Showing papers in "Journal for Healthcare Quality in 1996"
TL;DR: A four-level process for handling Layoffs and their effects is described in this paper, where the first level is to manage the Layoff Process, the second is to facilitate the Necessary Grieving, and the third is to break the Codependency Chain and empower people.
Abstract: THE SHATTERED COVENANT. Forgotten Survivors: What Happens to Those Who Are Left Behind. Changing Organizations and the End of Job Security. THE SURVIVOR EXPERIENCE. Learning from the Past: The Survivor Syndrome Across Time. Speaking for Themselves: Layoff Survivor Stories. Time Does Not Heal All Wounds: The Effects of Long-Term Survivor Sickness. INTERVENTIONS FOR HEALTHY SURVIVAL. A Four-Level Process for Handling Layoffs and Their Effects. Level One: Manage the Layoff Processes. Level Two: Facilitate the Necessary Grieving. Level Three: Break the Codependency Chain and Empower People. Level Four: Build a New Employment Relationship. THE GREAT WAKE-UP CALL. The Rebirth of Meaning and Direction: Leading the New Organization. Life After Downsizing: Revitalizing Ourselves and Our Organizations. Appendix A. The Survivor Groups. Appendix B. The Human Resource Study.
372 citations
TL;DR: This chapter discusses approaches to Involving Physicians in Total Quality Management and the Physician: Perspectives and Possibilites, David Blumenthal, as well as policy challenges in Promoting Quality Improvement.
Abstract: Part One 1 Improving as Science, David M Berwick 2 The Applicability of Industrial Quality Management Science to Physicians' Clinical Decisions, David Blumenthal 3 Continuous Quality Improvement and the Physician Building Bridges with Outcome Research, Sheldon Greenfield 4 Industrial Quality Management Science and Outcomes Research: Responses to Unwanted Variation in Health Outcomes and Decisions, Albert G Mulley, Jr Part Two 5 Applying the Statistical Methods of Continuous Quality Improvement to Primary Care: Hypertension, Duncan Neuhauser 6 Blood Pressure Variability: Beyond the State-of-the-Art, Glen L Laffel 7 What is TURP? Controlling Variation in the Performance of Clinical Processes, Brent C James 8 Physician Involvement in Quality Improvement: Issues, Challenges, and Recommendations, Steven M Shortell 9 Approaches to Involving Physicians in Total Quality Management: Results of a Study, David Blumenthal, Jennifer Edwards 10 Policy Challenges in Promoting Quality Improvement, John R Ball 11 Total Quality Management and the Physician: Perspectives and Possibilites, David Blumenthal
52 citations
TL;DR: The definitions and principles that should guide the use of control charts in healthcare quality are reviewed and examples from the literature are used to illustrate significant problems and issues in control chart construction.
Abstract: This article reviews the definitions and principles that should guide the use of control charts in healthcare quality. Several examples from the literature are used to illustrate significant problems and issues in control chart construction.
16 citations
TL;DR: This how-to guide covers successfully applying formal quality management methods--from Taguchi, Deming, and others--to the service enterprise.
13 citations
9 citations
TL;DR: It is concluded that differences in data collection processes may result in incorrect conclusions about differences in the quality of care provided by various providers.
Abstract: This article examines the applicability of a "report card" strategy as a means of differentiating among providers on the basis of performance. The specific focus is on the potential effect of differences in data collection processes on the meaningfulness of subsequent comparisons among similar types of providers. Variations in reported nosocomial infection rates are analyzed in light of differences in reported surveillance practices; data for similar nursing units are analyzed as well. Thirty-one rural, rural referral, and urban acute care hospitals in the midwest participated in the study. The reported nosocomial infection rates for different types of nursing units and different hospital groups varied substantially. Likewise, there were marked variations in the nosocomial infection surveillance practices at the hospitals, which were found to explain some of the variation in the reported nosocomial infection rates for specific types of nursing units and nosocomial infections. The study conclude that differences in data collection processes may result in incorrect conclusions about differences in the quality of care provided by various providers.
8 citations
TL;DR: A California hospital developed a program to better serve and satisfy its customers with the collection and use of data to measure success, promote staff accountability, and, ultimately, demonstrate improved customer satisfaction as measured by fewer complaints.
Abstract: A California hospital developed a program to better serve and satisfy its customers. This article details the hospital's plan to implement the program with the collection and use of data to measure success, promote staff accountability, and, ultimately, demonstrate improved customer satisfaction as measured by fewer complaints. The various activities initiated to promote staff education and recognize employees also are briefly addressed.
8 citations
TL;DR: It is proposed that parallel qualities exist between behavioral need theory and the clinical hierarchy of patient outcomes and a conceptual framework is developed and presented that illustrates the importance of this parallel relationship in improving and optimizing patient satisfaction.
