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PubMedDate not supplied

Audit. Operations in an academic setting.

A-U-D-I-T...the very word instills fear in the hearts of many. We recently received a letter from the director of the University of Rochester's Internal Audit Department, notifying us that they had scheduled a routine operational audit of our department. What is an "operational audit"? What is meant by "routine"? Who are these internal auditors and what do they want from us? This article illustrates two actual experiences: an operational audit and the process used to develop and implement standards and practices consistent with an auditor's recommendations. Additionally, it provides information on what an auditor looks for during an audit, and lastly, provides tips on how to prepare for a "painless" audit.

Academic Medical Centers↗
PubMed1996

Data protection and security within TANIT.

The word "TANIT" means "Telematics for ANaesthesia and Intensive Therapy". The objective of the TANIT project is to develop information and telematic systems in critical care environments that are integrated in the hospital information space. The goal is to produce an integrated European reference computer for Critical Care Environments (CCE). For this purpose, TANIT is developing methods and guidelines for the design, implementation, introduction and evaluation of systems, successful patient data management, medical/nursing activities, clinical audit, and departmental management for Anaesthesia and Intensive Care. In this context, the task of Workpackage PROTEC-Data Protection, Security and Confidentiality- was to develop confidentiality rules for personal and management data which arise in a CCE context, and at the same time to establish procedures that will allow medical personnel all data access needed for successful treatment of their patients. Furthermore, PROTEC proposed technical methods to protect sensitive data in the computerized records.

Anesthesia Department, Hospital↗
PubMedDate not supplied

Opening the books.

For years, small companies have experimented with forms of open-book management. Open-book systems have smoothed change efforts by giving workers the why instead of just the how of initiatives; they have enabled employees to think like owners. Now divisions of large organizations such as R.R. Donnelley & Sons and Amoco Canada are finding opening the books can work for them, too. It isn't easy, and companies must adapt the principles to their own situations. AES Corporation, for example, found that it had to declare all its employees "insiders" when it went public. One of the reasons for large companies' interest in open-book management is the success of a role-model company, Missouri-based Springfield ReManufacturing. Leaders of divisions of large companies have been able to visit and ask questions. Other early adopters are also showing competitive advantages. Among them are Wabash National, now the nation's leading truck and tractor manufacturer, and Physician Sales & Service, a distributor of supplies to doctors' office. Open-book principles are the same whether a company is large or small: every employee must receive all relevant financial information and be taught to understand it; managers must hold employees accountable for making their unit's goals; and the compensation system must reward everyone for the overall success of the business. Hexacomb Corporation is one large organization that has done well. Workers at the company's seven plants are inspired by a system of splitting profits over budget fifty-fifty: half goes to the company and half to the bonus pool. Such companies are learning the benefits of having everyone work to push the numbers in the right direction.

Decision Making, Organizational↗
PubMed1998

Medical equipment. Devices and desires.

High-tech medical solutions need careful implementation to ensure optimum reliability and good patient care. Figures from the Medical Devices Agency show that a patient may be three to 10 times more at risk from user error than from faulty equipment. Informed equipment selection and user training is paying dividends in one trust.

Equipment Failure↗
PubMed1998

Administrative benchmarks for Medicare, Medicaid HMOs.

Plus, check out benchmark data on Medicare and Medicaid administrative costs. Every provider knows that HMOs take a slice of the Medicare or Medicaid premium for their administrative costs before they determine provider capitation. But how much does administration really cost? Here's some PMPM data from a study by the Sherlock Company.

Benchmarking↗
PubMedDate not supplied

Rating game: tips on how to assess your safety program.

The author offers tips on measuring the effectiveness of your healthcare facility's safety program--from establishing objectives to developing programs to meet them. He provides an 11-step process to develop a performance standard. Through these standards, he says, healthcare managers can showcase the improvements that have been implemented.

Data Collection↗
PubMed1999

Use of performance standards in behavioral health carve-out contracts among Fortune 500 firms.

OBJECTIVE: To determine the prevalence and nature of performance standards in specialty managed behavioral healthcare contracts among Fortune 500 companies. STUDY DESIGN: This was a cross-sectional survey of all companies listed on the Fortune 500 during 1994, 1995, or both. METHODS: From April 1997 to May 1998 we conducted a mailed survey with phone follow-up. Of the 68% of firms that responded, over one third reported carve-out contracts. The survey focused on whether companies had behavioral health carve-out contracts with specialty vendors and characteristics of these contracts, including the use of performance standards. RESULTS: More than three quarters of the Fortune 500 companies reporting specialty behavioral healthcare contracts used at least one performance standard. Most common were administrative standards (70.2%) and customer service standards (69.4%). About half of the companies used quality standards, whereas only a third used provider-related standards. Most (58.8%) companies using performance standards also specified financial consequences. Larger Fortune 500 firms were significantly more likely to use performance standards. Risk contracts and contracts that included all covered employees were also more likely to include some categories of standards. CONCLUSIONS: Administrative and customer service standards may be most common because companies find it easier to specify those standards, especially compared with clinical quality measures. To the extent that employers want to obtain the most value from their behavioral healthcare purchasing, we expect that more will begin to adopt quality standards in their contracts, especially as performance measures become more refined. Reliance on accreditation, however, is an alternative approach for employers.

Behavioral Medicine↗