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At least 217 records · Page 12Linked to original sources
PubMed1999

A multiple-level analysis of hospital team effectiveness.

The purpose of this study was to identify factors at organizational, team, and individual levels that are most predictive of quality improvement team effectiveness. Numerous studies have been conducted on the use of teams in health care. The majority of these studies have focused on organizational-level issues. A few others have focused on team-level issues or individual-level issues. The authors believe that successful use of teams requires a more integrated approach. This study addresses this need by providing a multiple-level analysis of teams in three hospitals. Structured interviews were conducted with hospital administrators as well as quality improvement representatives and team leaders, and written questionnaires were administered to team members. Eight factors were related significantly to the effectiveness of team effort: frequency of team meetings, hours per week conducting team activities, willingness of members to serve on team, selection method of team members, communication of team plans, team member position/composition, team leader performance, and facilitator performance.

Chi-Square Distribution↗
PubMedDate not supplied

Strategic performance management: development of a performance measurement system at the Mayo Clinic.

Managing and measuring performance become exceedingly complex as healthcare institutions evolve into integrated health systems comprised of hospitals, outpatient clinics and surgery centers, nursing homes, and home health services. Leaders of integrated health systems need to develop a methodology and system that align organizational strategies with performance measurement and management. To meet this end, multiple healthcare organizations embrace the performance-indicators reporting system known as a "balanced scorecard" or a "dashboard report." This discrete set of macrolevel indicators gives senior management a fast but comprehensive glimpse of the organization's performance in meeting its quality, operational, and financial goals. The leadership of outpatient operations for Mayo Clinic in Rochester, Minnesota built on this concept by creating a performance management and measurement system that monitors and reports how well the organization achieves its performance goals. Internal stakeholders identified metrics to measure performance in each key category. Through these metrics, the organization links Mayo Clinic's vision, primary value, core principles, and day-to-day operations by monitoring key performance indicators on a weekly, monthly, or quarterly basis.

Academic Medical Centers↗
PubMed2002

Real-time management of IT.

The ability to successfully manage information technology-driven transformations of work processes into value--which has always been a critical requirement yet often a huge disappointment--is now becoming a main ingredient of success in all industries, including healthcare. This article prescribes management dimensions that healthcare leaders should focus on to improve their ability to manage and derive value from the re-invented work flow, especially the highly visible opportunities offered by e-commerce and the consumer movement.

Community Participation↗
PubMed2001

The Results Act: a challenging management framework.

This article provides the reader with a basic understanding of the Government Performance and Results Act of 1993. The Act requires federal agencies to institute a planning and reporting management framework to achieve results. It also identifies challenges federal agencies face in implementing a stronger results management approach and promising practices agencies can use in crafting their management approach.

Benchmarking↗
PubMed1992

Hypertension, obesity and response to antihypertensive treatment: results of a community survey.

A random sample of 2,854 subjects aged 35-64 was examined in the town of Vicenza (Italy) as part of the 'Hypertension Management Audit Project'. Pearson's correlation coefficient and multivariate analysis considering systolic and diastolic blood pressure, age and body mass index (BMI) were performed. SBP was more closely correlated with age than DBP. BMI correlated with both SBP and DBP, but very little with age. Fifty-seven percent of the men had a BMI of 25.5 or more and 49% of the women had a BMI of 24.5 or more. The quality of BP control in the treated patients was worse in the overweight when compared with the lean patients, although overweight and lean patients are treated with the same frequency.

Adult↗
PubMed2006

Hospital-physician joint ventures: maximizing the potential.

Four primary hospital-physician models are per-click service agreements, management services agreements, gainsharing, and equity joint ventures. Four key attributes needed for successful joint ventures are clinical quality, customer satisfaction, operational effectiveness, and financial soundness. Hospitals and physicians need to approach joint ventures with expectations of high performance.

Efficiency, Organizational↗
PubMed1988

Health service performance indicators.

