Editorial.

In healthcare, everybody is a customer. The radiologist waiting for x-ray images or a nurse waiting for a doctor's order is as much a customer as the patient waiting for an available bed. Each customer expects attention, courtesy, and service. This is a fact that we tend to overlook in today's always-urgent and always-important environment.

The irony is that the very thing we take for granted is often the very thing that can solve our acute challenges. The articles in this issue make a case that delivering customer satisfaction is a practical and doable response to our immediate needs and our lingering dilemmas--from professional shortages to adverse events to limited financial resources.

Our interviewee is a pioneer in healthcare management. Professor, author, and researcher Dr. Sam Levey has witnessed and been a part of many changes and trends in the field over the years. In the face of these difficult times, he asks us to "[rediscover] our healthcare roots: We are here to serve."

In the Physician Relations column, author Ken Cohn describes a number of strategies for engaging physicians. He argues that collaboration between healthcare managers and physicians leads to better clinical outcomes and more supportive medical staff. Trends columnist Mike LaPenna discusses the revival of an old practice-the company doctor. Termed "workplace medical clinics," this new development is steadily gaining a following, creating implications for traditional healthcare providers.

According to research by Koichiro Otani and colleagues, customer satisfaction does not necessarily lead to customer loyalty. This study reveals that a patient rating of "excellent" on factors that healthcare managers can control, such as staff and nursing care, influences that patient's satisfaction and intention to use the service again.

Many children are caught in this current environment of the uninsured and underinsured. The article by Colleen Acosta and colleagues offers a viable, no-cost model that links children without healthcare coverage to existing insurance programs.

Research by Raymond Lucas and colleagues examined the opportunity loss of time related to boarding patients in emergency departments (EDs). Findings and recommendations from this study can help healthcare managers develop practices that ease ED overcrowding, raise staff productivity, and improve care quality.

The benefits of participative management in the workplace are highlighted in the article by Ingo Angermeier and colleagues. These researchers found that employees who perceive a climate of involvement and support are more likely to deliver better customer service, make fewer errors, experience less burnout, and stay with the organization.

Rounding out this issue is an abstract by Marjorie Jenkins and Alice Stewart that outlines their research on nursing satisfaction.

We hope this issue adds value to your management resource library.

Kyle L. Grazier, DrPH

Editor

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