Management by missions in the healthcare sector | Revista de Calidad Asistencial

array:23 ["pii" => "S1134282X16300203" "issn" => "1134282X" "doi" => "10.1016/j.cali.2016.03.003" "estado" => "S300" "fechaPublicacion" => "2016-07-01" "aid" => "542" "copyright" => "SECA" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Calidad Asistencial. 2016;31:239-42" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 957 "formatos" => array:3 [ "EPUB" => 43 "HTML" => 575 "PDF" => 339 ] ] "itemSiguiente" => array:18 [ "pii" => "S1134282X15001505" "issn" => "1134282X" "doi" => "10.1016/j.cali.2015.10.001" "estado" => "S300" "fechaPublicacion" => "2016-07-01" "aid" => "510" "copyright" => "SECA" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Rev Calidad Asistencial. 2016;31:243-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 836 "formatos" => array:3 [ "EPUB" => 33 "HTML" => 519 "PDF" => 284 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "Carta al Director" "titulo" => "Estudio de las variables clínicas de predicción de la neumonía nosocomial por Staphylococcus aureus resistente a meticilina" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "243" "paginaFinal" => "244" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Study of clinical variables predictive of nosocomial pneumonia by methicillin-resistant Staphylococcus aureus" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "T. García-Lozano, F.J. Pascual-Plá, S. Martín-Utrilla, A. Egido-González" "autores" => array:4 [ 0 => array:2 [ "nombre" => "T." "apellidos" => "García-Lozano" ] 1 => array:2 [ "nombre" => "F.J." "apellidos" => "Pascual-Plá" ] 2 => array:2 [ "nombre" => "S." "apellidos" => "Martín-Utrilla" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Egido-González" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1134282X15001505?idApp=UINPBA00004N" "url" => "/1134282X/0000003100000004/v2_201704050057/S1134282X15001505/v2_201704050057/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1134282X15001682" "issn" => "1134282X" "doi" => "10.1016/j.cali.2015.10.004" "estado" => "S300" "fechaPublicacion" => "2016-07-01" "aid" => "513" "copyright" => "SECA" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Rev Calidad Asistencial. 2016;31:234-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 984 "formatos" => array:3 [ "EPUB" => 39 "HTML" => 646 "PDF" => 299 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original breve" "titulo" => "Efectividad de un programa de instilación de quimioterapia precoz en pacientes con cáncer de vejiga" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "234" "paginaFinal" => "238" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Effectiveness of a program of early instillation single chemotherapy in patients with bladder cancer" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1053 "Ancho" => 1374 "Tamanyo" => 64135 ] ] "descripcion" => array:1 [ "es" => "Incidencia de hematuria postoperatoria en el grupo con y sin tratamiento con quimioterapia postoperatoria (QTp). Se observan diferencias estadísticamente significativas para la hematuria grado 3 y 4 (p<0,05); sin diferencias estadísticas en la hematuria grado 2 (p>0,05)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "P. Beardo Villar, A.B. Pérez Pérez, M.J. Castro Dorantes, S.J. Jiménez Delgado, P. Alamillos Ortega, R. Gavira Moreno" "autores" => array:6 [ 0 => array:2 [ "nombre" => "P." "apellidos" => "Beardo Villar" ] 1 => array:2 [ "nombre" => "A.B." "apellidos" => "Pérez Pérez" ] 2 => array:2 [ "nombre" => "M.J." "apellidos" => "Castro Dorantes" ] 3 => array:2 [ "nombre" => "S.J." "apellidos" => "Jiménez Delgado" ] 4 => array:2 [ "nombre" => "P." "apellidos" => "Alamillos Ortega" ] 5 => array:2 [ "nombre" => "R." "apellidos" => "Gavira Moreno" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1134282X15001682?idApp=UINPBA00004N" "url" => "/1134282X/0000003100000004/v2_201704050057/S1134282X15001682/v2_201704050057/es/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "Special article" "titulo" => "Management by missions in the healthcare sector" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "239" "paginaFinal" => "242" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Fonseca Pires, C. Rey, M. Más-Machuca, M. Bastons" "autores" => array:4 [ 0 => array:3 [ "nombre" => "J." "apellidos" => "Fonseca Pires" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "C." "apellidos" => "Rey" "email" => array:1 [ 0 => "c.rey@dpmc.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "Más-Machuca" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "M." "apellidos" => "Bastons" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "AESE Business School, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Universitat Internacional de Catalunya, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La dirección por misiones en el sector sanitario" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 588 "Ancho" => 1650 "Tamanyo" => 45966 ] ] "descripcion" => array:1 [ "en" => "Shared missions: deployment of the corporate mission." ] ] ] "textoCompleto" => "IntroductionAs in other industries, the mission of a hospital is its reason for being; it defines its role and associated responsibilities in the community, namely, the service it should provide to society.<a class="elsevierStyleCrossRef" href="#bib0160">1</a>On the other hand, when seen alongside companies of the same size in other industries, the complexity and scope of the mission of hospitals are comparatively greater. The purpose of a hospital comprises and underscores variables such as clinical care, community service, health promotion, training and research (for and by doctors, nurses, pharmacists and other participants in the sector), financial results and, in some cases, religious factors, etc.<a class="elsevierStyleCrossRef" href="#bib0165">2</a>Taking into account the scope and importance of the studies on mission in leadership and the management of organizations in general, it is clear that the hospital industry lags far behind other sectors with respect to the design, development and use of the mission statement,<a class="elsevierStyleCrossRef" href="#bib0170">3</a> and there is a surprisingly meager amount of research that has applied it to the healthcare sector as a whole and to the mission statement in hospitals in particular.Desirability of health institutions having a missionCrafting a mission statement with the proper direction is one of the most critical strategic tools for a healthcare organization to succeed,<a class="elsevierStyleCrossRef" href="#bib0175">4</a> as it is an important management tool in healthcare sector organizations<a class="elsevierStyleCrossRef" href="#bib0180">5</a> and guarantees the foundations for the future success of a hospital. On one hand because it sets out organizational guidelines<a class="elsevierStyleCrossRef" href="#bib0185">6</a> and on the other, because it can be one of the most powerful methods for assessing the success of the hospital.<a class="elsevierStyleCrossRef" href="#bib0190">7</a>In addition, it is crucial for both executives and employees in the healthcare sector that there should be a robust mission statement that they can turn to in times of uncertainty, and this because the healthcare sector is the target of a rapidly changing situation (financing, legislation, technology, etc.) which may lead the members of healthcare organizations to lose sight of the institution's reason for being. Besides, given the scope and complexity of the interprofessional relations established among doctors, nurses, managers and other healthcare professionals, employees need to have the support of the organization as a whole, to know they are supported and included in the joint efforts involved in fulfilling the mission.<a class="elsevierStyleCrossRef" href="#bib0195">8</a>This is also upheld by Bart,<a class="elsevierStyleCrossRef" href="#bib0200">9</a> who sustains that given the progressive complexity and dynamics of change in the healthcare sector, the mission statement has gained increasing importance in modern healthcare organizations because<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">(a)it helps identify and focus on its critical core capabilities in order to better cope in times of change;</li><li class="elsevierStyleListItem" id="lsti0010">(b)it addresses the allocation of scarce resources, simultaneously promoting operational effectiveness and efficiency, especially important during periods of budget constraints;</li><li class="elsevierStyleListItem" id="lsti0015">(c)it helps react when faced with new strategies, turning the organization's focus back to its intended purpose;</li><li class="elsevierStyleListItem" id="lsti0020">(d)it can compensate the breakdown in employee morale, creating an inspiring, motivating movement around the high aspirations of the organization.<a class="elsevierStyleCrossRef" href="#bib0175">4</a></li></ul>In another study made of the healthcare sector<a class="elsevierStyleCrossRef" href="#bib0205">10</a> the reasons put forward to justify the mission statement were summarized as follows: focus resource allocation; motivate and inspire employees to reach a common purpose or aim; balance competing interests among the different stakeholders; ensure the alignment of the organization during a crisis; create standards of behavior; provide direction and common goals; define the challenge for the company's activities; maintain control over the organization; develop a common culture and values.The mission in hospitals and cooperation among professionalsA well-known phenomenon that is widely recognized in the literature is that professionals in the healthcare sector – doctors, nurses, managers and others, form different groups with specific activities, organizational arrangements and ways of relating with each other.<a class="elsevierStyleCrossRef" href="#bib0210">11</a>The healthcare sector is therefore multidisciplinary, insofar as it contains several professional groups. The dynamics of interprofessional interaction by far exceeds this complexity: the organizational subcultures that coexist in the healthcare sector – doctors, nurses, managers and others, are heterogeneous, have multiple levels of identity and arrange themselves in various professional communities.<a class="elsevierStyleCrossRef" href="#bib0215">12</a> The way these professionals experience the sector and their responsibilities often leads them to confinement in self-contained professional silos,<a class="elsevierStyleCrossRefs" href="#bib0220">13,14</a> which reveals certain growing complications.In an organization as complex as a hospital, a collaborative stance with views to fulfilling the mission may help overcome organizational obstacles. In a hospital setting, collaboration presupposes a shared mission.<a class="elsevierStyleCrossRef" href="#bib0230">15</a> Having a common culture is beneficial to professionals in that it leads them to identify with the institution and its operating model, share with others and remain motivated with altruistic aspects that benefit patients.<a class="elsevierStyleCrossRef" href="#bib0235">16</a>So, the success factors for this collaboration may include clearly defining the mission, having a robust implementation strategy<a class="elsevierStyleCrossRef" href="#bib0240">17</a> and striving for consistency between what is expressed in the mission and the day-to-day reality of the institution<a class="elsevierStyleCrossRef" href="#bib0245">18</a> what it's called “managing by missions”.Coordinating and integrating missionsIf we could speak of an “implicit” connection between the corporate mission and the personal mission, many would argue that the healthcare institutions have been managing by missions for a long time. And they would have a point. Chances are, as a philosophy of action, management by missions has been in the mindset of directors and collaborators in many healthcare organizations. But speaking of “implicit” management by missions can lead to confusion rather than understanding of what we are discussing here, since we are talking about something more than a philosophy of action of “some managers” or a cultural phenomenon (in which missions are transmitted tacitly through socialization processes).Management by missions is a systemic transformation of management, where missions are defined and, more importantly, explicitly evaluated by all members of an organization. Although management by missions starts when a company, a team or an individual defines a mission, it is not executed until the company, team or individual conducts continuous and periodic monitoring of the degree of fulfillment of these missions.