Abstract:
:This article reviews studies of the effects of medical organization structure on quality and cost conducted over the past three decades. Topics of inquiry have proceeded from the organizational to the individual provider level and from the inpatient to the ambulatory level. The article presents the findings of these studies as clues regarding the likely impact of integrated delivery systems. It also considers future areas for study in medical organization.
journal_name
Qual Manag Health Carejournal_title
Quality management in health careauthors
Burns LRdoi
10.1097/00019514-199503040-00002keywords:
subject
Has Abstractpub_date
1995-07-01 00:00:00pages
10-8issue
4eissn
1063-8628issn
1550-5154journal_volume
3pub_type
杂志文章,评审abstract:OBJECTIVE:This pilot study describes the development of an instrument to measure nursing quality knowledge, skills, and attitudes for practicing pediatric oncology nurses. Because many nurse leaders of academic centers are responsible for outcomes at both local and global level, ensuring nursing quality is critical, gi...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e3181aea256
更新日期:2009-07-01 00:00:00
abstract::The patient-centered medical home model of primary care requires increased collaboration in care delivery. Recent studies suggest that such a collaborative model of care is aided by physician leaders who practice an inclusive approach to leadership; however, they do not empirically demonstrate what such strategies loo...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e31825e876a
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Hospitals establish surgical assessment units to promote efficiency and improve patient experience. Surgical assessment units are believed to reduce unnecessary admissions. We evaluated a hospital's on-call surgery service without this facility to determine benefits of implementation. METHODS:All emergency ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000236
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Although organizational context can affect the implementation of quality initiatives, we know less about the influence of contextual conditions on quality outcomes. We examined organizational features of primary care clinics that achieved greatest performance improvements after implementing Lean redesigns. ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000198
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:The obesity epidemic threatens to shorten life expectancy and reduce the quality of life for large segments of the population. The purpose of this study was to develop a decision rule for referral to a weight-loss program on the basis of the relationship between body mass index (BMI) and self-rated overall h...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/01.QMH.0000281061.15108.f8
更新日期:2007-07-01 00:00:00
abstract::This article briefly describes natural induction approach to knowledge discovery, and then applies it to the problem of bad habit relapse prevention by analyzing patients' diaries. Natural induction seeks patterns in data that are in forms easy to understand and interpret, because they resemble those in which humans r...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/01.QMH.0000308640.89602.b1
更新日期:2008-01-01 00:00:00
abstract::This article proposes a new class of control charts that may be used for monitoring and improving the quality of care. Unlike conventional control charts that rely on observed performance data, these charts use risk-adjusted data in addition to the observed data. The resulting time-ordered charts are capable of reduci...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200301000-00004
更新日期:2003-01-01 00:00:00
abstract::The purpose of this study was to elucidate conditions at all system levels in a specific health care service to develop practices for identification of children as relatives. An interactive research approach with the intention to create mutual learning between practice and research was used. The participating health c...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000181
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVES:To determine whether employees working for a transformational leader perceive their leader as more effective than do those working for a transactional leader. To assess whether employees in private hospitals are more likely to perceive their leaders as transformational than are employees in public hospitals....
journal_title:Quality management in health care
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00019514-200410000-00009
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVE:Implementing change in a health care organization poses structural and cultural challenges. DESIGN:We developed a survey derived from an existing organizational change model and distributed it to the target population of an impending change initiative. RESULTS:The respondents (59.2% response rate) indicated...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000061
更新日期:2015-07-01 00:00:00
abstract::Several recent reports show that many physicians feel discontented and unhappy with their work situation. This could in part be due to a decline in status, loss of influence on health care organization, reduced wages etc. It is important to find ways to better understand their experiences of working life to get more f...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200401000-00008
更新日期:2004-01-01 00:00:00
abstract::In a previous article (M. K. Hart, Qual Manag Health Care. 2003;12(1):5-19), the authors presented risk-adjusted control charts applicable for attributes data. The present article discusses a similar class of control charts applicable for variables data that are often skewed. The key feature of these charts is their a...
