Olin Business School at Washington University in St. Louis | Groups
   
A new era in the efforts to professionalize the management of hospitals largely began after the conclusion of World War II. As the war wound down, the W.K. Kellogg Foundation identified the need for improvement of hospitals in the United States and Canada as a priority for programming because the hospital sector had been neglected during the war years. The founding organizations of the healthcare management profession were: The American Hospital Association (AHA) founded in 1899, American College of Hospital Administrators (ACHA) founded in 1933, and Joint Commission on Accreditation for Health Services Administration (JCAHA) founded in 1945.

The Kellogg Foundation assembled an advisory committee to study the needs of university education and training programs in hospital administration. This led to the appointment of the Joint Commission on Education for Hospital Administration (whose Vice Chairman was the founder of the Washington University Program). The Commission presented the Prall Report in 1948, calling for the expansion of university graduate programs, and provided detailed recommendations for content and organization of the programs.

The Association of University Programs in Health Administration, or (AUPHA), began in 1948 to develop academic standards for university education degrees in hospital administration. They required that university programs grant a master degree, required at least one academic year of courses (of which a third must be directly concerned with hospital administration), twelve months of residency or equivalent experience, have two professionally qualified faculty members, and have a degree of autonomy in operations.

In the period 1934-1953, ten university programs were opened. The founding programs were the University of Chicago, Northwestern University, Columbia University, the University of Minnesota, the University of Toronto, Washington University in St. Louis, and Yale University. 1946 was the official birth of the Hospital Administration degree, granted by the School of Medicine at Washington University in St. Louis (WUSM). The initial class graduated in 1948.

Frank R. Bradley, MD, Director of Barnes Hospital and Professor of Surgery, was the first standing Director (1946-1967) of the Hospital Administration Course offered by WUSM. In 1946, he and other members of the Barnes Hospital administrative group welcomed and taught seven students the basic elements of hospital operations. From 1951 until 1967, Harry Panhorst, one of the first program graduates, oversaw the day-to-day activities of the students. Students spent two semesters on campus followed by a 12-month residency in a general acute hospital. During that period, approximately 270 students graduated with a Master in Hospital Administration degree (MHA). During Dr. Bradley's era, his wife, Rachel, conducted monthly classes for students' wives in her home. Her goal was to insure they knew the etiquette of entertaining and proper behavior in support of their husbands' careers.

Mr. Panhorst (MHA '50) and Donald J. Horsh, Esq., (MHA '51) were instrumental in the early success of the Program and its graduates. Don Horsh taught the health law course for more than 30 years. Their contributions were invaluable. They personally contacted colleagues in acute hospitals throughout the US to establish residency sites and facilitate placement of the Program's students. Completion of an Administrative Residency at a general acute hospital, supervised by the hospital's administrator, was required prior to conferring the master degree.

In 1967 James O. Hepner, PhD. (MHA '59) became the 1st full-time Director of the Graduate Program in Health Administration (the Program). The name changed several times over the following years. Dr. Hepner's interest in hospital administration had deep roots. In high school, he worked as a hospital orderly earning 50 cents an hour. While he was there, the administrator encouraged him to consider hospital management as a career option. He revisited that idea while serving as an officer in the United States Marine Corps during the Korean War. He had enlisted after earning a Bachelor's degree in Sociology and Military Science from the University of Iowa. During his three-year military stint, Hepner served as an infantry platoon leader where he met fellow Marine officers considering careers in hospital administration following active duty. The idea stuck with Dr. Hepner, and in 1959 he earned the MHA degree from WUSM. After earning a Ph.D. in Hospital and Health Administration from the University of Iowa, Hepner returned to The Jewish Hospital in 1964 as a practicing administrator until 1967 when he was asked by Dr. Bradley and Dean Kenton King to lead the masters in hospital administration program into acclaimed academic status. Once again, The W.K. Kellogg Foundation's influence was felt when they awarded him a grant to organize a full-time faculty and advanced curriculum.

During the 1970s ,'80s, and ‘90s the Program was continuously fully approved by the Accrediting Commission for Health Services Education and consistently ranked in the top five university programs in health administration. Dr. Hepner's academic, professional and community achievements brought national and international recognition to the Program, the Medical School and the University. More importantly it opened many doors to students and served as an invaluable recruitment and placement resource.

Hepner served as Director of the Program for 33 years. He became the only tenured full Professor of Health Administration in the Medical School. He published five text books and 42 articles including some of the early chronicles of best practices and benchmarking. He developed a full-time faculty, was awarded 42 training grants, and led the Program as the profession evolved. In 1968 he was awarded a grant from the Comprehensive Health Planning Act. The Program name changed to the Health Administration and Planning Program. All students were required to complete four academic semesters and the residency became optional.

