Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Management”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 811 records · Page 45Linked to original sources
PubMed1999

Statistical method to evaluate management strategies to decrease variability in operating room utilization: application of linear statistical modeling and Monte Carlo simulation to operating room management.

BACKGROUND: Operating room (OR) managers seeking to maximize labor productivity in their OR suite may attempt to reduce day-today variability in hours of OR time for which there are staff but for which there are no cases ("underutilized time"). The authors developed a method to analyze data from surgical services information systems to evaluate which management interventions can most effectively decrease variability in underutilized time. METHODS: The method uses seven summary statistics of daily workload in a surgical suite: daily allocated hours of OR time, estimated hours of elective cases, actual hours of elective cases, estimated hours of add-on cases, actual hours of add-on cases, hours of turnover time, and hours of underutilized time. Simultaneous linear statistical equations (a structural equation model) specify the relationship among these variables. Estimated coefficients are used in Monte Carlo simulations. RESULTS: The authors applied the analysis they developed to two OR suites: a tertiary care hospital's suite and an ambulatory surgery center. At both suites, the most effective strategy to decrease variability in underutilized OR time was to choose optimally the day on which to do each elective case so as to best fill the allocated hours. Eliminating all (1) errors in predicting how long elective or add-on cases would last, (2) variability in turnover or delays between cases, or (3) day-to-day variation in hours of add-on cases would have a small effect. CONCLUSIONS: This method can be used for decision support to determine how to decrease variability in underutilized OR time.

Humans↗
PubMedDate not supplied

Managing diversity: the differing perceptions of managers, line workers, and patients.

This study assesses how hospital managers, line workers, and patients understand the impact of patient and workforce diversity on the delivery of hospital care. Data come from managerial interviews and staff and patient focus groups at five voluntary hospitals in New York City. Three findings emerge from the research. Cultural competence is critical to the provision of quality care, but the perceived significance of cultural competence depends on one's role in the organization. Language remains a problem for patients and staff, although all of the hospitals have extensive translation services. Compared with management, staff and patients identify diversity to be more of a problem. Differing perceptions about the meaning of diversity must ultimately be reconciled to effectively provide care.

Attitude of Health Personnel↗
PubMed2002

Diabetes pattern management: the key to diabetes self-management and glycemic control.

Technological advances in home blood glucose monitors have no practical value unless the test results are recorded and used for pattern management. This systematic approach is central to the plan of care for patients with diabetes. Pattern management helps patients, caregivers, and referring physicians identify patterns in blood glucose readings, so treatment and/or lifestyle changes can be made without delay.

Blood Glucose↗
PubMed1994

Management development: preparing nurse managers for the future. Part 1, Program model.

Nurse executives need to develop programs to help nurse managers meet rapidly changing role expectations and prepare for new healthcare challenges. This two-part series reports on one such program for nurse managers at The Johns Hopkins Hospital. Part 1 describes the program model, its conceptual framework, and its various components. Part 2 will present an in-depth evaluation of the program and recommendations for future development.

Baltimore↗
PubMed1990

Managing physician incentives in managed care. The role of for-profit ownership.

The recent rapid growth of HMOs has resulted in a proliferation of contractual arrangements that offer financial incentives to induce primary care doctors to change the way they practice medicine. The impact of these incentives varies with the different incentives and with the environments in which the incentives are implemented. Although financial incentives exist in some form in the great majority of HMOs, there has been no detailed and valid information available on the way these physician incentives are managed or on the characteristics of the standard operating "climate" in which the incentives exist. This study was designed to measure a firm (organizational) characteristic hypothesized to be related to the firm's effort, ability, or desire to make financial incentives work strongly. The characteristic considered is whether the firm is a for-profit or a not-for-profit organization. The goal of this study was to provide a direct test of the relationship between HMO ownership type and the effectiveness of primary care physician incentives. Results of the study indicate that for-profit ownership does enhance the power (or the need) of management to offer effective rewards for parsimonious use of health care resources.

Capitation Fee↗
PubMed2004

Glaucoma management in developing countries: medical, laser, and surgical options for glaucoma management in countries with limited resources.

PURPOSE OF REVIEW: Most people affected by glaucoma live in developing countries. Recent trials and reports provide sound evidence for management of glaucoma. This review extrapolates relevant articles to the developing world. RECENT FINDINGS: The predictive value of gonioscopy for progression of primary angle closure suspects (PACS) to primary angle closure (PAC) is only 22% (95% CI: 9.80-34.2). PACS are not uncommon; laser peripheral iridotomy (LPI) is neither indicated nor feasible for all. Twenty-eight and a half percent of PAC progress to primary angle closure glaucoma; the number needed to treat (NNT) for LPI to prevent progression is only 4. Laser peripheral iridoplasty controls acute angle closure glaucoma (AACG) faster than medical therapy alone. Primary lens extraction has also been suggested as treatment for AACG after control of the acute attack. A 5-year NNT for ocular hypertension (OH) of 20 is too high to allow treatment of all OH. High-risk OH and primary open angle glaucoma (POAG) have an NNT of 5 to 6 and merit treatment. Latanoprost and brimonidine are effective in lowering IOP in Asian eyes with POAG, but primary surgical therapy may be a more viable option. For cataract and coexistent glaucoma requiring filtration, trabeculectomy combined with the Blumenthal technique of cataract surgery may be as effective as trabeculectomy combined with phacoemulsification. SUMMARY: The principles of glaucoma management should be the same the world over. Considering the paucity of resources and competing opportunity costs, countries with limited resources have to extrapolate available information in a sensible and cost-effective manner.

