1. Issel, L. Michele PhD, RN

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The recent U.S. presidential election and the subsequent changes in the White House cabinet and federal directorships have unveiled strong opinions, reactions, and disagreements across our nation. As an editor of a scientific journal, I have focused my attention on the appointments and actions of relevance to health care administration and management. These appointments span the breath of our federal government, from protecting the air, water, and soil to protecting our medications and from overseeing federal health insurance to overseeing federal research grant portfolios. Rarely has so much come into immediate relevance so quickly.

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I value the scientific approach to understanding the world and answering the complex questions that lead to improvements in health, safety, and well-being. Yet, we have entered an era of fake news, allegations of fake news, and a seeming disregard for accuracy and precision. Within this context, I pause to consider the implication of this era for scholars of health care management and organizations and for their work.


One issue centers on the value and meaning of "evidence." Although some scholars and practitioners consider single case studies to be evidence, other scholars require randomized clinical trials. Regardless of where on that continuum one might feel comfortable, consensus centers on the need for information that is distanced from opinion and self-interest. To be clear, we consider findings from scholarly, rigorous, and ethical inquiry as evidence. HCMR seeks to publish work that informs evidence-based management, which ultimately supports evidence-based health care practice. Thus, HCMR welcomes manuscripts that represent the breadth of evidence generated through the application of any of the various rigorous scientific approaches. We realize, furthermore, that protecting research funding will require our readers, whether practitioners or scholars, to be active in efforts to maintain those research-funding streams and maintain them free of political agendas.


Another issue concerns the ways in which evidence becomes utilized. As scholars, we historically have been weak in our application of communication science to the distribution and dissemination of our individual and collective scientific wisdom beyond our professional networks. The enhanced immediacy of dissemination of news, fake or real, requires that we match that immediacy, despite our reluctance to speak before all the data have been analyzed, more than once. We must find ways to compete for attention and to engage in (small t) truth-telling. As Editor, I have occasionally worked with authors and the Publisher to disseminate time-sensitive research. Moving forward, doing as much and as quickly as possible will be a goal. This means that I will work actively with the Publisher to find the optimal dissemination modes.


The last issue, certainly, is uncertainty. A long and solid line of research exists on the effects of uncertainty on organizations and, to some extent, the effects of uncertainty on health care organizations. Over the past 8 years, health care organizations and systems seem to have been resilient in the face of uncertainty, creating a path forward that benefited shareholders as well as stakeholders. The current uncertainty presents a new opportunity to utilize and extend our understanding of managing uncertainty in the health care environment.


HCMR stands ready to use the means available as a scientific journal to defend the science of health care administration and management for our collective health, safety, and well-being.


L. Michele Issel, PhD, RN