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PubMed1991

Organizational performance and adaptation: effects of environment and performance on changes in board composition.

This study examined performance as a moderator of organizational adaptation to environmental change. Change in the composition of boards of directors was examined as a dependent variable reflecting organizational attempts to deal with changing external contingencies. We tested specific hypotheses in an analysis of 290 California hospitals over a seven-year period. Results indicate that hospitals change the composition of their boards to adapt to changing environmental contingencies but that the hospitals' performance moderates the rate of their response, with poorer performers being more willing to initiate changes in board composition than strong performers.

Administrative Personnel↗

PubMed1984

Medicare program; performance criteria and statistical standards for evaluating intermediary performance during fiscal year 1984--HCFA. Proposed notice.

This notice would update the performance criteria and statistical standards to be used for evaluating the performance of fiscal intermediaries in the administration of the Medicare program for fiscal year 1984. The performance criteria and statistical standards have been developed from available statistical data contained in routine intermediary reports; past performance results for the intermediaries; and from substantive input from the intermediary community, HCFA central office and HCFA regional offices. The results of these evaluations would be considered whenever we enter into, renew, or terminate an intermediary agreement; assign or reassign providers of services to an intermediary; or designate regional or national intermediaries.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1975

Performance evaluation of Wisconsin laboratories performing implied consent alcohol determinations.

Hospital, clinic, and public health laboratories are licensed to perform implied consent blood and urine alcohol determination. Methods include enzymatic, gas chromatographic, and distillation. The techniques of evaluation/certification are outlined. The performance exhibited no consistent bias toward high or low values. The distribution of participants' values, i.e. precision, indicated a 3% coefficient of variation performance. Laboratories showed an increase in quality of performance with time, especially after the initial 6 month period. Quality of results varied in the order: gas chromatographic, enzymatic, and distillation methods.

Ethanol↗

PubMed2001

The assessment of poorly performing doctors: the development of the assessment programmes for the General Medical Council's Performance Procedures.

BACKGROUND: Modernization of medical regulation has included the introduction of the Professional Performance Procedures by the UK General Medical Council in 1995. The Council now has the power to assess any registered practitioner whose performance may be seriously deficient, thus calling registration (licensure) into question. Problems arising from ill health or conduct are dealt with under separate programmes. METHODS: This paper describes the development of the assessment programmes within the overall policy framework determined by the Council. Peer review of performance in the workplace (Phase 1) is followed by tests of competence (Phase 2) to reflect the relationship between clinical competence and performance. The theoretical and research basis for the approach are presented, and the relationship between the qualitative methods in Phase 1 and the quantitative methods in Phase 2 explored. CONCLUSIONS: The approach is feasible, has been implemented and has stood legal challenge. The assessors judge and report all the evidence they collect and may not select from it. All their judgements are included and the voice of the lay assessor is preserved. Taken together, the output from both phases forms an important basis for remediation and training should it be required.

Clinical Competence↗

PubMed2003

Straight talk new approaches in healthcare. Performance management: assuring your financial and performance goals are met.

Performance management is a topic thrown around a lot in executive suites, but its key tenets are sometimes misunderstood. To be successful, performance management involves setting strategy at the board and executive levels and making day-to-day decisions at the line-manager level. But the process won't work unless those line managers have clearly defined goals to achieve as well as relevant reliable and timely information to assist them in monitoring their performance and making operational decisions to improve outcomes. Modern Healthcare and Pricewaterhouse Coopers present Straight Talk in the tenth installment of Straight Talk we discuss the steps necessary to build a successful performance-management program. The session was held at Modern Healthcare's Chicago head-quarters on January 7, 2003. Charles S. Lauer, publisher of Modern Healthcare, was the moderator.

Decision Making, Organizational↗

PubMed2003

Individual differences in infant fearfulness and cognitive performance: a testing, performance, or competence effect?

The author conducted 2 studies to examine the relations between infant fear and cognitive testing performance in 12-month-old infants. In Study 1, fear was assessed by using 2 standard temperament questionnaires and a laboratory-based, standardized stranger approach. Individual differences in cognitive development were assessed using the Object Permanence Scale of the Infant Psychological Development Scales (I. C. Uzgiris & J. M. Hunt, 1975). All 3 assessments of fear significantly predicted object permanence performance, with correlations ranging from -.32 to -.35. In Study 2, fear was assessed via a maternal report questionnaire, and habituation performance was assessed via a basic-level categorization task. Familiarity with the examiner and with the testing environment was manipulated to test for a familiarity influence on performance. Testing revealed individual differences in both fear and habituation. Results suggest that highly fearful infants required more trials to habituate and were less likely to meet the habituation criterion than infants who were less fearful. Methodological and conceptual implications of these results are discussed.

