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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.

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PubMed2001

The role of complaint management in the service recovery process.

BACKGROUND: Patient satisfaction and retention can be influenced by the development of an effective service recovery program that can identify complaints and remedy failure points in the service system. Patient complaints provide organizations with an opportunity to resolve unsatisfactory situations and to track complaint data for quality improvement purposes. SERVICE RECOVERY: Service recovery is an important and effective customer retention tool. One way an organization can ensure repeat business is by developing a strong customer service program that includes service recovery as an essential component. The concept of service recovery involves the service provider taking responsive action to "recover" lost or dissatisfied customers and convert them into satisfied customers. Service recovery has proven to be cost-effective in other service industries. THE COMPLAINT MANAGEMENT PROCESS: The complaint management process involves six steps that organizations can use to influence effective service recovery: (1) encourage complaints as a quality improvement tool; (2) establish a team of representatives to handle complaints; (3) resolve customer problems quickly and effectively; (4) develop a complaint database; (5) commit to identifying failure points in the service system; and (6) track trends and use information to improve service processes. SUMMARY AND CONCLUSIONS: Customer retention is enhanced when an organization can reclaim disgruntled patients through the development of effective service recovery programs. Health care organizations can become more customer oriented by taking advantage of the information provided by patient complaints, increasing patient satisfaction and retention in the process.

Cost-Benefit Analysis↗
PubMed2002

[Sustainable management for farmland shelterbelts].

The spatio-temporal pattern of shelterbelt regeneration is an important issue which determintes whether shelterbelt network produces protective effects sustainably. This article developed a new method of imitating "normal forest" to manage shelterbelts. Based on an administrative village as an organized management unit, each shelterbelt in the organized management unit will be individually regenerated and regulated, until the number of the shelterbelts in each age-class from young to mature ones will be equal, and the shelterbelts in each age-class will be spatially distributed uniformly in the shelterbelt network of an organized management unit. Consequently, this method might temporally ensure sustainable and stable ecological services which are provided by the shelterbelts in an organized management unit.

Agriculture↗
PubMed1992

Managed care.

Explore the source record for details and available documents.

California↗
PubMed2002

How patients with heart failure are managed in Portugal.

The prevalence of heart failure is increasing all over the world. It is a common and growing public health problem in Portugal as in many other European countries. This article provides a review of health service organization and current heart failure management in Portugal, discusses primary care and ward practices in different hospitals and reports on the use of proven standard therapies for the treatment of heart failure in the community. Despite major advances in diagnosis and treatment, heart failure is only satisfactorily managed. Furthermore efforts are necessary before the beneficial effects observed in trials have a real impact in clinical practice. A broader view and priority for the management of this syndrome on a national level are needed to improve the quality of heart failure care in Portugal.

Cardiotonic Agents↗
PubMed1992

Developing a quality improvement program in materiel management.

Materiel management frequently considers itself a service organization but infrequently considers the service provided as contributing to quality patient care. Quality patient care can only be delivered if every department is delivering quality service. Materiel management's ultimate customer is the patient waiting for the supply that is to be delivered by central stores or the prosthetic device to be obtained through purchasing. Quality service is the key to success, and materiel management must be proactive and deliver quality services.

Cost Control↗
PubMedDate not supplied

[Situation analysis and proposals for improving primary care nursing in Mallorca: study with focal groups].

BACKGROUND: The primary care reform (PCR) has give rise to some major changes in the nursing profession. The objectives of this study are to analyze the achievements made by the nurses, to identify the problems they currently have in primary care and to suggest some lines along which work can be done for the future. METHOD: Qualitative research (focal group method). Eight groups were made segmented by occupational category and the position held. Scope of the analysis: the role of nurses, services supply and organization, participation and management, marketing and training. RESULTS: In the opinion of those surveyed, the PCR has entailed a broadening of the nurses' skills, although their role is still well-defined. The nurses are of the opinion that there is no listing of services inherent to nursing despite the leading role they obviously play in home care and health education. The need has been identified of assess the existing health programs in terms of results. Concerning to health services organization, main problems were related to the lack of adapting staffing in keeping with the rise in population and difficulties of internal communications within the health professional teams and the very small degree to which nursing services are disseminated. The need is felt of broadening pre-diploma training with regard to some subjects (health education) and skills (teamwork). CONCLUSIONS: Although the PCR has meant improvements for the nurses, solutions have as yet to have been provided to some aspects (including defining a listing of services, adapting staffing, internal communications, marketing, training) and given the opportunity the transferring of authorities over health care entail, further progress must be made toward innovative proposals to improve the health services.

