To identify indicators that should be focused on in management aiming to improve hospital operating margins, we conducted a mailed questionnaire survey of Diagnosis Procedure Combination/Per-Diem Payment System (DPC/PDPS) hospitals from February to April 2020. This survey was regarding management indicators the hospitals prioritized and collected financial data for the same period from the responding hospitals.

Data from 105 hospitals was analyzed. Results revealed that in hospitals with high medical profit margins, in addition to “bed occupancy rate” and “number of inpatients”, management and administrative staff also placed importance on “medical revenue per staff member” and “number of inpatients per doctor”, and placed less emphasis on “number of outpatients per doctor”. Moreover, they expected staff members to focus on the “number of outpatients per staff member”. Viewing these factors from the perspective of an impact system that promotes behavior change, we can surmise that scope of control was made explicit by developing the hospital’s financial structure and narrowing the scope of response to revenue, and per capita indicators were used because they lead to more specific behavioral results.

Objective: This study used the “Nursing Manager Ability Measurement Scale for Building Collaborative Relationships between Nurses and Caregivers (for Nursing Evaluation)”, which has been verified for validity and reliability, to analyze factors that influence evaluation of nursing managers’ efforts to build collaborative relationships between nurses and caregivers. Method: A multiple regression analysis was conducted on 893 nurses working with patients in long-term care beds at 48 hospitals, with the overall mean score and scores in five categories as objective variables and characteristics of nurses and work environment as explanatory variables. Results: It was suggested that nonregular nurses with higher educational backgrounds and nurses with longer nursing experience may be more critical in evaluating the efforts of managers. Conclusion: Results revealed that personal characteristics of nurses as well as the work environment influence the overall evaluation of nursing managers’ abilities to build collaborative relationships between nurses and caregivers responsible for patients in long-term care beds.

Approval from head nurse for a nursing staff member is perceived as a positive evaluation and leads to growth of autonomy. This study aimed to clarify the relationship between career autonomy and approval that midcareer nursing staff, who play a central role in improving nursing quality, feel they receive from their supervisors.

This questionnaire was designed to investigate nursing staff’s proactive approach to nursing life, and revealed a correlation between approval and career autonomy, albeit to a small extent. Additionally, approval from supervisors also affected career autonomy of male nursing staff. Male nursing staff are likely to expect their supervisors to have management and leadership skills to lead the organization. Furthermore, the study revealed that career autonomy was enhanced when supervisors delegated authority, assigned roles, and approved role performance. Head nurses need to understand each individual’s characteristics and areas of expertise, and carefully examine what role is best suited for them.

In recent years, continuous increase in the cost of medical resources including labor cost and attempts to reduce total medical fees by public sectors have raised the needs to improve productivity of medical institutions. This has become essential not only from the perspective of the management sector of a hospital, but also from the perspective of the public concern to provide sustainable medical services. However, as the environment surrounding medical institutions is diverse, it is desirable to consider the characteristics of each medical institution during the process of verifying the production efficiency. In this study, public hospitals were seamlessly categorized using a dimension reduction methodology and examined the factors that affect the profitability of medical management. It was observed that while the number of patients is a universal factor of profit-efficiency, the profitability of inpatient care depends on the bed functions as well as the human resource profile, such as the work experience years of staff. The methodology used in this study enabled a built-in verification of profit efficiency that incorporates the characteristics of each hospital without setting arbitrary thresholds. Further understanding the actual situation of hospital management and improvement in operational and financial efficiency are expected through the application of this methodology in more detailed situations.

Background: Nursing professionals around retirement age are designated as “platinum nurses” and are expected to use their extensive nursing experience in various settings.

Objective: This study aimed to understand how platinum nurses perceive their careers and roles through their participation in advanced care planning (ACP) education for community-dwelling older individuals.

Method: Two group interviews were conducted with platinum nurses living in Region A, where the aging rate exceeded 30%, about what they felt and noticed through their participation in ACP education for community-dwelling older adults. The interview data were analyzed and categorized.

Results: Interviews conducted one month later elicited feedback on overall ACP education that the respondents had participated in. One year later, respondents realized the strength of the nursing profession in being able to accommodate various feelings toward ACP, and they also talked about the need to improve their skills.

In recent years, there have been proposals for human resource development and functional expansion of administrative staff in business administration. In this study, I conducted a quantitative survey of the functions that administrative staff should fulfill in business administration departments in hospitals run by medical corporations, including how to deal with conflicts with on-site medical departments, in relation to adapting to “the competitive situation with other hospitals”. Results of the analysis of 120 small- and medium-sized hospitals operated by medical corporations in Honshu suggest that, regarding the “competitive situation with other hospitals”, the issues include active involvement of administrative staff in the decision-making process for business management, in addition to ensuring a sufficient number of human resources in the form of nurses. To achieve this, results also suggested that administrative staff need to be given the status, authority, and role to discuss matters on an equal footing with doctors and other frontline professionals, that they need to be willing to proactively express their opinions when conflicts arise with doctors and other frontline professionals in public places such as meetings, and that administrative staff, who have a strong sense of attachment to the organization, need to be actively involved in the management decision-making process.