Child Development↗

PubMed1992

Performance of the Kodak DT-60 physician's office analyzer as measured by CLIA-88 proposed evaluation criteria. Assessment of demographic and quality assurance factors influencing performance.

The 1988 Clinical Laboratories Improvement Act (CLIA-88) proposes to mandate universal proficiency testing and internal quality assurance practices for all laboratories, including those in physician offices. For 3 years, we have provided an independent voluntary proficiency testing program to more than 400 physician office laboratories using Kodak DT-60 analyzers (Eastman Kodak, Rochester, NY). This unique data set enables us to evaluate, using the CLIA-88 proposed grading criteria, the ability of these laboratories to meet the proposed regulatory standards. Using the equivalent of a year's participation under the CLIA proficiency testing format (20 challenges per analyte), at least 88% would "pass," ie, achieve acceptable performance. We investigated the relationship between proficiency testing performance and several internal quality assurance practices as well as other factors commonly associated with quality performance, including analyst's professional background, monthly test volume, number of physicians served, and source of training on the instrument. The best indicator of successful performance in proficiency testing was on-site training provided by the manufacturer, as opposed to training provided by distributor personnel. We conclude that with proper on-site training and retraining, physician office laboratories will be able to meet the mandatory CLIA-88 proficiency testing requirements.

Calibration↗

PubMed2006

Relationships between scores on the COMLEX-USA Level 2-Performance Evaluation and selected school-based performance measures.

The Comprehensive Osteopathic Medical Licensing Examination USA Level 2 Performance Evaluation (COMLEX-USA Level 2-PE) is a national multistation performance examination designed to examine students' osteopathic clinical skills. The current study examines the relationship between achievement levels on the COMLEX-USA Level 2-PE and selected school-related variables for the class of 2005 at the West Virginia School of Osteopathic Medicine in Lewisburg, WVa (N=70). Significant (P<.01) correlations between the COMLEX-USA Level 2-PE summary performance and selected academic achievement measures include: weighted Physical Diagnosis grade, 0.41; weighted year 1 and year 2 Osteopathic Principles and Practice grade, 0.37: overall year 2 grade point average, 0.42; the objective structured clinical evaluation (OSCE) Physical Examination score, 0.40; and the OSCE Total Station score, 0.33. While further research is needed, the current study found modest but notable relationships between school-generated academic variables and performance on the COMLEX-USA Level 2-PE, and therefore supports the validity of the COMLEX-USA Level 2-PE examination for assessing the clinical skills of future osteopathic physicians.

Achievement↗

PubMed2006

Making the grade with pay for performance: 7 lessons from best-performing hospitals.

Top-performing hospitals in pay-for-performance initiatives: Engage clinicians in quality improvement initiatives from the start of the planning process. Make high-quality care the priority of the executive team. Have a dedicated quality, safety, and performance improvement department. Manage data collection effectively. Regularly share performance data with their staffs. Commit to sharing best practices. Celebrate the achievements of their healthcare teams.

Financial Management, Hospital↗

PubMedDate not supplied

CDC's Model Performance Evaluation Program: assessment of the quality of laboratory performance for HIV-1 antibody testing.

In 1986, the Centers for Disease Control (CDC) implemented the Model Performance Evaluation Program (MPEP) to evaluate the performance of laboratories that test for antibody directed against human immunodeficiency virus type 1 (HIV-1). The impetus for developing this program came from the recognition of a need to assess the quality of existing and changing laboratory technology and to ensure that the quality of testing was sufficient to meet medical and public health needs. To develop the program, CDC chose HIV-1 antibody testing as the first specific application for assessing the quality of laboratory performance because (a) of the importance of accurate and reproducible test results for acquired immunodeficiency syndrome (AIDS) surveillance, prevention, and treatment programs; (b) HIV-1 testing technology is new to many laboratories; and (c) HIV-1 testing practices and applications continue to evolve. Unlike proficiency testing programs, the MPEP is not limited to assessing quality in the analytical step, alone. It will also assess quality in the preanalytical and postanalytical steps of the testing process, that is, from the time a test is requested until the clinician who ordered the test takes an action based on the test result. The participating laboratories furnish the information needed for the performance evaluation program by (a) completing questionnaires designed to describe HIV-1 testing laboratories and their testing practices, (b) analyzing specially prepared sample panels for HIV-1 antibody reactivity, and (c) reporting results to CDC.

