Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Practice Management”

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.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7Linked to original sources

Retaining counseling staff at substance abuse treatment centers: effects of management practices.

The turbulence created by the emergence of managed care has increased the importance of staff retention for substance abuse treatment centers. This study examines the relationships between management practices, organizational commitment, and turnover intention among substance abuse treatment counselors. Counselors from 345 randomly selected privately funded treatment centers were surveyed about management practices, organizational commitment, and turnover intention. Structural equation model estimates indicate significant associations between these variables. The effects of performance-based rewards and support for creativity, two measures of management practices, on turnover intention are mediated by organizational commitment. Job autonomy has a direct effect on turnover intention. Treatment center administrators may improve staff retention by systematic attention to these factors shown to enhance organizational commitment and reduce counselors' intentions to quit. Such steps may include increasing counselor autonomy, providing rewards for strong job performance, and establishing a work environment that supports creativity and innovation.

Counseling↗

Physician asthma management practices in Canada.

OBJECTIVES: To establish national baseline information on asthma management practices of physicians, to compare the reported practices with the Canadian Consensus recommendations and to identify results potentially useful for interventions that improve physician asthma management practices. DESIGN: National, stratified cross-sectional survey. SETTINGS: The 10 provinces and two territories of Canada, from 1996 to 1997. PARTICIPANTS: Questionnaires were sent to 4489 physicians stratified by province/territory and specialty group (family/general practice, respirology, internal medicine, pediatrics and allergy/immunology); 2605 responses were received. OUTCOME MEASURES: Methods for the diagnosis, treatment, education and follow-up of patients with asthma ('asthma management practices'). RESULTS: Significant variations existed among the five specialty groups in asthma management practices. A low use of objective measures of airflow limitation to assist with diagnosis was found among some respondents (mostly family physicians). Up to 40% of physicians regarded the daily fixed dosing (three or four times a day) of inhaled, short acting beta2-agonist as 'first-line therapy' for moderate to severe asthma. A minority of physicians reported using written action plans for patients or referring them to other health professionals for asthma education. Insufficient time during appointments and a perceived lack of appropriate educational materials were frequently cited as reasons for not providing asthma education. The perceived knowledge of the Canadian Consensus recommendations varied among physicians but was lowest among nonspecialists. CONCLUSIONS: The survey showed variations in certain aspects of the management of asthma by physicians. The findings will help to target specific areas for future physician education programs and other behavioural change strategies.

Asthma↗

National survey of pediatric fever management practices among emergency department nurses.

INTRODUCTION: Management of pediatric fever is controversial. Although many nursing texts advocate aggressive fever management, research provides evidence that fever is a normal physiologic process with beneficial effects. We sought to describe emergency nurses' pediatric fever management practices, their rationales for practice, and their practice consistency. METHODS: A researcher-developed tool was mailed to a systematic random sample of approximately 5% of ENA members. Surveys were mailed to 1136 nurses nationally; 731 surveys were returned (64% response rate). RESULTS: Temperature at which nurses initiate fever interventions varied from 37.8 degrees C (100 degrees F) to 40.6 degrees C (105 degrees F). Most frequently identified rationales for intervention were prevention of fever increase (83.3%), fever reduction (76.9%), comfort (74.7%), and seizure prevention (65.3%). Most nurses (79.8%) employ tepid sponging to reduce fever; 31% sponge routinely. Nurses reported sponging for temperatures higher than 38.9 degrees C (102 degrees F) to 40.6 degrees C (105 degrees F). Rationales for sponging included seizure prevention (58%), rapid cooling (56.8%), and treatment of fevers unresponsive to antipyretics (45.6%). Factors influencing rationales for practice included departmental standards of care (67.2%), physician practices (65.8%), and common sense (64.2%). DISCUSSION: The results of this nationwide survey demonstrate that fever management practices vary. ED nurses are practicing in a manner consistent with that advocated in many nursing texts but not necessarily the research literature. We believe that clinical trials of commonly used fever treatments are indicated. Standards of care could then be revised to reflect the research literature.

Adult↗

Comparison of management practices between Ohio, USA dairy farms participating in whole-herd Johne's disease testing programs and those not participating.

