While they make up 73 percent of medical and health services managers, women account for only a small portion of CEOs at hospital and health care organizations, according to a report by RockHealth. The analysis of data from the U.S. Bureau of Labor Statistics and other surveys finds that just 4 percent of health care organization CEOs and 18 percent of hospital CEOs are women.

RockHealth’s report highlights a range of barriers to women’s advancement, including persistent gender roles in the workplace, a lack of mentors and role models for women, and more. To understand what women in the health care workforce thought, RockHealth conducted interviews with 100 women in the field. Nearly half the survey respondents reported that insufficient self-confidence was one of the biggest barriers to their career advancement. Among other reported obstacles: time constraints (45 percent) and the ability to connect with senior leadership (43 percent).

The Robert Wood Johnson Foundation has long championed leadership development, for women and men alike. Many of the Foundation’s programs offer leadership training for nurses, physicians and other health care professionals, to help advance their careers. Learn more about RWJF programs at RWJFLeaders.org.

What do you think? Are females underrepresented in health care leadership? What can we do to increase their representation? Register below to leave a comment.

See the RockHealth Women in Health Care report.
Read coverage of the report from Fierce Healthcare and Forbes.

The U.S. Department of Health and Human Services, Office on Women’s Health has designated May 13 to May 19 as National Women’s Health Week. It is designed to bring together communities, businesses, government, health organizations and others to promote women’s health. The goal in 2012 is to empower women to make their health a top priority. The Robert Wood Johnson Foundation (RWJF) Human Capital Blog is launching an occasional series on women’s health in conjunction with the week. This post is by Rebekah Gee, MD, MPH, RWJF Clinical Scholars alumna and an assistant professor of public health and obstetrics and gynecology at Louisiana State University (LSU). She is director of the Louisiana Birth Outcomes Initiative.

Louisiana is a fantastic place to live. It’s one of the most culturally rich and enchanting places in the United States. The state, however, also faces some of the greatest challenges in our nation.

Louisiana has a long history of poverty, poor education, and social problems that affect the health of too many of its citizens. And for women—particularly African American women—the challenges are even greater. We are 49th in the nation in terms of overall birth outcomes, like infant prematurity and mortality, and we get failing grades on report cards that measure those indicators of health.

In 2010, Bruce Greenstein, Secretary of the Louisiana Department of Health and Hospitals (DHH), recognized the importance of poor birth outcomes as a crucial public health issue—and named it his top priority. We were the first state in the nation to offer birth outcomes this kind of backing from our government officials. In November, 2010, we launched the Birth Outcomes Initiative, which I direct. It engages partners across the state—physicians, hospitals, clinics, nurses—and provides them with the best evidence and guiding principles to achieve change. We have made significant progress already.

We are working with the state’s hospitals on maternity care quality improvements, including ending all medically unnecessary deliveries before 39 weeks gestation. We have partnered with 15 of the largest maternity hospitals to provide them with the support and resources to make this a reality. Now, every maternity hospital in the state (there are 58) has signed on to the 39-Week Initiative.

Soon, we will be publishing perinatal quality scores—available to the public—so hospitals and physicians are held accountable for outcomes. In our pioneer facilities, we have seen the rates of elective deliveries drop by half. Many facilities have had as much as a 30-percent drop in the number of babies who needed to go to the NICU. The efforts of the Birth Outcomes Initiative are improving lives day after day.

An appendectomy in California could cost anywhere from $1,500 to more than $180,000, even at the same hospital or within the same county, according to a study led by RWJF Physician Faculty Scholar Renee Y. Hsia, MD, MSc. The study, published this week in the Archives of Internal Medicine, found wide variations in fees for the routine procedure, about one-third of which could not be explained even after reviewing all the cases and accounting for individual health variations.

“We expected to see variations of two or three times the amount, but this is ridiculous,” Hsia told the New York Times. “There’s no rhyme or reason for how patients are charged or how hospitals come up with charges… There’s no other industry where you get charged 100 times the same amount, or 121 times, for the same product.”

Among the other media outlets to report on the study’s findings: ABC News, ABC News Radio, The Associated Press/Washington Post, CBS News and Fox News.

Read the study.

See the stories that ran on ABC World News and CBS Evening News.

Read a post Hsia wrote for the RWJF Human Capital Blog about ambulance diversion and emergency department crowding.

A newly released ranking of the nation’s “top 100 hospitals” concludes that if every U.S. hospital had performed as well over the last 30 months as the hospitals that earned spots on the list, nearly 180,000 Medicare patients would still be alive today.

That calculation and the list itself come from HealthGrades, an independent hospital- and doctor-rating company based in Denver. Researchers analyzed approximately 150 million Medicare patient records dating back to 1998, looking at specific medical procedures and conditions. Collectively, the hospitals registered a 30-percent lower risk-adjusted mortality rate across 17 specific procedures and diagnoses during 2008 and 2010. The company calculates that if all hospitals delivered care as effective, some 179,593 Medicare patients’ lives would have been saved.