AIDS Serodiagnosis↗

PubMedDate not supplied

The evolution of standards. From capability of performance to demonstrated performance.

Standardization of performance expectations and accountability for nursing care have been an integral part of nursing departments for many years. The Joint Commission on Accreditation of Hospitals (JCAHO) has used the nursing standards manual to evaluate a nursing division's capability to provide quality care. In this article, the way in which a meaningful quality assurance system is developed is discussed. The aspects discussed in depth are (1) development of standards that define performance; and (2) quality assurance measures that audit performance. By following the steps outlined, a nursing department will have progressed from describing the nurse's capability to provide optimum care to demonstrating optimum performance.

Fluid Therapy↗

PubMed1988

The use of performance-based assessment scores and traditional measures in predicting first-year residency performance.

The purpose of this study is to examine the relationship between students' performance on a performance-based clinical examination and their subsequent performance during the first year of residency. Additionally, its purpose is to further examine the relationship between the performance-based clinical examination and existing measures of clinical competence (clerkship ratings, and NBME Part I and II scores).

Clinical Clerkship↗

PubMed1993

Patterns of performance on the verbal and performance subtests of the Wechsler Adult Intelligence Scale-Revised: some Australian data.

The pattern of performance of 345 vocational guidance clients on the WAIS-R was examined in relation to previous studies of client populations. An exploratory principal axis factor analysis was conducted, and two factors that accounted for 89% of the total variance were selected. These comprised a general factor on which the Verbal subtests loaded most highly and a smaller Performance subtest factor. A hypothesis-testing approach was undertaken as a second step, using multiple group analysis. Two factors (which correlated .58) accounted for 65% of the total variance. The first factor (51%) was also a general factor on which all subtests, but moreso the Verbal tests, loaded highly. The second factor was dominated by Performance subtests. Implications for special client samples and intellectual assessment are discussed.

Adolescent↗

PubMed1998

The effects of creatine supplementation on high-intensity exercise performance in elite performers.

The aim of this research was to determine whether creatine supplementation at a dose of 20 g x day(-1), given in 4 x 6-g doses (5 g creatine monohydrate and 1 g glucose) for 5 days, was effective in improving kayak ergometer performances of different durations. Sixteen male subjects with the following characteristics [mean (SEM)]: age 21 (1.2) years, height 170.2 (1.7) cm, weight 75.3 (2.3) kg, sigma8 skinfolds 59.3 (2.6) mm, and maximal oxygen consumption 67.1 +/- (4.3) ml x kg x min(-1), undertook three maximal kayak ergometer tests of 90, 150 and 300 s duration on a wind-braked kayak ergometer (CON). Two groups were then randomly formed, with one group taking the supplement (SUP) while the other took a placebo (PLAC). No pre-test differences existed between the SUP and the PLAC groups in any of the variables measured. After supplementation each group then repeated the same kayak ergometer tests as performed previously and after a 4-week "washout period" the groups took either the PLAC or SUP for another 5 days and then completed the final tests. The SUP group completed significantly more work than either the CON or PLAC groups in all of the tests (90 s, P < 0.01; 150 s, P < 0.001; 300 s, P < 0.05). Body mass remained stable throughout the test period in both the CON and PLAC groups, but both were significantly less than the SUP body mass of 77.3 (1.0) kg (P < 0.01). The results of this work indicate that creatine supplementation can significantly increase the amount of work accomplished during kayak ergometer performance at durations ranging from 90 to 300 s.

Adult↗

PubMed1996

High performing rats are more sensitive toward catecholaminergic activity enhancer (CAE) compounds than their low performing peers.

