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 facets of this issue. The Medical Management Centre at the Karolinska Institute in Stockholm offers courses in leadership for physicians in specialty training (residency). Participants in 2 courses were used in a study of their views of their work situation and their employer, using an open interview form. The results with the residents in the present study do not support the statement that physicians are unhappy. On the contrary, findings in the study indicate that they have a predominantly positive view of their work situation and of their employer. It is proposed that the mixed feelings they show to some extent is a natural stage in professional development. A possible way for achieving a better dialogue between physicians and managers is suggested.
journal_name
Qual Manag Health Carejournal_title
Quality management in health careauthors
Bergin E,Johansson H,Bergin Rdoi
10.1097/00019514-200401000-00008keywords:
subject
Has Abstractpub_date
2004-01-01 00:00:00pages
81-7issue
1eissn
1063-8628issn
1550-5154journal_volume
13pub_type
杂志文章abstract:BACKGROUND:Popular quality improvement tools such as Six Sigma and Lean Systems (SS/L) claim to provide health care managers the opportunity to improve health care quality on the basis of sound methodology and data. However, it is unclear whether these 2 quality improvement tools actually improve health care quality. ...
journal_title:Quality management in health care
pub_type: 杂志文章,评审
doi:10.1097/QMH.0b013e3181eb140e
更新日期:2010-07-01 00:00:00
abstract::Many hospitals are unable to successfully implement evidence-based practices. For example, implementation of the central line bundle (CLB), proven to prevent catheter-related bloodstream infections (CRBSIs), is often challenging. This problem is broadly characterized as a "change implementation failure." A prospective...
journal_title:Quality management in health care
pub_type: 杂志文章,多中心研究
doi:10.1097/QMH.0000000000000017
更新日期:2014-01-01 00:00:00
abstract::For the implementation of the proposed European standardized vaccination, total quality management (TQM) and reengineering could be powerful tools with a potentially synergistic effect. In the case examined, nonexplicit TQM prepared the organization in several ways for reengineering: providing the human capital, makin...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200210020-00009
更新日期:2002-01-01 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::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:BACKGROUND:Although often used in health care settings as a method for continuous quality improvement, experience with the breakthrough collaborative in nonclinical health care settings is limited. In this article, we report pilot data from a social services collaborative conducted in 2007 to 2009 in Sweden, with speci...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e3181c58e20
更新日期:2009-10-01 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::A variety of approaches are available to monitor and quantify the frequency of medical errors and the harm associated with them. The University HealthSystem Consortium Patient Safety Net provides a categorical, rank-ordered approach for designating harm associated with medical errors but does not lend itself to routin...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e3181fa074e
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Organizational health literacy is the degree to which an organization considers and promotes the health literacy of patients. Addressing health literacy at an organizational level has the potential to have a greater impact on more health consumers in a health system than individual-level approaches. OBJECTI...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000162
更新日期:2018-04-01 00:00:00
abstract::Pay for performance cannot consist of a one-size-fits-all approach. Variation in quality and cost of care is best measured using a single "value" (quality/cost) score that is decomposed into component cost and quality for every health care encounter type. Economic incentives must be enough to focus the provider's atte...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200501000-00004
更新日期:2005-01-01 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::The past decade has been marked by extensive change in the organization of health care delivery systems (the "supply side" of health care). There has been relatively less change in the nature of the health care consumer (the "demand side" of health care). The emergence of the Internet as a consumer health care technol...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200008020-00009
更新日期:2000-01-01 00:00:00
abstract::Patient flow improvement strategies have been effective in reducing emergency department (ED) crowding, but little guidance is available on the implementation process. By using a qualitative research design, our objective was to identify common facilitators and barriers to the implementation of patient flow improvemen...
journal_title:Quality management in health care
pub_type: 杂志文章,多中心研究
doi:10.1097/QMH.0b013e318222a3b0
更新日期:2011-07-01 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: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::Should the United States require mandatory reporting of medical errors within the health care system? Many barriers to medical error reporting currently exist and have made it difficult to establish a nationwide reporting system. As such, individual states have begun to address this issue one state at a time. This art...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/01.QMH.0000344594.48510.82
更新日期:2009-01-01 00:00:00
abstract::Quality is an illusive concept with different meanings to different people. Providers often define quality in terms of patient outcomes, professional standards of practice, predetermined criteria used to measure quality, and even subjective opinion. Patients describe quality in terms of the interpersonal aspects of ca...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200008040-00002
更新日期:2000-07-01 00:00:00
abstract::Accountability in health care has taken on new dimensions with the drive to base contracting and provider of care selection upon data driven "report cards." The measurement and development of reportable outcomes are driving providers to move their organizations from a focus not only on "caring" but to one highly cogni...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200009010-00005
更新日期:2000-10-01 00:00:00
abstract::We present an approach to assessing the impact of surveillance for surgical site infections and providing feedback to surgeons on their progress, as part of continuous quality improvement. Adjusting for patient risk factors using the Standardized Mortality Ratio, there was a marked decrease over time in both SMR (1.3 ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199806030-00006
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:Metformin is recommended as initial therapy for most patients with type 2 diabetes mellitus. Its most serious adverse effect, lactic acidosis, is a rare entity with a high mortality rate. Despite well-publicized contraindications, metformin is inappropriately prescribed to many hospitalized patients. OBJECT...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e31826d1ef9
更新日期:2012-10-01 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::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::This article examines a recently implemented strategy to transfer responsibility for local public health service delivery from a county health department to a hospital-based integrated delivery system. Innovative quality management efforts at both local and state levels offer opportunities for sustained improvement in...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199705020-00003
更新日期:1997-01-01 00:00:00
abstract::The article describes the Breakthrough Series, a collaborative improvement model developed by the Institute for Healthcare Improvement. The model adapts and applies existing knowledge to multiple, similar sites to accomplish common aims. It has been used to address several of the most pressing issues in health care to...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199806040-00001
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVES:To describe health care staff members' usage and documentation in a Swedish quality registry focusing on a preventive care process regarding the risk area of malnutrition among persons with dementia. The preventive care process includes risk assessment, analysis of underlying causes, planning and performing ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000116
更新日期:2017-01-01 00:00:00
abstract::A lost surgical specimen prompted an investigation of both the human processes and the systemic factors involved in surgical specimen handling regarding how health care organizations approach medical error prevention and patient safety promotion. Quality improvement techniques and the conceptual error model of James R...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200110010-00006
更新日期:2001-10-01 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::In an environment where there is increased demand for hospital beds, it is important that inpatient flow from admission to treatment to discharge is optimized. Among the many drivers that impact efficient patient throughput is an effective and timely discharge process. Early morning discharge helps align inpatient cap...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000049
更新日期:2015-01-01 00:00:00
abstract::Improvement will be constrained by the function-based organizational model found in most health care organizations. Most components of the typical organization are driven by the concept of division of labor. The organization needs to challenge the underlying assumptions and reengineer from top to bottom. Reengineering...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:1994-04-01 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