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Results for “Professional Autonomy”

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PubMed1998

[Practice guidelines for medical treatment from the perspective of health law].

Clinical practice guidelines are directions for medical doctors on the action to be taken in a given situation, thus standardising medical performance as regards content. The implementation of clinical practice guidelines (CPGs) is stimulated by government and health care insurers. Court decisions frequently refer to these guidelines. From a medical and legal perspective, the implementation of CPGs in daily medical practice has advantages (e.g. they contribute to best medical practice as well as to the quality of information to be provided to the patients), but also disadvantages (they may replace professional responsibility and may put cost containment over professional autonomy). CPGs may contribute to quality of care provided they are applied flexibly and responsibly.

Humans↗
PubMedDate not supplied

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Attitude to Health↗
PubMed1998

Research in plastic surgical nursing.

This article discusses nursing research, its goals, and nurses' roles and responsibilities in the research process. A major focus of the article describes the concept of research utilization as an integral part of professional nursing practice. Implications for plastic surgical nursing practice and research activities with the American Society of Plastic and Reconstructive Surgical Nurses, Inc. (ASPRSN) are explored.

Ethics, Nursing↗
PubMed1991

Productivity-enhancing work innovations: remedies for what ails hospitals?

Prospective pricing, the proliferation of alternative delivery systems, and the demands of third party payers and corporate employers for the containment of health care costs have engendered the keen interest of hospital executives seeking strategies for improving labor productivity. Despite this interest, the relevant literature suggests that few work innovations designed to enhance labor productivity have been implemented in hospitals. This article describes generic versions of four such work innovations--quality circles, union-management committees, autonomous work groups, and gainsharing--and discusses relevant research indicating the types of benefits gained from each and the reasons why some have failed. Each innovation's potential for success in hospitals is evaluated, and suggestions for increasing the effectiveness of each in hospitals is offered.

Decision Making, Organizational↗
PubMed1995

Primary care HMO clinicians' opinions about clinical practice guidelines.

OBJECTIVE: To assess primary care clinicians' opinions about the principal goals that national guideline developers foresee for clinical practice guidelines, and about possible effects of guideline implementation that are known to concern practicing clinicians. DESIGN: Preintervention survey of attitudes conducted as part of a larger study to evaluate alternative strategies for implementing clinical practice guidelines. SETTING: Kaiser Permanente, Northwest Region, a large, group model HMO. PARTICIPANTS: Primary care clinicians (N = 211) with at least 1 year of work experience in the HMO. The response rate was 80% (N = 168). RESULTS: Clinicians' responses suggest they will not object to the implementation of specific practice guidelines in the HMO. Guidelines' information-synthesizing and consensus-building functions are likely to be welcomed. Increased guideline implementation is apparently not perceived as a threat to professional autonomy. CONCLUSIONS: Further research is recommended, using this measure, or refined versions of it, in diverse practice settings. In addition, studies are needed of the relationship between clinicians' general expectations about the effects of guidelines and their level of adherence to specific guidelines.

Adult↗
PubMed1996

Contemporary models of change in the health professions.

This article reviews the special position that health professionals have occupied and the ways in which changes threaten the foundations of professional work. The application of modern management principles to health care runs the risk of overriding the "action orientation" that is a defining component of professional work. One goal of health workforce design should be the engineering of opportunities for the preservation of "professional voice" as a countervailing force to ensure high quality health care. Contemporary models of change applied to health care workforce include: (1) the system of professions models in which securing and maintaining jurisdiction are the mechanisms that professions employ to sustain their position, (2) a strategic adaptation model by which professions attempt to adjust to changing environments, (3) a model of redesigning patient care which applies Total Quality Management (TQM) and other "industrial techniques" to the health care workplace, and, (4) model of "consumer sovereignty" in which groups of citizens come together to determine the nature of care services and professional work, with the participation of the organizations and providers.

Health Occupations↗
PubMed1996

The old ways of doing medical business are passing.

Doctors must realize that the ¿us and them¿ labels have to be discarded. No longer do physicians wield the ultimate power. We've lost our patients to insurance companies and part of our medical knowledge rests with nonphysicians. Likewise, physicians must accept the reality that all doctors aren't going to be in the same practice setting: some will work for hospitals, some for insurance companies, some for HMOs, some for themselves. But we're all members of a great profession that has proven its ability to give high-quality care to our patients, and now more than ever with more attention paid to costs.

Decision Making, Organizational↗
PubMedDate not supplied

Role stress among physician executives.

On the one hand, physician executives are clinicians who place value on professional autonomy. As clinicians, the best interests of the patient drive their decision making and their value system. On the other hand, as managers, physician executives serve as agents of an organization. Because of the differences in the two cultures, some physicians have called the physician executive position a "no man's land" To address these issues and answer the questions that surround them, the authors developed a survey that was mailed to a random sample of the membership of the American College of Physician Executives. Parts of the survey served in other studies of role conflict and role ambiguity. Parts of the survey are new, developed specifically to analyze the physician executive role. The findings are reported in this article.

Adult↗