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At least 235 records · Page 13Linked to original sources

PubMed1999

How should the obese patient be managed? Possible approaches to a national obesity management network.

There is clearly a need for novel approaches to obesity and its management. This has been addressed by the Czech Society for the Study of Obesity, which established a multi-level obesity management network in response to the increasing prevalence of obesity in the Czech Republic. This network includes obesity management centres attached to major teaching hospitals, combined with input from obesity specialists, other specialists, primary healthcare physicians and weight reduction groups. Such an obesity management system aims to provide appropriate diagnostic and treatment facilities for various degrees of obesity throughout the country. The proposed density of the obesity management network takes into account the limited resources in the healthcare system. The network is designed to overcome the current poor level of understanding of obesity and the lack of time and financial resources which have been the most significant barriers to more involvement of primary care physicians in obesity management. In order to implement this system, a comprehensive education programme on obesity was initiated with postgraduate courses for obesity specialists and with training for counsellors of weight reduction groups.

Czech Republic↗

PubMedDate not supplied

Electronic managed care: the utilization of information technology in a managed care environment.

Health care managers must use information technology in managed care negotiations with all players in the managed care model-employers, managed care organizations, providers, and patients. Information technology effectuates these negotiations, provides a value added to all those involved in terms of efficiency and communication, and helps managers remain within regulations. This article describes each phase of the managed care model and how information technology is used. It also provides an operational overview of how to integrate the technology into health care settings.

Health Facility Administrators↗

PubMedDate not supplied

Strategy management system in perinatal services: the role of a patient resource manager.

The purpose of this article is to illustrate the role of a patient resource manager in an academic healthcare organization which has implemented a strategy management system. This management system is composed of communication tools organized in a balanced scorecard to support/promote ongoing growth and development using Kaplan and Norton's Strategy Management System. The historical development of Duke University Health System (DUHS) is presented articulating the mission, vision, and strategic agenda of the DUHS with the Clinical Service Unit initiative and its relevance to Women's Services. Kaplan and Norton's 5 core principles of the strategy management system are applied to Women's Services with implementation and evaluation of the patient resource manager role. Moreover, outcomes are discussed using the Balanced Scorecard. Lastly, implications and recommendations for replication of this system are summarized for ongoing development in this continuous learning organization.

Academic Medical Centers↗

PubMedDate not supplied

Emergency department case management: the dyad team of nurse case manager and social worker improve discharge planning and patient and staff satisfaction while decreasing inappropriate admissions and costs: a literature review.

A model of emergency department (ED) case management consisting of a social worker and a nurse case manager can prevent inappropriate admissions, improve discharge planning, decrease cost, and enhance patient satisfaction.3 The individual and combined roles of the dyad team of social worker and nurse case manager are discussed. A literature review includes how a case management dyad team of social worker and nurse case manager in the ED can decrease utilization of the ED for nonemergent visits, promote the use of community resources, and improve discharge planning to avoid excessive costs. The importance of the dyad team working with the interdisciplinary team in the ED, the primary care physician (PCP), and other community health care providers in order to provide a holistic approach to care is addressed. A discussion about the improvement of both patient and staff satisfaction demonstrates the results of case management strategies that support and advocate for patients to receive quality, cost-effective care across the health care continuum, while decreasing the use of the ED for nonemergent care.

Case Management↗

PubMedDate not supplied

Emergency department case management: the dyad team of nurse case manager and social worker improve discharge planning and patient and staff satisfaction while decreasing inappropriate admissions and costs: a literature review.

A model of emergency department (ED) case management consisting of a social worker and a nurse case manager can prevent inappropriate admissions, improve discharge planning, decrease cost, and enhance patient satisfaction. The individual and combined roles of the dyad team of social worker and nurse case manager are discussed. A literature review includes how a case management dyad team of social worker and nurse case manager in the ED can decrease utilization of the ED for nonemergent visits, promote the use of community resources, and improve discharge planning to avoid excessive costs. The importance of the dyad team working with the interdisciplinary team in the ED, the primary care physician (PCP), and other community health care providers in order to provide a holistic approach to care is addressed. A discussion about the improvement of both patient and staff satisfaction demonstrates the results of case management strategies that support and advocate for patients to receive quality, cost-effective care across the health care continuum, while decreasing the use of the ED for nonemergent care.

