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Biomedical subjects

P Leatt

Publications and source records attributed to P Leatt.

At least 37 records · Page 2Linked to original sources
PubMed1992

Different systems, different costs? An examination of the comparability of workload measurement systems.

This study examines the equivalence of the hours of care estimates of four patient classification/workload measurement systems. Although the hours of care estimates of the systems were similar, differences between the estimates could be as great as 4.53 hours per day for the same patient. The researchers developed relational statements that made hours of care estimates equivalent for all systems studied. System differences can have a profound impact on nursing unit and department budgets, if not adjusted.

Costs and Cost Analysis↗
PubMed1991

Are managers compensated for hospital financial performance?

Management compensation in a sample of 213 nonprofit hospitals in Ontario, Canada, is examined. Management compensation is determined first and foremost by hospital size and teaching status. Results indicate only a weak relationship between management compensation and hospital financial performance.

Chief Executive Officers, Hospital↗
PubMed1990

Skeletal muscle fiber type, fiber size, and capillary supply in elite soccer players.

This study determined the fiber type composition, the fiber size, and the capillary characteristics of the vastus lateralis muscle in 11 young, elite, male soccer players and 8 sedentary male, age-matched controls. There were no significant differences (P less than 0.05) in the fiber type percentages and fiber diameter between the soccer players and controls; however, all fiber types tended to be larger in the soccer players. The soccer players possessed a greater capillary supply; this was characterized by a significantly greater mean number of capillaries surrounding each fiber (5.7 +/- 0.9 vs. 4.9 +/- 0.4), a significantly larger capillary density (282.7 +/- 42.0 vs. 220.8 +/- 38.1), and a significantly higher capillary to fiber ratio (2.2 +/- 0.6 vs 1.7 +/- 0.1). The results indicate that soccer may be an appropriate stimulus for simultaneous adaptation to endurance and high intensity exercise.

Adult↗
PubMed1990

The nature and extent of hospital competition in a government-funded health system.

A national study of Canadian hospitals assessed the perceived level and types of competition and the strategies pursued by these hospitals. Questionnaire data were obtained from chief executive officers in 715 hospitals, yielding a national response rate of 68%. Respondents indicated the perceived level of competition in the environment, the content of competition, and stated hospital strategies. Additional data were obtained on market share and hospital type. Close to half of the respondents indicated little or no competition in their environment, while 30% indicated substantial levels of competition. This represents a significant deviation from conventional wisdom about the Canadian health services environment. Respondents in hospitals with more than 75% of the market share were less likely to perceive competition than those with a smaller market share. CEOs in teaching hospitals and in hospitals located in larger communities reported higher levels of competition. Hospitals competed mostly for capital, programs, and staff; about a third of hospitals competed for patients and no differences were found by type of institution. Those hospitals in more competitive environments were more likely to indicate the use of diversification and horizontal integration as organizational strategies.

Canada↗
PubMed1989

Decentralized hospital management: rationale, potential, and two case examples.

Sunnybrook Medical Centre (SMC) in Toronto designed a unique organizational model for managing hospital services and programs in three clinical units. The SMC model, like a similar model at The Johns Hopkins Hospital (JHH), emphasizes the active participation of physicians in management, the decentralization of budgetary control, and accountability for resource use to the clinical unit level. Expanding on the JHH model, SMC implemented additional financial incentives to encourage changes in clinical practice which would bring direct financial benefit to the respective clinical unit, and thereby to the medical center. To improve quality of service, SMC has also expanded the JHH model of multidisciplinary and participatory approaches to patient care by standardizing managerial roles and responsibilities of each member of the management team. A brief description of issues related to implementation of these unique models summarizes the program's success.

Baltimore↗
PubMed1988

Multidisciplinary teams in health care: lessons from oncology and renal teams.

An indepth study conducted on units treating renal disease and cancer clinics determined that multidisciplinary teams are relatively commonplace in these areas. Developing four team organizational structures--sequential, primary, nucleus and dynamic--the authors hypothesize that each varies on a continuum in terms of how highly structured they are. The framework suggests that the ideology of equal participation on the team is the most difficult to sustain, and that difficulties typically arise as organization requirements become more complex. More research seems to be indicated to develop a comprehensive organizational framework, and the probable effect of organizational form on team performance. One of the key issues addressed is team leadership.

Canada↗
PubMed1988

Management partnerships: a reaction.

Although there are important differences that will affect future changes in the Canadian system, health care in Canada often parallels that in the United States. The concept of the hospital is changing from sickness care to health care. There is a growth of multi-institutional arrangements, bureaucracy is on the rise, and the number of nursing and other allied health professionals is growing. These trends are having an impact on the physician-nurse-administrator partnerships of program management.

Canada↗
PubMed1988

Technology acquisition in Canada. Control in a regulated market.

The authors provide a detailed overview of how the national and provincial health systems of Canada exercise control over the diffusion of medical technology. In particular, they examine the diffusion of CT scanning and the adoption of non-ionic radio contrast media. While the nature of the parliamentary system theoretically allows the government, especially the executive, to exert more control over its policy agenda than in the United States, the authors believe that effective control is hampered by a lack of political will and insufficient "teeth" in the Ministry of Health's mandate and policy. The authors also conclude that the manipulation of reimbursement systems to encourage or discourage the diffusion of various medical technologies is not always effective, and that political clout often triumphs over rational decision making.

Canada↗
PubMed1988

Future directions for AUPHA (Association of University Programs in Health Administration)? Results of a survey of faculty members.

