This study reviews and synthesizes empirical research literature focusing on the relationship between boards of directors and organizational effectiveness of U.S. hospitals. The study examines literature published in scholarly journals during the period of 1991-2017. Fifty-one empirical articles were identified that met the study's inclusion criteria. A framework from the corporate governance and nonprofit governance literature is used to classify the articles according to level of analysis (individual actors, governing bodies, organizations, and networks, alliances and multiorganizational initiatives) and focus of research (formal structure and behavioral dynamics-including informal structures and processes). Results are discussed, emerging trends are identified, and recommendations are made for future research.

In light of the challenges involved in leading a health care organization, it is important that the executives and managers charged with doing so are competent in a variety of areas. However, leading at all organizational levels does not necessarily require the same levels and types of competencies. The purpose of this research is to determine how well competency training works in health care organizations, and to obtain a better understanding of the competencies needed for leaders at different points of their careers and at various organizational levels. Ten health care management competency domains thought to positively influence job performance for health care executives are presented. The study seeks to answer four hypotheses related to self-perceptions of competencies and training opportunities at various hierarchical levels. A survey method was used to sample a subset of the healthcare executive population in the USA, based on three variables of interest, competency training opportunities, self-reported level of competency and hierarchical level. A series of Kruskal-Wallis and Mann-Whitney U tests were conducted to identify perceived differences in both competency level and training opportunities among respondents of various hierarchical levels. The most significant result of our research is that competency training is effective in health care organizations. The implications and need for additional research are discussed.

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Many hospitals are competing for survival in their service areas. Because of intense competition within markets, hospitals are developing strategies to differentiate themselves. One way to do so is to create a physical infrastructure and service environment that generate a positive impact on patient perceptions. The purpose of this study is to review the literature on servicescape (i.e., a total impression of a service encounter developed through the use of human senses) and its effects on service quality and patient outcomes in healthcare settings. Servicescape studies have taken place in various healthcare settings (i.e., teaching hospitals, dental clinics, outpatient clinics) in 10 countries. Although servicescape in healthcare settings is a rarely researched topic at both the national and international levels, research indicates a significant positive association between servicescape and patient perceptions, patient satisfaction, and patient emotions. In light of the increasing emphasis in quality and value-based purchasing initiatives on patient experience and outcomes, more servicescape research in healthcare settings is needed. This systematic review underscores this need and enhances the knowledge base in this area.