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Successful business process design. Business plan development for the occupational health services unit.

1. The occupational health nurse is often mandated by management to validate health services offered and programs developed for employees as valuable to the business and company mission. 2. The business plan of the occupational health service is a working document, changing as needs of the client/customer and internal and external business and socio-economic environment evolve. 3. Alignment with and support of the company mission, goals, and objectives is another method of proving good occupational health is good business. 4. Business planning is a basic business tool the wise and prudent occupational health nurse can use in proving good occupational health is vital to the success of a company.

Commerce↗

Improvement of treatment plans developed with intensity-modulated radiation therapy for concave-shaped head and neck tumors.

PURPOSE: To improve dose conformity and normal tissue sparing in patients with concave-shaped head and neck cancers by using tomotherapy and static step-and-shoot intensity-modulated radiation therapy (IMRT) and by comparing results with those of three-dimensional (3D) conformal radiation therapy (CRT) and two-dimensional (2D) radiation therapy. MATERIALS AND METHODS: Treatment planning in 10 patients with concave-shaped head and neck tumors was performed by using tomotherapy and step-and-shoot IMRT, 3D CRT, and 2D techniques. IMRT plans were modified by placing "virtual critical structures" in regions outside the target where hot spots occurred. These modified plans were used for comparison because they provided better dose conformity. Critical structures were the spinal cord, the parotid glands, and the mandible. Comparisons were performed by means of dose-volume histograms, clinical target volume (CTV), target covered by 95% isodose (D(95%)), dose received by 5% of the critical structure volume (D(5%)), maximum dose, mean dose, and normal tissue complication probability for critical structures. RESULTS: Original IMRT plans showed more conformal dose distributions than those in 3D CRT and 2D plans. However, hot spots developed in the posterior and anterior neck. Introduction of virtual critical structures in IMRT plans resulted in removal of these hot spots without affecting target coverage. Modified IMRT plans also demonstrated better CTV coverage than that in 3D CRT and 2D plans. The average D(95%) was 97.3% with tomotherapy, 97.1% with step-and-shoot IMRT, 84.7% with 3D CRT, and 69.4% with 2D techniques. D(5%) for the spinal cord changed from approximately 45 Gy with 3D plans and 46 Gy with 2D plans to approximately 28 Gy with IMRT. CONCLUSION: IMRT demonstrated better target coverage and sparing of critical structures than that of 3D CRT and 2D techniques. Use of virtual critical structures resulted in removal of hot spots around the spinal cord.

Head and Neck Neoplasms↗

Randomized field experiments for program planning, development, and evaluation: an illustrative bibliography.

This bibliography lists references to over 300 field experiments undertaken in schools, hospitals, prisons, and other social settings, mainly in the U.S. The list is divided into 10 major categories corresponding to the type of program under examination. They include: criminal and civil justice programs, mental health, training and education, mass media, information collection, utilization, commerce and industry, welfare, health, and family planning. The main purpose of the bibliography is to provide evidence on feasibility and scope of randomized field tests, since despite their advantages, it is not always clear from managerial, political, and other constraints on research that they can be mounted. Dates of publications range from 1944 to 1978.

Bibliographies as Topic↗

Business plan development: a door to the future.

The face of the American health care delivery system is changing, and change means opportunity. A business plan--the medical entrepreneur's tool to create future opportunities--can be introduced, described, and explained in terms of a positive contribution to an organization's financial viability.

Ambulatory Care↗