<a class="elsevierStyleCrossRefs" href="#bib0250">19–21</a>As management by missions becomes standard practice in business organizations, several forms of developing the connection between the institutional mission and the role mission of their members have emerged in the literature. Some of these are, for example, the “nested missions”,<a class="elsevierStyleCrossRef" href="#bib0265">22</a> “shared missions”,<a class="elsevierStyleCrossRef" href="#bib0255">20</a> the “matrix of interdependencies”,<a class="elsevierStyleCrossRef" href="#bib0245">18</a> the “leadership philosophy”,<a class="elsevierStyleCrossRef" href="#bib0250">19</a> the “letter of understanding”,<a class="elsevierStyleCrossRef" href="#bib0270">23</a> or the “mission impact plan”.<a class="elsevierStyleCrossRef" href="#bib0275">24</a> These solutions seek vertical coordination of the missions (by deploying the corporate mission in cascade throughout the divisions, departments and people) and horizontal coordination (by establishing negotiation and support processes among people who have interconnected missions). In turn, they propose the integration of missions in management systems (objectives, processes, competencies, compensation, etc.).Applying these ideas in the healthcare sector involves tackling a fundamental issue which is not always well resolved, namely, clarifying the shared mission of the 3 main groups in the healthcare sector: doctors, nurses and managers/administrators.<a class="elsevierStyleCrossRef" href="#bib0210">11</a> This should result in a vertical as well as horizontal coordination of the missions. The aim of vertical coordination is that everyone knows how they contribute to the organization's mission from their own job. As suggested by some authors,<a class="elsevierStyleCrossRefs" href="#bib0245">18,21</a> this would be achieved through a knock-on effect of the institution's mission, beginning with each of the 3 groups, continuing down to the level of each collaborator.In turn, horizontal coordination of the missions should seek to clarify the relations of mutual interdependence that exist among the 3 groups since, while it is important that each group understands its role mission, it is also fundamental that each group understands the mission of the other roles. In this way, doctors should fully understand the role of nurses as well as of managers (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). And the same can be said about nurses and managers; ensuring that each collaborator understands the mission of the institution, their own, and that of the other groups with which they interact.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>According to Cardona and Rey,<a class="elsevierStyleCrossRef" href="#bib0245">18</a> mission integration should follow 3 fundamental criteria:Criterion of inclusionInclusion means that each shared mission must contribute to the accomplishment of the next higher-level mission and, ultimately, the corporate mission. In the healthcare sector, this would entail asking each of the 3 groups the following question: How does my area (doctors, nurses or managers) help to achieve the institutional mission?For example, if we want to derive a definition of the shared missions directly from the Hospital mission and the Hospital mission is oriented toward patient satisfaction, employee development and quality of care, then each area will have to ask itself: How does our area contribute to patient satisfaction? How does it contribute to employee development? How does it contribute to providing high-quality care?Criterion of complementarinessComplementariness ensures that there is a horizontal or logic process among the various shared missions. It is important to ensure that the shared missions adopted by the different areas or functions do not collide with one another. On the contrary, the shared missions at any given level should be complementary in every respect. Taking patient satisfaction as an example common to most hospitals’ missions,<a class="elsevierStyleCrossRefs" href="#bib0160">1,3,9,25–28</a> management must ensure that each area defines its contribution to patient satisfaction in a way that is complementary and no against to the way other areas define theirs. The same applies to other mission contributions, such as the contribution to employee development and quality of care.Criterion of coherenceCoherence contemplates that all missions have common content that guarantees unity among them; in other words, that the issues of shared responsibility in the institutional mission are accurately reflected in all the next higher missions. For example, if quality of care provided to patients is included in the institutional mission, this does not only apply to doctors and nurses, but must also be included in the administrators’ missions (for example, ensuring that reports are delivered in a timely and complete fashion). Likewise, if the hospital's financial survival is included in the mission, this concern should not only be contemplated in the managers’ mission, but in the doctors’ and nurses’ missions as well. In fact, we believe that a good criterion of coherence for missions in the healthcare sector is that they all include at least 3 focal points: patient satisfaction, employee development and the sustainability of the institution.ConclusionThrough management by missions, healthcare organizations have the opportunity to attain a greater level of identification among their members and better coordination of groups. This new form of management will offer healthcare institutions a huge potential for motivation and performance, we think of equal magnitude as the transformation that meant moving from management by tasks to management by objectives. This becomes especially evident in the matter of coordination, where the missions and other elements of an organization (structures, processes and systems) form a whole that cannot be coordinated properly if it is not considered as such.<a class="elsevierStyleCrossRefs" href="#bib0245">18,29,30</a> Thus, further research on organizational theory based on missions is required; one that contemplates individuals from a transcendent perspective, capable of acting for reasons other than the mere satisfaction of their own needs, and considers something that is especially relevant in the healthcare sector: above all other things, the first motivation of human beings is to find a mission in their daily activities.<a class="elsevierStyleCrossRef" href="#bib0310">31</a>Conflict of interestThe authors declare that there is no conflict of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres824632" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec821109" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres824633" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec821110" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Desirability of health institutions having a mission" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "The mission in hospitals and cooperation among professionals" ] 7 => array:3 [ "identificador" => "sec0020" "titulo" => "Coordinating and integrating missions" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "Criterion of inclusion" ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Criterion of complementariness" ] 2 => array:2 [ "identificador" => "sec0035" "titulo" => "Criterion of coherence" ] ] ] 8 => array:2 [ "identificador" => "sec0040" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflict of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-03-03" "fechaAceptado" => "2016-03-07" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec821109" "palabras" => array:6 [ 0 => "Healthcare" 1 => "Mission" 2 => "Management" 3 => "Interdependence" 4 => "Coordination" 5 => "Integration" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec821110" "palabras" => array:6 [ 0 => "Sanidad" 1 => "Misión" 2 => "Gestión" 3 => "Interdependencia" 4 => "Coordinación" 5 => "Integración" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "This article discusses the importance of the mission statement in the healthcare sector. It's also argued that only formal declaration of the mission it's insufficient to the appropriate professional coordination of doctors, nurses and managers. It's proposed a systematic approach to facilitate the introduction of the mission within the systems of the organization, what is called “Management by missions.” It promotes horizontal and vertical integration between doctors, nurses and managers. Criteria that ensure this integration are specified." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "En este artículo se aborda la importancia de la declaración de la misión en instituciones del sector sanitario; también se constata la insuficiencia de esta declaración formal para la adecuada coordinación profesional de médicos, enfermeros y gestores. Se propone un abordaje sistemático que facilite la introducción de la misión en los sistemas de la organización, lo que se denomina “Dirección por misiones”. Se explicita como esto promueve la integración horizontal y vertical entre médicos, enfermeros y gestores. Se especifican los criterios que garantizan esa integración." ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 588 "Ancho" => 1650 "Tamanyo" => 45966 ] ] "descripcion" => array:1 [ "en" => "Shared missions: deployment of the corporate mission." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:31 [ 0 => array:3 [ "identificador" => "bib0160" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The mission, vision and values in hospital management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Rego" 1 => "B. Araújo" 2 => "D. Serrão" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hosp Adm" "fecha" => "2015" "volumen" => "5" "paginaInicial" => "62" "paginaFinal" => "72" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0165" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The challenges are organizational not just clinical" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Amanujam" 1 => "D. Rousseau" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Org Behav" "fecha" => "2006" "volumen" => "827" "paginaInicial" => "811" "paginaFinal" => "827" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0170" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparing mission statement content in for-profit and not-for-profit hospitals: does mission really matter?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D.S. Bolon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3200/HTPS.83.4.2-10" "Revista" => array:6 [ "tituloSerie" => "Hosp Top" "fecha" => "2005" "volumen" => "83" "paginaInicial" => "2" "paginaFinal" => "9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16425696" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0175" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mission statements in Canadian non-for-profit hospitals: does process matter?