Case Management↗

PubMed1998

Medical managers can make research-based management decisions.

The paper has three messages. First, doctors in management can use evaluation methods and research to make better management decisions and to manage projects. Second, health policy makers and managers can no longer afford not to make a greater use of evaluation in making and implementing decisions. Third, the model of evidence-based medicine is not appropriate for management decisions, but there are other approaches which can be used to develop evaluation-informed health management.

Decision Making, Organizational↗

PubMed1994

Future management opportunities for minorities in managed care.

Current proposals for health care reform emphasize managed care in an effort to achieve universal coverage and access to health care for all Americans. One of the many strategies to achieve this goal is to create a new health care workforce by supporting the recruitment and education of health professionals from population groups underrepresented in health care. To help insure that the managed care industry will be adequately prepared to face the challenges of reform, the Group Health Foundation of the Group Health Association of America, Inc., has crafted an innovative Minority Training Program--a management training program in the field of managed care. The program involves resident fellows who will train in select health maintenance organizations (HMOs) in the Washington, DC/Baltimore metropolitan area. To augment training, the fellows will simultaneously participate in a comprehensive didactic program especially designed to prepare each fellow for a first or middle-management position in an HMO or a similar managed care organization. Following successful completion of the first years in Washington, DC, the program will be broadened to other geographical areas.

Health Facility Administrators↗

PubMed2002

Racial/ethnic variation in asthma status and management practices among children in managed medicaid.

OBJECTIVE: Racial/ethnic disparities in hospitalization rates among children with asthma have been documented but are not well-understood. Medicaid programs, which serve many minority children, have markedly increased their use of managed care in recent years. It is unknown whether racial/ethnic disparities in health care use or other processes of care exist in managed Medicaid populations. This study of Medicaid-insured children with asthma in 5 managed care organizations aimed to 1) compare parent-reported health status and asthma care processes among black, Latino, and white children and 2) test the hypothesis that racial/ethnic variations in processes of asthma care exist after adjusting for socioeconomic status and asthma status. METHODS: This cross-sectional study collected data via telephone interviews with parents and computerized records for Medicaid-insured children with asthma in 5 managed care organizations in California, Washington, and Massachusetts. The American Academy of Pediatrics (AAP) Children's Health Survey for Asthma was used to measure parent-reported asthma status. We used multivariate models to evaluate associations between race/ethnicity and asthma status while controlling for other sociodemographic variables. We evaluated racial/ethnic variations in selected processes of asthma care while controlling for other demographic variables and asthma status. RESULTS: The response rate was 63%. Of the 1658 children in the respondent group, 38% were black, 19% were Latino, and 31% were white. Black children had worse asthma status than white children on the basis of the AAP asthma physical and emotional health scores, symptom-days, and school days missed in the past 2 weeks. Latino children had equivalent AAP scores but missed more school days than white children. On the basis of the AAP asthma physical health score, the black-white disparity persisted after adjusting for other sociodemographic variables. After adjusting for sociodemographic variables and asthma status, black and Latino children were less likely to be using inhaled antiinflammatory medication than white children (relative risk for blacks: 0.69; relative risk for Latinos: 0.58). They were more likely to have home nebulizers. Other processes of asthma care, including ratings of providers and asthma care, use of written management plans, use of preventive visits and specialists, and having no pets or smokers at home, were equal or better for minority children compared with white children. CONCLUSIONS: Black and Latino children had worse asthma status and less use of preventive asthma medications than white children within the same managed Medicaid populations. Most other processes of asthma care seemed to be equal or better for minorities in the populations that we studied. Increasing the use of preventive medications is a natural focus for reducing racial disparities in asthma.

Black or African American↗

PubMed1993

The materiel manager's role in executive management.

The ability to achieve advancement for materiel management is a potential that few have challenged and achieved. Reasons for this lack of growth vary in degree, but the opportunities in the 1990s will be tremendous. The political skill and team leadership ability expressed by materiel managers throughout hospitals will ultimately result in whether this challenge is met or not. Materiel managers will need certainly to change their perception of their own role, as well as the perception of hospitals, in order to achieve this. The road will be challenging, but with the winning attitude, skill building, and proven management ability, I believe that materiel managers will become successful in hospital executive management in the 1990s.

