Gender Disparity in Composition and Compensation Among Maryland Hospital Executives

Introduction: Senior executive positions in hospitals have traditionally been held by men, and do not reflect the gender, racial, ethnic, and cultural diversities of the communities they serve. Despite sex parity in medical school graduates, women remain underrepresented in hospital executive leadership positions. In this study, the authors examined differences in gender composition and compensation of Maryland hospital executives. Methods: The authors examined 47 Maryland hospitals’ publicly available tax forms from 2013-2018. Data collected included hospital revenue and executive positions’ count, salary, and gender. Executive positions included President and/or Chief Executive Officer (P/CEO), Chief Financial Officer (CFO), Chief Medical Officer (CMO), Chief Nursing Officer (CNO), and Chief Operating Officer (COO). All monetary values were inflation-adjusted to the 2017 dollar. Results: Women executives were underrepresented across most roles: P/CEO (41/272, 15%), CFO (72/260, 28%), CMO (28/182, 15%), and COO (44/147, 30%). CNO showed a higher proportion of women executives (129/140, 92%). There were no significant changes in the proportion of women executives over the study period (p=0.19). Men CNO’s had significantly higher salaries as a percentage of hospital revenue (0.16% vs 0.12%, p=0.04) and men COOs had significantly higher salaries as a percentage of hospital positive profit (3.65% vs 2.24%, p\u3c0.01). Conclusion: Data from Maryland hospitals suggest that women remain underrepresented in healthcare executive roles. Further, women executives are generally undercompensated compared to men in similar roles. This study further highlights the need for mentorship and dedicated career pathways to improve women representation in leadership roles in healthcare

Fulfillment of administrative and professional obligations of hospitals and mission motivation of physicians

Background: To be successful, hospitals must increasingly collaborate with their medical staff. One strategic tool that plays an important role is the mission statement of hospitals. The goal of this research was to study the relationship between the fulfillment of administrative and professional obligations of hospitals on physicians' motivation to contribute to the mission of the hospital. Furthermore the mediating role of the physicians' emotional attachment to the hospital and moderation effect of the exchange with the head physicians were considered. Methods: Self-employed physicians of six hospitals participated in a survey. Descriptive analyses and linear regression were used to analyse the data. Results: The results indicate that affective commitment mediated the relationship between psychological contract fulfillment and mission statement motivation. In addition, the quality of exchange with the Chief Medical Officer moderated the relationship between the fulfillment of administrative obligations and affective commitment positively. Conclusion: This study extends our understanding of social exchange processes and mission statement motivation of physicians. We showed that when physicians perceive a high level of fulfillment of their psychological contract they are more committed and more motivated to contribute to the mission statement. A high quality relationship between physician and Chief Medical Officer can enhance this reciprocity dynamic

An implementation research agenda.

In October 2006, the Chief Medical Officer (CMO) of England asked Professor Sir John Tooke to chair a High Level Group on Clinical Effectiveness in response to the chapter 'Waste not, want not' in the CMOs 2005 annual report 'On the State of the Public Health'. The high level group made recommendations to the CMO to address possible ways forward to improve clinical effectiveness in the UK National Health Service (NHS) and promote clinical engagement to deliver this. The report contained a short section on research needs that emerged from the process of writing the report, but in order to more fully identify the relevant research agenda Professor Sir John Tooke asked Professor Martin Eccles to convene an expert group - the Clinical Effectiveness Research Agenda Group (CERAG) - to define the research agenda. The CERAG's terms of reference were 'to further elaborate the research agenda in relation to pursuing clinically effective practice within the (UK) National Health Service'. This editorial presents the summary of the CERAG report and recommendations

Montefiore Medical Center: Integrated Care Delivery for Vulnerable Populations

Describes a system of hospitals and community- and school-based clinics tailored to low-income patients through systemwide strategies, high-quality specialty and hospital care, and integrated care delivery via care management and information technology

Moving epidemic method (MEM) applied to virology data as a novel real time tool to predict peak in seasonal influenza healthcare utilisation. The Scottish experience of the 2017/18 season to date

Scotland observed an unusual influenza A(H3N2)- dominated 2017/18 influenza season with healthcare services under significant pressure. We report the application of the moving epidemic method (MEM) to virology data as a tool to predict the influenza peak activity period and peak week of swab positivity in the current season. This novel MEM application has been successful locally and is believed to be of potential use to other countries for healthcare planning and building wider community resilience

Communication Bandwidth Considerations for Exploration Medical Care During Space Missions

Destinations beyond low Earth orbit, especially Mars, have several important constraints, including limited resupply, limited to no possibility of medical evacuation, and delayed communication with ground support teams. Therefore, medical care is driven towards greater autonomy and necessitates a medical system that supports this paradigm, including the potential for high medical data transfer rates in order to share medical information and coordinate care with the ground in an intermittent fashion as communication allows. The medical data transfer needs for a Martian exploration mission were estimated by defining two medical scenarios that would require high data rate communications between the spacecraft and Earth. One medical scenario involves a case of hydronephrosis (outflow obstruction of the kidney) that evolves into pyelonephritis (kidney infection), then urosepsis (systemic infection originating from the kidney), due to obstruction by a kidney stone. A second medical scenario involved the death of a crewmembers child back on Earth that requires behavioral health care. For each of these scenarios, a data communications timeline was created following the medical care described by the scenario. From these timelines, total medical data transfers and burst transmission rates were estimated. Total data transferred from the vehicle-to-ground were estimated to be 94 gigabytes (GB) and 835 GB for the hydronephrosis and behavioral health scenarios, respectively. Data burst rates were estimated to be 7.7 megabytes per second (MB/s) and 15 MB/s for the hydronephrosis and behavioral health scenarios, respectively. Even though any crewed Mars mission should be capable of functioning autonomously, as long as the possibility of communication between Earth and Mars exists, Earth-based subject matter experts will be relied upon to augment mission medical capability. Therefore, setting an upper boundary limit for medical communication rates can help factor medical system needs into total vehicle communication requirements

Implementation pathway report: Community Resource Person An intervention by the Technical Support Unit Uttar Pradesh, India, February 2015

A report describing the methodology behind an implementation pathway for the Community Resource Person innovation being implemented by the Technical Support Unit (a large-scale collaboration between the Bill & Melinda Gates Foundation and the Uttar Pradesh government) in Uttar Pradesh, India