Nursing director responses to the rural hospital environment.
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Adult↗
Biomedical subjects
H L Smith
Publications and source records attributed to H L Smith.
Marketing strategy determinants in rural hospitals.
Rural hospitals confront an inauspicious environment due to changes in patient reimbursement and medical practice. Facing a situation of declining revenues, marketing presents an option for rural hospitals to adapt to the growing constraints. This paper analyzes the determinants of marketing strategy emphasis in rural hospitals. The conceptual model adopted in this study predicts that prior performance and contextual variables explain marketing strategy emphasis. The relationships are examined in a case study of rural New Mexico hospitals. Results suggest that prior performance and several contextual variables explain variations in marketing strategy emphasis. In particular, higher gross patient revenues are associated with more emphasis on television and radio advertising. Furthermore, rural New Mexico hospitals with high numbers of licensed beds and medical staff members, or that are affiliated with a chain organization, place greater emphasis on market research and market planning. The implications for marketing practice in rural hospitals are discussed.
Advertising↗
Reflections on total quality management and health care supervisors.
Total quality management (TQM) has become an integral process in service delivery for many health care organizations. This article reviews the fundamental concepts underlying TQM and how TQM is relevant to health care supervisors. In many respects TQM represents a contemporary approach to supervising innovation and change, to analytically solving customer problems, and to implementing continuous quality improvement. Several strategies are examined that health care supervisors can adopt for improving service quality, including cultivating a climate for innovation, motivating by example, leading staff to do what is right and to tolerate no service delivery errors, retraining staff, developing control systems, and creating barrier-free organizations. These strategies are examined from the perspective of achieving continuous improvement in health care settings.
Health Maintenance Organizations↗
On the limited utility of KAP-style survey data in the practical epidemiology of AIDS, with reference to the AIDS epidemic in Chile.
Population surveys concerning 'risk behaviours' thought to be related to the AIDS epidemic are many. Nevertheless, unfocused inquiry into diffuse behaviours in undifferentiated populations is not productive in low-seroprevalence populations, especially when the point is to design some form of intervention that might actually avert further infection. This is because of a failure to distinguish conceptually between the relevance of AIDS-related behavioural data for individuals and for populations. An illustration is drawn from the AIDS epidemic in Santiago, Chile, and an alternative perspective, based on extensive interviews with persons with AIDS and a survey of current HIV-surveillance and blood-screening programs, is described.
Acquired Immunodeficiency Syndrome↗
Physician-assisted suicide. Both physicians and Christians should know that this is not an idea whose time has come.
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Attitude of Health Personnel↗
Necrotizing lymphadenitis (Kikuchi's disease).
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Biopsy↗
Critical factors in recruiting health maintenance organization physicians.
What factors facilitate successful physician recruiting by health care organizations? Answers surfaced in a study of physician recruiting by a large HMO in the Southwest. Professional networking and word-of-mouth advertising appear to be the prominent means by which physicians learn of attractive staff positions. Successful recruiting also depends on a practice setting that fosters quality care, emphasis on patient care delivery, and collegial interaction.
Employment↗
Productive relationships with mover-and-shakers. Recognizing the agents of influence in your hospital.
Hospital administrators need every available asset these days, and one potential resource is the people in every organization who seem to naturally attract and lead others. The authors tell how to, first, recognize such persons and, second, establish a constructive relationship with them.
Communication↗
A comparison of financial performance, organizational characteristics and management strategy among rural and urban nursing facilities.
Despite efforts to deinstitutionalize long-term care, it is estimated that 43 percent of the elderly will use a nursing facility at some point. Whether sufficient nursing facility services will be available to rural elderly is debatable due to cutbacks in governmental expenditures and recent financial losses among nursing facilities. This paper explores the challenges confronting rural nursing facilities in maintaining their viability and strategies that might be considered to improve their longevity. A comparative analysis of 18 urban and 34 rural nursing facilities in New Mexico is used in identifying promising strategic adaptations available to rural facilities. Among other considerations, rural facilities should strive to enhance revenue streams, implement strict cost control measures, emphasize broader promotional tactics, and diversify services commensurate with the constraints of the communities and populations served.
Costs and Cost Analysis↗
Strategic planning in rural health care organizations.
Is strategic planning associated with higher levels of performance in health care organizations? Is strategic planning effective? This article examines strategic planning's impact on rural hospital and rural nursing facility performance, organizational characteristics, and strategy. The findings suggest that strategic planning in rural hospitals is strongly associated with higher profits, operating margins and planning effectiveness, and associated to a lesser extent with lower costs and higher revenues per patient day. However, strategic planning does not appear to be associated with higher performance in nursing facilities. The implications for strategic planning in rural health care organizations are discussed.
Financial Management↗
The role of structural symmetry in linearizing ocular reflexes.
