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PubMed2005

Evaluating public relations effectiveness in a health care setting. The identification of communication assets and liabilities via a communication audit.

The practice of public relations has experienced tremendous growth and evolution over the past 25 years, especially in the area of medical public relations. The constant changes in health care delivery have often led to increased need for communication with important publics. At the same time, practitioners in all fields of public relations have explored methods of accurately measuring the effectiveness of public relations programs. One such method of evaluation is the communication audit. This paper includes a brief overview of the communication audit concept followed by a case study based on an audit conducted for a small, multicultural non-profit health-care agency. Steps taken to conduct the audit and the methodology used are discussed. An analysis of the data is used to address two research questions regarding the efficacy of the Center's mission and vision. Suggestions for future audits are provided.

Communication↗
PubMed1995

Implementing total quality management in an academic surgery setting: lessons learned.

Total Quality Management, a philosophy developed by W. Edwards Deming, has been used successfully in many countries and in many types of organizations to improve the quality of processes. The system is based upon the scientific method and provides the ability to solve long-standing, recalcitrant problems. The application of the TQM philosophy to health care, although recommended by many medical economists, is still in its infancy. At our medical center, three departments (Surgery, Anesthesiology, and Operating Room Services) joined forces to implement TQM. Critical activities early in implementation included establishing a Steering Committee, training key employees, providing systems for communicating TQM activities, and developing the leadership, facilitator, and other resources needed to support teams. Two of our first teams studied very different processes (one in the Operating Room, the other in outpatient Surgery clinics), providing many useful insights regarding keys to successful application of the TQM philosophy. We have learned strategies for increasing acceptance of and participation in TQM efforts on the part of staff members and, in particular, physicians, and for initiating the cultural change needed for TQM. Although the teams have met with resistance to behavioral changes and a lack of full support from some upper-level administrators in the Medical Center and the Hospital, most of them have been quite successful in improving the processes under study. We conclude that, with the proper leadership and facilitation, the TQM philosophy can be successfully implemented in the health care environment. Total Quality Management (TQM) as a system for improving the quality of processes has been successful in many countries throughout the world for organizations offering a wide variety of products and services. This article will describe specific TQM endeavors, both successful and unsuccessful, undertaken in an academic surgery department in the United States. This description will illustrate the lessons we have learned in our attempt to change a complex organization and will enable readers to determine whether an analogy exists between our organization's response to problem solving and theirs.

Academic Medical Centers↗
PubMed1996

Asthma management in accident and emergency and the BTS guidelines--a study of the impact of clinical audit.

OBJECTIVE: To determine whether the care of asthma patients in accident and emergency Departments (A&E) is improved by clinical audit of asthma management. METHODS: The quality of care during continuous cycles of clinical audit was compared with that one year later, after an audit programme had ended and most of the medical staff had changed. This was done by a retrospective case notes review of all asthma cases (n = 79) in April and May 1993, compared to the same months (n = 93) in 1994. RESULTS: The quality of care was higher during the audit in a number of areas, as determined by conformity to the British Thoracic Society (BTS) guidelines. Comparing the management of episodes for the earlier to the later study periods, the significant differences were: the ability to complete a sentence in one breath was recorded in 63% and 33% of episodes; a nebuliser was given when indicated in 97% and 88%; when indicated a chest x ray was ordered in 73% and 43%; and arterial blood gases were measured in 73% and 33% of episodes. CONCLUSIONS: The initial assessment and management of asthma was better when the audit was in progress. However, in both study periods some areas of care did not receive the attention recommended in the BTS guidelines, these were all areas which would have influenced asthma control after discharge.

Adult↗
PubMed1994

Quality improvement in the biomedical communications audio visual unit.

The audio visual unit is a highly visible and most frequently requested service provided by a biomedical communications department. To continuously improve service, delivery, and operation of an audio visual communications function is a challenge. This article presents a field-tested audit tool for describing audio visual unit strengths and limitations. The tool suggests four assessment areas: the service plan, the client communication network, training and managing staff, and standard operating policy and procedures.

Audiovisual Aids↗
PubMed1994

Regional organisational audit of district departments of public health.

