One of the most significant lessons learned from this process is that setting objectives with performance standards is the key to continuous quality improvement. The critical differences between health administration and health management are threefold: (1) performance standards are developed with clarity, (2) care delivery is monitored and measured against these standards, and (3) improvements are made based on information from these measurements.

California↗

PubMed1991

Plan design innovations to control health care costs.

Southern California Edison has achieved measurable success in health care cost management. Dr. Sokolov observes that the essence of SCE's problem-solving approach can be transferred to almost any organization.

California↗

PubMed1990

Drug use trends in a nuclear power facility: data from a random screening program.

This paper has detailed the creation, implementation and results of the new Two Strike, Random Model substance screening program at Southern California Edison's San Onofre Nuclear Generating Station. This program, the fourth in an evolutionary process beginning in 1984, shows good results after one year of operation. Although not without its difficulties, the reduction in substance screen failure rates achieved thus far provides incentive to continue the quest for a truly drug free workplace.

California↗

PubMed1989

Drug use trends in a nuclear power company: cumulative data from an ongoing testing program.

This article has traced the evolution of Southern California Edison's San Onofre Nuclear Generating Station (SONGS) from fledgling nuclear facility to one of the largest nuclear power installations in America. Paralleling this growth has been an increasing sophistication and commitment to preserving the public trust through efforts to eliminate substance abuse in the workplace. Southern California Edison's substance abuse program has grown and changed in many ways. The results of this change were presented through data gathered at SONGS. These efforts continue to be directed toward an ultimate goal--the creation of a truly drug-free workplace. Work continues.

California↗

PubMed1987

Cardiovascular adaptations to intense swim training in sedentary middle-aged men and women.

Central and peripheral cardiovascular adaptations to 12 weeks of intense swim training were characterized in 12 previously sedentary middle-aged men and women. Peak oxygen uptake (VO2) during upright bicycle exercise improved from 29.2 +/- 5.6 to 34.7 +/- 6.7 ml/kg/min (mean +/- SD, p less than .01) because of similar increases in peak cardiac output (CO) and calculated arteriovenous oxygen difference (both p = .02). Peak supine VO2 was 10% higher after training (p less than .005) solely because of enhanced CO (p = .005). Peak heart rate decreased in both postures; therefore stroke volume at peak exercise was greater by 10% and 18% in the upright and supine postures, respectively (p = .05 and p = .005). There was an identical 18% rise (p = .01) in peak supine left ventricular end-diastolic volume index by radionuclide ventriculography but no change in left ventricular ejection fraction or end-systolic volume index (ESVI). Peak systolic blood pressure (SBP) was unchanged in the upright posture but was 8% higher (p = .002) during recumbency despite a similar total peripheral resistance and SBP/ESVI ratio. Maximal calf conductance (Gmax), assessed separately by venous occlusion plethysmography after local ischemic exercise to fatigue, was augmented 20% (p less than .02) by training, resulting in an 18% greater hyperemic blood flow (p = .05). Peak VO2, CO, and Gmax were unchanged in five nonexercising control subjects. We conclude that in middle-aged humans, intense swim training for 12 weeks produces adaptations that include a greater capacity for vasodilatation in skeletal muscle and an enhanced cardiac pump capacity.

Adaptation, Physiological↗

PubMed1976

Isolation of substances from human vaginal secretions previously shown to be sex attractant pheromones in higher primates.

Fractionation of vaginal secretions from sexually human females by partitioning and chromatographic procedures demonstrates the presence of short-chain fatty acids seen as crucial pheromonal components in previous higher primate studies. In addition, the appearance of these short-chain fatty acids suggests a possible correlation of the rise and fall of hormone levels during the female menstrual cycle.

Adult↗

PubMedDate not supplied

Building a prototype for the Nineties.

Explore the source record for details and available documents.

California↗

PubMedDate not supplied

Building integrated systems--on the brink of a third generation.

The ability to capture both financial and clinical data is at the heart of integrating the insurance and delivery functions.

California↗

PubMedDate not supplied

The emerging health care landscape. The drivers of health care.

Other than hold on tight, how does a health care system successfully weather the turbulent conditions facing the industry? This article focuses on key drivers in the three main segments of the health care market: employer-based, commercial/ERISA, and Medicare and Medicaid. Effectively managing the dynamics within these markets will be vital to a delivery system's success and its ability to withstand the forces of change. Given the market changes that are occurring, how does an academic medical center, emerging hospital-sponsored IDS, or a large physician clinic trying to develop a system determine the necessary components and structure? What kind of system will work best? The considerations are numerous and explored in this article.

California↗