Best practices and benchmarking in healthcare : a practical journal for clinical and management application最新文献

Applicant attraction theories stipulate that employment inducements be customized to meet the desires and specific characteristics of potential applicants. This study examined the relationship between nurses' level of work experience and perceived importance of organization and job attributes in attracting them to nursing home jobs. Importance ratings of recruitment factors varied significantly by nurses' level of work experience. Unique variation was attributed to education opportunities, potential for career advancement, compensation issues, benefits, and work flexibility.

A study of 11 Academic Health Center Teaching Hospitals (ATHs) in 11 states found that cost reduction programs, internal reorganizations, reengineering, benchmarking, and broadened entrepreneurial activity were prominent among the strategic initiatives reported in dealing with an increasingly turbulent environment. Although none of the ATHs had experienced negative net margins, we conclude that today's competitive healthcare system requires ATHs be reimbursed separately for their educational and other societally related costs to assist them in competing on a level playing fields.

Iatrogenic injury, in which patients are unintentionally injured by medical treatment, occurs in 4% of hospital admissions and causes considerable human suffering, financial losses, and waste of healthcare resources. This article discusses why existing quality initiatives have had little impact on iatrogenic injury and suggests an approach to clinical risk modification that may enhance the safety of medical treatment.

The evolving paradigm shift in healthcare emphasizes population health status. Disease management is gaining popularity as a means of providing cost-effective, quality healthcare to an entire population at risk. Outcomes measurements, standardized clinical protocols and commitment by physicians and staff are crucial to a successful program. This article presents a case study from Lovelace Health Systems in Albuquerque, N.M., and identifies key components, cost savings and successes of one of its disease management programs.

Patient perceptions of the quality of services provided are a key factor in determining a healthcare organization's competitive advantage and survival. This article examines the advantages, disadvantages, and problems associated with nine different qualitative and quantitative methods of measuring patient satisfaction with service quality and concludes with guidelines for measurement of patient satisfaction and implementation of managerial follow-up.

Background: Technology assessment has become a rapidly growing component of the healthcare system. It has assumed a functional role in operational settings and is rapidly impacting decisions involving purchasing, coverage, and reimbursement. This review is intended to assist the healthcare decision maker in considering the application of technology assessment in healthcare, so as to maximize the efficiency of future purchasing decisions.

Methods: This "best practice" was synthesized after identifying key institutions performing technology assessment in healthcare and analyzing their working processes, including literature review, consensus panel discussions, and expert opinion.

Results: We describe this best practice on a reiterative loop that consists of five processes: awareness, strategic appropriateness, analysis versus need, acquisition and implementation, and reassessment. Typical barriers to adoption of technology assessment are also identified and discussed.

Conclusions: This review suggests a common terminology for the core processes involved in technology assessment, thereby facilitating a more uniform understanding among the different components of the healthcare system (i.e., payer, provider, and society) while recognizing their different perspectives.

Similar to the Residents Review Committee's "Essentials for a Residency Training Program," this article provides Educational Practice Guidelines for a required surgical clerkship. The Guidelines presented are ones that can be adopted by any department of surgery in the United States, but in some cases not without significant increase in resources and faculty effort. The 10 essential components provide an opportunity for intensive program evaluation of all medical student clerkship experiences.

A systematic method for assessing the health status of communities has been under development at the University of South Florida since 1991. The system, known as CATCH, draws 226 indicators from multiple sources and uses an innovative comparative framework and weighted evaluation criteria to produce a rank-ordered community problem list. The CATCH results from II Floridian counties have focused attention on high priority health problems and provided a framework for measuring the impact of health expenditures on community health status outcomes. The method and plans to create an automated data warehouse to support its expansion and enrichment are described.

Efficiency has different connotations and denotations in management, organizational behavior, and economics. This article explores different economic and organizational orientations that have given rise to alternative definitions with the hope that better understanding of these perspectives will improve terminology and theory building.