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[Structured public health quality circle on the topic of diabetes management in general practice].

The efficacy of quality circles has not yet been evaluated in controlled studies in Germany. The Central Research Institute for Ambulatory Health Care in Germany conducted a prospective controlled trial in order to evaluate the effects of structured quality circles on the process of quality ambulatory care for diabetic patients. Following a training for moderators (two for each quality circle) two quality circles undertook five sessions. In a representative random sample (25 diabetic patients per practice), the quality of diabetes care was evaluated before and after participation in the quality circles and was compared to the results of a control group without peer review. The participation in a quality circle resulted in a significant and relevant improvement of the quality concerning the detection of diabetes related complications.

Diabetes Mellitus↗

Productivity-enhancing work innovations: remedies for what ails hospitals?

Prospective pricing, the proliferation of alternative delivery systems, and the demands of third party payers and corporate employers for the containment of health care costs have engendered the keen interest of hospital executives seeking strategies for improving labor productivity. Despite this interest, the relevant literature suggests that few work innovations designed to enhance labor productivity have been implemented in hospitals. This article describes generic versions of four such work innovations--quality circles, union-management committees, autonomous work groups, and gainsharing--and discusses relevant research indicating the types of benefits gained from each and the reasons why some have failed. Each innovation's potential for success in hospitals is evaluated, and suggestions for increasing the effectiveness of each in hospitals is offered.

Decision Making, Organizational↗

The Joint Commission and quality patient outcomes: role of materiel management.

Again, employee orientation and ongoing education are crucial. The orientation should include not only cover protection of the employee but protection and management of supplies as they reach the consumer. The consultative role of the infection control person is also valuable, especially with regard to sterilizers and to sterilization and equipment management. Employees also need to understand the principles of effective sterilization, disinfection, and basic sanitation. There also need to be documented maintenance and surveillance of sterilization equipment.

Costs and Cost Analysis↗