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C.K. Bart" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Health Care Manag Rev" "fecha" => "2000" "volumen" => "25" "paginaInicial" => "45" "paginaFinal" => "63" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0180" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The level and determinants of mission statement use: a questionnaire survey" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Desmidt" 1 => "A. Prinzie" 2 => "A. Heene" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijnurstu.2007.11.004" "Revista" => array:6 [ "tituloSerie" => "Int J Nurs Stud" "fecha" => "2008" "volumen" => "45" "paginaInicial" => "1433" "paginaFinal" => "1441" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18243207" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0185" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Engaging doctors in the health care revolution" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "T.H. Lee" 1 => "T. Cosgrove" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Harv Bus Rev" "fecha" => "2014" "volumen" => "92" "paginaInicial" => "104" "paginaFinal" => "111" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25051859" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0190" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A comparative analysis of mission statement content in secular and faith based hospitals" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C. Bart" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Intellect Cap" "fecha" => "2007" "volumen" => "8" "paginaInicial" => "682" "paginaFinal" => "694" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0195" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Available from: http://www.biomedsearch.com/article/Mission-Organizational-Performance-in-Healthcare/63714418.html [cited 18.02.16]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mission and organizational performance in the healthcare industry" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. Forehand" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2016" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0200" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mission statement content and hospital performance in the Canadian not-for-profit health care sector" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Bart" 1 => "J. Tabone" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Health Care Manag Rev" "fecha" => "1999" "volumen" => "24" "paginaInicial" => "18" "paginaFinal" => "29" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0205" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relevance of mission statements in Flemish not-for-profit healthcare organizations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D. Vandijck" 1 => "S. Desmidt" 2 => "M. Buelens" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2834.2007.00669.x" "Revista" => array:6 [ "tituloSerie" => "J Nurs Manag" "fecha" => "2007" "volumen" => "15" "paginaInicial" => "131" "paginaFinal" => "141" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17352695" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0210" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Managing the care of health and the cure of disease – Part II: Integration" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Glouberman" 1 => "H. Mintzberg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Health Care Manag Rev" "fecha" => "2001" "volumen" => "26" "paginaInicial" => "70" "paginaFinal" => "84" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0215" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Subcultural dynamics in transformation: a multi-perspective study of healthcare professionals" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Morgan" 1 => "E. Ogbonna" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Hum Relat" "fecha" => "2008" "volumen" => "61" "paginaInicial" => "39" "paginaFinal" => "65" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0220" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Leadership, service reform, and public-service networks: the case of cancer-genetics pilots in the English NHS" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G.P. Martin" 1 => "G. Currie" 2 => "R. Finn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Public Adm Res Theory" "fecha" => "2008" "volumen" => "19" "paginaInicial" => "769" "paginaFinal" => "794" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0225" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G. Tett" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:2 [ "titulo" => "The silo effect: the peril of expertise and the promise of breaking down barriers" "serieFecha" => "2015" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0230" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Doctor and nurse perception of inter-professional co-operation in hospitals" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "U. Krogstad" 1 => "D. Hofoss" 2 => "P. Hjortdahl" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/intqhc/mzh082" "Revista" => array:6 [ "tituloSerie" => "Int J Qual Health Care" "fecha" => "2004" "volumen" => "16" "paginaInicial" => "491" "paginaFinal" => "497" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15557359" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0235" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Common experiences of staff working in integrated health and social care organisations: a European perspective" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "K. Coxon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Integr Care" "fecha" => "2005" "volumen" => "13" "paginaInicial" => "13" "paginaFinal" => "21" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0240" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Producing synergy in collaborations: a successful hospital innovation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Corwin" 1 => "J.H. Corbin" 2 => "M.B. Mittelmark" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Innovation J" "fecha" => "2012" "volumen" => "17" "paginaInicial" => "2" "paginaFinal" => "16" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0245" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The mission, vision and values in hospital management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Rego" 1 => "B. Araújo" 2 => "D. Serrão" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hosp Adm" "fecha" => "2005" "volumen" => "5" "paginaInicial" => "62" "paginaFinal" => "72" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0250" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management by missions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Cardona" 1 => "C. Rey" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2008" "editorial" => "Palgrave Macmillan" "editorialLocalizacion" => "Basingstoke, England" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0255" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The culture engine: a framework for driving results, inspiring your employees, and transforming your workplace" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S.C. Edmonds" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2014" "editorial" => "Wiley" "editorialLocalizacion" => "Hoboken, NJ" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0260" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management by missions: how to make the mission a part of management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Cardona" 1 => "C. Rey" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Probl Persp Manag" "fecha" => "2006" "volumen" => "4" "paginaInicial" => "164" "paginaFinal" => "174" ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0265" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The nested mission statement: align departmental mission statements with the overall mission statement" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.J. Warner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Exec Excel" "fecha" => "1995" "volumen" => "12" "paginaInicial" => "8" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0270" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "First, let's fire all the managers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G. Hamel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Harv Bus Rev" "fecha" => "2011" "volumen" => "89" "paginaInicial" => "48" "paginaFinal" => "60" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21510518" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0275" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "From purpose to impact" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "N. Craig" 1 => "S. Snook" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Harv Bus Rev" "fecha" => "2014" "volumen" => "92" "paginaInicial" => "104" "paginaFinal" => "111" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25051859" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0280" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mission statements in Canadian hospitals" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Bart" 1 => "M. Hupfer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1108/14777260410538889" "Revista" => array:6 [ "tituloSerie" => "J Health Organ Manag" "fecha" => "2004" "volumen" => "18" "paginaInicial" => "92" "paginaFinal" => "110" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15366277" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0285" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Available from: http://journals.lww.com/hcmrjournal/Abstract/1990/01530/An_empirical_investigation_of_the_nature_of.5.aspx [cited 18.02.16]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An empirical investigation of the nature of hospital mission: health care management review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C. Gibson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2016" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0290" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Strategic management of health care organizations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. Ginter" 1 => "W. Duncan" 2 => "L. Swayne" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2013" "editorial" => "Jossey-Bass, Wiley" "editorialLocalizacion" => "San Francisco, CA" ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0295" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Available from: http://www.ncbi.nlm.nih.gov/pubmed/16292007 [cited 18.02.16]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A study of thematic content in hospital mission statements: a question of values – PubMed – NCBI Ncbi.nlm.nih.gov" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Williams" 1 => "W. Smythe" 2 => "T. Hadjistavropoulos" 3 => "D.C. Malloy" 4 => "R. Martin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2016" ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0300" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Combining purpose with profits" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Birkinshaw" 1 => "N.J. Fos" 2 => "S. Lindenberg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "MIT Sloan Manag Rev" "fecha" => "2014" "volumen" => "55" "paginaInicial" => "49" "paginaFinal" => "56" ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0305" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aligning organizational processes with mission: the case of service excellence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Crotts" 1 => "D. Dickson" 2 => "R. Ford" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acad Manag Exec" "fecha" => "2005" "volumen" => "19" "paginaInicial" => "54" "paginaFinal" => "68" ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0310" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Man's search for meaning – an introduction to logotherapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "V. Frankl" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "1992" "editorial" => "Beacon Press" "editorialLocalizacion" => "Boston" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/1134282X/0000003100000004/v2_201704050057/S1134282X16300203/v2_201704050057/en/main.assets" "Apartado" => array:4 [ "identificador" => "17673" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Artículo especial" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/1134282X/0000003100000004/v2_201704050057/S1134282X16300203/v2_201704050057/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1134282X16300203?idApp=UINPBA00004N"]

