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PubMed1979

Unionism in the health care industry: an overview.

Block profiles the two unions that are the most active in organizing non-nurse health care employees: the National Hospital Union (NHU) and the Service Employees International Union (SEIU). The two international unions present a contrast in structure and ideology. The SEIU is a truly international, decentralized union, whereas NHU is a far more centralized affiliate. As an international union, SEIU characterizes, taxes, and disciplines locals. Its decentralized strategy has been to permit locals to do the bulk of the organizing and collective bargaining, while the national union merely coordinates and offers financial and technical support. Conversely, NHU is an affiliate of the retail, wholesale, and department store union, deriving authority from, paying tax to, and subject to discipline by the parent organization. Its centralized approach has been for national officers to determine when a district will be created and what its jurisdiction will be. The structural differences of the two unions can be traced to their respective histories. As an old-line AFL union, SEIU had an existing structure of independent local unions that operated in health care as they did in other industries. NHU, however, originated as a union of drug store employees and its structure evolved over time. Membership growth and geographic expansion elevated it beyond the status of a local into a division with its own districts. The unions also diverge in their ideology; SEIU takes a more traditional business union approach to collective bargaining and unionism, while NHU is oriented to social welfare, involving itself in more than the work aspect of members' lives. These differences again can be attributed to contrasting histories of the old-line SEIU and the more radical NHU. The authors emphasize that unions are not homogeneous entities but organizations that respond to a similar environment as a result of their respective structures and histories.

Health Workforce↗
PubMedDate not supplied

Made in U.S.A.: a renaissance in quality.

In the opinion of some journalists and business leaders, Japan's preeminence in product quality is a direct consequence of lectures delivered 40 years ago in Tokyo by two Americans--W. Edwards Deming and Joseph M. Juran. According to Dr. Juran, this view is pure chauvinist nonsense. Despite the shoddiness of Japanese consumer goods before the war, the Japanese did have a quality tradition in the superb workmanship of certain ancient crafts and in the design and manufacture of their military hardware, which, at the outset of the war, was highly competitive with our own. It was just that the Japanese had never devoted engineering expertise, capital, or management attention to the quality of exportable consumer goods. The shock of losing the war changed that mind-set. When Dr. Juran first lectured in Japan in 1954, his audience consisted of 140 CEOs. He had given the very same lectures dozens of times in the United States, but never to top management. American CEOs concentrated their attention on financial reports. Quality was a discipline that they delegated to engineers and special quality departments. In Japan, senior executives took personal charge of managing for quality; trained their managers, engineers, and employees in quality methods; developed quality measurements; pursued quality change at a revolutionary pace; and kept at it year after year until, by the mid-1970s, Japan had passed the United States in quality manufacturing. The unsung heroes of the Japanese quality revolution were Japanese managers, not American experts. Now Dr. Juran sees the beginnings of a quality revolution in the United States as global competition drives managers to focus on their nondelegable responsibilities in quality management.

Administrative Personnel↗
PubMed1988

A trade union perspective on AMT.

Amalgamated Engineering Union (AEU) members often observe that poor design not only makes their work unnecessarily difficult, it also cuts into company profits. Sadly, mistakes 'scientific management' was intended to rectify 60 years ago are still being made in British manufacturing today, with consequences - especially for health and safety - that the trade union movement cannot accept. The introduction of the microprocessor, and of advanced manufacturing technology (AMT), have not always seen a comparable improvement in the design of tools or the workplace. Too often, lessons which should have been learned with the old technology are having to be learned all over again with the new. This points to the lack of a healthy management tradition in which lessons can be passed from one generation to another. One issue which is high-lighting this is repetitive stress injury (or occupationally-related musculo-skeletal disorders). The AEU is committed to the training and re-training of its members, and is convinced that this is part of the key to the successful introduction of AMT. Workers used to the physical disciplines of an older generation of technology will need re-training to make the most of the new. If this is to be done effectively, the employee's interest in having a satisfying and interesting job should be accepted as an ergonomic aim at least as important as the efficient use of time and space. In the past, workers and their unions have not been allowed a significant input in the decisions about their own workplaces and jobs. This has had two serious effects: design has been worse for it, and trade unions have not paid the attention to ergonomics they should have done, but have concentrated on other matters which they could influence. It is important for Britain's economic future that we listen to the voice of the workers.