Abstract: With the advent of quality improvement and outcome measurement imperatives, providers of healthcare services must fully understand the importance of the human and clinical processes that lead to positive patient encounters. To that end, this article proposes that parallel qualities exist between behavioral need theory and the clinical hierarchy of patient outcomes. A conceptual framework, or construct, is developed and presented that illustrates the importance of this parallel relationship in improving and optimizing patient satisfaction. The article concludes with a discussion of these similarities and implications for the future.
7 citations
TL;DR: A number of straightforward approaches are outlined that will help healthcare quality professionals obtain physician involvement in the improvement effort.
Abstract: To realize significant and sustained improvement in quality and in overall performance, hospitals must have the support and participation of the medical staff Although it sometimes is difficult to recruit busy physicians to join the effort, they will become champions if their experience is productive and results in improved patient care This article outlines a number of straightforward approaches that will help healthcare quality professionals obtain physician involvement in the improvement effort
7 citations
TL;DR: How having access to and learning to use the Internet can benefit the careers of quality management professionals is related.
Abstract: This article relates how having access to and learning to use the Internet can benefit the careers of quality management professionals. Some ways to use the Internet for career enhancement are addressed, and some basic terms are explained.
6 citations
TL;DR: A team reviewed the facility's process for providing patient education and developed interdisciplinary process and documentation forms that improved both the quality of education provided and the documentation of that education in the medical record.
Abstract: The education of patients and their families can support positive patient healthcare outcomes. Patient and family education is an essential component of the healthcare delivery process, but it often is fragmented, with individual disciplines providing information without coordination. At the Carl T. Hayden VA Medical Center in Phoenix, AZ, a team reviewed the facility's process for providing patient education. As a result of this review, interdisciplinary process and documentation forms that improved both the quality of education provided and the documentation of that education in the medical record were developed.
TL;DR: A proper framework for quality management must include a profound understanding of the customer's "dimensions of quality", and an approach for developing such an understanding is offered.
Abstract: The quality of healthcare services is as much a matter of perception as of hard clinical data. Therefore, to improve quality, it is necessary to understand the way in which customers perceive, rank, and weigh the variety of elements that make up this elusive attribute. Otherwise, the management of quality becomes a hit-or-miss affair, with misses more likely than hits. Thus, a proper framework for quality management must include a profound understanding of the customer's "dimensions of quality." This article offers an approach for developing such an understanding.
TL;DR: How the cause-and-effect diagram becomes an effective tool to systematically delineate the key elements required to accomplish the transmission of infections among a facility's patients and staff members is related.
Abstract: A comprehensive infection control program in home healthcare consists of activities related to direct patient care as well as activities that support the provision of such care. All these activities are designed so as to reduce the transmission of infections among a facility's patients and staff members. This article relates how the cause-and-effect diagram becomes an effective tool to systematically delineate the key elements required to accomplish this goal.
TL;DR: The author rejects many "faddish" approaches to productivity such as TQM or re-engineering, and instead provides a realistic, economical 12-step method for increasing productivity.
Abstract: Most business leaders agree that achieving high levels of productivity is the key strategic tool for international competitiveness. In this book, the author rejects many "faddish" approaches to productivity such as TQM or re-engineering, and instead provides a realistic, economical 12-step method for increasing productivity. His method shows how to: get involvement in and commitment to productivity at every level of an organization; use technology, empowerment and networking to help employees achieve the most they can; manage performance effectively by cutting out unproductive practices, hiring wisely and rewarding productivity; measure productivity and its effect on the bottom line.
TL;DR: This article on the human side of reengineering describes the issues and concerns faced by healthcare executives who are considering or who already are involved in a reengineering project.
Abstract: This article on the human side of reengineering describes the issues and concerns faced by healthcare executives who are considering or who already are involved in a reengineering project. It offers a practical approach to understanding issues such as the importance of assessing the culture and its readiness for change, the importance of human resource policy development prior to initiating a reengineering project, and how to ensure buy-in and support from the healthcare organization and its community.
TL;DR: A 110-bed community hospital used a multidisciplinary continuous quality improvement process to decrease the time needed to admit a non-critical care patient to the hospital from the emergency department (ER).
Abstract: A 110-bed community hospital used a multidisciplinary continuous quality improvement process to decrease the time needed to admit a non-critical care patient to the hospital from the emergency department (ER). The specific objective was to reduce the total amount of time needed for a patient who has entered the ER to be assigned to a bed on a designated medical/surgical unit, while at the same time maintaining quality of care and providing the patient with a pleasant atmosphere.
TL;DR: The continuous quality improvement team at Hermann Children's Hospital in Houston, TX, development of a clinical pathway to reduce variation in patient care led to a reduction in length of stay and a corresponding reduction in costs.
Abstract: In May 1994, the continuous quality improvement team at Hermann Children's Hospital in Houston, TX, began to study the structure, process, and outcome of asthma care for pediatric patients. The team's immediate goals were to identify variation in the treatment of pediatric asthma and to determine the most cost-effective interventions. This article details the team's development of a clinical pathway to reduce variation in patient care; use of the pathway led to a reduction in length of stay and a corresponding reduction in costs.