As part of its strategic planning process, the Association of University Programs in Health Administration (AUPHA) conducted a survey of individual faculty members in health administration programs. The objective of the survey was to assess the faculty development needs of individual faculty members in terms of their professional association affiliations, and to identify what, if any, additional roles might be filled by AUPHA. The findings supported a role for AUPHA beyond its historical role of serving the needs of health administration programs primarily through program directors. Of particular importance to faculty members were exchanges with faculty in other health administration programs around research and teaching issues. While these views were held by those of all academic ranks and educational levels, the importance of these activities was judged higher by those respondents with doctorates and those of assistant professor rank. A specific role indicated for AUPHA is one of creating opportunities for exchange among individual faculty members in health administration programs. Furthermore, the data suggest that those faculty members of assistant professor rank should be a major focus for AUPHA faculty development activities. Roles for AUPHA in the areas of revising curricula and exploring new methods of instruction, developing closer linkages with management practitioners and discussions of ways to facilitate multidisciplinary exchange and research were outlined in this study.

Curriculum↗
PubMed1987

Specific muscular development in under-18 soccer players.

A comparison of the under-18 (U-18) and under-16 (U-16) squads of the Canadian national soccer team with a representative sample of Canadians (Canada Fitness Survey, 1983) showed a tendency for the development or selection of the older players in teams of stature (U-18, 175.8 cm; U-16, 171.1 cm; CFS, 170.9 cm) and lean body mass (U-18, 63.4; U-16, 57.9; CFS, 54.2 kg). The larger lean mass of the older players could not be explained simply by size. The U-18s also showed greater isokinetic leg extension force (particularly for rapid movements) and explosive strength (vertical jump) relative to the younger players, although the knee extension force was less than in some classes of athlete. Part of the gain in mass seems due to local training of the hip and leg muscles and part to a more general muscular development. Contrary to some reports, the hip flexibility of the Canadian players (sit and reach test) was greater than for a national sample; this may be important in avoiding soft tissue injuries to the legs. However, aerobic power (58.3 +/- 5.3 ml kg-1 min-1) and body fat (8.0 +/- 1.1%) were unremarkable.

Adolescent↗
PubMed1987

Corporatization and deprivatization of health services in Canada.

Canada's system of health services has been shaped by the forces and values in the Canadian political, cultural, social, and economic environment; these forces continue to place constraints on future changes. We distinguish between "corporatization" and "privatization", and the implications of each for improved efficiency of the system. Although the organization of health services is, in certain provinces, undergoing significant structural changes, there is evidence that rather than privatizing, the system may actually be continuing to experience what we have termed deprivatization, as the scope of government involvement expands to include a more comprehensive definition of health care. Trends in Canada differ considerably from those in the United States; universal health insurance has curbed the ability and desire of institutions to exclude members of some socioeconomic groups from receiving care. U.S.-based models, if applied to Canada, could lead to both higher costs and lower quality of care. Considerable efficiencies can be realized within Canada's current system.

Canada↗
PubMed1986

Spinal loading during circuit weight-training and running.

Spinal shrinkage was used as an indicant of loading on the spine in circuit weight-training and running regimes. The loss of stature during two sets of a circuit of weight-training (n = 10), a 6 km run by novices (n = 9) and a 25 km run by trained runners (n = 7) was assessed in male subjects. Shrinkage was not significantly different between the weight-training regime and the 6 km run by novices, mean losses being 5.4 and 3.25 mm respectively. The rate of height loss in the experienced runners was 2.35 mm over 6 km run at 12.2 km.h-1, representing 0.4 mm.km-1 over the 6 km run, this shrinkage rate being continued over the last 19 km run at 14.7 km.h-1. The loss of height could not be predicted from a set of covariates. The magnitude of the circadian variation, mean 14.4 mm, exceeded the change in height during the 25 km run. The diurnal variation conformed to a cosine function, though a better fit was obtained with a power function equation. A marked diurnal pattern was also observed in lumbar extension. Though reversal of spinal shrinkage was observed during a night's sleep, no significant recovery occurred during a 20 min resting period immediately following the exercise regimes. These results have implications for the warm-up and timing of exercise regimes that impose significant loading on the spine.

Adolescent↗
PubMed1986

The multidisciplinary renal team: who makes the decisions?

Members of renal unit teams across Canada and in Michigan were asked to describe the involvement of various occupational groups and of patients in the treatment decision-making process in their actual unit and in an ideal unit. All occupational groups shared a belief in a relatively egalitarian team, in which the nephrologists would have primary responsibility for decision-making and the other groups would be highly involved. Nephrologists perceived reality as largely in accord with this ideology, indicating little difference between their authority in actuality and in an ideal unit, and perceiving other team members as having greater responsibility for decision-making than those groups perceived themselves as having. Ambiguity existed as to the appropriate level of decision-making involvement for the semiprofessional roles, and a substantial minority of nonphysician respondents saw staff nurses in particular (as well as patients) as having too little involvement. The findings suggest that as a technology becomes routinized, the multidisciplinary team approach may become less realistic. The resulting dissonance between ideology and reality may lead to job stress and adverse effects on job functioning.

Attitude of Health Personnel↗
PubMed1986

An approach to the assessment of learning needs for physician-managers.

In recent years physicians have become increasingly involved in the decision-making and policy-making processes in hospitals and other health service organizations. Consequently, there is a growing awareness of the need for specialized education programs for physicians who have managerial responsibilities. While education programs in management for physicians have been available in Britain and the United States for a number of years, relatively few programs have existed in Canada. Typically, physicians who have assumed administrative positions either within the medical staff organization or within the hospital's management structure have received no formal training in management. This article examines reasons for the increased demand for management education for physicians in Canada, specific needs of physicians in the area of management education, and the assessment of needs for management education programs.

Canada↗