Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Practice Management”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 325 records · Page 18Linked to original sources
PubMed2001

Ethical and research dilemmas arising from a questionnaire study of psychological morbidity among general practice managers.

A questionnaire-based research project enquiring into the psychological health of general practice managers found that 5% of managers admitted to suicidal ideas. This paper explores the moral issues raised when research conducted at a distance uncovers information about participants which indicates that they may be at increased risk of harm. It examines whether the authors of such studies have responsibilities towards their research participants beyond those of analysing and properly interpreting the data supplied to them. The paper is an exercise in self-reflection and self-criticism; not all the questions posed and explored by it can be answered definitively. Implications for planning studies of this kind are discussed.

Administrative Personnel↗
PubMed2001

Changing farmers' land management practices in the hills of Nepal.

This paper sheds light on changing farmers' land management practices in two mountain watersheds, with and without extemal assistance, in the western hills of Nepal. Information used in the analysis were obtained through a survey of 300 households, group discussion, key informant interviews, and field observation conducted during April-September 1999. Confronted with ever-decreasing landholding size due to a steadily growing population and scarcity of nonfarming employment opportunities, farmers in both watersheds have increasingly adopted assorted types of structural and biological measures to control soil erosion, landslides, gully expansion, and soil nutrient loss to maintain or even enhance land productivity. Adoption of guly control measures, construction of the retention walls, alley cropping, use of vegetative measures for landslide control, mulching, and use of green manure and chemical fertilizers are found significantly high in the project area due to the provision of technical and financial support, whereas composting is found significantly high in the nonproject area. Different from the traditionally held beliefs, population pressure on a finite land resource has brought positive change in land management. However, the experience from both watersheds indicates that there is limit to the extent that resource poor farmers can respond to land degradation without any extemal assistance. Required is the arrangement for appropriate polices and support services and facilities enabling farmers to adopt locationally suitable and economically attractive land management technologies.

Agriculture↗
PubMed2003

Assessment of clinical characteristics, management practices, and activities of geriatric horses.

OBJECTIVE: To describe the demographic and clinical characteristics, management practices, and owner perception of a population of geriatric horses, and to compare these data with findings in a group of younger horses. DESIGN: Original study. ANIMALS: 218 horses. PROCEDURE: Data were collected via a survey tool from owners of 165 horses that were > or = 20 years of age and 53 horses that were < 20 years of age. RESULTS: Compared with young horses, the geriatric group included a significantly greater number of ponies; geriatric horses were also more likely to have a history of colic, dental disease, tumors, lameness, and pituitary disease, but not laminitis, diarrhea, allergies, respiratory tract disease, thyroid disease, or fractures. Horses that had participated in Western equestrian disciplines were more likely to have a history of lameness. Among old horses, those with pituitary dysfunction were more likely to have a history of laminitis than those without pituitary dysfunction. Geriatric horses were more likely to have long hair and shedding abnormalities than were younger horses. Owners perceived their horses as old at approximately 22 years of age. In horses older than 16.5 years of age, age was a negative factor in the purchase of horses. CONCLUSIONS AND CLINICAL RELEVANCE: Geriatric and young horses share some similar health problems, but old horses have distinct health problems and veterinary medical requirements. The management and athletic history of horses may influence health as they age.

Age Distribution↗
PubMed2006

Life cycle optimisation for highway best management practices.

Highway runoff can cause a number of water quantity and quality problems. Stormwater management systems for highways have been developed based on a fast drainage for large storm situations. Non-point source pollution from highway runoff is a growing water quality concern. Stormwater quality control needs to be integrated into highway drainage design and operation to reduce the stormwater impacts on the receiving water. A continuous simulation/optimisation model for analysing integrated highway best management practices (BMPs) is presented. This model can evaluate the life cycle performance of infiltration and/or storage oriented highway BMPs. It can be directly integrated with spreadsheet optimisation tools to find the least cost options for implementing BMPs throughout a specified life cycle.

Benchmarking↗
PubMed2005

A review of information management practices for health ministries.

This is a review paper on best practices in information management for health ministries in governments. It is based on a recent study in which we examined information management (IM) and information technology (IT) functions inside a provincial health ministry. In order to foster best IM practices we offer five key guiding principles followed by five recommendations for action. We urge governments to consider these principles and recommendations when planning the IM function for their health ministries.

Benchmarking↗
PubMedDate not supplied

An examination of nursing attitudes and pain management practices.

