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Biomedical subjects

P H Walker

Publications and source records attributed to P H Walker.

At least 19 recordsLinked to original sources
PubMed1997

Merger motorway. Giving staff the tools to reengineer.

Mergers and health care agencies' response to mergers dominate current conversations in this evolving managed care environment. Hospitals are rapidly learning to adjust to declining occupancy rates and deceased utilization of resources. A business model to guide mergers was adapted to assist staff with the people, structural, cultural and political issues of organizational change. Creating successful new work environments, moving from a "We-they" mentality to unity and decreasing use of resources are outcomes described in this article.

Adaptation, Psychological↗
PubMed1997

The University of Rochester experience.

To establish a school-based health center, it is more important than ever to plan for financial support for building a practice. It is difficult to get to and stay at the target enrollment for this population since it is ever-changing group of students. Plan for increased numbers of initial assessments since every year at least one-fourth of the enrollees in the program change. Work closely with primary care providers and make it clear in verbal and written communication that there is no intent to disrupt the relationship with the student. Assess risk of the population and attempt to predict utilization of services (number and type of encounters) and determine costs of care. It is also important to find ways to track hospitalizations, emergency room visits and other unscheduled access to care. Since adolescents frequently seek confidential care, parents and providers may be uninformed regarding the actual cost of management of covered lives in a managed care environment.

Adolescent↗
PubMed1996

Exploring cost and quality: community-based versus traditional hospital delivery systems.

This article presents two approaches for comparison studies of cost and quality outcomes between community-based and traditional hospital systems of care. Two methodologies are used specifically to compare midwifery practice in a free-standing birth center to traditional obstetric practice with hospital deliveries. Findings from both studies reinforce the potential cost savings of community-based care without compromising quality. The methodologies used here can be applied to other settings. These approaches are also relevant for comparison studies of cost and quality outcomes between physicians and other nonphysician providers such as physician assistants and nurse practitioners, who frequently staff emerging models of community-based care. Issues related to obtaining comparable clinical and cost data versus reimbursement for both community-based and hospital care will be highlighted.

Birthing Centers↗
PubMed1994

Dollars and sense in health reform: interdisciplinary practice and community nursing centers.

Historically, community nursing centers (CNCs) provided care to underserved populations, and today they are reemerging to provide accessible, nurse-managed care in urban and rural settings. The quality and cost-effectiveness of care provided by advanced practice nurses in a managed-care environment is described using the Neuman Systems Model. Significant documentation from the literature underscores the value of nurse-managed care, but supports the need for interdisciplinary practice. CNC primary and preventive care in a "center without walls" is described and promoted for accessible, cost-effective and quality care in the context of health care reform.

Community Health Centers↗
PubMed1994

Informatics for nurse managers: integrating clinical expertise, business applications, and technology.

Nurse managers must become familiar with computers, information systems, and nursing informatics in order to be competitive in the future. Knowledge and skills for identifying critical data elements, organizing the data into information, and presenting it for decision making can be learned through formal and informal education. After learning to use computers and to apply nursing informatics, nurse managers will be equipped to make more relevant, data-driven management decisions. This article describes how nurse managers can identify business applications relevant to management, learn how to use them, and put nursing informatics to work in very practical ways.

Clinical Competence↗
PubMedDate not supplied

A comprehensive community nursing center model: maximizing practice income--a challenge to educators.

The potential role of community nursing centers to generate revenue through faculty practice is critical for the survival of nursing centers in the future. A nursing center entrepreneurial model for faculty practice within the University of Rochester School of Nursing uses sound business principles to enhance financial success and challenges current paradigms in education, practice, and research.

Community Health Centers↗