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An Exploration of the Purpose, Value, and Impact of Professional

Development Activities in U.S. Hospitals

Stephen L. Walston, Ph.D., FACHE

Associate Professor Department of Health Administration and Policy

University of Oklahoma Health Sciences Center, College of Public Health

405-271-2114

[email protected]

Amir A. Khaliq, Ph.D.

Associate Professor Department of Health Administration and Policy

University of Oklahoma Health Sciences Center, College of Public Health

405-271-2114

[email protected]

This research was supported by a contract from the Foundation of the American College of Healthcare

Executives. The American College of Healthcare Executives is an international professional society of

more than 30,000 healthcare executives who lead our nation's hospitals, healthcare systems, and

other healthcare organizations. The views expressed here are solely those of the authors.

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OVERVIEW:

Through a grant provided by the American College of Healthcare Executives (ACHE), the University of

Oklahoma (OU) conducted a national survey of the scope and impact of professional development of hospital

chief executives during late 2008 and early 2009. This research was designed to understand hospital CEO

perceptions regarding the value and impact of professional development for themselves and their direct

reports. Preferences for types of professional development were explored, along with the value of continuing

education, credentialing and coaching. CEOs were specifically asked about the importance of professional

society membership, continuing education, and coaching today and how the importance of these activities

has changed in the past five years for themselves and their direct reports. Also, the explicit individual and

organizational value of professional development are examined.

KEY OBSERVATIONS AND FINDINGS:

The results showed that many CEOs believe that membership in professional societies is important for career

development (53%) and to develop a network of colleagues who can be called upon for advice (66%). Many

CEOs (40%) also believe that the importance of membership in professional societies has increased in the last

five years. However, these views are not shared by those who are neither Members nor Fellows of the

American College of Healthcare Executives. Those not affiliated with ACHE rated the importance of

membership in a professional society for themselves and for their senior management significantly lower

than ACHE affiliates.

The results also indicate that CEOs engage in continuing education with the purpose of staying abreast with

current events (74%), to learn techniques to solve problems (62%), to learn about new technology (59%), and

to understand changes in the health care delivery system (81%). For the most part, there were no significant

differences between the views of ACHE affiliates and non-affiliates regarding the value of continuing

education. More than half (51%) of the respondents suggested that continuing education is even more

important today than it was five years ago. The respondents also showed a strong preference for offsite

(78%) and onsite (52%) seminars as well as webinars (50%) but not as many (43%) like large conferences

while fewer still like discussion groups (29%), CDs or DVDs (26%), or self-study activities (24%). The least

preferred mode of continuing education (15%) was the online seminars. The views and preferences

expressed by CEOs for the continuing education of their senior managers were similar to those expressed for

themselves.

The CEOs reported that obtaining credentials in health care management is important for multiple reasons

including the need to signal competence in managerial skills (57%), to demonstrate knowledge of issues in

health care delivery (56%), and to assist in career development (59%). Once again, credentialing was reported

to be significantly more important by ACHE Fellows and Members than it was to non-members. A vast

majority (88%) of the respondents indicated that the importance of credentials had either remained

unchanged (48%) or had actually increased (40%) in the last five years. The views of CEOs about the value of

credentials for their senior managers were consistent with the views they held in this regard for themselves.

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In fact, they considered credentialing to be as important for the career development of their senior managers

(61%) as for their own career development (59%).

Finally, a majority of the respondents considered coaching of their senior management to be important to

improve staff performance (72%), retention (66%) and career development (63%). ACHE affiliates and non-

affiliates seemed to hold similar views in this regard and most (96%) believed that the importance of

coaching had either remained the same or had increased since 2003. More importantly, most of the CEOs

reported that they too benefit from being coached to improve staff performance (64%), retention (61%) and

career development (54%).

INTRODUCTION:

Professional growth and development is critical in the complex and evolving world of healthcare

administration. The profession has become more difficult with changing regulations, technological advances,

and increased demands. Hospitals must demonstrate constant learning and development of their leaders to

meet the current and future challenges. Healthcare organizations attempt to achieve professional

development of their managers and executives through a variety of mechanisms including participation in

leadership programs, mentoring and hands-on experience, membership in professional associations, and by

encouraging the attainment of formal credentials such as certificates and fellowships. However, the

composition of healthcare leadership ranks has become increasingly diverse. For example, over one-half of

new members of the American College of Healthcare Executives (ACHE) originate from non-healthcare

educational backgrounds (ACHE 2007). The needs and motivations for professional development of this

diverse group are not understood. To meet the challenges of the future, it is important to understand the

underlying purposes, processes, and resources used for professional development and continuing education

of healthcare leaders. This research assists healthcare leaders to better understand the attitudes, choices,

and preferences for professional development, continuing education, coaching, and credentialing of their

peers.

Professional development has been identified for many years as an important organizational function that

some believe has been inadequately addressed (Romano, 2004). Across all industries over $50 billion is spent

annually on employee training and about 27% of this amount is allocated for leadership development

(Dolezalek 2005). Presumably, the purpose of professional development is to assist the participants in

improving their leadership skills and to manage change effectively. Accordingly, professional development

activities or programs are often specifically designed to improve individual job performance and managerial

skills. Such efforts also positively impact organizational culture and climate (Scheck & McAlearney 2005).

Developing leaders for healthcare organizations has been identified as one of the most pressing challenges

for the future (Meyers 2007). Four general modalities of professional development have been proposed: 1)

personal growth, 2) conceptual understanding, 3) feedback, and 4) skill building (Allen & Hartman 2008). As

shown in Figure 1 below, various activities fall under these four categories.

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Figure 1 – Approaches to Professional Development

Personal Growth Conceptual Understanding

Fellowships Degree Programs

Sabbaticals Classroom Based Learning

Networking E-Learning

Feedback Skill Building

Executive Coaching/Mentoring Development Assignments

Assessments Personal Development Plans

Simulations

Job rotations

Adapted from Allen & Hartman, 2008

Hospitals offer many of these activities to improve quality of care, employee morale, and organizational

viability (Rice 2007). The use of specific developmental activities or modalities varies according to the

characteristics of the participating individuals and those of the parent organization. In general, the choices

include coaching or mentoring, hands-on experience, on-campus leadership training, skill building workshops,

job rotations, self-study, and formal degree programs (Rice 2007, Peterson 2002, Sherer 1994). While some

organizations have established “leadership academies” and hired “chief learning officers” to promote

professional and organizational development, others now require their leaders to take a fixed number of

classroom hours in leadership development each year (Dixon & Bilbrey, 2004). Professional development

allows for growth, longer tenure, and planned successions (Meyers, 2007). Mentoring and succession

planning is seen as critical functions in hospitals and, in the past, ACHE has provided support for these

functions (Dolan, 2004).

METHODS:

The survey was sent to a random sample of approximately 2,000 hospital CEOs across the US in late

December of 2008. A second copy of the survey was sent to non-respondents in January 2009. A copy of the

survey can be seen in Appendix 1. A total of 582 useable responses or 29.1% of the sample population was

received. Professional development was examined by professional society membership, continuing

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education, coaching, and credentialing. Throughout this report the number of responses may vary because

not every respondent answered every question.

This report provides the overall response descriptive data and also segments the respondents by their

affiliation with the ACHE. The differences in affiliation are statistically explored using Duncan’s Multiple

Range Test in ANOVA SAS analysis. In the multiple-mean comparisons presented in this document, a “*” on

the data indicates that the value is significantly statistically different from one of the other two affiliation

values. Two “**” signifies that the data is significantly statistically different from both other affiliation values.

The survey responses also were tested for response bias using Chi-Square in Proc Freq in SAS. The responses

(total 582) were compared to the full sample (2,001). Four variables that were thought to potentially affect

survey responses were used to determine if response bias might have occurred. The factors examined include

the geographic region of the hospital, the type of organizational control/ownership, the bed size of the

hospital, and whether the hospital CEO was an affiliate of ACHE. As can be seen in detail in Appendix 2, three

of the examined variables were significant and one non-significant. The region of the country was significant

with the Chi-Square probability of 0.0227, indicating that over response may have occurred in some of the

regions. Heavier responses seem to have happened in the West North Central, which had a 37.8% response

rate. All other regions appeared to have response rates between 23 to 30%.

Likewise, the Chi-Square for type of control/ownership for the hospital was also significant (0.0387). There

appears a relatively lower response rate from investor owned hospitals that in our survey have a 20% to 22%

response rate. On the other hand, Governmental Non-Federal City and County hospitals had higher rates of

responses with 37% and 39%, respectively. There did not seem to be sample bias present for hospital bed

size. However, there was a higher rate of response for ACHE affiliated hospital CEOs. Only 18.4% of non-

affiliated ACHE hospital CEOs responded to the survey, versus 41% of ACHE affiliated hospital CEOs.

Therefore, we suggest that the survey responses may over-represent hospitals in the West North Central

Region, governmental hospitals, and ACHE affiliated hospital CEOs.

ORGANIZATION OF THE REPORT:

This report presents the findings of the survey. The objectives and methods of the research are first

reviewed, followed by key definitions, respondents’ demographics, the CEOs’ perception regarding their own

professional development, a section on CEOs’ views of the professional development of their immediate

reports, and finally a section on the impact of professional development.

