Administrative case rounds. Institutional policies and leaders cast in a different light

Abstract

GOVERNING the institutions of health care provision is becoming increasingly difficult. This is largely caused by an accelerating pace of technological innovation that alters their financial status and internal structure, a growing number of constituencies in society that demand authority to influence institutional policies, and a widening gap between the professional and administrative staff of institutions concerning goals and purpose. To better cope with these issues, institutional leaders should recognize and learn to fulfill effectively the pedagogic role they take on for their staff and constituents when they create and carry out policy. They also should consider holding regular discussions about institutional policy alternatives within the framework of one of the most significant and powerful means of teaching and research in medicine—the case round. In reaching decisions, administrators who govern health care institutions, such as hospitals or health science centers, frequently separate the policies developed to guide institutional action from