Statistics

Special article

Management by missions in the healthcare sector

La dirección por misiones en el sector sanitario

J. Fonseca Piresa, C. Reyb,

Corresponding author

c.rey@dpmc.es

Corresponding author.

, M. Más-Machucab, M. Bastonsb

a AESE Business School, Portugal

b Universitat Internacional de Catalunya, Spain

Read

3353

Times
was read the article

982

Total PDF

2371

Total HTML

Share statistics

 array:23 [
  "pii" => "S1134282X16300203"
  "issn" => "1134282X"
  "doi" => "10.1016/j.cali.2016.03.003"
  "estado" => "S300"
  "fechaPublicacion" => "2016-07-01"
  "aid" => "542"
  "copyright" => "SECA"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Rev Calidad Asistencial. 2016;31:239-42"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 957
    "formatos" => array:3 [
      "EPUB" => 43
      "HTML" => 575
      "PDF" => 339
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1134282X15001505"
    "issn" => "1134282X"
    "doi" => "10.1016/j.cali.2015.10.001"
    "estado" => "S300"
    "fechaPublicacion" => "2016-07-01"
    "aid" => "510"
    "copyright" => "SECA"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Rev Calidad Asistencial. 2016;31:243-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 836
      "formatos" => array:3 [
        "EPUB" => 33
        "HTML" => 519
        "PDF" => 284
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>"
      "titulo" => "Estudio de las variables cl&#237;nicas de predicci&#243;n de la neumon&#237;a nosocomial por <span class="elsevierStyleItalic">Staphylococcus aureus</span> resistente a meticilina"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "243"
          "paginaFinal" => "244"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Study of clinical variables predictive of nosocomial pneumonia by methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus</span>"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "T&#46; Garc&#237;a-Lozano, F&#46;J&#46; Pascual-Pl&#225;, S&#46; Mart&#237;n-Utrilla, A&#46; Egido-Gonz&#225;lez"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "T&#46;"
              "apellidos" => "Garc&#237;a-Lozano"
            ]
            1 => array:2 [
              "nombre" => "F&#46;J&#46;"
              "apellidos" => "Pascual-Pl&#225;"
            ]
            2 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Mart&#237;n-Utrilla"
            ]
            3 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Egido-Gonz&#225;lez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1134282X15001505?idApp=UINPBA00004N"
    "url" => "/1134282X/0000003100000004/v2_201704050057/S1134282X15001505/v2_201704050057/es/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1134282X15001682"
    "issn" => "1134282X"
    "doi" => "10.1016/j.cali.2015.10.004"
    "estado" => "S300"
    "fechaPublicacion" => "2016-07-01"
    "aid" => "513"
    "copyright" => "SECA"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Rev Calidad Asistencial. 2016;31:234-8"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 984
      "formatos" => array:3 [
        "EPUB" => 39
        "HTML" => 646
        "PDF" => 299
      ]
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original breve</span>"
      "titulo" => "Efectividad de un programa de instilaci&#243;n de quimioterapia precoz en pacientes con c&#225;ncer de vejiga"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "234"
          "paginaFinal" => "238"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Effectiveness of a program of early instillation single chemotherapy in patients with bladder cancer"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figura 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1053
              "Ancho" => 1374
              "Tamanyo" => 64135
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Incidencia de hematuria postoperatoria en el grupo con y sin tratamiento con quimioterapia postoperatoria &#40;QTp&#41;&#46; Se observan diferencias estad&#237;sticamente significativas para la hematuria grado 3 y 4 &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#59; sin diferencias estad&#237;sticas en la hematuria grado 2 &#40;p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "P&#46; Beardo Villar, A&#46;B&#46; P&#233;rez P&#233;rez, M&#46;J&#46; Castro Dorantes, S&#46;J&#46; Jim&#233;nez Delgado, P&#46; Alamillos Ortega, R&#46; Gavira Moreno"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Beardo Villar"
            ]
            1 => array:2 [
              "nombre" => "A&#46;B&#46;"
              "apellidos" => "P&#233;rez P&#233;rez"
            ]
            2 => array:2 [
              "nombre" => "M&#46;J&#46;"
              "apellidos" => "Castro Dorantes"
            ]
            3 => array:2 [
              "nombre" => "S&#46;J&#46;"
              "apellidos" => "Jim&#233;nez Delgado"
            ]
            4 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Alamillos Ortega"
            ]
            5 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Gavira Moreno"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1134282X15001682?idApp=UINPBA00004N"
    "url" => "/1134282X/0000003100000004/v2_201704050057/S1134282X15001682/v2_201704050057/es/main.assets"
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Special article</span>"
    "titulo" => "Management by missions in the healthcare sector"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "239"
        "paginaFinal" => "242"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "J&#46; Fonseca Pires, C&#46; Rey, M&#46; M&#225;s-Machuca, M&#46; Bastons"
        "autores" => array:4 [
          0 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Fonseca Pires"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:4 [
            "nombre" => "C&#46;"
            "apellidos" => "Rey"
            "email" => array:1 [
              0 => "c&#46;rey&#64;dpmc&#46;es"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "M&#225;s-Machuca"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Bastons"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "AESE Business School&#44; Portugal"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Universitat Internacional de Catalunya&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "La direcci&#243;n por misiones en el sector sanitario"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 588
            "Ancho" => 1650
            "Tamanyo" => 45966
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Shared missions&#58; deployment of the corporate mission&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">As in other industries&#44; the mission of a hospital is its reason for being&#59; it defines its role and associated responsibilities in the community&#44; namely&#44; the service it should provide to society&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">On the other hand&#44; when seen alongside companies of the same size in other industries&#44; the complexity and scope of the mission of hospitals are comparatively greater&#46; The purpose of a hospital comprises and underscores variables such as clinical care&#44; community service&#44; health promotion&#44; training and research &#40;for and by doctors&#44; nurses&#44; pharmacists and other participants in the sector&#41;&#44; financial results and&#44; in some cases&#44; religious factors&#44; etc&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Taking into account the scope and importance of the studies on mission in leadership and the management of organizations in general&#44; it is clear that the hospital industry lags far behind other sectors with respect to the design&#44; development and use of the mission statement&#44;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">3</span></a> and there is a surprisingly meager amount of research that has applied it to the healthcare sector as a whole and to the mission statement in hospitals in particular&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Desirability of health institutions having a mission</span><p id="par0020" class="elsevierStylePara elsevierViewall">Crafting a mission statement with the proper direction is one of the most critical strategic tools for a healthcare organization to succeed&#44;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">4</span></a> as it is an important management tool in healthcare sector organizations<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">5</span></a> and guarantees the foundations for the future success of a hospital&#46; On one hand because it sets out organizational guidelines<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">6</span></a> and on the other&#44; because it can be one of the most powerful methods for assessing the success of the hospital&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In addition&#44; it is crucial for both executives and employees in the healthcare sector that there should be a robust mission statement that they can turn to in times of uncertainty&#44; and this because the healthcare sector is the target of a rapidly changing situation &#40;financing&#44; legislation&#44; technology&#44; etc&#46;&#41; which may lead the members of healthcare organizations to lose sight of the institution&#39;s reason for being&#46; Besides&#44; given the scope and complexity of the interprofessional relations established among doctors&#44; nurses&#44; managers and other healthcare professionals&#44; employees need to have the support of the organization as a whole&#44; to know they are supported and included in the joint efforts involved in fulfilling the mission&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">8</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">This is also upheld by Bart&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">9</span></a> who sustains that given the progressive complexity and dynamics of change in the healthcare sector&#44; the mission statement has gained increasing importance in modern healthcare organizations because<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#40;a&#41;</span><p id="par0035" class="elsevierStylePara elsevierViewall">it helps identify and focus on its critical core capabilities in order to better cope in times of change&#59;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#40;b&#41;</span><p id="par0040" class="elsevierStylePara elsevierViewall">it addresses the allocation of scarce resources&#44; simultaneously promoting operational effectiveness and efficiency&#44; especially important during periods of budget constraints&#59;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#40;c&#41;</span><p id="par0045" class="elsevierStylePara elsevierViewall">it helps react when faced with new strategies&#44; turning the organization&#39;s focus back to its intended purpose&#59;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#40;d&#41;</span><p id="par0050" class="elsevierStylePara elsevierViewall">it can compensate the breakdown in employee morale&#44; creating an inspiring&#44; motivating movement around the high