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At least 73 records · Page 4Linked to original sources
PubMed1995

Process redesign: making your film library work for you.

When Riverside Methodist Hospitals in Columbus, Ohio, experienced serious problems in its radiology film library, administrators recognized that poor processes were to blame and used quality management techniques to create a new system. A radiology information system was part of Riverside's long-range plan, but an effective manual process was implemented first. Riverside had decided that closing the library to referring physician access would result in more successful operations. An Operational Changes Planning Committee composed of file clerks, technologists, managers, radiologists and referring physicians planned the redesign. The committee identified four goals: Reduce unmet requests. Improve response time. Benchmark operations of comparable organizations. Implement an effective manual process prior to automation. Steps in the redesign process included identifying the problem, applying statistical tools to the situation and understanding customer requirements. Flow charts, benchmarking, data collection within the department and focus groups provided important quantitative information. Creating an improved process included the following actions: Work simplification. Work elimination (especially non-value-added work). Uncovering and removing causes of delay. Automation of repetitive tasks via the RIS. Reduction and elimination of any rework steps. One important change was to close the library to physician access. There were moderate gains in effectiveness as a result of redesign of the manual process. Results have continued to improve, and the redesign process provided greater commitment and cooperation for the more significant improvements that followed the RIS introduction.

Efficiency, Organizational↗
PubMed1992

Stress, computer-based work monitoring and measurement systems: a conceptual overview.

The design and implementation of computer-based work monitoring systems can result in changes in the organization, job and task. Electronic performance monitoring (EPM) systems are one type of change based on principles of work simplification and work rationalization. In this new work arrangement, control and coordination functions are allocated to the computer. The supervisor becomes a monitor of information and primarily provides negative performance feedback to the employee. The employee is constrained in his/her ability to use either job resources or social resources to meet the greater demands resulting from the system controlling the pace of work. It is proposed that these work arrangements provoke stress responses in employees that can result in short-term illness and potentially long-term changes in health status. Information enriched work environments are proposed as an alternative. These new work arrangements could improve job resources and social resources to manage job demands and reduce the potentially damaging stress responses. To provide a frame of reference we focus on the impact of EPM systems on the organizational and job elements involved in provoking individual stress responses. The impact of EPM systems on individual health is described using a psychosocial stress framework. Ergonomics interventions discussed include: participation in the design process; allocation of control and coordination functions between the computer and the employee; development of feedback systems; and work measurement and the development of performance appraisal systems.

Journal Article↗
PubMed1985

The Enhanced Productivity Program.

The Enhanced Productivity Program is based on an organizational audit of a dietary department by a foodservice consultant. The objective of the program was to enhance department productivity by increasing personnel efficiency through work simplification and work organization principles while maintaining quality standards. The Enhanced Productivity Program comprises 13 subsystems that interact to affect overall productivity of the department. The program was structured by a task-oriented program schedule that identified tasks to be carried out in each subsystem. A system diagram detailed time frames and milestones guiding each task to completion. A comprehensive work plan was developed for each task. Time and motion studies carried out before and after implementation of program changes demonstrate a savings of 9.27 labor hours per day. Trayline speed increased from 1.7 trays to 3 trays per minute. Improved personnel efficiency allowed an 11% growth in meal volume in 6 months, thus improving departmental productivity.

Efficiency↗
PubMed1991

Activity and post-polio fatigue.

Fatigue was studied in 12 subjects with post-polio sequelae (PPS). Results of the Fatigue Severity Scale (FSS) demonstrated a mean score of 4.8 +/- 1.6 (non-disabled scores = 2.3 +/- 0.7). The Human Activity Profile (HAP) was not sensitive enough to measure fatigue. Fifty percent of subjects scored below the first percentile based on age and sex matched norms. The Activity Record (ACTRE) results revealed that subjects spent 5% of their time resting and 1% in planning or preparation activities. Fatigue peaked in the late morning or early afternoon and was relieved by rest periods. Use of energy conservation and work simplification skills along with frequent rest periods was suggested as a possible method for managing PPS fatigue.

Activities of Daily Living↗
PubMed1986

Evaluation and management of the patient with acute back pain.

Patients with low back pain are among the largest group of health care consumers today. During an episode of acute back pain the patient may be hospitalized for diagnostic workup and medical management, processes to which occupational therapists can contribute. The occupational therapist's evaluation includes assessment of the patient's activities of daily living and understanding of back protection and pain behaviors. The therapist involves the patient in managing his or her back problem by teaching problem-solving skills and identifying appropriate life-style changes. Instruction is provided in proper body mechanics, anatomy of the spine, work simplification, relaxation, and adaptive methods of performing daily activities. Given the short hospitalization period, outpatient follow-up may be provided to facilitate the application of information learned in the hospital to home and work settings. The goal of occupational therapy is to help the patient with low back pain return to a productive life-style.

Activities of Daily Living↗
PubMed2000

Guideline implementation in the department of defense.

