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At least 19 recordsLinked to original sources
PubMed2006

Assessing the institutional approach to implementing smoking cessation practice guidelines in veterans health administration facilities.

National smoking cessation guidelines include recommended strategies for providers and health care organizations, but they offer little guidance on how to structure care. We conducted a cross-sectional survey at 40 Veterans Health Administration facilities, to describe the structure of smoking cessation care, to assess adherence to national guidelines, and to assess facilities' preferred approach to providing smoking cessation treatment. We categorized sites as those using a primary care approach (most smokers treated by the primary care provider) versus a specialty approach (medication restricted to smoking cessation clinics, to which most patients were referred). Nearly all sites reported systematic screening for smoking and counseling of smokers, usually by both nursing staff members and the primary care provider. Most sites used a specialty approach, restricting medication access to smokers attending a cessation program. Future research should evaluate whether this approach provides adequate access and responsiveness to patient preferences for the full population of smokers in primary care.

Cross-Sectional Studies↗
PubMed1988

Utilization, attitudes, and experiences of Vietnam Era veterans with Veterans Administration health facilities: the American Legion experience.

A random sample of American Legion members in six states who had served in the Armed Forces during the Vietnam Era was conducted through a mailed questionnaire, in order to determine patterns of usage of Veterans Administration health facilities, as well as attitudes toward the VA and experiences at these facilities. Of the 6810 male respondents, 42.0% had served in Southeast Asia. These subjects were categorized according to their level of combat in South Vietnam. Thirty-six percent of those who had served in Southeast Asia had used VA health facilities, compared to only 18% of men who served elsewhere. Among Southeast Asia veterans, combat level was an important predictor of extent of usage of VA facilities for problems of both physical and mental health. Combat level was also associated with lack of basic and major medical insurance. While men with lower incomes tended to make greater use of VA mental health facilities, nearly one-fourth of mental health users had family incomes above $30,000. Despite their greater usage of the VA, men with higher combat levels expressed lower feelings of security about this agency, and rated its staff less helpful and of lower quality than did men who experienced lower levels of combat. On the other hand, higher combat veterans thought themselves better informed about VA services. Men who had gone to the VA for mental health assistance reported a disturbingly low frequency of having been asked basic questions that relate to possible diagnosis of post-traumatic stress disorder (PTSD), questions related to combat, which may be one of its etiologic factors, or other questions relating to their military history. Because combat level in Vietnam veterans is a major determinant of both attitudes toward and utilization of VA health facilities, the VA as well as other health agencies which deal with Vietnam veterans should be especially sensitive to this factor, and should take it into consideration when evaluating veterans' physical and mental health.

Attitude↗
PubMed2002

On the value of architecture and facility management in health administration education.

This article discusses the role and function of architecture and facility management in health administration education vis-à-vis an interdisciplinary set of courses taught in a graduate-level health administration program. These courses provide the future health care executive with theory and applied knowledge on a variety of topics. These include the history of health care facilities, issues in facility planning and management, principles of patient and staff-focused design, campus master planning, participatory methods to involve end users in the design of their work, and care settings. Additional skills acquired include an introduction to contract negotiations, the reading of technical documents such as blueprints, the post-occupancy assessment of facilities-in-use, and familiarity with future trends. Students address the topic of managerial ethics in relation to the built environment in some detail as a vehicle to illustrate the nature of key fine-grain issues of importance to the health administration scholar and professional. The discussion concludes with the presentation of a model curriculum in this subject area.

Architecture↗
PubMed1999

A survey of assaultive behavior in Veterans Health Administration facilities.

