More than half of the new businesses formed each year in this country fail within the first two years. The primary reason for these failures has been deter mined to be inadequate, inexperienced management (1). Hospice programs may fail for the same reason, even though it may seem difficult to visualize hospices as businesses. Generally, hospice staff uphold such a high purpose in tending to the needs of terminally ill patients and their families that people sometimes assume hospices should not be compared with business operations. Experience has shown, however, that hospices are not immune and that they can fail, particularly if the administrative strengths of successful businesses are lacking. We have found that many programs, whose planners and staff have had the best intentions towards patients and families, failed because of insufficient or inade quate developmental and operational management (2, 3). They have suffered from lack of clarity in the allocation of administrative responsibility, from inattention to budgeting or financing, from assumptions of agreement not con tractually confirmed, from insufficient emphasis on staff selection and training,
and from inadequate communication-not only internally, but also externally with the health community and the public at large.