摘要:

This article describes two personal experiences with health maintenance organizations (HMO) that occurred over the past two years. The first is a positive experience and the second a negative experience. In the first encounter, the HMO worked with the client. In the second encounter, the insurance did not work with its client. This article shows that partnerships developed at administrative levels within these organizations can affect the multiple barriers and obstacles that currently exist in many HMOs.

ISSN:0363-9568    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The following case study exemplifies for the nurse leader some of the difficulties involved in making a merger work and selecting the best options to sustain nursing services following the merger. Three nurse leaders look at the case study from a variety of viewpoints and suggest a range of responses that gives the reader an opportunity to consider a selection of insights that best address the issues presented in the case study. All of the respondents have been involved in complex mergers and bring a depth of experience to their review of the case.

ISSN:0363-9568    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Managed care is forcing health care organizations to change. Many are seeking structures in which staff can deliver sound, better-integrated care and service faster and at lower cost. The University of Virginia Medical Center developed and implemented a type of “boundaryless” or “seamless” organizational structure aimed at achieving these goals through more highly developed interdisciplinary clinical and administrative practice. This article is a progress report of that reorganization.

ISSN:0363-9568    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

In response to the need to improve health care efficiency and effectiveness, hospital organizations are exploring and implementing restructured patient care delivery models. The shift away from traditional patterns creates an opportunity for redesign of health care resource utilization and creation of new staff mixes. Many emerging models appear to provide substitute workers for the RN rather than complement the nursing role. One concern evident in the literature is the lack of evaluation of these staff mix models as they become more prevalent. The outcomes for patient, hospital system, and nurse remain unclear.

ISSN:0363-9568    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Rural hospitals are confronted with multiple challenges to survive in the competitive health care environment of today's world. Declining population, corporate mergers and downsizing, transportation, cost of technology, and health manpower shortages are only a few of the issues rural hospitals must be prepared to address in order to survive. Federal- and state-administered programs are available that can contribute to the survival of the rural hospital. The nurse executive has a key role in contributing to the planning, development, and implementation of survival strategies.

ISSN:0363-9568    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

In an attempt to increase organizational innovation and flexibility, Cardinal Hill Rehabilitation Hospital moved from the traditional discipline-management model to the program-management model. In the restructuring; the integrity of professional nursing practices was put to the test when the director of nursing position and numerous staff nursing positions were eliminated. This article evaluates statistics from the three years that have elapsed since the restructuring event in order to determine the new program-management model's compatibility with patient outcomes associated with professional nursing standards.

ISSN:0363-9568    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The health care revolution is challenging nursing to change, as are the rapidly changing population demographics. The aging of America underlines a need for the health care revolution to address continuum-based care requirements, particularly of the chronically ill older population. They and their families are stressed with the current fragmentation of the health care system. Continuum-based care for the chronically ill is critical in altering the trajectory of health care consumption, and case management is central to it. A model of nurse case management is presented as an emerging solution.

ISSN:0363-9568    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Change impacts affected people and often causes difficulties. Health care organizations, locally and nationally, have undergone tremendous change to deliver quality services in a more effective and efficient manner in a competitive environment, with varying degrees of success. This article presents Robbins's categories of change and relates them to current changes in health care organizations. It discusses areas to consider to develop adaptable plans and to assist affected employees to better deal with these changes throughout the transition.

ISSN:0363-9568    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This article describes a systems approach for effectively implementing a delivery model of care using unlicensed support personnel, unlicensed workers trained in assistive tasks of clinical care under the direct supervision of the RN. The approaches described derive from practice, research, and consultant experiences. Successful implementation requires an ongoing, multisystems approach to (he development of a change plan, development of roles, development of staff, and development of rituals of practice that promote successful differentiated practice and team functioning.

ISSN:0363-9568    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0363-9568    

出版商:OVID    

年代:1997

数据来源: OVID