What forces lead to changes in governance among medical schools and their associated teaching hospitals? To what extent do such changes affect how well those schools and hospitals do their work? In this book, John A. Kastor, M.D., focuses on the academic medical centers of the University of Pennsylvania and the Johns Hopkins University, two institutions that underwent dramatic change in governance during the late 1990s. Drawing on extensive interviews with more than three hundred administrators, physicians, and other medical professionals at Penn, Hopkins, and elsewhere, Kastor identifies the factors that influenced changes in governance at these two institutions. Chief among these, he finds, are structure, personality conflicts, and current events. This book will be of interest to administrators of teaching hospitals as well as professionals in health policy and management.

This work portrays the manner that the teaching hospital of the Federal University is facing the integration process of governance practices in their environment, especially the impact that this will suffer during and after the adoption of restructuring measures (REHUF). The hospital serves as a large organization and, in this way, is able to align management practices with governance policies making it necessary to have clarity and soundness in the strategies, processes and structures of these hospitals. In this context, the research helps to clarify some points: The management model of the hospital to adopt governance practices. If so, how they occur in the context of internal processes. To ensure that the analysis of the empirical data is able to contemplate the various aspects that involve the whole object of investigation, the procedures following the assumptions of the exploratory and qualitative research. The guidelines of the research include: degree of centralization/decentralization of administration, form of participation in the decisions of hierarchical levels, degree of autonomy and managerial accountability and reporting process.

"Without a governance structure, IT management at many hospitals and health systems is a haphazard process that typically results in late, over budget projects and, ultimately, fragmented systems. IT Governance in Hospitals and Health Systems offers a practical 'how to' guide to creating an information technology governance structure that ensures that IT projects supporting a hospital's or health system's strategy are completed on time and on budget ..."--Back cover.

Why would a university renowned for its school of medicine ever sell its teaching hospital? In his newest book, Dr. John A. Kastor presents an insider’s view of why university medical centers decide to sell teaching hospitals, why the decision might be a good one, and how such transitions are received by the faculty and administration. Kastor tells the story of two universities that, under financial duress for more than a decade, chose to sell their teaching hospitals. George Washington University sold to a national, for-profit corporation, Universal Health Services, Inc., and Georgetown University sold to a not-for-profit, local company, MedStar Health. Through interviews with key players involved in and affected by these decisions, Kastor examines the advantages and disadvantages of selling and describes the problems that can afflict medical schools that separate from their faculty practice plans. For the current leaders of medical schools facing similar financial challenges, Kastor analyzes how much it costs to teach clinical medicine and offers valuable advice on how to reduce expenses and increase surpluses.