aspirations of the organization&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">4</span></a></p></li></ul></p><p id="par0055" class="elsevierStylePara elsevierViewall">In another study made of the healthcare sector<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">10</span></a> the reasons put forward to justify the mission statement were summarized as follows&#58; focus resource allocation&#59; motivate and inspire employees to reach a common purpose or aim&#59; balance competing interests among the different stakeholders&#59; ensure the alignment of the organization during a crisis&#59; create standards of behavior&#59; provide direction and common goals&#59; define the challenge for the company&#39;s activities&#59; maintain control over the organization&#59; develop a common culture and values&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">The mission in hospitals and cooperation among professionals</span><p id="par0060" class="elsevierStylePara elsevierViewall">A well-known phenomenon that is widely recognized in the literature is that professionals in the healthcare sector &#8211; doctors&#44; nurses&#44; managers and others&#44; form different groups with specific activities&#44; organizational arrangements and ways of relating with each other&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">11</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">The healthcare sector is therefore multidisciplinary&#44; insofar as it contains several professional groups&#46; The dynamics of interprofessional interaction by far exceeds this complexity&#58; the organizational subcultures that coexist in the healthcare sector &#8211; doctors&#44; nurses&#44; managers and others&#44; are heterogeneous&#44; have multiple levels of identity and arrange themselves in various professional communities&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">12</span></a> The way these professionals experience the sector and their responsibilities often leads them to confinement in self-contained professional silos&#44;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">13&#44;14</span></a> which reveals certain growing complications&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">In an organization as complex as a hospital&#44; a collaborative stance with views to fulfilling the mission may help overcome organizational obstacles&#46; In a hospital setting&#44; collaboration presupposes a shared mission&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">15</span></a> Having a common culture is beneficial to professionals in that it leads them to identify with the institution and its operating model&#44; share with others and remain motivated with altruistic aspects that benefit patients&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">16</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">So&#44; the success factors for this collaboration may include clearly defining the mission&#44; having a robust implementation strategy<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">17</span></a> and striving for consistency between what is expressed in the mission and the day-to-day reality of the institution<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">18</span></a> what it&#39;s called &#8220;managing by missions&#8221;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Coordinating and integrating missions</span><p id="par0080" class="elsevierStylePara elsevierViewall">If we could speak of an &#8220;implicit&#8221; connection between the corporate mission and the personal mission&#44; many would argue that the healthcare institutions have been managing by missions for a long time&#46; And they would have a point&#46; Chances are&#44; as a philosophy of action&#44; management by missions has been in the mindset of directors and collaborators in many healthcare organizations&#46; But speaking of &#8220;implicit&#8221; management by missions can lead to confusion rather than understanding of what we are discussing here&#44; since we are talking about something more than a philosophy of action of &#8220;some managers&#8221; or a cultural phenomenon &#40;in which missions are transmitted tacitly through socialization processes&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Management by missions is a systemic transformation of management&#44; where missions are defined and&#44; more importantly&#44; explicitly evaluated by all members of an organization&#46; Although management by missions starts when a company&#44; a team or an individual defines a mission&#44; it is not executed until the company&#44; team or individual conducts continuous and periodic monitoring of the degree of fulfillment of these missions&#46;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">19&#8211;21</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">As management by missions becomes standard practice in business organizations&#44; several forms of developing the connection between the institutional mission and the role mission of their members have emerged in the literature&#46; Some of these are&#44; for example&#44; the &#8220;nested missions&#8221;&#44;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">22</span></a> &#8220;shared missions&#8221;&#44;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">20</span></a> the &#8220;matrix of interdependencies&#8221;&#44;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">18</span></a> the &#8220;leadership philosophy&#8221;&#44;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">19</span></a> the &#8220;letter of understanding&#8221;&#44;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">23</span></a> or the &#8220;mission impact plan&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">24</span></a> These solutions seek vertical coordination of the missions &#40;by deploying the corporate mission in cascade throughout the divisions&#44; departments and people&#41; and horizontal coordination &#40;by establishing negotiation and support processes among people who have interconnected missions&#41;&#46; In turn&#44; they propose the integration of missions in management systems &#40;objectives&#44; processes&#44; competencies&#44; compensation&#44; etc&#46;&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Applying these ideas in the healthcare sector involves tackling a fundamental issue which is not always well resolved&#44; namely&#44; clarifying the shared mission of the 3 main groups in the healthcare sector&#58; doctors&#44; nurses and managers&#47;administrators&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">11</span></a> This should result in a vertical as well as horizontal coordination of the missions&#46; The aim of vertical coordination is that everyone knows how they contribute to the organization&#39;s mission from their own job&#46; As suggested by some authors&#44;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">18&#44;21</span></a> this would be achieved through a knock-on effect of the institution&#39;s mission&#44; beginning with each of the 3 groups&#44; continuing down to the level of each collaborator&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">In turn&#44; horizontal coordination of the missions should seek to clarify the relations of mutual interdependence that exist among the 3 groups since&#44; while it is important that each group understands its role mission&#44; it is also fundamental that each group understands the mission of the other roles&#46; In this way&#44; doctors should fully understand the role of nurses as well as of managers &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; And the same can be said about nurses and managers&#59; ensuring that each collaborator understands the mission of the institution&#44; their own&#44; and that of the other groups with which they interact&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">According to Cardona and Rey&#44;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">18</span></a> mission integration should follow 3 fundamental criteria&#58;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Criterion of inclusion</span><p id="par0110" class="elsevierStylePara elsevierViewall">Inclusion means that each shared mission must contribute to the accomplishment of the next higher-level mission and&#44; ultimately&#44; the corporate mission&#46; In the healthcare sector&#44; this would entail asking each of the 3 groups the following question&#58; How does my area &#40;doctors&#44; nurses or managers&#41; help to achieve the institutional mission&#63;</p><p id="par0115" class="elsevierStylePara elsevierViewall">For example&#44; if we want to derive a definition of the shared missions directly from the Hospital mission and the Hospital mission is oriented toward patient satisfaction&#44; employee development and quality of care&#44; then each area will have to ask itself&#58; How does our area contribute to patient satisfaction&#63; How does it contribute to employee development&#63; How does it contribute to providing high-quality care&#63;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Criterion of complementariness</span><p id="par0120" class="elsevierStylePara elsevierViewall">Complementariness ensures that there is a horizontal or logic process among the various shared missions&#46; It is important to ensure that the shared missions adopted by the different areas or functions do not collide with one another&#46; On the contrary&#44; the shared missions at any given level should be complementary in every respect&#46; Taking patient satisfaction as an example common to most hospitals&#8217; missions&#44;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">1&#44;3&#44;9&#44;25&#8211;28</span></a> management must ensure that each area defines its contribution to patient satisfaction in a way that is complementary and no against to the way other areas define theirs&#46; The same applies to other mission contributions&#44; such as the contribution to employee development and quality of care&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Criterion of coherence</span><p id="par0125" class="elsevierStylePara elsevierViewall">Coherence contemplates that all missions have common content that guarantees unity among them&#59; in other words&#44; that the issues of shared responsibility in the institutional mission are accurately reflected in all the next higher missions&#46; For example&#44; if quality of care provided to patients is included in the institutional mission&#44; this does not only apply to doctors and nurses&#44; but must also be included in the administrators&#8217; missions &#40;for example&#44; ensuring that reports are delivered in a timely and complete fashion&#41;&#46; Likewise&#44; if the hospital&#39;s financial survival is included in the mission&#44; this concern should not only be contemplated in the managers&#8217; mission&#44; but in the doctors&#8217; and nurses&#8217; missions as well&#46; In fact&#44; we believe that a good criterion of coherence for missions in the healthcare sector is