Document Detail

Commentary: institutes versus traditional administrative academic health center structures.
MedLine Citation:
PMID:  22531588     Owner:  NLM     Status:  In-Data-Review    
In the Point-Counterpoint section of this issue, Kastor discusses the pros and cons of a new, institute-based administrative structure that was developed at the Cleveland Clinic in 2008, ostensibly to improve the quality and efficiency of patient care. The real issue underlying this organizational transformation is not whether the institute model is better than the traditional model; instead, the issue is whether the traditional academic health center (AHC) structure is viable or whether it must evolve. The traditional academic model, in which the department and chair retain a great deal of autonomy and authority, and in which decision-making processes are legislative in nature, is too tedious and laborious to effectively compete in today's health care market. The current health care market is demanding greater efficiencies, lower costs, and thus greater integration, as well as more transparency and accountability. Improvements in both quality and efficiency will demand coordination and integration. Focusing on quality and efficiency requires organizational structures that facilitate cohesion and teamwork, and traditional organizational models will not suffice. These new structures must and will replace the loose amalgamation of the traditional AHC to develop the focus and cohesion to address the pressures of an evolving health care system. Because these new structures should lead to more successful clinical enterprises, they will, in fact, support the traditional academic missions of research and education more successfully than traditional organizational models can.
Michael Karpf; Richard Lofgren
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Academic medicine : journal of the Association of American Medical Colleges     Volume:  87     ISSN:  1938-808X     ISO Abbreviation:  Acad Med     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8904605     Medline TA:  Acad Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  555-6     Citation Subset:  AIM; IM    
Dr. Karpf is executive vice president for health affairs, University of Kentucky, Lexington, Kentucky. Dr. Lofgren is vice president for health care operations and chief clinical officer, University of Kentucky, Lexington, Kentucky.
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