As mentioned above, this report presents both aggregated and segmented results. The results are segmented

by the respondents’ affiliation with the ACHE. There are three categories explored in this report: 1) non-

members of ACHE – these are individuals whose primary professional membership society is an organization

other than ACHE; 2) Members of ACHE – these are individuals who must have a minimum of a bachelor's

degree from an accredited institution and an interest in or commitment to the profession of healthcare

management, but have not yet passed the Board of Governors exam; and 3) ACHE Fellows – these are ACHE

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members who have Master’s or other post baccalaureate degree, a current healthcare management position

and five years of healthcare management experience, three years tenure as an ACHE Member, Faculty

Associate or International Associate, three references from current Fellows (one of which must be a

structured interview), 40 hours of continuing education—at least 12 of which are Category I (ACHE

education) hours—earned during the five years prior to becoming a Fellow, participation in two healthcare

related and two community/civic activities, and pass the Board of Governors Examination in Healthcare

Management. The above categories will be referred to in this report as Non-Members, Members, and

Fellows, respectively.

Demographic Characteristics of Respondents:

As can be seen in Table 1, a majority of the respondents (62%) have master degrees in healthcare

management. On average CEOs have 8 direct functional reports (Table 7), and are 53 years of age (Table 3).

The respondents were 81% male (Table 5).

As can be seen Table 3 and displayed in Chart 1, the mean tenure as CEOs is 12.6 years. However, this

number is skewed by some of the respondents with very long tenures as CEOs and, thus, the median tenure

is lower at 10 years. More than a quarter of the CEOs have worked as CEOs for less than 5 years and almost

20% held such positions between 5 and 9 years. As could be expected, the number of years in the current

position is much lower than the total years as a CEO. On average, CEOs in this study have been at their

hospital 7 years with a median of 5 years. (Nationally, hospital CEOs have been at their hospital 6 years with a

median of 4 years, showing the disproportionate impact of ACHE affiliated hospital CEOs in this research.)

Table 1

CEOs' Educational Degree

n Percent

Bachelors in HC Management 107 19%

Masters in HC Management 358 62%

Doctorate in HC Management 10 1.7%

Other 237 41% Percentages will not total to 100 since respondents could check

more than one degree they had acquired.

Table 2

Direct Reports to CEO

n Percent

Operations 548 95%

Medical Staff 439 76%

Nursing 509 88%

Corporate 242 42%

Finance 527 91%

IS 319 55%

Table 3

CEO Years of Work

Mean Median

Years as a CEO 12.6 10

Years in Current Position 7.1 5

Years at current hospital 10.1 7

Age 53.4 54

Seventy four percent indicated that their primary professional society was

highest affiliation (10%) was with no society and six percent

society. Of the entire respondent group, 25%

the respondents are Fellows.

When the demographics are segmented

in Table 7, ACHE Fellows have been CEO

and a greater percent of them are male (86.0% vs. 7

0%5%

10%15%20%25%30%

< 5

years

26%

Primary Professional Affiliation

Primary Membership

AAMA

ACHE

ACPE

HFMA

AONE

Other

None

Table 5

CEO Gender

n Percent

Male 472 81

Female 106 18Percentages in this and other tables may not

total to exactly 100 because of rounding error.

Seventy four percent indicated that their primary professional society was with ACHE (Table 4)

with no society and six percent claimed HFMA as their primary professional

Of the entire respondent group, 25% are non-ACHE members, 28% are ACHE Members and 47% of

segmented by Non-member, Member, and Fellow status within ACHE,

have been CEOs longer than other groups (14.3 years vs. 11.5 for non

male (86.0% vs. 74.1% Non-Members). Non-Members

5 to 9

years

10 to

14

years

15 to

19

years

20 to

24

years

> 24

years

19% 17%12% 11%

15%

Chart 1:

Years as Hospital CEO

Table 4

Primary Professional Affiliation

Primary Membership n Percent

7 1%

430 74%

10 2%

33 6%

7 1%

33 6%

62 10%

Percent

81%

18% Percentages in this and other tables may not

total to exactly 100 because of rounding error.

Table 6

Professional Affiliation

n

ACHE Fellow 272

ACHE Member (non-Fellow) 162

Non-ACHE Affiliated 143

Total 577

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(Table 4). The next

as their primary professional

ACHE members, 28% are ACHE Members and 47% of

status within ACHE, as shown

longer than other groups (14.3 years vs. 11.5 for nonmembers)

Members tend to be older

Percent

272 47%

162 28%

143 25%

7 100%

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(58.2 years versus 53.7 for Fellows) and have more direct reports (8.7 vs. 7.7 for Fellows). As can be seen

below, Fellows have a significantly longer tenure as CEOs. Fellows also are more likely to administer a

Thomson 100 Hospital.

Table 7

CEO Demographics by Professional Affiliation

Non-

member Member

Overall

Fellow Mean

Years as a CEO 11.5 10.7 14.3* 12.6

Age 58.2* 51.3 53.7 54.2

Number of Direct Reports 8.7* 8.5 7.7 8.2

Male 74.1% 80.1% 86.0%* 81.5%

Thomson 100 Hospital 2.1% 4.3% 7.4%* 5.2%

Number of Respondents 143 162 272 582

* indicates a significant difference between one other value;

** indicates a significant difference between the two other values.

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CEO Views About their Own Professional Development

I Change in the Importance of Professional Society Membership Since 2003

As can be seen in Table 8, membership in a professional society has become more important for many CEOs

(40%) in the past 5 years. Few (11%) believe that it has become less important. Not surprisingly, Table 9

illustrates that Non-members rate the importance significantly lower than ACHE affiliates.

Table 8

The importance of professional society membership for you

when compared to 2003

Percent

Much less important 2%

Less important 9%

About the Same 48%

More important 26%

Much more important 14%

Total 100%

Table 9

Comparison of ACHE Affiliation

Non-

member Member Fellow

Overall

Mean

Membership in professional society today

compared with 2003+ 3.06** 3.53 3.51 3.41

+Data shows the means for a Likert scale of 1 (Much less important) to 5 (Much more important)



II Importance of Professional Development Functions

As Table 10 and Chart 2 show, CEOs view professional development important to set ethical standards (44%),

provide a network of colleagues (66%), and assist in career development (53%). However, a large portion

(25%) indicates that setting ethical standards is an unimportant purpose. As can be seen in Table 11, Non-

members value each of these items much less than Fellows and Members.

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Table 10

How important is professional development for you for each of the following functions? (n=582)

Very

unimportant Unimportant Indifferent Important

Very

Important

Set ethical standards 10.3% 14.8% 31.3% 26.5% 17%

Provide a network of colleagues 4.3% 8.6% 21.5% 37.1% 28.4%

Assist career development 5.8% 11.3% 29.4% 35.7% 17.4%

Table 11

Comparison by ACHE Affiliation

Non-member Member Fellow

Overall

mean

a. To ensure executive

adherence to ethical

standards

2.89** 3.30 3.40 3.25

b. To develop a network

of colleagues who can

be called upon for advice

3.46** 3.73** 3.96** 3.77

c. To assist in career

development 3.03** 3.60 3.64 3.48

+Data shows the means for a Likert scale of 1 (Very unimportant) to 5 (Very important)



0%

10%

20%

30%

40%

50%

60%

70%

Unimportant Neutral Important

Chart 2

CEO's Relative Importance of Professional Societies by

Function

Ethics

Network

Career Dev

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III Continuing Education

As illustrated in Table 12, CEOs mostly value continuing education to keep themselves abreast of current

trends (74%), to solve problems (62%), to learn about new technology (59%), and to understand new changes

(81%). To a lesser extent, they value continuing education for career development (55%) and for succession

planning (48%). Table 13 demonstrates that Non-members actually value continuing education more to learn

about new technology, but see it of less value for career development.

Table 12

How important is continuing education for you (n=582)

Very


Very

Important

To stay current 3.3% 7% 15.6% 35.4% 38.3%

To solve problems 1.9% 7.1% 28.8% 39.1% 23.1%

To learn about new technology 2.2% 10.8% 27.5% 41.6% 17.9%

To understand Changes 1.7% 5.5% 11.5% 41.1% 40.2%

For Career development 3.3% 10.1% 31.8% 36.1% 18.7%

For Succession Planning 5.8% 14.4% 31.4% 31.2% 17.1%




Table 13

Comparison by ACHE Affiliation

Value of Continuing Education for CEOs+

Non-

member Member

Overall

Fellow Total

a. To stay current with political

changes 4.00 3.94 4.03 3.99

b. To learn techniques to solve

immediate problems 3.68 3.86 3.72 3.74

c. To learn about new technology 3.78* 3.58 3.56 3.62

d. To understand changes in

healthcare delivery 4.06 4.15 4.16 4.13

e. To assist in career development 3.32** 3.65 3.64 3.57

f. To contribute to succession planning 3.28 3.44 3.39 3.39

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IV Change in the Importance of Continuing Education Since 2003

As can be seen in Table 14, a majority (51%) of CEOs feel that continuing education has become more

important since 2003. Interestingly, as shown in Table 15, Members feel stronger that continuing education

has become more important in these past 5 years.

Table 14

The importance of continuing education for you when compared to 2003

Percent


Less important 3%

About the Same 45%

More important 30%


Total 100%

Table 15

Comparison by ACHE Affiliation+

Non-


Overall

Mean

Continuing education today compared with

2003

3.61 3.89** 3.58 3.67




V Preference for Modes of Continuing Education

As illustrated in Table 16 and Chart 3, there is a strong preference for offsite seminars (78%) for continuing

education. Somewhat surprising is that the next preferred modes of continuing education are onsite

seminars (52%) at the hospital and webinars (50%). Fewer CEOs liked large conferences (43%) and even fewer

books/discussion groups (29%), CDs or DVDs (26%), self-study (24%), and very last online seminars (15%). It

should be noted that these last four had sizable proportions of the respondents not preferring them – online

seminars (49%), self-study (41%) and CDs/DVDs (32%) and books/discussion groups (32%).

