Managing Health Services Organizations and Systems, Seventh Edition


By Kurt Darr, JD, ScD, LFACHE, and Michael Nowicki, M.H.A., Ed.D., FACHE, FHFMA

approx. 756 pages
7 x 10 paper
© February 2021

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Coming February 2021!

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A trusted professional reference and a teaching text, the new edition of Managing Health Services Organizations and Systems continues to provide the most comprehensive coverage available of the leadership, financial understanding, and conceptual frameworks required to effectively manage the delivery of health services in the U.S. Emphasizing continuous quality and performance improvement throughout the organization, the authors explore essential knowledge and skills required for success in areas that include managerial problem solving, resource allocation and utilization, effective communication, organizational culture, human resources, facilitation of change, and ethical and legal responsibilities.

This fully updated, reorganized, and revised 7th edition contains new content on information technology, artificial intelligence, and financial/quantitative analysis currently in widespread demand. Ninety case studies with discussion questions sharpen readers’ problem-solving skills while inviting them further into the real world of hospital administration.

Instructor materials are available with this text and include:

  • PowerPoint presentations
  • Test banks and answer keys
  • Learning objectives
  • Instructor manual
  • Figures and tables
  • PLUS a PDF of all acronyms used in the text

Format: E-book
e-ISBN 978-1-938870-91-0

Coming soon!


Chapter 1: Healthcare Services in the United States

  • Health and System Goals
  • Lack of Synchrony
  • Processes That Produce Health Policy
  • A Brief History of Health Services in the United States
  • Other Western Systems
  • Structure of the Health Services System Classification and Types of HSOs
  • Local, State, and Federal Regulation of HSOs/HSs Other Regulators of HSOs/HSs
  • Accreditation in Healthcare
  • Regulation and Education of Selected Health Occupations
  • Associations for Individuals and Organizations
  • Paying for Health Services Government Payment Methodologies
  • System Trends

  • Case Study 1. Gourmand and Food—A Fable
  • Case Study 2. Normal Saline and Hurricane MariaWhere’s My Organ?
  • Case Study 3. Bipartisan Policy Group Proposes Cuts to Hospital Spending

Chapter 2: Ethical and Legal Dimensions

  • Society and the Law
  • Relationship of Law to Ethics
  • Ethics Framework
  • Personal Ethic and Professional Codes
  • Health Services Codes of Ethics
  • Ethical Issues Affecting Governance and Management
  • Biomedical Ethical Issues
  • End-of-Life Decisions
  • Organizational Responses to Ethical Problems Managers and the Law
  • Torts and HSOs/HSs
  • Reforms of the Medical Malpractice System
  • Select Legal Areas Affecting HSOs/HSs
  • Legal Process of a Civil Lawsuit
  • Special Considerations for the Manager

  • Case Study 1. Understanding
  • Case Study 2. Viral Pandemic
  • Case Study 3. Concerned Physicians; Unconcerned Managers
  • Case Study 4. Which Hurts More: The Truth or the Lie?

Chapter 3: Healthcare Economics

  • Economic Growth in Healthcare
  • Special Characteristics of the Healthcare Economy
  • Healthcare Demand
  • Healthcare Supply
  • Economic Solutions for Healthcare

  • Case Study 1. Price and Discount Transparency
  • Case Study 2. Comparing Health Care in High-Income Countries
  • Case Study 3. The Role of Health Insurance in Guaranteeing Health
  • Case Study 4. Physician Consolidation

Chapter 4: The Quality Imperative: The Theory

  • Improving Quality and Performance
  • Taking a CQI Approach
  • CQI, PI, and Competitive Position
  • Theory of CQI
  • Strategic Quality Planning: Hoshin Planning Organizing for Improvement
  • The Next Iteration of CQI: A Community Focus

  • Case Study 1. Extent of Obligation
  • Case Study 2. Surgical Safety—Retained Foreign Objects
  • Case Study 3. Which Team’s Fastest?