Focus Groups↗
PubMed1997

Implementing programs for chronic illness management: the case of hypertension services.

BACKGROUND: This article describes the process by which HealthSystem Minnesota (a vertically integrated health care organization), functioning in a competitive managed care environment, has been implementing a hypertension services program. The program involves a team approach to care, with emphasis on patient participation in treatment; decentralized care delivery by nurse coordinators at primary care practice sites; ongoing training and education for patients and providers; and the continuous monitoring and evaluation of patient outcomes and satisfaction. JOB-LEVEL ISSUES: A variety of issues, such as the role and responsibilities of the nurse coordinator, became evident as the program moved towards operational status at four primary care practice sites, which prolonged the implementation period. PROCESS-LEVEL ISSUES: Issues relating to work process changes were more complicated to resolve and required, in some cases, changes in the proposed model. The most significant process-level issues related to educating physicians about the program to secure their participation and support. ORGANIZATION-LEVEL ISSUES: Such issues, which were the most difficult for program implementors to anticipate and resolve, included an organizational culture that emphasized decision making autonomy at primary practice sites. In part, the difficulty encountered in resolving organization-level issues reflected the implementors' lack of awareness of the strength or complexity of the environmental pressures facing the organization, as well as a lack of sensitivity to nuances relating to organizational culture. MOVING AHEAD: Two groups of hypertensive patients--at the implementation and comparison sites--will be compared with respect to satisfaction with care, clinical outcomes, and costs. Expansion of the model to patients with other chronic conditions is under consideration.

Case Management↗
PubMedDate not supplied

Data model management in a clinical service: application in an echography unit for tocho-gynaecology.

The organization and management of clinical information must take place according to the classical concept of department section or specialty area. Traditional organization and communication models must be respected, and those to be executed by the computer system must be developed on top of them. Information models that describe the organic structure of any specialty area must be proposed independently from the content and with the possibility of particularizing in each case. Taking these specifications into account and using our general entity relationship model for a specialty service, we present the description of the 'central clinical services function, particularizing for an echography unit within a tocho-gynaecology area. We present entity and relationship tables, data dictionary and organization and description of the basic user views.

Hospital Information Systems↗
PubMed2002

Managed care--present day challenges and a working model for future consideration.

With the emergence of managed care as a dominant form of coverage for the American workforce and the concomitant growth in the number of uninsured and underinsured citizens, attention is increasingly focused on the development of cost-effective and efficient reimbursement strategies for the future. This manuscript provides both a summation of the different forms of coverage now available and a look at a possible future scenario through the only universal health insurance program now in place in the United States--Hawaii's health care system.

Consumer Behavior↗
PubMed1994

Health services research in radiology: opportunities and imperatives.

"Health services research is a field of inquiry that examines the impact of the organization, financing, and management of health care services on the delivery, quality, cost, access to, and outcomes of such services." This organizational definition, from the Association for Health Services Research (AHSR; membership services, personal communication), is a new buzz word in the current era of health care reform. Radiologists will be asked or expected to become active participants in this field. If they do not take part, they will be shut out of important policy making. The process and outcome of this research often determine whether examinations and procedures will be reimbursed in the future and at what level. This article addresses the particular need for trained health service researchers in radiology, opportunities for formal research training, and available sources of funding for health services training and research. It is not intended to be a definitive resource for those wishing to enter this field; rather, it provides a foundation for beginning pursuit of this evolving academic discipline.

