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Results for “Knowledge Management”

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At least 649 records · Page 36Linked to original sources

PubMed1998

Practical intelligence at work: relationship between aging and cognitive efficiency among managers in a bank environment.

A study was conducted to determine which better predicts performance among bank managers: tacit practical knowledge as assessed by the Tacit Knowledge Inventory for Managers (TKIM) or 2 psychometric measures of reasoning, the Raven's Advanced Progressive Matrices (Raven's) and the Verbal Reasoning subtest of the Differential Aptitude Test (DAT). Two hundred bank managers (43 experts and 157 nonexperts), ages 24-59 years old, participated. Increased age was associated with lower performance in Raven's and the DAT but less so in the TKIM; best performing older managers on average had high levels of tacit knowledge, although they scored lower on psychometric reasoning measures; TKIM predicted managerial skill; DAT and Raven's did not. These results suggest that stabilization of some aspects of intelligence may occur in old age. Implications of the findings for the study of practical intelligence, expertise, and compensatory abilities are discussed.

Administrative Personnel↗

PubMed2006

Scientific evidence changes prescribing practice--a comparison of the management of the climacteric and use of hormone replacement therapy among Swedish gynaecologists in 1996 and 2003.

OBJECTIVES: To study changes in attitudes, knowledge and management strategies concerning hormone replacement therapy (HRT) among gynaecologists in Sweden. DESIGN: Comparative questionnaire study. SETTING: National survey. POPULATION: Practising gynaecologists. METHODS: In 1996, gynaecologists in Sweden (n= 1323) were invited to return a postal questionnaire concerning their attitudes, knowledge and management strategies concerning HRT. They were also asked about their own use of HRT. In 2003, a similar questionnaire was sent to practising gynaecologists (n= 1320) in Sweden. MAIN OUTCOME MEASURES: Attitudes to and personal use of HRT. RESULTS: The response rate was 76% in 2003 when 11% of the gynaecologists thought that all women without contraindications should be offered HRT compared with 44% in 1996 and 89% found it difficult to evaluate pros and cons with HRT in a clinical situation (74% in 1996). More gynaecologists in 2003 believed that HRT increased the risk for breast cancer (95% vs 71%). Twenty-five percent in 2003 stated that risk factors for osteoporosis were absolute indications for HRT (60% in 1996). Current ischaemic heart disease was considered to be an indication for HRT by 7% in 2003 (60% in 1996). In 2003, current use of HRT was reported by 71% of female menopausal gynaecologists (88% in 1996). CONCLUSIONS: Swedish gynaecologists were more cautious in their management strategies concerning HRT in 2003 compared with 1996, probably influenced by results from the Heart and Estrogen/Progestin Replacement Study (HERS) and Women's Health Initiative (WHI) studies. Current use of HRT was still high among female gynaecologists, although it had decreased since 1996.

Adult↗

PubMed2004

Comparison of knowledge on diarrheal disease management between two types of community-based distributors in Oyo State, Nigeria.

Community-based distributors (CBDs) have been trained and utilized to promote a variety of health commodities. In addition, a variety of different types of community residents have been trained ranging from traditional birth attendants (TBAs) to patent medicine vendors. A training programme for CBD agents in the Akinyele Local Government Area of Oyo State, Nigeria, provided the opportunity to compare the knowledge of two different types of CBD agents, TBAs and volunteer village health workers (VHWs). Although VHWs were younger and better educated than the TBAs, the two groups had similar levels of knowledge about diarrhea recognition, cause and prevention. It was common for the respondents to confuse diarrhea and dehydration in their answers about signs (recognition) and prevention, showing that at least they had some perception that the two conditions were connected. Overall knowledge results showed some gaps that may likely be a natural result of knowledge decay. The major lesson learned is that the type of CBD agent may not be as important as the fact that they receive follow-up after they have been trained.

Adult↗

PubMed1999

Promoting from within: the best way to build management.