This work presents a simulation study using an anatomically relevant model of the vestibulo-ocular reflex (VOR). The aim is to explore the functional properties of a bilateral structure in the premotor circuits of the oculomotor system. The major conclusions using sinusoidal inputs are: A bilateral structure in a sensory-motor system improves its linear range beyond expected central limits, if provided with symmetric interconnections. Given a bilateral (push-pull) sensory arrangement, non-linear sensor characteristics are actually advantageous. The greatest improvement in linear range of the reflex (here VOR) relies on intact sensors on both sides. In the case of a single sensor (unilateral head velocity input), or unmatched bilateral sensors, this study predicts a decrease in the linear range and the appearance of a variable bias. These implications are compatible with available data and can be tested in a clinical environment.
Animals↗
Assessing neck extension-flexion as a basis for temporomandibular joint dysfunction.
In the August 1987 issue of the Journal of Oral and Maxillofacial Surgery, Weinberg and LaPointe published an article entitled "Cervical Extension-Flexion Injury (Whiplash) and Internal Derangement of the Temporomandibular Joint" in which they proposed an explantation for injury to the temporomandibular joint resulting from certain motor vehicle accidents. In this article, the previous mechanism is assessed and the authors conclude that it is inaccurate.
Acceleration↗
Critical issues surrounding the evolution of ambulatory surgery.
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Ambulatory Surgical Procedures↗
Cultivating physician relations to enhance rural hospital utilization.
Rural hospitals are searching for new strategies to enhance utilization in view of constraints introduced by prospective payment and other environmental pressures. Developing physician relations is an approach that is reportedly leading to better hospital-physician collaboration and subsequently to improved utilization. This paper examines rural hospital-physician relations and the association with utilization. The findings suggest that rural hospitals emphasize quality care as well as diagnostic and treatment equipment procurement as methods for building relationships with physicians. These strategies are correlated with efforts to build a larger medical staff. Higher rural hospital utilization, in terms of occupancy, discharges and patient days provided, is associated with a larger medical staff. The results suggest that rural hospitals' attempts to cultivate physician relations have the potential for making significant differences in utilization outcomes. However, the linkages between utilization and physician relations are complex and require further research.
Hospitals, Rural↗
Building productive relationships with movers and shakers.
Movers and shakers often demonstrate capabilities that health care managers should recognize before attempting to build productive relationships with them. First, the charisma associated with outstanding leaders is reflected in superior communication skills and presence. Next, a broad experiential base coupled with penetrating analytical skills allows movers and shakers to earn exceptional authority and power. Third, movers and shakers are able to focus on strategic visions. Movers and shakers work through other team members to select and implement solutions that are consistent with organizational mission statements. Fourth, their entrepreneurial mindset enables them to take calculated risks and design creative solutions in response to formidable challenges. Finally, movers and shakers are not reticent to face facts and make tough decisions. Not all movers and shakers possess all of these characteristics equally. Nor are they all concerned about the same issues. As individuals, they bring differing interests and capabilities to health care organizations. Health care managers may strive to cultivate one or more of these characteristics themselves. Self-improvement begins with identifying personal deficiencies and systematically planning to overcome them. Until health care managers mature into movers and shakers, they can coopt the influence and power associated with movers and shakers. By establishing a trusting relationship and using borrowed power constructively, they can earn the respect and confidence of movers and shakers. A third approach promotes power transfer through a continuing viable relationship. Health care managers may need to use some combination of these methods. Additionally, they can consider tailoring various methods into a coordinated strategy. Health care managers have a variety of promising strategies available for building productive relationships with movers and shakers. Pursuit of these strategies may improve personal prospects and promote the achievement of organizational missions and objectives.
Commerce↗
Responses to prospective payment by rural New Mexico hospitals.
A cross-sectional study is used to determine how rural New Mexico hospitals altered service diversification, inpatient service emphasis, and service promotion during Medicare's prospective payment system (PPS) transition and posttransition phases. Results suggest that the hospitals implemented distinct strategies in response to PPS. The posttransition strategies were examined for their association with improved revenue and utilization indicators. Few of the service diversification and promotional strategies were consistent predictors of performance. Emphasis on fine-tuning inpatient services was the most promising predictor of higher utilization and revenue measures. The implications for other rural hospitals are discussed.
Cross-Sectional Studies↗
Managing hospital-physician relations: a strategy scorecard.
Since the initiation of prospective payment, hospitals have been struggling to develop strategies that improve their prospects for long-run viability. Foremost among these strategy formulations have been efforts to build hospital-physician relations. This article reviews several popular strategies designed to achieve mutually satisfying hospital-physician relations.
Hospital Administration↗
The effects of a pectin-supplemented elemental diet in a boy with short gut syndrome.
The effect of a pectin-supplemented diet in short gut syndrome was investigated in a 3-year-old boy. Nitrogen absorption was higher and stomach-to-anus transit time was prolonged during pectin supplementation of the enteral feed. Pectin supplementation had no adverse effects on electrolyte balance or glucose absorption. These data indicate that pectin supplementation of enteral feed may enhance nitrogen absorption and seems not to adversely affect absorption in short gut syndrome.
Child, Preschool↗