Non-members, as can be seen in Table 17,

than Fellows and ACHE members. Most dislike self

self study manuals more than the other groups.

What is your preference for various modes of continuing education?

Onsite Seminars

Offsite Seminars

CDs or DVDs

Webinars

Large Conferences

Self Study Manuals

Books or Discussion

Groups

Online Seminars

00.10.20.30.40.50.60.70.8

Preferred Modes of Continuing Education

embers, as can be seen in Table 17, also like offsite face to face seminars and large conferences

than Fellows and ACHE members. Most dislike self-study manuals and online seminars, but Fellows dislike

self study manuals more than the other groups.

Table 16


Not

Preferred

Somewhat

Not Preferred Neutral

Somewhat

Preferred

7.6% 7.1% 33% 34.5%

1.4% 4.5% 15.7% 51.2%

10.4% 21.6% 41.7% 21.3%

4.8% 10.9% 34.6% 36.0%

4.5% 12.3% 39.9% 36.9%

11.9% 28.6% 36.0% 20.3%

9.8% 22.6% 38.7% 25.7%

20.2% 28.9% 36% 13.3%

Chart 3

Preferred Modes of Continuing Education

Not Pref

Neutral

Pref

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also like offsite face to face seminars and large conferences less

study manuals and online seminars, but Fellows dislike


Somewhat

Preferred

17.8%

27.2%

5.0%

13.7%

6.4%

3.3%

3.1%

1.6%

Not Pref

Neutral

Pref

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Table 17


What is your preference for these modes of continuing education?+

Non-


Overall

Mean

a. Face to face seminars at your

healthcare facility 3.53 3.56 3.41

3.48

b. Offsite face to face seminars 3.78** 3.99 4.09 3.98

c. CDs or DVDs 2.94 2.96 2.83 2.89

d. Webinars 3.41 3.41 3.45 3.43

e. Large conferences with 90 to 180

minute presentations 3.16* 3.24 3.37

3.28

f. Self study manuals 2.73 2.93 2.64* 2.75

g. Books/journal discussion groups 2.83 3.02 2.86 2.90

h. Online seminars for several weeks 2.46 2.48 2.48 2.47

+Data shows the means for a Likert scale of 1 (Not preferred) to 5 (Preferred)



VI Change in the Importance of Continuing Education Since 2003

Table 18 and Chart 4 show that new modes of continuing education have increased in the frequency of

offerings in recent years. The most technologically driven of these modes of continuing education, webinars

(72%) and CDs/DVDs (34%) have increased in importance for CEOs since 2003. Online seminars (29%) and

offsite seminars (24%), self-study (23%), books/discussion groups (23%), and large conferences (22%), had

the greater number of CEOs believing that they had diminished in importance since 2003.

Table 19 demonstrates very little difference between the different types of CEOs. The only significant

difference is Fellows’ use of offsite seminars decreased more in the past 5 years than that of Members.

Table 18

How has your use of the various modes of continuing education changed from 2003?

Decreased

a lot

Somewhat

Decreased

About the

Same

Somewhat

Increased

Increased a

lot

Onsite Seminars 4.3% 11.6% 62.5% 17.4% 4.1%

Offsite Seminars 5.7% 18.2% 54.7% 19.3% 2.1%

CDs or DVDs 3.7% 9.4% 52.5% 30.0% 4.4%

Webinars 1.6% 3.1% 23.4% 46.2% 25.7%

Large Conferences 5.0% 17.3% 63.9% 11.7% 2.1%

Self Study Manuals 6.3% 16.9% 61.8% 13.2% 1.7%

Books or Discussion

Groups 5.2 17.9 60.1 15.5 1.4

Online Seminars 12.5 16.9 57.9 11.1 1.6


How has your use of these modes of continuing education changed from 2003?


healthcare facility

b. Offsite face to face seminars

c. CDs or DVDs

d. Webinars

e. Large conferences with 90 to 180

minute presentations

f. Self study manuals

g. Books/journal discussion groups

h. Online seminars for several weeks

+Data shows the means for a Likert scale of 1 (



00.10.20.30.40.50.60.70.8

Change in Importance of CE Mode 2003 to present

Table 19


How has your use of these modes of continuing education changed from 2003?

Non-


Overall

Mean

your

3.08 3.01 3.07 3.06

Offsite face to face seminars 2.92 3.06 2.87* 2.94

3.24 3.21 3.22 3.22

3.93 3.86 3.94 3.91

Large conferences with 90 to 180

2.86 2.93 2.86 2.89

2.84 2.94 2.84 2.87

groups 2.86 2.90 2.91 2.90

h. Online seminars for several weeks 2.66 2.71 2.76 2.72

means for a Likert scale of 1 (Decreased a lot) to 5 (Increased a lot)



Chart 4

Change in Importance of CE Mode 2003 to present

Decreased

Same

Increased

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How has your use of these modes of continuing education changed from 2003?+

Overall

Mean

3.06

2.94

3.22

3.91

2.89

2.87

2.90

2.72

Decreased

Increased

VII Time Spent by CEOs on

As shown in Table 20 and Chart 5, CEOs

annually. As can be seen in Chart 5, a

other hand, 13% participated in more than 80 hours

was 45 hours. Surprisingly, as illustrated in Table 21

continuing education across the past 12 months (56.1 hours) compared to

(44.5).

Number of hours CEOs pa

0%

5%

10%

15%

20%

< 10

hours

10 to

19

hours

4%

15%

Number of Continuing Education Hours in Past 12

Time Spent by CEOs on Continuing Education

CEOs appear to undertake a very wide range of continuing education

As can be seen in Chart 5, a small number (4%) spent less than 10 hours in the past

more than 80 hours this past year. The median was 36 hours an

, as illustrated in Table 21, non-ACHE affiliates state that they spent more time

continuing education across the past 12 months (56.1 hours) compared to Fellows (40.6) and ACHE members

Table 20

participated in continuing education in the past 12 month

N 570

Mean 45.08

Median 36

St. Dev. 55.8

Minimum 0

Maximum 1050

20 to

29

hours

30 to

39

hours

40 to

49

hours

50 to

59

hours

60 to

69

hours

70 to

79

hours

80 or

more

hours

19%

14%

19%

7% 7%

2%

13%

Chart 5

Number of Continuing Education Hours in Past 12

months

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to undertake a very wide range of continuing education

in the past year. On the

. The median was 36 hours and the mean

ACHE affiliates state that they spent more time on

(40.6) and ACHE members

in continuing education in the past 12 months

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Table 21


Number of CEO hours of continuing education in past 12 months

Non-


Overall

Mean

ESTIMATED NUMBER OF HOURS 56.1* 44.5 40.6 45.5



VIII Credentialing

Table 22 and Chart 6 indicate that CEOs feel that credentialing is important to the first three functions: signal

competence (57%), evidence of knowledge (56%), and assist in career development (59%). They are less

positive about its importance relative to succession planning (43%). However, credentials seem to be

significantly more important to Fellows and secondarily so to Members. On a Likert scale for the importance

of credentials (1 = very unimportant, 5 = very important), Fellows assign much more importance to

credentials in all four functions. For example, Fellows’ mean score for signaling executive competence was

significantly higher (4.03) than Non-Members (2.80). They also believe that it assists in career development.

Table 22

How important is credentialing to... (n=582, Percent of respondents)

Very


Very

Important

Signal Competence 8.6% 11.7% 23.2% 32.6% 23.9%

Evidence of Knowledge 6.9% 10.5% 26.2% 33.1% 23.3%

Assist Career

Development 6.2% 7.7% 26.6% 37.1% 22.3%

Succession Planning 10.7% 14.9% 31.1% 28.7% 14.6%

How important is

a. To signal the executive is competent in

managerial skills

b. To provide evidence that the executive has

requisite knowledge of healthcare delivery issues

c. To assist in career development

d. To contribute to succession planning



** indicates a significant difference between

IX Change in the Importance of Credentials

Table 24 shows that about half (48%)

A large percentage (40%) believes that it has become more important today. Table 25 demonstrates that

Non-members feel that the change in value of obtaining a credential in healthcare management less

important than Fellows and Members

0

0.1

0.2

0.3

0.4

0.5

0.6

signal

competence

evidence

know.

CEO reasons for credentialing

Table 23


How important is healthcare management credentialing to…+

Non-


competent in

2.80** 3.28** 4.03**

b. To provide evidence that the executive has

requisite knowledge of healthcare delivery issues 2.93** 3.35** 4.00**

c. To assist in career development 3.10** 3.52** 3.94**

contribute to succession planning 2.85 3.04 3.51**




Importance of Credentials Since 2003

Table 24 shows that about half (48%) of the CEOs feel that credentialing is just as important as it was in 2003.

that it has become more important today. Table 25 demonstrates that

members feel that the change in value of obtaining a credential in healthcare management less

important than Fellows and Members.

evidence

know.

career devel succession

plan

Chart 6

CEO reasons for credentialing

unimportant

neutral

important

18 | P a g e

Overall

Mean

3.51

3.55

3.62

3.22

feel that credentialing is just as important as it was in 2003.

that it has become more important today. Table 25 demonstrates that

members feel that the change in value of obtaining a credential in healthcare management less

unimportant

important

19 | P a g e

Table 24

The importance of credentialing for you when compared to 2003

Percent


Less important 6%

About the Same 48%

More important 26%


Total 100%

Table 25


The importance of credentialing for you now compared to 2003+

Non-


Overall

Mean

Obtaining a healthcare management

credential today compared to 2003 3.08** 3.38 3.51 3.36




X Coaching

Coaching, as displayed in Table 26 and Chart 7, is believed to improve staff performance (64%) and improve

staff retention (61%) and also to a lesser degree to assist career development (54%) and succession planning

(47%). More CEOs felt that coaching was not important for succession planning (18%) than any other factor.