journal_title:Quality management in health care
pub_type: 评论,杂志文章
doi:10.1097/00019514-200404000-00003
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVES:This article explores and describes key processes facilitating the integration of neophyte graduate nurses into safe and effective organizational systems and processes as part of a hospital's overall local clinical governance and clinical risk management (CRM) program. METHODS:This study was undertaken usin...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/01.QMH.0000316994.02039.80
更新日期:2008-04-01 00:00:00
abstract::The Agency for Health Care Policy and Research pain guidelines and implementation theories were used in this improvement initiative to ensure that evidence-based pain management reached every provider and patient in a large tertiary care hospital. Implementation strategies, products, and outcome measures are described...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199907020-00004
更新日期:1999-01-01 00:00:00
abstract::Most health care organizations are using critical pathways in an attempt to reduce the variation in patient care, improve quality, enhance communication, and reduce costs. Virtually all of the critical path efforts to date have developed tables of treatments, medications, and so forth by day and have displayed them in...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199503020-00005
更新日期:1995-01-01 00:00:00
abstract::The authors collected data from the record of a patient who had recently undergone coronary bypass surgery and used these data to construct control charts. The control charts helped them to interpret the variation in several clinical parameters and to evaluate the clinical responses to this variation. ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
abstract::To see the world systematically through the practice of systems thinking means to see the relationship in the phenomena we experience. The systems view is not just another way of improving an object, a process, or even services. It should not be viewed as a method that is focused only on "quality." The intrinsic value...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199807010-00004
更新日期:1998-10-01 00:00:00
abstract::The aim of this study is to empirically identify and present different kinds of practice-based improvement ideas developed in health care services. The focus is on individual placement needs, problems/issues, and the ability to organize work on the development, implementation, and institutionalization of ideas for the...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e3182134b3c
更新日期:2011-04-01 00:00:00
abstract::Recently in this journal, F. Alemi (Qual Manage Health Care. 2004;13(4):216-221) proposed the use of Tukey's Control Chart because of the unique benefits associated with nonparametric inferential statistics including robust performance with (1) low N sizes, (2) nonnormal data, and (3) the presence of outliers, However...
journal_title:Quality management in health care
pub_type: 评论,杂志文章
doi:10.1097/00019514-200504000-00006
更新日期:2005-04-01 00:00:00
abstract::Part II of this three-part tutorial focuses on the logistics of data collection. The author presents a checklist of things to consider when planning the details of a data collection effort; touches on the topics of bias and stratification; discusses examples of popular data collection methods; and points out some comm...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The mission of nonprofit health care clinics is particularly challenging to fulfill given the large number of uninsured and underinsured people they serve. In addition, these clinics feel pressure to provide services in an efficient manner to prevent patient no-shows and encourage the continua...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000215
更新日期:2019-07-01 00:00:00
abstract::Each department in a hospital is given the responsibility of managing its own day-to-day work. For the hospital as a whole to change, the individual departments must undergo a similar change. As each department aligns itself with the purposes of the whole organization, synergy is created and the hospital gradually, in...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract::With costs and competitive pressures increasing, pharmaceutical sponsors and contract research organizations are examining the drug development process. Investigators who conduct clinical studies significantly impact research quality and, thereby, costs. This article reviews current investigator selection methods and ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199907030-00004
更新日期:1999-04-01 00:00:00
abstract::Increasingly, businesses are reporting successful implementation of self-directed work teams. In health care, team-based structures in both clinical and nonclinical areas are now rapidly emerging. This paper describes the linkage between the literature of sociotechnical systems theory and current applications of self-...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199301020-00007
更新日期:1993-01-01 00:00:00
abstract::Many hospitals are unable to successfully implement "evidence-based practices" at the unit level. For example, consistent implementation of the central line bundle (CLB), proven to prevent catheter-related bloodstream infections (CRBSIs) is often difficult. This problem has been broadly characterized as "change implem...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e31827dea7d
更新日期:2013-01-01 00:00:00
abstract::Academic medical centers and clinicians have been slow to embrace continuous quality improvement. The Mount Sinai Medical Center in New York has created a new Department of Health Policy that combines an academic research mission with an administrative mission to demonstrate improving quality of care. This article dis...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199604040-00006
更新日期:1996-07-01 00:00:00
abstract::"Quality" of care has become one of the main foci of the American health care system during the last 20 years. As costs escalated in all areas of health care, the purchasers and consumers of health care have begun to demand accountability for the products they purchase. The initial focus of the system was "quality of ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200407000-00005
更新日期:2004-07-01 00:00:00
abstract::The gastroenterology unit at the Höglands Hospital in Eksjö is responsible for the care of all 466 patients with inflammatory bowel disease (IBD) in a geographic area including approximately 115,000 inhabitants. In 2000, the frustration over an inadequate traditional outpatient clinic inspired us to redesign our outpa...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200701000-00006
更新日期:2007-01-01 00:00:00
abstract::The aim of this study was to explore and evaluate managers' views of a large-scale improvement program, including their experiences and opinions about improvement initiatives and drivers for change. The study is based on a survey used in 2 nationwide mappings of improvement initiatives and developmental trends in Swed...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e31828bc276
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:To identify risks associated with delivery of treatment with oral antineoplastic agents in an outpatient setting and to evaluate additional value and feasibility of engaging patients in a proactive risk analysis. METHODS:We conducted 2 separate but parallel failure mode and effects analyses (FMEAs) among pa...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000199
更新日期:2019-01-01 00:00:00