PURPOSE: The purpose of this evaluation is to examine the relationship among nurses' pain management attitudes and pain management practices and to begin to explore the theoretical underpinnings that may influence this relationship. DESCRIPTION OF STUDY: A convenience sample of 29 female registered nurses working in hospice or home health settings participated in an educational program 1 day per week for 6 weeks. All participants were asked to complete the Cancer Pain Knowledge Inventory and Survey of Expectations and Pain Assessment Questionnaire 5 weeks before, immediately before, immediately after, 6 months after, and 12 months after the program. Seventeen participants completed all questionnaires at the 6-month follow-up; 16 participants completed all questionnaires at the 1-year follow-up. Personal beliefs about pain were evaluated in relation to the dimensions and treatment of pain. Intentions and expectations to perform specific activities were evaluated in relation to in-depth assessments, equianalgesic conversions, demonstration of new ideas, and communication. RESULTS: Nurses' attitudes, beliefs, intentions, and expectations about pain and pain management influenced nurses' patient care and educational activities. Nurses who believed that patients should be pain free and nurses who focused on both the dimensions and treatment of pain implemented more pain management activities. In general, nurses who had high intentions and expectations performed more pain management activities. CLINICAL IMPLICATIONS: Although nurses reported change in attitude, and high expectancy for change, feelings of increased credibility, and increased motivation as advocates for new approaches to practice, nurses sometimes found it difficult to implement new practices because of constraints in time and collaborative efforts. To implement new knowledge and achieve individualized goals for change, nurses must be allowed adequate time to analyze the relationships between their beliefs about pain and the ways that they solve patients' pain problems. In addition, more support for multidisciplinary collaboration is needed.

Adult↗
PubMed2003

A multisite survey of suctioning techniques and airway management practices.

BACKGROUND: Ventilator-associated pneumonia, common in critically ill patients, is associated with microaspiration of oropharyngeal secretions and may be related to suctioning and airway management practices. OBJECTIVES: To describe institutional policies and procedures related to closed-system suctioning and airway management of intubated patients, and to compare practices of registered nurses and respiratory therapists. METHODS: A descriptive, comparative, multisite study of facilities that use closed-system suctioning devices on most intubated adults was conducted. Nurses and respiratory therapists who worked at the sites completed surveys related to their practices. RESULTS: A total of 1665 nurses and respiratory therapists at 27 sites throughout the United States responded. The typical respondent had at least 6 years' experience with patients receiving mechanical ventilation (61%) and a baccalaureate degree or higher (54%). Most sites had policies for management of endotracheal tube cuffs (93%), hyperoxygenation (89%) and use of gloves (70%) with closed-system suctioning, and instillation of isotonic sodium chloride solution for thick secretions (74%). Only 48% of policies addressed oral care and 37% addressed oral suctioning. Nurses did more oral suctioning and oral care than respiratory therapists did, and respiratory therapists instilled sodium chloride solution more and rinsed the suctioning device more often than nurses did. CONCLUSIONS: Policies vary widely and do not always reflect current research. Consistent performance of practices such as wearing gloves for airway management and maintaining endotracheal cuff pressures must be evaluated. Collaborative, research-based policies and procedures must be developed and implemented to ensure best practices for intubated patients.

Adult↗
PubMed1996

Practicing managed care in the academic medical center.

The purpose of this article is to outline the contrasts between the traditional AMC and an organization oriented toward the delivery of population-based managed care. Academic medical centers differ from one another considerably in the extent to which they serve as quaternary care community resources, the degree to which they emphasize primary care in training and care delivery, and the amount of research undertaken. Nor is there a single organizational structure for managed care; successful managed care is practices in IPAs, multispecialty groups, PHOs, and staff-model HMOs. Nonetheless, the contrasts outlined here between AMCs and managed care organizations (MCOs) are valid in most cases.

Academic Medical Centers↗
PubMed2001

Optimisation of operational management practices for the detention basins.

The objective of this study is to develop new operational management practices for detention basins during rainfall events in order to limit flooding risk and, at the same time, to reduce pollutant discharges by optimising the settling process. For this work, a methodology was developed to study the integration of the stormwater treatment into existing detention structures. In this article, it was applied on two experimental sites. The current operation of the basins and "on/off" regulation studies were first carried out to quantify the freedom to act to change the control schemes. Relying on the support of these studies, new operational rules based on the current or "on/off" principle were then elaborated and tested on the experimental basins using a hydraulic model. Finally, their efficiency to protect against flooding and to reduce pollutant discharges was assessed.

Benchmarking↗
PubMed2006

National Heart, Lung, and Blood Institute guidelines and asthma management practices among inner-city pediatric primary care providers.