When comparing by ACHE affiliation in Table 27, Fellows, however, are less positive than nonmembers about

the value of coaching to improve retention of high performing staff (3.59 vs. 3.69).

Table 26

How important is managerial coaching for... (n=582, Percent of respondents)

Very


Very

Important

Improving staff

performance 3.8% 7.6% 24.4% 42.0% 22.3%

Improve staff retention 3.6% 7.8% 27.4% 39.3% 21.8%

Assist Career

Development 4.3% 7.6% 34.1% 37.2% 16.8%


Comparison to ACHE Affiliation

The importance of obtaining managerial coaching

a. To improve staff performance

b. To improve retention of high performing staff






XI Change in the Importance of Coaching

The importance of Coaching in the past 5 years was perceived more important by

(Table 28) and, as shown in Table 29, M

Members (3.73 vs. 3.53).

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

improve

staff

staff

retention

Reasons for Coaching

Table 27

Comparison to ACHE Affiliation

The importance of obtaining managerial coaching+

Non-


3.74 3.83 3.63

b. To improve retention of high performing staff 3.69 3.82 3.59*

3.50 3.64 3.51

d. To contribute to succession planning 3.40 3.42 3.35




Change in the Importance of Coaching Since 2003

in the past 5 years was perceived more important by half of

(Table 28) and, as shown in Table 29, Members feel that coaching is more important today

staff

retention

career

develop

succession

plan

Chart 7

Reasons for Coaching - CEOs

unimportant

neutral

important

20 | P a g e

Overall

Mean

3.71

3.68

3.54

3.38

half of the respondents

more important today than do Non-

21 | P a g e

Table 28

The importance of coaching for you when compared to 2003

Percent


Less important 5%

About the Same 43%

More important 30%


Total 100%

Table 29


The importance of coaching compared to 2003+

Non-


Overall

Mean

Being coached today compared to 2003 3.53* 3.73 3.59 3.62




22 | P a g e

CEO Views About the Professional Development of Their Direct Reports

I Importance of Professional Society Membership for Direct Reports

More than half of responding CEOs (52%), as illustrated in Table 30, feel that professional society membership for

their direct reports is just as important as it was five years ago in 2003. Only a small percentage (10%) feels that it

has become less important. Non-Members see less importance in professional society membership than those

directly affiliated with ACHE (Table 31).

Table 30

The importance of professional society membership for senior managers


Percent


Less important 8%

About the Same 52%

More important 27%


Total 100%

Table 31


Importance of Professional Society Membership for Senior Managers compared to 2003+

Non-


Overall

Mean

Membership in professional society

today compared with 2003 3.09** 3.43 3.39 3.23




II Benefits of Professional Society Membership for Direct Reports

As shown in Table 32 and Chart 8, professional society membership is perceived to be more important for

networking and assisting career development for senior managers (67% and 63%, respectively). Establishing

ethical standards is not seen as high a benefit (43%) and one-fourth (25%) see this as an unimportant

function of professional society membership. Table 33 shows that Non

in these three areas for their direct reports. Fellows see the greatest value in membership assisting career

development.

How important is professional society membership for your direct reports for each of the following

unimportant

Set ethical standards

Provide a network of

colleagues

Assist career development

Importance of Professional Society Membership for CEOs’ Direct Reports for….

a. To ensure executive adherence to

ethical standards

b. To develop a network of colleagues

who can be called upon for advice





0

0.2

0.4

0.6

0.8

Negative

Sr Mngrs' Relative Importance of Professional Societies

function of professional society membership. Table 33 shows that Non-members see consistently less benefit


Table 32


functions? (n=582)

Very


9.7% 15.1% 32.2% 28.0%

3.5% 7.9% 21.2% 43.3

3.3% 8.9% 24.9% 44.8

Table 33


Importance of Professional Society Membership for CEOs’ Direct Reports for….

Non-


a. To ensure executive adherence to 2.90** 3.25 3.39


who can be called upon for advice

3.50** 3.75 3.91

c. To assist in career development 3.17** 3.62** 3.92**




Negative Neutral Positive

Chart 8

Sr Mngrs' Relative Importance of Professional Societies

for functions

Ethics

Network

Career D

23 | P a g e

members see consistently less benefit



Important

Very

Important

.0% 15.0%

43.3% 24.0%

44.8% 18.0%

Importance of Professional Society Membership for CEOs’ Direct Reports for….+

Overall

Mean

3.23

3.76

3.65


Ethics

Network

Career D

24 | P a g e

III Mechanisms to Encourage Direct Reports to Participate

in Professional Societies

On the whole, most hospitals provide three main incentives to encourage members to participate in

professional societies. As shown in Table 34, these include paying society dues (88%), paying educational

expenses (91%), and providing time off to participate (88%). A much smaller percentage (36%) includes

professional society membership in their annual evaluation, but very few use bonuses (5%) or any other

means to encourage membership activity. As can be seen in Table 35, Fellows are more likely to encourage

their subordinates to participate in professional societies by paying their annual dues (94.4% vs. 78.7% for

Non-Members) and providing time off to participate in activities (90.1% vs. 82.2%). Conversely, non-members

are less likely than Fellows to pay for educational program expenses (82.4% versus 94.1%).

Table 34

How do you encourage your direct reports to participate in professional societies?

% Yes

Pay their Annual Dues 87.5%

Pay Educational Expenses 90.9%

Time off to participate 87.9%

Bonus on Certification 5.2%

Include in Annual Evaluation 36.3%

Other 1.9%

Table 35


How do you encourage your direct reports to participate in professional societies?

Non-

Member

Member

Fellow

Overall

Mean

a. Pay their annual dues 78.7% 84.6% 94.4%* 87.8%

b. Pay for educational program

expenses

82.4%* 92.6% 94.1% 90.9%

c. Time off to participate in

professional activities

82.2% 88.9% 90.1%* 87.9%

d. A bonus when certification is

achieved

5.0% 5.6% 5.1% 5.1%

e. Include in annual evaluation

criteria

32.3% 35.8% 38.6% 36.3%

Data shows the percentages for the given categories



25 | P a g e

IV Importance of Continuing Education for Direct Reports

Most CEOs feel that continuing education is important for their direct reports. Table 36 shows that except for

succession planning, more than half of the respondents felt that each of the potential benefits was deemed

to be important. Of the responding CEOs few thought that continuing education was unimportant for staying

current (12%), learning technology (11%), and career development (10%). When ACHE affiliation is compared

in Table 37, we find that the only significant value is that Non-members feel that continuing education is less

important to assist their direct reports’ career development than Fellows.

Table 36

How important is continuing education for your direct reports to... (n=582, Percent of

respondents)

Very


Very

Important

To stay current 3.0% 9.3% 26.4% 37.9% 23.4%

To solve problems 1.2% 6.5% 24.7% 41.0% 26.6%

Learn New technology 2.1% 9.1% 21.9% 44.9% 22.0%

Understand Changes 1.7% 4.5% 13.6% 46.0% 34.1%

Career development 1.4% 8.6% 25.3% 42.3% 22.4%


Table 37


Importance of continuing education for CEOs’ direct reports……+

Non-


Overall

Mean

To stay current with political changes 3.69 3.63 3.74 3.70

To learn techniques to solve immediate

problems

3.76 3.95 3.85 3.85

To learn about new technology 3.86 3.69 3.74 3.76

To understand changes in healthcare delivery 4.01 4.13 4.06 4.06

To assist in career development 3.47** 3.76 3.90 3.76

To contribute to succession planning 3.32 3.37 3.48 3.42




26 | P a g e

V Change in the Importance of Continuing Education Since 2003

More than half (54%) of CEOs believe that continuing education has become more important for their direct

reports in the past 5 years (Table 38); while very few (4%) felt that it had become less important. Members

felt that it has become more important in the past five years than nonmembers and Fellows (3.85 versus 3.66

and 3.64).

Table 38

The importance of continuing education

for senior managers when compared to 2003

Percent


Less important 3%

About the Same 43%

More important 34%


Total 100%

Table 39


Importance of continuing education for senior managers compared to 2003+

Non-


Overall

Mean

Continuing education today compared with 2003 3.66 3.85** 3.64 3.70




VI Involvement of Direct Reports in continuing education over the past 12 months

As shown in Table 40, most direct reports had been either moderately (51%) or considerably (35%) involved

in continuing education over the past 12 months. Very few had little (4%) or very little (1%) involvement in

continuing education. Table 41 shows that there is not a significant difference among the CEO comparison

groups.

27 | P a g e

Table 40

Senior Managers involvement in continuing

education in the last 12 months

Percent

Do Not Know 1%

Very Little 1%

Little 4%

Moderate 51%

Considerable 35%

Highly Involved 8%

Total 100%

Table 41


Senior Managers involvement in continuing education in the last 12 months+

Non-


Overall

Mean

Sr. Mgt involvement with

continuing education 3.43 3.44 3.41 3.42

+Data shows the means for a Likert scale of 1 (Very little) to 5 (Highly involved)



VII Importance of Credentialing for Direct Reports

Table 42 and Chart 9 illustrate that CEOs perceive that credentialing provides greater value to assist in career

development (61%) than in the three other functions that credentialing might impact i.e., signaling

competence (47%), providing evidence of knowledge (50%) and succession planning (43%). Conversely, a

large proportion believe that credentials are unimportant in signaling competence (19%), showing evidence

of knowledge (17%), and succession planning (24%). Table 43 shows that Fellows are more positive about the

importance of credentialing relative to each of these functions than non-Members. Fellows perceive

credentialing for their direct reports much more important than the other groups. Credentialing is seen as

important (3.51 vs. 2.90 for Non-members) even for succession planning and is consistently higher as a signal

for competent managerial skills, evidence of knowledge, and assistance in career development.

