HOSPITAL POLICY DECISIONS PROCESS AND ACTION.

Arthur B. Moss, Wayne G. Broehl Jr."'Robert H.Guest, John W. Hennessey Jr (all TuckSchool). New York: G. P. Putnam's Sons,1966. 332 pp. $8.50.

Hospitals in one form or another are old as human history. The science and ? of hospital policy making and the transltion of policies into process and action art of quite recent origin. They have by almost caught up with the dramatic vances in the fields of medical and relate' science, fields which today rely so heavily upon the institutional facilities and services of modern hospitals. Likewise, the socioeconomics of the health field, coupled with the increasing influence of government makes it all the more necessary for hosnital policy makers and implementers to discharge their unique responsibilities to the American hospital and health system just as wisely and constructively as possible.

Hospital Policy Decisions: Process andAction is the report by the four authors of a two-year research project undertaken un der the investigative program of the Amos Tuck School of Business Administration and aided by a grant from the Division of Hos and Medical Facilities of the US Public Health Service. The volume has been said to deal with the "dynamics of policy process at several organizational levels." The authors not only carefully examined available material relating to the hospital field but conducted laboratory investigations in considerable depth, using in this process three rather typical general, voluntary nonprofit institutions, all located in the northeastern section of the country, but all apparently demonstrating policy making and management characteristics suitable to the research.

The resulting report represents a valuable addition to the literature in the hospital field. Its cast of characters might be said to include representatives of those thousands of public spirited people in the United States who serve voluntarily on hospital governing boards. Particular attention is focused on the policy makers of that uniquely American social instrument, the voluntary nonprofit hospital: created and owned by the publicat large and directed by persons selected for their interest in perpetuating the free enterprise system in the institutional branchof the health field for the benefit, of course, of their fellow citizens.

The study as reported in the book examines carefully the forces determining hospital policydecisions, including social and environmental influences, the institutional resources of the health system in America, and the behavioral characteristics of the health system as it bears upon hospitals. The book not only traces policy making and the various forms it takes organizationally and functionally, but shows how policy matters are examined not only within a governing group but at the general administrative and operating levels. There is much to promote constructive thought and reexamination of thepolicy making process by those charged with this responsibility. The study furthermore translates the effect on hospitals of trends in such important related areas as medical economics, health education, research and medical science. There is also analysis of specific duties and responsibilities of governing board members, doctors, and administrators with particular attention to their essential interrelationship.

This is a volume that should be on the shelf of every hospital library for particular attention by governing board members. It would also be useful reading for administrators and their management colleagues as well as for those members of the hospital's medical staff who should necessarily be concerned with the effective establishment of policies and the translation of these policies into operational effectiveness. All of this, of course, is geared ultimately toward process and action, as the title implies, which will assure those who seek care within our nation's hospitals the best and most effective service possible.

Clinical Instructor inHospital Administration