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A decision support system for hospital bed assignment. 病床分配决策支持系统。
Hospital & health services administration Pub Date : 1995-01-01
D Clerkin, P J Fos, F E Petry
{"title":"A decision support system for hospital bed assignment.","authors":"D Clerkin,&nbsp;P J Fos,&nbsp;F E Petry","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article presents the use of a computer-based decision support system for hospital bed assignment. The specific computer application discussed involves the development of an expert system, which mimics the decision-making process typically used by experts in a field. Expert systems are useful as consultants for problems that are best approached from the perspective of an expert. The prototype expert system presented in this article can be used to efficiently assign hospital beds to specific patients at the time of hospital admission or during the hospital stay. This assignment is based on a matching process by the expert system of patient needs and hospital bed characteristics. Data needed for this assignment are routinely collected at admission and updated during the patient's stay in the hospital. Use of this computer-based decision support system in conjunction with existing hospital information systems will result in more effective management of physical and human resources. As may be expected, any improvement in efficiency of use of resources will have an associated reduction in cost. Implications of using expert systems for future practice are also discussed.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 3","pages":"386-400"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21016080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Service quality revisited: striving for a new orientation. 重新审视服务质量:追求新方向。
Hospital & health services administration Pub Date : 1995-01-01
S J O'Connor, R M Shewchuk
{"title":"Service quality revisited: striving for a new orientation.","authors":"S J O'Connor,&nbsp;R M Shewchuk","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article examines the concept of service orientation. A brief overview of what is known about the concept in general service and health care organizations is provided, as is consideration of measurement issues and directions for future research in this area. Unfortunately, despite the great need for information, very little is known about service orientation in health care. This state of affairs, however, affords abundant opportunities for relevant research.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 4","pages":"535-52"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21023809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fear of HIV contagion as workplace stress: behavioral consequences and buffers. 对HIV传染的恐惧作为工作压力:行为后果和缓冲。
Hospital & health services administration Pub Date : 1995-01-01
K Montgomery, C E Lewis
{"title":"Fear of HIV contagion as workplace stress: behavioral consequences and buffers.","authors":"K Montgomery,&nbsp;C E Lewis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article conceptualizes employees' fears for their health on the job as a form of stress with a collective, detrimental impact on work behavior. It tests a job-control of stress reduction that focuses on reducing uncertainty. Results indicate that fear levels are lower in organizations that have policies providing employees with certain types of information about the stressor. Analysis reveals that mechanisms conveying explicit information, rather than information that is indirect or implied, have the strongest association with lower fear levels. Hypotheses are tested in the context of nursing staff fears of contagion from HIV-infected patients, using data from 558 randomly selected hospitals nationwide. Implications for the policymaking dilemma of conflicting rights to privacy and disclosure are discussed.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 4","pages":"439-56"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21024030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patients, physicians, and professional knowledge: implications for CQI. 患者、医生和专业知识:对CQI的影响。
Hospital & health services administration Pub Date : 1995-01-01
M J Young, S Rallison, P Eckman
{"title":"Patients, physicians, and professional knowledge: implications for CQI.","authors":"M J Young,&nbsp;S Rallison,&nbsp;P Eckman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As we consider how to improve health care, we must understand the transformation that focuses on the physician's role in health care. A multidisciplinary team is critical for improvement activities-hospital administrators, nurses, and other colleagues. All need to learn new knowledge and leadership skills, but there is a special need to understand underlying issues that will require a transformation in many physicians. This will not be easy--nor should it be. Physicians must continue to achieve the benefits for patients that come from traditional professional knowledge. However, there is an even greater need to understand how physicians can move from the dominance approach of the medical model to a partnership approach inherent in CQI. This article describes lessons learned from our CQI work with physician colleagues over the last several years. First the relationship of professional knowledge to knowledge for improvement is described, and then the individual patient-doctor relationship is reexamined. Next, the implications of knowledge for improvement for the roles of physicians in organized health care systems are considered.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 1","pages":"40-9"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21012745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing the evidence on CQI: is the glass half empty or half full? 评估CQI的证据:玻璃杯是半满还是半空?