How important is obtaining a credential in healthcare management for your direct reports to...

(n=582, Percent of respondents)

Very

unimportant

Signal Competence 7.8

Evidence of Knowledge 6.8

Assist Career

development 5.4

Succession Planning 9.7


Importance of obtaining healthcare management credential for direct reports

To signal the executive is competent in

managerial skills

To provide evidence that the executive has

requisite knowledge of healthcare delivery issues

To assist in career development

To contribute to succession planning




0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

signal

competence

evidence

know.

Sr Mngrs' Reasons for Credentialing

Table 42

credential in healthcare management for your direct reports to...

(n=582, Percent of respondents)

Very


7.8% 11.1% 34.1% 35.0%

6.8% 10.3% 32.5% 36.5%

5.4% 6.8% 26.5% 41.1%

9.7% 14.3% 33.4% 29.9%

Table 43


Importance of obtaining healthcare management credential for direct reports+

Non-


Overall

To signal the executive is competent in

2.81** 3.09** 3.73**

To provide evidence that the executive has

requisite knowledge of healthcare delivery issues 2.91** 3.19** 3.79**

3.16** 3.47** 3.99**

To contribute to succession planning 2.90 2.99 3.51**



indicates a significant difference between the two other values.

evidence

know.

career devel succession

plan

Chart 9

Sr Mngrs' Reasons for Credentialing

unimportant

neutral

important

28 | P a g e

credential in healthcare management for your direct reports to...

Very

Important

12.0%

13.9%

20.2%

12.7%

Overall

Mean

3.32

3.40

3.64

3.22

unimportant

29 | P a g e

VIII Change in the Importance of Credentialing Since 2003

Most CEOs feel that healthcare management credentials are of the same or greater importance now for their

senior managers , than they were 5 years ago (Table 44). When compared to Members and Fellows, non-

Members see credentialing as less important today than 5 years ago (Table 45).

Table 44

The importance of credentialing for senior managers


Percent


Less important 6%

About the Same 54%

More important 25%


Total 100%

Table 45


Importance of credentialing for senior managers compared to 2003+

Non-


Overall

Mean

Obtaining a healthcare management

credential today compared to 2003 3.09** 3.30 3.44 3.31




IX Importance of Coaching for Direct Reports

As shown in Table 46 and Chart 10, most CEOs feel that managerial coaching is important for their direct

reports, especially to improve staff performance (72%), improving staff retention (66%), and assisting in

career development (63%). Fewer (50%) feel that it is important for succession planning. There is no

significant difference when ACHE affiliation is compared in Table 47.

How important is obtaining managerial coaching for your direct reports to... (n=582, Percent

Very

unimportant

Improve staff

performance 2.3

Improve staff retention 2.4

Assist in career

development 3

Succession Planning 5.9


Importance

a. To improve staff performance

b. To improve retention of high performing

staff






0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

improve

staff

staff

retention

Reasons for Coaching

Table 46


of respondents)

Very


2.3% 5.2% 20.2% 44.6%

2.4% 7.0% 24.3% 42.1%

3.0% 5.2% 29.1% 40.9%

5.9% 9.9% 34.6% 30.5%

Table 47


Importance of Coaching for Direct Reports+

Non-


Sr. Mgt 3.88 4.02 3.85

b. To improve retention of high performing

Sr. Mgt 3.76 3.91 3.73

Sr. Mgt 3.65 3.76 3.77

d. To contribute to succession planning Sr. Mgt 3.42 3.50 3.48




staff

retention

career

develop

succession

plan

Chart 10

Reasons for Coaching - Sr Mngrs

unimportant

neutral

important

30 | P a g e


Very

Important

27.7%

24.3%

21.8%

19.0%

Overall

Mean

3.90

3.79

3.73

3.47

31 | P a g e

X Change in the Importance of Coaching for Senior Managers Since 2003

A majority of CEOs (55%) feel that coaching has become more important for their senior managers in the past

5 years (see Table 48). Very few (4%) feel that it has become less important. Non-Members when compared

to Members ascribe less importance to coaching today than five years ago (see Table 49).

Table 48

The importance of coaching for senior managers


Percent


Less important 3%

About the Same 41%

More important 34%


Total 100%

Table 49


Importance of Coaching for senior managers compared to 2003+

Non-


Overall

Mean

Being coached today compared to 2003 3.61* 3.83 3.70 3.72




Value and Impact of Professional Development

I Value of Professional Development

Table 50 and Chart 11 illustrate a mixed perception among CEOs. Although almost half (43%) disagree that

professional membership costs too much, almost one-fourth (22%) agree with this statement. Likewise,

about one-fourth (21%) believe that there is little value in certification, while 61% disagree. Not surprisingly,

Table 51 shows that Non-members see less value in professional development; while Fellows see the greatest

value.

How much do you agree with the following statements?

Professional Society Membership c

There is little value for HC certification

Professional societies educational programs provide

little value to my organization


little value to me

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

too high cost

of

membership

Table 50


Strongly

Disagree Disagree Neutral

rofessional Society Membership costs too much 7.2% 35.7% 35.1

There is little value for HC certification 17.4% 42.8% 19.1


17.4% 53.1% 19.6


18.2% 54.0% 17.9

little value

certif

little value of

educ prog to

organ

little value

prof to me

Chart 11

Professional Society has....

disagree

neutral

agree

32 | P a g e

Neutral Agree

Strongly

Agree

35.1% 17.5% 4.5%

19.1% 15.1% 5.7%

19.6% 8.6% 1.4%

17.9% 7.6% 2.4%

disagree

neutral

agree

33 | P a g e

Table 51


How much do you agree with the following statements?+

Non-


Overall

Mean

a. Membership in professional societies

costs too much for the value I receive. 3.22** 2.78** 2.50** 2.76

b. There is little value for me to achieve

certification in healthcare management. 3.31** 2.66** 1.94** 2.49

c. Educational programs sponsored by

professional societies provide little

value to my organization.

2.60** 2.23** 2.03** 2.24

d. Educational programs sponsored by


value to me.

2.69** 2.19** 1.98** 2.22

+Data shows the means for a Likert scale of 1 (Strongly disagree) to 5 (Strongly agree)



II Additional Value of Professional Development

As demonstrated in Table 52, professional relationships formed from professional society membership were

felt to have been important for CEOs’ individual careers (60%) and the CEOs’ organizations (58%). Most also

agree that they effectively apply information learned from outside educational programs (87%). Only a

relatively small minority believe that professional relationships have not been useful in their career (15%) and

that professional relationships have not been beneficial to their organization (14%). However, as shown in

Table 53, Fellows feel greater value from membership and Non-members do not apply as effectively the

information obtained from outside educational seminars.

Table 52


Strongly

Disagree Disagree Neutral Agree

Strongly

Agree

Professional relationships I have formed through my

professional society membership have been important in

my career

3.8 11.6 24.9 42.1 17.6

I apply information I learn from outside educational

seminars effectively to use in my organization 0.7 1.4 11 67.4 19.5

The professional relationships I have formed through my

professional society memberships have been important

for my organization

3.7 9.8 28.9 41.1 16.6

34 | P a g e

Table 53

Comparison with ACHE Affiliation


Non-

member

Member

Fellow

Overall Mean

a. The professional relationships I have

formed through my professional society

memberships have been important in my

career

3.35 3.43 3.79* 3.58

b. I apply information I learn from outside

educational seminars effectively to use in my

organization

3.89* 4.03 4.12 4.04

c. The professional relationships I have


memberships have been important for my

organization

3.36 3.47 3.74* 3.57




III Value of Professional Development to Direct Reports

CEOs believe rather strongly that professional society affiliation benefits their senior staff and certification is

of value (Table 54 and Chart 12). Given the statement that professional membership is too expensive to

benefit their senior managers, half of the respondents (56%) disagreed whereas nearly one third (31%)

remained neutral. This sentiment was even stronger in reacting to the statement that there was little value

for senior managers getting certification. However, 13 percent felt that membership for their direct reports

was too expensive and 12 percent believed there was little value for their senior managers to obtain

certification. Again, as can be seen in Table 55, Non-members perceive less value; while Fellows see greatest

value in professional society membership for their direct reports.


Membership in professional societies is too expensive to

benefit my senior management

There is little value for my senior management

achieving certification in healthcare management

Educational programs sponsored by professional

societies provide little value to my organization


a. Membership in professional

is too expensive to benefit

managers.

b. There is little value for my senior

managers in achieving certification in

healthcare management.



to my organization.




0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

disagree

Professional Society education for Sr Mngrs is

Table 54


Strongly

Disagree Disagree Neutral

Membership in professional societies is too expensive to 7.6% 48.6% 30.7

my senior management in

achieving certification in healthcare management 10.9% 54.1% 22.8

Educational programs sponsored by professional

my organization. 12.8% 57.1% 21.8

Table 55



Non-


Membership in professional societies

to benefit my senior 2.93** 2.52** 2.30**

my senior

certification in 2.86** 2.49** 2.11**

Educational programs sponsored by

provide little value 2.65** 2.25** 2.08**




neutral agree

Chart 12

Professional Society education for Sr Mngrs is

too high cost of

membership

little value certif

little value of educ prog to

organ

35 | P a g e

Neutral Agree

Strongly

Agree

30.7% 10.2% 2.9%

22.8% 9.1% 3.1%

21.8% 6.7% 1.6%

Overall

Mean

2.52

2.41

2.27


little value of educ prog to

IV Additional Value of Professional Membership fo

Table 56 and Chart 13 indicate that most CEOs believe that their senior

organization gains value from professional relationships

seminars they attend. More than sixty percent agree wit

that Non-Members perceive less value


a. The professional relationships formed by

senior managers through professional society

memberships have been important

careers.

b. Information senior managers learn from

outside educational seminars is effectively

transferred to our organization

c. The professional relationships formed by my


memberships have been important

organization.

