Abstract:
:Our objective was to test whether the Structured Problem and Success Inventory (SPI) instrument could capture mental representations of organizational and work-related problems as described by individuals working in health care organizations and to test whether these representations varied according to organizational position. A convenience sample (n = 56) of middle managers (n = 20), lower-level managers (n = 20), and staff (n = 16) from health care organizations in Stockholm (Sweden) attending organizational development courses during 2003-2004 was recruited. Participants used the SPI to describe the 3 most pressing organizational and work-related problems. Data were systematically reviewed to identify problem categories and themes. One hundred sixty-four problems were described, clustered into 13 problem categories. Generally, middle managers focused on organizational factors and managerial responsibilities, whereas lower-level managers and staff focused on operational issues and what others did or ought to do. Furthermore, we observed similarities and variation in perceptions and their association with respondents' position within an organization. Our results support the need for further evaluation of the SPI as a promising tool for health care organizations. Collecting structured inventories of organizational and work-related problems from multiple perspectives may assist in the development of shared understandings of organizational challenges and lead to more effective and efficient processes of solution planning and implementation.
journal_name
Qual Manag Health Carejournal_title
Quality management in health careauthors
Nyström ME,Terris DD,Sparring V,Tolf S,Brown CRdoi
10.1097/QMH.0b013e31824d18ffsubject
Has Abstractpub_date
2012-04-01 00:00:00pages
93-103issue
2eissn
1063-8628issn
1550-5154pii
00019514-201204000-00005journal_volume
21pub_type
杂志文章abstract::A control chart can be an effective way to display process data over time. It can differentiate common cause variation from special cause variation through the application of several probability-based interpretation rules. In addition, a control chart can be helpful in evaluating the effectiveness of a change. There a...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200109030-00003
更新日期:2001-04-01 00:00:00
abstract::The physician-patient relationship is an essential part of end-of-life planning, including discussions of advance directives (AD). Physicians likely to encounter AD issues with their patients were identified and queried as to their knowledge, opinion, and experience with ADs. Though most physicians felt ADs were helpf...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200008030-00004
更新日期:2000-04-01 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: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::Quality indicators and a quality-monitoring system developed for use in the regulatory survey process offer a quality improvement tool for nursing home staff. The systematic use of resident assessment data can aid in the identification of quality of care problems and the determination of the nature of those problems. ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199604030-00008
更新日期:1996-04-01 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::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::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:CONTEXT:In October 2008, the Centers for Medicare & Medicaid Services reduced payments to hospitals for a group of hospital-acquired conditions (HACs) not documented as present on admission (POA). It is unknown what proportion of Medicare severity diagnosis related group (MS-DRG) assignments will change when the Intern...
journal_title:Quality management in health care
pub_type: 历史文章,杂志文章
doi:10.1097/QMH.0b013e3181ccbd07
更新日期:2010-01-01 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::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::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::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::Recently, many have begun to explore the possibility of using analytical methods associated with continuous quality improvement in the efforts to improve health care. Central to this paradigm is the proposition that such analytical methods can be used to identify and react to variations in the processes and outcomes o...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:1992-10-01 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:AIMS:The purpose of this quantitative descriptive correlational study was to assess for presence and degree of critical thinking skills among perioperative (OR) nurses. BACKGROUND:Critical thinking has become a multidisciplinary "buzz phrase"; however, critical thinking, reflective thinking, or mental discipline was d...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e3181dafec7
更新日期:2010-04-01 00:00:00
abstract::Like many organizations, Continental Rehabilitation Hospital of San Diego designs and communicates templates and targets for desired changes in behaviors and tracks results. It recognizes and celebrates successes and struggles with its failures. A recent case example demonstrates the importance of generating immediate...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199706010-00007
更新日期:1997-10-01 00:00:00
abstract::Methods to produce change in physician practice patterns are of increasing importance to payers and regulators as well as to physicians themselves. Because some of the strategies being adopted occur without physician input and participation, they have aroused concern in the medical community. We describe the methods u...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:1997-07-01 00:00:00
abstract::As a group, physicians strive for quality but often resist quality measurement. Cost, inconvenience, lack of time, mistrust of quality measures, and a fear of what assessment may find are all factors contributing to this resistance. However, quality, in both rich and poor counties, continues to be poor at worse and va...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:2006-04-01 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:PURPOSE:Medical home care has been identified as a model for improving primary care delivery and population-specific quality and safety outcomes. Questions remain how this model affects older adult quality. This systematic review addresses 2 important questions: Are quality and safety outcomes associated with medical h...
journal_title:Quality management in health care
pub_type: 杂志文章,评审
doi:10.1097/QMH.0000000000000041
更新日期:2014-10-01 00:00:00
abstract::There are various methods to get some projections of health indicators that do not always produce satisfactory results. Our aim is to establish the rules for obtaining reliable projections, using simple models. In the procedure proposed here, there is no need, as in many other techniques, to directly connect the level...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:2006-07-01 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::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::The U.S. Healthcare Fellowship in Quality Management at Hahnemann University was developed by a managed health care organization and health science university in order to train physicians in the theory and practice of quality management and clinical outcomes measurement. This article describes in detail the program co...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:1996-10-01 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::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::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: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::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