One of the best ways to build knowledgeable, quality management is to promote from within the ranks of your organization. Allowing employees to work their way up the pyramid of promotion will give them the necessary knowledge to run your Call Center effectively and successfully.

Career Mobility↗

PubMedDate not supplied

Legal and regulatory education and training needs in the healthcare industry.

As in any other industry, laws and regulations significantly impact the functioning of the healthcare industry. Some laws, such as those relating to malpractice and social insurance systems, affect the manner in which the industry operates. Other laws, such as those regulating antitrust and employment practices, affect the organization and the environment in which the industry operates. It is increasingly important that practitioners and managers be cognizant of this complex and dynamic legal minefield. This study examined healthcare managers and executives' knowledge of 9 key issues in the legal and regulatory environment of the healthcare industry. Specifically, the study focused on knowledge concerning tort and contract liability, insurance law, labor and employment regulation, criminal and ethical responsibility, antitrust regulation, the law governing business associations and recent developments. Findings suggest that the levels of knowledge required to manage legal and regulatory issues are much greater than the existing levels of knowledge.

Antitrust Laws↗

PubMed2000

Management of osteoporosis: a survey of Israeli physicians' knowledge and attitudes.

BACKGROUND: Osteoporosis is the most common human bone disease. It affects millions of persons throughout the world and its prevalence will increase as the population ages worldwide. OBJECTIVE: To assess Israeli physicians' attitudes and knowledge with regard to management of osteoporosis. METHODS: A questionnaire was mailed to 1,900 Israeli physicians concerning their attitudes to the management of osteoporosis, their prescribing habits, and their knowledge on the pharmacological treatment of the disease. RESULTS: Replies were received from 19% of the physicians. The respondents encouraged physical activity and cessation of smoking for all women, and prescribed estrogen replacement as the main treatment for 50-year-old women. A relatively low level of knowledge was found regarding the adequate dosage of several of the pharmacological treatments. CONCLUSIONS: The findings of the present study stress the need to provide clear guidelines and to extend physicians' knowledge regarding the management of osteoporosis.

Adult↗

PubMed2002

Pancreatic trauma in the adult: current knowledge in diagnosis and management.

BACKGROUND/AIMS: Although pancreatic trauma, isolated or not, is uncommon, it carries significant morbidity and mortality because of the delay in recognition and consequent treatment. METHODS: The current knowledge of pancreatic injury, concerning the incidence, mechanism of induction, diagnosis, treatment, complications and outcome, is herein presented based on a literature review and our limited experience. RESULTS: The diagnosis of pancreatic trauma entails a high index of suspicion because neither clinical nor laboratory evaluation provide pathognomonic elements. Patients with penetrating injuries are usually evaluated during laparotomy, while those with a blunt trauma can be managed conservatively, provided they are in a stable condition, there is no pancreatic duct involvement and care is intensive. At laparotomy, minor pancreatic injuries are best managed by drainage. Distal pancreatectomy is best suited for distal pancreatic trauma with ductal involvement. For severe trauma, Roux-en-Y pancreaticojejunostomy, pancreaticogastrostomy, duodenal diversion operations and Whipple's procedure are all indicated according to the preoperative evaluation and intraoperative findings. Independent of the procedure to be performed, drainage is mandatory. CONCLUSION: Because pancreatic injury is rare, most general surgeons lack experience and ability to deal with such injured patients. Therefore, an experienced and skilled surgeon should govern the management of pancreatic trauma in order to minimize the incidence of morbidity and mortality.

Adult↗

PubMed2004

A framework for the application of knowledge technology to the management of diseases.

Medical diagnosis and treatment constitute a network of interrelated processes. The conventional method of medical diagnosis and treatment of diseases involves a state space search of the medical knowledge of diseases and patient history, which could be combinatorially explosive. This paper presents a report on the experimental study of an intelligent, interactive, user-friendly, knowledge-based system which performs a stepwise analysis of a patient's complaints, filtering cognitive and emotional elements to be able to make inferences. It applies both forward and backward chaining in making inferences concerning the management of disease. A case study of the system is carried out using some tropical diseases. It is believed that the system will serve as a useful contribution towards tropical medical informatics.