Dr. Hepner served more than 20 years as Consultant to the Surgeons General of the US Air Force; and, for five years the Program hosted the Inter-Agency Institute for Federal Health Care Executives with him as its Director. These efforts aided recruitment and for decades the Program welcomed a steady stream of junior officers seeking the MHA degree.

In 1981, the Program evolved again by adding joint degrees in law, business, and social work. The name changed again to the Health Administration Program (HAP).

Dr. Hepner was the recipient of dozens of local, state, national and international awards; and he never tired of promoting the Program, its students and graduates. In 1991, he became the first full-time academic to serve as board chairman of the American College of Healthcare Executives (ACHE), a post normally held by health care administrators. In 1982, the group presented him with one of its most distinguished honors, the Silver Medal Award of Excellence in Health Services Administration.

From the period of 1948 to the early 2000's, HAP at Washington University had changed from a one-year degree granting program, to a two-year program which still prepared students to run hospitals, but also to direct physicians' group practices, manage hospices and long term care organizations, oversee home health care delivery systems and even work for pharmaceutical companies and health benefits programs in Fortune 500 companies.

From 2000 to 2007, Stuart Boxerman, D.Sc. served as the third program director of HAP at Washington University. Dr. Boxerman earned three degrees from Washington University - two in engineering, a bachelor's degree in 1963 and a master's degree in 1965. In 1970, he earned a doctorate in applied mathematics and computer science. Boxerman joined the Health Administration Program in 1974 as assistant professor. He was named Associate Director in 1983, Deputy Director in 1991 and Interim Director in 2000. During Boxerman's tenure at HAP, he provided insight into quantitative methods which were becoming more and more demanding as the healthcare landscape changed with the advent of managed care in the early 1980's. This development in U.S. healthcare called for a big change in the way hospitals and managers delivered care. Namely, this change meant that healthcare managers needed to acquire a more defined set of business skills as these were the skills that were becoming an expectation for hospital administrators. This change also meant that healthcare managers had to acquire more demanding quantitative skills in the areas of finance, statistics, operations research, and information systems. Boxerman co-authored a well received book, "Quantitative Analysis for Health Services Administration" on these topics. This book is still in widespread production, and is still used by graduate programs in health administration under the name, "Austin and Boxerman's Information Systems for Healthcare Management", 7th edition. In addition to Boxerman's academic experience, he had industrial experience as a radar systems analyst with a defense contractor, a power system planner with an electric utility, and director of information systems for an architectural firm. Throughout his health administration teaching career, Boxerman worked with numerous hospitals on a variety of systems analysis, process improvement, and planning projects. His research activities included projects in patient-focused care, care path development, process reengineering, and cost-benefit analysis. Boxerman was also active in task forces and faculty forums sponsored by the Association of University Programs in Health Administration (AUPHA). These activities included the Quantitative Methods Task Force, the Information Management Faculty Forum, and the Curriculum Development Task Force for Information Management.

From 2005-2007, HAP at Washington University in St. Louis had achieved international status. The Ministry of Health of the Saudi Arabian Government approached HAP at Washington University in St. Louis to discuss the potential of an Executive Master of Health Administration (EMHA) degree, for Saudi healthcare executives. Stuart Boxerman was instrumental in formulating this program which conferred approximately 15 EMHA degrees in 2008.

In 2008, Dr. Ronald Gribbins served as the director in the Program's final year. Dr. Gribbins also served as faculty for the health administration program from 1975 to 2008, in which he taught courses in Organizational Behavior and Human Resources. Dr. Gribbins also served as the Program Director for the Master of Human Resource Management at the Danforth Campus.

The History of HAP would be incomplete without mentioning the Administrative Assistants who supported the students in their daily academic lives. Loyce Rutherford, secretary to Dr. Bradley and Harry Panhorst, Joyce Rudolph, Julie Radcliff, Shirley Axelrod and Marilyn Hummert all served as support to the directors, faculty and spent endless hours processing all the documents required by students, preceptors, graduates and employers. The contributions they made to students' success can never be quantified.

On March 5, 2007, the Washington University School of Medicine formally announced its decision to dissolve the Health Administration Program.

In the Program's 62-year history, 1,491 students graduated with an advanced degree in healthcare management. These people have dedicated their lives to providing leadership to the U.S. healthcare system. Approximately 35% of HAP graduates have served as chief executive officers or presidents of hospitals and healthcare organizations. The proud tradition and network of HAP at Washington University is still alive with an active Board of Directors, and an annual alumni reception which convenes every year during ACHE's Congress on Healthcare Leadership.