OBJECTIVE: To more clearly define the scope and impact of violence in health care facilities, national data on assaults in VA medical centers and freestanding clinics were examined. METHODS: A survey was distributed to all VA medical centers and freestanding clinics asking for cumulative data for one fiscal year (October 1990 through September 1991). Data were obtained on number, types, and locations of physical assaults and other assaultive behavior; the types of staff assaulted and number of workdays lost due to injuries; diagnoses of perpetrators; recommendations made after the incidents were reviewed; training in prevention and management of assaultive behavior; and the impact of training on rates of assaultive behavior. RESULTS: During the survey year, 24,219 incidents of assaultive behavior were reported by 166 VA facilities; 8,552 incidents involved battery or physical assault. Weapon possession by perpetrators was common (8.5 percent of incidents), and weapons were used in 130 assaults (1.5 percent of assaults). Assaults occurred most frequently in psychiatric units (43.1 percent), followed by long-term-care units (18.5 percent) and admitting or triage areas (13.4 percent). Assault-related injuries were most common among nursing personnel. Perpetrators of assaults were most typically diagnosed as having psychoses, substance use disorders, or dementia. On inpatient psychiatry units, an inverse correlation was found between expenditures on staffing and the frequency of assaultive incidents. Staff training on management of assaultive behavior varied widely. CONCLUSIONS: Assaultive behavior is a significant problem for health care workers. Staff in all clinical areas need to be prepared to deal with assaultive patients. More research is needed on staff training and interventions for preventing and limiting assaults.

Data Collection↗
PubMed2002

Effectiveness in meeting recommended standards for annual diabetic eye examinations at a veterans health administration facility.

This study determined the effectiveness of one Veterans Affairs Medical Center facility at providing annual diabetic eye examinations. A medical records review of a simple random sample of 350 diabetic patients was conducted to assess the impact of delayed access to care, practitioner referral patterns, patient no-show rates, and sample sizes used in performance reports. A 55.6% adherence rate was found, which increased to 81% when adjusted for future scheduled appointments. A high rate of physician referral for diabetic eye care was documented (68.9%), with a 10.2% patient no-show rate. The primary factor adversely affecting diabetic eye examination rates at this facility was a delayed access to care, complicated by an increased demand for eye care services. Also, sample sizes used in official performance reports were not sufficient to accurately determine true examination rates at the local level.

Diabetic Retinopathy↗
PubMed1995

Interior design. Mastering the master plan.

Reflecting on the results of the survey, this proposed interior design master planning process addresses the concerns and issues of both CEOs and facility managers in ways that focus on problem-solving strategies and methods. Use of the interior design master plan process further promotes the goals and outcomes expressed in the survey by both groups. These include enhanced facility image, the efficient selection of finishes and furnishings, continuity despite staff changes, and overall savings in both costs and time. The interior design master plan allows administrators and facility managers to anticipate changes resulting from the restructuring of health care delivery. The administrators and facility managers are then able to respond in ways that manage those changes in the flexible and cost-effective manner they are striving for. This framework permits staff members to concentrate their time and energy on the care of their patients--which is, after all, what it's all about.

Attitude of Health Personnel↗
PubMed1991

Organizational assessment: concept, method and application.

The concept of organizational assessment of health institutions is explored in terms of why it is becoming increasingly popular, alternative approaches, and its potential as a tool for quality assurance or program evaluation. There is an outline of an approach to developing standardized performance criteria and a design for carrying out an assessment through a self-assessment method. Illustrations of the application of the model are included.

Decision Making, Organizational↗
PubMed1982

Managerial innovation and health policy: theoretical perspectives and research implications.

Stimulated by a variety of external pressures, managerial innovation is likely to become more common in health care organizations. Relatively little is known, however, about the phenomenon. This paper develops a framework for the analysis of managerial innovation in health care organizations, based on the premise that control is at the heart of effective managerial practice. Physician control over the production process in health care is likely to be increasingly challenged, partially as a consequence of the ascendency of managerial ideology. Opportunities for managerial innovation will be created, but are likely to be successful only to the extent that physician expertise is incorporated into rather than excluded from the resulting changes.

Communication↗
PubMed1976

Management noninformation systems in health care organizations.

The health care manager is often an unwitting accomplice in the creation of noninformation systems because he fails to assume leadership in designing, installing and operating the system. There's also strong evidence that many managers could use a good course in basic accounting.

Computers↗