TL;DR: Two different methods of providing psychiatric clinical care are addressed and a confluence of worldwide megatrends is affecting the mental health and substance abuse delivery system.
Abstract: The mental health profession is plagued by the perception that it is a vague, ambiguous, and sometimes ineffective field. A confluence of worldwide megatrends is affecting the mental health and substance abuse delivery system. Two different methods of providing psychiatric clinical care are addressed.
TL;DR: Way in which healthcare professionals can assess the situation, evaluate the environment, and actively participate and cope with changes are described--in other words, ways to "survive" the process of reengineering.
Abstract: Reengineering has become a fact of life for all professionals in the healthcare industry. It is a time of dynamic change and challenge. This article describes ways in which healthcare professionals can assess the situation, evaluate the environment, and actively participate and cope with changes--in other words, ways to "survive" the process of reengineering.
TL;DR: There are no quick or easy guidelines for maintaining and protecting confidentiality and avoiding discovery and managers who are responsible for information that is at risk will have to make an extra effort to learn not only their own state laws, but also the laws of any other states their facility or corporation might do business in.
Abstract: In summary, there are no quick or easy guidelines for maintaining and protecting confidentiality and avoiding discovery. It appears that managers who are responsible for information that is at risk will have to make an extra effort to learn not only their own state laws, but also the laws of any other states their facility or corporation might do business in. Close contact with the organization's attorney certainly enhances the ability to stay on top of the issues as healthcare delivery systems change.
TL;DR: Key issues that organizations must address in order to manage the change effectively are reviewed in this article.
Abstract: Reengineering provides the means to radically affect the way in which services are provided and results in significant change within an organization. Many reengineering efforts fail to deliver on their promises, however, because of poor implementation. This article reviews some key issues that organizations must address in order to manage the change effectively.
TL;DR: The model transformed existing full-time equivalent services at an acute care hospital in Florida into value-added services on behalf of patients, physicians, the hospital, and payers and presented a practical approach to organizing a case management program.
Abstract: Case management as a concept of efficiency and effectiveness has demonstrated its applicability in acute care. This article addresses one model of case management that integrates the traditional structure of independently functioning, nonrevenue-producing activities of quality, risk, and utilization management under the comprehensive umbrella of quality resource management. The model transformed existing full-time equivalent services at an acute care hospital in Florida into value-added services on behalf of patients, physicians, the hospital, and payers and presented a practical approach to organizing a case management program. Issues in the transformation process also are addressed.
TL;DR: Some of the implementation issues and decisions that a plan must resolve to gather accurate HEDIS data are reviewed.
Abstract: Historically, employers have asked health plans to measure performance in terms of quality, utilization, satisfaction, and cost. As organizations collected these data, employers realized that rarely were all the data comparable. Several employers, such as Xerox Corporation, Digital Equipment Corporation, and Bull HN Information Systems, Inc., agreed to work together to create reporting criteria that would standardize measurement. This collaboration resulted in the Health Plan Employer Data Information Set (HEDIS) criteria. This article reviews some of the implementation issues and decisions that a plan must resolve to gather accurate HEDIS data.
TL;DR: In this special issue of Journal for Healthcare Quality, Readers' Forum takes a question-and-answer format, and the questions on reengineering are answered by editorial review board members Suzanne Belanger, Nancy Claflin, and Danny van Leeuwen.
Abstract: In this special issue of Journal for Healthcare Quality (JHQ), Readers' Forum takes a question-and-answer format. The questions on reengineering are answered by JHQ editorial review board members Suzanne Belanger, Nancy Claflin, and Danny van Leeuwen, all of whom have experience in this critical area affecting healthcare quality professionals.
TL;DR: The ambulatory care area has been slower to develop integrated monitor ing tools than have hospital-based systems, but one multispeciality clinic's process to meet this goal is described.
Abstract: The ambulatory care area has been slower to develop integrated monitor ing tools than have hospital-based systems. This article outlines some reasons for this slowness, elaborates on the need for further developments in this field, and describes one multispeciality clinic's process to meet this goal.
TL;DR: An experimental work therapy program that seeks to address the needs of early-stage Alzheimer's disease and other dementia patients is described, using feedback from patients and caregivers to validate the benefits of the program activities in reducing the total burden of illness.
Abstract: There are two goals that should be of paramount concern to clinicians today. With the current emphasis on cost control in healthcare, it has become necessary to search for ways to (a) decrease the total burden of illness for costly conditions and (b) compile outcomes data to measure effectiveness and efficiency. This article describes an experimental work therapy program that seeks to address the needs of early-stage Alzheimer's disease and other dementia patients. Feedback from patients and caregivers was used to validate the benefits of the program activities in reducing the total burden of illness. These data also were used as a basis for improving program components. Once the program was well defined, patient and caregiver feedback measures were used to ensure that the program continued to meet their needs.