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PubMed1986

Health policy implications of health promotion and disease prevention for allied health.

Regardless of the direction health policies in this country may take, allied health professionals seem uniquely positioned to meet the health promotion needs of a variety of clients, such as patients, families, other providers, employees, and members of communities. If allied health professionals choose to respond to health promotion as an area of clinical expertise, they will have to accept the challenge presented by the numerous complex issues associated with implementing a new discipline. However, the successful application of energy and resources to resolving these problems would allow allied health professionals to provide significant interventions in meeting national health goals. This article reviews the history of health promotion in the United States, discusses current practices in health promotion, and suggests some future trends.

Allied Health Personnel↗
PubMed1991

Effect of hazard warning on workers' attitudes and risk taking behavior.

Until recently, the issue of job hazards has been largely ignored as a research and theoretical topic in business and management disciplines although workers' perceptions and assessments of job hazards are of significance to managers. In this paper are reported results of an experiment conducted in Egyptian chemical firms to test the generality of an implicit rational model used to explain employees' reactions to and perceptions of job hazards. Four hypotheses were tested: (1) workers' subjective estimates of their job hazards are positively related to the objective hazard, (2) workers' subjective estimates of a prospective new job hazard will vary directly with the extent of hazard communicated by the new product label, (3) workers' demand for new hazard wage premiums will vary directly with perceived prospective new work hazards, (4) workers' intention to quit the job will vary directly with subjective and objective estimates of job hazards. All hypotheses were supported. The rational worker model appears to be a general explanation for workers' responses to hazardous jobs and information on hazards. This model not only holds for USA workers but also for those in a nonwestern culture. Implications for management and the industrial setting are discussed.

Accidents, Occupational↗
PubMed1999

Impact factors: use and abuse in biomedical research.

Impact factors are increasingly being used as measures in the process of academic evaluation; however, the pitfalls associated with such use of impact factors are not always appreciated. Impact factors have limited use as criteria in determining the quality of scientific research. Classical anatomists may be actively discriminated against if journal impact factors are used as measures of scientific merit in comparison with colleagues in more popular or faster-moving disciplines such as molecular biology. Research evaluation based on citation rates and journal impact factors is inappropriate, unfair, and an increasing source of frustration.

Anatomy↗
PubMed2000

Occupational health in the USA in the 21st century.

Comparable to the confusion encountered in the birth of the machine age is the perplexing reconfiguration of the United States' health care system. Paralleling the advances in medicine have been the divesting mergers and downsizing of industry, coupled with globalization, which have released millions of long-time workers. The labour contingent is changing, with the addition of great numbers of women and immigrant workers, and the manufacturing economy has become one of service and information. Serving the occupational health (OH) needs of such a force have been the professional societies of physicians, nurses, and industrial hygienists, with their members providing care in a broad variety of facilities. It is possible that a national organization, including all these disciplines, would have a greater voice in the protection of workers' health. Immediate leadership of an occupational health service (OHS) can be rotated among the disciplines, so that competition for primacy among the professionals would end. The new workforce demands culture sensitivity among OH personnel and polylingual capabilities may be demanded in the future. Management skills will be required of all in OH, and greater participation of employees in OH policy will characterize the decades ahead. Nearly neglected up to now, occupational mental health programming will be required to meet the real needs of workers, and to counter the move to outsource OH services, where little patient contact results. Behavioural safety, total quality management, and application of the rapidly developing technologies in health care will define the 21st century efforts in OH. Remaining issues, such as violence, telecommuting injuries, the inclusion of alternative medicine, and women's health, among others, will see carry-over for resolution into the year 2000.

Forecasting↗
PubMed1990

How effective is cockpit resource management training? Exploring issues in evaluating the impact of programs to enhance crew coordination.

The question "Is cockpit resource management effective?" has been asked frequently in the years since 1979 when a National Aeronautics and Space Administration (NASA)/Industry workshop addressed the concepts of crew coordination and effective utilization of all available resources in flight operations (Cooper, White, & Lauber, 1980). If one looks at the proliferation of cockpit resource management (CRM) training programs in domestic and foreign, civil and military aviation, and the enormous investment in time and money that they entail, it would appear that the question has been answered in the affirmative. It is our position, however, that the question remains open and that empirical evidence is just beginning to accumulate.

Accidents, Aviation↗
PubMed1986

The honeymoon effect in job performance: temporal increases in the predictive power of achievement motivation.

Correlations between a job performance criterion and personality measures reflecting achievement motivation and an interpersonal orientation were examined at three points in time after completion of job training for a sample of airline reservations agents. Although correlations between the personality predictors and performance were small and nonsignificant for the 3-month period after beginning the job, by the end of 6 and 8 months a number of significant relationships had emerged. Implications for the utility of personality measures in selection and performance prediction are discussed.

Achievement↗
PubMed2000

What can the chronobiologist do to help the shift worker?

This article is composed of a review of how the increasing numbers of people working abnormal hours (referred to as "shift workers") can best be helped by the science of chronobiology. While recognizing that chronobiologists can give much general advice regarding such things as diet, sleep hygiene, cardiovascular health, and the need to address social and domestic tensions, this article will focus specifically on the advice that can be given to employers and employees, which is directly rooted in our knowledge of chronobiology.

