摘要:

With the increasing demands on hospitals for improved quality and lower costs, hospitals have been forced to reevaluate their manner of operation and quality assurance (QA) programs. Hospitals have been faced with customer dissatisfaction with services, escalating costs, intense competition, and reduced reimbursement for services. As a result, many hospitals have incorporated total quality management (TQM), also known as continuous quality improvement (CQI) and quality improvement (QI), to improve quality care and decrease costs. This article examines the concept of TQM, its rationale, and how it can be implemented in a hospital. A comparison of TQM and QA is made. Examples of hospital implementation of TQM and problems and issues associated with TQM in the hospital setting are explored.

ISSN:1057-3631    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Managers of home care organizations in the 1990s are faced with serious challenges. The magnitude of change occurring makes it difficult to distinguish a reasonable course of action. Quality improvement techniques offer an exciting opportunity for organizations to regain control of their strengths by identifying and improving their weaknesses. This article presents a transitional model for quality improvement involving structure, process, and outcome variables adapted to home care organizations. It encompasses unique committee structures mandated by licensure and certification requirements, which can be adapted to quality improvement focus. Finally, it identifies customer service trends that provide managers with information to fine-tune good business practice.

ISSN:1057-3631    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Health care organizations across the country are in different phases of transition from quality assurance to quality improvement. A plan is essential to ensure quality assessment and improvement requirements are met while the organization is in transition. Based on the hospital's commitment to quality improvement, the Division of Nursing at The New York Hospital has built on the strengths of the QA program and begun transition to QI by incorporating the principles of QI and developing quality improvement teams with other disciplines and within nursing.

ISSN:1057-3631    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A multidisciplinary team simplified the process of antibiotic delivery to patients admitted with community-acquired pneumonia and successfully implemented key changes that resulted in improved clinical practice and patient satisfaction at Providence Medical Center. Within 6 months of implementing an emergency room preadmission procedure, an antibiotic treatment protocol, and a sputum collection protocol, the average antibiotic initiation time dropped from 6.8 hours to 3.6 hours. Recommendations made for antibiotic selection and dosing led to a cost savings of over $109,000 per year. Highlighted in this article are several quality improvement tools, as well as practical tips and advice on effective team building.

ISSN:1057-3631    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Mexican-American patients' perceptions of quality related to the care delivered by health care providers were explored. The review of literature demonstrated that a great volume of work has been done regarding patient satisfaction; however, very few reports of application of this type of research to the Mexican-American population exist. This pilot project attempted to relate the concepts of perception, satisfaction, and quality. Observations occurred in two hospitals with distinctly different patient populations, and results indicated a need to repeat this study with a much larger sample.

ISSN:1057-3631    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Rising health care costs and competition among hospital facilities have resulted in the need to recognize patient satisfaction as an important indicator of quality care. Nurses provide the primary service to patients; therefore, their role is influential in overall satisfaction. Several instruments have been developed to measure patient satisfaction with nursing care; however, most of them focus only on patient perceptions. One such approach to evaluating patient satisfaction with nursing care involves an instrument, SERVQUAL, derived from a marketing service perspective. Adapting SERVQUAL for use in evaluating nursing care is the focus of this article. SERVQUAL assesses both patient perceptions and expectations of quality service and permits managers and clinicians to view the gaps between the two; thus, the overall areas of improvement in nursing services can be determined.

ISSN:1057-3631    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

This article describes elderly patients' and health care professionals' perceptions of quality in discharge planning. Qualitative data were collected in semistructured interviews with a purposive sample of 25 elders who had been hospitalized for an acute episode of a chronic illness and 38 health care professionals. The constant comparative approach was used in analyzing the data. The findings indicate that both health professionals and patients identified process and outcome indicators of quality. Effective communication–a process that consisted of asking questions, getting answers, and questioning inconsistencies–was identified as a key component of successful discharge planning.

ISSN:1057-3631    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Extending quality improvement principles to coordinating patient care among multiple levels of health care service providers has received only limited attention. Referrals function by communicating information about patients' continuing care needs between health care organizations as they transfer responsibility for providing different levels of care. Our evidence suggests several procedural improvements with immediate benefit for improving the quality of referrals. These include employing standardized, written referral forms; assigning responsibility for communication by requiring a signature on each referral; and instituting an information feedback system between sending and receiving health care providers.

ISSN:1057-3631    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A key to improving patient care in hospitals is the use of staff nurses on a continuous quality improvement team to redesign the patient care delivery model. This article describes the planning process and strategies for patient care delivery redesign on a medical-surgical unit in a small community hospital. A team of 12 staff nurses working with trained facilitators and a team leader began the seven-month project. The article describes how the team assessed the needs of the customers, developed a plan for a pilot, and drafted evaluation criteria.

ISSN:1057-3631    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The transition of health care organizations to total quality improvement (TQI) models has significant consequences for quality manager roles and quality systems. Changing paradigms regarding one's quality role and programs requires critical self-awareness, new knowledge, and a fresh approach to employee-customer relations. The quality manager's challenges are to discover one's own learning needs, integrate new philosophies into one's behavior, and successfully model and mentor TQI to fellow health care providers. Quality managers have an opportunity to develop a vital and powerful leadership role vis-à-vis TQI and the point of contact between health care provider and patient.

ISSN:1057-3631    

出版商:OVID    

年代:1994

数据来源: OVID