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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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At least 127 records · Page 7Linked to original sources
PubMed1995

Teaching an integrated approach to health care: lessons from five schools.

Medical education has excelled in bringing a sound biomedical base to the practice of medicine; however, there is now growing interest in helping students and residents learn an integrated approach to health care that addresses the complex interaction of many factors influencing health and illness. The authors' purpose was to learn about how some medical schools teach students a more integrated approach to health care. They used a qualitative, multiple-case-study design and collected data through document review and interviews with faculty, administrators, students, and residents at five U.S. and Canadian medical schools, chosen for their reputed excellence in addressing an integrated approach to care. Visits to the schools were made in the spring of 1993. Data analysis focussed on the institutional factors associated with teaching such an approach and the ways in which the schools help students and residents learn about this approach. The interviewees described the strong presence of an institutional mission or philosophy that is unique to each school but that generally has a service-oriented, patient-centered perspective. They reported that the primary means for learning about an integrated approach was the attention, woven into the curriculum, to four relationships; physician-patient, physician-community, physician-other practitioners, and faculty-student. A broad-based shared mission or philosophy was important in focusing attention on the integration of biomedical and non-biomedical concerns and promoting a perspective that focuses outward toward the community and its people. The pervasive attention to the four relationships suggests that such attention is intimately related to each school's underlying mission or philosophy.(ABSTRACT TRUNCATED AT 250 WORDS)

Administrative Personnel↗
PubMed1997

Changing structure to improve function: one academic health center's experience.

Academic health centers (AHCs) have been under siege for the past few years, with decreased federal and state funding for educational and research programs and increasing competition in the health care marketplace. In addition, many AHCs are burdened with the bureaucratic red tape of large educational institutions, which makes agility in responding to a demanding health care market difficult. The authors describe the response to these threats by Oregon Health Sciences University (OHSU), an approach that has been different from those of most similar institutions. OHSU chose to change its structure from being part of the state system of higher education to being an independent public corporation. The authors outline the political process of building widespread support for the legislation passed in 1995, the key features of the restructuring, the challenges faced before and after the transition to a public corporation, and lessons learned in this metamorphosis to a new form.

Academic Medical Centers↗
PubMed1997

Beyond corporate-style downsizing: a better way for medical schools to succeed in a changing world.

There is a critical need for medical schools and universities to consider strategies beyond corporate-style downsizing to address revenue needs and reposition their organizations. The author presents considerable evidence and three reasons to reject downsizing as a way to facilitate long-term organizational success. Instead, she recommends that institutions use a comprehensive approach to individual and organizational development to assure a flexible, enduring organization. Specifically, medical schools and universities should take an institution-wide perspective and approach to continually training, retraining, or reassigning faculty and should continually adapt their organizational structures and procedures as necessary to achieve changing institutional goals. The result will be the retention of able and dedicated faculty, who will be crucial in helping their schools continue to be successful while adapting to a changing world.

Academic Medical Centers↗
PubMed1998

A paradigm shift in academic medicine?

The author states that one definition of "paradigm shift" is "the process whereby a governing conceptual framework becomes destabilized and is eventually replaced, more or less wholesale, by a new conceptual consensus." He asks whether recent fundamental changes in academic medicine amount to a paradigm shift, and then briefly describes and comments on 25 changes under way in academic medicine (e.g., the growing importance of cost considerations; focus on episodic care of the acutely ill individual moving instead toward clinical and fiscal responsibility for the health of a population; relative autonomy of the physician evolving to increasing interdependence, both clinical and financial). The author maintains that the basic conceptual framework of academic medicine's core mission--patient care, teaching, and research--remains the same, and that this mission's capacity for good has greatly grown in recent decades. Over the same interval the core business of academic medicine (i.e., its financing) and how that relates to the core mission have indeed become destabilized. These also comprise a "conceptual framework" by which academic medicine has functioned, and that framework is being replaced, compellingly, by what amounts to a new conceptual consensus--in short, a paradigm shift. He urges his colleagues in academic medicine to be clear-eyed, responsive, and innovative, and never to give up as they work to forge a new and sustainable system that maintains and strengthens scholarship and service.

Academic Medical Centers↗
PubMed1992

Strategy and marketing tactics in nonprofit hospitals.

