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PubMedDate not supplied

A Hawthorne strategy: implications for performance measurement and improvement.

The Hawthorne experiments are a backdrop for diverse studies assessing the impact of treatment and experimentation on human and organizational performance. The Hawthorne effect is used to describe the positive impact on behavior that sometimes occurs in a study or experiment as a result of the interest shown by the experimenter in humans who are being treated, studied, or observed. We propose that the Hawthorne effect can be viewed as an active construct to develop a coherent strategy for performance improvement. We propose a "Hawthorne strategy" that transcends the Hawthorne effect in that it offers an approach to improving performance indefinitely. This strategy uses external observations of performance to increase internal commitment to performance improvement. The focus of individual responsibility increases as does the perceived connection between individual efforts and external performance improvement. The sense of accountability is maintained by institutional recognition and periodic reinforcement of individual behaviors that contribute to performance improvement. A successful Hawthorne strategy encourages providers of care to be evaluators of their performance as individuals, as members of groups, and as members of institutions.

Effect Modifier, Epidemiologic↗
PubMed2002

Benchmarking: the backbone of successful performance improvement.

Although there are many valid applications for comparative data--sometimes simply "knowing where you stand" is valuable--it is time for home care agencies to use benchmarking that moves beyond that point. Benchmarking is integral to organizational and management strategies whose ultimate goal is to improve, and not simply measure, performance. Peer benchmarks can be a critical resource in addressing the full spectrum of management challenges.

Benchmarking↗
PubMed2006

8 tips for a smooth Medicare audit.

Make the audit process less stressful with these commonsense tips: Delegate response to information requests to those with appropriate experience. Prepare a well-organized submission package that is easy to access. Know that the auditors cannot change the rules--and that their work gets audited, too.

Financial Management, Hospital↗
PubMed1981

Operational audit--the respiratory department.

Although our operational audit involved evaluating the cost effectiveness and efficiency with which procedures or functions are performed, our focus remained on the actual operational problem as defined in our criteria. The pre-determined standards, on which our criteria statements were based, provided the yardstick for measurement. Our assessment and Treatment Plan for patient care was audited, followed by a review of our policy and procedure compliance and the application of managerial systems and controls. Although the total impact of this audit tool on astute clinical care, management, judgement, and educational needs is yet to be addressed, we believe we have taken an important step in the direction of quality control through the initiation of an evaluation system in the Respiratory Department.

Concurrent Review↗
PubMed2006

[Standard of integration management at company level and its auditing].

SITUATION: Responsibility at company level for the employment of workers with health-related problems or disabilities has increased, inter alia because of integration management at company level according to section 84 (2) of the German Social Code Book IX. Although several recommendations exist, no standard is available for auditing and certification. Such a standard could be a basis for granting premiums according to section 84 (3) of Book IX of the German Social Code. AUDIT AND CERTIFICATION: One product of the international "disability management" movement is the "Consensus Based Disability Management Audit" (CBDMA). The Audit is a systematic and independent measurement of the effectiveness of integration management at company level. CBDMA goals are to give evidence of the quality of the integration management implemented, to identify opportunities for improvement and recommend appropriate corrective and preventive action. In May 2006, the integration management of Ford-Werke GmbH Germany with about 23 900 employees was audited and certified as the first company in Europe. STANDARD OF INTEGRATION MANAGEMENT AT COMPANY LEVEL: In dialogue with corporate practitioners, the international standard of CBDMA has been adapted, completed and verified concerning its practicability. Process orientation is the key approach, and the structure is similar to DIN EN ISO 9001:2000. Its structure is as follows: (1) management-labour responsibility (goals and objectives, program planning, management-labour review), (2) management of resources (disability manager and DM team, employees' participation, cooperation with external partners, infrastructure), (3) communication (internal and external public relations), (4) case management (identifying cases, contact, situation analysis, planning actions, implementing actions and monitoring, process and outcome evaluation), (5) analysis and improvement (analysis and program evaluation), (6) documentation (manual, records).

Disability Evaluation↗
PubMed2000

Brain attack!--How good is the early management of subarachnoid haemorrhage in accident and emergency departments? South Thames A&E Specialty Sub Committee Audit Group.

OBJECTIVES: The aim of this study was to assess the characteristics and audit the management of patients for whom a diagnosis of subarachnoid haemorrhage was made and who were admitted to a neurosurgical centre from an accident and emergency (A&E) department. The objective was to use the results to make recommendations for improving care in this group of patients. METHODS: Four neurosurgical centres in the South Thames Region provided lists of patients admitted with a diagnosis of subarachnoid haemorrhage during 1997. The medical records and computed tomography of 162 patient episodes from 20 A&E departments were reviewed. The speed of presentation, the provisional diagnosis and the referral patterns were examined. Patient records were audited to investigate what proportion were treated according to established guidelines while in the A&E departments. RESULTS: 63.7% of patients presented to A&E within six hours of ictus and 81.1% within three days. Some 49.2% of patients were seen by a doctor within 30 minutes and 74.7% within one hour. Computed tomography was performed on 18.8% within two hours and only 66.3% within six hours of arrival at the A&E department. Eighteen per cent were treated with nimodipine, 26% with intravenous fluids and 32% were given analgesia before leaving the department. Delays occurred in obtaining computed tomography. CONCLUSIONS: The management of patients who present to A&E departments with subarachnoid haemorrhage is suboptimal. Improved awareness of the disorder, management by senior A&E staff and clear care pathways could help with management.

Emergency Service, Hospital↗
PubMed2002

Methodological problems in comparing audits from the Nordic countries. A critical review of results from audit on Nordic general practitioners' management of patients with psychiatric problems.

In 1998, an audit on psychiatric problems in general practice was conducted in four Nordic countries. Five-hundred-and-sixty general practitioners participated and made registration according to the Audit Project Odense method. This paper describes the methodological problems related to international differences in the organisation of health care, recruitment of general practitioners and the registration of contacts. Nordic differences in this audit gave rise to inspiring discussions at national meetings, but methodological problems remain to be resolved if the results are to prove useful in scientific reporting.

Family Practice↗