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Biomedical subjects

François Sainfort

Publications and source records attributed to François Sainfort.

5 recordsLinked to original sources
PubMed2004

Quality of work life of family physicians in Wisconsin's health care organizations: a WReN study.

PROBLEM CONSIDERED: Most family physicians in Wisconsin are employed by large health care organizations. Because of its impact on physician recruitment, retention, commitment to the organization, and patient care, the quality of physician work life is an important problem. METHODS: A survey was designed based on a literature review and augmented by focus group data. It was sent to all 1482 members of the Wisconsin Academy of Family Physicians in 2000. RESULTS: Overall response rate was 47%. Three hundred ninety-seven of the respondents were employed by 18 different health care organizations having 10 or more respondents. There were significant differences among Wisconsin's health care organizations in terms of physicians' satisfaction with their organization. There was a strong significant negative correlation between satisfaction with one's organization and turnover intention and a strong positive correlation between satisfaction with one's organization and ability to achieve one's professional goals. There were also significant, though less strong, correlations between satisfaction with one's organization and satisfaction with being a physician and perceived quality of care delivered. CONCLUSIONS: Some of Wisconsin's health care organizations are doing better than others at working with their family physicians to maximize these physicians' satisfaction with the organization, reduce the likelihood of turnover, and enable them to reach their professional goals.

Analysis of Variance↗
PubMed2003

Quality management and the work environment: an empirical investigation in a public sector organization.

The integration of quality management initiatives, particularly total quality management (TQM), and ergonomics has received increasing attention from scholars and practitioners. Above all, the question of how TQM programs relate to ergonomic aspects of organizational design and culture is at the center of this discussion. This study examines how elements of a "typical", Deming-inspired, TQM program in the public sector interact with the work environment. Elements of the TQM program were defined and measured using the Malcom Baldridge Award criteria. The specific elements examined were "Management Support of Quality", "Information and Analysis", "Human Resources", "Processes and Quality Results", and "Customer Focus and Satisfaction". The relationship between these TQM elements and the work environment were defined through five separate hypotheses. The work environment was described by the constructs "Supervisor Support", "Task Clarity", "Task Orientation", and "Innovation". Data were obtained through survey questionnaires administered to employees of four departments in a municipal government organization. Results supported three of the hypotheses, but produced some unanticipated outcomes with regard to the other two. Namely, "Management Support of Quality" was significantly related to "Supervisor Support", "Task Orientation", "Task Clarity" and "Innovation"; "Human Resources" was significantly related to "Supervisor Support"; "Processes and Quality Results" was significantly related to "Task Orientation" and "Innovation". Contrary to predicted "Information and Analysis" was negatively related to "Innovation", and "Customer Focus" was unrelated to any of the outcome variables. The relationships between these TQM elements and work environment dimensions are discussed. Implications for TQM and ergonomic practice are analyzed, and directions for future research proposed.

Empirical Research↗
PubMed2003

Process utility for imaging in cerebrovascular disease.

RATIONALE AND OBJECTIVES: The morbidity associated with a diagnostic test can influence its cost-effectiveness, but the quantification of that morbidity is controversial. Accounting for pain and invasiveness requires the measurement of "process utility" in addition to the expected value of testing. An original time trade-off variant was applied to the imaging evaluation of cerebrovascular disease, for which differences in morbidity are important to patients. MATERIALS AND METHODS: A "waiting trade-off" (WTO) was used to evaluate the preferences of 89 patients for magnetic resonance (MR) angiography and conventional x-ray angiography. Patients were experienced with both tests. A weighted difference was calculated between the period a patient was willing to wait for a test result and treatment after a hypothetical "ideal" test and the choice to undergo conventional angiography or MR angiography with immediate treatment. A rating scale was used to check the convergent validity of the WTO. RESULTS: Paired data showed a highly significant difference (P = .0001) between the mean preference for conventional and MR angiography, favoring the latter and translating into a difference of 5 quality-adjusted life days. The more negatively patients judged their conventional angiographic experience, the longer they were willing to wait for the ideal test result. CONCLUSION: The WTO provides a reasonable estimate of the relative morbidity of more invasive conventional angiographic procedures and provides a quality-adjustment term for economic analysis. Such an approach may enable more complete evaluation of the effects of other processes on medical care.

Adolescent↗
PubMed2003

Developing and testing a model to predict outcomes of organizational change.

OBJECTIVE: To test the effectiveness of a Bayesian model employing subjective probability estimates for predicting success and failure of health care improvement projects. DATA SOURCES: Experts' subjective assessment data for model development and independent retrospective data on 221 healthcare improvement projects in the United States, Canada, and The Netherlands collected between 1996 and 2000 for validation. METHODS: A panel of theoretical and practical experts and literature in organizational change were used to identify factors predicting the outcome of improvement efforts. A Bayesian model was developed to estimate probability of successful change using subjective estimates of likelihood ratios and prior odds elicited from the panel of experts. A subsequent retrospective empirical analysis of change efforts in 198 health care organizations was performed to validate the model. Logistic regression and ROC analysis were used to evaluate the model's performance using three alternative definitions of success. DATA COLLECTION: For the model development, experts' subjective assessments were elicited using an integrative group process. For the validation study, a staff person intimately involved in each improvement project responded to a written survey asking questions about model factors and project outcomes. RESULTS: Logistic regression chi-square statistics and areas under the ROC curve demonstrated a high level of model performance in predicting success. Chi-square statistics were significant at the 0.001 level and areas under the ROC curve were greater than 0.84. CONCLUSIONS: A subjective Bayesian model was effective in predicting the outcome of actual improvement projects. Additional prospective evaluations as well as testing the impact of this model as an intervention are warranted.

Bayes Theorem↗