BACKGROUND AND OBJECTIVE: Most surveys of pediatric outpatient asthma management obtain information from parents and caregivers. Studies based on surveys of primary health-care providers are sparse. Suboptimal outpatient management may play a role in the high hospitalization rates among inner-city asthmatic children. Asthma management practices were compared between hospital-based and community-based primary care providers (PCPs). Adherence to National Heart, Lung, and Blood Institute (NHLBI) guidelines was evaluated, along with practices not clearly defined in the guidelines such as use of oral cough medicines and albuterol suspension. DESIGN/METHODS: An 8-point questionnaire was administered to 48 community-based and 32 hospital-based PCPs practicing in inner-city neighborhoods. The questionnaire addressed three "positive" practices (classification of asthma severity, use of asthma action plan, and use of a spacer) and three "negative" practices (use of cough syrup, use of albuterol suspension, and preferential use of leukotriene modifiers instead of inhaled corticosteroids as the first line of preventive therapy). Response options were as follows: never, rarely, sometimes, and always, scored from 0 to 3. The two physician groups were compared on score means for the positive and negative practices using a t test with statistical significance set at p < 0.05. RESULTS: Overall, the rate of adherence to the positive practices was high, with no significant difference between the two groups. Negative practices, while present in both the groups, were reported significantly more often by the community-based group, particularly the use of cough suppressants and albuterol suspension. CONCLUSIONS: Greater emphasis is needed to increase the awareness among PCPs of the NHLBI guideline recommendations, as suboptimal outpatient asthma management may contribute to the disproportionately higher hospitalization rates among inner-city asthmatic children. Clarification on the use of potentially harmful medications and those of doubtful value need to be incorporated in the guidelines. The extent to which these negative practices contribute to the elevated pediatric hospitalization rates warrants further investigation.

Adult↗
PubMed2006

Practical management of avian influenza in humans.

There has been much alarm about avian influenza and its potential for a global pandemic ever since the current epidemic of avian influenza infections in humans began in 2003. While there have been a number of published reports on the clinical features of avian influenza, there are few guidelines on the practical management of patients with avian influenza. A symposium organised by the Society of Infectious Disease (Singapore), Society of Intensive Care Medicine and the Singapore General Hospital was held in Singapore to gather the views of experts from Turkey, Thailand, Vietnam and Indonesia who collectively had first-hand experience of the management of the majority (more than 100 of 192) of cases of avian influenza worldwide. The experts emphasised the importance of adapting international guidelines to the practicalities of situations on the ground. There was stress on wide screening using clinical criteria primarily, molecular diagnostic techniques (with reference laboratory confirmation) for diagnosis, and rational use of antiviral prophylaxis as well as infection control using at least surgical masks, gowns and gloves. A detailed analysis of data from a pooled database from these and other affected countries is critical to building up the evidence base for practical internationally applicable guidelines.

Antiviral Agents↗
PubMed2002

Evaluating best management practices at an urban golf course.

This three-year study evaluated the effects of best management practices (BMPs) in reducing surface water contamination at an urban golf course. Water samples were collected before BMP implementation from two ponds on Braeburn Golf Course (Wichita, KS, USA). The pesticides 2,4-dicholorodiphenoxyacetic acid (2,4-D) and simazine were periodically found at concentrations above recommended water quality criteria. Excessive nutrients in the form of nitrates and total phosphorus were also measured. In addition, an assessment of macroinvertebrate populations revealed only a few tolerant species. Beginning in year 2, recommendations to alter chemical applications on the course were implemented as part of the BMPs. Surface water sampling during year 2 showed significant declines in nitrate and total phosphorus levels; however, seasonal contamination from pesticides continued to occur. Beginning in year 3, structural changes to the golf course were made as part of the BMPs. Subsequent water sampling indicated further reductions of nitrates (80%) and total phosphorus (40 and 60% in the two ponds, respectively), and elimination of contamination from spring applications of 2,4-D and simazine. Finally, an assessment of macroinvertebrate populations indicated an improvement in taxa richness, as well as repopulation by less tolerant organisms. Results of this study can be used to develop and refine golf course management procedures to protect aquatic environments.

2,4-Dichlorophenoxyacetic Acid↗
PubMed1990

A randomized trial to improve self-management practices of adults with asthma.

The prevalence and impact of adult asthma are substantial, and poor self-management practices, especially failures to adhere to treatment regimens, appear to be a significant problem. Desirable characteristics of an intervention program to improve self-management were identified through needs assessment and review of existing patient education resources. A comprehensive program was developed that integrated a workbook with one-to-one counseling and adherence-enhancing strategies. A longitudinal 1-year study compared patients receiving this self-management program with "usual care" patients receiving standard asthma pamphlets. Patients were randomly assigned to conditions. Baseline score and asthma severity were statistically controlled. Self-management patients had substantially better adherence than usual care patients, as well as improved functional status, at follow-up. Hospital and emergency department visits decreased in both groups but did not differ between groups.

Adult↗
PubMed2002

The effect of feeding and management practices on calving rate in dairy herds.