Attitude of Health Personnel↗

PubMedDate not supplied

Managing the multi-cultural laboratory, Part II: Tools for managing the differences.

This second article provides practical advice from managers in a variety of industries who have first-hand experience as multi-cultural managers. It will help laboratory professionals make practical application of two conceptual models in managing their culturally diverse employees. The advice covers such areas as performance standards, interpersonal skills, language issues, and other management practices. The first article explained what is meant by "culture" and featured the research-based model set forth by Dutch social psychologist and management consultant, Dr. Geert Hofstede. His four dimensions of culture (Power Distance, Masculinity/Femininity, Individualism/Collectivism, and Uncertainty Avoidance) provide a useful framework for assessing the different values, attitudes, and behaviors exhibited by those of different cultural backgrounds. In this article, abbreviated reference tables are presented that make these cross-cultural data more useful for management decision making. Laboratory supervisors can use both the models and the advice to challenge their own built-in cultural biases and to meaningfully interpret some of the attitudes and behaviors of culturally diverse coworkers and employees.

Communication Barriers↗

PubMed1988

Information management: emergence of a new deal. Roundtable on information management.

Is a new position in healthcare management--the chief information officer (CIO)--emerging? As yet, there is no clear answer. However, if such a management position were to emerge, it could be one that facilitates and coordinates the informational interests of the CEO, CFO, and others in the healthcare organization. This position and others on the management team could work together in a cooperative and mutually supportive relationship. In a roundtable discussion sponsored by HFMA, six individuals, part of a CIO advisory panel for the Healthcare Information and Management Systems Society, met to discuss up-coming issues in information management. In this discussion, trends in information management, characteristics of the ideal CIO, and the relationship between the CFO and CIO were explored.

Efficiency↗

PubMed1999

Public substance abuse and managed behavioral healthcare. American Managed Behavioral Healthcare Association and National Association of State Alcohol and Drug Abuse Directors, Inc.

In the interest of establishing a dialogue between state policy makers and commercial managed behavioral healthcare organizations, the American Managed Behavioral Healthcare Association (AMBHA) and the National Association of State Alcohol and Drug Abuse Directors (NASADAD) met to facilitate collaborative efforts around the use of managed care strategies in public substance abuse systems. Although diverse in their respective opinions on numerous issues, state substance abuse directors and AMBHA representatives identified several areas of agreement on which to build future dialogues. The provision of addictions treatment is complicated by the multiple priorities established by purchasers. Clinically sound service necessity criteria must be constructed in ways that acknowledge this complexity. Uniform clinical necessity criteria are needed and must be applied in ways that facilitate, rather than inhibit, consistent access to care. Benefits plan designers must ensure a balanced relationship among benefits, outcomes and price and must hold care managers accountable for performance and results. Participants agreed that open and fair competition is in the public interest and that this competition should be structured to preserve the values that protect vulnerable populations. Because public providers have developed significant expertise in offering a broad array of effective treatment and support services, they should be incorporated into both public and private systems of care. State substance abuse authorities can assist providers in developing the capacity to participate in managed systems by supporting training, conducting managed care readiness assessments and adopting uniform treatment guidelines. More uniform performance and outcomes measures would help the field demonstrate its value and these systems should be based on streamlined data collection and timely incorporation of data into quality-improvement efforts. The addictions treatment community, like other components of the healthcare system, can benefit from the adoption of quality-improvement programs that are data-driven and outcome-oriented and that document the positive results achieved by both public and private providers.

Economic Competition↗

PubMedDate not supplied

[The management of the risk due to the manual lifting of patients in a hospital risk-management program].

