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Biomedical subjects

W J McCabe

Publications and source records attributed to W J McCabe.

6 recordsLinked to original sources

Continually improving governance.

What can governance do to ensure the continual improvement of organizational performance? This article explores this question, with particular emphasis on two central considerations. First, what constitutes good governance? Second, what are the sources of and opportunities for leveraging performance available to governance? We argue that focusing on strategy, evaluating performance, and developing the means to learn are the key venues available to governance for leveraging its own and organizational performance.

Documentation↗

Total quality management in a hospital.

The adaptation of the management philosophy and tools of total quality management (TQM) to the modern American hospital, its staff, and physicians is a major challenge facing health care today. The TQM "bandwagon" is one that hospitals both want to--and are required to--jump on, insofar as TQM is now part of the revised Joint Commission standards [Ed note: The standards encourage hospitals to adopt TQM, continuous quality improvement, or a similar approach to improve performance]. TQM holds out the promise of improving clinical quality while simultaneously reducing the "cost of poor quality." Although the actual realization of cost savings through TQM remains to be seen, the author provides an exceptionally clear overview of the issues involved in TQM implementation at the hospital level. This article is noteworthy in its practical and experienced approach to the necessary groundwork for a successful TQM program, including strategic commitment, human resource issues, and oversight of the TQM process as it unfolds. Quality review professionals may still wonder how to merge hospital and medical staff quality assurance efforts with TQM initiatives in the near future.

Consumer Behavior↗

Dysregulation of hypothalamic-pituitary-adrenal axis function in depressed alcoholic patients.

Hypothalamic-pituitary-adrenal (HPA) axis function was examined in 28 hospitalized, withdrawing alcoholic patients. Fourteen patients met DSM-III criteria for Major Depressive Disorder. Elevated 8 a.m. basal cortisols were noted in 7 depressed alcoholic patients (50%) and no non-depressed alcoholics (P less than 0.01). Escape from dexamethasone suppression was noted in 9 depressed alcoholics (64%) and no non-depressed alcoholics (P less than 0.005). The measurement of HPA axis function may be a useful marker for endogenous depression in an alcoholic population.

Adult↗