that they all include at least 3 focal points&#58; patient satisfaction&#44; employee development and the sustainability of the institution&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusion</span><p id="par0130" class="elsevierStylePara elsevierViewall">Through management by missions&#44; healthcare organizations have the opportunity to attain a greater level of identification among their members and better coordination of groups&#46; This new form of management will offer healthcare institutions a huge potential for motivation and performance&#44; we think of equal magnitude as the transformation that meant moving from management by tasks to management by objectives&#46; This becomes especially evident in the matter of coordination&#44; where the missions and other elements of an organization &#40;structures&#44; processes and systems&#41; form a whole that cannot be coordinated properly if it is not considered as such&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">18&#44;29&#44;30</span></a> Thus&#44; further research on organizational theory based on missions is required&#59; one that contemplates individuals from a transcendent perspective&#44; capable of acting for reasons other than the mere satisfaction of their own needs&#44; and considers something that is especially relevant in the healthcare sector&#58; above all other things&#44; the first motivation of human beings is to find a mission in their daily activities&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">31</span></a></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conflict of interest</span><p id="par0135" class="elsevierStylePara elsevierViewall">The authors declare that there is no conflict of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres824632"
          "titulo" => "Abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec821109"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres824633"
          "titulo" => "Resumen"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0010"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec821110"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Desirability of health institutions having a mission"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "The mission in hospitals and cooperation among professionals"
        ]
        7 => array:3 [
          "identificador" => "sec0020"
          "titulo" => "Coordinating and integrating missions"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Criterion of inclusion"
            ]
            1 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Criterion of complementariness"
            ]
            2 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Criterion of coherence"
            ]
          ]
        ]
        8 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Conclusion"
        ]
        9 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Conflict of interest"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-03-03"
    "fechaAceptado" => "2016-03-07"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec821109"
          "palabras" => array:6 [
            0 => "Healthcare"
            1 => "Mission"
            2 => "Management"
            3 => "Interdependence"
            4 => "Coordination"
            5 => "Integration"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec821110"
          "palabras" => array:6 [
            0 => "Sanidad"
            1 => "Misi&#243;n"
            2 => "Gesti&#243;n"
            3 => "Interdependencia"
            4 => "Coordinaci&#243;n"
            5 => "Integraci&#243;n"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This article discusses the importance of the mission statement in the healthcare sector&#46; It&#39;s also argued that only formal declaration of the mission it&#39;s insufficient to the appropriate professional coordination of doctors&#44; nurses and managers&#46; It&#39;s proposed a systematic approach to facilitate the introduction of the mission within the systems of the organization&#44; what is called &#8220;Management by missions&#46;&#8221; It promotes horizontal and vertical integration between doctors&#44; nurses and managers&#46; Criteria that ensure this integration are specified&#46;</p></span>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En este art&#237;culo se aborda la importancia de la declaraci&#243;n de la misi&#243;n en instituciones del sector sanitario&#59; tambi&#233;n se constata la insuficiencia de esta declaraci&#243;n formal para la adecuada coordinaci&#243;n profesional de m&#233;dicos&#44; enfermeros y gestores&#46; Se propone un abordaje sistem&#225;tico que facilite la introducci&#243;n de la misi&#243;n en los sistemas de la organizaci&#243;n&#44; lo que se denomina &#8220;Direcci&#243;n por misiones&#8221;&#46; Se explicita como esto promueve la integraci&#243;n horizontal y vertical entre m&#233;dicos&#44; enfermeros y gestores&#46; Se especifican los criterios que garantizan esa integraci&#243;n&#46;</p></span>"
      ]
    ]
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 588
            "Ancho" => 1650
            "Tamanyo" => 45966
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Shared missions&#58; deployment of the corporate mission&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:31 [
            0 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The mission&#44; vision and values in hospital management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Rego"
                            1 => "B&#46; Ara&#250;jo"
                            2 => "D&#46; Serr&#227;o"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Hosp Adm"
                        "fecha" => "2015"
                        "volumen" => "5"
                        "paginaInicial" => "62"
                        "paginaFinal" => "72"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The challenges are organizational not just clinical"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Amanujam"
                            1 => "D&#46; Rousseau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Org Behav"
                        "fecha" => "2006"
                        "volumen" => "827"
                        "paginaInicial" => "811"
                        "paginaFinal" => "827"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparing mission statement content in for-profit and not-for-profit hospitals&#58; does mission really matter&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;S&#46; Bolon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3200/HTPS.83.4.2-10"
                      "Revista" => array:6 [
                        "tituloSerie" => "Hosp Top"
                        "fecha" => "2005"
                        "volumen" => "83"
                        "paginaInicial" => "2"
                        "paginaFinal" => "9"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16425696"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mission statements in Canadian non-for-profit hospitals&#58; does process matter&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46;K&#46; Bart"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Health Care Manag Rev"
                        "fecha" => "2000"
                        "volumen" => "25"
                        "paginaInicial" => "45"
                        "paginaFinal" => "63"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The level and determinants of mission statement use&#58; a questionnaire survey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Desmidt"
                            1 => "A&#46; Prinzie"
                            2 => "A&#46; Heene"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijnurstu.2007.11.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Nurs Stud"
                        "fecha" => "2008"
                        "volumen" => "45"
                        "paginaInicial" => "1433"
                        "paginaFinal" => "1441"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18243207"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Engaging doctors in the health care revolution"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46;H&#46; Lee"
                            1 => "T&#46; Cosgrove"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Harv Bus Rev"
                        "fecha" => "2014"
                        "volumen" => "92"
                        "paginaInicial" => "104"
                        "paginaFinal" => "111"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25051859"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A comparative analysis of mission statement content in secular and faith based hospitals"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46; Bart"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Intellect Cap"
                        "fecha" => "2007"
                        "volumen" => "8"
                        "paginaInicial" => "682"
                        "paginaFinal" => "694"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available from&#58; <span class="elsevierStyleInterRef" id="intr0005" href="http://www.biomedsearch.com/article/Mission-Organizational-Performance-in-Healthcare/63714418.html">http&#58;&#47;&#47;www&#46;biomedsearch&#46;com&#47;article&#47;Mission-Organizational-Performance-in-Healthcare&#47;63714418&#46;html</span> &#91;cited 18&#46;02&#46;16&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mission and organizational performance in the healthcare industry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Forehand"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:1 [
                        "fecha" => "2016"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mission statement content and hospital performance in the Canadian not-for-profit health care sector"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46; Bart"
                            1 => "J&#46; Tabone"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Health Care Manag Rev"
                        "fecha" => "1999"
                        "volumen" => "24"
                        "paginaInicial" => "18"
                        "paginaFinal" => "29"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relevance of mission statements in Flemish not-for-profit healthcare organizations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; Vandijck"
                            1 => "S&#46; Desmidt"
                            2 => "M&#46; Buelens"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2834.2007.00669.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Nurs Manag"
                        "fecha" => "2007"
                        "volumen" => "15"
                        "paginaInicial" => "131"
                        "paginaFinal" => "141"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17352695"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Managing the care of health and the cure of disease &#8211; Part II&#58; Integration"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Glouberman"