Computer Systems↗

PubMed1997

Bone marrow transplant nurses' knowledge, beliefs, and attitudes regarding pain management.

PURPOSE/OBJECTIVES: To measure bone marrow transplant (BMT) nurses' knowledge, beliefs, and attitudes regarding pain management. DESIGN: Descriptive, exploratory. SETTING: A 32-bed BMT unit in a 567-bed tertiary-care institution located in the midwestern United States. SAMPLE: 39 BMT nurses (20 pediatric, 19 adult). The mean length of BMT experience was 7.05 years. METHOD: BMT nurses completed a 49-item, investigator-developed questionnaire. MAIN RESEARCH VARIABLES: Nurses' knowledge, beliefs, and attitudes related to pain management. FINDINGS: Many BMT nurses had high knowledge levels and positive beliefs and attitudes related to pain management. The mean of correct responses to knowledge items was 79%. Nurses had a high knowledge level of pain assessment, but only 74% indicated that patient self-report of pain is the most reliable indicator of pain. The majority of the nurses' responses were congruent with literature sources regarding the onset of mucositis pain, self-report of pain, and opioid tapering. Most nurses agreed that pain management is rewarding and satisfying; fewer agreed that it is not stressful. Nurses' requests for information focused on opioid therapy. CONCLUSIONS: The investigators identified specific knowledge gaps. The variability of scores indicated that some nurses are more expert than others regarding pain management and therefore could be resources for other nurses. IMPLICATIONS FOR NURSING PRACTICE: Educational offerings can increase knowledge and promote positive beliefs and attitudes among BMT nurses, thereby enhancing pain management.

Adult↗

PubMedDate not supplied

Mother's knowledge of, attitudes toward, and management of fever in preschool children in Italy.

BACKGROUND: We examined mothers' knowledge of, attitudes toward, and management of fever in their children. METHODS: Interviews of mothers of preschool children were performed using a structured questionnaire administered by interviewers with no specific medical competence. RESULTS: Of a total of 1,237 mothers who were interviewed, data were analyzed for the 707 mothers who had coped with a febrile episode in their children during the previous month. Of these, 59% were concerned about fever in their children and 17% were very worried. At the onset of fever, 48% of the mothers gave their child an antipyretic and 18% called the physician immediately. In logistic regression analysis, five variables were significantly associated with mothers' concern: the absence of previous information on the management of fever, temperature > 39 degrees C, an only child, mother's low educational level, and mother's residency in the south of Italy. For the request for a physician's visit, of the variables entered, the only explanatory ones were the mother's concern and the absence of previous information on the management of fever. CONCLUSIONS: These findings suggest that informing mothers on the definition, consequences, and treatment of fever can significantly improve their confidence in managing fever, as reflected by fewer requests for physicians' visits.

Child, Preschool↗

PubMed2006

Patient education in asthma: a survey of physicians' knowledge of the principles and implementation of self management in practice.

