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Clinical directorates.

Christine Hancock

    Nursing Standard (Royal College of Nursing (Great Britain) : 1987)
    |September 27, 2016
    PubMed
    Summary
    This summary is machine-generated.

    The clinical directorate model, originating from Johns Hopkins Hospital, decentralizes budgeting by involving doctors in revenue and expense management. This approach empowers clinicians with financial oversight for improved resource allocation.

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    Area of Science:

    • Healthcare Management
    • Hospital Administration
    • Financial Decentralization

    Background:

    • The concept of clinical directorates is often attributed to the Johns Hopkins Hospital model.
    • This model has been in practice since 1973 in Baltimore, USA.
    • Existing literature frequently references this origin without critical examination.

    Purpose of the Study:

    • To critically examine the origins and operational model of clinical directorates.
    • To analyze the decentralization of budgeting and financial management within healthcare settings.
    • To understand the role of physicians in budget oversight and resource allocation.

    Main Methods:

    • Review of historical administrative practices at Johns Hopkins Hospital.
    • Analysis of the structure and function of decentralized budgeting systems.
    • Examination of physician involvement in financial decision-making processes.

    Main Results:

    • The clinical directorate model indeed involves significant decentralization of revenue and expense budgeting.
    • Physicians are actively engaged in the budgeting and budget management processes.
    • The system aims to align financial responsibility with clinical practice.

    Conclusions:

    • The clinical directorate model represents a significant decentralization of financial authority in hospitals.
    • Involving clinicians in budgeting can lead to more informed resource allocation.
    • Further research is needed to evaluate the long-term impact of this model on hospital performance.