                            1 => "H&#46; Mintzberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Health Care Manag Rev"
                        "fecha" => "2001"
                        "volumen" => "26"
                        "paginaInicial" => "70"
                        "paginaFinal" => "84"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Subcultural dynamics in transformation&#58; a multi-perspective study of healthcare professionals"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46; Morgan"
                            1 => "E&#46; Ogbonna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Hum Relat"
                        "fecha" => "2008"
                        "volumen" => "61"
                        "paginaInicial" => "39"
                        "paginaFinal" => "65"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Leadership&#44; service reform&#44; and public-service networks&#58; the case of cancer-genetics pilots in the English NHS"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46;P&#46; Martin"
                            1 => "G&#46; Currie"
                            2 => "R&#46; Finn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Public Adm Res Theory"
                        "fecha" => "2008"
                        "volumen" => "19"
                        "paginaInicial" => "769"
                        "paginaFinal" => "794"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "G&#46; Tett"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:2 [
                        "titulo" => "The silo effect&#58; the peril of expertise and the promise of breaking down barriers"
                        "serieFecha" => "2015"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Doctor and nurse perception of inter-professional co-operation in hospitals"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "U&#46; Krogstad"
                            1 => "D&#46; Hofoss"
                            2 => "P&#46; Hjortdahl"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/intqhc/mzh082"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Qual Health Care"
                        "fecha" => "2004"
                        "volumen" => "16"
                        "paginaInicial" => "491"
                        "paginaFinal" => "497"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15557359"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Common experiences of staff working in integrated health and social care organisations&#58; a European perspective"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "K&#46; Coxon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Integr Care"
                        "fecha" => "2005"
                        "volumen" => "13"
                        "paginaInicial" => "13"
                        "paginaFinal" => "21"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Producing synergy in collaborations&#58; a successful hospital innovation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Corwin"
                            1 => "J&#46;H&#46; Corbin"
                            2 => "M&#46;B&#46; Mittelmark"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Innovation J"
                        "fecha" => "2012"
                        "volumen" => "17"
                        "paginaInicial" => "2"
                        "paginaFinal" => "16"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The mission&#44; vision and values in hospital management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Rego"
                            1 => "B&#46; Ara&#250;jo"
                            2 => "D&#46; Serr&#227;o"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Hosp Adm"
                        "fecha" => "2005"
                        "volumen" => "5"
                        "paginaInicial" => "62"
                        "paginaFinal" => "72"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management by missions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46; Cardona"
                            1 => "C&#46; Rey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2008"
                        "editorial" => "Palgrave Macmillan"
                        "editorialLocalizacion" => "Basingstoke&#44; England"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The culture engine&#58; a framework for driving results&#44; inspiring your employees&#44; and transforming your workplace"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;C&#46; Edmonds"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2014"
                        "editorial" => "Wiley"
                        "editorialLocalizacion" => "Hoboken&#44; NJ"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management by missions&#58; how to make the mission a part of management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46; Cardona"
                            1 => "C&#46; Rey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Probl Persp Manag"
                        "fecha" => "2006"
                        "volumen" => "4"
                        "paginaInicial" => "164"
                        "paginaFinal" => "174"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The nested mission statement&#58; align departmental mission statements with the overall mission statement"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;J&#46; Warner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Exec Excel"
                        "fecha" => "1995"
                        "volumen" => "12"
                        "paginaInicial" => "8"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "First&#44; let&#39;s fire all the managers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "G&#46; Hamel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Harv Bus Rev"
                        "fecha" => "2011"
                        "volumen" => "89"
                        "paginaInicial" => "48"
                        "paginaFinal" => "60"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21510518"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "From purpose to impact"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46; Craig"
                            1 => "S&#46; Snook"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Harv Bus Rev"
                        "fecha" => "2014"
                        "volumen" => "92"
                        "paginaInicial" => "104"
                        "paginaFinal" => "111"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25051859"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mission statements in Canadian hospitals"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46; Bart"
                            1 => "M&#46; Hupfer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1108/14777260410538889"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Health Organ Manag"
                        "fecha" => "2004"
                        "volumen" => "18"
                        "paginaInicial" => "92"
                        "paginaFinal" => "110"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15366277"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available from&#58; <span class="elsevierStyleInterRef" id="intr0010" href="http://journals.lww.com/hcmrjournal/Abstract/1990/01530/An_empirical_investigation_of_the_nature_of.5.aspx">http&#58;&#47;&#47;journals&#46;lww&#46;com&#47;hcmrjournal&#47;Abstract&#47;1990&#47;01530&#47;An&#95;empirical&#95;investigation&#95;of&#95;the&#95;nature&#95;of&#46;5&#46;aspx</span> &#91;cited 18&#46;02&#46;16&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An empirical investigation of the nature of hospital mission&#58; health care management review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46; Gibson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:1 [
                        "fecha" => "2016"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Strategic management of health care organizations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Ginter"
                            1 => "W&#46; Duncan"
                            2 => "L&#46; Swayne"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2013"
                        "editorial" => "Jossey-Bass&#44; Wiley"
                        "editorialLocalizacion" => "San Francisco&#44; CA"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available from&#58; <span class="elsevierStyleInterRef" id="intr0015" href="http://www.ncbi.nlm.nih.gov/pubmed/16292007">http&#58;&#47;&#47;www&#46;ncbi&#46;nlm&#46;nih&#46;gov&#47;pubmed&#47;16292007</span> &#91;cited 18&#46;02&#46;16&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A study of thematic content in hospital mission statements&#58; a question of values &#8211; PubMed &#8211; NCBI Ncbi&#46;nlm&#46;nih&#46;gov"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Williams"
                            1 => "W&#46; Smythe"
                            2 => "T&#46; Hadjistavropoulos"
                            3 => "D&#46;C&#46; Malloy"
                            4 => "R&#46; Martin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:1 [
                        "fecha" => "2016"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Combining purpose with profits"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Birkinshaw"
                            1 => "N&#46;J&#46; Fos"
                            2 => "S&#46; Lindenberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "MIT Sloan Manag Rev"
                        "fecha" => "2014"
                        "volumen" => "55"
                        "paginaInicial" => "49"
                        "paginaFinal" => "56"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aligning organizational processes with mission&#58; the case of service excellence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Crotts"
                            1 => "D&#46; Dickson"
                            2 => "R&#46; Ford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acad Manag Exec"
                        "fecha" => "2005"
                        "volumen" => "19"
                        "paginaInicial" => "54"
                        "paginaFinal" => "68"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Man&#39;s search for meaning &#8211; an introduction to logotherapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "V&#46; Frankl"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "1992"
                        "editorial" => "Beacon Press"
                        "editorialLocalizacion" => "Boston"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/1134282X/0000003100000004/v2_201704050057/S1134282X16300203/v2_201704050057/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "17673"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Art&#237;culo especial"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/1134282X/0000003100000004/v2_201704050057/S1134282X16300203/v2_201704050057/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1134282X16300203?idApp=UINPBA00004N"
]

