Microsoft Word - 17Review Romanian Neurosurgery (2011) XVIII 1: 103 – 104 103 The management of the hospital unit A.V. Ciurea, V.G. Ciubotaru, E. Avram (2010, Editura Universitară, Bucharest, 310 p.) Healthcare is a priority in all civilised countries. The right to healthcare is guaranteed by constitution and the gross domestic product allocated to this domanin is greatly variable from country to country. In France, for example, healthcare recieves an astonishing 11% of the GDP, having insured in this way it’s efficiency as many analysts consider it to be the best healthcare system in the world. Fund allocation has to be strenghtened by a good management. Monitoring, distribution of the expenses and their control as well as setting proper running parameters are tasks carried out at ministry level. Finances and management insure efficiency in all the branches of the healthcare system with an special interest in preventive medicine, primary, secondary and tertiary medicine, research institutes, the approach on major health issues such as rare pathologies, dangerous diseases, strokes, trauma, vascular diseases and so on. For the proper functioning of the system it is necessary that financing and hospital managment are correctly callibrated. At hospital level a great emphasis is placed on managerial training. A tight cooperation with local healthcare authorities such as health departments is required. Furthermore, a great importance is granted to the activity control mechanisms that are converted into parrameters for a better quantification : the bed usage index, the mixed case index, the adresability, the utilities usage index, the complications occurence percentage, nosocomial infections occurence percentage etc. The hospital unit is a important phalanx in preserving the health of the population. It’s the place where curative treatment is underwent. The leaders of the hospital unit must have a proper medical training, adequate managerial knowledge as well as administrative capabilities. Many clinincs bind together appropriate medical education with a superior level medical practice. The modern healthcare systems add in advanced investigative technologies and minimally invasive instruments and techniques offering young doctors solid 104 A.V. Ciurea et al The management of the hospital unit grounds for personal development. The management of the hospital unit is in full consolidation due to the current european demands transfigured by the Ministry of Health as demanded criteria published in special medical literature. Furthermore, healthcare leading personnel are supplied with a variety of training courses in management that aim amongst others in developing teamwork, leadership, quality management, project management, administration etc. The work “The management of the hospital unit” is the latest appearance in what regards institutional organization. Edited under the supervision of A.V. Ciurea MD, PhD, MSc, and colaborators. The editors believe that focusing towards hospital units has the best results in what regards healthcare management in the actual context. A proactive management is imperative. Each decisional factor (unit leaders) should develop his own hospital unit and solve local conflicts without waiting support from outranking authorities. The editors consider that „we must relaunch ourselves, in this historical crisis moment, a time when society blames us and invites us to go serve other healthcare systems [...] We have to refreshen ourselves, take care of our patients and lead those who we outrank on the right path – fulfilling our duty and our destiny” This work contains contributions from several doctors, psychologists and sociologists already appreciated in practice and fields such as medical and managerial literature. Contributions worthy of mentioning are those of Prof. Cary L. Cooper, Prof. Ivan Robertson and Prof. Gordon Tinline from the Lancaster University in The United Kingdom. Each chapter analizes a series of actual realities and suggests a broad spectrum of internal remedies at unit level. The first part chapters approach the organizing and the proper running of the hospital unit or department: the hospital unit management in the context of actual challenges in the Romanian healthcare system, management through objectives in the neurosurgical clinic, running the clinic unit, from stress to welfare in the health system, health risks and security risks at work. The second part approaches the human resources management, the updating of personnel training programs, satisfaction at work, personnel policies principles in hospital units, the flexibility and relocation of the medical personnel. The third part underlines aspects of the relationship between healthcare personnel and the patient, including the patient’s familly as well: the theory of trust in the doctor- patient relationship, the trust in medical assistance, medical personnel and the terminally-ill patient, the terapeutical relationship with the elder patient, psychological aspects of cancer in adults. This work’s main goal is internal mobilization and challenging all doctors to propoze local managerial solutions. In a deliberate way, the authors don’t approach issues connected to managment of services. They concentrate only on organizational issues. This work’s purpose is to deffinitivate the editorial efforts done by Proffesor A.V. Ciurea and his collaborators during years past, and acts as a liaison from system and organizational management to departmental management. Al. Constantinovici MD, PhD Member of the Romanian Academy of Medical Sciences