Hospital & health services administration Pub Date : 1995-01-01
S M Shortell, D Z Levin, J L O'Brien, E F Hughes
{"title":"Assessing the evidence on CQI: is the glass half empty or half full?","authors":"S M Shortell,&nbsp;D Z Levin,&nbsp;J L O'Brien,&nbsp;E F Hughes","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Review of the literature on CQI/TQM in both health care and non-health care settings reveals some evidence of a positive impact for selected dimensions of CQI/TQM. There is little research, however, that examines CQI/TQM as a holistic integrated approach to quality improvement, nor are there many studies that go beyond single or small sample case studies. Using a conceptual framework involving cultural, technical, strategic, and structural dimensions, a number of barriers to CQI implementation are identified along with suggestions for high-priority areas of research.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 1","pages":"4-24"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21013039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The role of knowledge utilization in adopting innovations from academic medical centers. 知识利用在采用学术医疗中心创新中的作用。
Hospital & health services administration Pub Date : 1995-01-01
J Shaperman, T E Backer
{"title":"The role of knowledge utilization in adopting innovations from academic medical centers.","authors":"J Shaperman,&nbsp;T E Backer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A literature review and an exploratory survey were conducted to find out about knowledge utilization activities in academic medical centers. Structured interviews were conducted with one respondent in each of ten selected programs in one center and were followed by qualitative data analysis concerning types of knowledge utilization activities and their effectiveness, and barriers and incentives to the success of knowledge utilization. Suggestions are provided for ways administrators in both academic and community medical centers may increase their effectiveness in using knowledge utilization strategies to promote the adoption of innovations.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 3","pages":"401-13"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21016081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Physician practice acquisitions: valuation issues and concerns. 医师执业收购:估值问题和关注。
Hospital & health services administration Pub Date : 1995-01-01
T B Rimmer
{"title":"Physician practice acquisitions: valuation issues and concerns.","authors":"T B Rimmer","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 3","pages":"415-25"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21016082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
U.S. hospital workforce-to-population ratios by service area. 按服务领域分列的美国医院劳动力与人口比率。
Hospital & health services administration Pub Date : 1995-01-01
R A Connor
{"title":"U.S. hospital workforce-to-population ratios by service area.","authors":"R A Connor","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Traditionally, hospital productivity has been measured in terms of episodic patient services such as days or admissions. However, the delivery of health care is shifting toward a greater focus on the health of a covered population. Thus, population-based indicators of hospital productivity are needed. This work analyzes hospital FTEs per 10,000 served population across the United States as a function of regional demographic, socioeconomic, and geographic factors. For managers of integrated service networks, it provides benchmarks for hospital FTEs per service population for several personnel categories. Important findings for public policy include an 11 percent increase in FTEs per 1 percent increase in interns and residents and a 2 percent increase in FTEs per 1 percent increase in the elderly.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 4","pages":"496-508"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21023806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The consequences of disclosure: one hospital's response to the presence of an HIV-positive physician. 披露的后果:一家医院对hiv阳性医生的反应。
Hospital & health services administration Pub Date : 1995-01-01
B J Stephens, P G Sinden, R H Ketcham, N Rzepkowski
{"title":"The consequences of disclosure: one hospital's response to the presence of an HIV-positive physician.","authors":"B J Stephens,&nbsp;P G Sinden,&nbsp;R H Ketcham,&nbsp;N Rzepkowski","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Health care administrators are having to confront the many and complex problems associated with patient fears about the transmissibility of the HIV virus. Particularly acute are concerns that are raised when the physicians are HIV-positive or have AIDS. This article presents a case history of how one hospital handled the problems created by the announcement by one of its emergency room physicians that he was HIV-positive. The hospital's response--which included disclosure to the community, the full cooperation of the physician, provision of free counseling, and HIV testing--and the aftermath of this AIDS-related event are described. This case is discussed in relationship to the ongoing debate about the ethics and consequences of disclosure of the HIV status of health care workers.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 4","pages":"457-71"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21024031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Product-line evaluation of graduate medical education program costs. 研究生医学教育项目成本的产品线评估。
Hospital & health services administration Pub Date : 1994-01-01
P P Brooke, R P Hudak, K Finstuen
{"title":"Product-line evaluation of graduate medical education program costs.","authors":"P P Brooke,&nbsp;R P Hudak,&nbsp;K Finstuen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article reports the results of an innovative application of traditional multivariate approaches to estimating hospital costs in order to support product-line evaluation of graduate medical education (GME) program costs among the clinical departments and teaching facilities of a nationwide, federal multi-institutional system. Department-level data for 1988, 1989, and 1990 were used to estimate a multiple regression model of total costs per disposition for the specialties of medicine, surgery, obstetrics/gynecology, orthopedics, psychiatry, and pediatrics. Systemwide and facility-specific GME program costs per disposition were estimated for each specialty on the basis of dependent variable scores predicted by the regression model. Measures of case-mix intensity, facility bed size, department staff size, clinical specialty, GME status, teaching intensity, operating efficiency, and regional variation each made statistically significant contributions to the explained variance in total costs per disposition, and yielded an adjusted R2 of .701. Estimates of total costs and GME costs per disposition revealed substantial variation among clinical specialties, both systemwide and within specific facilities. The results of these techniques, their usefulness for enhancing executive ability to evaluate costs of GME programs as product lines, and their implications for public policy regarding hospital payments are discussed.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"39 2","pages":"265-78"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21006898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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