Application of Law 626/94 in the health care area is still only partial and in many respects practically in the initial stages. This is due to a number of causes, including the special features of this sector and the extreme variability and diffusion of the risk factors involved. Assessment of risk, especially the newest ones (from manual patient handling to biological agents) involves considerable difficulties, also because the usual methods cannot be applied. The process of assessment and especially the management of risks in this sector is an extremely complex problem, and to address it requires the creation of an organized structure within the hospital consisting of a general manager, or a person delegated by the same, the medical director, the administrative director, the certified occupational physician, the director of prevention and protection. This management team must be flexible in character, draw up strategic plans according to priority criteria, periodically assess the state of advancement of the plans that will be carried out in phases. It is also necessary to ensure the active cooperation of worker safety representatives and of other experts who may be involved in the various topics addressed from time to time. The authors propose a method used in a three-year project, still under way, for the assessment of risk due to manual patient handling in a major Italian hospital; the data obtained from an assessment made in 58 wards were the following: about 60% of the wards showed a medium-high exposure level, 24% negligible exposure levels and 13.8% zero exposure due to the absence of disabled patients. On the basis of the initial data obtained from health surveillance programmes on a group of 431 exposed subjects, about 10% were judged fit with limitations due to spinal disorders. The main problems that have arisen (management, organisation, training, transfer of workers with limited job fitness, accreditation) are discussed. The method proposed for management of risk due to manual handling of patients is considered suitable for other risk factors, within the framework of a more far reaching programme for application of Law 626/94, as a means of permanent management of risk in a particularly complex working environment such as that of a hospital.

Humans↗

PubMed2002

Strategies for managing injectable drugs in a managed care setting.

Injectable medications represent one of the fastest growing and most expensive categories of prescription drugs with costs rising to $26 billion by 2006. Historically, managed care organizations have not aggressively overseen this area of the prescription benefit, resulting in a disjointed system. However, a growing number of MCOs are developing programs to better manage injectable medications. Key components of these programs include sophisticated infrastructure, clinical management, consolidated databases, and improved pharmaceutical contracting. This article presents a new model for managing injectables, illustrated by the implementation of a comprehensive injectables' management program for a large managed care population that resulted in a 12:1 return on investment.

Chronic Disease↗

PubMed1994

Managed competition and managed care. What are the ethical issues?

Managed competition and managed care, two hallmarks of President Clinton's health care reform proposal, would significantly change the way that health care in the United States is structured and delivered. This article presents ethical debates about managed care in historical perspective, reviews ethical arguments for and against managed care systems, and concludes with a set of practical guidelines to govern existing managed care arrangements. Throughout the paper, special attention is devoted to the impact of managed care on the elderly population and on physician-patient relationships.

Aged↗

PubMed1996

The challenge of managing laboratory information in a managed care environment.

This article considers some of the major changes that are occurring in pathology and pathology informatics in response to the shift to managed care in the United States. To better understand the relationship between information management in clinical laboratories and managed care, a typology of integrated delivery systems is presented. Following this is a discussion of the evolutionary trajectory for the computer networks that serve these large consolidated healthcare delivery organizations. The most complex of these computer networks is a community health information network. Participation in the planning and deployment of community health information networks will be important for pathologists because information management within pathology will be inexorably integrated into the larger effort by integrated delivery systems to share clinical, financial, and administrative data on a regional basis. Finally, four laboratory information management challenges under managed care are discussed, accompanied by possible approaches to each of them. The challenges presented are (1) organizational integration of departmental information systems such as the laboratory information system; (2) weakening of the best-of-breed approach to laboratory information system selection; (3) the shift away from the centralized laboratory paradigm; and (4) the development of rule-based systems to monitor and control laboratory utilization.

Community Networks↗

PubMed1996

Case management: a management system for quality and cost effective outcomes.

1. Case management is an effective strategy for occupational health nurses to use to reduce corporate health insurance, workers' compensation, and disability expenditures. 2. Case management has evolved from a reactive to a proactive strategy useful in many arenas. While there are differences among group health, workers' compensation, and disability, the basic case management process is the same. 3. Early intervention and comprehensive assessment are the foundation of a successful case management process. 4. Occupational health nurses have extensive clinical, interpersonal, and management skills enabling them to excel as case managers.

Case Management↗

PubMed1997

Managing patient care in a case management model: elements for success.

The challenge in the current health care environment is providing high-quality patient care at low cost. This shift to managed care has made the delivery of patient care more complex. Case management models continue to evolve to meet the demands for cost-effective care with measurable quality outcomes. Essential management skills for first-line managers and case managers are discussed. Education, training, and performance requirements for a case management model are presented. The development and implementation of clinical protocols as a tool to guide the delivery of patient care across the continuum and the requirement for variance analysis are included.

Case Management↗