A cardiac service line approach to patient-centered care

The traditionally organized, functionally structured nature of hospitals is no longer affordable in today's economic environment. Managed care, the outcomes movement, and changed stakeholders have challenged hospitals to become more patient centered with seamless, streamlined operations. A service line approach focusing on patient populations across a broad continuum of care offers a system that maximizes results. Strong leadership that emphasizes a clear vision of the future, a process-oriented organizational structure, multidisciplinary clinical practice, performance-based management, and broadened roles that emphasize lifelong learning have contributed to the success of the cardiac service at Virginia Heart Center. Nurse managers have taken the lead at this center in achieving superior performance.

Novice to expert: an application of the Dreyfus model to management development in health care

It has been the intent of the authors to describe a management development method which has as its basis a way to differentiate methods for skill development based on levels of skill acquisition. The intent is to provide an efficient and effective framework within which management development can occur as well as to test the utility of the Drefus model in the critical arena of developing management talent in health care environments. Further work and experience with both the model and the skills identified will continue.