Adaptation, Physiological↗
PubMed1987

Productivity analysis.

This paper discusses productivity analysis, a method used in the Department of Rehabilitation Services at the Brigham and Women's Hospital in Boston to measure the efficiency of occupational therapy services. Input and output information forms are displayed for a computerized program of productivity analysis. Input information includes time and nontime (modality) units and scheduled downtime. Output reports contain productivity analyses which allow the manager to monitor the ratio between actual hours worked by therapists and allocated hours per service. The data generated give weekly, monthly, and yearly feedback on performance by service and discipline. The objective information produced by these reports on service and department function contributes to management decisions on resource allocation and equipment requests.

Boston↗
PubMed1997

Interdisciplinary quality improvement in the perioperative program. A collaborative model.

The practice at Children's Hospital has demonstrated the many benefits of the collaborative method of TQM. It allows the various disciplines to share their perspectives on patient care with other members of the health-care team. This broadens each person's perspective and generates respect for the work of others in achieving high levels of patient care. An effective committee empowers by providing a way for every employee to feel that his or her voice can be heard and that legitimate issues of quality of care, cost reduction, and system efficiency will be explored when identified.

Adult↗
PubMed1996

Cigarette smoking at hire as a predictor of employment outcome.

We have reported that cigarette smoking at the time of hire is associated with elevated rates of accidents, injuries, absence, discipline, and firing among US postal workers. We followed this cohort of 2537 for a second year to assess whether these associations would change with time in a workplace with active smoking cessation programs. Smokers' elevated risks for accidents, injuries, and discipline decreased after the first year. Risk for involuntary turnover was slightly higher in the 2-year analysis. The elevation in the rate of absence for smokers remained comparable in both periods. Although it is possible that the decline in the relative risk of accidents, injuries, and discipline may reflect changes in smoking status, we were unable to obtain follow-up data on smoking status to test this hypothesis.

Absenteeism↗
PubMed2005

Participatory inquiry with a colleague: an innovative faculty development process.

Clinical evaluation is central to the aims of nursing education; however, little has been written about the actual evaluative practices of nurse educators and the sources of influence on those practices. In this article, we describe our experience as co-investigators into the evaluation practices of one of us (J.A.J.) and overview some of the challenges and opportunities of participatory inquiry. We describe how J.A.J.'s involvement in this research project encouraged her to explore her evaluative practices in a meaningful way, which moved her to a place of deeper understanding about her work and transformed her as a nurse educator. As a result of this study, we are convinced of the necessity for a faculty development process whereby colleagues commit to a critical inquiry process focused on identifying each other's evaluative practices and sources of influence on those practices. In addition, schools of nursing can encourage faculty participation in peer development by adopting an expanded view of scholarship in which the disciplined examination of one's evaluative practices is accepted as evidence of the scholarship of teaching.

Attitude of Health Personnel↗
PubMed1997

Success in managed care: improving clinical quality.

What are the economic elements for success in managed care? Although they are quite simple, achieving them can be difficult. The criteria for success in the fee-for-service medical delivery system, generally characterized as "see more--do more--get more," are no longer valid for delivering care in a managed care system. This article identifies the economic elements for success in managed care, and offers a disciplined approach to achieving them, combining both actuarial and clinical expertise.

Cost Control↗
PubMed2004

Managerial process: the reflective practitioner.

The successful management journey is replete with moments of truth. Recognizing those moments and their significance for successful managerial practice is both a reflective and a conscious practice. This article, written by a successful pharmacist who now manages a busy public service hospital pharmacy documents his management journey from starting position as a drug store pharmacist to his present position in the public service. The paper uses managerial process theory as a critical tool to assess the author's own managerial style. Starting off as an autocratic manager with micro management tendencies, he has now developed a different style of management built on a basic philosophy about the value of people. He sees a need for managers to build a work environment that supports the efforts of employees. This style has not only made him a more effective people manager and motivator, but he argues it has also made him a better pharmacist. The author concludes by advocating the value of reflective practice, particularly for healthcare administrators as a means of balancing the technical demands of their disciplines with the ongoing requirements of managing people.

Canada↗
PubMed1993

Negotiating nurse-patient authority in pediatric home health care.

In this qualitative study, pediatric home health nurses described the solitary, ambiguous, and unprogrammed nature of home health nursing. As employees of the family, the nurses in this study found it necessary to negotiate their work tasks and working conditions with family members. In describing the meaning of their work, the nurses emphasized differences between hospital and home health nursing with regard to their authority for care decisions, methods of child discipline, parental control of care, and innovations of nursing routines and interventions. Characteristics of pediatric home nursing are identified in order for these to be communicated to prospective home care nurses, to pediatric nurse educators, and to home health managers. With knowledge of these characteristics, a new home health nurse will be better prepared to negotiate shared patient care responsibilities with the client's family.

Child↗
PubMed1999

Health-promoting behaviours in public health: testing the health promotion model.

