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Integration of intradisciplinary quality assessment into a multidisciplinary approach.

One challenge for the QA professional in healthcare today is initiating, coordinating, and facilitating QA programs that cross traditional departmental and discipline barriers and bring together multidisciplinary teams. When looking at healthcare from a customer's perspective, the QA professional must not isolate what nursing does for the patient, what the medical staff does for the patient, what pharmacy does for the patient, and so on. The imperative, instead, is to evaluate the healthcare as it truly is perceived and delivered-as a team effort. This article presents one method that uses the Joint Commission on Accreditation of Healthcare Organizations' 10-step model to create an effective multidisciplinary QA program.

Hospital Departments↗

Categorical differentiation and intergroup relationships.

In this study we attempted to replicate the well-known Doise & Sinclair (1973) procedure for manipulating category salience, in a different social context. We considered the relationship between two groups of professionals: doctors and nurses, as perceived by 40 members of the superior group. The results did not confirm those obtained by Doise & Sinclair since they showed reduced categorical differentiation when the out-group was evoked in advance of the intergroup evaluations. The implications of these findings for theories of social categorization and social identity are discussed.

Adult↗

Social workers and general practice.

Weekly case conferences have been found valuable in the management of problem families in a general practice in a new town. These are attended by health visitors, mental welfare and child care officers, welfare officers, and psychiatric social workers, as well as by the family doctors. The conferences are a quick and easy way of exchanging important information and leading to rapid decisions.

Adult↗

Seventeen years' experience of a voluntarily based drug rationalisation programme in hospital.

A study was carried out analysing the operation of a drug rationalisation programme in a central London teaching district that had evolved from experience over 17 years. Creation of a limited list of about 700 drugs had been achieved by local consensus. Drug selection was based on appraisal of efficacy, safety, and cost and was undertaken by means of collaborative participation of most consultant specialists in the district. Educative and other non-restrictive strategies for reinforcing the rationalisation policy had achieved a consistently high rate of compliance in prescribing recommended drugs. The concept of selectivity in drug use and its continuous local reappraisal had a beneficial impact on the prescribing habits of doctors at all levels of seniority as well as on the training of medical undergraduates and nurses in the therapeutic use of medicines. Peer review and self audit were encouraged by use of an extensive monitoring system which incorporated continuous "facilitative" dialogue between ward pharmacists and prescribers. Two models of drug rationalisation programme were studied, the second of which together with other local initiatives had been associated with substantial and sustained reductions in drug spending each year over nine years since 1978. It is concluded that the second drug rationalisation programme model substantially improves the cost effective use of drugs in hospital and furthermore has the potential of being extended to general practice, especially in types of prescribing that are common to both forms of patient care.

Drug Prescriptions↗

Who's a bully then?

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Health Personnel↗