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Journal of the Society for Health Systems最新文献

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Selling high quality and low cost: market conditions and successful quality improvement projects. 销售高质量和低成本:市场条件和成功的质量改进项目。
Journal of the Society for Health Systems Pub Date : 1996-01-01
D M Uttermohlen
{"title":"Selling high quality and low cost: market conditions and successful quality improvement projects.","authors":"D M Uttermohlen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Many potentially useful health care improvement projects fail to achieve much improvement. Even a technically excellent project can fail because, under certain conditions, economic factors in the health care market do not support high quality and low cost. Most health care markets evolve from the traditional fee for service market through a consolidation phase into risk shared market. At each phase, payment mechanisms will support specific quality and productivity improvement projects and discourage others. For example, the implementation of critical paths/clinical protocols is not supported until the majority of payers pay a fixed cost per illness or covered life. Prior to that point, loss of income for the hospital and/or physicians will inhibit successful implementation. Maximum quality and productivity improvements outcomes can be achieved with minimum efforts when project leaders understand the maturity of their organization's market, and strategic needs. This paper will review the types of payment systems (fee for service, discounted fee for service, and risk shared payments) and identify the types of projects that maximize benefit to the stakeholders involved.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 2","pages":"73-81"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19943860","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
Activity-based costing for clinical paths. An example to improve clinical cost & efficiency. 临床路径的作业成本计算。提高临床成本和效率的一个例子。
Journal of the Society for Health Systems Pub Date : 1996-01-01
M J Asadi, W A Baltz
{"title":"Activity-based costing for clinical paths. An example to improve clinical cost & efficiency.","authors":"M J Asadi,&nbsp;W A Baltz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>How much does this medical service or surgical procedure cost the hospital to provide? What is the most efficient clinical pathway that maximizes the quality of patient care while minimizing costs? More and more hospitals are discovering that they don't have solid answers to these critically important questions. In an age of managed care and capitation, however, it is imperative for management to know if the patient care services they provide are making or losing money-and by how much. This article discusses how a powerful new tool called activity-based costing (ABC) can be used to help hospitals accurately determine patient care costs. We show how to build a model that combines both clinical and financial data to measure how efficiently the operation allocates human, material and capital resources to provide its services. The modeling approach described in this article can be used to better analyze a wide range of important operational and financial issues, including: How to efficiently allocate resources, and what resources will be needed as patient demand changes-ideal for operational management and planning; How efficiently activities and processes are performed to meet patient needs-effective for measuring performance and improving quality; Determining clinical pathway profitability-essential for understanding where you're making or losing money; Cycle time, throughput and the impact of resource capacity constraints-critical for meeting patient demand; Costs of idle capacity-important for using resources more efficiently. We will illustrate with an example how this modeling technique can be used to develop and implement efficient clinical pathways.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 2","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19944566","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
Introduction: evolution of patient-focused care within the contextural framework of an integrated delivery system (IDS). 简介:在综合交付系统(IDS)的背景框架内以患者为中心的护理的演变。
Journal of the Society for Health Systems Pub Date : 1995-01-01
J McQueen, P Marwick
{"title":"Introduction: evolution of patient-focused care within the contextural framework of an integrated delivery system (IDS).","authors":"J McQueen,&nbsp;P Marwick","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Whatever the specific actions taken to move toward a truly integrated delivery system, the most critical success factor may be the \"rate of integration.\" (See Figure 2 below). The IDS that achieves the most rapid rate of integration (A) may not initially be the market leader. However, the ability to integrate will have a major impact on how well an organization manages managed care and subsequently the long-term growth and profitability of the system. Many thanks are extended to the authors of the following articles. I believe you will find the articles helpful in developing a deeper understanding of patient-focused care in general and in understanding strengths, areas of needed improvement, and application of the model in an IDS environment.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 1","pages":"5-9"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18666609","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 total quality management in patient-centered restructuring. 全面质量管理在以患者为中心的结构调整中的作用。
Journal of the Society for Health Systems Pub Date : 1995-01-01
G M Auton
{"title":"The role of total quality management in patient-centered restructuring.","authors":"G M Auton","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The fundamental structure and organization of the American hospital has changed little in the past fifty years. The current and future environment requires hospitals to reconsider how basic patient care delivery systems are organized and managed. Organizations are discovering how the traditional structure limits a hospital's ability to achieve sustainable improvements in clinical and service quality. A number of pioneering hospitals have initiated efforts during the past several years to completely redesign their organizations to create systems that are patient-centered and customer responsive. This paper discusses the opportunities and obstacles of operational restructuring and how total quality management principles can assist in achieving an effective transition to a new system.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 1","pages":"63-71"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18666612","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
HOROPLAN: computer-assisted nurse scheduling using constraint-based programming. HOROPLAN:使用基于约束的编程的计算机辅助护士调度。
Journal of the Society for Health Systems Pub Date : 1995-01-01
S J Darmoni, A Fajner, N Mahé, A Leforestier, M Vondracek, O Stelian, M Baldenweck
