egulations and involvement; consumer and third-party demands for better quality service and/or care; growing employee dissatisfaction with increased work loads; and of course, cost containment. In other words, how much are they willing to give up to achieve what they want, or think they want? Applying the maximization principle to hospital management means that administrators must always ask what the effects of changes will be (Stiles, 1994; Cooper et al., 1991; Wyszewianski et al., 1987; Coulam et al., 1991; Clare et al., 1995; Eastaugh, 1985; 1990; 1997).
Among the many factors affecting hospital staff and management concerning the issues of greater productivity while at the same time containing or reducing costs are these:
* Hospitals are faced with increased regulations from both the Federal Government and third-party insurers (Cooper et al., 1991).
* Consumers and third party insurers alike are clamoring for improved quality of health care (Eastaugh, 1992).
...