A health-promoting lifestyle encompasses far more than preventing disease and is characterised by behaviours that lead to optimal well-being, self-actualisation, and personal fulfillment. This study was undertaken to investigate the health-promoting lifestyles of employees working in local public health departments (n = 602) and to test two research hypotheses suggested by the Health Promotion Model. The first hypothesis posited that public health professionals would report significantly more favourable health-promoting behaviours than support staff employed in the same departments. The second hypothesis postulated that occupational discipline in public health would be a significant predictor of health-promoting behaviours. Health-promoting behaviours were measured by the Health-Promoting Lifestyle Profile (HPLP), a psychometrically-validated measure of overall health-promoting lifestyle and six dimensions of health-promoting behaviours, which comprise the instrument's subscales. The findings of the study tended to support the research hypotheses. Overall, public health professionals tended to report more favourable health-promoting behaviours than departmental support staff, and occupational discipline was a significant predictor of a health-promoting lifestyle. In general, public health nursing personnel reported the highest mean levels of health-promoting behaviours compared to the other occupational disciplines examined.

Adolescent↗
PubMed1997

Responding to domestic violence: a coordinated response by a consortium of teaching hospitals. Domestic Violence Task Force, Conference of Boston Teaching Hospitals.

Increasingly, health care providers are recognizing their role in the struggle against domestic violence. Although individual institutions around the country have developed protocols and programs in conjunction with community providers, there has been no unified health care effort. In May 1995, the Conference of Boston Teaching Hospitals (COBTH)--a collaborative body of the 14 academic hospitals and medical centers in the Boston area--formed the COBTH Domestic Violence Task Force. This task force, chaired by the president of Children's Hospital, represents the first time that hospital administrators and clinical staff have joined forces to deal with this issue. Critical to this effort were (1) the recognition that the hospitals have a responsibility to respond to patients as well as employees who are battered, (2) that in order for this work to move forward and become integrated into hospital systems, the involvement of senior medical staff and management is necessary, (3) that training and education must be ongoing and penetrate all levels of staff, and (4) that this work must be collaborative, with hospital staff working across disciplines and with community service providers. This paper outlines the year-long work of this Committee, including specific objectives and recommendations.

Boston↗
PubMed1998

[Some current questions concerning occupational diseases in Hungary].

The author reviews the management of the professional diseases in Hungary from the beginning till now. It can be stated that the number of the registered professional diseases in Hungary has decreasing steadily. He thinks that this tendency can be explained not only by the improvement of the labour higienic conditions and systematic screening tests with biologic monitoring but also by the increase of unemployment and the threatening of the latter of the workers as well as the lack of the discipline of the registration. The change of the economical structure resulted in the change of the problems concerning the professional diseases too. The liquidation of the old large factories and the development of many small economic plants represents a big problem of the labour hygienic control of the latters and make difficult the prophylactic examinations of all employees. This is a factor counteracting the further decrease of number of professional diseases. The change of the spectrum of the professional diseases is to be expected too. The criteria of the diagnosing, the therapy and the prognosis of the professional diseases are described. The most effective method of the medical prevention of the professional diseases in the precise fulfillment of the prophylactic medical examinations.

Female↗
PubMed1991

Shared governance for nursing. Part II: Putting the organization into action.

Shared governance is a major departure from traditional management-drive systems. It requires commitment and investment from all of nursing. It builds on the trust developed in the nursing service between all participants who deliver nursing care. It requires management and clinical teams to work closely and redefine their roles. The need for mutual understanding and support is undeniable. Unfortunately, there has not been much reason for that trust to develop at a rate and a level it should in most health care facilities. As institutions move to higher levels of interaction to compete and survive and as the nursing shortage requires hospitals to address the role of the nurse, hospitals are laying the groundwork for nurses to play a larger role in governance and control. These circumstances, among others, stimulate interest and provide a basis on which nurses can work together, whether in management or clinical positions, to strengthen the accountability and role of nurses in managing their services and their practices. Moving to shared governance affects the way in which nurses work and relate to the organization. The use of collective bargaining strategies, movement of the nurse into areas of control over issues that institutions once considered beyond his or her role or right, and conflict management strategies will have to change to facilitate the move of nurses into the main-stream of decision making. As the institution moves from a hierarchical structure to a multiservice setting and a more responsive market-based organization is created, nurses will have to play a stronger role in marketing and managing their practices. This flexibility extends to moving health care services out of the institution and into the community and the home and requiring nurses to become more invested in processes and mechanisms that affect what they do and how they do it. If nurses are to have a place in creating policies and define their part in unfolding the future of health care, they must be able to reorganize their services, create stronger peer-based governance approaches, and exhibit stronger control in the exercise of their practices. That will not happen by accident, nor will there be many people from other disciplines who will be heralding this cause for nurses. Before others in policy-making positions move over to provide the necessary space for nurses, the practicing nurse will have to operate and manage his or her practice at the same level and in a similar manner as other professional workers who are outside of the typical dependent, vocational employee role.(ABSTRACT TRUNCATED AT 400 WORDS)

Decision Making, Organizational↗