Changes in the health care environment necessitate revisiting management-related competencies for both clinical and administrative practitioners. Major changes include the shift from recruitment to reengineering, direct service to multiple service models, department to program management, professional standards to market-driven standards, and single-system to multisystem management. Important competencies include the ability to identify and implement flexible staffing, to use communication technologies to support staff members across multiple sites, to understand of the business of health care, and to create innovative service delivery models consistent with the core values of the profession.

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