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PubMedDate not supplied

How right should the customer be?

If your salespeople aren't sure who their boss is--the district manager? the regional manager? the customer?--it could be a sign that your company's sales force controls are working at cross-purposes and that your sales function is in trouble. Sales force controls are the policies and practices that govern the way you train, supervise, motivate, and evaluate your sales staff. They include the types of compensation you offer your people and the criteria your sales managers use to evaluate the reps' performance. These controls let salespeople know which trade-offs the company would prefer them to make when the inevitable conflicts arise between what they want to do (spend lots of time and money to get a sale) and what they actually can do (use limited resources and still get the sale). When sales force controls aren't aligned--when, say, the system simultaneously encourages reps to be entrepreneurial but also to file detailed call reports and check in frequently with their bosses--individuals become discouraged and unproductive, and they eventually leave the company. The authors' research suggests there are significant differences between the control systems of companies that encourage salespeople to put the customer first-outcome control (OC) systems--and those that encourage reps to put their managers first--behavior control (BC) systems. In this article, they list the characteristics of OC and BC systems, describe the potential fallout from conflicts within these systems, and explain how you can tell which control system is appropriate for your firm. In most cases, the right choice will be a consistent system somewhere in the middle of the OC-BC continuum.

Commerce↗

PubMed1994

An evidence-based approach to evaluating and improving clinical practice: guideline development.

Group Health Cooperative of Puget Sound has developed a model for evaluating and improving clinical practice based on an explicit, evidence-based approach. It is designed to identify gaps between current and optimal practices, and to bring about changes in physician behavior so that health care outcomes (health status, patient satisfaction, provider satisfaction, cost/utilization) are maximized. This model stresses the importance of a rigorous process in looking objectively at evidence in working to improve outcomes. Discrete tools have been developed which help teams move successfully from problem identification to the ongoing evaluation and improvement of a new clinical practice.

Clinical Medicine↗

PubMed1990

The quality of life of hemodialysis recipients treated with recombinant human erythropoietin. Cooperative Multicenter EPO Clinical Trial Group.

Initial clinical trials with recombinant human erythropoietin provided evidence of a quality-of-life benefit for patients with anemic end-stage renal disease who received maintenance hemodialysis. As part of a phase III clinical trial of recombinant human erythropoietin, the quality of life of patients was systematically assessed. More than 300 patients at nine dialysis centers were evaluated. A statistically significant improvement was established between baseline and second follow-up on most objective and subjective quality-of-life parameters, including energy and activity level, functional ability, sleep and eating behavior, disease symptoms, health status, satisfaction with health, sex life, well-being, psychological affect, life satisfaction, and happiness. No change was observed in ability to work or employment status. We conclude that, in addition to substantial improvement in hematologic parameters, recombinant human erythropoietin greatly enhances the quality of life of anemic patients who receive maintenance hemodialysis.

Adult↗

PubMed1987

Determinants of adherence to medical regimens by hypertensive patients.

This study employed multivariate analyses and structural modeling procedures to examine a model for the determinants of adherence to medical regimens. Fifty adult hypertensive patients at a health maintenance organization completed questionnaires and participated in home interviews over a 10-week period. Knowledge of medical regimens, information communication between the patient and the medical professionals, satisfaction with health-care providers, health locus of control, social support, and treatment disruption to life-style were assessed. Adherence was assessed through self-report and behavioral (i.e., pill-count ratio, percentage of kept medical appointments) indices. Finally, repeated blood-pressure measurements were obtained. Structural modeling procedures revealed that greater expectancy for internal control over health and hypertension, greater knowledge of the treatment regimen, and stronger social support were significant determinants of adherence; in turn, higher levels of adherence facilitated blood-pressure reduction.

Adult↗

PubMed2003

Estimating price elasticities when there is smuggling: the sensitivity of smoking to price in Canada.

A central parameter for evaluating tax policies is the price elasticity of demand for cigarettes. But in many countries this parameter is difficult to estimate reliably due to widespread smuggling, which significantly biases estimates using legal sales data. An excellent example is Canada, where widespread smuggling in the early 1990s, in response to large tax increases, biases upwards the response of legal cigarette sales to price. We surmount this problem through two approaches: excluding the provinces and years where smuggling was greatest; and using household level expenditure data on smoking. These two approaches yield a tightly estimated elasticity in the range of -0.45 to -0.47. We also show that the sensitivity of smoking to price is much larger among lower income Canadians. In the context of recent behavioral models of smoking, whereby higher taxes reduce unwanted smoking among price sensitive populations, this finding suggests that cigarette taxes may not be as regressive as previously suggested. Finally, we show that price increases on cigarettes do not increase, and may actually decrease, consumption of alcohol; as a result, smuggling of cigarettes may have raised consumption of alcohol as well.

Canada↗

PubMed2002

A validation and reduced form of the Female Condom Attitudes Scale.

