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Alternative medicine.
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Absenteeism in acute care hospitals.
Lack of standardization in formulas for calculating absenteeism impeded comparison among institutions and comparison to rates reported for the health care industry. Even though illness related benefits, replacement costs for absent employees and attendance incentives absorbed scarce financial resources, more than 40% of hospitals had no standard for excessive absence. Directors of nursing were concerned about staffing and the possibility that employees were tiring to the point of becoming ill. Among directors, concern about absenteeism was greatest in urban hospitals of 100-200 beds.
External funding obtained to study the effectiveness of nurse disciplinary actions.
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Disciplinary counseling process.
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Linking work and domestic problems with police suicide.
We reviewed the records of 134 police officers who had undergone their first fitness-for-duty evaluation at our center. Fifty-five percent admitted to previous suicide attempts. We examined possible contributing factors. A logistic regression model correctly classified 79.1% of subjects as to whether or not they attempted suicide. Results indicated that officers reporting marital problems were 4.8 times more likely to have attempted suicide, and 6.7 times more likely if they had been suspended. Interestingly, complaints of being administratively harassed were associated with a lower likelihood that an officer would attempt suicide. Variance explained due to age, race, gender, and substance use was nonsignificant.
Charts without covers.
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Problem doctors. Three wise men procedure is effective.
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Harvey A. K. Whitney Lecture. Shifting pharmacy's paradigm.
Changes occurring in the pharmacy profession and their effects on the paradigm for pharmacy practice are discussed. The paradigm of pharmacy, the pattern or model of pharmacy's structure, services, daily activities, and organization, is shifting, and if pharmacists do not shift with it, they will be left behind. Advances in technological capabilities often result in automation and centralization of services. Improvements in drug therapy have caused shifts in the performance of clinical functions. Philosophical changes about the way health care should be delivered have produced the concepts of pharmaceutical care, patient-focused care, and continuous quality improvement of care. Teams of caregivers whose primary concern is the patient have replaced caregiving based on technology, discipline, or employee needs. Pharmacists have focused on the patient as their primary customer instead of the nurse or practitioner, and they anticipate the patient's needs in a structured and documented fashion. The principles of continuous quality improvement have been applied to every aspect of providing pharmaceutical care. If pharmacists are to adjust to the shift in the pharmacy paradigm, they must recognize their strength as a group, make proper recommendations about pharmaceutical use, move horizontally to grow as professionals, consider themselves clinicians, be active in the making of pharmaceutical care decisions, and believe in themselves.
Using computers to monitor conflict indicators.
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The state license hearing--information for empowerment.
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Disciplinary procedures. Cautionary tales.
HVA local accredited representatives are reporting an increase in disciplinary cases against field staff. Disciplinary cases can be very stressful for all concerned. They should not be used unless clearly appropriate, as Roger Kline explains.
Suspension pending inquiries: an English medical phenomenon?
The suspension of doctors in the National Health Service by health authorities, often for long periods for what appear to be trivial reasons, while inquiries into allegations are pending seems to have become an increasing problem in the United Kingdom. In some cases the hearing has been conducted years after the suspension. This situation caused the Society of Clinical Psychiatrists to establish a study group with the aim of producing a fact-finding report into what appeared to be a growing abuse of procedures. This article presents a summary of the study group's findings and the lessons to be learned from this disturbing bureaucratic phenomenon.