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Biomedical subjects

D D Persaud

Publications and source records attributed to D D Persaud.

7 recordsLinked to original sources
PubMed2003

Gaining and maintaining commitment to large-scale change in healthcare organizations.

Healthcare administrators have sought to improve the quality of healthcare services by using organizational change as a lever. Unfortunately, evaluations of organizational change efforts in areas such as total quality management (TQM), continuous quality improvement (CQI), and organizational restructuring have indicated that these change programmes have not fulfilled their promise in improving service delivery. Furthermore, there are no easy answers as to why so many large-scale change programmes are unsuccessful. The aim of this analysis is to provide insights into practices that may be utilized to improve the chances of successful change management. It is proposed that in order to effect change, implementers must first gain commitment to the change. This is done by ensuring organizational readiness for change, surfacing dissatisfaction with the present state, communicating a clear vision of the proposed change, promoting participation in the change effort, and developing a clear and consistent communication plan. However gaining commitment is not enough. Many change programmes have been initially perceived as being successful but long-term success has been elusive. Therefore, maintaining commitment during the uncertainty associated with the transition period is imperative. This can be done by successfully managing the transition using action steps such as consolidating change using feedback mechanisms and making the change a permanent part of the organization's culture.

Efficiency, Organizational↗
PubMed2000

Organizational justice principles and large-scale change: the case of program management.

Many of the barriers to implementation of large-scale change in healthcare organizations seem to be related to a lack of attention to the human change that needs to occur. One element of this human dimension that change agents overlook is the role that perception of fairness to employees plays in implementing large-scale organizational change. This article uses program management (an organizational design that has been implemented in many healthcare facilities across Canada) as an example of large-scale structural change and demonstrates the importance of applying procedural and interactional justice principles to enhance the implementation of organizational change.

Attitude of Health Personnel↗
PubMed1999

Determining Ontario's supply and requirements for ophthalmologists in 2000 and 2005: 1. Methods.

BACKGROUND: We performed a study to determine the supply of and requirements for ophthalmologists in Ontario in 2000 and 2005. In this paper we describe our methods. METHODS: The future supply of ophthalmologists was estimated by means of iterative multiple regression analysis using the baseline number of ophthalmologists, the number of ophthalmology residents and the numbers of ophthalmologists entering and exiting the workforce between 1989 and 2004. Data were obtained from the Ontario Physician Human Resource Data Centre, Statistics Canada, the Ontario Ministry of Finance and residency program directors of Ontario universities. We calculated requirements using four models. The physician:population ratio method used an ophthalmologist:population ratio (1:29,650) proposed by the Royal College of Physicians and Surgeons of Canada and Statistics Canada population projections for 2000 and 2005. The utilization-based, substitution and needs-based models used Ontario Health Insurance Plan data for 1995. The supply and requirements are expressed as full-time equivalents, defined as the average number of minutes worked by ophthalmologists in 1995. The 401 ophthalmologists practising in Ontario in 1995 accounted for 452 full-time equivalents. INTERPRETATION: Incorporating the results of several requirement models increases the reliability and acceptability of estimates of physician workforce requirements.

Female↗
PubMed1999

Determining Ontario's supply and requirements for ophthalmologists in 2000 and 2005: 2. A comparison of projected supply and requirements.

BACKGROUND: To determine whether the projected supply of ophthalmologists in 2000 and 2005 in Ontario will be matched by the predicted requirements. METHODS: Described in the accompanying paper (page 74). RESULTS: Multiple regression analysis predicted a supply of 485 +/- 15 full-time-equivalent (FTE) ophthalmologists in 2000 and 476 +/- 14 FTEs in 2005. Except for the needs-based method of determining requirements, which generated a figure of 524 +/- 16 to 533 +/- 16 FTEs, the requirement methods yielded estimates that were within the range of the projected supply for 2000 (physician:population ratio method 458, utilization-based method 500 +/- 15 and substitution method 470 +/- 14 to 490 +/- 15). For 2005, only the physician:population ratio method gave an FTE requirement estimate (489) that was in keeping with the projected supply. The other models gave FTE estimates that were higher than the projected supply (utilization-based model 559 +/- 17, substitution model 526 +/- 16 to 548 +/- 16, and needs-based model 585 +/- 18 to 596 +/- 18). INTERPRETATION: The reduction in the number of ophthalmology residents in Ontario that began in 1994 will not affect the short-term requirements for ophthalmologists but may result in fewer ophthalmologists than will be necessary to fulfil Ontario's requirements in 2005 and beyond. Possible solutions include doubling the number of residency positions beginning in 1999.

Female↗
PubMed1992

Personal computers and risk management.

The personal computer is fast becoming an important tool for healthcare administrators. In this article, the authors describe a patient-incident report program at their hospital that enables management to provide patients with higher quality care and, concomitantly, reduce the possibility of litigation.

Accidental Falls↗
PubMed1992

Effects of a surgical pre-operative assessment clinic on patient care.

Surgery makes many demands of both hospitals and patients. For the hospital, there are many procedural aspects: admission, health assessment, and patient education; the actual operation; and the post-surgical recovery period, a time when patients are susceptible to complications and nosocomial infections. For the patient, surgery means physical pain and emotional anxiety. A pre-operative assessment clinic (POAC), however, can assist both hospital and patients by streamlining their admission, assessment, and education, by decreasing the time they spend in the hospital recovering from surgery, and by easing their anxiety. In this article, the authors describe a study of a POAC at a Canadian hospital.

Admitting Department, Hospital↗