Anatomy of psychiatric administration : the organization in health and disease

목차 (Table of Contents)

• CONTENTS
• 1. Perspectives = 1
• Diversity = 2
• Turbulent Times = 4
• The National Trend : From Health Policy to Fiscal Policy = 5
• Quality Assurance = 5
• Risk Management = 6
• Government Involvement = 6
• Ethical Questions = 6
• The Response = 7
• Changes in Public Attitudes toward the Mentally Ⅲ = 8
• Stigma Attached to Mental and Emotional Disorders = 10
• Competition among Health Service Organizations = 12
• The New Trinity = 14
• Changes in Patterns of Care : Inside the Institution = 17
• What Helps the Patient? = 17
• The Multiple Subcultures in the Mental Hospital = 18
• Summary and Comments = 20
• References = 22
• 2. Toward Scientific Management = 25
• Ways of Looking at Human Systems = 25
• Max Weber = 26
• Frederick W. Taylor and Henri Fayol = 27
• Chester I. Barnard = 27
• Wallace S. Sayre = 28
• Ludwig von Bertalanffy, James G. Miller, and Jessie L. Miller = 29
• E. J. Miller and A. K. Rice = 30
• Elton Mayo : Douglas McGregor and Theory X and Theory Y = 30
• William G. Ouchi : Theory Z = 31
• Rensis Likert : The Likert System = 33
• Chris Argyris : Integrating the Individual and the Organization = 34
• Abraham Maslow = 35
• Frederick Herzberg = 35
• Sociological Views of Mental Health Organizations = 36
• Psychodynamic Views = 41
• Developmental View of Organization = 43
• The Life Cycle of the Organization = 44
• The Executive Constellation in Organizational Leadership = 45
• Fairness and the Span of Discretion = 47
• Summary and Comments = 48
• References = 51
• 3. Toward Better Theory and Practice = 55
• The Social System Clinician View = 55
• The Need for a General Approach to Leader-Organizational Dynamics = 55
• The Systems Clinician Model : An Embracing Concept of the Administrator's Role? = 56
• The Social System in Health and Disease = 59
• Inherent Stresses within Organizations = 63
• Summary and Comments = 64
• Institutional Change = 65
• Aims and Goals = 65
• Goal Slippage = 67
• Implementation of Change : Concepts and Techniques = 68
• Pace of Change = 69
• Other Observations Applying to System Change = 71
• Bench Strength = 71
• Executive Mastery of the System : Seven Principles = 71
• Summary and Comments = 73
• Practical Interventions : Illustrations = 74
• Group Meetings = 76
• Job Changes = 76
• Constructive Evaluation of Job Performance = 77
• Overload Reduction = 77
• Develop New Challenges = 78
• Sanctions = 78
• Case Illustrations of System Pathology and Treatment = 80
• Summary and Comments = 83
• References = 83
• 4. Entering and Leaving the System = 85
• Governance = 86
• Constituencies = 90
• Management Succession = 90
• Stages of Management Succession = 91
• Research on Executive Succession = 93
• How the New CEOs Perform = 93
• Other Succession Studies = 94
• Succession Planning = 96
• Choice of Successor = 97
• On Leaving the Organization = 98
• Reciprocal Tasks of the Entering and Exiting Executives = 99
• Personal Reflections on the Experiences of the Departing Executive = 99
• Comment = 104
• Summary and Comments = 105
• References = 106
• 5. Internal Dynamics : Stresses and Strains = 109
• Stress between Administrative and Clinical Divisions = 109
• Stress between Doctor and Nurse = 120
• Interprofessional Rivalry = 125
• Recruitment of Mental Health Professionals = 131
• The Great Nursing Shortage = 132
• Emotional Problems of Workers = 134
• Quirks and Aberrations of Executives = 135
• Characteristics of Successful Executives = 137
• Discrimination in the Mental Hospital = 138
• Absenteeism = 140
• Summary and Comments = 141
• References = 143
• 6. Human Resource Management = 145
• Human Resource Management = 145
• Employment Interview = 146
• Sexual Harassment = 146
• Discrimination = 147
• Human Resource Utilization = 148
• External Factors : The Plateau Phenomenon = 150
• Middle Management = 151
• End Runs and Reverse End Runs = 153
• Variations = 158
• Dynamics = 159
• Treatment = 160
• Closed Dyads and Broken Dyads = 160
• Multiple Subordination = 163
• Multiple Subordination in Medical School Affiliations = 164
• Uncovering Hidden Beliefs and Practices = 165
• Satisfaction and Dissatisfaction = 167
• Summary and Comments = 171
• References = 173
• 7. Economics of Mental Health = 175
• Financing Health Care = 175
• The Deinstitutionalization Movement = 175
• Other Changes in the Mental Health Industry = 176
• Privatization = 181
• Development of Health Care Coverage = 184
• Managed Mental Health Care(Utilization Management) = 192