Article information

ISSN: 1134282X
Original language: English

DOI:10.1016/j.cali.2016.03.003

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 October	10	8	18
2024 September	64	23	87
2024 August	43	7	50
2024 July	42	14	56
2024 June	37	10	47
2024 May	26	8	34
2024 April	43	11	54
2024 March	41	16	57
2024 February	30	6	36
2024 January	29	5	34
2023 December	31	13	44
2023 November	35	9	44
2023 October	32	7	39
2023 September	20	3	23
2023 August	25	5	30
2023 July	26	7	33
2023 June	25	6	31
2023 May	21	3	24
2023 April	19	1	20
2023 March	22	4	26
2023 February	11	2	13
2023 January	21	7	28
2022 December	23	7	30
2022 November	27	24	51
2022 October	17	16	33
2022 September	21	12	33
2022 August	20	10	30
2022 July	15	7	22
2022 June	19	14	33
2022 May	27	14	41
2022 April	15	31	46
2022 March	28	13	41
2022 February	18	8	26
2022 January	20	8	28
2021 December	28	12	40
2021 November	52	7	59
2021 October	44	10	54
2021 September	43	9	52
2021 August	40	8	48
2021 July	35	14	49
2021 June	41	12	53
2021 May	53	10	63
2021 April	132	52	184
2021 March	53	24	77
2021 February	38	17	55
2021 January	36	18	54
2020 December	44	11	55
2020 November	33	9	42
2020 October	19	6	25
2020 September	34	15	49
2020 August	35	10	45
2020 July	27	5	32
2020 June	23	11	34
2020 May	30	7	37
2020 April	23	13	36
2020 March	19	17	36
2020 February	22	15	37
2020 January	19	20	39
2019 December	25	26	51
2019 November	14	19	33
2019 October	22	16	38
2019 September	29	17	46
2019 August	12	14	26
2019 July	24	20	44
2019 June	40	32	72
2019 May	114	63	177
2019 April	71	16	87
2019 March	22	19	41
2019 February	20	15	35
2019 January	10	3	13
2018 December	11	10	21
2018 November	14	7	21
2018 October	22	15	37
2018 September	8	3	11
2018 August	8	1	9
2018 July	4	0	4
2017 October	1	0	1
2017 August	1	0	1
2017 April	1	0	1
2017 March	1	0	1
2017 February	2	0	2
2017 January	2	0	2
2016 December	2	0	2
2016 October	1	0	1
2016 September	5	3	8
2016 August	20	7	27
2016 July	39	5	44

Show all

Indexed in:

Follow us:

Subscribe:

Statistics

Indexed in:

Follow us:

Subscribe:

Statistics

Subscribe to our newsletter