That health care organizations and their environments keep changing is both a mantra and an understatement. The nature of the changes can be evolutionary and adaptive or episodic and morphogenic. Each change poses opportunities and challenges for health care administrators. I believe that researchers have some responsibility to provide evidence on how best to move forward through the changes. To that end, I offer a short list of changes intended to direct research interests toward neglected or unpopular areas that remain worthy of scholarly attention.
(1) The need for continued attention to enhancing the coordination of health care across providers, organizations, and settings. Since the early study of coordination as continuity of care by Shortell (1976), coordination of care has continued to be a holy grail. The key question concerns how to achieve a nuanced and implementable understanding of this phenomenon that is theory and empirically based.
(2) The need to focus on the role and importance of midmanagement in delivering health care services. Research and general press attention tends to be on either the top executives or on the direct care providers. In between, at varying organizational level, a host of managers works to achieve the strategic goals of the executives. We need answers on how to optimize the effectiveness and efficiency of midmangers in the health care organizations of today.
(3) The need to humanize health care in a highly technological environment. The health care environment has been a technological wonderland of elaborate diagnostic tools, beeping monitoring devices, and text messaging. What can health care managers and administrators know when and where this has become problematic, and then what can they do to keep the focus on the personhood of both the patient and those using the technology?
(4) The need to respond to and engage communities, patients, and consumers in redesigning and improving health care delivery. Recent developments, including the Affordable Care Act (ACA) community benefit requirement and Blue Cross' release of cost information, have increased the importance and relevance of community members and consumers. Lines of inquiry need to address what managerial skills and organizational factors successfully predict management of diverse stakeholders.
(5) The need to understand and anticipate new organizational forms. The ACA legislation and the arrival of Accountable Care Organizations reopen the research into organizational forms and interorganizational relationships. How can existing typologies and theories inform health care management practice, and what possible theory advances do these new forms offer? It may be time to revive population ecology theory, given the ACA context.
(6) The need to manage the workforce shift toward the millennial generation. As the health care workforce ages and the predicted workforce shortages arrive, the personality of the millennial workforce will gain significance. Research on intergenerational work teams and loss of institutional memory are two of the many areas deserving research attention.
In summary, HCMR seeks to advance knowledge by publishing research that contributes to improving the health care system and enterprise. This includes publishing more health care management implementation science, more correlational and experimental research, and more focus on the most current data that address the six research topic areas.
L. Michele Issel, PhD, RN
Editor-in-Chief
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