{"title":"HOROPLAN: computer-assisted nurse scheduling using constraint-based programming.","authors":"S J Darmoni,&nbsp;A Fajner,&nbsp;N Mahé,&nbsp;A Leforestier,&nbsp;M Vondracek,&nbsp;O Stelian,&nbsp;M Baldenweck","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Nurse scheduling is a difficult and time consuming task. The schedule has to determine the day to day shift assignments of each nurse for a specified period of time in a way that satisfies the given requirements as much as possible, taking into account the wishes of nurses as closely as possible. This paper presents a constraint-based, artificial intelligence approach by describing a prototype implementation developed with the Charme language and the first results of its use in the Rouen University Hospital. Horoplan implements a non-cyclical constraint-based scheduling, using some heuristics. Four levels of constraints were defined to give a maximum of flexibility: French level (e.g. number of worked hours in a year), hospital level (e.g. specific day-off), department level (e.g. specific shift) and care unit level (e.g. specific pattern for week-ends). Some constraints must always be verified and can not be overruled and some constraints can be overruled at a certain cost. Rescheduling is possible at any time specially in case of an unscheduled absence.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 1","pages":"41-54"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18666607","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
Combining total quality management and simulation with application to family therapy process design. 将全面质量管理与模拟相结合，应用于家庭治疗流程设计。
Journal of the Society for Health Systems Pub Date : 1995-01-01
C R Standridge, M D Brown-Standridge
{"title":"Combining total quality management and simulation with application to family therapy process design.","authors":"C R Standridge,&nbsp;M D Brown-Standridge","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This case study shows how a new combined total quality management and simulation procedure was used to design, test, and implement a unique clinical process for brief systems family therapy. A process design procedure was developed that combines total quality management and simulation strategies and tactics. The six strategic check-points of the new procedure emphasize the use of both designed experimentation and process modeling and simulation to find process faults, evaluate process improvement alternatives, and test selected process improvements. Other information needed for process design was gathered from families in therapy, the family therapy literature and observations of student and experienced therapists. Simulation helped identify and compare alternative sequences of therapy process steps. Designed experimentation revealed improvements resulting from the new Brief Systems Family Therapy process as used by doctoral-level family therapy practicum students in a university clinic.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 1","pages":"23-40"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18666634","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
Breakthrough delivery systems: applying business process innovation. 突破交付系统:应用业务流程创新。
Journal of the Society for Health Systems Pub Date : 1995-01-01
J G Nackel
{"title":"Breakthrough delivery systems: applying business process innovation.","authors":"J G Nackel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The way the health care industry conducts business today has been ingrained by over fifty years of tradition. This tradition includes physician training concepts, physician/nurse/patient relationships, and overall organization of the health care delivery system. The industry is now beginning to understand that viewing its operations from an organizational process perspective can provide tremendous competitive advantage. The industry faces perhaps the greatest challenge, because business process innovation requires rethinking the way an organization conducts business. It requires a rediscovery of customer expectations and new revelations about how to provide them with value-added service.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 1","pages":"11-21"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18666631","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
A portable, GUI-based, object-oriented client-server architecture for computer-based patient record (CPR) systems. 用于基于计算机的病人记录(CPR)系统的可移植的、基于gui的、面向对象的客户机-服务器体系结构。
Journal of the Society for Health Systems Pub Date : 1995-01-01
T K Schleyer
{"title":"A portable, GUI-based, object-oriented client-server architecture for computer-based patient record (CPR) systems.","authors":"T K Schleyer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Software applications for computer-based patient records require substantial development investments. Portable, open software architectures are one way to delay or avoid software application obsolescence. The Clinical Management System at Temple University School of Dentistry uses a portable, GUI-based, object-oriented client-server architecture. Two main criteria determined this approach: preservation of investment in software development and a smooth migration path to a Computer-based Patient Record. The application is separated into three layers: graphical user interface, database interface, and application functionality Implementation with generic cross-platform development tools ensures maximum portability.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 1","pages":"55-62"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18666610","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
Work reengineering: the benefits and the barriers, an analytical review. 工作再造:效益与障碍分析。
Journal of the Society for Health Systems Pub Date : 1995-01-01
R Murphy
{"title":"Work reengineering: the benefits and the barriers, an analytical review.","authors":"R Murphy","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hospital executives who are considering patient centered care (PCC) delivery models are undertaking a fascinating and sometimes frightening journey. Although the benefits are many, several barriers are often encountered on the way to achieving successful results. Many hospitals begin this initiative with enthusiasm and optimism because it makes so much sense. However, fear of change can set in when barriers overcome the motivation to proceed. This paper explores both the benefits and strategies for successfully overcoming the barriers. In the final analysis, each hospital's executive team must answer the call to this challenge. Their decisions hold the future of their hospital in the balance.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 1","pages":"73-84"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18667203","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
Cross-functional clinical teams: significant improvement in operating room quality and productivity. 跨职能临床团队:手术室质量和工作效率显著提高。
Journal of the Society for Health Systems Pub Date : 1993-01-01
R N Davis
{"title":"Cross-functional clinical teams: significant improvement in operating room quality and productivity.","authors":"R N Davis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper will describe a successful application of Quality Improvement concepts to the complex Perioperative System at an academic medical center in the Northeast. The initiation of multi-disciplinary teams (including surgeons, anesthesiologists, and nurse managers) will be discussed, as will the steps, skills, and techniques employed. The paper will catalogue keys to success from those observed during this and five similar recent Quality Improvement engagements facilitated by such a process.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"4 1","pages":"34-47"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19256920","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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