Founder’s Corner: James A. Hamilton

James A. Hamilton founded the University of Minnesota Master’s Degree in Hospital Administration in 1946. He built the curriculum, attracted the faculty, and created the Program’s niche within the University. The new MHA Program sought the best and brightest students to lead the nation’s hospitals and the Program became a model for other colleges and universities around the world. That reputation and orientation continues today and can been seen in our graduates. Known for his 14 Step Method of Problem Solving, his credo was learning by doing. His motto was “never assume.” He relished the Socratic dialogue, encouraging students to probe into ideas rather than simply take notes. Although he often left them shaking and sweating in the classroom, behind his confrontational method lay a deep commitment to each student’s outcome in the field. Hamilton’s uncompromising high standards and values were matched only by the espirit de corps that he created among his students. This led to his founding of the Alumni Association in 1948 and then the Educational Trust Fund within the Association in 1955.

14 Step Method of Problem Solving

James A. Hamilton was known for his 14-step problem solving method, the core of his teaching. Today the problem-solving method is core to the full-time program curriculum where students apply it to real world healthcare management problems.

1. Define the problem by apprehending the real issues of the situation and stating the problem precisely.

2. Budget the time as well as the effort available and necessary to arrive at an acceptable solution.

3. List the areas necessary for consideration to determine the best solution.

4. List the elements to be measured and the best means of measurement.

5. Plan, make contact, collect, and classify data.

6. Make comparisons with others, with existing standards, or with past experience.

7. Interpret results of comparisons by seeking the real reasons for variance.

8. Develop temporary conclusions.

9. Consider various solutions; choose the best, not the first acceptable.

10. Take a fresh look at the approach to the problem and the selected solution.

11. Develop a plan of accomplishing the solution.

12. Determine recommendations, which invite action.

13. Prepare and present a report to those who make the final decision.

14. Implement the action to carry out the selected solution.

The Future of Graduate Education of U.S. Health System Leaders: A Reflection and Look Forward

By Daniel K. Zismer, Ph.D
Associate Professor and Director
MHA and Executive Studies Program

On October 20, 1938, Mr. Hamilton addressed the 21st annual Hospital Standardization Conference of the American College of Surgeons in New York City. The topic of his address was the “Need for Adequate Education and Training for Hospital Executives.” His remarks were published in Hospitals three months later. While studying this article, I abstracted and paraphrased seven points that are as relevant today as they were then. Although some editorial license was taken in the summarization, readers will clearly see the prescience of “James A.” as he helped the healthcare industry look forward.

What do today’s U.S. healthcare system leaders need to know to plan for tomorrow? Consider these points:

• As the U.S. health care industry consolidates, community health systems become a central source of healthcare and health education for individuals and the community. These systems of care take on a new responsibility and accountability.
• The complexity of community health systems expands. Care is provided by trained professionals with varied and interdependent skill sets working from facilities with evermore complex and expensive technologies.
• For many communities, healthcare systems are important economic engines. While they are a cost to the U.S., they employ a growing proportion of the workforce.
• Trustees of community health systems are feeling the pressures of an increasing accountability for the demonstrable benefits (and related costs) of contemporary healthcare.
• Patients are more demanding and less tolerant of substandard performance and results.
• Physicians are concerned with the competence of those running the systems of care.
• The government and insurance companies are exerting influence over the results and costs of care in the U.S.

The article was authored by James A. Hamilton in the Journal of the American Hospital Association, January 1939.