The development of statistical indicators for monitoring performance throughout the National Health Service began in 1981. In recent years, computer software packages containing performance indicators have been amended to include Health and Social Services Boards in Northern Ireland. Although this information is available to anyone with an interest in service provision, the main purpose of the indicator packages is to provide a framework and discipline for ensuring proper accountability to a higher tier authority.Efficiency and effectiveness are concepts central to performance appraisal. Most performance indicators are concerned with the input of resources or treatment activity rather than health outcome. Consequently the context within which the accountability review procedure operates is predetermined towards efficiency. The validity of the review process is limited by the accuracy of the indicators and the manner in which they are interpreted. The scale at which performance indicators function and the constraints associated with their use as an analytic tool are illustrated using data from a mental illness hospital in Northern Ireland.

Efficiency↗
PubMed1986

Hospital information systems--a need to re-evaluate the roles of management.

Hospital information systems are now entering a third generation, not only as regards new technology but more significantly with regard to the role of those involved in their design and implementation. This new emphasis requires a re-evaluation of the roles of the designer and user. In the design of a hospital information system, its unique nature--relating central management to a number of independent clinical specialties--must be recognized. One way to achieve this is the establishment of a minimum basic data set dictated by the specific needs of top management interacting with independent clinical subsystems.

Hospital Administrators↗
PubMed1995

Computer-based medical clerking.

All admissions to hospital begin with medical clerking. Thus, it is an essential element of any electronic patient record system. This paper describes some initial experiments to develop a computer-based clerking tool with which doctors can record their clinical observations. The clerking tool uses a structured data entry technique which is based upon an underlying semantic network of clinical terminology. This enables data to be captured and stored in a semantically structured manner, facilitating its use in computer-based record systems and also for audit, management, and decision support purposes. The prototype tool is described, and the evaluation and preliminary results obtained are reported. Initial results indicate that structured data entry is feasible for hospital-based clerking.

Admitting Department, Hospital↗
PubMed1996

Lessons from worldwide experience with hypertension control.

Control of hypertension encompasses primary prevention, early detection and adequate treatment of high blood pressure. Primary prevention involves action at the community level to reduce obesity, alcohol and salt consumption, and increase physical activity. Management of hypertension involves diagnostic work-up, assessment of overall CVD risk, nonpharmacological and pharmacological treatment. The concept of community control was introduced to WHO's cardiovascular programme in the late 1960s, with hypertension as a spearhead. Once it had been demonstrated that the community approach was feasible, activities were extended to other cardiovascular, and later to noncommunicable, diseases. Outcome and process evaluations were made. A decrease in mortality and morbidity from stroke and myocardial infarction was demonstrated in most studies. As a result of these programmes, hypertension awareness, treatment and control rates increased remarkably and mean blood pressure levels decreased. The WHO/WHL Hypertension Management Audit Project attempted more complex analyses in various European populations. The majority of community control programmes emphasized detection and treatment, rather than primary prevention. Therefore, despite a decline in age-adjusted average blood pressures in various populations, the incidence of hypertension did not follow this trend. The decline observed in average blood pressure was achieved mainly by widespread drug treatment. Since cardiovascular risk grows with increasing blood pressure continuously and progressively, events occurring in the "normotensive' blood pressure range escape control. Developing countries will encounter the problem of prohibitive costs of care and drug treatment for hypertension. Therefore greater emphasis must be put on primary prevention in community control programmes.

Adult↗
PubMed2005

A multi-district audit of the management of HIV infection in pregnant women and the prevention of mother-to-child transmission: Yorkshire HIV pregnancy audit.

A regional audit was performed to compare clinical practice against the British HIV Association guidelines for the management of HIV infection in pregnancy. Data were collected from 2000 to 2002 from eight clinics across Yorkshire using a questionnaire. There were 22 live births to 22 HIV + pregnant women. There were no cases of transmission of HIV from mother to child. The majority (20/22) of mothers received therapy as recommended in the guidelines, with only two initially receiving inappropriate dual therapy. In all, 16/22 (73%) had elective caesarean sections, 5/22 (23%) emergency sections after the onset of labour and one had a vaginal delivery. Also, 12/22 (55%) definitely received intravenous zidovudine during delivery. Added to these, 19/22 infants received appropriate antiretroviral medication for four to six weeks after birth. No mothers were known to have breast-fed.