Journal Article↗
PubMed2004

An assessment of the readiness of hospice organizations to accept technological innovation.

We surveyed seven of the 62 certified hospice programmes in the state of Missouri. The survey consisted of 19 questions that covered demographic information, how employees received new information, the current use of various forms of technology, employees' comfort with technology and their perceptions of the use of video-phones. A total of 124 surveys were returned. Respondents were categorized within the following disciplines: nurses (48%), administrators and nurse supervisors (6%), social workers (9%), physicians (3%), home health aids (18%), chaplains (5%) and other staff (e.g. clerical and bereavement staff) (12%). Staff reported using several types of technological device at work but not a video-phone or a Web camera. There were significant differences between hospices in the degree of use of computers at work, the number of devices used at work and the perceived benefits of video-phone technology. There were significant differences between disciplines in the degree of use of computers at work and at home, the number of devices used at work, and their comfort both with the use of new technology and with the idea of introducing new technology to patients and their families. Because there were variations in the perceived usefulness of video-phones for hospice care, the introduction of such equipment would require substantial involvement of the users.

Attitude of Health Personnel↗
PubMed1987

Thinly disguised contempt: a barrier to excellence.

Many elements in contemporary leadership and management convey contempt for employees. "Thinly disguised contempt," a concept introduced by Peters and Austin in A Passion For Excellence, explains many barriers to the achievement of excellence in corporations across disciplines. Health care executives and managers can learn from the errors of corporate management and avoid replicating these errors in the health care industry.

Communication↗
PubMed1982

Publication characteristics of family practice faculty nominated for academic promotion.

A survey of family practice department chairmen identified 74 faculty who were nominated for promotion during the 1980-81 academic year; 72 percent had medical degrees, 18 percent had academic doctorates, and 11 percent held other degrees. In each professorial rank those promoted had twice as many publications as those not promoted. Successful and unsuccessful candidates also differed noticeably in the median number of journal publications per year spent on the tenure track. These norms are descriptive, not prescriptive. As the discipline develops academically, promotion characteristics are likely to change.

Achievement↗
PubMed2006

A review of the literature on preventive occupational health and safety activities in small enterprises.

The scientific literature regarding preventive occupational health and safety activities in small enterprises has been reviewed in order to identify effective preventive approaches and to develop a future research strategy. During the last couple of years, there has been a significant increase in the number of studies of small enterprises, but the research community is scattered between many different disciplines and institutions. There is a lack of evaluation of intervention studies, both in terms of effect and practical applicability. However, there is sufficiently strong evidence to conclude that employees of small enterprises are subject to higher risks than the employees of larger ones, and that small enterprises have difficulties in controlling risk. The most effective preventive approaches seem to be simple and low cost solutions, disseminated through personal contact. It is important to develop future intervention research strategies which study the complete intervention system: from the intermediaries through dissemination methods to the resulting preventive activities of the small enterprises.

Accident Prevention↗
PubMed1996

Psychoactive substance use in forensic psychiatry.

OBJECTIVE: The purpose of this article is to discuss the interface between judicial discipline and behavioral science in the context of substance-related disorders. METHOD: We review the epidemiology of psychoactive drug use and crime and discuss the courts' decisions on relevant landmark cases, particularly as they influence the practice of psychiatry. RESULTS: (1) The phenomenology of addiction and crime is of great epidemiological import. (2) Our legal system inclines toward the view that the use of alcohol or other substances involves an element of choice and therefore would not amount to a legal insanity defense if the substance abuser commits a crime while intoxicated. (3) A state can confine an addict or alcoholic for compulsory treatment if that individual presents a danger to self or others. (4) The law has found that alcoholism and drug abuse are both "willful misconduct" and a disabling condition; the former definition contains the end in view of punitive action. The latter is aimed toward treatment and rehabilitation. (5) The law gives the right to the employer to test a suspected employee for drug abuse. The addicted or alcoholic employee has the choice to either go for treatment or face job termination. (6) Our judicial system gives serious consideration to the welfare of a child whose parents are alcoholic or drug addicted. CONCLUSION: The two disciplines of psychiatry and law follow their own modes in resolving issues in alcoholism and other substance abuse. We need research and new approaches to build a bridge between the two.

