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Biomedical subjects

A Bushy

Publications and source records attributed to A Bushy.

At least 37 records · Page 2Linked to original sources

Healthcare: considerations for changing practice.

Changes are rampant in the healthcare industry. Some are economically driven while others occur because of revisions in the national health policy, mandates of third party payors to alter reimbursement policies, and efforts of consumers to influence health professional's practices. As a result, healthcare institutions must monitor the quality and the cost effectiveness of their product. Yet, implementing a Quality Assurance (QA) program necessitates numerous changes on the part of all who work within an institution. A healthcare organization's leaders must have the ability to respond rapidly to the domino effects of change. For some institutions, this may mean modifying a long-standing infrastructure, purchasing new biotechnology, reorganizing staffing patterns, or revising management practices. Hence, it is important for health care providers to understand the change process. Likewise, health professionals should be aware of, and anticipate the potential responses to change. Because humans are motivated by different forces, there is need for a repertoire of strategies to address these individual needs. Ultimately, these efforts can facilitate the implementation of change. Overview of the Content: In this submission I will define common terms associated with change theory. This is followed by an overview of Lewin's and Rogers' theories of change. Subsequently, the models are applied to a household innovation (microwave oven). Finally, strategies to implement changes, specifically QA activities, are provided for the reader's consideration. The information herein is useful for management, education, as well as hypothesis development relative to research on change in healthcare.

Delivery of Health Care↗

Implementing an ethics committee in rural institutions.

Ethical conflicts occur in rural as well as in urban healthcare institutions. One means of addressing these complex issues is through interdisciplinary discussions by a bioethics committee. There are, however, social, economic, geographic, and demographic variations unique to both environments that can impact ethical issues, and these must be addressed when such a committee is implemented in either setting. The authors describe the rural variations and the implications for nurse administrators who often assume an active role in planning and organizing bioethics committees.

Budgets↗

Quality assurance in rural hospitals.

Within the last decade there has been an expanding amount of information on quality assurance in healthcare. Despite the prolific citations on the topic, only a few address the needs and concerns regarding quality assurance programs in rural healthcare institutions. The author summarizes the more frequently expressed concerns of nursing administrators in implementing a comprehensive quality assurance program in the rural environment.

Accreditation↗

Nurse satisfaction with work in rural hospitals.

Little is written about retention and recruitment of nurses in small rural hospitals. The authors present findings of a nursing study that identified factors that encouraged and deterred nurses to practice in the rural environment.

Hospitals, Rural↗

The myth of the cowboy and its meaning for rodeo families.

Because of the nature of the sport of rodeo, there is a unique lifestyle associated with it. The impact of its stereotypical myth versus the realistic lifestyle of cowboys and the subsequent effects on the women and children who share their lives are described in this article. This information has implications for health professionals and community planners who provide services to this group of individuals.

Adult↗

Rural U.S. women: traditions and transitions affecting health care.

Warren (1972) proposed a means for determining differences between rural and urban social contexts that expands on the population definitions. Essentially, these differences are geographical, social, and economic in nature, and the health status of individuals in either setting may be affected by these variations. The health issues of women that evolve from these rural factors are the focus of this article.

Community Participation↗

Biomedical conflicts in the heartland. A systemwide ethics committee serves rural facilities.

Big-city medical research centers are not the only institutions facing ethical dilemmas. Bioethical conflicts occur regardless of community location or size. The Presentation Health Care System, Sioux Falls, SD, established a systemwide ethics committee. It owns, leases, or manages 15 rural institutions in four North Central states: South Dakota, North Dakota, Montana, and Minnesota. Of these facilities, 10 are hospitals and 5 are nursing homes. Most are located in small communities stretched along 1,100 interstate miles. The Presentation system began organizing its ethics committee in spring 1985. The ethics committee was to provide educational opportunities for its members, as well as for local facilities. These opportunities were to include subscriptions to appropriate publications, meetings with guest speakers, videos, and group "brainstorming" sessions. An annual ethics conference would provide community education and address the ethical issues confronting affiliates. Organizers scheduled a planning session at a systemwide leadership conference and invited anyone interested to attend. Eventually, 23 representatives of system affiliates were selected as members of the committee. The group meets twice a year. Since 1985, the committee has been holding ethics conferences on a regular basis.

Bioethics↗

Rogers' adoption model in the implementation of change.

In this era of marketplace competition and cost containment, the most efficient methods of implementing change must be utilized. Rogers' adoption of innovation theory (1972; 1983) provides a framework to identify human responses to innovation/change. The model's six categories exemplify varying degrees of acceptance or rejection behaviors. In the current paper employee responses to the implementation of a new computer system in a larger hospital in the upper midwest with implications for clinical nurse specialists will be discussed.

Adaptation, Psychological↗