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PubMedDate not supplied

Value-based partnering in healthcare: a framework for analysis.

Value-based partnering is designed to move the healthcare system beyond cost-based competition. It recognizes that the healthcare "product" is not a commodity and that much of the value in the system comes from relationships between and among four stakeholders: consumers, providers, health plans, and employers. Given the difficulty of measuring such benefits as quality of care, improved health status, and increased employee productivity, stakeholders within the system traditionally have focused on easily measurable financial considerations such as premium rates. This focus has led to a system that defines relationships in purely financial terms. In contrast, the value-based partnering model presented in this article recognizes the range of factors that stakeholders consider in their relationships with each other. This approach has the potential to change the nature of competition and presents opportunities for those organizations that can effectively partner with other stakeholders and demonstrate value, rather than just lower cost. Moreover, by recognizing the interdependencies among stakeholder groups, the approach creates a strategic reason for employers, health plans, providers, and consumers to exchange information and create long-term alliances.

Consumer Behavior↗
PubMed2001

E-mail etiquette.

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California↗
PubMed2001

Managing waterway health in the Goulburn Broken Catchment, Victoria, Australia.

Historically within most catchments, resource management programs have been planned and implemented in isolation of one another. This was once the case in the Goulburn Broken Catchment, a major catchment of the Murray Darling Basin, Australia. Although only 2% of the Murray Darling Basin's land area, the catchment generates 11% of the basin's water resources. Learning from the past, a cooperative and collaborative approach to natural resource programs has developed. This approach is the envy of many other catchment communities and agencies. Through a combination of "Partnership Programs", "Operational Initiatives" and community involvement, significant programs have been implemented within the catchment, which will benefit not only the local community but communities further afield. The outcomes of the waterway health program highlight the benefits provided through the establishment of cooperative and partnership resource improvement programs. These programs were founded on the ability of the community to recognise the need for integration, base management decisions on best available science and an ability to work together. Their effective delivery has been provided through the resources provided, to the local community, by the Natural Heritage Trust with matching and State and local allocations. While programs have shown success, challenges still face the community. These challenges include verification and implementation of environmental flows, storage of the catchment's vital water resources, and maintaining community involvement and participation in on-going works programs. The Goulburn Broken Catchment community, with the support of Federal, State and Local Governments, is looking at opportunities for continued improvements in waterway health.

Conservation of Natural Resources↗
PubMed2001

What makes catchment management groups "tick"?

The work of catchment management groups throughout Australia represents a significant economic and social investment in natural resource management. Institutional structures and policies, the role of on-ground coordinators, facilitation processes, citizen participation and social capital are critical factors influencing the success of catchment management groups. From a participant-researcher viewpoint, this paper signposts research directions and themes that are being pursued from the participant/coordinator, catchment group, and lead government/non-government agency perspective on the influence of these factors on the success of a catchment management group in the Pumicestone Region of Southeast Queensland, Australia. Research directions, themes and discussion/reflection points for practitioners include--the importance of understanding milieu; motivation; success; having fun; "networking networks"; involvement of "nontraditional" stakeholders; development of stakeholder/participant partnerships; learning from other practitioners; methods of stakeholder/participant representation; evaluation; the need for guiding principles or philosophy; the equivalence of planning, implementation, evaluation, and resourcing; catchments as fundamental units of Nature; continuity of support for groups; recognising a new role for government; working with existing networks; and the need for an eclectic approach to natural resource management.

Community-Institutional Relations↗
PubMedDate not supplied

Taking the stress out of stressful conversations.

Stressful conversations are unavoidable in life. In business, they can run the gamut from firing a subordinate to, curiously enough, receiving praise. But whatever the context, stressful conversations carry a heavy emotional load. Indeed, stressful conversations cause such anxiety that most people simply avoid them. Yet it can be extremely costly to dodge issues, appease difficult people, and smooth over antagonisms; avoidance usually only worsens a problem or a relationship. Using vivid examples of the three basic stressful conversations that people bump up against most often in the workplace, the author explains how managers can improve those interactions unilaterally. To begin with, they should approach the situations with greater self-awareness. Awareness building is not about endless self-analysis; much of it simply involves making tacit knowledge about oneself more explicit. It is important for those who are vulnerable to hostility, for example, to know how they react to it. Do they clam up or do they retaliate? Knowing how you react in a stressful situation will teach you a lot about your trouble areas and can help you master stressful situations. The author also recommends rehearsing difficult conversations in advance to fine-tune your phrasing and tone. And the best way to keep from being thrown off balance by difficult conversations that crop up unexpectedly is to develop a few hip-pocket phrases that you can pull out on the spot. We all know from past experience what kinds of conversations and people we handle badly. The trick is to have prepared conversational tactics to address those situations.

Communication↗
PubMedDate not supplied

Office romances.

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Adult↗
PubMed1992

Commentary on "Being on time for appointments.

In "Being on time for appointments," Sharon Schwarze addresses an important issue -- the tendency for doctors to keep patients waiting for their appointments. Let me state categorically that I agree that this is a deplorable situation that warrants discussion and warrants a serious attempt to correct the practice. I do believe, however, that this is an issue more appropriately considered under the rubric of etiquette rather than ethics, though clearly it is subsumed in the category of respect for persons....

Communication↗
PubMed1990

The physician-patient relationship: a patient-physician's view.

The physician-patient relationship, like any human relationship, blends two types of interactions described by philosopher Martin Buber. In an "I-It" interaction, the physician objectifies the patient and his or her problem; in an "I-Thou" interaction, the physician perceives the patient as an emotional being. My encounters with medical practitioners as a patient with brachial neuritis and Guillain-Barré syndrome illustrate these forms of the physician-patient relationship.

Attitude↗