摘要:

Advocates of Inpatient managed care employing clinical pathways are confident that this patient management strategy reduces cost while promoting optimal patient outcomes. Other health care professionals are concerned that cost reductions place patients at higher risk for adverse health events. Research is needed to demonstrate the true impact of cost-containment strategies on clinical outcomes. The article describes a study in progress comparing patients conventionally managed by their physicians with similar patients whose overall management involved a nurse case manager. This study explores the issue of resource costs that can be linked to clinical and financial outcome measures.

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A multidisciplinary group of clinicians and administrators was convened to find innovative ways to contain costs and improve the quality of care on an inpatient orthopedic unit. This group was charged with examining all phases of care and recommending changes. The team proved to be a model of effective, successful collaboration and has enabled ambitious goals to be realized on this unit. The article outlines changes related to preoperative, intraoperative, and postoperative care and discusses the dynamics of effective interdisciplinary professional collaboration.

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

An activity-based cost management system provides a framework to Integrate the disciplines of quality and cost management. The integration occurs through the development of performance measures that collectively measure operations with respect to internal and external customers. It is the measurement process that allows management staff to evaluate where they are, determine where they want to be, and set a course of action that closes the gap between the two.

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The process of quality improvement/total quality management (QI/TQM) plays a key role in the delivery of health care in a managed care system. The concepts and ideas surrounding QI/TQM and managed care are interrelated, and the success of health care delivery depends on the integration and coexistence of these two philosophies. In looking more closely at these concepts, it becomes clear that the principles of QI/TQM must underlie strategic decisions involved in the implementation of a managed care system. Nurses play a key role in the success of this integration as nurse case managers, nurse practitioners, and nurse administrators. They have a direct impact on the many variables and goals of both QI/TQM and managed care.

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The health care industry is compelled to reduce costs while providing high-quality patient care. Outcomes analysis enables monitoring and maintenance of quality of care in our rapidly changing practice environment. Comprehensive outcomes research cannot occur, however, without a database incorporating practice-related data, interventions and components of care, and outcomes of care. The article reports the design and proposed implementation of an outcomes assessment infrastructure in a multifacility health maintenance organization in Northern California. The infrastructure integrates traditionally measured outcomes and cost data with nontraditional, nurse-influenced, health-related outcomes.

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Model-based practice was identified by the Nursing Department at Riverview Health Centre, a 320-bed long-term care facility located in Winnipeg, Manitoba, as having the potential to enhance care quality significantly. To achieve real impact in the clinical setting, however, the model selected would need to reflect closely the culture and values of the department. It was decided to explore these phenomena using cross-method triangulation involving a cultural assessment survey (the Nursing Unit Cultural Assessment Tool) and focus groups. Patient comfort and empathy emerged consistently as core values for staff. Greater appreciation of the depth and complexity of the nursing department culture and values has provided invaluable direction visa- vis conceptual model selection.

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The article describes a study undertaken to assess patient satisfaction with nursing care in a rural hospital emergency department with respect to psychological safety, discharge teaching, information giving, and technical competence. This descriptive research utilized Davis' Consumer Emergency Care Satisfaction Scale to determine the degree to which 52 patients perceived overall satisfaction with nursing care. Findings indicated that patients were satisfied with nursing care. No statistically significant effect of gender or education level on consumer satisfaction or on any subscale was detected, but African American consumers were less satisfied with discharge teaching, which may suggest that discharge teaching should reflect the cultural diversity of consumers presenting to the emergency department. Nursing staff may need to spend more time with rural African American consumers. Staff may need to be inserviced to meet the cultural and educational needs of African Americans.

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Preliminary data developed by the Health Care Financing Administration under its pilot cooperative cardiovascular screening project indicate that 50 percent of Medicare heart attack patients arriving in emergency departments who are appropriate for thrombolytic therapy do not receive it within the time period specified by the American College of Cardiology. Indicators developed for quality assurance monitoring and evaluation of a hospital emergency department prompted closer review of some cases. It was determined that a critical outcomes team using the principles of total quality management and the FOCUS-PDCA models should be empowered to deal with these issues. Through this process, the need for the development of a chest pain center at the hospital was identified and supported.

ISSN:1057-3631    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A Delphi survey was conducted to investigate the frequency and importance of conflicts identified by quality assurance/improvement professionals as well as the actions taken and resources used to deal with the conflicts. Responses to three rounds of the Delphi survey from 86 participants indicated that the predominant conflicts involved intrapersonal concerns, such as worry about the future, interpersonal and political barriers to change in quality work, and, rarely, ethical conflicts. A variety of collaborative and educational strategies were used to deal with conflicts. Results may be useful to examine from the perspective of health care professionals currently involved in quality work.

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