Chapter 5: Healthcare Technology

  • Background
  • Types of Technologies
  • Effects of Technology on Health Status
  • Forces Affecting Development and Diffusion of Technology
  • Responses to Diffusion and Use of Technology
  • Health Technology Assessment
  • HSO/HS Technology Decision Making
  • Managing Biomedical Equipment
  • Health Information Technology
  • Telemedicine
  • Future Developments
  • Technology and the Future of Medicine

  • Case Study 1. Is Cleansing Your Hands in my Room a Problem, Doctor?
  • Case Study 2. “Who Does What?”
  • Case Study 3. “Let’s ‘Do’ a Joint Venture”


Chapter 6: Managerial Problem Solving and Decision Making

  • Problem Analysis and Decision Making
  • Problem Solving
  • Process and Model
  • Influencing Problem Solving and Decision Making Unilateral and Group Problem Solving
  • Problem-Solving and Decision-Making Styles

  • Case Study 1. The Nursing Assistant
  • Case Study 2. The New Charge Nurse
  • Case Study 3. Chris’s New Baby

Chapter 7: Financial Management

  • Organization of Financial Management
  • Healthcare Financial Accounting
  • Cost Accounting
  • Reimbursement
  • Working Capital
  • Resource Allocation

  • Case Study 1. Calculating Net Patient Services Revenue
  • Case Study 2. Calculating Bad Debt Expense
  • Case Study 3. Analyzing Financial Statements
  • Case Study 4. Break-even Analysis for a Capitated Contract
  • Case Study 5. Your Organization’s Path to the Second Curve: Integration and Transformation
  • Case Study 6. Economic Order Quantity and Total Cost

Chapter 8: The Quality Imperative: Implementation

  • Undertaking Process Improvement
  • Other Improvement Methodologies
  • Improvement and Problem Solving
  • Statistical Process Control (SPC)
  • Tools for Improvement
  • Productivity and Productivity Improvement
  • LIPs and CQI
  • Patient and Staff Safety in Healthcare
  • QI Methods Useful in Patient and Staff Safety
  • Overlap of Patient and Staff Safety
  • Sustainability

  • Case Study 1. The Carbondale Clinic
  • Case Study 2. Respiratory Pandemic and the Hospital
  • Case Study 3. Infections—CLABSI
  • Case Study 4. Sharps Injuries
  • Case Study 5. Violence in the Workplace

Chapter 9: Communicating

  • Communicating Is Key to Effective Stakeholder Relations Communication Process Model
  • Barriers to Effective Communication
  • Flow of Intraorganizational Communication
  • Communicating with External Stakeholders
  • Special Situations of Communicating with External Stakeholders
  • Special Situations of Communicating with Internal Stakeholders

  • Case Study 1. How Much Should We Say?
  • Case Study 2. Getting Help When Needed
  • Case Study 3. Adding Verbal Orders to Written Orders


Chapter 10: Planning

  • Strategizing and Systems Theory
  • Strategizing and Planning
  • The Strategizing Process
  • Situational Analysis
  • Internal Environmental Analysis
  • External Environmental Analysis
  • Formulating Strategy
  • Implementing Strategy
  • Strategic Control
  • Strategic Marketing
  • Core Concepts in Marketing
  • Examples of Marketing Strategies
  • Strategic Issues Management

  • Case Study 1. No Time for Strategizing
  • Case Study 2. A Response to Change
  • Case Study 3. HSO Strategic Assessment

Chapter 11: Organizing

  • Designing the Organization
  • Culture and Values
  • Theoretical Background
  • Formal and Informal Organizations
  • Designing Interorganizational Relationships
  • The Triad of Key HSO Components
  • Organization of Select HSOs
  • Diversification in HSOs and HSs
  • The HSO/HS Environment

  • Case Study 1. The Clinical Staff
  • Case Study 2. State Allocation Decisions—Centralize or Decentralize
  • Case Study 3. Physicians’ Unprofessional Behavior
  • Case Study 6. CEO Salary versus Patient Care