NurseZone.com checked in with a number of the hospitals on the list, and found that many “credit their nursing staffs with helping them achieve the best safety records and high rankings.”

“Nurses are most important and are very much a part of the team,” says Victoria King, MHA, MSN, RN, CNOR, NEA-BC, chief nursing officer at Memorial Hermann The Woodlands in Texas. “Nurses contribute, because they are at the bedside and are the captain of the ship every single day, watching those patients.” She notes that an important element of the hospital’s “culture of safety” is that nurses are encouraged to speak up if an error seems imminent. “That makes our nurses feel free, safe and protected to do the right thing and speak up when they need to,” she says.

Jan Mauck, RN, BSN, MSN, NEA-BC, chief nursing officer of Sarasota Memorial Hospital in Florida, also on the top 100 list, highlights the importance of interprofessional collaboration, according to NurseZone.

The Robert Wood Johnson Foundation (RWJF) Interdisciplinary Nursing Quality Research Initiative (INQRI) has announced a series of webinars that will explore recommendations from the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health.

The first in the series, which will address the implementation of nurse residency programs, will be held February 29 from 12-1 pm EST. “Developing and Sustaining the Professional Nursing Organization through New Graduate RN Transition-to-Practice” will be presented by Charles F. Krozek, MN, RN, FAAN, managing partner of Versant Holdings, LLC.

Register for the webinar.

Lean more about the RWJF Interdisciplinary Nursing Quality Research Initiative.

The Bureau of Labor Statistics national employment numbers for September show continued expansion in the health care industry, with an additional 44,000 health care jobs. That includes 26,000 in ambulatory health care services and 13,300 in hospitals.

A survey released by health care staffing company Merritt Hawkins & Associates [registration required] suggests that hospital employment may continue to rise, in part because new physicians increasingly prefer working in a hospital to solo private practice. The survey finds that 32 percent of final-year medical residents say they would like to be employed by a hospital, up 10 percent since the 2008 survey.

Part of the reason for the growing trend may be that physicians report feeling unprepared to handle the business side of medicine (48 percent). “The days of new doctors hanging out a shingle in an independent solo practice are over,” Merritt Hawkins founder James Merritt said in a news release. “Most new doctors prefer to be employed and let a hospital or medical group handle the business end of medical practice.”

Those medical students who do want to work in their own practices, once they graduate, say that partnering with another physician is their preferred approach. Fully 28 percent of the surveyed students opted for such a partnership, while only 1 percent said they would prefer to work in a solo practice.

Read our previous coverage on this topic.

What do you think? Is working in a hospital more desirable than private practice? Register below to leave a comment.

Five major organizations issued a national call to action to eliminate disparities in health care last week. The “Equity of Care” campaign is a collaboration between the American Hospital Association, the Catholic Health Association, the American College of Healthcare Executives, the Association of American Medical Colleges and Catholic Health Initiatives. It was announced July 18 in San Diego at the American Hospital Association's Leadership Summit.

The campaign calls on health care providers to address the following areas:

1. Data Collection and Use - Increasing the collection of race, ethnicity and language preference data to facilitate its increased use.
2. Cultural Competency - Increasing cultural competency training for clinicians and support staff.
3. Diversity in Governance and Leadership - Increasing diversity in governance and management.

"How do you know that the patients within your walls are getting the same care, and if they're getting the same care, are they getting the same outcomes,” American Hospital Association President and CEO Rich Umbdenstock said to Health Leaders Media. “I hope [a few years down the road] we can say that we're seeing a narrow gap in the actual care and outcomes for minority populations. We want to see that needle move in the right direction.”

More information on health disparities is available from the U.S. Department of Health and Human Services here and here.

What do you think are the most important actions the government and health care providers can take to reduce disparities both in health care and health outcomes? Register and leave a comment below to share your views!

For more information on the new initiative, visit www.equityofcare.org.

As the health care system is transformed, hospitals are trying to lure primary care physicians away from private practice, the Washington Post reports this week. With new emphasis on care coordination among health care professionals, hospitals are seeking to take over existing practices or hire away doctors and new graduates to work alongside nurses and specialists.

Reaction among doctors is mixed. A salaried job comes with greater security, and gives physicians access to otherwise costly technologies like electronic medical records. On the other hand, physicians may have less flexibility in the amount of time spent with patients and how they care for them.

Read the story from the Washington Post.

What do you think? Register and leave a comment below to let us know.

RWJF Executive Nurse Fellow Lois Skillings, M.S., R.N., N.E.A.-B.C. (2008-2011), current executive vice president of Mid Coast Health Services, will take over for retiring president and CEO Herbert Paris on July 1.

The Times Record reports that Skillings went through an extensive interview and review process, and the transition committee and organizational board voted unanimously to install her as the next president and CEO.

Skillings has previously served as vice president of nursing and patient services at Mid Coast and president of the Organization of Maine Nursing Executives.

Look for more information on Skillings in the upcoming issue of Sharing Nursing’s Knowledge.

Learn more about the RWJF Executive Nurse Fellows program.