Antihypertensive Agents↗
PubMedDate not supplied

Conflict management styles of Asian and Asian American nurses: implications for the nurse manager.

Foreign nurses and American nurses who are culturally diverse make up an increasing number of the US nursing workforce. Of foreign nurses, Asians constitute the largest number. Conflict is an inevitable aspect of human relations in health care settings. Nurses and other health team members with diverse cultural background bring to the workplace different conflict behaviors that directly impact the outcomes of conflicts. It is essential for health care team members and managers to be cognizant of different conflict behaviors as well as different conflict management styles so that strategies can be designed to build a culturally diverse health care team that is able to effectively achieve group and organizational objectives.

Asian↗
PubMed2006

Nasal and paranasal sinus carcinoma: how can we continue to make progress?

PURPOSE OF REVIEW: New developments in the nasal and paranasal sinus cancers are reviewed. RECENT FINDINGS: In addition to woodworking, several risk factors for nasal and paranasal sinus cancers have been identified, most notably smoking. Progress in the differential diagnosis of small round cell nasal and paranasal sinus cancers allows the precise diagnosis of esthesioneuroblastoma. Despite recent improvements, T staging for ethmoid and nasal cavity needs refinement. An association of surgery and radiation therapy remains the best treatment modality. Major developments include endoscopic resection of nasal and paranasal sinus cancers, high-precision radiotherapy techniques such as intensity-modulated radiotherapy, and proton-beam radiotherapy. There is probably no role for chemotherapy in esthesioneuroblastoma. Although chemotherapy is important for aggressive neoplasms, its generalized use for nasal and paranasal sinus cancers awaits the application/development of newer drugs. These drugs might be applied locally since the majority of recurrences remain local. SUMMARY: Progress in the treatment of nasal and paranasal sinus cancers could be achieved through better prevention and the developments of more selective treatments such as endoscopic resection, high-precision radiotherapy, and new chemotherapy drugs.

Carcinoma↗
PubMed2004

The effectiveness of a multidisciplinary pain management programme managing chronic pain.

The aim of this study was to develop and evaluate the effects of a multidisciplinary pain management programme on coping, health-related quality of life and pain intensity. Seventy-six outpatients suffering from chronic pain completed this eight-week programme with the primary aims to increase coping, as measured by the Ways of Coping Checklist, and health-related quality of life, as measured by the Short Form-36 Health Survey. Therapeutic dialogues and education, combined with physical activity, were given in order to increase understanding of and attention to non-medical factors that might affect pain perception. The programme was active, time-limited and structured on the basis of multidisciplinary pain management programmes based on a cognitive-behavioural approach. The findings suggest that this programme has the potential to improve coping skills and health-related quality of life. Additionally, pain intensity, as measured by the Visual Analogue Scale, was reduced. Age and disability were revealed as the prominent predictors of change after treatment. The differences in this sample indicated that the drop-outs tended to be older and reported more health problems, although these findings were non-significant. Clinical and research implications are discussed.

Adaptation, Psychological↗
PubMed2006

Critical appraisal of the management of severe malnutrition: 2. Dietary management.

In the dietary management of severe acute malnutrition in children, there is evidence to support the WHO Manual's protocol of cautious feeding of a low energy and protein formula with small frequent feeds in the initial phase of treatment, particularly in kwashiorkor. However, this initial milk diet (WHO F-75) might benefit from increasing the sulphur amino acid, phosphorus and potassium content and reducing the lactose content, but further studies are needed. Careful tube-feeding results in faster initial recovery and weight gain, but has a significant risk of aspiration in poorly supervised settings. Ready-to-use therapeutic food is an important recent advance in the dietary management of malnutrition in ambulatory settings, allowing more effective prevention programmes and earlier discharge from hospital where community follow-up is available. It should be included in future protocols. There is very good evidence on the use of micronutrients such as zinc, and preliminary evidence suggests that smaller doses of daily vitamin A are preferable to a single large dose on admission for severe malnutrition.

Child↗
PubMed2005

Evidence-based recommendations for short- and long-term management of uninvestigated dyspepsia in primary care: an update of the Canadian Dyspepsia Working Group (CanDys) clinical management tool.