Through the analysis of questionnaire data, this study examines the strategic management styles of 114 nonprofit hospitals and the relationship between each of these styles and hospital marketing tactics. The analysis has important implications for nonprofit hospitals and other health care organizations.

Financial Management, Hospital↗
PubMed1998

Mission statement rationales and organizational alignment in the not-for-profit health care sector.

This article presents the findings from a research study conducted on the use of mission statements in not-for-profit health care organizations. In particular, the study sought to determine if a relationship exists between the initial "rationales" that led to the creation of a mission statement and hospital performance. The findings suggest that some of the rationales for developing mission statements are indeed more important than others and that organizational alignment with the mission statement is of key importance to both the mission's and the hospital's success.

Canada↗
PubMedDate not supplied

An analysis of the ethical and linguistic content of hospital mission statements.

An analysis of the ethical and functional linguistic content of Canadian hospital mission statements was conducted. The ethical content analysis identified deontology as the dominant ethical orientation. The functional linguistic analysis revealed a trend toward the depersonalization and objectification of action. Implications for formulating effective mission statements were discussed.

Canada↗
PubMed1999

The organization of vocational rehabilitation: the structure of success.

Focusing on vocational rehabilitation goals provides an understanding of the underlying structural and behavioural factors affecting successful employment outcomes. Two types of vocational centres having contrasting rehabilitation employment orientations are examined. Both types have similar end goals but organizational structures shaping divergent means toward the gainful employment of disabled persons. Utilizing a split sample of 14 vocational rehabilitation programmes in Israel, 7 sheltered and 7 supported programmes, a structured questionnaire of key administrative personnel and employees was generated. Success was based on six consensus measures. Clear differences between administrative, organizational and programme goals emerge, which affect goal priority and source of success measurement. Employing regression models, three keys to success are detected which stress the interplay between internal and external organization reference criteria in affecting success attainment. The results suggest that the organization of vocational rehabilitation has a direct impact on rehabilitation success.

Adult↗
PubMed1997

A performance evaluation system for primary care providers in a community health services program.

A performance evaluation system (PES) serves to motivate employees to provide desired behaviors that achieve organizational objectives. In 1989, Denver Health and Hospital (DHH), a publicly funded, integrated delivery system with a large primary care program, instituted a new PES. This report summarizes performance evaluation results for DHH's community health center program. The evaluation focused on the performance of primary care physicians, midlevel practitioners (i.e., physicians assistants, nurse practitioners, and dentists), over a 4-year study period (1990 to 1993). Category-specific performance ratings were based on a 5-point ordinal scale: unacceptable, expectations not met, meets expectations, exceeds expectations, and outstanding. Performance ratings were analyzed as variables that were dependent on several practice characteristics. Results demonstrated a relationship between performance ratings and specific practice characteristics. Based on the results, limitations of the new PES and implications for designing more effective evaluation systems are discussed.

Colorado↗
PubMed2001

Back to the future: trusting birth.

Research over the past 30 years provides support for once again trusting birth. This is a paradigm shift in thinking about birth and requires a dramatic change in the practice of nursing. Confidence in a woman's ability to give birth, the freedom to find comfort in response to pain, and the support of family, friends, and professionals facilitate normal, natural birth. Hospital policies and routine care practices that decrease confidence, restrict freedom and support, and separate mothers from their infants sabotage natural birth and breastfeeding. The goal of the perinatal nurse is to promote, protect, and support women's efforts to give birth naturally and breastfeed their children.

Attitude to Health↗
PubMedDate not supplied

The Delphi method?

Explore the source record for details and available documents.

Data Collection↗
PubMed1996

A national model for participative management and policy development.

This article describes the virtual application of an innovative administrative model that addresses national nursing policy issues in the Department of Veterans Affairs. Using a constituency center model of organization, nurse and interdisciplinary experts in the areas of clinical, education, administration, research and informatics are drawn from throughout the country to manage projects that meet the specifications of the national nursing service strategic plan. The impetus for the development of the model, examples products developed and areas of interest explored to date, and an evaluation of the first 18 months of experience are discussed.

Decision Making, Organizational↗
PubMedDate not supplied

Strategic state-level nursing workforce initiatives: taking the long view.

This article reviews long-range, strategic nursing workforce initiatives developing in 5 states. It also summarizes progress in establishing a national network of state nursing centers for sharing workforce data, and new education, workplace, and policy initiatives being undertaken by and on behalf of the nursing profession.

Data Collection↗