ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Financial issues are encroaching upon health care decisions at a rapid pace in today's managed care arena. An examination of the parallel historical perspectives of bioethics, health care reimbursement, and quality improvement reveals that, by integrating an ethical framework with the quality improvement process, health care professionals can preserve patient-centered care. The article demonstrates the strength of this combined approach using restraints as an example.

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

As today's health care system undergoes dramatic changes, it becomes imperative that quality improvement efforts mesh with these changes to maintain quality outcomes in patient care. The confusing flurry of health care reform, cost containment, resource allocation, and advances in medical technology raises a variety of ethical issues. In the recent past ethics committees have been one strategy used to provide direction and support to care providers facing ethical dilemmas in clinical practice. The mutual goal of quality outcomes for the patient provides the rationale for linking quality improvement programs with ethics committees. As we move toward a more integrated and seamless health care system, this link may be critical to quality outcomes in caring for the patient from cradle to grave.

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Seclusion and restraint continue to spark debate regarding their therapeutic value and ethical, legal, and humanitarian implications, yet they remain frequently used forms of treatment in psychiatric settings. Identifying specific alternatives to seclusion and restraint use, teaching nursing staff how and when to use them, and determining their effect on patient outcome are important quality improvement issues. A quality improvement study conducted at a long-term care psychiatric facility identified alternatives that nursing staff used and their effect on reducing seclusion and restraint rates. A total of 773 incidents of disruptive behavior were managed with least restrictive alternatives and did not require the use of seclusion or restraint. One-to-one verbal intervention followed by medication as needed represented the most frequently used alternative. Total seclusion and restraint hours decreased by 31 percent, and restraint hours decreased by 47 percent.

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

One of the key factors for organizational success is service excellence. Nursing service has been proved to be a pivotal factor in the overall patient satisfaction rating on hospital surveys. The article describes a service improvement implemented by one nursing service that improved patient satisfaction survey results. Standards developed were expanded to all departments to affect the entire organization.

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Using professional shopping, or sub rosa investigative methods, an actor was admitted to a hospital with a diagnosis of rule out myocardial infarction to ascertain quality data. An interesting finding was the interrelatedness of quality throughout the organization. The sub rosa investigator described many intra organizational quality problems, including how the actions of one department affected quality in another. To evaluate the enormous amount of information provided by the investigator, the data were segregated by events that could be evaluated for quality. Only one event led to the conclusion that a new source of quality information was attributable to the sub rosa investigator's findings. Hospitals using sub rosa investigative techniques may obtain large amounts of quality information in a relatively short period.

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Work restructuring is an intensive, time-consuming undertaking that succeeds when proper planning and a disciplined process promote open lines of communication between administration and staff. Surveying staff members to understand their values and how they are spending their time sets the stage for work restructuring. The data collected identify opportunities for change to improve care and increase staff satisfaction and become a baseline for bench marking success. Surveys also identify what staff members value, what they want to retain from the current system, what needs to be better integrated with other departments, what activities can be eliminated, and any changes that already have positively affected care delivery.

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID