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PubMed1986

Systems analysis of schools of allied health using Leavitt's Organizational Model: a meta-analysis.

Schools of allied health are relative newcomers to the formal academic setting. Consequently, these new academic units are particularly vulnerable to external threats to survival as they struggle to achieve acceptance by faculty and administrators in the traditional disciplines. This paper describes an application of Leavitt's Organizational Model for systems analysis of schools of allied health. A meta-analysis of studies reported in the Journal of Allied Health was conducted to provide administrative insight for the model's dimensions of task, structure, technology, and people. The model is helpful in organizing information and predicting effects of intervention strategies when any single dimension is changed. By viewing schools of allied health from a holistic perspective, deans and chair persons can anticipate the effect of change on variables (dimensions) other than those being manipulated and weight intervention strategies before their adoption.

Humans↗
PubMed1990

Case management organizational models & administrative methods.

Case management is one of the more popular buzzwords in the health care marketplace today. It is also commonly misunderstood. Virtually all providers have some experience with case management activities, either as direct providers of service, or as health care providers who interact with other agencies that practice case management on behalf of clients. This article will define some of the leading organizational models of case management programs and explain the implications of their alternative practice philosophies. This discussion is followed by an outline of the essential core elements of any case management program. Agencies can compare their own case management methods to widely recognized standards that characterize successful strategies used by different organizations throughout the United States.

Home Care Services↗
PubMed1999

On organizational models for clinical education.

For reasons more epistemological than pedagogical, the preclinical, theoretical part of allied health education can be provided by a relatively small number of faculty in a centralized educational institution. Clinical education, however, is pluralistic, requiring a variety of clinical teachers, who use a variety of clinical approaches, in various clinical settings. Three models for the organization of clinical education are explored: 1) the external model, in which theory teaching is offered in an educational institution relatively divorced from clinical teaching provided in clinical service settings; 2) the internal model, in which both theory and clinical teaching are provided in the same institution; and 3) the bridging model, in which educational and clinical service institutions remain organizationally separate but with bridging arrangements to facilitate the clinical education. The advantages and disadvantages of each model are considered.

Allied Health Personnel↗
PubMedDate not supplied

Completing the hospice organizational model.

Hospices must be thought of as still being in their formative stages. We need not be satisfied with staffing arrangements and practices that, largely for reasons of expediency and the lack of other models, were inherited from other healthcare agencies or foisted on us by federal bureaucrats and third party payers. These external demands will be countered and features unique to hospices created only to the extent that all of us are clear about what we most need and want for ourselves as staff. That is how we created the patterns used in working with clients. Now let us use the same ingenuity in fashioning ways of working among ourselves.

Health Personnel↗
PubMedDate not supplied

[Independent medical processing enterprises as innovative organizational model for market of medical services].

In Russia, current stage of health care development is characterized by occurrence of various problems. Most of them are related to cooperation between participators of market of medical services. Different options are proposed to resolve cooperation problems embedded into medical services market with emphasis on development of ultimately different medical processing enterprise with brand-new organizational and functional structure. Its functioning is based on process management logistics. The company broad professional experience allows to implement above-mentioned managerial structure and make it function as well as claims positive perspectives of described option.

Health Care Reform↗
PubMed1992

[Major ambulatory surgery: organizational models].

In this essay, the authors provide a definition for those medical care facilities representing a consolidated alternative to traditional hospitalization. These facilities can be basically ascribed to the following patterns: day case surgery; day-hospital activity; home-care. Day case surgery is a complex and, in most cases, interdisciplinary procedure; this type of activity necessitates a pre-hospitalization period and often also a "protected discharge" or even a home-care service. Some specific criteria regarding day surgery activity have been defined as follows: the main criteria have a clinical nature, but they interact with others belonging to a social and structural-organizational order. The Royal College of Surgeons of United Kingdom has officially recognized in 1985 this medical care typology as one of the constituents of surgical care, and has evaluated that at least 1/3 of the overall operations could be carried out as day care surgery. In the United States, besides hospital and ambulatory surgery activity, a new pattern known as "free-standing center" has been promoted; in 1993, 35% of the operations is expected to be carried out in day case surgery centers. As far as Italy is concerned, in 1988 only day-hospital practice has been adequately recognized as an alternative medical care facility to traditional hospitalization. The Emilia Romagna region, in order to increase day case surgery activity, has issued in 1991 a list of 53 DRGs, in which day bed units treatment was possible. Up to now, however, only a small part of these diseases is treated on a day case surgery basis.

Ambulatory Care Facilities↗
PubMed1996

From research to practice: one organizational model for promoting research-based practice.

This paper describes a framework used by the National Institute for Nursing in Oxford to integrate research, development and practice. With the increasing attention given to the topic of how research findings are implemented into clinical practice, it was felt important to share the challenges that have arisen in attempting to combine traditional research activities with more practice-based development work. The emerging conceptual framework, structures and functions are described, highlighting the variety of partnerships to be established in order to achieve the goal of integrating research into practice. While the underpinning principles of the framework-generating knowledge, implementing research into practice and evaluating the effectiveness of programmes-are not new, it is the way they have been combined within an organizational structure that could be helpful to others considering such a strategy. Both the strengths and weaknesses of the framework are discussed, a number of conclusions drawn as to its robustness and consideration given to its replication.

Diffusion of Innovation↗
PubMed2006

[The observation unit and patients with chest pain--an efficient organizational model?].