Education, Medical, Graduate↗
PubMed1996

Why will physicians in this new environment replace MHAs?

The competitive forces of managed care, capitated payment, cost constraints, and the formation of health networks are among the major precipitating factors leading to the employment of additional executives and middle managers with clinical backgrounds. These factors will require our health leaders to know how to cut costs without seriously impinging on the accessibility and quality of patient care. Physicians with leadership and management skills, and with prior hands-on patient care expertise, will continue to be sought after in the foreseeable future by various types of health organizations. With this scenario, health services management generalists are predicted to experience increasing difficulties to secure senior positions in the health industry,

Canada↗
PubMed2000

Oncology business update.

This article explores a variety of environmental factors that influence the delivery of oncology care in both academic and community settings. These factors include fragmentation of the managed-care process, increased backlash to managed-care organizations, greater federal and state intervention, and new technologies, medicines, and procedures. The author also discusses continued consolidation of managed-care organizations, as well as how physicians and hospitals are being compensated for oncology services. Other topics explored include the progress of case rate and capitation as an alternative to fee-for-service medicine, the latest events in insurer coverage of clinical trials, and the progress of oncology disease management. In addition, the author discusses the interest of national payers in the management of oncology services and delivery mechanisms for highly specialized oncology services.

Health Maintenance Organizations↗
PubMed2004

Assessing patient category/dependence systems for determining the nurse/patient ratio in ICU and HDU: a review of approaches.

BACKGROUND: A huge range of patient classification systems/tools are used in critical care units to inform workforce planning, however, they are not always applied appropriately. Many of these systems/tools were not originally developed for the purposes of workforce planning and so their use in determining the nurse:patient ratio required in critical care settings raises a number of issues for the organisation and management of these services. AIM: The aim of this paper is to review the three main assessment systems that are commonly used in critical care settings in the UK and evaluate their effectiveness in accurately determining nurse : patient ratios. If the application of these systems/tools is to enhance care, a thorough understanding of their origins and purpose is necessary. If this is lacking, then decisions relating to workload planning, particularly when calculating nurse : patient ratios, may be flawed. CONCLUSIONS: Patient dependency/classification systems and patient dependency scoring systems for severity of illness are robust measures for predicting morbidity and mortality. However, they are not accurate if used to calculate nurse : patient ratios because they are not designed to measure nursing input. Nursing intensity measures provide a useful framework for calculating the cost of providing a nursing service in critical care and can serve as a measure of nursing input, albeit a fairly basic one. However, many components of the nursing role are not "accounted" for in these measures. IMPLICATIONS: The implications of these findings for the organization and management of critical care services are discussed. Careful consideration of these areas is vital if a cost efficient and cost-effective critical care service is to be delivered.

Activities of Daily Living↗
PubMed1998

Restructuring public mental health and substance abuse service systems.

The authors originally circulated the concepts in this proposal during May 1995. The purpose was to support an open, public dialogue regarding the restructuring of the mental health and substance abuse services in Illinois in anticipation of Medicaid funding changes. Restructuring mental health and substance abuse service systems should follow certain key principles. These principles are applicable to other states, particularly those large in territory and population. The authors propose the temporary use of multiple managed care companies serving as administrative services only (ASO) organizations, each of whom would have responsibility for a given geographic portion of a state. The role of the ASOs would be to organize providers into networks on a regional basis and transfer managed care expertise in financing and clinical management to the relevant state departments and provider groups. Changes in the service delivery system would be phased in over time with reorganization of key components of the system during each phase. Where the provision of mental health, substance abuse, and social services is split among multiple state agencies, these agencies would be merged to achieve unified funding and administrative efficiency. Patients and advocacy organizations would play a key role in overseeing and shaping system restructuring at all levels, including a governmental board reporting to the governor, overseeing ASO organizations' operations and assuring quality and access at the provider level. The authors propose funding of public behavioral health services through use of a tiered, integrated funding model.

Case Management↗