Neurosurgery at the crossroads: leadership role of the American Association of Neurological Surgeons. The 1979 AANS presidential address

The President of the American Association of Neurological Surgeons (AANS) reviews the formative history of the major neurosurgical societies, together with their agreement to consolidate their efforts in the joint AANS. As a united group, the Association has been effective in carrying out relations with other professional organizations and with government. Long-range planning is being pursued steadily to increase the role of organized neurosurgery in maintenance of, and improvement in, patient care, education, and research.

Menu planning competencies in administrative dietetic practice. I. The methodology

This research was intended to develop a methodology to analyze competencies in one area of administrative dietetic practice--menu planning. Five basic competencies, with sub-competencies, in menu planning were drawn from previous research. To produce descriptive statements for each sub-competency, taped interviews were held with twenty practitioners to ascertain knowledge, attitudes, and skills required in menu planning. The original 607 responses were reduced to ninety-two by eliminating duplication and ranking them by importance. These were then expressed in appropriate behavioral terminology and validated by an educational consultant. The competency statements and sub-competencies with the ninety-two descriptors were incorporated into a questionnaire submitted to a nationwide sample of hospital administrative and generalist dietitians for further validation.

Health Administration: of fleas and smaller fleas

Monitoring as an official management tool has been a source of discontent since its introduction with reorganisation. Normal pride in a job well done is replaced by tension over monitoring being a negative and censorious act of interference. Drew Clode reports on some schemes that aim to make it a participatory and constructive exercise.

Problems for women in psychiatric residency

Some of the basic problems confronting women in psychiatric training are reflected in four major areas: supervision, administration, research, and peer relationships. The authors recommend a residency seminar on female psychology, flexible-schedule residencies, inclusion of more women in all phases of the profession, reeducation in female psychology for supervisors, more research opportunities, the availability of male and female mentors, and training program encouragement of peer support; these suggestions would help overcome the problems and improve training programs for women and men.

Effectiveness of hospital administrators: a study

A survey study of the effectiveness of hospital administrators was conducted by Graduate Studies in Health Services Management, University of Missouri, Columbia. The purpose of the study was to determine whether or not hospital administrators and others knowledgeable about hospital administrators believe that these professionals are effective in their work. In general, administrators, chiefs of staff, and board chairmen rated the administrator's effectiveness higher than did directors of health agencies.

An approach to an index of hospital performance

Two indexes are described, based on measures of administrative effectiveness and patient care effectiveness. The measures used were selected and ranked by a Delphi panel from a list of 30 measures drawn from the literature. Weights were assigned by the panel to 19 selected measures. The resulting indexes did well in a test on data collected from 32 Texas hospitals.

The need for leadership in hospital respiratory services

The duration of a position as physician-director of respiratory services proved to be less than five years in 68 per cent of cases followed.Based on available information, in the 50 such cases, the act of separation was not elective in these instances, except as a final response to an otherwise intolerable situation. Further study revealed the prime cause to be ignorance of the basic essentials of management. Technical incompetence was never an issue in cases of separation. The general application of principles of management to the control of respiratory services is illustrated by a series of case reports and subsequent discussion. Presently, candidates aspiring to such positions appear to rely almost entirely on their elaborate technical skills. Choice of such a career option, however, should carry with it an obligation to "learn the rules of the game." Logically, graduate training programs should provide this training.