The United States is practicing the most typical market economy model of our time, which is based on private ownership (88.1% of the GNP), characterized by a high degree of decentralization of economic decision-making, and the complete implementation of a free economy, free business, and free competition, with very limited government intervention in the economy. As a result, hospital management has basically adopted the enterprise management model and methodology. In the organization and management system, the majority of the implementation of the board of directors. The board of directors is the highest authority of the hospital, and the main duties of the board of directors are:
1) appointing and evaluating the main administrative heads of the hospital (especially the president);
2) evaluating and monitoring the quality of all medical services provided by the hospital;
3) ensuring that the hospital is financially adequate;
4) ensuring that the hospital follows all laws and regulations appropriate to the hospital, rules and regulations;
⑤ Appointment of physicians and all categories of medical personnel.
In the U.S., hospital chairmen are voluntary servants, elected by the community in which the hospital is located, and board members generally serve 2-3 year terms, with the possibility of reelection, and a variety of special competencies or skills are generally considered in electing board members in a variety of ways, such as legal, financial, fund-raising, and political. The hospital president is appointed by the board of directors, and usually the president is also a member of the board. In hospitals that do not have a board of directors, the president is elected directly and democratically by the hospital staff. The qualifications for a dean are:
① Bachelor's degree with an MBA (Master of Business Administration), or MHA (Master of Health Administration), or MPA (Master of Public **** Health Administration);
② Generally, a minimum of 10-15 years of managerial experience prior to assuming the position of director of a major hospital;
③ Participate in continuing education programs and have received intensive instruction in courses such as economics, marketing, human resource management, business law, information technology, marketing strategy, and organizational behavior.
The Hospital Director is responsible for the overall management of the hospital and is accountable to the Board of Directors. He is assisted by 2-4 senior Vice Presidents who are responsible for medical operations and administrative and financial management respectively. There are two Vice-Presidents under the Senior Vice-President of Medical Technology, who are in charge of nursing and medical services (e.g., pathology, radiology, radiotherapy, biomedical engineering, material and equipment management, etc.); and two Assistant Presidents under the Senior Vice-President of Administration, who are in charge of human resources, staff health, environmental health, general affairs, safety, contract management, etc. The above President, Senior Vice President, Vice President and Assistant Presidents form the Hospital Council, which discusses and decides on major administrative matters of the hospital. The hospital has a Board of Management with two executive committees:
1) Medical Executive Committee with such committees as: Internal Medicine, Surgery, Emergency Committee, Pharmacy Committee, Infection Control Committee, Quality Control Committee, Medical Qualification Committee, Education Committee, etc.;
2) Administrative Executive Committee with such committees as Space Committee, Purchasing Committee, etc.
The problems of the hospital in all aspects are generally not first discussed by the Board of Directors, but must first be reflected to the relevant committees, the committees to accept, organize, discuss, and make recommendations to the Board of Directors for consideration and adoption. The hospital personnel system is based on open recruitment and employment at all levels. In addition to some government hospitals, physicians are usually not employees of the hospital, the head of each medical department of the hospital must be elected by the medical staff from the physicians, physicians in the medical work of the terms of reference proposed by the Board of Directors submitted to the Board of Directors for approval. Hospitals in the United States have an Associate Dean of Nursing, which is under the leadership of the Vice President of Medical Resources and is equivalent to our Director of Nursing. The qualification requirements to serve as associate dean of nursing are:
①Registered nurse certification;
②Bachelor's degree. In fact it is almost always a master's degree in nursing or a master's degree in management;
③ five years of experience in nursing management;
④ managerial competence in the following areas: including positions in schools of nursing, state and national nursing organizations, etc.;
⑤ competence in the following management areas, including: ward nursing activities, the operating room, quality control programs, the emergency room, continuing nursing education and hospital nursing research.