Organisational audit of public health in the United Kingdom is rare. To provide a framework for a structured organisational audit in district public health departments in one region organisational factors contributing to efficient, high quality work were identified and compared between districts, enabling each department to identify its organisational strengths and weaknesses. A draft list of organisational factors, based on the King's Fund organisational audit programme, were rated by 52 public health physicians and trainees in 12 district public health departments in South East Thames region for their importance on a scale of 0 (not relevant) to 5 (vital). Factors with average ratings of > 4, judged to be "vital" and proxies for standards, were then used to compare each district's actual performance, as reported by its director of public health in a self reported questionnaire. In all, 37 responses were received to the rating questionnaire (response rate 71%) and 12 responses to the directors' questionnaire. Of the 54 factors identified as vital factors, 20(37%) were achieved in all 12 districts and 16(30%) in all but one district; 18 were not being achieved by two (33%) districts or more. Overall, vital factors were not being achieved in 9% of cases. The authors concluded that most departments are achieving most vital organisational factors most of the time, but improvement is still possible. The results have been used as a basis for planning the organisation of public health departments in several of the newly formed commissioning agencies. This was the first regional audit of public health of its kind performed in the region and it provided valuable experience for planning future regional audit activity.

Health Facilities↗
PubMed1999

Auditing and monitoring--elements of HIM compliance.

Auditing and monitoring are two important components of a compliance plan. The author answers the most frequently asked questions about audits. In addition, find out how to get started--and what to do with the results.

Abstracting and Indexing↗
PubMed1989

Management of asthma in general practice.

An audit of the management of asthma in two large general practices has been undertaken. The overall level of therapy prescribed was, in general, related to both the objective severity of the patients' asthma and the extent of symptoms. However, many individual patients received sub-optimal therapy. Prophylactic inhaled beta agonists were used infrequently. Inhaled steroids were prescribed to only one third of the patients and to less than half of severely affected patients. The results suggest that this group of adult asthmatics were relatively under treated in general practice, but a prospective study with proven compliance is necessary to confirm this.

Adolescent↗
PubMed1999

Organisational culture, organisational learning and total quality management: a literature review and synthesis.

As health services face increasing pressure to meet the expectations of different stakeholders, they must continuously improve and learn from their experience. Many fail in attempts at continuous improvement programs because managers have not understood the complexity of making changes in organisations with multiple subcultures and interests. This article examines the related concepts of organisational culture, organisational learning and total quality management and shows how a synthesis of this knowledge can assist in developing continuous organisational learning and improvement.

Adult↗
PubMed2001

Multidisciplinary top management teamwork: effects on local health department performance.

Local health departments often use multidisciplinary top management teams (TMTs) to organize the work of the agency. The purpose of this study was to examine the use of TMTs in North Carolina local health departments and how TMTs use affected agency performance. TMT diversity and TMT performance positively affected the local health departments' (LHDs) performance. As well, the TMTs' agenda affected LHD performance. The more that TMTs discussed community health assessment and political changes in the community, the better the LHD performance on the core functions. Implications for public health practice and leadership in local health departments are discussed.

Conflict, Psychological↗
PubMed1996

Achieving effective service-contracting results: the process is the key to success.

Focuses on the contract process as a source of information for managers seeking to contract more effectively. Draws on the findings of a multiple-case comparative study undertaken to understand service-contracting processes and the factors that influence them. Offers specific ideas for ways to manage contracting processes more effectively. Includes case examples to clarify the points raised.

Contract Services↗
PubMedDate not supplied

Utilization management advancement system: a career ladder for nonclinical nursing.

This article describes a utilization management advancement system at the authors' facility that recognizes the staff members' levels of utilization management expertise and links them with the annual performance appraisal. After 2 years of brainstorming, analysis, discussion, and research, the utilization management nurses were able to define their practice in terms of functional domains that reflect levels of experience and competencies. The process of developing these levels and the performance appraisal standards is addressed.

Career Mobility↗
PubMedDate not supplied

Value-based cost management: the foundation of a balanced performance measurement system.

Healthcare organizations need critical performance measures if they are to lead, manage, and operate effectively. Traditional financial measures or report cards on patient satisfaction and clinical outcomes are insufficient, however. Value-based cost management directly links cost accounting, processes, clinical outcomes, and patient and employee satisfaction through organizational, work environment, and financial relations measures. These measures address three levels of performance: strategic, diagnostic, and operational. Their linkages identify value in three areas: business-related financial and operational measures; employee-related measures such as those related to satisfaction and well-being; and learning and patient-related measures linked to clinical outcomes, satisfaction, and population.

Cost Control↗