BACKGROUND: Therapeutic patient education, particularly when including written instructions in self-management, improves outcomes in asthma. The education of patients in self-management requires specific knowledge and skills, which are not generally taught in under- or postgraduate training programmes. PURPOSE: To investigate physicians' knowledge of the principles and implementation of self-management in asthma care. METHOD: A 14-item questionnaire was developed, piloted and subsequently sent to 1039 general physicians (general practitioners and internists) and pulmonologists registered as members of the Medical Society of Zurich. RESULTS: 368 (35%) of the physicians returned the questionnaire. 352 (96%) stated that they care for patients with asthma, 312 (87%) provided asthma education, 264 (75%) gave information about the mechanisms of illness, 272 (77%) provided instructions on how to use inhalers although only 212 (60%) checked inhaler technique. 170 (48%) instructed patients in home measurement of peak flow recordings (PEFR). 21% of general physicians and 52% of pulmonologists provided written action plans outlining what actions to take if PEFR or symptoms deteriorated. The majority of physicians were aware of positive benefits of patient education and over 80% stated that all asthmatic patients should be offered education. Only 32% felt that they should personally be educating the patients whilst two-thirds expressed a preference for the education to be provided by a specialist centre. 66% of the physicians expressed a desire to undertake further training in effective patient education. CONCLUSION: Whilst most physicians in this study state to be aware of the benefits of patient education in asthma, only 24% actually provide their patients with asthma self-management plans. With a low response rate, our study is likely to be biased towards those physicians with a greater interest in asthma; hence actual use of self-management plans is likely be lower than in our sample.

Asthma↗

PubMedDate not supplied

Animated simulation: a valuable decision support tool for practice improvement.

Animated computer simulation is a powerful tool for healthcare operation improvement. As a decision support tool, it offers a systematic method to compare alternative approaches to healthcare operations. Because staff interaction is encouraged by this tool, simulation projects facilitate staff team building and process change ownership. Information that is not used as applied knowledge for the purpose of improvement is worthless. Simulation offers management detailed knowledge of processes, enabling management to make better-informed decisions by providing performance data, such as resource usage rates, patient wait times, capacity rates, and process performance information. Alternatives under consideration can be compared and modified without high financial, personal, and customer costs to the healthcare operation. The knowledge gained from each alternative's simulation response variables can be evaluated against set criteria, the status quo, and each other to determine the best option. Current automation systems and software products allow decision makers to use this tool without investing resources in errant options. A simulation project strategy with examples and a case study of change and renovation of a family practice clinic are provided.

Community Health Services↗

PubMed1994

Differences in the treatment of patients with acute myocardial infarction according to patient age.

OBJECTIVE: To identify age-related differences in the treatment of patients with acute myocardial infarction. DESIGN: Retrospective cohort study. SETTING: Two university-affiliated medical centers with integrated clinical programs. PATIENTS: 329 patients admitted with acute myocardial infarction in 1988-1990 for whom complete medical records were available. Study exclusions included patients transferred from other hospitals specifically to undergo angiography or other cardiac procedures, nursing home residents, patients with metastatic cancer or dementia, and patients in whom "do not resuscitate" orders were written during the first 2 hospital days. MEASUREMENTS: Medical records were reviewed to determine socio-demographic data, comorbidity, admission severity of illness, medications, the use of specific diagnostic and therapeutic modalities during and after hospitalization, treatment limitations, and patient outcomes. MAIN RESULTS: Chronological age of patients was related to the use of several diagnostic and therapeutic modalities. Using logistic regression to adjust for comorbidity, severity, infarct size and location, and other covariates, patients 75 years and older were 12 times less likely to receive thrombolytic therapy, 8 times less likely to undergo coronary angiography, and 7 times less likely to undergo coronary angioplasty than patients less than 65 years of age. However, age was not related to the use of other modalities, including echocardiography or gated blood pool scanning, pulmonary artery catheterization, and transvenous pacing. Finally, in a logistic regression model, the risk of in-hospital death was 4 times greater for patients 75 years and older than patients less than 65 years. CONCLUSIONS: Physicians' management of patients with acute myocardial infarction differed greatly according to patient age for some diagnostic and therapeutic modalities, but not for others. These findings indicate that generalizations about age-related practice variations should not be based on analysis of a single procedure. Moreover, judgments about the appropriateness of age-related differences in management require knowledge of the relative effectiveness of management strategies in older and younger patients.

Acute Disease↗

PubMed2003

Biomedical informatics training for dental researchers.

