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Group processes of decision making for hospital-based technology assessment committees.

There are a variety of group-judgment methods to resolve controversial issues in health care. Meta-analysis and group judgment methods such as consensus conferences are attempts to bring diverse elements of information together for synthesis. Leape notes that a significant body of literature exists regarding the techniques used to elicit opinions from groups. Organizational structures and functions of groups vary in terms of the natures of interactions among group members and the manners in which final conclusions are reached and expressed. The introduction of the process of technology assessment into the hospital setting introduces a problem inherent in the introduction of somewhat academic processes into the operational real world of interpersonal relations, administrative and medical staff interactions, staff costs, and institutional priorities. Hospital administrative processes are based on the committee approach. Medical staff credentialing, drug formularies, and administrative policies are all developed, approved, and implemented through committees. It would seem logical that if technology assessment is to be effective in the hospital setting, then those same group decision processes inherent in committees should be used in technology assessment. Relatedly, if technology assessment is to be successful in the hospital setting, then how can the limited resources of hospital-based staff be best utilized to carry through the assessment of elected technologies? This paper discusses group decision processes, particularly as they relate to technology assessment. The processes of particular interest are those that focus on group interactions rather than theory-based decision processes. The purpose for the paper is to provide to clinical engineering management and senior hospital management background information to use in the formulation of the operating parameters of a hospital-based technology assessment committee.

Biomedical Engineering↗
PubMed1994

Credentialing physicians for new technology: the physician's learning curve must not harm the patient.

Laparoscopic Cholecystectomy (L.C.) offers advantages that are realized only when patient safety is assured. In November 1990, The Department of Surgery at The New York Hospital Medical Center of Queens initiated a program to introduce this new technology to surgeons who had not performed the operation previously. A preceptorship program was initiated, accompanied by contemporaneous quality assurance review. This is the experience of 15 general surgeons who performed their first 400 L.C.s from November 1990 through March 1993. There were no deaths and only one common bile duct injury (0.25%).

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1979

Who makes decisions about new technology in hospitals?

Three top managers from different kinds of hospitals explain how decisions to buy expensive new technology are made in their institutions. Financial feasibility, competition with other hospitals, and the advantages of new equipment to patients and members of the medical staff are all considerations administrators must keep in mind when buying new equipment.

Costs and Cost Analysis↗
PubMed1994

Satisfaction, motivation, and commitment of senior medical record administration and medical technology students.

This study refined an existing Allied Health Career Attitude Scale (AHCAS) and measured the attitudes of a nationwide sample of students in medical record administration and medical technology. A survey of seniors enrolled in 35 medical record administration and 37 medical technology programs was conducted with 756 usable student responses. The 39-item questionnaire was used to measure the satisfaction of seniors with their career choice, motivation to participate in professional organizations, and career outlook. On the total scale, scores of medical record administration students were significantly more positive. No significant difference was found between groups on the subscale measuring satisfaction with career choice. Medical record administration seniors were significantly more positive on the subscale measuring motivation to participate in professional organizations and the subscale measuring career outlook. The paper contains various interpretations of these findings with suggestions for the use of the scale by allied health educators.

Career Choice↗
PubMed1997

A survey of outpatient visits in a United States Army forward unit during Operation Desert Shield.

Reports suggest that deployed soldiers during Operations Desert Shield and Desert Storm remained healthy, but primary care data are limited. We reviewed the outpatient visit surveillance data from the 3d Armored Cavalry Regiment to obtain information regarding soldiers' health in the field. Nontraumatic orthopedic problems accounted for the highest incidence of primary health care visits, followed by unintended injuries, gastrointestinal, respiratory, and dermatologic conditions. Visits for heat injuries, sexually transmitted diseases, unexplained fever, and psychiatric problems were low, probably due to preventive measures. These results suggest that increased prevention to decrease orthopedic problems and unintended injuries may substantially reduce outpatient visits during future deployments. Medical surveillance during future deployments can be improved by taking advantage of current advances in technology to facilitate patient data retrieval and provide timely information to first- and second-echelon medical personnel.

Ambulatory Care↗