The Female Condom Attitudes Scale is an instrument comprising five correlated factors derived from 15 Likert-scale survey items that measure women's attitudes toward the female condom. This scale originated from the 30-item scale of Choi, Gregorich, Anderson, Grinstead, and Gómez (2001; manuscript under review). Exploratory factor analysis of this scale extracted eight correlated factors. Reliability coefficients and confirmatory factor analyses refined the instrument by reducing the number of factors to five and halving the number of items. The reduced form of the Female Condom Attitudes Scale demonstrated both construct and convergent validity by predicting self-reported female condom use behavior. It also correlated with self-efficacy to use male condoms, sexual comfort, and attitudes toward the male condom. The five factors remaining in the final survey instrument were Sexual Pleasure Enhancement, Inconvenience, Improved Prophylaxis, Sexual Pleasure Inhibition, and Insertion Reluctance. Implications of these findings for basic and applied intervention research are discussed.

Adolescent↗

PubMed2005

Parents' priorities and satisfaction with acute pediatric care.

OBJECTIVE: To identify parents' priorities and satisfaction in relation to pediatric care to assess nurses' and physicians' ability to provide care and treatment that fulfill parents' needs. DESIGN, SETTING, AND PARTICIPANTS: The study took place in the pediatric ward of a regional hospital in Denmark. It included 300 parents of children admitted for acute care, and the data were collected by means of a self-administered questionnaire. After admission, parents were asked about priorities. After discharge from the hospital, parents were asked to report their level of satisfaction with the elements of care they had received during their stay. RESULTS: A total of 253 questionnaires were returned for the first section (a response rate of 84%), and 170 questionnaires were returned for the second section (response rate of 67%). The greatest gap between priorities and satisfaction was in the waiting time related to admission, waiting time related to fulfillment of the child's needs, and information given about care and treatment. Parents were most satisfied with the nurses' behavior; however, physicians' performance was given the highest priority score. CONCLUSIONS: Parents' priorities and assessments of inpatient pediatric care rest heavily on the communication between physicians and parents. The present study pointed to the need for improved and clearer communication. In addition, the poor performance with regard to waiting time indicates that this is a major area for improvement.

Adult↗

PubMed1986

Patient satisfaction with primary-care consultations.

This study examines patients' perceptions of their latest consultation with a primary-care physician. A new questionnaire measured patients' views on their "ideal" physician prior to the visit and their satisfaction on similar dimensions immediately afterward. Ratings by the 503 eligible patients (87% response rate) showed that all 43 items were relevant and that a shortened version could also be used successfully. Patients held high expectations for, but were also quite satisfied with, their physicians' actual behavior during the consultation. Factor analysis of perceptions supported other research findings and raised some anomalies in relation to overordering of investigations and waiting time. Other analyses showed which characteristics of physicians and patients were most influential on satisfaction and which dimensions of care were common or distinct to the 22 physicians involved in this study.

Adolescent↗

PubMed1982

An evaluation of the impact of a continuing education course in diabetes.

This article represents the results of an evaluation of a continuing education program for dietitians. The evaluation was built into the program at its inception and involved an assessment of participant satisfaction, short-term knowledge gain and a follow-up assessment of self-reported behavior change. The results of this evaluation indicate that the course did, indeed, impact on both knowledge and behavior. In addition, however, the evaluation also uncovered some problems in planning which minimized the potential impact of this course. These results suggest that there should be increased attention to rigorous educational needs assessment and both process and impact program evaluations in order to determine approaches to education that could make more effective use of the resources available for continuing education in health care.

Analysis of Variance↗

PubMed2001

Design and effectiveness of a computer-based continuing education program for orthodontists.

The design of computer-based continuing education for health professionals is an important consideration for Internet delivery because the size of graphic files greatly affects the speed with which information is delivered. Orthodontists who had indicated an interest in computer-based continuing education were shown via CD-ROM either a dynamic version of a computer continuing education program (with transitions and animations to liven up the content) or a plain version (identical content except that the transitions and animations were omitted). The program provided new information about superelastic arch wires for the initial stage of orthodontic treatment. For both versions, over 90% of the viewers thought the program was well done and provided useful information. Six of the orthodontists who received the dynamic version felt that the animations were distracting rather than helpful; only one who received the plain version felt that it was lifeless. A follow-up questionnaire showed that two-thirds of those who viewed the program had subsequently reviewed the performance data for the initial wire they were using and 20% had changed it, so the computer program was effective in changing clinical behavior. Those who saw the plain version also were more likely to have changed their clinical procedures. For Internet delivery of information to highly motivated professionals, it appears that transitions and animations are not necessary and may be more likely to decrease than increase the effectiveness of the teaching material.

Adult↗

PubMed2002

Suicide survivors' perceptions of the treating clinician.

Seventy-one suicide survivors were surveyed about their perceptions of the clinicians who were treating their loved one at the time of death. Survivors provided information regarding their perceptions and attitudes toward clinician behaviors before and after the suicide and their perceptions of helpful and troubling aspects of clinician behaviors. Results indicated that survivors share a number of common opinions regarding the mental health care providers treating their loved ones. Several differences existed between survivors who consider lawsuits against mental health care providers versus those who do not. The implications of these findings for clinical practice, legal issues, surviving suicide, and future research are discussed.