• Summary and Comments = 194
• Concepts and Techniques Used in Balancing the Budget = 196
• Techniques to Effect Savings on Personnel = 196
• Save through Reductions in Equipment, Supplies, and Telephone Charges = 199
• Techniques Related to Increasing Revenue = 200
• Risk Management = 206
• Summary and Comments = 209
• References = 211
• 8. Ethics of Administration = 215
• History = 216
• Ethics and the Law = 218
• Ethical Principles = 219
• Informed Consent = 220
• The Rights of Patients = 223
• The Balance of Rights, Privileges, and Responsibilities = 226
• Patient Responsibilities = 227
• Employees = 227
• Management = 228
• Ethical Challenges for the Administrator = 228
• Ethical Concerns in Special Clinical Areas = 229
• Issues in Inpatient Practice = 229
• Emergency Psychiatry = 230
• Community Psychiatry = 230
• Mental Health Data Systems = 231
• AIDS = 231
• AIDS and Public Policy = 233
• Therapist-Patient Sexual Contact = 234
• Definition of Sexual Intimacy = 234
• Prevalence of Sexual Intimacies between Therapist and Patient = 234
• Views on Therapist-Patient Sexual Intimacies = 235
• Effects on Patients = 236
• Legal Aspects = 236
• Possible Solutions = 237
• The Bioethics Service = 238
• Ethics of Research = 244
• Ethics in Training = 246
• Summary and Comments = 247
• Appendix A Oath of Hippocrates = 248
• Appendix B American Medical Association Principles of Medical Ethics = 249
• References = 249
• 9. Education and Research = 255
• Education of the Administrator = 255
• Who Is to Be Trained? = 255
• What Is the Nature of the Job? = 256
• The Training Program = 256
• Experiential Training = 257
• Backgrounds, Talents, and Skills = 257
• Role as a Conceptual Approach in Training = 259
• Health Factors : Physical and Mental Impairment = 259
• Educational Programs and Opportunities = 259
• Residency Education and Administrative Psychiatry : A Survey = 262
• Education of Staff : The Administrator's Role = 264
• The Challenge = 264
• Education at Lower Levels = 266
• Summary and Comments = 268
• Research : The Administrator's Role = 269
• Collaboration with Academe = 269
• The VA Model = 270
• Functions of Administration and the Research Director = 270
• Are Researchers Different? = 271
• Who Can Do Research? = 272
• Obstacles and Resistances = 272
• The Clinical Research Center = 274
• Multihospital Research = 275
• Research as an Instrument for Social Change = 275
• Summary and Comments = 276
• References = 277
• 10. Relation of the Organization to the Outside World = 281
• The Body Politic = 282
• The Political System = 282
• Characteristics of the Political System = 283
• The Politicians = 284
• How Politicians Relate to Mental Health = 285
• Disjunction Between State and County = 286
• Legislative Investigations = 287
• The Media = 288
• Professional Organizations and Boards = 290
• Educational Institutions = 291
• Regulation : Licensure and Accreditation = 293
• Licensure and Accreditation = 293
• Professional Licensure and Credentialing = 294
• Joint Commission on Accreditation of Healthcare Organizations = 295
• Professional Standards Review Organizations(PSROs) = 297
• Volunteerism and Citizen Involvement = 297
• The Span of Volunteer Projects = 299
• Student Volunteers = 299
• Volunteers from the Business Community = 301
• Voluntary Citizen Organizations = 301
• Implications for Mental Health Leaders = 302
• Surrounding Clinics and Facilities = 302
• Labor Unrest and the Strike = 304
• Varieties of Job Actions = 305
• Homelessness : The New Epidemic = 309
• Summary and Comments = 313
• References = 314
• 11. Power and Decision Making in Organizational Context = 317
• Power, Authority, and Influence = 318
• Developmental View of Power = 319
• Authority = 320
• Administrative Therapy = 320
• Taxonomy of Power = 321
• Modification and Constraint of Power = 324
• Abuse of Power = 326
• Decision Making = 327
• Summary and Comments = 334
• References = 335
• 12. Executive Careers = 337
• Psychiatrists in Leadership Positions = 337
• What Does Administration Offer the Mental Health Professional? = 338
• What Can Psychiatrists Bring to the Executive Role? = 339
• Study of Top-Level Administrators = 339
• The Multiple Roles of Leaders = 343
• Administrative Styles = 345
• Personal Factors Related to Administrative Performance = 346
• Comment = 348
• Outcome = 348
• Stresses and Strains of Administration = 348
• Rewards = 351
• Reduction of Administrative Stress = 352
• What Lies Ahead? = 356
• Summary and Comments = 357
• References = 358
• Index = 361