Antisocial Personality Disorder↗
PubMedDate not supplied

Changing the way we change.

More and more companies struggle with growing competition by introducing improvements into every aspect of performance. But the treadmill keeps moving faster, the companies keep working harder, and results improve slowly or not at all. The problem here is not the improvement programs. The problem is that the whole burden of change typically rests on so few people. Companies achieve real agility only when every function and process--when every person--is able and eager to rise to every challenge. This type and degree of fundamental change, commonly called revitalization or transformation, is what many companies seek but rarely achieve because they have never before identified the factors that produce sustained transformational change. The authors identify three interventions that will restore companies to vital agility and then keep them in good health: incorporating employees fully into the principal business challenges facing the company, leading the organization in a different way in order to sharpen and maintain incorporation and constructive stress, and instilling mental disciplines that will make people behave differently and then help them sustain their new behavior. The authors discovered these basic sources of revitalization by tracking the change efforts of Sears, Roebuck & Company, Royal Dutch Shell, and the United States Army. The organizations used these interventions to alter the way their people experienced their own power and identity, as well as the way they dealt with conflict and learning. As at Sears, Shell, and the U.S. Army, any major shift in those four elements will create a landmark shift in any organization's operating state or culture.

Commerce↗
PubMed2001

Implementing continuous quality improvement at the facility level.

Continuous Quality Improvement (CQI) is a disciplined approach to problem solving. The 4 basic building blocks of the program include; leadership, planning, quality control, and quality improvement. It is customer focused, data driven, and empowers the employees to meet the needs of their patients. Management teams that successfully adopt the underlying philosophic tenets of the program and provide adequate resources for training and implementation may realize such benefits as improved clinical outcomes, increased patient and staff satisfaction, increased staff productivity, fewer adverse events, enhanced cost effectiveness, and an improvement in overall organizational performance.

Humans↗
PubMed2003

Implementing a job hazard analysis program.

Analyzing the workplace for hazards and controlling the hazards identified to reduce risk is a proactive approach to workplace safety and the primary prevention of occupational illnesses and injuries. A JHA is a simple, time tested, and effective tool to assist in this analysis. Job hazard analysis methods may enhance and complement many current business initiatives. When programs can be integrated to contribute to leadership mandates, there are opportunities for increased support and resources. Involving other departments and disciplines with complementary programs also reduces duplication of effort. Prioritizing jobs to be analyzed based on risk assessment results in a manageable approach for beginning a program. A team process involving employees, supervisors, and key safety participants is most effective. Successful programs encourage each team member to observe or videotape key jobs, list the job steps, and involve the team in developing hazard reduction solutions and safe job procedures. When effectually used, JHAs have been proven to improve communication and participation, while enhancing worker safety.

Health Plan Implementation↗
PubMedDate not supplied

The health-care manager's guide to managing change in challenging times.

Fifteen years ago, Bill Gates was a college dropout working for a four-member, fledgling company in New Mexico. Today, he is the richest man in America and the head of perhaps the most powerful company in recent corporate history. Ten years ago, managed health care was merely a concept discussed in academic and industry observer circles. Now it is a norm in almost every health-care organization nationally. Five years ago, health-care professionals in every discipline believed the maxim that, ¿as long as people get sick, health-care professionals will have jobs.¿ In 1995, health-care executives have alternately referred to the widescale process of laying off employees as reengineering, rightsizing, downsizing, or RIF (reduction in force). With this massive amount of change, both societally and professionally, health-care managers have been contending with the change management process. Although a breadth of concepts borrowed from other industries and a plethora of conceptual practicums have entered the health-care educational realm, a straightforward, immediately useful approach to managing change is probably more beneficial, as the need to manage change quickly and effectively becomes the paramount criterion for health-care management success in the second half of this decade of change. In this article we will explore the four areas where mistakes are made most frequently by leaders in the change process, and we will provide specific strategies to not only avoid these mistakes but moreover reduce resistance to change, activate positive action, and ultimately improve performance through optimum staff contribution. The four critical areas we will explore are the reasons for resistance to change, the management of the proactive phase of change, creating staff interdependence, and key leadership roles for change management.

