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Healthcare organizations that can attract and retain talented women executives have the advantage over their peers. In 2018, the American College of Healthcare Executives (ACHE) conducted the sixth in a series of surveys of its members to compare the career attainments, attitudes, and workplace experiences of men and women healthcare executives. Data from the 2018 survey indicate that women healthcare executives with 5 to 20 years of experience in the field are significantly less likely than their male peers to perceive their employers as gender-neutral regarding key employment factors such as hiring, promotion, evaluation, and compensation. Further, the results indicate there has been little to no improvement in many of these outcomes since ACHE began measuring these perceptions more than a decade ago. The perception that an employing organization is lacking in gender equity is also associated with lower overall satisfaction, engagement, and willingness to stay with the organization on the part of women executives.

Although much has been learned about the care of persons with human immunodeficiency virus (HIV) infection, there are persistent questions about the population under care, how much care they receive, where they get it, what it costs, and who pays for it. Unbiased answers to questions such as these are crucial to understanding the care of HIV-infected people, whether new research is being translated into practice, and where future clinical and policy challenges will lie. The generalizability of available studies has been limited by the use of patient groups selected because of location, convenience of sampling, or some other arbitrary . . .

The relationship between total foliar nitrogen content and feeding by Odontota dorsalis Thun. on Black Locust trees (Robinia pseudoacacia L.) was examined via experimental manipulation of foliar nitrogen levels. Trees with high concentrations of foliar nitrogen received more herbivory by adult O. dorsalis, but herbivory by larvae was independent of foliar nitrogen concentration. Late in the growing season, leaf abscission induced by herbivory tends to mask the dependence of herbivory by adults on foliar nitrogen concentration. The percentage of variation in herbivory attributable to foliar nitrogen concentration drops from 20% in June to 2% by August. These observations suggest that variation in the interaction between R. pseudoacacia and O. dorsalis is at least partially conditioned on variation in foliar nitrogen concentration.

[...]today's healthcare landscape is quite different from the one that existed even five years ago, and the pace of change is likely to continue. Position or role changes mentioned by more than one of the 22 firms noting changes included the following: * More physician leadership roles and an emphasis on integrating physician leadership into the senior team (mentioned by 9 responding firms) * An increase in population health roles (5) * A rise in positions relating to clinical integration or medical group management (4) * More roles focused on quality (3) * An increase in roles with an IT or technology emphasis (3) * A greater number of roles with a strategy or business development focus (3) * A rise in positions related to accountable care organizations (3) * A higher number of clinical positions (2) * More roles addressing value-based payment (2) Additionally, survey results reveal that healthcare organizations are streamlining or consolidating senior leadership roles (mentioned by 3 respondents) and are centralizing roles, such as those in human resources (also mentioned by 3 respondents).

This article talks about the different inclusions in healthcare organizations. There are clearly differing perceptions between white and minority respondents about the degree to which healthcare organizations have reached racial and ethnic parity in the workplace. Black respondents were about twice as likely as white respondents (81% versus 40%) to say more effort is needed to increase the proportion of racial/ethnic minorities in senior positions in their organizations. The authors analyzed the relationship between the existence of diversity programs and the likelihood that minority executives would describe race relations in their organization as good. That, combined with other results from the survey, leads them to make the following recommendations to healthcare organizations looking to increase diversity and inclusion: 1. Ensure equity in pay. 2. Sponsor social gatherings for employees. 3. Establish mentoring programs. 4. Implement a policy of seeking diversity in candidates considered for hire. 5. Increase the diversity of the senior leadership team. 6. Offer residency and fellowship programs.

Attracting, retaining and developing qualified women executives is vital to the success of healthcare organizations. While there have been great strides since the 1990s, there has been little progress regarding gender equity in the last six years. These findings were based on a survey that has been conducted by ACHE every five to six years since 1990, which compares the career attainments of male and female healthcare executives garnered from a sampling of ACHE members with between five and 19 years of experience in the field. The most recent of these studies, conducted in 2012, found that while some of the gains reported in 2006 have remained, there has been little progress on further closing the gender gap in healthcare management. Even controlling for tenure in the healthcare management field, women in the 2012 study had achieved CEO status at half the rate of men. However, healthcare organizations need to attract and retain talented women executives.

