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PubMed2003

[Communication of useful information from laboratory physicians to clinical physicians].

In recent years increasing importance has been placed on the role of hospital clinical research, such as the promotion of intra-laboratory human, material and informational resources, previously restricted to the laboratory, to the whole hospital system, and the appropriate usage of laboratory findings via common consultation systems, or specialized informational consultants in the clinical laboratory department. The volume of clinical laboratory information, which plays an important role in the decision-making process of routine clinical practices, is enormous for each individual hospital, and appropriate use of this information has a major influence on institutional clinical practice efficiency. In response to the need for the communication of useful laboratory information to clinical physicians, departments of laboratory research consultants have been organized in individual hospitals as a way forward. In the near future, laboratory physicians will play a leading role in the communication of research information from the viewpoint of EBLM (evidence-based laboratory medicine). From the work of these laboratory research consultants, it becomes possible to obtain relevant EBLM-related information, such as frequently asked questions and opinions, from their users. By replying to these questions and opinions appropriately, laboratory research consultants can provide information that is both advantageous and useful, and which meets the needs of the clinical physician side. Effective communication of useful laboratory research information should not be restricted to either the laboratory physicians or the technicians; it is a job that needs the cooperation and teamwork of both sets of people. Also, they should always keep in mind that communication by itself is not sufficient; they should not assume the useful evaluation of information by the users, but rather ensure that they are presented with information that precisely meets their needs.

Clinical Laboratory Information Systems↗
PubMed1987

Developing self-care skills and reducing institutionalized behaviour in a long-stay psychiatric population: the role of the nurse in behaviour modification.

This paper examines the potential for behaviour modification in the rehabilitation of chronic, long-stay psychiatric patients and the impact such procedures may have on the work role of ward-based nursing staff. Through the use of five case histories the effectiveness of behavioural analysis and modification in encouraging self-help skills and constructive activity is identified. In addition to a critical examination of the clinical and organizational factors involved in patient improvement, it is argued that behaviour modification develops the therapeutic potential of nurses. The development of the patient-teaching dimension of the nursing role not only fosters greater clinical responsibility, but also promotes both professional independence and institutional power. This is not to imply that the use of behavioural methods cannot be combined with customary nursing practices, for in many ways they provide nurses with an appropriate technology to achieve established therapeutic goals. In conclusion, it is noted that clinical success is not sufficient to ensure the acceptance of ward-based behavioural programmes. The critical issues concern conventional hospital and staff practices and institutional rigidity, not the commitment of nursing staff or patient improvement.

Aged↗
PubMedDate not supplied

Evaluation of the business side of the group practice.

Because of the changes and complications affecting the business of health care, medical practices need to evaluate whether or not they are getting the best management for their money. Two options presented in this article are hiring a professional management firm or creating an internal management team. The points to be addressed include evaluating the various professional management firms available, determining the necessary skills for an internal management team, determining the business functions the team or firm will perform, considering the right factors when selecting a legal or accounting firm, and evaluating performance on an ongoing basis.

Contract Services↗
PubMed1985

Hospital-based group practice and HMOs: a case study.

In its seven years of operation, Family Health Associates (FHA), established in 1977 by St. Mary's Hospital, Rochester, NY, has grown steadily, proving that hospital-based group practices can provide a solution to the need for reasonably priced high-quality care. An extension of the hospital's outpatient department, FHA combines features of the private-practice and hospital settings. Its physicians, who are hospital employees, may join HMOs and contract with third parties. All revenue, however, accrues to the hospital. The practice incorporates a complex sharing of decision-making authority to allow physicians to feel involved as well as to support the hospital administration's authority. Physicians may structure their schedules within the required total office time and refer patients to any hospital or specialist in the area. They are encouraged to participate in the hiring of nurses and secretaries and as a group may approve or disapprove facility schedules, plans for expansion and physician recruitment, revision of charges, and budget requests. They do not have final authority over budgets or staff terminations. Because of a shortage of physicians and diminishing referrals to the hospital's consultant staff, no appreciable opposition to FHA resulted in the beginning. Midway through the program's history, however, a conflict arose over FHA physicians referrals to the hospital's surgical specialists. Although surgeons believed that referrals should be shared equally, the medical staff's governing body supported FHA's objective of freedom of referral. Patient volume would increase more quickly, the medical staff believed, if FHA physicians were perceived as competitive in the public's eyes. Relationships with the medical staff gradually have improved as FHA physicians involve themselves in hospital committees and admit an increasing share of inpatients.

Family Practice↗