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

disagree neutral

Additional Value of Professional Membership for Direct Reports

Table 56 and Chart 13 indicate that most CEOs believe that their senior managers’ careers

value from professional relationships they develop and from the outside educational

. More than sixty percent agree with each of the statements. As before, Table 57 shows

Members perceive less value for their direct reports in all three categories.

Table 56


Strongly


a. The professional relationships formed by my

through professional society

memberships have been important in their 1.7% 7.0% 29.4% 53.7

learn from

outside educational seminars is effectively 0.2% 3.6% 19.9% 66.1


through professional society

memberships have been important in our 2.1% 7.8% 28.4% 53.8

neutral agree

Chart 13

Sr Mngrs receive....

prof relationships

important in career

seminars effect in organ

prof relationships

important for org

36 | P a g e

r Direct Reports

managers’ careers and the

outside educational

h each of the statements. As before, Table 57 shows

Agree Strongly

Agree

53.7% 8.2%

66.1% 10.2%

53.8% 7.8%

seminars effect in organ

37 | P a g e

Table 57



Non-


Overall

Mean



memberships have been important in their

careers.

3.36* 3.61 3.72 3.60



transferred to our organization

3.57* 3.85 3.96 3.83



memberships have been important in our

organization.

3.34* 3.58 3.71 3.57




V Change in Money Spent on Continuing Education in the Past 5 Years

Interestingly, as shown in Table 58, in the past 5 years the amount of money spent on non-clinical continuing

education has increased at many hospitals (8% increased substantially and 30% increased somewhat).

However, over one-fourth of all hospitals decreased their expenses in this area during this time (8%

decreased substantially and 20% decreased somewhat). The change in the amount of money spent on

professional educational activities was not significantly different among the three categories of respondents.

Table 58

How has the money spent at your hospital for non-clinical

continuing education changed in the past 5 years?

% Yes

Increased substantially (25% or more increase) 8.4%

Increased somewhat (5% to 24% increase) 29.7%

Stayed constant 32.9%

Decreased somewhat (-5% to -24% decrease) 19.8%

substantially (-25% or more decrease) 7.9%

Do not know 1.2%

38 | P a g e

Table 59


How has the money spent at your hospital for non-clinical continuing education changed in the

past 5 years

Non-


Overall

Mean

a. Increased substantially (25% or more increase) 10.6% 11.1% 5.9% 8.4%

b. Increased somewhat (5% to 24% increase) 27.0% 35.8% 26.8% 29.7%

c. Stayed constant 32.6% 27.2% 36.8% 32.9%

d. Decreased somewhat (-5% to -24% decrease) 21.3% 18.5% 19.9% 19.8%

e. Decreased substantially (-25% or more decrease) 6.4% 6.2% 9.9% 7.9%

f. Do not know 2.1% 1.2% 0.7% 1.2%



VI Programs Financially Supported by Hospitals

As shown in Table 60, almost all hospitals pay for formal degree programs directly related to their work (88%)

and a high percentage pay for non-degree certification programs (73%). Fewer pay for non-degree non-

certification programs (34%) and fewer still for degree programs not related to their work (16%) and degree

programs based at their hospital (17%). Table 61 shows that CEOs who are Fellows are more likely to pay for

formal degree programs directly relating to the work role of their direct reports than are Members or

nonmembers.

Table 60

Which of the following programs does your hospital financially

support?

% Yes

Formal degree programs directly related to work role 88.1%

Formal degree programs without regard to relatedness 16.1%

Non-degree certification programs 73.1%

Non-degree non-certification programs 34.0%

Degree programs based at hospital 16.8%

Do not know 2.4%

39 | P a g e

Table 61


Which of the following programs does your hospital financially support?

Non- Overall

Member Member Fellow Mean

a. Formal degree programs directly related to work role 82.1% 85.2% 94.1%* 88.6%

b. Formal degree programs w/o regard to relatedness 16.4% 15.4% 16.2% 16.1%

c. Non-degree certification programs 69.3% 74.7% 73.9% 73.1%

d. Non-degree non-certification programs 35.7% 35.2% 32.0% 34.0%

e. Degree program based at hospital 15.0% 15.4% 18.4% 16.8%

f. Do not know 2.9% 3.7% 1.5% 2.4%



VII Drivers of Professional Development Activities

Overall, as illustrated in Table 62 and Chart 14, professional development seems to be driven by quality

concerns (87%), employee retention (83%), and the desire to encourage innovation (83%). The least

important driver was succession planning (39%). When comparing ACHE affiliation in Table 63, we find that

non-ACHE affiliates state that career development is less of a driver for professional development in their

organization than it is in organizations led by affiliates of ACHE (3.49 versus 3.84). Fellows acknowledge that

community need is less of a driver for their organizations’ professional development initiatives than

Members (3.37 versus 3.56).

Table 62

Professional development activities in my organization are driven by the need for….

(Percent of responses)

Strongly


Strongly

Agree

Career development 1.0% 6.8% 25.2% 54.0% 12.9%

Succession Planning. 4.7% 15.6% 40.4% 30.9% 8.4%

Community Needs 1.4% 11.4% 37.0% 41.1% 9.1%

Quality Concerns 1.2% 1.4% 10.1% 55.0% 32.3%

Employee Retention 0.2% 3.3% 13.4% 62.2% 20.9%

Encouraging Innovation 0.5% 2.1% 14.2% 57.5% 25.7%

Need to Reduce Costs 1.2% 6.8% 23.1% 47.5% 21.5%


Professional Development activities in my organization are driven by the need for…

a. Career Development.

b. Succession Planning.

c. Community Needs

d. Quality Concerns

e. Employee Retention

f. Encouraging Innovation

g. Reducing Costs




00.10.20.30.40.50.60.70.80.9

Professional Development is driven by

Table 63


Development activities in my organization are driven by the need for…

Member Fellow

Non-

member

Overall

Mean

3.49* 3.70 3.84 3.71

3.19 3.32 3.20 3.23

3.49 3.56 3.37* 3.45

4.17 4.24 4.11 4.16

3.93 4.08 4.00 4.00

3.98 4.11 4.07 4.06

3.68* 3.84 3.88 3.82




Chart 14

Professional Development is driven by -

disagree

neutral

agree

40 | P a g e

Development activities in my organization are driven by the need for…+

Overall

Mean

3.71

3.23

3.45

4.16

4.00

4.06

3.82

disagree

41 | P a g e

VIII Organizational Impact of Professional Development

Overall, as shown in Table 64 and Chart 15, increasing innovation (78%), attracting better employees (76%),

and lowering turnover (68%) were the most frequent outcomes associated with professional development

activities suggested by CEOs. Although over half (53%) agreed that professional development improved

profits, a sizeable proportion, 41 percent, were neutral. The comparison of CEOs in Table 65 demonstrated

that consistently, Non-Members compared to affiliates of ACHE, believe that professional development has

less impact on their organization’s operations in terms of net profits, attracting better employees, lowering

turnover, and increasing innovation.

Table 64

How does professional development impact your organization's operations?

Strongly


Strongly

Agree

Improves net profits 1.6% 4.2% 41.3% 43.2% 9.7%

Attracts better

employees 1.7% 3.5% 18.6% 57.1% 19.1%

Lowers turnover 2.1% 3.1% 26.4% 54.9% 13.5%

Increases innovation 1.2% 1.9% 17.9% 59.9% 19.0%

.



** indicates a significant difference between the two other values

Table 65


How does professional development impact your organization’s operations?+

Member Fellow

Non-

member

Overall

Mean

Improves net profits 3.42* 3.63 3.59 3.55

Attracts better employees 3.72* 3.94 3.93 3.88

Lowers turnover 3.61* 3.82 3.77 3.75

Increases innovation 3.81* 3.97 3.99 3.94

CONCLUSIONS:

The study revealed that CEOs place a great deal of importance on professional development activities such as

membership in professional societies, credentialing

They demonstrate their commitment to professional develo

professional societies, getting credentialed, and by participating in continuing educational activities

on-site and off-site seminars, meetings and conferences

the professional development of their direct reports by paying for

attend seminars and conferences. The CEOs believe that credentials

competence and knowledge. They also believ

improves staff performance but also enhances retention rates and encourage

management.

The study suggests that investment

management has grown in the last five years

positive impact of professional developmental activities in terms of lower turnover rates and indirect benefits

accrued by networking and the ability to stay abreast with new developments in health care management.

general, a majority of CEOs thought

resulted in an improved workforce. Not only d

increased innovation. Respondents were less positive about its impact on improving the profitability of their

organizations however.

0

0.1

0.2

0.30.4

0.5

0.6

0.7

0.8

improves

profit

attracts

better

employees

Professional Development Outcomes

d that CEOs place a great deal of importance on professional development activities such as

membership in professional societies, credentialing and participation in continuing educational activities.