The present paper is an update to and extension of the previous systematic review on the primary care management of patients with uninvestigated dyspepsia (UD). The original publication of the clinical management tool focused on the initial four- to eight-week assessment of UD. This update is based on new data from systematic reviews and clinical trials relevant to UD. There is now direct clinical evidence supporting a test-and-treat approach in patients with nondominant heartburn dyspepsia symptoms, and head-to-head comparisons show that use of a proton pump inhibitor is superior to the use of H2-receptor antagonists (H2RAs) in the initial treatment of Helicobacter pylori-negative dyspepsia patients. Cisapride is no longer available as a treatment option and evidence for other prokinetic agents is lacking. In patients with long-standing heartburn-dominant (ie, gastroesophageal reflux disease) and nonheartburn-dominant dyspepsia, a once-in-a-lifetime endoscopy is recommended. Endoscopy should also be considered in patients with new-onset dyspepsia that develops after the age of 50 years. Conventional nonsteroidal anti-inflammatory drugs, acetylsalicylic acid and cyclooxygenase-2-selective inhibitors can all cause dyspepsia. If their use cannot be discontinued, cotherapy with either a proton pump inhibitor, misoprostol or high-dose H2RAs is recommended, although the evidence is based on ulcer data and not dyspepsia data. In patients with nonheartburn-dominant dyspepsia, noninvasive testing for H pylori should be performed and treatment given if positive. When starting nonsteroidal anti-inflammatory drugs for a prolonged course, testing and treatment with H2RAs are advised if patients have a history of previous ulcers or ulcer bleeding.

Age Factors↗
PubMedDate not supplied

Management of subglottic stenosis in infancy and childhood. Review of a consecutive series of cases managed by surgical reconstruction.

The management of mature subglottic stenosis secondary to endotracheal intubation in infancy and childhood remains a controversial issue. If treated similarly to congenital subglottic stenosis by tracheotomy and a "wait-and-see" period then there is a considerably higher mortality and morbidity for the acquired disease compared with the congenital. Eighteen children with severe acquired subglottic stenosis managed by surgical reconstruction are presented; 17 have been successfully extubated. The longest follow-up is 5 1/2 years. No evidence of interference with laryngeal growth is evident.

Adolescent↗
PubMed1992

Outpatient management vs in-hospital management of children with new-onset diabetes.

The long-term results of outpatient management of subjects with newly diagnosed insulin-dependent diabetes mellitus (IDDM) are unknown. The longest follow-up described to date is for only one year, a time when most children with IDDM still make endogenous insulin. In this study, 41 young subjects with IDDM, treated and educated in the outpatient setting (1980 to 1984), were compared to a group of 80 similar subjects who received their initial education as hospital inpatients. Long-term glycemic control, as measured by longitudinal glycohemoglobin (HbA1) values was not different in the two groups (p greater than .05). We conclude that outpatient education and management of newly diagnosed subjects with IDDM is as safe and effective as inpatient treatment.

Adolescent↗
PubMed1997

Management of asymptomatic term neonates whose mothers received intrapartum antibiotics--Part 2: Diagnostic tests and management strategies. Center of Disease Control and Prevention.

The evaluation of the potentially septic newborn is often a source of frustration for practitioners. In the past, it has often been standard practice to evaluate and treat empirically all neonates whose mothers received antibiotics during labor, regardless of whether the infant had any signs or symptoms suggestive of infection. With the advent of recommendations for intrapartum antibiotic therapy to prevent early-onset neonatal group B streptococcal infections, this strategy is no longer practicable because too many infants would thus be evaluated and treated needlessly. This two-part review addresses the issues involved in managing asymptomatic newborns whose mothers received intrapartum antibiotics. Part I, published separately, reviewed the rationale behind strategies for preventing intrapartum transmission of bacterial infection. This final part addresses the evaluation and management of the newborn. A number of diagnostic tests are often used in looking for bacterial infections in the neonate. Unfortunately, none of these is both rapid and reliable. A clinical pathway provided here can serve as a useful guide for the clinician, but uncertainty will always remain. Ultimately, each practitioner must determine the degree of risk or uncertainty that he or she can accept on the basis of clinical experience.

Adult↗
PubMed1989

Measurement for management: report of a pilot project to quantify ambulance misuse for managers of a Fife hospital.

Ambulance services appear to be under increasing pressure to provide a full range of services to the Community. It is important, therefore, that the service is appropriately utilised by patients. Health Service Managers, however, have little readily available information which identifies 'appropriate' utilisation. A simple technique is suggested to measure 'appropriateness' of utilisation of ambulances and a pilot survey of ambulance use by patients attending Dunfermline and West Fife Hospital Out-Patient clinics is described. In each case of ambulance use a panel of health professionals evaluated the 'appropriateness' of the patient having utilised this service. In the clinics surveyed, 91% of the sample of 328 patients did not use an ambulance to travel to clinics; in only two cases was use of the ambulance considered to be 'probably inappropriate'. Misuse of the ambulance service was minimal during this study. Health Service Managers have been provided with some evidence to refute suggestions of substantial, inappropriate use of the ambulance service.

Age Factors↗
PubMed1989

Resource management or managing resources?

Claims made by Stilwell and Hamlyn to have recorded reductions of 25% in average cost per patient in an out-patient clinic where detailed patient costing data was collected and employed are examined critically. Their failure to allow for case-mix differences is shown to nullify the apparent gain in resource efficiency. This raises issues concerning the value of providing managers with detailed patient costings, and throws doubt on the wisdom of current initiatives in Clinical Budgeting and Resource Management.

Costs and Cost Analysis↗