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EXECUTIVE SUMMARY Multisource or 360-degree feedback has become a widely used component of leadership development in many organizations, and a growing body of research supports its use for this purpose. [...]

This article examines the use of clinical research in improving performance in health care settings. The diffusion of current findings from researchers to practitioners facilitates the development, implementation, and evaluation of clinical practices and improves the overall quality of care.

Several Ontario hospitals were studied from June 1996 to Jan 1997 to determine how they were coping with reduced funding. Results show that hospitals were dealing with the existing healthcare environment by implementing CQI programs, emphasizing customer service, strategic planning and communicating plans to stakeholders. Hospitals have also reengineered their operations by shifting from a departmental to program-based structure.

The role of physicians in managing health care facilities is discussed. No systematic strategies for involving physicians in managerial positions have been detected. However, the 'clinical directorate' model developed at Johns Hopkins University gives doctors a chance for playing the role of administrators of health facilities. The clinical directorate delegates physicians as heads of unit with its own budget allocation. They are accountable for financial as well as clinical outcomes.

A research study presents a concurring opinion of some of the assumptions made by Richard Johnson and Montague Brown on the past and future of the health and hospital fields. Emphasis was placed on the act of trying to benefit from past experiences to make health care more accessible and cost-effective. Medicine should be service-oriented as opposed to being profit-oriented. A macromanaged multipayer system that uses worldwide budget goals to control national health care expenditures is expected to take the place of managed care and capitated payment.

Health care practitioners were asked to identify and rank the obstacles that they are likely to encounter when trying to implement the total quality management (TQM) concept in their respective organizations. Health care professionals believed that the lack of proof that TQM could bring success was the greatest barrier to a successful TQM implementation. The study considered several factors that differentiated success from failure in innovation and improvement. Results of research work on innovations showed support for customer and quality mindedness. Future research work is recommended.

The emergence of managed care in the US healthcare industry has created a number of adverse effects on medical practices, particularly on the overall performance of physicians. A survey conducted on medical practitioners in Arizona revealed a significant reduction in the satisfaction level of physicians in terms of work schedule and salary. Although managed care encouraged physicians to spend more time responding to patient complaints, it has been reported to undermine the clinical decision making of doctors.