PubMed · 8337236
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J M Rothstein. 1993. The case for case reports.. https://doi.org/10.1093/ptj%2F73.8.492
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This paper considers the effect that globalization is having on knowledge and higher education. Having undertaken this, it applies the discussion to the future of nurse education. The paper has a long introduction in which globalization is considered, thereafter it has three parts: the first examines the changing nature of knowledge; the second the changing nature of education; and the final part locates nurse education in this discussion.
UNLABELLED: FINNISH HEALTH CARE: Although health care services in Finland are organized uniformly throughout the country, they, along with the application of total quality management (TQM)/continuous quality improvement (CQI), are the responsibility of municipalities. CASE 1: At the Helsinki City Health Organization, top management launched an organizationwide quality improvement (QI) initiative in 1993, entailing 150 CQI projects. Yet top and middle managers were not sufficiently dedicated to the initiative to provide adequate support to many of the quality projects. Only "islands of activity" were spotted. CASE 2: A physician in the pediatrics department of a hospital helped initiate CQI projects--for improvements in administration of x-rays for patients with antebrachium fractures, transport of samples to the microbiology laboratory, and admissions of patients with acute infectious disease. Successes led senior management in the hospital federation to issue a quality policy based on CQI management, showing the power of the good example. CASE 3: The first launch of CQI at the Helsinki University Central hospital was part of a management development project that did not have the full support of senior management and that, consequently, failed. A second initiative undertaken a year later, the quality council, was more successful. CASE 4: At a local center for social services and primary care, quality projects have strengthened the organization's team and network structures across two professional cultures. DISCUSSION: The four cases provide insight into the diffusion of TQM/QI and implementation strategies on the local level.