They demonstrate their commitment to professional development activities by becoming members of

professional societies, getting credentialed, and by participating in continuing educational activities

, meetings and conferences. They demonstrate the same commitment toward

the professional development of their direct reports by paying for such activities and by allowing time off to

seminars and conferences. The CEOs believe that credentials and memberships

. They also believe that support of professional development activities not only

improves staff performance but also enhances retention rates and encourages innovative approaches in

The study suggests that investment at many U.S. hospitals in the professional development of

has grown in the last five years in terms of financial resources. Many CEOs also reported a


crued by networking and the ability to stay abreast with new developments in health care management.

thought that professional development for themselves and their direct reports

in an improved workforce. Not only did it lower turnover, but it attracted better employees and

innovation. Respondents were less positive about its impact on improving the profitability of their

attracts

better

employees

lowers

turnover

increases

innovation

Chart 15

Professional Development Outcomes

disagree

neutral

agree

42 | P a g e

d that CEOs place a great deal of importance on professional development activities such as

and participation in continuing educational activities.

by becoming members of

professional societies, getting credentialed, and by participating in continuing educational activities; including

. They demonstrate the same commitment toward

activities and by allowing time off to

and memberships signal professional

support of professional development activities not only

innovative approaches in

in the professional development of top

resources. Many CEOs also reported a


crued by networking and the ability to stay abreast with new developments in health care management. In

for themselves and their direct reports

better employees and

innovation. Respondents were less positive about its impact on improving the profitability of their

disagree

43 | P a g e

CEOs who were already credentialed or were otherwise affiliated with the American College of Healthcare

Executives placed greater value on supporting and engaging in professional development activities than their

counterparts without such credentials.

Our research offers a glimpse at the value and use of professional development in U.S. hospitals. We hope

that this information will encourage further analyses to determine new questions that can be raised by our

study, including the causality of coaching, mentoring, and professional affiliation and their relationship to

organizational outcomes, such as profitability and employee turnover. We hope that this research helps

inform healthcare executives and assists them to improve their organizations and employees.

44 | P a g e

BIBLIOGRAPHY

ACHE. Healthcare Executive. Chicago: Jul/Aug 2005. Vol. 20, Iss. 4; pg. 64, 2 pgs

Allen, S., N. Hartman, “Leadership Development: An Exploration of Sources of Learning”. S.A.M. Advanced

Management Journal. Cincinnati: Winter 2008. Vol. 73, Iss. 1; pg. 10, 12 pgs

Alter, A., “Leadership development: What works?” Computerworld. Framingham: Mar 22, 1999. Vol. 33, Iss.

12; pg. 54, 2 pgs

Dixon, D. and P. Bilbrey, “Developing Leaders Daily”. Executive Excellence. Provo: Jun 2004. Vol. 21, Iss. 6; pg.

18, 1 pgs

Dolan, T. “Mentoring at Every Level”, Healthcare Executive. Chicago: Sep/Oct 2004. Vol. 19, Iss. 5; pg. 6, 2 pgs

Hatcher, L. 1994, “A Step by Step Approach to Using SAS for Factor Analysis and Structural Equation

Modeling”, SAS Institute, Gary, NC.

Hollis, R., “Leader-as-Teacher: A Model for Executive Development Success”, Organization Development

Journal. Chesterland: Summer 2007. Vol. 25, Iss. 2; pg. P85, 5 pgs

Koester, J., J. Nunley, E. Higgins, C. Laarkamp, J. Baker, “A nursing career leadership program”. Nursing

Management. Chicago: Sep 1995. Vol. 26, Iss. 9; pg. 84, 4 pgs

McAlearney, A., “Exploring mentoring and leadership development in healthcare organizations: Experience

and opportunities”, Career Development International. Bradford: 2005. Vol. 10, Iss. 6/7; pg. 493, 20 pgs.

Meyers, S. “Growing Leaders in Your Own Backyard”. Trustee. Chicago: Jun 2007. Vol. 60, Iss. 6; pg. 8, 4 pgs

Peterson, R., “Skill-building resources for medical staff”, Healthcare Executive. Chicago: May/Jun 2002. Vol.

17, Iss. 3; pg. 80, 2 pgs

Penuel, W., B. Fishman, R. Yamaguchi, L. Gallagher, “What Makes Professional Development Effective?

Strategies That Foster Curriculum Implementation”, American Educational Research Journal. Washington:

Dec 2007. Vol. 44, Iss. 4; pg. 921, 38 pgs

Reese, A. “Tools for Professional Excellence”. Supply & Demand Chain Executive. Fort Atkinson: Aug/Sep

2006. Vol. 7, Iss. 5; pg. 28, 4 pgs

Rice, J., G. Clark, “C-Suite Talent Development”. Healthcare Executive. Chicago: Nov/Dec 2005. Vol. 20, Iss. 6;

pg. 46, 2 pgs

Romano, M., “Masters of the universe”. Modern Healthcare. Chicago: Jan 19, 2004. Vol. 34, Iss. 3; pg. 6

45 | P a g e

Schoenhard, W. “Investing in the next generation”, Modern Healthcare. Chicago: Mar 27, 2006. Vol. 36, Iss.

13; pg. 49, 1 pgs

Scott, G., “Coach, challenge, lead: Developing an indispensable management team”. Healthcare Executive.

Chicago: Nov/Dec 2002. Vol. 17, Iss. 6; pg. 16, 5 pgs

Sherer, Jill L. “Retooling leaders” Hospitals & Health Networks, 1994, 68(1): 42-45

46 | P a g e

Appendix 1

ACHE Professional Development Survey

Distributed December 2008 and January 2009

Are you the hospital CEO? Yes ___ No ___

If no, please forward this survey to the CEO.

1. Please indicate if you have any of the following educational degrees. (Check all that apply.)

Bachelor’s degree in healthcare management

Master’s degree in healthcare management

Doctorate degree in healthcare management

Other________________________ (please provide degree & major)

2. How many managers/executives report directly to you? ENTER NUMBER ______

NOTE: We will refer to the managers/executives who report directly to you as

senior management (Sr. Mgt.) in this survey.

3. Which functional areas do your reports supervise?

Operations Finance

Medical Staff Information systems

Nursing Other specify:

Corporate Services ____________________________

____________________________

47 | P a g e

Professional Society Membership

4. Please rate the importance of professional society membership for you and your direct reports (Sr. Mgt)

when compared to 2003? (Please circle one number in each row)

Much less About Much more

important the same important

Membership in professional society CEO 1 2 3 4 5

today compared with 2003 Sr. Mgt 1 2 3 4 5

5. In your view, how important is professional society membership for you, the CEO, and for your direct

reports (Sr. Mgt) in each of the following functions? (Please circle a number in each row)

Very

unimportant

Very

important

a. To ensure executive adherence CEO 1 2 3 4 5

to ethical standards Sr. Mgt 1 2 3 4 5


who can be called upon CEO 1 2 3 4 5

for advice Sr. Mgt 1 2 3 4 5

d. To assist in career CEO 1 2 3 4 5

development Sr. Mgt 1 2 3 4 5

6. In which ways do you encourage your direct management reports (Sr. Mgt.) to participate in

professional societies? (Please check all that apply)

a. Pay their annual dues

b. Pay for educational program expenses

c. Time off to participate in professional activities

d. A bonus when certification is achieved

e. Include in annual evaluation criteria

48 | P a g e

f. Other_______________

Continuing Education

7. In your view, how important is continuing education for you and for your direct reports (Sr. Mgt)?

(Please circle one number in each row)

Very

unimportant

Very

important

a. To stay current with political CEO 1 2 3 4 5

changes Sr. Mgt 1 2 3 4 5

b. To learn techniques to solve CEO 1 2 3 4 5

immediate problems Sr. Mgt 1 2 3 4 5

c. To learn about new CEO 1 2 3 4 5

technology Sr. Mgt 1 2 3 4 5

d. To understand changes in CEO 1 2 3 4 5

healthcare delivery Sr. Mgt 1 2 3 4 5

e. To assist in career CEO 1 2 3 4 5


f. To contribute to CEO 1 2 3 4 5

succession planning Sr. Mgt 1 2 3 4 5

8. Please rate the importance of continuing education for you and your direct reports (Sr. Mgt) when

compared to 2003? (Please circle a number in each row)

Much less About Much more

important the same important

Continuing education today CEO 1 2 3 4 5

compared with 2003 Sr. Mgt 1 2 3 4 5

49 | P a g e

9. What is your preference for the various modes of continuing education?

Not

Preferred Neutral Preferred


healthcare facility 1 2 3 4 5

b. Offsite face to face seminars 1 2 3 4 5

c. CDs or DVDs 1 2 3 4 5

d. Webinars 1 2 3 4 5

e. Large conferences with

90 to 180 minute presentations 1 2 3 4 5

f. Self study manuals 1 2 3 4 5

g. Books/journal discussion groups 1 2 3 4 5

h. Online seminars for several weeks 1 2 3 4 5

i. Other 1 2 3 4 5

10. Compared to 2003, how has your use of the following modes of continuing education changed?

Increased

a lot

About

the

same

Decreased

a lot


healthcare facility 1 2 3 4 5

b. Offsite face to face seminars 1 2 3 4 5

c. CDs or DVDs 1 2 3 4 5

d. Webinars 1 2 3 4 5

e. Large conferences with 1 2 3 4 5

50 | P a g e

90 to 180 minute presentations

f. Self study manuals 1 2 3 4 5

g. Books/journal discussion groups 1 2 3 4 5

h. Online seminars for several weeks 1 2 3 4 5

i. Other (if listed in # 9.i.) 1 2 3 4 5

11. Defining continuing education as activities listed from “a” to “i” in the previous question, over the past

12 months, approximately how many hours have you participated in continuing education?