The objective of this study was to examine the effects of nutrition and management practices on reproductive performance in 31 Irish dairy herds participating in the Moorepark Dairy Management Information System (DairyMIS) during the period 1991-1998. Fifty variables relating to herd reproductive indices, calving events, stocking rate, disease, concentrate feeding, fertiliser usage, milk production and economic performance were studied using factor analysis. A factor analysis, followed by varimax rotation, identified 13 factors, which accounted for 83% of the total variance of the original variables. A regression model was used to predict calving rate from the orthogonal factor scores identified by factor analysis. Calving rate was defined as the proportion of services, for which an outcome was known, which resulted in a subsequent calving. Year, farm code and factor 3 (labelled herd size) together accounted for 40% of the observed variation in calving rate. The factor scores for factor 3 (herd size) were plotted against calving rate and because the plot was not linear, it was decided that dividing the factor scores into quartiles would produce a better fitting model. The factor scores for herd size were sorted and assigned to four equal categories (n = 47 per category), from lowest to highest. The ranges in herd size according to category were as follows: category 1 (34-96), category 2 (47-103), category 3 (66-152) and category 4 (108-359). The calving rate (%), (+/-S.E.) was 67.0 +/- 2.5 for category 1, 61.8 +/- 1.8 for category 2, 56.9 +/- 1.5 for category 3 and 53.2 +/- 2.85 for category 4. Using pair-wise comparisons, calving rates differed significantly (P < 0.05) between all categories except between categories 3 and 4 (P > 0.05). Herd-level milk production was not associated with calving rate indicating that good management may overcome any adverse effects of high milk production on reproductive performance. Larger herds, in combination with other associated herd characteristics, are likely to have poorer calving rates than medium or small herds.

Animal Husbandry↗
PubMed2006

Survey of management practices on reproductive performance of dairy cattle on large US commercial farms.

A survey regarding general management, sire selection, reproductive management, inseminator training and technique, heat abatement, body condition scoring, facility design and grouping, nutrition, employee training and management, and animal health and bio-security was carried out from March to September of 2004 in 153 herds in the Alta Genetics (Watertown, WI) Advantage Progeny Testing Program. A total of 103 herds (67.3%) completed the survey. Herd size was 613 +/- 46 cows, with herds located in Wisconsin (26), California (12), New York (11), Minnesota (10), Michigan (7), Washington (6), Pennsylvania (6), Iowa (5), Idaho (5), Texas (4), Ohio (4), and other states (7). These farms sold 34.5 +/- 0.3 kg of milk/d per cow, with an annual culling rate of 34 +/- 1% and a calving interval of 13.8 +/- 0.1 mo. Cows were observed for estrus 2.8 +/- 0.3 times/d, for a duration of 27 +/- 4 min, but 78% of the respondents admitted that detection of estrus was not the employee's sole responsibility at that time. Managers tried to achieve pregnancy until 8.8 +/- 0.9 failed inseminations, 300 +/- 26 d postpartum, or milk yield <17.7 +/- 0.5 kg/d. Nonpregnant cows were culled at 326 +/- 36 d postpartum or milk yield <16.4 +/- 0.3 kg/ d. Mean durations of the voluntary waiting period were 52 +/- 1.3 and 53 +/- 1.4 d for primiparous and multiparous cows, respectively. Hormonal synchronization or timed artificial insemination programs were used in 87% of the herds, with 86% synchronizing first services, 77% resynchronizing repeat services, and 59% treating cystic, anestrous, or anovular cows. Finding good employees was identified as the greatest labor challenge, followed by training and supervising employees. Mastitis and hairy heel warts were noted as the greatest animal health concerns, followed by lameness, abortions, and death losses, whereas the greatest reproductive challenges were artificial insemination service rate, conception rate, twinning, and retained placenta or metritis. Results of this study can provide a useful benchmark or reference with regard to commonly used management practices on large commercial US dairy farms at the present time.

Animals↗
PubMed1996

Practice management, health maintenance, and the use of computers in today's medical office.

It is clear that a successful medical practice needs a competent caring physician as well as office personnel who understand how to manage an office. The successful management of a practice helps achieve the goals that the physician and practice manager have established. This article has introduced ideas about how to manage and evaluate a practice. Adoption of some or all of these ideas helps provide more comprehensive and satisfying care for the physician and his or her patients.

Management Information Systems↗
PubMed1995

Practicing pathology through multiple hospitals at multiple sites. Practice management issues.

OBJECTIVE: To describe a successful method of management for pathologists to use in an environment of hospital consolidation and managed care. DESIGN: This article draws on the experience of a large, pathologist-owned regional laboratory in applying management principles needed for practice in the future. SETTING: A group of 20 pathologists, with 19 affiliated pathologists (multiple groups) practicing in rural and urban areas of five states in the Southern Plains. PRINCIPAL FINDINGS: Planning, personnel management, organizational structure, finance, and information systems are necessary keys for pathology management in a dispersed system. CONCLUSION: The opportunity exists for a professionally and economically satisfying practice in the medical environment of the future.

Clinical Laboratory Information Systems↗