Occupational therapy services in early intervention and school-based programs (2004).
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The Retirement Village/Rest Home industry is growing rapidly. Many of those fulfilling managerial roles within this industry do not appear to have management qualifications or prior managerial experience outside the public sector health system. If the industry is to effectively manage anticipated growth, managers may need to update their qualifications and knowledge base to ensure that they possess the skills and abilities required to meet changing business needs. This paper reports on an exploratory study designed to gather information that identifies the primary duties and responsibilites of retirement village managers and nurse managers, and their essential and desirable skills, attributes, and characteristics.
Interprofessional practice is a way of practicing that is based on collaboration. We cannot assume that health professionals have either the skills or attributes required for interprofessional practice. They may need to learn how to collaborate. Developing interprofessional practice requires a commitment to engage in shared learning and dialogue. Dialogue has the potential to encourage collegial learning, change thinking, support new working relationships, and improve client care.
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A clinical ethics consultant gathers information firsthand at the patient's bedside. The consultant's special clinical skills include the ability to identify and analyze ethical problems; use reasonable clinical judgment; communicate effectively; negotiate and facilitate negotiations; and teach others how to construct their own ethical frameworks for medical decision making. Appropriate roles for the consultant include those of professional colleague, negotiator, patient and physician advocate, case manager, and educator. The training necessary for an ethics consultant includes substantial patient care experience, instruction in health care law and moral reasoning, and preparation in medical humanism. We favor a clinical model for ethics consultation. When urgent care is needed, other consultants promptly see the patient; the clinical ethics consultant can be expected to do the same.
Reports of an impending surplus of physicians have intensified economic incentives to exclude competing professionals from the hospital workplace. These conditions have led to a substantial increase in the number of private lawsuits instituted by the excluded physicians. Denials of hospital privileges can be essential to the maintenance of high standards of quality and efficiency at a hospital. However, unreasonable denials of staff privileges, staff closures, and exclusive contracts can raise antitrust implications depending on the facts. The relevant factual and economic questions that should be asked about such conduct in order to determine the degree of antitrust risk are discussed.
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In this article, the author reflects on the nature of specialist and advanced nursing practice. He argues that the essence of nursing lies not in names and title but in the way individuals approach daily practice.
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Political action, like leadership behavior, may or may not be beneficial to the success of organizations and their personnel. At one end of the scale, political behavior is selfish. Some outliers are even unethical or illegal. In the upper registers, politically astute behavior supplements professional competency. It is beneficial not only to the practitioner, but also to his or her subordinates, superiors, peers, and employer. Negative political behavior is self-serving, manipulative, and violates the spirit of honest communication. It produces resentment and destroys morale. Often what is perceived as politics is merely poor communication. The remedy for this is better use of formal and informal channels of information. Incompetent employees often rationalize their failures by using politics as a scapegoat. To encourage positive political strategies, employers should institute training programs. Such programs should promote teamwork and teach positive interpersonal skills. Seminars on ethical decision making must be supplemented by model behavior on the part of upper managers.
Today, healthcare chief executive officers (CEOs) face many pressing issues. To survive the 1990s, CEOs must master "transformational practices" such as continuous quality improvement. CEOs can adopt the following 10 practices to help them become transformational leaders: Establish and act on key commitments. Form teams. Establish a job shadow program. Brainstorm more. Befriend the opposition. Communicate more. Wipe out gossip. Look for breakdowns. Revise the appraisal system.
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