Survey shows gaps in competencies of new RNs.
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Biomedical subjects
Publications and source records attributed to P Eubanks.
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With operating costs ever rising and reimbursements ever tightening, hospitals are looking for ways to cut costs at every turn. The good news is that there are a lot of innovative, imaginative approaches being tried in every area of hospital operations--approaches that don't require massive financial investment, organizational restructuring, or teams of outside consultants. The examples we've found through talking with hospitals across the country are a fair sample of the types of opportunities out there. They range across the entire hospital, from the laboratory to the pharmacy to nursing to waste management to the medical staff to the operating suite. In other words, something for everyone.
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TQM/CQI and patient-centered care initiatives are also spurring changes in hospitals' employee payment and performance systems. The tricky part is that those systems have to change at the same time delivery systems are changing. "We feel we can't first develop new care delivery systems and then spend the next two years adjusting compensation systems," says one executive.
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Hospitals are entering a complex new era. As they strive to work fairly with their HIV-positive workers, they are encountering a range of legal and operational challenges. Beginning on page 24, we look at the legal hurdles facing hospitals as they balance the right of HIV-positive workers to work, while ensuring co-worker and patient safety. On page 28, we look at the pioneering human resources policies being employed by one hospital in the infection control area. And on page 30, we look at the ongoing search for safer needle devices.
There may have been a time when hospital CEOs could promote executive advancement simply by hiring the most talented individuals who walked through their doors. But the world has changed, and a variety of factors, including fewer opportunities for advancement and greater work-force diversity, are compelling CEOs and boards to think carefully and strategically about the issue.
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The Americans with Disabilities Act is compelling hospitals to make extensive changes in the hiring and accommodation of disabled employees. But, according to experts, such plans must be integrated with broad strategic planning to succeed.
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The total quality movement is transforming hospital leadership. CEOs are finding that signing on to a TQM or CQI program requires intensive commitment, as well as adjustments to management style and scheduling. And it raises a host of questions about how to initiate and manage such a program--and even what to call it (TQM versus CQI). But CEOs seem ready to accept the challenge. An exclusive Hospitals survey finds that over 60 percent of the CEOs involved in TQM/CQI programs believe their involvement is "the most important thing I've ever done." Still, the proliferation of TQM/CQI in hospitals has created a backlash in the field; Donald Berwick, M.D., the "father" of TQM in health care, explains why.