henry Ford Hospital: Henry Ford Health System" 

  1. Multiple comparisons: Overviews, statistics, and case studies.
     
    • National Association of Public Hospitals and Health Systems, Charles Luband, Presentation to Broward Health, Why Do Public Hospitals Restructure PDF, September 22, 2010
      • Creation of Not-for- Profit Corporations": Grady Health System, Truman Medical Centers, Regional Medical Center at Memphis, and Tampa General Hospital.
      • "Merger or Affiliation with Existing Not-for-profit": Boston Medical Center, Great Lakes Health System of W. New York, Shands Jacksonville, UMass Memorial Health Care System, Fresno
        County Valley Medical Center, Brackenridge Hospital, and University of Arizona Healthcare.
      • Listing of "Other Issues to Think About
         
    • Hospital Management Associates, Hospital Conversions: Issues and Lessons Learned PDF, January 31, 2011
      • "Governance Change: Drivers and Issues."
      • "Forms of Conversion."
      • "Case Studies/Discussion:  Truman Medical Center, Maricopa Integrated Health System, Grady Memorial Hospital, University Medical Center/Brackenridge, and Nebraska Medical Center.
      • Florida and Broward Health overviews.
         
  2. Denver Health. "Making a Public Hospital Work PDF." Patricia A. Gabow. Health Affairs, 20, no.4 (2001):182-187.
     
    • The chief executive officer of Denver Health sees properly governed public hospitals as a winning proposition for entire communities, not just the poor…. It was critical to separate Denver Health from the city's operational control. After four years of soliciting community input, developing a new purchasing system, building a new personnel system separate from the city's civil service system, and creating legal structures for a new entity and a meaningful long-term contract with the city, we became independent.
       
  3. Grady Memorial, Atlanta, Georgia. "Best Practices for Public Hospital Governance PDF", Elaine Zablocki, Great Boards, Fall 2007.
     
  4. Hillsborough County Hospital Authority and Tampa General Hospital.
     
    • The Hillsborough County Hospital Authority is created and governed by Special Act of the legislature, Chapter 96-449, Laws of Florida, as amended. Until October 1, 1997, the Authority owned and operated Tampa General Hospital. On October 1, 1997, Florida Health Sciences Center, Inc., assumed responsibility for owning and operating Tampa General Hospital pursuant to a Lease Agreement entered into with the Authority. Since the Authority no longer operates the hospital, its mission has evolved into a monitoring role in connection with the Leas and a commitment to the provision of health services to indigent citizens of Hillsborough County. [Extract from Hospital Authority Non-Binding Request for Information (RFI) For Funding Opportunities Related to Health Related Services for Indigent Residents, dated February 2, 2007.]
       
      The Authority is a Public Body Corporate and Special District of the State of Florida created by Special Act of the Florida Legislature, Chapter 96-449, Laws of Florida, as amended (attached). The governing body of the Authority is composed of fifteen (15) members, appointed for staggered terms of four years by the Board of County Commissioners of Hillsborough County, Florida. The Authority has no employees and contracts for necessary legal and other professional services with independent contractors….The Authority leases the hospital facilities located on Davis Island, Tampa, Florida, commonly know as Tampa General Hospital (TGH"), to Florida Health Sciences Center, Inc. ("FHSC"), a not-for-profit corporation, in accordance with a Lease Agreement dated as of June 20, 1997, as amended (attached). FHSC has operated TGH as a tertiary hospital and level I trauma center serving the residents of Hillsborough County and other counties pursuant to that lease since October 1, 1997. The Authority does not operate, manage or oversee the operations of TGH, and has had no claims since leasing the hospital facilities to FHSC. [Extract from Hospital Authority Request for Quotations For Not-For-Profit Individual and Organization Directors and Officers Liability Insurance Coverage for the Hillsborough County Hospital Authority.]
       
    • Hillsborough County Code, Part II, Section IV. - Hillsborough County Hospital Authority.
       
  5. Middle Tennessee Medical Center, Murfreesboro, Tennessee. "A Unified Health Ministry in Central Tennessee: Eleven Years of Successful Partnership," Hospital & Health Services Administration, Winter 1997, 42:4, 473-478.
     