BACKGROUND: Patients with chest pain make up 5-8% of all acute admissions to a department of internal medicine. Many of these patients could be discharged safely after a limited period of observation. Aker University Hospital opened an observation unit in the autumn of 2000, but for organizational reasons closed the ward on weekends for 4 months in the autumn of 2001. METHOD: This study assessed the effect of this observation unit on the average admission time (in days) for patients who presented with chest pain. This was a retrospective cohort study which compared the average admission time for patients admitted on Fridays and Saturdays in the autumn of 2001 (n = 75), compared with those admitted in the autumn of 2000 and 2002 (n = 100). RESULTS: The two groups are directly comparable with regards to age, gender, general risk factors, pre-morbid hospitalization and co-morbidity. The average hospital stay was 3.84 days when the unit was closed, as opposed to 2.59 days when it was in operation. Corrected for age and previous cardiac illness, the closing of the observation ward led to an increase in hospital stay by 1.11 days, p = 0,001. This corresponded to an increase in average admission time of 43%. Most of this difference was accounted for by a higher discharge rate within 24 hours when the unit was in operation. There was no increase in the number of readmissions within 30 days. CONCLUSION: The observation unit leads to a meaningful shortening of admission time for patients with chest pain. This has not previously been shown in a Norwegian hospital.

Adult↗
PubMed1991

Modeling organizational determinants of hospital mortality.

This study examines hospital characteristics that affect the differential in hospital mortality. Death rates for 1984 Medicare inpatients in acute care hospitals, released by the Health Care Financing Administration in 1986, were analyzed. A confirmatory statistical approach to organizational determinants of hospital mortality was formulated and validated through an empirical examination of 239 hospitals. The findings suggest that the effect of hospital size and specialization on mortality was a spurious one when the effects of other variables were simultaneously controlled. A positive association existed between service intensity and hospital mortality: the more hospital services consumed, the higher the mortality rate. Community attributes accounted for more variance in hospital mortality rates than did organizational attributes. The organizational and community factors studied explained 27 percent of the total variance in hospital mortality.

Catchment Area, Health↗
PubMedDate not supplied

Appraisal of the coordinator-based transplant organizational model.

In 1999, the Italian Parliament passed a law aimed at setting the standards of practice and quality in organ, tissue and cell donation, and transplantation. For the first time in the history of Italian transplantation, a coordinator-based model reproducing some of the basic principles of the Spanish system was officially enacted by the Parliament, bringing to an end years of lacking regulation. What differentiates those coordinator-based systems adopted in Southern Europe from Northern European national and multinational transplant organizations is the functional integration of donor and transplant care activities enacted by national governments. The Italian model of transplant health care consists of four levels of transplant coordination: local, regional, interregional, and national. The latter is represented by Centro Nazionale Trapianti (CNT; the Italian National Center for Transplantation). CNT objectives consist of ensuring equitable access to donation and transplant care for all citizens according to the principles of the Italian National Health System. In achieving these goals, CNT acts in cooperation with three interregional transplant agencies: the Nord Italia Transplant program, the Associazione InterRegionale Trapianti, and the Organizzazione Centro Sud Trapianti. Whereas local and interregional coordinators are at the front line of all donation and transplant activities, regional and national coordinators function to monitor, direct, and plan donation and transplant health care activities. Based on the increase in donation and transplant activities recently achieved in those countries that have adopted a governmental coordinator-based transplant care model, we believe that such a system is appropriate to serve patients' interests according to the principles of subsidiary and equity. However, it should further be improved by expansion of the governance model throughout Europe, through implementation of current standards of care, and by adopting the definition of common European objectives, health care strategies, and research integration.

Europe↗
PubMed1988

Sunnybrook's matrix organizational model--moving ahead.

Traditionally, hospitals have denied the true intricacy of their organization by forcing all reporting relationships into a single structure. To address this complexity, Sunnybrook has developed three independent, yet interrelated, organization dimensions. Three structures--the traditional, the clinical unit and the programmatic dimension--provide a better link of accountability by holding departments responsible for the efficiency of their operations, holding physicians accountable for the resource implication of volume and case mix, and ensuring that the activities of the hospital's departments and clinical units are in line with hospital's overall mission and programs.

Hospital Administration↗
PubMed2001

Framework PEACE: an organizational model for examining physical exercise across the cancer experience.

The primary purpose of this article is to provide a framework for organizing research on physical exercise and cancer control. A secondary purpose is to use this framework to provide an overview of the extant literature and to offer directions forr future research. The proposed framework, entitled Physical Exercise Across the Cancer Experience (PEACE), divides the cancer experience into 6 time periods: 2 prediagnosis (i.e., prescreening and screening/diagnosis) and 4 postdiagnosis (i.e., pretreatment, treatment, posttreatment, and resumption). Based on these time periods, 8 general cancer control outcomes are highlighted. Two cancer control outcomes occur prediagnosis (i.e., prevention and detection), and 6 occur postdiagnosis (i.e., buffering, coping, rehabilitation, health promotion, palliation, and survival). An overview of the physical exercise literature indicates that only I time period (i.e., prescreening) and cancer control outcome (i.e., prevention) has received significant research attention. Some time periods (i.e., treatment and resumption) and cancer control outcomes (i.e., coping and health promotion) have received modest research attention, whereas other time periods (i.e., screening/diagnosis, pretreatment, and posttreatment) and cancer control outcomes (i.e., detection, buffering, rehabilitation, palliation, and survival) have received only minimal attention. It is hoped that Framework PEACE will stimulate a more comprehensive and in-depth inquiry into the role of physical exercise in cancer control.

Exercise↗