The group practice management game 2. Lessons and strategies of medical group management.
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AIMS: This study set out to facilitate the development of evidence-based practice in the assessment of pressure damage risk to patients within a large acute hospital. BACKGROUND: The importance of nursing practice being based on the best available evidence is emphasized in recent health policy. Meeting this objective is not easy as both individual and organizational factors create barriers to the implementation of research findings and the achievement of change. METHODS: The study was based on an action research model. It comprised three stages: a review of the research evidence; a survey of qualified nurses' knowledge of risk assessment of pressure damage and an audit of record keeping, and a multifaceted approach to achieving change in which researchers, managers, practitioners and clinical nurse specialists worked together collaboratively. FINDINGS: The findings from the survey and audit indicated a shortfall in nurses' knowledge of risk assessment of pressure damage and in their record keeping. The researchers, with the help of the clinical nurse specialist, built upon these findings by assisting practitioners and managers to take ownership of the need to base practice on the appropriate evidence. CONCLUSIONS: Achieving evidence-based practice is a complex undertaking that requires the development of an evaluative culture and a commitment by practitioners and managers to change practice. Researchers can play a valuable role in facilitating this process.
Managers must ensure that financial and human resources are used efficiently and effectively in the accomplishment of an organization's objectives. This involves establishing plans and performance standards and correcting deviations from those plans and standards.
Electronic data interchange (EDI) experts in the healthcare industry are advising physicians and physician groups to increase their use of EDI for claims processing, eligibility verification, and remittance advice. Studies have shown that using EDI can, in fact, cut the number of errors on claims, and improve productivity.
We surveyed 218 Level I trauma centers to determine operative airway management preferences for patients with midface fractures requiring maxillomandibular fixation. A two-page survey was distributed to anesthesiologists, plastic surgeons, otolaryngologists, and oral surgeons participating in the management of major craniofacial trauma at each center. Specific fracture patterns were described, and the preferences for endotracheal intubation for operative management were surveyed among the respondents. We analyzed 105 responses from surgeons and 51 responses from anesthesiologists. Although there were differences in the preferences expressed by surgeons compared with anesthesiologists, more than 50% of the respondents in each practice category chose some form of nasotracheal intubation for fracture patterns involving the midface. Tracheostomy was a first choice for patients with panfacial fractures or those with loss of consciousness and midface fractures. This report serves as a basis for surgeons and anesthesiologists to review their practices and discuss planning of operative airway management for the patients with these fracture patterns. On the basis of this survey, midface fractures need not prohibit any consideration of nasotracheal intubation.
A great deal of preparation, time, and expertise are needed to find a good staff member. Remember to be clear about your expectations and formalize your requirements with a written job description. If you plan to run a classified ad, be sure to write one that stands out from the rest. Conduct exceptional interviews that allow applicants to be themselves and demonstrate their abilities. Don't take any shortcuts. Check references, conduct working interviews, and provide training with positive feedback. Your investment of both finances and time will be rewarded when you choose and hire a highly qualified employee who will be able to contribute to the success of your practice.
Many people have been trained from childhood up through dental or professional school to depend on others to structure their time. Dentists cannot afford to rely on someone else to decide how their time should be used. As an executive in charge of your own business, learn the behaviors that your new role requires. Learn appropriate skills for taking charge of your responsibilities. This will require experience-based training in small group dynamics and interpersonal communication along with the usual business skills. This does not mean you need to become an expert in these areas. It does mean you must enhance your personal development to the point of being able to separate what is comfortable behavior from what is effective behavior. Plan and organize your duties and work assignments to get the results you want and to get rid of the stress that occurs with crisis management. Coordinate your activities so that you are clear how they relate to the results you get. Control the different factors that may influence your ability to choose how you use the time available to you. The crucial factors are your objectives and priorities. Focus on developing the ability to lead and direct your auxiliaries for effective use of time.
Individuals continue to smoke despite its numerous proven adverse health effects. Now viewed as a chronic medical condition, health-care professionals are more involved in cessation efforts. Physicians are often the first line of defense, providing intervention through prescription management and counseling. Some insurers recognize these efforts as health promoting and cost saving, revising policies to include reimbursement. This article addresses the most recent smoking cessation policy revision implemented by the Centers for Medicare and Medicaid Services.
Older adults are visiting their dentists more frequently than in the past and expecting higher levels of oral health throughout their lives. Special considerations for this age group and marketing tips are discussed.
Many words have been written about how the marketplace is changing--and hurting--medical group practice. However, not all problems are external. Physicians and managers are doing some of the harm to themselves. "Deadly sins," including a lack of urgency, copycat strategies, trend chasing and the creation of meaningless networks, inhibit growth. Avoiding these mistakes can make it easier to handle those changes group practices can't control.
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There's a hot new acronym in town, and investors from Wall Street to your street are paying attention. Physician management companies--better known as PMCs--are the newest force in the health care market. But is this bigger-is-better approach alienating more people than it's attracting? And how long before the boom goes burst?
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The mandate to convert outpatient primary care programs to family practice programs reached the overseas military theater a number of years ago. Everyone seemed positive about initiating a system that facilitated the relationship between the patient and the health care professional of his/her choice. As a consequence, many new programs were started. A number of concerns have been raised by local medical treatment facility commanders. These concerns demonstrate uncertainty regarding the goals, principles, and expectations of family practice programs. This article endeavors to bring helpful information regarding the philosophy and strengths of family practice. Two very different patterns of organizational structure are discussed and practical advice is given that will, it is hoped, be helpful to senior clinical managers.
In 1986, 1,019 residents of Seattle were surveyed about their dental fears, dental experiences, and perceived oral health status. High dental fear in Seattle was found to affect 204 per 1,000 people. More than 66% acquired their fear in early childhood. Females were 1.8 times more likely than males to report high fear (P less than .001). An individual was 1.6 times as likely to have high levels of dental fear if he or she had at least one oral problem such as bleeding gingiva (P = .004).
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.