Dental researchers collaborating closely with biomedical informaticians have achieved many advances in oral health research, such as in mapping human genetics and addressing oral health disparities. Advances will continue to increase as dental researchers and biomedical informaticians study each others' disciplines to increase the effectiveness of their collaborative research. The combined skills will greatly increase the effectiveness of dental research. This manuscript summarizes the core of biomedical informatics curriculum (biomedical informatics knowledge, data management, and software engineering) for dental research. It also summarizes the obstacles that must be overcome for all dental research students to receive the training in biomedical informatics they require. These issues are: a lack of biomedical informatics faculty, a lack of biomedical informatics courses, and a lack of accreditation standards. Last, intra- and inter-institutional collaboration solutions are described.

Accreditation↗

PubMed1995

Evaluation of a knowledge-based decision-support system for ventilator therapy management.

Evaluation of knowledge-based systems differs from that of conventional systems in terms of verification and validation techniques. Furthermore, evaluating medical decision-support systems is difficult because the field is thus far comparatively unexplored. This paper presents an evaluation of a medical knowledge-based system called VentEx that supports decision-making in the management of ventilator therapy. Real patient data from 1300 hours of patient care involving 12 patients with 6 diagnoses are used to validate the knowledge base. The results range from 4.5% to 15.6% disagreement between the setting recommendations produced by VentEx and a gold standard, and 22.2% disagreement for recommendations for weaning. A comparison between the standard and two physicians showed that VentEx produced advice of the same quality as the physicians.

Databases, Factual↗

PubMed2002

Poor communication and knowledge deficits: obstacles to effective management of children's postoperative pain.

AIM OF THE STUDY: To explore the perceptions of nurses and parents of the management of postoperative pain in children. This paper focuses on issues of knowledge and communication. BACKGROUND: Nurses are the key health care professionals with responsibility for managing children's pain, however, nurses are not well supported educationally to manage the level of responsibility. RESULTS: Using matched interviews between 20 parents and 20 nurses many issues arose relating to the nurse/parent communication process. It was also clear that despite nurses' knowledge of pain management being deficient, they had expectations that required parents to have a level of knowledge they did not possess. CONCLUSIONS: The findings suggest that nurses' poor communication with parents and nurses' knowledge deficits in relation to children's pain management create obstacles to effective pain management. These obstacles need to be addressed in order to improve the management of children's pain through better education of nurses and two way communication with parents.

Attitude of Health Personnel↗

PubMed1999

Present knowledge of gynecologic sarcoma management.

Sarcomas arising in the gynecologic pelvic organs encompass different diseases with very different prognoses. This article attempts to define the different pathologies that arise from tissues of different histologic origin (mesodermal, stromal, and epithelial), and reviews the actual therapeutic knowledge based on the intrinsic prognosis of the sarcoma.

Female↗

PubMedDate not supplied

Evaluation stages and design steps for knowledge-based systems in medicine.

After the early experiments in artificial intelligence a methodology is emerging around advanced systems for the management of medical knowledge. The stress is moving away from the implementation of prototypes to the evaluation. It is possible to adapt and to apply this to field evaluation techniques already developed in similar contexts of knowledge management (books, drugs, epidemiology, consultants, etc.). The time is ready for a further step: to envisage a methodology for the design of real systems that cope with the 'knowledge environment' of the user. Every stage of the evaluation process is re-examined here, and considered as a framework to define goals and criteria about a step of design: (1) the impact of the system on the progress of health care provision (priorities, cost-benefit analysis, share of tasks among different media); (2) effectiveness in the end-user's environment and long-term effects on his behaviour (changes in people's role and responsibilities, improvements in the quality of data, acceptance of the system); (3) the intrinsic efficiency of the system apart from the operational context (correctness of the knowledge base, appropriateness of the reasoning). The need to differentiate the test sample into three classes (obvious, typical, atypical) is emphasized, discussing the influence on both evaluation and design. In particular the difficulty of having 'gold standards' on atypical cases, due to the disagreement among the experts, leads to the definition of two alternative attitudes: the 'standardization mode' and the 'brain-storming mode'.

Expert Systems↗