To improve the effectiveness of evidence-based clinical practice guidelines (CPGs), four other components of implementation are necessary. Together, they impressively optimize the process and outcomes of health care, and reduce undesirable variation of care. Aside from CPGs, the four components help make up a successful, long-term, facility-wide, comprehensive disease-management program. First, executive clinical and administrative leaders need to create the expectation and reveal hands-on commitment. Second, work-simplification tools are needed to accomplish the tasks more effectively and to encourage a path of least resistance. Third, useful, accurate metrics are needed to provide feedback for patients and health-care providers who need the most assistance. These metrics must be easily obtained, disseminated in near-real time, patient-specific, anonymous to others, and penalty free. Fourth, and most important, with nonmonetary compensation, this review addresses the question, "What's in it for all the passionate people who assist in the delivery of health care?"

Asthma↗
PubMed1991

Energy conservation, occupational therapy, and the treatment of post-polio sequelae.

Individuals experiencing post-polio sequelae (PPS) are usually advised to make significant lifestyle changes to lessen symptoms and prevent further decline in function. These individuals have spent most of their lives equating success with over-achievement and find it difficult to implement such recommendations. As specialists in energy conservation and work simplification, occupational therapyists increasingly are being called on to evaluate and treat these patients. Over the past 2 years, an occupational therapy educational program has been developed to educate patients about their condition and about ways to implement lifestyle changes while preserving the ability to do valued activities. This article describes the components of a thorough occupational therapy evaluation and the design and functional outcomes of a successful occupational therapy educational program to treat PPS.

Adult↗
PubMed1994

Reinjury prevention follow-through for clients with cumulative trauma disorders.

OBJECTIVES: Fifteen subjects with upper extremity work-related cumulative trauma disorders were involved in a quality improvement study to determine their self-reported degree of follow-through with reinjury prevention regimens. The effect of cuing was also studied. METHOD: During occupational therapy, subjects were involved in an educational session that focused on recommendations in ergonomic equipment, therapeutic maintenance techniques, body mechanics, and work simplification techniques. Follow-through with reinjury prevention education was evaluated and rated via telephone interviews approximately 2 weeks (T1) and 4 weeks (T2) after the educational session. Subjects did not know the questions they would be asked at T1, but were cued that their progress would be checked again at T2. Dependent t tests were conducted to compare the mean number of recommendations for which complete follow-through was expected with the mean number of recommendations at T1 and T2 that were implemented completely. RESULTS: A significantly lower degree was found of absolute completion of recommendations at T1 and T2 than had been anticipated (p < .002). No significant difference between T1 and T2 was found, indicating that cuing at T1 had little effect on subjects' actual follow-through rate. CONCLUSION: The implications of these findings for occupational therapists support the need for further research in reinjury prevention and employer education.

Adult↗
PubMedDate not supplied

Daily life for eight urban gay men with HIV/AIDS.

OBJECTIVE: The purpose of this qualitative research study was to gain an understanding of the daily life experiences of eight gay men with HIV/AIDS living alone in New York City. METHOD: The participants ranged in age from 25 to 50 years. Data were primarily collected using in-depth personal interviews in 1996 followed by telephone interviews 1 year later. Constant-comparison and thematic analyses were used to identify themes and subthemes. RESULTS: Two broad themes with related subthemes were generated from the data. "A Reasonably Stable Base" represented the emotional, physical, and environmental foundation that preexisted or was created as a consequence of living with HIV/AIDS. This theme played a particularly important role in the participants' lives, especially during periods of emotional and physical instability. "Finding and Maintaining Balance" was a second theme that illustrated strategies used for managing and readjusting daily routines, goals, and priorities, as well as how the participants experienced this readjustment process. CONCLUSIONS: All of the participants developed their own daily living strategies that were comparable to intervention methods provided in occupational therapy such as energy conservation and work simplification. The findings suggest that occupational therapy practitioners could potentially assist urban gay men with HIV/AIDS with finding and maintaining stability and balance in their daily lives.

Acquired Immunodeficiency Syndrome↗
PubMed1976

Rehabilitation in postmenopausal osteoporosis.

Rehabilitation and nursing care of patients with postmenopausal osteoporosis require a comprehensive team effort. The primary purpose of rehabilitation is to restore these elderly women to an optimal level of well-being and activity and return them to home and community life as soon as possible. Medical management, rehabilitative nursing and physical therapy are interdependent. Emphasis is placed on estrogen replacement to prevent further fractures and height loss, individualization of care, early ambulation, improving patient confidence, physiotherapy procedures, orthopedic supports, optimal nutrition, safety precautions, work simplification, occupational therapy and the need for appropriate social contacts. The economic, physical and emotional consequences of deforming postmenopausal osteoporosis are enormous. Current research indicates that this disease is preventible. An effective program of prophylaxis is needed now; otherwise many more women will need increasing amounts of costly rehabilitation.

Diet↗