Adult↗

PubMed1997

Formative evaluation of a World Wide Web-based Chiari malformation hypermedia program.

The interface design of a Chiari malformation hypermedia document was tested with formative evaluation, a type of usability testing. The evaluation tested six common interactive design features essential for the design of user-friendly interfaces: image, size, label highlighting, text presentation (scrolling vs. hyperlinks), color (text, visual material, and background), and button behavior. Six neurosurgical residents answered a questionnaire focusing on these interactive design features during the development of the hypermedia document. Over a period of two months, the responses to the questions and suggestions made by the volunteers were used to improve the six interactive design features for the specific target audience of Toronto Hospital, Western Division neurosurgical residents.

Arnold-Chiari Malformation↗

PubMed1991

Plastic surgery on identical twins.

Four pairs of identical female twins have undergone a variety of plastic surgery procedures, including rhinoplasties, rhytidectomies, augmentation mammaplasties, and trochanteric liposuction. Performing plastic surgery on identical twins implies special considerations: the extent of preoperative phenotypic identity, the behavior of each twin (dominant or recessive), the twins' personal interdependence and individual expectations, the operative strategy (simultaneous versus sequential operations), the eventual complications, and the extent to which the operative results and postoperative appearance are identical. In general, counseling, operative technique, and responsibility for producing good results place greater demands on surgeons when performing plastic surgery on identical twins than on singletons. Still, the results have been gratifying.

Adult↗

PubMed2005

Now and again: the food and beverage industry demonstrates its commitment to a healthy America.

There exists a complex relationship between food and health in our society that is intrinsically linked to our obesity epidemic. The food and beverage industry recognizes that it can influence and modify the eating behavior of Americans. The American Council for Fitness and Nutrition was formed in January 2003 as a partnership of food and beverage companies, trade associations, and nutrition advocates that work together to create long-lasting remedies for the obesity epidemic. The American Council for Fitness and Nutrition recognizes that the current American lifestyle contributes to an energy imbalance and, therefore, supports approaches that aim to correct that imbalance. The American Council for Fitness and Nutrition also supports the underrepresented populations that are disproportionately affected by obesity, specifically, the African American and Hispanic American communities. Cooperation between industry, government, and academia will be key in establishing long-term strategies to help consumers make healthy lifestyle choices.

Beverages↗

PubMed1977

Client evaluation of community mental health services: relation to demographic and treatment variables.

Community mental health center (CMHC) outpatient clients' satisfaction and perceived problem improvement were assessed by telephoning 108 clients, representing 40% of clients discharged during the period under investigation. The CMHC's services were perceived positively, and most clients were satisfied with their therapy experience, found it helpful, and felt more able to handle future problems. Data on reasons for termination, expected future behavior, and extratherapeutic factors were also gathered. Of particular interest were the findings that satisfaction and improvement were unrelated to client age, sex, marital status, or social class, but significantly more positive outcome responses were found for those clients who terminated therapy with a mutual client--therapist decision as compared to those who terminated unilaterally.

Adaptation, Psychological↗

PubMed1989

Accepting criticism. A positive process.

Criticism often has negative connotations, even when it is a planned supervisory technique and is part of a comprehensive approach aimed at improving employee behavior without damaging employee morale. The nurse may be the target of criticism from a variety of other people that he or she encounters in the health care setting. The nurse's response to criticism is important to optimal conflict resolution and to maintaining relationships with integrity. The nurse's actions and attitudes in response to criticism should be planned deliberately and directed at resolving the conflict.

Anger↗

PubMed1994

Differences in perceptions of hospital marketing orientation between administrators and marketing officers.

Hospital administrators have been struggling for more than a decade to determine the role and proper position for marketing and marketers within their organizations. Results of a study now confirm the expected--administrators and their chief marketing officers do not see the same marketing actions being conducted for their hospitals. The consequence of such perceptual differences in marketing orientation for the role of marketers within the hospital are significant and are discussed in this article. Of particular importance is the finding that the marketing behaviors of the organization as identified by line managers correlate strongly with both revenues (r = .6r for inpatient revenue) and occupancy levels (r = .44). Additionally, it was found that as little as a 10 percent improvement in a hospital's marketing orientation is associated with a $25 million increase in total net patient revenues and an 8 percentage point increase in occupancy rate.

Attitude of Health Personnel↗

PubMedDate not supplied

Improve quality in nursing homes or institute community placement? Implementation of OBRA for individuals with mental retardation.

A matched sample longitudinal design was used to compare the outcomes for individuals with mental retardation who were either retained in nursing homes or transferred to community based living arrangements. Persons who moved from nursing homes to community residences experienced increased performance in adaptive behavior skills, whereas persons who remained in nursing homes regressed. Individual habilitation plans became nearly universal in both environments, but those plans prepared in the community were more focused on vocational type goals. Hours of service also increased in both environments, with the greatest increases being observed in habilitation training. Nursing services dropped to near-zero levels in community-based programs.

Activities of Daily Living↗