REVIEWED BY KATHRYN H. RUSCITTO, MPA, PhDH
BY PAUL B. HOFMANN AND FRANKIE PERRY, eds.
Cambridge University Press, New York City, 2004, 272 pp., $90
Health care is a complex and tumultuous environment that, every day, in every health care institution across this country, presents its leaders with complicated ethical and strategic questions requiring quick decisions. How these decisions are made results in progress or mistakes for our institutions and networks.
Management Mistakes in Healthcare: Identification, Correction, and Prevention was edited by Paul Hofmann, DPH, and Frankie Perry, RN. Hofmann has written for Health Progress ("The High Cost of Being a Moral Chameleon," November-December 2005, pp. 9-10) and is a former member of its Editorial Advisory Board. Perry teaches at the University of New Mexico. Their book should be an important addition to every health care executive's reading list because it provides a refresher course in improving decision making.
As we Americans have watched the development of corporate ethical problems of the last few years, beginning with the Enron scandal of 2001, we have observed the disintegration of public trust in the leadership of business executives. Today the public challenges health care leaders to be more transparent and accountable concerning the impact of mistakes they make.
Management Mistakes in Health Care is a good compilation of essays, case studies, and commentary concerning the challenges facing governing boards, health care executives, and their leadership teams. The editors wisely chose essays written by executives who have both health care experience and solid policy backgrounds.
The book carefully provides the reader with frameworks for analyzing and reporting mistakes, managing mistakes, understanding the causes of medical errors, and acting with accountability. The second half of the book provides useful case studies, accompanied by good commentary, on topics ranging from medical errors to failed hospital mergers, from information technology setbacks to ineffectual governance. The important insights provided in the first several chapters are ones the reader will want to return to often.
Wanda Jones, president of the New Century Health Care Institute, San Francisco, reminds us in Chapter 3 that "while management mistakes are not assessed as those of our clinical colleagues, management decisions can adversely impact clinical care." The authors reveal important insights that health care executives can use in creating a culture that views mistakes in an analytical framework, thereby ensuring that the lessons learned from them will help prevent future mistakes.
The essays serve to guide executives through the leadership challenges we are facing in this complex health care arena. They remind us of the importance of leadership in establishing a culture that is open to finding mistakes, learning from them, and being accountable and coping with the outcomes when mistakes are made. Carol Bayley, vice president, ethics and justice education, Catholic Healthcare West, San Francisco, notes in Chapter 4 that "both in medical and management mistakes, the organizational culture plays a significant role."
The case studies provide real-life examples followed by expert commentary. The studies will be especially useful if the members of leadership teams will, having read them, ask themselves, "Could this happen in my hospital?" When leadership teams undergo simulation experiences using case studies, they are forced to clarify their leadership styles and understand the ways that egos can blur strategic decisions.
Hofmann and Perry have made a realistic and significant contribution in creating a primer for today's health care executive.
Kathryn H. Ruscitto
Senior Vice President
St. Joseph's Hospital Health Center
Syracuse, NY
Copyright © 2006 by the Catholic Health Association of the United States
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