Disease Management↗
PubMed2003

Cost-minimization analysis and audit of antibiotic management of bone and joint infections with ambulatory teicoplanin, in-patient care or outpatient oral linezolid therapy.

Bone and joint infections are significant causes of morbidity, mortality and healthcare costs. The cost of treatment for such infections is driven primarily by the length of hospital stay. Many of these infections will require treatment with prolonged periods of parenteral antibiotic therapy. Clinicians and healthcare managers are being attracted increasingly by administering treatment in the ambulatory setting as this offers clinical, economic and quality of life advantages from both the hospital's and patient's perspective. Our retrospective audit of managing 55 treatment episodes of bone and joint infections with teicoplanin delivered in the outpatient or home setting revealed that the mean cost of care per episode of infection was less with treatment in the ambulatory setting ( pound 1749.15) compared with the in-patient setting ( pound 11 400) or compared with the hypothetical situation of treatment with oral linezolid in the home setting ( pound 2546). Teicoplanin therapeutic drug monitoring appears to be valuable in establishing optimal serum levels, which appear to correlate with good clinical outcomes. The potential for alternative day or thrice weekly dosing with teicoplanin may offer further cost advantages whilst maintaining equivalent clinical effectiveness.

Acetamides↗
PubMed2002

National audit of the management of peritonsillar abscess.

An anonymous postal survey of 200 consultants was used to audit the current prevalent practices in the management of quinsy in the UK; 101 responded. The findings reveal that on average an otolaryngology department treats 29 cases per year, the vast majority (94%) on an inpatient basis. The main initial treatment was needle aspiration combined with intravenous antibiotics. Interestingly, those departments treating more than 20 cases a year are more likely to use needle aspiration, while departments in England and Wales use significantly more incision and drainage than those in Scotland. Incision and drainage (52%) was the most common form of treatment of non-resolving patients. The median hospital stay was two days.

Anti-Bacterial Agents↗
PubMed1996

Department audit of inpatient management of asthma.

Rising asthma morbidity and mortality worldwide has prompted the recommendation of guidelines for its management. There has also been recent interest in the role of medical audit in assessing the effectiveness of guidelines, and in identifying deficiencies in clinical practice. We disseminated guidelines for the inpatient management of asthma to our department in March 1994, and subsequently performed a criterion-based audit in which we measured our performance in fulfilling various criteria deemed essential for good asthma management. Three periods in time were audited: a five-week period in March/April 1993 before the existence of guidelines (n = 22), the same period in March/April 1994 (n = 27), and the month of August 1994 (n = 17). The introduction of guidelines resulted in definite improvement in history-taking, physical examination, management, review, monitoring and patient fulfillment of pre-discharge criteria. Specific deficiencies identified were underuse of peak flow measurements, which improved after guidelines; and under prescription of oxygen, which persisted despite the guidelines. No difference was noted in terms of the quality outcome indicators of length of hospital stay, complications of procedures, hospital incidents, morbidity, mortality or visits to the A & E. There was, however, an encouraging drop (although not statistically significant) in the one-month readmission rate from 13.6% in 1993, to 7.4% and 5.9% in 1994, after the introduction of guidelines.

Adolescent↗
PubMed1996

Documenting wound management.

An audit of new wound management guidelines was conducted in October 1993 at St James's University Hospital, Leeds. Five patients with wounds (including pressure sores, cavity wounds and leg ulcers) were randomly sampled in each ward. Where the number of patients with wounds in a ward was five or less, all patients were recruited. An audit questionnaire based on an agreed standard was completed for all wounds. The areas included in the audit were all wards in general surgery, orthopaedics, plastic surgery, gynaecology, intensive care, elderly care and medicine. A sample of 120 patients with 152 wounds was obtained, comprising pressure sores, leg ulcers and infected wounds. A new wound assessment form was used in 89.5% of wounds audited (136/152), and only one of these patients did not have a designated care plan. The audit process raised awareness of the issues involved. The process of reviewing documentation with the wound-care link nurse identified areas for further improvement. The guidelines and wound-care forms are now in widespread use.

Humans↗