Chapter 12: Staffing

  • Background
  • Staffing
  • HRM Activities
  • Labor Relations Law and Unionization
  • Self-service HR
  • Foreign Workers
  • Teams
  • Virtual Workforce
  • Social Media in the Workplace and in HR
  • Personality Testing
  • Outsourcing Some HRM

  • Case Study 1. Today’s Workforce
  • Case Study 2. The Photographer Who Posed as a Gynecologist
  • Case Study 3. Doctor of Death
  • Case Study 4. Let the Punishment Fit the Crime

Chapter 13: Directing

  • Directing as Leading: Defined and Modeled
  • Work of Managers
  • Management Functions, Skills, Roles, and Competencies
  • Managers and Leaders: Are They Different?
  • Ethical Responsibilities of Leaders
  • Power and Influence in Leading
  • Motivation Defined and Modeled
  • Conclusions About Power, Influence, and Motivation in Leading
  • Approaches to Understanding Leadership
  • Toward an Integrative Approach to Effective Leading

  • Case Study 1. Healthcare Executives’ Responsibility to Their Communities
  • Case Study 2. The Young Associate’s Dilemma
  • Case Study 3. Ethical Aspects of Leadership
  • Case Study 4. Reluctant Leader

Chapter 14: Controlling

  • Monitoring (Control) and Intervention Points Control Model
  • Levels of Control
  • Control Considerations
  • Control and CQI
  • Control and Problem Solving
  • Control and Information Systems
  • RM and Quality Improvement
  • Healthcare and Public Health Emergency Preparedness Control Methods
  • Project Management

  • Case Study 1. Centralized Printers
  • Case Study 2. Healthcare Emergency Preparedness
  • Case Study 6. Placing Imaging Services to Support ED Operations

Coming soon!

Kurt Darr, JD, ScD, LFACHE, is Professor Emeritus of Hospital Administration, and of Health Services Management and Leadership, Department of Health Services Policy and Management, School of Public Health, The George Washington University.

Dr. Darr holds the Doctor of Science from The Johns Hopkins University and the Master of Hospital Administration and Juris Doctor from the University of Minnesota. His baccalaureate degree was awarded by Concordia College, Moorhead, MN.

Dr. Darr completed an administrative residency at the Rochester (MN) Methodist Hospital and subsequently worked as an administrative associate at the Mayo Clinic. After being commissioned in the U.S. Navy during the Vietnam War, he served in administrative and educational assignments at St. Albans Naval Hospital (NY) and Bethesda Naval Hospital (MD). He completed postdoctoral fellowships with the U.S. Department of Health and Human Services, the World Health Organization, and the Accrediting Commission on Education for Health Services Administration.

Dr. Darr is admitted to practice before the Supreme Court of the state of Minnesota and the Court of Appeals of the District of Columbia. He was a mediator for the Civil Division of the Superior Court of the District of Columbia and has served as a hearing officer for the American Arbitration Association. Dr. Darr is a member of hospital committees on quality improvement and on ethics in the District of Columbia metropolitan area. He is a Life Fellow of the American College of Healthcare Executives.

Dr. Darr’s teaching and research interests include health services management, administrative and clinical ethics, hospital organization and management, quality improvement, and applying the Deming method in health services. Dr. Darr is the editor and author of numerous books, articles, and cases used for graduate education and professional development in health services.

Michael Nowicki, M.H.A., Ed.D., FACHE, FHFMA, holds an Ed.D. degree in Educational Policy Studies & Evaluation from the University of Kentucky and a master of hospital administration from George Washington University. He is currently a professor of health administration at Texas State University. Board certified in both healthcare management and healthcare financial management, he is a fellow of the American College of Healthcare Executives and the Healthcare Financial Management Association. Dr. Nowicki has held various administrative positions in healthcare organizations around the country. He is a noted speaker and author on healthcare financial management.

Details coming soon!


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