Two breeds of rats, Charles River Wistar [Crl(Wi)Br.] and HSD Wistar [Wistar per LATI (Budapest) Br.], with remarkable difference in learning performance were selected. The rats were trained in the shuttle box with 100 trials per day and the number of conditioned avoidance responses (CARs), the escape failures (EFs) to the unconditioned stimulus and the intersignal reactions (IRs) were counted and evaluated by multi-way analysis of variance (ANOVA). Rats of the Crl (Wi) breed proved to be the 'low performing' (LP) animals and rats of the Wistar per LATI (Budapest) breed the 'high performing' (HP) ones. The HP rats produced higher number of CARs (p<0.001), lower number of EFs (P<0.05) and higher number of IRs (P<0.01) than their LP peers. Significantly higher amounts of noradrenaline from the locus coeruleus and serotonin from the raphe were released in the HP than in the LP rats (p<0.01). There was no difference between HP and LP rats in the amount of dopamine released from the striatum, the substantia nigra and the tuberculum olfactorium. The catecholaminergic activity enhancer (CAE) substance, 1-phenyl-2-propylaminopentane HCl, [(-)PPAP], which enhances action potential-transmitter release coupling in the catecholaminergic neurons, fully antagonized in a dose of 1 mg/kg, tetrabenazine-induced learning depression in HP rats and this dose was ineffective in LP rats. The findings were regarded as further support for the view that endogenous CAE substances regulate catecholaminergic activity in the brain and (-)PPAP acts via this regulation.

Animals↗

PubMed2001

Self-monitoring enhances Wisconsin Card Sorting Test performance in patients with schizophrenia: performance is improved by simply asking patients to verbalize their sorting strategy.

Patients with schizophrenia have Wisconsin Card Sorting Test (WCST) deficits, which are commonly interpreted as reflecting frontal cortex-based executive dysfunction. One means of assessing the refractoriness of frontal-executive impairment is to utilize a training or modification strategy to improve WCST performance. In this study, 73 patients with schizophrenia were assigned to 1 of 2 groups. Group 1 received the standard WCST instructions for 64 cards (Condition 1). For the second 64-card deck, the patients were asked to verbalize the reason that they placed the card where they did after each sort (Condition 2). Group 2 received this modified instruction 1st (Condition 1) and then the standard instructions for the second deck (Condition 2). A group of normal comparison participants was also tested using standard instructions alone. Group 2 committed significantly fewer perseverative responses than did Group 1. Furthermore, there was no significant difference between Group 2 (Condition 1) and the normal participants. Group 1's performance improved when patients were exposed to the modified instructions (Condition 2). Additionally, poor premorbid factors and disorganized symptoms were associated with decreased benefit from the modified instructions across both groups. Cumulatively, these data suggest that a simple instruction may enhance executive function and impact WCST performance in patients with schizophrenia.

Adult↗

PubMed1990

Cognitive and motor deficits in the performance of an object retrieval task with a barrier-detour in monkeys (Cercopithecus aethiops sabaeus) treated with MPTP: long-term performance and effect of transparency of the barrier.

To assess the stability of neural deficits produced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), the performance of monkeys on an object retrieval (detour) task was studied. The task required retrieval of a banana slice from a transparent box open on one side and fastened to a tray in front of the cage. The orientation of the open side, position on the tray, and position of the banana in the box were manipulated to vary the difficulty of the trials. Six African green monkeys (Cercopithecus aethiops sabaeus) were treated with MPTP (1.5-1.6 mg/kg cumulative doses over 4-5 days) and compared with 5 saline-treated control monkeys. The MPTP-treated monkeys had no gross neurological deficits but did have motor and cognitive deficits during acquisition of the object retrieval task 8-12 months after treatment (J. R. Taylor, Elsworth, Roth, Sladek, & Redmond, in press). Performance on the task was examined for 3 months after it had been learned. The MPTP-treated subjects reached at the barrier (transparent side) significantly more than controls and were less successful at retrieving the reward on the 1st reach than controls. Although they took longer to initiate the reach and had more motor problems than controls, they were as likely as controls to retrieve the reward in the end. These deficits remained stable throughout testing. An opaque but otherwise identical box was used randomly on some trials. MPTP-treated subjects decreased barrier reaches to control levels on trials in which the opaque box was used, whereas motor problems increased compared with trials in which the transparent box was used. The task can detect subtle performance deficits similar to those found in Parkinson's disease.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗

PubMed2001

Attributions of the "causes" of group performance as an alternative explanation of the relationship between organizational citizenship behavior and organizational performance.

The purpose of this study was to examine the possibility that feedback regarding team performance may influence team members' reports of organizational citizenship behaviors. Ninety-five teams of business students (N = 412) participated in a labor-scheduling simulation over a local area network. Teams were provided with false negative, false positive, or neutral feedback regarding their performance. Results support the hypothesis that the perception of 2 forms of organizational citizenship behavior (helping behavior and civic virtue) in work groups may, in part. be a function of the nature of the performance feedback that group members receive. However, negative feedback appears to play a more critical role than positive feedback in this attributional process. Possible reasons for these findings, as well as their implications, are discussed.

Adult↗