Types of Health Care Management Theories

Health care management is a growing field. The U.S. Bureau of Labor Statistics predicts that the the job market for health care managers will grow by 16 percent. Health care managers have the important task of administering entire health care systems, such as hospitals. Differing opinions exist as to how these health care systems should be run. The effectiveness of a hospital or other health care facility is dependent upon the type of health care management theory it subscribes to and how well that theory is implemented.

Attribution theory, as applied to health care management, is a way of assessing the successes and failures of a health care system or program. In Patrick Palmieri and Lori Peterson's "To Err is Human: Building a Safer Health Care System" (2009), attribution theory is described as one possible health care management theory that can be used to create a safer environment for patients. Although not fully developed as a health care management theory, the authors suggest that attribution theory can be used as a conceptual framework to foster a positive and safe work environment for both health care workers and patients. Attribution theory assumes health care management can be improved by understanding that error in health care can sometimes occur. When it does it can lead to feelings of cynicism and "organizational inertia" in the health care system. By understanding where these feelings arise, health care managers can learn to foster a positive work environment that will improve employee response to errors in health care. By learning to recognize these mistakes as simply "human" errors, health care workers can learn to focus on continuing to provide a positive environment for patient recovery rather than focusing on what they have not done successfully,

A second health care management theory is the evidence-based management theory. A 2001 report by K. Walshe and T.G. Rundall at the University of Birmingham suggests that health care managers have been slow to accept and apply the same theories to which they often hold health care workers, an evidence-based approach that requires doctors, nurses and other health care professionals to make decisions based on the best available evidence. Some researchers like Walshe and Rundall suggest that there is a need to impose these same standards on the decision-making process of health care managers. Doing so will bring a level of uniformity to the decisions of health care officials. Practical considerations such as time constraints and deadlines often make the transition from evidence-based theory to practice somewhat difficult.

Utilization management is a third health care management theory, one that has received wider application in the health care industry than the more theoretical attribution and evidence-based theories. Utilization management is a proactive approach to managing health care through preset guidelines. The American College of Medical Quality identifies several tasks in utilization management that are essential to effective management of a health care organization. First it is essential to determine the organization's priorities. This is followed by research and a determination of who will benefit from the major decisions that are made. From this information, health care managers then determine what goals to set and how to go about implementing further research. Once data is collected and evaluated, policies, guidelines and procedures can be developed and implemented.