The purpose of our mail survey was to compare the adoption of management practices recommended for Johne's disease (JD) control between herds involved in whole-herd testing programs versus those that do not routinely test the entire herd for JD. A questionnaire consisted of 38 closed-ended questions that inquired about: general herd characteristics; management practices related to JD control; changes that occurred within the last 5 years regarding management practices recommended for the control of JD; producer knowledge of JD; the perceived infection status of the herd by the producer; and herd JD-testing history. The questionnaire was mailed to 810 Ohio dairy producers in September 2002; 266 questionnaires were returned (32.8% response). We used univariable logistic-regression models to assess the relationship between whole-herd testing status (TESTING versus NON-TESTING) and each management practice, each change in management practice and producer knowledge about JD. Because it is conceivable that only producers who believe their herds to be infected would be motivated to adopt the management practices recommended for control of JD, the comparisons were repeated with models that controlled for producer-perceived infection status. Of the 20 management practices recommended for JD control that we evaluated, 7 differed between TESTING and NON-TESTING herds. Additionally, TESTING herds more-frequently reported adopting changes within the past 5 years relative to NON-TESTING herds with respect to 7 of 9 management practices evaluated. Producers with TESTING herds also reported greater familiarity with JD than those with NON-TESTING herds.

Animal Husbandry↗

Practice management in obstetrics and gynecology residency curriculum.

OBJECTIVE: To establish the current level of instruction in practice management in obstetrics and gynecology residency programs; review recommendations of medical school practice management executives and current and former residents on design of practice management instruction programs; and develop recommendations for future management instruction by residency programs in obstetrics and gynecology. METHODS: A questionnaire was sent to 101 practice plan executives of obstetrics and gynecology departments at medical schools in the United States and Canada. A modified version was sent to 44 current obstetrics and gynecology residents and 72 former residents from the University of Tennessee, Memphis. RESULTS: The response rates were 71% (practice executives), 93% (current residents), and 81% (former residents). There were no formal management programs at 87% of responding institutions, although most respondents (62%) thought there should be mandatory participation in management programs, probably given by organizations outside the university. Potential subjects that received high ratings were current procedural terminology and diagnosis coding, managed care, billing procedures, contractual agreements between medical doctors, patient record management, and practice economics. CONCLUSION: Residency programs should establish formal practice management instruction programs and make participation mandatory. Funding should come from the medical school and university. Instructional help should come from extradepartmental organizations and individuals.

Canada↗

Practice management. Gender offenders.

A postal survey of practice managers in London found that women earned 5,000 Pounds a year less than men, on average. Women who had previously worked as receptionists in the practice were particularly poorly paid. Practice management remains a female-dominated profession. Primary care trusts should seek to standardise rates of pay and promote greater equality.

Data Collection↗

Administering an employee exit survey to pinpoint practice management problems.

Valued employees may leave your practice but still serve as valuable sources of practice management support. In this article, the author suggests administering an exit survey to departing employees, both on their last day of work and months later. Through such a survey, the former employee has a structured method for offering constructive feedback about your practice management systems and techniques. This article also offers sample exit survey questions and discusses the benefits and how-to's for implementing a former employees' alumni relations program for your practice.

Employee Grievances↗

What is the impact of theoretical knowledge on children's nurses' post-operative pain management practices? An exploratory study.

Despite the availability of the evidence to guide pain management practices, practices are often sub-optimal with children experiencing moderate to severe pain post-operatively. Limited theoretical knowledge about managing pain has been suggested as one reason for this. Several studies have identified gaps in nurses' theoretical knowledge. However, the affect of theoretical knowledge on pain management practices has not been explored. This explored whether there is a relationship between nurses' theoretical knowledge and the quality of their practices. Nurses (n=13) on one children's surgical ward were shadowed for a five-hour period during two-four shifts. Data about post-operative pain management practices were collected using a pain management checklist and field notes. Nurses (n=12) also completed the revised pain management knowledge test. Questionnaire scores were compared to the observational data. No positive relationship was found between nurses' level of theoretical knowledge and how well they actually managed pain. Nurses did not appear to routinely apply theoretical knowledge in practice. This may explain, at least in part, why pain management practices remain poor despite the evidence to guide practice being readily available. The hypothesis, put forward in other studies, that increasing nurses' theoretical knowledge about pain will improve practices may be overly simplistic.

Adult↗

Patients first: a philosophy of medical practice management.

