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At least 865 records · Page 48Linked to original sources
PubMed1985

The management structure for research in the RSA, with a proposed management model for medical faculties.

Government accepts responsibility for stimulating and supporting research and development for the welfare of the entire community. Research is therefore a matter of serious concern which should be approached with the greatest degree of responsibility by those trained and qualified to engage in its pursuit. A description is given of those institutions established for overall planning of matters of common concern to all research bodies: the Scientific Advisory Council, the Science Planning Branch of the Department of Constitutional Development and Planning, and the Scientific Priorities Committee. Medical research has made significant progress since the establishment in 1969 of the Medical Research Council, which has devised a management structure to discharge its responsibilities effectively on a national basis. This structure and its underlying philosophy are discussed. There is a great need to strengthen the management structures of research at medical faculties, teaching hospitals and other medical institutions to ensure cost-effectiveness and provide an ongoing flow of research manpower. A research structure for this purpose is proposed and described.

Faculty, Medical↗
PubMed1994

Physicians in health care management: 10. Managing conflict through negotiation.

The recent focus on collaborative relationships in health care means that people and groups must cooperate to accomplish clinical and management tasks. This increasing interdependence may also cause increased organizational conflict. The management of conflicts is critical to the effectiveness of an organization. Negotiating strategies, based on Fisher and Ury's method of "principled negotiation," include establishing superordinate goals, separating the people from the problem, focussing on interests, inventing options, using objective criteria and defining success in terms of gains.

Canada↗
PubMed1993

[Perspective for clinical laboratory management and its systematization--effects of the systematization of clinical laboratory management].

There are a large number of ideas concerning the systematization of clinical laboratory management. Therefore many types of laboratory systems have been constructed. As our hospital is not large, we adopted a small scale laboratory system. In introducing it, we expected not only an increase in value-added labor productivity by automating laboratory tests, but also an improvement in technologist's cost awareness. Consequently, new system equipment has itself performed the former in many sections, but not the latter. Improvement in cost awareness was caused by the technologist's routine work in managing reagent and material stocks. We found that this soft-type systematization has been more important than the advanced hard-type system.

Awareness↗
PubMed1996

Practice guidelines for the clinical assessment and care management of Alzheimer's disease and other dementias among adults with intellectual disability. AAMR-IASSID Workgroup on Practice Guidelines for Care Management of Alzheimer's Disease among Adults with Intellectual Disability.

The AAMR/IASSID practice guidelines, developed by an international workgroup, provide guidance for stage-related care management of Alzheimer's disease, and suggestions for the training and education of carers, peers, clinicians and programme staff. The guidelines suggest a three-step intervention activity process, that includes: (1) recognizing changes; (2) conducting assessments and evaluations; and (3) instituting medical and care management. They also provide guidance for public policies that reflect a commitment for aggressive care of people with Alzheimers's disease and intellectual disability, and avoidance of institutionalization solely because of a diagnosis of dementia.

Activities of Daily Living↗
PubMed1997

[Psychology of patient management: evaluation and quality assurance of psychosocial management in pediatric oncology].

Since the introduction of health-care reform in Germany, quality assurance of inpatient care is required. In paediatric oncology this also includes quality assurance measures of psycho-social care. Care Psychology deals with the development, testing and continual improvement of high-quality psycho-social care. Based on clinical experience, scientific knowledge and ascertained requirements a handbook and manual of service delivery of psycho-social care is formulated and tested in everyday practice. Service performance analyses are carried out, and verified improvements are re-tested in practice. This, as well as additional attempts, should lead to total quality management (TQM) of psycho-social care in paediatric oncology according to the criteria of the European Foundation of Quality Management (EFQM).

Adaptation, Psychological↗
PubMed1997

[Penetrating gluteal injuries management--the need for management protocols].

Gunshot wounds are the most common cause of penetrating injuries in the gluteal region (PIGR), while only 17.5% result from stabbing. Complications and even death have been described as resulting from stab injury in this area, which is thus a hazard that demands an algorithm for proper management. Recently, DiGiacomo et al. recommended that transpelvic bullet trajectory warrants surgery. Mercer et al., in a study of 81 patients with PIGR, recommended an algorithm based on anatomical gluteal zones and concluded that angiography is not mandatory in such injuries. We describe 9 cases of PIGR, 4 of which were from stab wound and 1 a gunshot wound, which bled from rami of the gluteal arteries. In 2 there was no apparent bleeding, and they were hemodynamically stable. Thus in this type of injury significant damage may be obscured. Our results suggest that angiography is important in the evaluation of such injuries an should be part of the protocol for management of PIGR.

Algorithms↗
PubMed2004

Clinical outcomes in managed-care patients with coronary heart disease treated aggressively in lipid-lowering disease management clinics: the alliance study.

