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This study examines entrepreneurship and assesses its relevance to health care organizations through a detailed description of the optimal environment, organizational factors, and managerial roles in the entrepreneurship process. The article finds entrepreneurship processes to be especially useful to health care organizations as they struggle to survive in the competitive managed care environment.

The purpose of this research is to provide an overview of the management skills and competencies required by a director of social work as they perform their multiple roles and functions in order to effectively manage a medical social work team to better serve the needs of patients through the new hospital‐based case management model.

This is a conceptual paper that reviews the literature on managerial roles, management functions, and skills and competencies of directors of social work. Management frameworks that are applicable under the case management model are discussed. Interviews with five directors of social work and their perceptions are described.

Managing a department that is going through continuous changes is often difficult.

This paper has practical implications for general health care managers and specifically, directors of social work, to develop skills and gain competencies to be successful in today's evolving health care environment. This research also has practical implications for social workers to gain insight into productive and effective ways to collaborate with members of an interdisciplinary team.

This paper is original and of value to those working in social work and in the health care field to develop their skills and competencies as they perform new roles and functions in the complex health care environment.

This paper describes managed care, competition and high health care costs and reductions in funding as the major market forces that affect US academic health centers. As academic health centers continue to preserve their missions of providing patient care, educating and training health professionals and conducting research, they are negatively impacted by these market changes, thus, resulting in increased expenses and lowered revenue. A key component to surviving in difficult times is market‐focused management. This paper develops a model to show the path of senior level management teams in their decision making. Through the performance of essential managerial roles, senior level managers are responsible for strategies that result in the long‐term viability and growth of academic health centers.

The purpose of this paper is to discuss the need for the service line management approach in health care. Service line management is increasingly utilized by US health care organizations as an innovative method for providing the needed stimulus to increase viability and profitability for the ailing health care sector.

Using current literature, this study describes a paradigm shift from traditional health care management approaches to focus on the importance of a service line management approach with its specific emphasis on competencies of leaders.

Four essential competencies – conceptual, participation, interpersonal, and leadership – must be gained by leaders to bring about organizational growth.

Health care managers must understand and practice these four key competencies to become effective health care leaders.

This paper provides useful information on the need for the service line management approach in health care.

This paper describes major trends in the health care market. They include increased health care costs, the growth of managed care, emphasis on quality of care, consumer choice and the growth of the elderly and uninsured populations. The relationship between cost, quality, managed care and choice are explored in the Medicare and Medicaid programs. A clearer understanding of these trends enables managers in health care organizations to make strategic decisions resulting in organizations' survival and growth.

This paper aims to examine the issue of quality of care in the US managed care system and to compare state‐level policies and programs. Specifically, it aims to describe five states which are making the most quality of care improvements.

This study examines the literature to identify states' care quality rankings. Additionally, five state case studies are presented to illustrate various programs approach to quality.

The paper finds that some states are better than others in their strategies to enhance quality of care. California, Florida, Maryland, Minnesota and Rhode Island are considered among the best. Thus, their programs are described.

From a research perspective the study brings a renewed focus on various methods in which states invest to improve residents' quality of care.

From a practical standpoint, since quality of care is an important topic and interesting to all stakeholders in health care – policymakers, consumers, providers, and payers – readers can use the study's results to compare states' strategies and develop new ways to increase quality.

This study's value lies in the way it helps states to compare their performance over time and against other states as they make improvements to enhance quality.

This paper describes several approaches for implementing quality improvement initiatives to improve patient satisfaction, which enables health‐care organizations to position themselves for success in today's global and increasingly competitive environment. Specifically, measuring the views of patients, improving patient satisfaction through a community‐wide effort, and using a Six Sigma program are discussed. Each of these programs can be an effective mechanism for quality improvement. A key component to quality improvement techniques involves collaborative efforts by all health‐care professionals and managers as they seek to increase patient satisfaction.

As health care organizations seek innovative ways to change financing and delivery mechanisms due to escalated health care costs and increased competition, drastic changes are being sought in the form of re‐engineering. This study discusses the leader's role of re‐engineering in health care. It specifically addresses the reasons for failures in re‐engineering and argues that success depends on senior level leaders playing a critical role. Existing studies lack comprehensiveness in establishing models of re‐engineering and management guidelines. This research focuses on integrating re‐engineering and leadership processes in health care by creating a step‐by‐step model. Particularly, it illustrates the four Es: Examination, Establishment, Execution and Evaluation, as a comprehensive re‐engineering process that combines managerial roles and activities to result in successfully changed and reengineered health care organizations.

The purpose of this paper is to analyze the study results conducted at a four-year university in Hawaii investigating the impact of providing nursing students with an educational intervention session aimed at improving cultural competence.

A descriptive-correlational research method was used to examine the correlations between a control group and experimental group using pre-and post-tests. The t-test for equality of means and Levene’s test for equality of variances were conducted for statistical analysis on pre-and post-test scores. In addition, a power analysis was conducted due to the small sample size.

The control group receiving no intervention scored lower on the post-test in overall competency by five points, while the experimental group increased their post-score by five points after receiving the intervention; however, this increase did not change the overall cultural competence score. The results indicate that the educational intervention of a two-hour didactic, discussion and presentation did not provide as robust as what was needed to increase domain scores for the experimental group. Further, the domains of awareness, skill, knowledge, encounter and desire cannot be taught by instruction alone and should be reinforced over time.

The study was a convenience sample and limited by the small sample size. The sample may not be representative of all senior nursing students. The study is limited to one school of nursing in Hawaii; the results may not be generalized to other populations.

This research provides a foundation for future curriculum development and the evaluation of nursing programs. For instance, incorporating a value-added instructional project on cultural competence into each nursing class would increase cultural competence awareness and knowledge.

This study also emphasizes the necessity of education in cultural competence for all health professionals, which has implications for improving quality, patient satisfaction and increased health outcomes.

This research is unique to examining and applying an educational intervention on cultural competence for nursing students in Hawaii. This research sheds light on studying the importance of culture competence for nursing students and other health professionals. This is not a skill that can be taught in one class or only even a single immersion experience and should be acquired over time where continuing education and encounters are necessary in order to become culturally competent; this will enable health professionals to provide meaningful and appropriate care to patients.