Our organization has developed an approach to practice management that optimizes good results on many levels. This strategy, which sometimes is at odds with conventional medical practice management techniques. This article outlines efforts that could be applicable to a wide range of practices.

Georgia↗

Asthma management practices at home in young inner-city children.

Information on parental asthma management practices for young children is sparse. The objective of this article is to determine if specific caregiver asthma management practices for children were associated with children's asthma morbidity. Caregivers of 100 inner-city children diagnosed with persistent asthma and participating in an ongoing asthma intervention study were enrolled and interviewed to ascertain measures of asthma morbidity, medication use, health care use (acute and primary care), and asthma management practices. Overall, asthma morbidity was high with almost two thirds of caregivers reporting their child having one or more emergency department visits within the last 6 months and 63% receiving specialty care for their asthma. Appropriate medication use was reported predominantly as albuterol and inhaled steroids (78%). However, only 42% of caregivers reported administering asthma medicines when their child starts to cough and less than half (39%) reported having an asthma action plan. There were no significant differences by asthma severity level for any asthma management practice. In conclusion, caregivers lack knowledge regarding cough as an early asthma symptom. Caregivers should be encouraged to review asthma action plans with health care providers at each medical encounter.

Adult↗

Improving access for patients - a practice manager questionnaire.

BACKGROUND: The administrative and professional consequences of access targets for general practices, as detailed in the new GMS contract, are unknown. This study researched the effect of implementing the access targets of the new GP contract on general practice appointment systems, and practice manager satisfaction in a UK primary health care setting. METHODS: A four-part postal questionnaire was administered. The questionnaire was modified from previously validated questionnaires and the findings compared with data obtained from the Western Health and Social Services Board (WHSSB) in N Ireland. Practice managers from the 59 general practices in the WHSSB responded to the questionnaire. RESULTS: There was a 94.9% response rate. Practice managers were generally satisfied with the introduction of access targets for patients. Some 57.1% of responding practices, most in deprived areas (Odds ratio 3.13 -95% CI 1.01 - 9.80, p = 0.0256) had modified their appointment systems. Less booking flexibility was reported among group practices (p = 0.006), urban practices (p < 0.001) and those with above average patient list sizes (p < 0.001). Receptionists had not received training in patient appointment management in a quarter of practices. Practices with smaller list sizes were more likely than larger ones to utilise nurses in seeing extra patients (p = 0.007) or to undertake triage procedures (p = 0.062). CONCLUSION: The findings demonstrated the ability of general practices within the WHSSB to adjust to a demanding component of the new GP contract. Issues relating to the flexibility of patient appointment booking systems, receptionists' training and the development of the primary care nursing role were highlighted by the study.

Administrative Personnel↗

Practice management in pediatric dentistry.

Good practice management in the pediatric dental office is not piecemeal, sporadic, or a series of random, uncoordinated activities. Instead, it encompasses the philosophy of the practice; is centered around the patient; and is a fluid, consistent management function. It begins with the pediatric dentist as the leader and continues in all phases of daily activity. It is a well-developed, highly functioning system. It results in staff and patient loyalty and high patient satisfaction. It is an ongoing, continuously active, evolutionary process. It permits a positive attitude of professional growth for the entire pediatric dental staff team.

Attitude of Health Personnel↗

Tuberculosis management practices in Kentucky: comparison with national guidelines.

BACKGROUND: We assessed the quality of tuberculosis management practices in a predominantly rural state. METHODS: Medical records of persons reported to the Centers for Disease Control and Prevention (CDC) with the diagnosis of tuberculosis were audited; management practices were compared with guidelines from the American Thoracic Society (ATS) and CDC. RESULTS: We reviewed 207 records from 24 health districts in Kentucky. These records represented 30% of the cases reported to the CDC during the 17-month study. Tuberculosis was diagnosed by culture in 66% of patients; 12 different antibiotic regimens for antibiotic sensitive bacteria were prescribed; human immunodeficiency virus testing was documented in only 39%; monitoring for drug toxicity and bacteriologic cure was appropriate in < 65%; directly observed therapy was used in only 38%, and only 23% of close contacts were reevaluated at 12 weeks. CONCLUSIONS: Tuberculosis management practices in Kentucky fall short of ATS/CDC guidelines. Continuing quality-improvement efforts are warranted.

Aged↗