Goal:The objective of this study was to evaluate the prevalence of burnout and professional fulfillment among healthcare administrative leaders and examine the association between burnout and professional fulfillment and personal and professional characteristics.Methods:Between June 7 and June 30, 2021, we performed a national survey of CEOs and other senior operational leaders to evaluate their personal work experience. Burnout and professional fulfillment—as well as a sleep-related impairment and self-valuation—were assessed using standardized instruments.Principle Findings:Of the 5,994 members of the American College of Healthcare Executives who were sent an invitation to participate, 1,269 (21.2%), including 279 CEOs, submitted usable responses. The mean overall burnout score was 2.71 (range: 0–10), and 33% of participants had burnout scores that fell in the high range (unfavorable). Mean professional fulfillment score was 7.29 (range: 0–10), with 56.6% scoring in the high range (favorable). Burnout and professional fulfillment scores varied by role. On multivariable analysis, sleep-related impairment (OR for each 1-point increase = 1.29, 95% CI [1.19–1.41]; p < .001) and self-valuation (OR for each 1-point increase = 0.63, 95% CI [0.57–0.68]; p < .001) were independently associated with burnout after adjusting for all other variables.Applications to Practice:Results of this study suggest that healthcare leaders had lower burnout and professional fulfillment scores than clinicians. Nonetheless, one third of healthcare leaders had burnout scores that fell in the high range. At the individual level, improved sleep health and self-valuation appear to reduce risk of burnout and promote professional fulfillment.

Goal: The objective of this study was to evaluate the prevalence of burnout and professional fulfillment among healthcare administrative leaders and examine the association between burnout and professional fulfillment and personal and professional characteristics. Methods: Between June 7 and June 30, 2021, we performed a national survey of CEOs and other senior operational leaders to evaluate their personal work experience. Burnout and professional fulfillment-as well as a sleep-related impairment and self-valuation-were assessed using standardized instruments. Principle Findings: Of the 5,994 members of the American College of Healthcare Executives who were sent an invitation to participate, 1,269 (21.2%), including 279 CEOs, submitted usable responses. The mean overall burnout score was 2.71 (range: 0-10), and 33% of participants had burnout scores that fell in the high range (unfavorable). Mean professional fulfillment score was 7.29 (range: 0-10), with 56.6% scoring in the high range (favorable). Burnout and professional fulfillment scores varied by role. On multivariable analysis, sleep-related impairment (OR for each 1-point increase = 1.29, 95% CI [1.19-1.41]; p < .001) and self-valuation (OR for each 1-point increase = 0.63, 95% CI [0.57-0.68]; p < .001) were independently associated with burnout after adjusting for all other variables. Applications to Practice: Results of this study suggest that healthcare leaders had lower burnout and professional fulfillment scores than clinicians. Nonetheless, one third of healthcare leaders had burnout scores that fell in the high range. At the individual level, improved sleep health and self-valuation appear to reduce risk of burnout and promote professional fulfillment.

SUMMARY Goal: The objective of this study was to evaluate satisfaction with work-life integration (WLI), social isolation, and the impact of work on personal relationships (IWPR) among senior healthcare operational leaders. Methods: Between June 7 and June 30, 2021, we performed a national survey of CEOs and other senior healthcare operational leaders in the United States to evaluate their personal work experience. Satisfaction with WLI, social isolation, and IWPR were assessed using standardized instruments. Burnout and professional fulfillment were also assessed using standardized scales. Principal Findings: The mean IWPR score on the 0-10 scale was 4.39 (standard deviation was 2.36; higher scores were unfavorable). On multivariable analysis to identify demographic and professional factors associated with the IWPR score, each additional hour worked per week decreased the likelihood of a favorable IWPR score. The IWPR, feeling isolated, and satisfaction with WLI were independently associated with burnout after adjusting for other personal and professional factors. On multivariable analysis, healthcare administrators were more likely than U.S. workers in other fields to indicate work had adversely impacted personal relationships in response to the item \"In the past year, my job has contributed to me feeling more isolated and detached from the people who are most important to me.\" Practical Applications: Experiencing an adverse IWPR is common among U.S. healthcare administrators, who are more likely than the general U.S. working population to indicate their job contributes to isolation and detachment from the people most important to them. Problems with WLI, isolation, and an adverse IWPR are associated with increased burnout and lower professional fulfillment. Intentional efforts by both organizations and administrative leaders are necessary to address the work characteristics and professional norms that erode WLI and result in work adversely impacting personal relationships.