    • Middle Tennessee Medical Center (MTMC) is a not-for-profit community hospital located in Murfreesboro, Tennessee. Eleven years ago, a large investor-owned hospital company presented the institution's board of trustees with a purchase offer. As an alternative, two church-related institutions in Nashville--Baptist Hospital and Saint Thomas Hospital, which is part of the Daughters of Charity National Health System--presented the board of trustees with a plan whereby a new not-for-profit holding company sponsored jointly by Baptist Hospital and Saint Thomas Hospital would become the corporate member of Middle Tennessee Medical Center. Funds contributed by Baptist and Saint Thomas Hospitals would be infused into the Christy-Houston Foundation, a not-for-profit entity devoted to identifying and serving community needs in Murfreesboro and the surrounding area. Their proposal was accepted, and the two church-related institutions became partners in jointly sponsoring and governing an important not-for-profit healthcare institution in central Tennessee. In 1996, The Lewin Group, a healthcare consulting firm based in Fairfax, Virginia, was commissioned by Baptist Hospital, Saint Thomas Hospital, and Daughters of Charity National Health System to conduct a retrospective assessment of the progress of this jointly sponsored ministry in relation to the original vision and goals. Historical and operational data were analyzed, and interviews were conducted with 24 people who were directly involved in conceiving, developing, or implementing this ministry. This article summarizes the principal findings and conclusions of this ten-year assessment.
       
  6. Privatization of Public Hospitals, prepared for the Henry J. Kaiser Family Foundation. Mark W. Legnini, Stephanie E. Anthony, Elliot K. Wicks, Jack A. Meyer, Lise S. Rybowski, and Larry S. Stpnick. Economic and Social Research Institute. January 1999.
     
    • Boston Medical Center
      • In 1996, Boston City Hospital (BCH), a public teaching hospital, Boston Specialty and Rehabilitation Hospital (BSRH), a public long-term care hospital, and Boston University Medical Center Hospital (BUMCH), a private, non-profit teaching hospital, consolidated their operations to form Boston Medical Center (BMC), a private, non-profit entity. As part of the consolidation agreement between the city of Boston and BUMCH, BSRH closed 90 days after the affiliation and its services were consolidated into the former BCH facility at BMC.
    • Brackenridge Hospital and Children's Hospital, Austin, Texas
      • Brackenridge Hospital and Children's Hospital were owned and operated by the city of Austin, Texas. On October 1, 1995, the city of Austin leased all of the assets of both hospitals to Seton Healthcare Network, a local, non-profit hospital system operated by the Daughters of Charity National Health System. Under the 30-year renewable lease, Seton effectively took over financial and operational responsibility for both institutions.
    • University Hospital, Colorado
      • In 1991, the Colorado legislature passed a law enabling University Hospital, part of the University of Colorado's Health Sciences Center, to become a "quasi-public" organization under an authority structure. Under the University Hospital Authority, the institution retains several of the benefits of a public institution, but may operate free of many of the constraints on personnel management, debt issuance, and purchasing normally imposed by the state.
    • Sutter Medical Center of Santa Rosa, California
      • Sutter Medical Center of Santa Rosa, California is the result of a 1996 agreement between Sonoma County, located north of San Francisco, and Sutter Health, a non-profit organization that operates 26 hospitals in Northern California. Sutter leases the former county hospital and operates it under contract to the county.
    • Oakwood Healthcare System, Dearborn, Michigan
      • Oakwood Healthcare System, in Dearborn, Michigan, is a product of the 1991 merger of Oakwood Hospital, a non-profit community hospital, and the five public hospitals that made up the People's Community Hospital Authority (PCHA), which served more than 20 communities in the suburban Detroit area.
         
  7. "Shared Governance at Henry Ford Hospital: Henry Ford Health System" (Undated, online summary)
     
    • In 1987, Henry Ford Hospital was the second hospital in Michigan to implement a Shared Governance model. Shared Governance is the decision making process that places the authority, responsibility and accountability for patient care with practicing nurse clinicians….At the core of Shared Governance is the Unit Governance Council. The purpose of the Unit Governance Council is to empower staff and share accountability for unit decisions related to: customer service and service excellence, practice, performance improvement, education, operations, and retention and recognition. These decisions are limited in scope to the unit only. If an idea, concern, or new findings affects more than the unit it is moved to the appropriate Council. Besides the Unit Governance Council, there are nine other councils that make up the Shared Governance structure. Councils include: Coordinating, Practice, Education, Research, Regulatory, Administrative, Retention & Recognition, and Quality Improvement.

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