PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 10131454

Beyond resource management: towards total quality.

P R Holt
View original source ↗Export metadata ↓

Abstract

Suggests that health organizations which have successfully introduced devolved management by involving clinicians are reaching a position where they can move forward beyond "Resource Management" towards managing in a total quality way. This is not an in-depth explanation of TQM (which in itself is rarely understood) but a brief examination of how health organizations can move towards becoming total quality organizations. The trend to decentralize the management of clinical services in hospitals is seen in many countries across the world and where well established, the natural evolution has been towards total quality management.

Explore related subjects

Health ResourcesHospital AdministrationInterdepartmental RelationsModels, OrganizationalOrganizational CultureState MedicineTotal Quality ManagementUnited KingdomJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

P R Holt. 1993. Beyond resource management: towards total quality.. https://doi.org/10.1108/09526869310045831

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2006

Improving outcomes in a regional trauma system: impact of a level III trauma center.

BACKGROUND: Trauma systems decrease morbidity and mortality of injured populations, and each component contributes to the final outcome. This study evaluated the association between a referring hospital's trauma designation and the survival and resource utilization of patients transferred to a level I trauma center. METHODS: Data from the Registry of the American College of Surgeons on patients transferred to a level I trauma center during a 7-year period were subdivided into 3 categories: group 1 = level III-designated trauma center; group 2 = potential level III trauma centers; and group 3 = other transferring hospitals. Trauma and Injury Severity Score methodology was used to provide a probability estimate of survival adjusted for the effect related to injury severity, physiologic host factors, and age. A W statistic was calculated for each type of referring hospital so that comparisons between observed survival and predicted survival could be measured. Differences in W, length of stay, intensive care unit days, and ventilator days were examined using general linear models. RESULTS: Patients transferred to a level I from a level III trauma center (group 1) were more seriously injured (P < .0001) and had improved survival (P < .0018) compared with those transferred from nondesignated hospitals (groups 2 and 3). Patients transferred from large nondesignated hospitals (group 2) had outcomes similar to patients transferred from all other hospitals (group 3). Level I hospital resource utilization did not show significant differences based on referring hospital type. COMMENTS: Outcomes of patients in a trauma system are associated with trauma-center designation of the referring hospitals.

Health Resources↗
PubMed2006

Quebec model for low vision rehabilitation.

The increase in longevity (and secondary morbidity) in the Quebec population adds social and financial pressure to society, as it does elsewhere in Canada and in many western countries. This article gives a brief history of the evolution of vision rehabilitation services in Quebec and describes how services are provided for people with low vision throughout the province. Although numerous groups, associations, centres, and resources are available to assist people with vision impairments, such as the Canadian National Institute for the Blind-Québec, the majority of visual rehabilitation services are provided by government-sponsored rehabilitation centres, namely the Centres régionaux de réadaptation en déficience physique that are located strategically throughout the province. Low vision clinical evaluations in these centres are shared by 36 optometrists throughout the province. Between 5 and 7 ophthalmologists are involved in low vision care, half in university-affiliated hospitals, primarily in Montreal. There may be delays of up to 6 months to be seen in a funded low vision clinic. Statistics obtained from la Régie de l'assurance maladie du Québec show that there are approximately 8,000 requests for low vision aids every year, and that 80% of clients retain at least some level of visual function. Services are covered by Medicare and low vision aids are provided at no cost, although ophthalmologists cannot prescribe low vision aids through the Medicare-funded system. We must ensure that the capacity of our system continues to provide adequately for clientele in the future.

Health Resources↗