ENTER AN ESTIMATED NUMBER OF HOURS ___________

12. Defining continuing education as activities listed from “a” to “i” in the previous question, over the past

12 months on average how involved have your direct reports (Sr. Mgt.) been in continuing education?

Very little Moderate Highly

Do not

know

involvement involvement involved

Sr. Mgt involvement with

continuing education 0 1 2 3 4 5

Credentialing

13. In your view, how important is obtaining a credential in healthcare management for the CEO and for your

direct reports (Sr. Mgt)? (Please circle one number in each row)

Very

unimportant

Very

important

a. To signal the executive is CEO 1 2 3 4 5

competent in managerial skills Sr. Mgt 1 2 3 4 5

51 | P a g e

b. To provide evidence that the

executive has requisite knowledge CEO 1 2 3 4 5

of healthcare delivery issues Sr. Mgt 1 2 3 4 5

c. To assist in career CEO 1 2 3 4 5


d. To contribute to CEO 1 2 3 4 5


14. Please rate the importance of healthcare management credentials for you and your direct reports (Sr.

Mgt) when compared to 2003?

Much less About

the

Much

more

important same important

Obtaining a healthcare management CEO 1 2 3 4 5

credential today compared to 2003 Sr. Mgt 1 2 3 4 5

Coaching

15. In your view, how important is obtaining managerial coaching for you and for your direct reports (Sr.

Mgt)? (Please circle one number in each row)

Very

unimportant

Very

important

a. To improve staff performance CEO 1 2 3 4 5

Sr. Mgt 1 2 3 4 5

b. To improve retention of high CEO 1 2 3 4 5

performing staff Sr. Mgt 1 2 3 4 5

52 | P a g e

c. To assist in career CEO 1 2 3 4 5


d. To contribute to CEO 1 2 3 4 5


16. Please rate the importance of coaching for you and your senior management team when compared to

2003? (Please circle one number in each row)

Much less About the Much more

important same important

Being coached today compared CEO 1 2 3 4 5

to 2003 Sr. Mgt 1 2 3 4 5

Impact of Professional Society Membership

17. How much would you agree with the following statements?

Strongly

Disagree Neutral Agree

Strongly

agree disagree

a. Membership in professional societies

costs too much for the value I receive. 1 2 3 4 5

b. There is little value for me to achieve

certification in healthcare management. 1 2 3 4 5


professional societies provide little value to

my organization. 1 2 3 4 5

53 | P a g e

d. Educational programs sponsored by


me. 1 2 3 4 5

If you circled 4 or 5 in response to Q. 17 above, please tell us why you hold these views.

___________________________________________________________________________

___________________________________________________________________________

18. Again, indicate your views of the following statements:

Strongly


Strongly

agree disagree

a. The professional relationships I have


memberships have been important in my

career 1 2 3 4 5

b. I apply information I learn from

outside educational seminars effectively

to use in my organization 1 2 3 4 5

c. The professional relationships I have


memberships have been important for

my organization 1 2 3 4 5

If you circled 1, 2, 3 in response to the Q. 18 above, please tell us why you hold these views.

___________________________________________________________________________

___________________________________________________________________________

19. How much would you agree with the following statements?

Strongly Disagree Neutral Agree Strongly

54 | P a g e

disagree agree

a. Membership in professional societies are

too expensive to benefit my senior

management. 1 2 3 4 5

b. There is little value for my senior

management in achieving certification in

healthcare management. 1 2 3 4 5



my organization. 1 2 3 4 5

If you circled 4 or 5 in response to Q. 19 above, please tell us why you hold these views.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

20. Again, indicate your views of the following statements:

Strongly


Strongly

agree disagree



memberships have been important in their

careers. 1 2 3 4 5



transferred to our organization 1 2 3 4 5

55 | P a g e



memberships have been important in our

organization. 1 2 3 4 5

If you circled 1, 2, 3 in response to Q. 20, please tell us why you hold these views.

___________________________________________________________________________

___________________________________________________________________________

21. How has the money spent at your hospital for non-clinical continuing education changed in the past 3 years?

(please check one of the following)

a. Increased substantially (25% or more increase)

b. Increased somewhat (5% to 24% increase)

c. Stayed constant

d. Decreased somewhat (-5% to -24% decrease)

e. Decreased substantially (-25% or more decrease)

f. Do Not Know

22. Which of the following programs does your hospital financially support? (please check all appropriate)

a. Formal degree programs directly related to work role

b. Formal degree programs without regard to relatedness to work role

c. Non-degree certification programs

d. Non-degree non-certification programs

e. Degree program based at hospital

f. Do Not Know

56 | P a g e

23. Professional development activities in my organization are driven by the need for

Strongly

Neutral

Strongly

agree disagree

a. Career Development. 1 2 3 4 5

b. Succession Planning. 1 2 3 4 5

c. Community Needs 1 2 3 4 5

d. Quality Concerns 1 2 3 4 5

e. Employee Retention 1 2 3 4 5

f. Encouraging Innovation

g. Reducing costs 1 2 3 4 5

24. In your opinion, how does professional development impact your organization’s operations?

Strongly

Neutral

Strongly

agree disagree

Improves net profits 1 2 3 4 5

Attracts better employees 1 2 3 4 5

Lowers turnover 1 2 3 4 5

Increases innovation 1 2 3 4 5

Other __________ 1 2 3 4 5

About you

25. How many years have you worked as a hospital CEO? _______ years

26. How many years have you worked at your current hospital?

57 | P a g e

a. In your current role? ___________ years

b. In total at your hospital _________ years

27. Your age? ________ years

28. Your sex a. Male b. Female

29. What would you say is your primary professional membership society? (Check one only)

American Academy of Medical Administrators

American College of Healthcare Executives

American College of Physician Executives

Healthcare Financial Management Association

American Organization of Nurse Executives

Other (please specify) _______________________________________

_________________________________________________________

None

30. Are you a Fellow in American College of Healthcare Executives? YES No

If you would like a copy of the results please provide us your email

______________________________________

Thank you for your assistance!

58 | P a g e

Appendix 2: Non-Response Analysis

The following non-response analysis examines possible response bias using a Chi-Square procedure.

Factors that were considered include the geographic region of the hospital, the type of organizational

control/ownership, the bed size of the hospital, and whether the hospital CEO was an affiliate of

ACHE. The first three variables were obtained from the 2007 American Hospital Association data

base.

GEOGRAPHIC REGION

Region

No

Response Responded

Total

Number

% No

Response

%

Respondents

Not Given 16 11 27 59.3% 40.7%

New England 53 20 73 72.6% 27.4%

Mid Atlantic 120 51 171 70.2% 29.8%

South Atlantic 210 72 282 74.5% 25.5%

East North

Central 207 87 294 70.4% 29.6%

East South

Central 128 48 176 72.7% 27.3%

West North

Central 186 113 299 62.2% 37.8%

West South

Central 203 78 281 72.2% 27.8%

Moutain 113 44 157 72.0% 28.0%

Pacific 185 56 241 76.8% 23.2%

Total 1421 580 2001 71.0% 29.0%

Response Bias Test by

Geographic Region

Statistic DF Value Prob

Chi-Square 9 19.3107 0.0227

Likelihood Ratio Chi-Square 9 18.8553 0.0265

Mantel-Haenszel Chi-Square 1 0.6279 0.4281

Phi Coefficient 0.0982

Contingency Coefficient 0.0978

Cramer's V 0.0982

Effective Sample Size = 2001

Frequency Missing = 3

59 | P a g e

CONTROL/OWNERSHIP

No

Response Responded

Total

Sample

Population

% No

Response

%

Respondents

Governmental Non-Federal State 27 13 40 67.5% 32.5%

Governmental Non-Federal County 110 69 179 61.5% 38.5%

Governmental Non-Federal City 29 17 46 63.0% 37.0%

Governmental Non-Federal City/County 9 4 13 69.2% 30.8%

Governmental Non-Federal Hospital

District 174 68 242 71.9% 28.1%

Non-Governmental NFP Church 147 59 206 71.4% 28.6%

Non-Governmental Other NFP 669 278 947 70.6% 29.4%

Investor Owned 63 17 80 78.8% 21.3%

Investor Owned Corporation 193 55 248 77.8% 22.2%

Total 1421 580 2001 71.0% 29.0%


Control/Ownership


Chi-Square 9 17.7124 0.0387





Cramer's V 0.0941

Effective Sample Size = 2001

Frequency Missing = 3

60 | P a g e

BED SIZE

Bed Size

No

Response Responded

Total

Sample

Population

% No

Response

%

Respondents

<100 680 293 973 69.9% 30.1%

100 to

249 395 168 563 70.2% 29.8%

250 to

499 259 84 343 75.5% 24.5%

>500 87 38 125 69.6% 30.4%

Total 1421 583 2004 70.9% 29.1%


Hospital Bed Size


Chi-Square 3 4.2699 0.2338





Cramer's V 0.0462

Sample Size = 2004

61 | P a g e

ACHE AFFILIATION

ACHE

Affiliation

No

Response Responded

Total

Sample

Population

% No

Response

%

Respondents

No 867 195 1062 81.6% 18.4%

Yes 554 385 939 59.0% 41.0%

Total 1421 580 2001 71.0% 29.0%


ACHE Affiliation


Chi-Square 1 124.0932 <.0001

Likelihood Ratio Chi-Square 1 125.3521 <.0001

Continuity Adj. Chi-Square 1 122.9958 <.0001

Mantel-Haenszel Chi-Square 1 124.0312 <.0001



Cramer's V 0.2490

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