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Biomedical subjects

Michael R Bleich

Publications and source records attributed to Michael R Bleich.

13 recordsLinked to original sources
PubMed2005

A model for evaluating systemic change: measuring outcomes of hospital discharge education redesign.

Hospitals have restructured job duties and responsibilities in response to market pressures and in an effort to improve quality. This study presents a model for evaluating patient satisfaction outcomes following a work redesign that included the realignment of responsibility for discharge education from clinical nurse specialists to cross-trained, multidisciplinary workers. The outcomes data cannot be generalized, as they relate to a particular redesign and one institution. However, this analysis provides a framework for a systematic, multidisciplinary approach to evaluating organizational change.

Aged↗
PubMed2004

Dissipating the perfect storm - responses from nursing and the health care industry to protect the public's health.

This article summarizes the major national workforce reports and references the need for a tiered and comprehensive approach to avert the imminent nursing shortage crisis. Since 2002, commendable efforts have been made to increase supply, respond to current demand, and enhance the working environment to benefit recruitment and retention. Four areas are highlighted as exemplars of effort: supply and demand; work environment; new partnerships and public/private ventures; and patient-centered and essential patient-safe care.

American Nurses' Association↗
PubMed2004

The academic nursing practice dean: an emerging role.

This article describes the contributions of academic nursing practice to nursing education; delineates the role characteristics and competencies needed by academic practice deans; and provides examples of the challenges and issues academic practice deans face related to nursing education, research, and practice. While schools' missions vary from a strong focus on education to multiple emphases on education, research, and practice, academic nursing practice has the potential to facilitate achievement in each of these areas. Academic nursing practice deans play important roles in advancing the missions of their schools through the clinical practice activities within the schools. Strong academic nursing practice programs can serve as catalysts for the development and refinement of new models of care delivery and for the development of future nursing leaders who are comfortable with innovation.

Education, Nursing, Baccalaureate↗
PubMed2004

Developing the academic nursing practice in the midst of new realities in higher education.

The academic nursing practice has a role in replenishing the diminished resources that confront higher education and, if well conceived and managed, is a viable option to support existing academic program stability and growth. An alternative model for defining the academic practice--beyond traditional nurse-managed centers--is presented in this article. The cohesive interconnection of the education, research, and practice missions is addressed with examples of how each contributes to a variety of communities of interest and expands professional nursing roles through innovative care model testing and development. With effective business planning and infrastructure support, faculty practice plans can evolve to a second generation, with heightened societal accountability for service, academic, and collaborative research outcomes.

Community Health Centers↗
PubMed2003

Analysis of the nursing workforce crisis: a call to action.

In our integrative review of reports on the health care workforce shortage, we examined 15 reports that focused primarily on nursing and were conducted by various stakeholders. We studied these reports objectively, identifying problems and solutions as described by the authors, which we then categorized by theme. We found problems at both the national and institutional levels and noted that the reports contained similar problem and solution "themes." Yet we also found gaps between these-some problems had no solutions and some solutions didn't address any of the suggested problems. Gaps occurred among problems and solutions listed in the following theme categories: demand, health care economics, workforce planning, research and data support, and technology. Despite the urgent need, we still lack a national strategy designed to avert the nursing shortage. This review may provide a foundation for such a plan.We present the results of our analysis and our recommendations to the federal government and national organizations, to institutions, and to nurses. These recommendations don't provide a comprehensive strategy for averting the nursing shortage, but they do offer a basis upon which one may be created.

Health Planning↗
PubMed2002

"The less-than-perfect medication system": a systems approach to improvement.

The 1999 Institute of Medicine (IOM) report increased the focus by health care providers, regulators, and the public on the cause and effect of medical errors. The IOM report recognizes the complexity of the problem of medical errors and advocates a systematic approach to error reduction. Medication delivery systems in health care facilities are an excellent example of the complexity that exists. General Systems Theory (GST) provides a framework to evaluate system design and effectiveness. This article presents an example of the use of GST in the design and evaluation of medication systems with a focus on error reduction.

Humans↗
PubMed2002

Short staffing and iatrogenic stressors: can we survive our own doings?

If there was ever a time when the nursing profession was under the spotlight and gaining national and local attention, this is it. There are those whose efforts will help with nurse recruitment and retention. There will be increased funding for scholarships and other financial inducements for nurses. Regulators are looking at mandated nurse-patient ratios and examining mandatory overtime for nurses. External change agents can--and are--influencing the state of nursing. There are changes that need to be made within nursing. Systems, role, and environmental change is best directed by nurses. We are called to be internal change agents within nursing with an eye toward seriously re-examining how we create our own stress. Using a 1970's team model for eight-hour shifts is redundant with 12-hour scheduling models in place. Recalling the scarcity of vital information in days gone by (i.e., blood gases were drawn but once a day as an adjunct to intense nursing observations), today there is a plethora of unending clinical data, such that limits need to be established. Failing to sufficiently address the human condition in a coordinated and effective manner, given the cost of care and the rising expectations of consumers is a constant challenge if we fail to address the soundness of our operational systems. Systems must be kept current with the times. For instance, how we blend temporary workers with "core resource" nurses remains largely unanswered. We must systematically address these issues, or be subject to the stress caused by the failure to do so. Nurse leader--and effective nurse followers--should use the spotlight to demand a re-hauling of our ineffective practices. Not in the spirit of work reengineering aimed at cost savings alone, but pragmatically to address the essence of the nurse-patient relationship and to create a savory environment for nursing professionals.

Nurses↗
PubMedDate not supplied

Beyond tradition: synergizing intellectual and material capital to forge the new academic-service partnership.

Academic-service partnerships are being touted as a solution to workforce problems. "Traditional" approaches to these partnerships have been directed primarily at academic and hospital institutions for mutual benefit. An expanded model of partnership possibilities is presented through three detailed exemplars that include population health (with descriptors from an Institute of Medicine study addressing the public's health in the 21st century), public-private ventures (public institution with faith-based and community agencies), and nursing-corporate opportunities (academia and a proprietary information technology corporate supplier). The benefits of these expanded partnerships and the criteria for selecting a partnership sensitive to the scholarship of practice and the mission/purpose/goals of each partnering organization is highlighted.

Community Health Planning↗
PubMedDate not supplied

Collaboration: aligning resources to create and sustain partnerships.

Academic-service partnerships are the future. These partnerships require a new paradigm and new practice models that necessitate change in how and where decisions are made as well as who is accountable for both the decisions and the outcomes of those decisions. The role of organizational leaders in this new paradigm becomes aligning resources to create and sustain partnerships. Partnerships are relationships and are only as effective as the communication between all entities. Decision-making is an important outcome of partnerships, yet there is little research regarding specific behavioral strategies that promote quality problem solving and decision-making. This paper extends the work of organizational theorist Ralph Stacey by proposing an event-driven typology of behavioral strategies for problem solving. The typology can assist organizational leaders to align resources for best practices in academic-service partnerships and be used as a framework for future research.

Benchmarking↗