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Creative partnerships: the profession's plan (Presidential Address).

Through interprofessional collaboration on behalf of the populations we serve, and through the integration of science and art, we shall transform our present and direct our future. The crisis of the entrepreneurial idea in health care must not become the pathology of our service ideals. Rather, this crisis must be viewed as our opportunity to adopt marketing as an exchange relationship and engage in activities that market ourselves as a vital profession that places the good of those we serve above our own self-interest. Through our creative partnerships, we can achieve professional excellence. Professional excellence is the key to assuring occupational therapy's position in the marketplace.

Art↗

Creative proposal plays to a tough crowd.

Even avowed opponents of prospective payment for capital debt admit the plan unveiled by Administrator Gail Wilensky is creative and addresses the hospital industry's complaints. But there's skepticism about how the solutions will hold up in practice, and not many are willing to embrace it yet.

Capital Expenditures↗

Creative payment strategy helps ensure a future for teaching hospitals.

The Colorado Medicaid Program in years past relied on disproportionate share hospital (DSH) payment programs to increase access to hospital care for Colorado citizens, ensure the future financial viability of key safety-net hospitals, and partially offset the state's cost of funding the Medicaid program. The options to finance Medicaid care using DSH payments, however, recently have been severely limited by legislative and regulatory changes. Between 1991 and 1997, a creative Medicaid refinancing strategy called the major teaching hospital (MTH) payment program enabled $131 million in net payments to be distributed to the two major teaching hospitals in Colorado to provide enhanced funding related to their teaching programs and to address the ever-expanding healthcare needs of their low-income patients. This new Medicaid payment mechanism brought the state $69.5 million in Federal funding that otherwise would not have been received.

Colorado↗

The multimedia power portfolio: creative strategy for core curriculum.

To address today's rapidly changing health care environment, educational programs for students in the health professions must also change by exploring new and innovative ways to better prepare students for their future as members of the health care team. This demand for change in allied health and nursing educational programs comes at a time when institutions of higher education are faced with shrinking funds. Therefore, creative efficient utilization of resources must be a prime consideration when implementing new educational models.

Allied Health Personnel↗

Maryland Health Care System, Inc.: a creative response to change.

Maryland Health Care System, Inc. represents the first multihospital activity in a large eastern city to incorporate a subsidiary management system. The creative coordination of health care capabilities encouraged by the MHCS interpretation may be applied elsewhere as new hospital systems develop.

Economics, Hospital↗

Departmental newsletters: creative, cost-effective communication.

Communication is a focus of management concern in the Eighties. Efforts in communication don't always succeed. A newsletter approach to facilitate communication has been effective in different work environments, and could easily be adapted by consultants and educators. A newsletter provides a convenient, cost-effective, and creative format for communication and can create a sense of positive participation.

Communication↗

Creative staffing models in medical transcription.

This article is a summary of staffing alternatives for medical transcription developed over the years and proven successful in certain hospital facilities. Creative approaches to staffing the medical transcription unit have proved to be effective tools in the maintenance and even expansion of transcription services on a cost-effective basis in a changing marketplace.

Cost-Benefit Analysis↗

Psychodynamic perspective on therapeutic boundaries: creative clinical possibilities.

Discussion of boundaries in therapeutic work most often focuses on boundary maintenance, risk management factors, and boundary violations. The psychodynamic meaning and clinical management of boundaries in therapeutic relationships remains a neglected area of discourse. Clinical vignettes will illustrate a psychodynamic, developmental-relational perspective using boundary dilemmas to deepen and advance the therapeutic process. This article contributes to the dialogue about the process of making meaning and constructing therapeutically useful and creative boundaries that further the psychotherapeutic process.

Adult↗

Creative technological aids for the learning-disabled child: an interdisciplinary project.

An interdisciplinary team of engineering students and occupational therapists have developed prototype electromechanical toys to enhance adaptive learning performance of developmentally disabled children. This paper describes the Creative Technological Aids (CTA) project undertaken under the joint auspices of the Undergraduate Research Opportunities Program (UROP) of the Massachusetts Institute of Technology and the Kennedy Memorial Hospital occupational therapy department. Four prototype CTA devices were evaluated in clinical and community settings and preliminary results show that these devices are highly motivational in teaching eye-hand coordination and perceptual-motor skills.

Cerebral Palsy↗

Creative stress-management techniques for self-renewal.

The daily stress and pressure of today's nurses are profound. As workloads escalate and staffing declines, nurses must be proactive and develop healthier lifestyles. Creative stress management techniques offer health-promoting strategies to manage stress in nurses' lives.

Assertiveness↗

Ideational conflict: the key to promoting creative activity in the workplace.

This article defines the concept of ideational conflict as it applies to the process of identifying a problem and developing a plan of action for resolving the problem. Then the article examines and illustrates how the ideational conflict that is generated by brainstorming can lead to creative thinking that resolves disparate points of view. The illustration extends the generally accepted view of brainstorming and applies it to identifying a problem related to the university/college work environment. The problem situation is that of the loss of high ability faculty and sutdents to other institutions.

Journal Article↗

Making room for more beds. With additional patients streaming in every day, hospitals must learn to think creatively to find space for everyone.

With more patients streaming inside, acute-care hospitals are being forced to get creative about finding spots for beds. Some are reactivating dormant rooms, opening shuttered wings or transforming administrative areas into clinical space, such as Florida Hospital East Orlando, left. The surge comes as the number of hospitals drops and the number of beds rises along with census counts.

Bed Conversion↗

The doctor/patient relationship for the 21st century. Clash of 'cultural creatives' and 'traditionals' helps focus the future of patient care.

The doctor/patient relationship is at a crossroads. Some patients--traditionals--want the doctor calling all the shots, deciding the best treatment path to follow. But cultural creatives--heavily influenced by bioethics--desire more of a give and take when it comes to their health care. They see the physician as an advisor, and they want to decide the best treatment on their own terms. Take a close-up look at factors influencing the doctor/patient relationship in the 21st Century.

Cultural Characteristics↗

Policy reform as creative destruction: political and administrative challenges in preserving the public-private mix.

As political pressure for affordable universal coverage intensifies, various proposals have been crafted to improve the system without sacrificing the role of the private sector. Some analysts view the preservation of a mixed public-private system as an exercise in incrementalism, avoiding disquieting departures from familiar arrangements. A review of the political and administrative challenges of several main options--market innovation, tax credits, play or pay, and Medicaid expansion--suggests that the path to true reform is a slippery slope. Over time, changes in particular sectors, such as insurance, employers, government, and providers, will very likely implicate the others too. Although redefining the public-private mix may be more incremental than (say) adoption of a Canadian model, it will also entail considerable "creative destruction" of existing patterns and cannot fail to disturb the institutional status quo substantially.

Financing, Government↗

A creative recruitment program. Future nurses' camp.

Attracting high school students into nursing is a concern of staff development educators. "Future Nurses' Camp" was a creative, cost-effective program developed by a hospital education department. A 2-week, fun-filled, informative camp that included the use of high-tech equipment and patient-care decision games promoted a positive image of nursing. Experiencing nurses' roles reinforced the students' desire to enter nursing.

Adolescent↗