OBJECTIVES: This study sought to determine if an aggressive, focused low-density lipoprotein cholesterol (LDL-C)-lowering strategy was superior to usual care for coronary heart disease (CHD) patients enrolled in health maintenance organization or Veterans Administration settings. BACKGROUND: Statin therapy benefits are well established. No prospective, randomized studies have tested strategies to optimize these benefits in a "real-world" setting. METHODS: A total of 2,442 CHD patients with hyperlipidemia were randomized to either an aggressive treatment arm using atorvastatin or usual care and followed for 51.5 months on average. Atorvastatin-group patients were titrated to LDL-C goals of <80 mg/dl (2.1 mmol/l) or a maximum atorvastatin dose of 80 mg/day. Usual-care patients received any treatment deemed appropriate by their regular physicians. End point assessments were complete in 958 atorvastatin-group and 941 usual-care patients. Partial assessments occurred in 259 patients in the atorvastatin group and 284 patients in the usual care group who did not complete four years of study participation because of adverse events, withdrawn consent, or follow-up loss. The primary efficacy parameter was time to first cardiovascular event. RESULTS: A total of 289 (23.7%) patients in the atorvastatin group compared with 333 (27.7%) patients in the usual care group experienced a primary outcome (hazard ratio, 0.83; 95% confidence interval 0.71 to 0.97, p = 0.02). This reduction in morbidity was largely due to fewer non-fatal myocardial infarctions (4.3% vs. 7.7%, p = 0.0002). Levels of LDL-C were reduced more (34.3% vs. 23.3%, p < 0.0001) and National Cholesterol Education Program goals (LDL-C <100 mg/dl) more likely met at end-of-study visits (72.4% vs. 40.0%) in patients receiving atorvastatin compared with those receiving usual care. CONCLUSIONS: An aggressive, focused statin therapy management strategy outperformed usual care in health maintenance organization and Veterans Administration clinic patients with CHD.

Adult↗
PubMedDate not supplied

Case management in managed care: past, present, and future.

Case management (CM) has undergone radical, rapid change during the past 20 years and, from all appearances, shows no signs of slowing down. This article attempts to lay out the factors that will lead to the future of CM from three perspectives: patients, providers, and payers--the trilogy of the health care industry. The content of this article is rather provocative, intentionally designed to kindle thought and generate alternative ways to approach CM programs.

Case Management↗
PubMed2000

Dermatology practice management enhancement: implications for dermatology in the age of managed care.

Health care delivery in the United States has changed dramatically during the past 10 years. Dermatologists are faced with challenging changes in the way they learn new skills, practice, and provide dermatologic care. Dermatologists can survive and flourish in this environment if they learn proper management and enhancement skills. These skills include proper coding and documentation, regulatory compliance, and new levels of practice effectiveness and efficiency. Dermatologists can offer also the benefit of cosmetic procedures and ethical office-based dispensing to their patients. Greater future unification of this specialty will allow dermatology to flourish and show its need, efficiency, and cost-effectiveness.

Cosmetics↗
PubMed2002

Disease burden profiles: an emerging tool for managing managed care.

As health plans assume financial risk for providing health care services, effectively managing the health of a population remains one of the toughest challenges. This article shows how risk assessment methods can be used to measure disease burden in the full population and to discriminate levels of future health care needs within specific disease cohorts. We also examine and compare the predictive power of claims-based models within a diabetic cohort.

Chronic Disease↗
PubMed1992

Managing care and the risk for managing quality.

The purpose of this paper is to outline the potential liability of managed care organizations. Specifically, the paper enumerates the various types of liability of health maintenance organizations for the negligent acts of its contracting physicians. The recent cases discussed below demonstrate both the extent to which courts are willing to stretch the liability of HMOs and also the limits that courts place on that liability.

Credentialing↗
PubMedDate not supplied

Managed care is data management.

As managed care evolves, it has become apparent that greater control of both the patient and the provider side of the process is necessary. Specifically, improvements are necessary in monitoring the appropriateness of service, accessibility, authorship and authorization of referrals and claims, patient advocacy, and assimilation of data.

Database Management Systems↗
PubMed1992

Total quality management and statistical quality control: practical applications to waste stream management.

TQM offers a completely new approach to problem solving in health care. The approach requires dedication and persistence in monitoring, understanding, and changing systems at a level that has never been reached before in the United States' health care system. Materiel management, purchasing, nursing, housekeeping, and administration now have the necessary tools to centrally study the medical waste stream flow at their facilities. The intent of this article is to display how TQM techniques can be applied to minimize a hospital's medical waste stream. The approach of studying medical waste as a defect generated during the process of delivering high-quality care enables a hospital to pinpoint causes of these defects, modify the parent system of the defect, and lessen the generation of medical waste defects. Successful implementation of these techniques as a continuous process will enable hospitals to be leaders in the preservation of their host communities' environments.

Data Collection↗
PubMed1993

Case management a must to survive managed care.

Fast, efficient access to patient information is now an essential management tool. Not only does it facilitate a streamlined approach to the continuum of care, but it also helps ensure the kind of quality that consumers are clamoring for.

Continuity of Patient Care↗
PubMed1995

Quality management in managed care.

Managed care creates a corporate environment in which competitiveness demands close attention to quality. Although the health care sector may benefit from solutions derived in other industries, it attaches unique importance to noneconomic, intangible factors. Adequate cost-utility analysis must take such factors into account instead of relying on artificial numerical values.

Cost-Benefit Analysis↗
PubMed1999

The future of managed care: integration of financing, risk management, and delivery.

The most significant transformation of health-care delivery and the health insurance industry is under way in the United States. It will change forever, and for the better, the way the delivery and financing of our nation's health-care is structured. We are witnessing the industrialization and consolidation of what was once a fragmented cottage industry. The new system--we call it wave III--will result in the re-establishment of the physician/providers as the key decision makers in our health-care system of the future. In this next phase of change, organized groups of physicians and hospitals will replace the current HMO insurance structure. This Third Wave will witness the integration of technology, managerial skills, marketing, sales, and negotiating acumen that were previously in the domain of health insurance companies (HMOs) into a delivery system where physicians and hospitals become partners focusing their coordinated efforts in managing health-care and the associated premiums.

Delivery of Health Care, Integrated↗