Attitude of Health Personnel↗
PubMed2002

Managing pharmacy benefits cost-effectively for an aging workforce.

Many baby boomers believe age is no more than a number. Employers and plan sponsors will need to provide cost-effective pharmacy benefits to this group, as well as other Americans, all of whom will be using more prescriptions that cost more. Employers and union trusts can use a pharmacy benefits management (PBM) company that understands the importance of cost management, focuses on improving patient outcomes and works with the plan sponsor to create a phased approach to a disciplined pharmacy management strategy. Education of all parties is key.

Adult↗
PubMedDate not supplied

Case management: entry-level practice for occupational therapists?

As American businesses have sought means to control employee health benefits, managed care has evolved. This evolution has brought greater demand for case management. Case management is not a profession but a practice area within one's own profession. Case managers come from a variety of disciplines and work in a variety of practice settings, which include medical, psychosocial, educational, vocational, and rehabilitation.

Accreditation↗
PubMed2003

Rethinking the concept of professionalism: the case of journalism.

Journalists in the UK have always been ambivalent about what form of occupational control to pursue. Although resistant to the structures of the conventional profession, they have embraced the idea of 'professionalism'. As the formations traditionally associated with Anglo-American professions become relevant to fewer and fewer employees and increasingly subject to external regulation it is more relevant, we suggest, to investigate how the discourse of 'professionalism' as a set of values and identities can be mobilized by employers as a form of self-discipline. Journalism, notable for its powerful occupational mythology, provides a vivid example of how this process has eased the imposition of radical changes to the organization of work. Now, ironically, recent changes in the occupation's social composition and training may mean that journalists, who have always cherished a self-image as socially marginal, will aspire to conventional professional respectability.

Humans↗
PubMed1993

Autogenic feedback training improves pilot performance during emergency flying conditions.

Studies have shown that autonomous mode behavior (AMB) is one cause of aircraft fatalities caused by pilot error. In AMB cases, the pilot is in a high state of psychological and physiological arousal and tends to focus on one problem, while ignoring more critical information. The following study, conducted under the auspices of the U.S. National Aeronautics and Space Administration's (NASA) Ames Research Center, examined the effect of training in physiological self-recognition and regulation, as a means of improving crew cockpit performance. Seventeen pilots were assigned to the treatment and control groups matched for accumulated flight hours.

Accidents, Aviation↗
PubMed2005

Interdisciplinary practice, education, and research: the expanding role of the occupational health nurse.

The nurses' roles are changing and expanding along with the changing health care system. Occupational health and environmental health nurses are in key positions to coordinate and direct interdisciplinary practice, education, and research. Occupational and environmental health nurses have a broad knowledge base in which they deal with employers, employees, stakeholders in communities, different governmental organizations, and families. Interdisciplinary collaboration is a way to find possible solutions to meet the needs of the work force, their families, communities, and the global community. Nurses must educate the different disciplines about their worth in collaborative interdisciplinary practice, education, and research. No single discipline can help individuals reach their full level of well-being. Interdisciplinary practice, education, and research should be encouraged for nurses to provide the best care for individuals in need of health care.

Humans↗
PubMed2005

[Characteristics of work stimulation of the medical personnel in the treatment-and-prophylactic institutions].

Social and economic relations of the last years that were formed in our country have lead to the changes in approaches to administrative activity. Under conditions of administrative-and-command guidance the patriotism and requirements of production discipline ensured the highly effective work. Today the economic relations between employer and personnel are of the first priority. These principles can be attributed to the military medical collective activity. The algorithm developed during the investigation for stimulating the employees working in the in-patient military medical institutions suggests the following performance of measure complex directed to the improvement of professional training of managerial staff working in the military medical institutions work with subordinates, fulfilment of motivation activity, summing up the medical staff work.

Attitude of Health Personnel↗