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In the near future, almost one-third of all American physicians will be women. Many of these women will be pressured by the needs to balance parental/family and professional responsibilities during the formative stages of their careers. Recommendations for medical school policy changes that recognize these pressures are made.
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The management of organizational conflicts is one of the most relevant skills for headnurses. The data were collected from a sample of 97 headnurses of general hospitals, using the "Rahim Organizational Conflict Inventories". The results show that the most important type of conflict measured is the "intragroup". The ways of handling interpersonal conflict used most often are "integrating" and "obliging". Besides verifying the validity and the reliability of the inventories, the differences connected with sex and age are analyzed. "Integrating" style is more widely used with increasing age while with increasing working years, interpersonal conflicts decrease.
OBJECTIVE: This study examines how "strategic partnerships" between community-based consortia of oncologists and hospitals (CCOPs) and clinical cooperative groups emerge, develop, and influence patient accruals (i.e., the number of patients enrolled in clinical trials) over time. DATA SOURCES AND STUDY SETTING: Study analyses are based on 65 pairwise relationships that 38 CCOPs established with eight clinical cooperative groups in September 1983 and maintained through February 1989. Data are drawn from grantee applications and progress reports. STUDY DESIGN: The study examines how different types of CCOP-cooperative group exchange relate to one another and to CCOP patient accruals over six time points. Key independent variables include resource dependence, information exchange (i.e., meeting attendance and committee membership), and protocol exchange (i.e., the number of different protocols used). DATA COLLECTION METHODS: Data extracted from secondary sources were entered in a data base. PRINCIPAL FINDINGS: The number of CCOP physicians and support staff who attend cooperative group meetings during the first two years of a clinical research partnership has a significant influence on meeting attendance and protocol use in later years. Two-thirds or more of the variance in patient accruals at each time point can be explained by the number of different protocols used and the number of CCOP representatives serving on cooperative group committees (or attending cooperative group meetings). CONCLUSIONS: The findings highlight the importance of historical relationships and anticipated resource dependence in shaping initial exchange patterns. They also suggest that strategic partnerships need to emphasize structures and processes that encourage early involvement in collaborative activities and that reward participants for maintaining high levels of interaction.
BACKGROUND: Physicians' satisfaction with their professional life influences the quality of patient care they provide and helps to determine the number and type of students attracted to the various fields of medicine. In this study, we sought to delineate areas of satisfaction and dissatisfaction among family physicians. METHODS: A self-administered questionnaire was sent to all physicians in the state of Pennsylvania who were included in the 1990 directory of the American Board of Family Practice (N = 1944). RESULTS: Completed questionnaires were received from 1066 family physicians in full-time practice. Sixty-five percent were satisfied with their professional lives. Patient relationships, a sense of clinical competence, and their relationships with their partners were among the most satisfying aspects of practice for all family physicians. Problems identified included regulations by third-party payers and government agencies and the large amount of paperwork encountered in practice. There were significant (P < .001) differences in satisfaction between physicians in different practice arrangements. Significant differences between practice types were also found in the degree of dissatisfaction with third-party payers and government agencies, paperwork, isolation from other physicians, and the threat of a malpractice suit. CONCLUSIONS: Almost two thirds of family physicians are satisfied with their general professional lives. Conversely, one third are not. Clear areas of satisfaction and dissatisfaction have been defined for family physicians in general as well as for family physicians in various practice environments. This information may be useful in the development of policy to structure a medical system that meets the needs of both patients and physicians.
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According to recent research data, interactions between people will be impacted by four types of psychological boundaries. Each of the boundaries has specific key distinctions that identify them. If the boundary can be identified, then specific skills can be used to facilitate successful, positive interactions between people. These data provide a strong foundation on which managers can build as they develop new skills to cope with new demands.
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Explore the source record for details and available documents.
Building effective interdisciplinary teams depends on interventions to create a shared vision of the future, to clarify roles and relationships, and to establish a culture of positive change.
BACKGROUND: To maintain a high standard of quality nursing care the individual critical care nurse s competencies should be determined objectively. Few international guidelines describe the qualities required by critical care nurses to function effectively in a critical care unit. These guidelines often focus only on the education and training of critical care nurses. OBJECTIVE: To formulate and describe guidelines for the competency requirements of registered critical care nurses. METHOD: A focus group interview, a qualitative research method, was conducted as an open conversation in which each participant could ask questions, comment, or respond to comments. Interaction among the respondents was encouraged to stimulate in-depth discussion. The study was conducted within the framework of South African critical care nursing. RESULTS: The four main categories that were identified are as follows: professional competence, cognitive competence, interpersonal skills, and critical care patterns of interaction. These are described in detail along with a formulated guideline for critical care nurse competency requirements. CONCLUSION: This study describes an attempt to formulate objective guidelines for critical care nurses competency requirements.
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Preventive medicine is an exciting specialty that is often blocked in its progress by internal conflicts and external obstacles. We can all change this state of affairs. I present and compare definitions of important terms to clarify the discussion. Structural problems of the specialty include, among others, fragmentary representation, unfocused academic departments, lack of control over professionalization, and specialty identification, particularly with respect to occupational medicine. A set of suggested solutions to these problems include these actions: (1) federate the leading organizations into a coalition for organizational strength, without sacrificing their individual identities; (2) define the core content of the specialty once and for all by the mechanism of consensus-driven competency-based learning objectives; (3) build stronger bridges to clinical specialties other than family medicine, particularly to internal medicine; (4) restructure academic departments to form a preventive medicine unit as such, encouraging health care research and community medicine to connect principally with family medicine departments; (5) rethink specialty certification, including a model defining a knowledge and skills set in defined modules, which would be combined in various ways to support flexible specialty certification; and (6) integrate occupational medicine with preventive medicine generally by exploring issues of common interest and building closer institutional ties when the opportunity arises. These and other ideas might be discussed by the leadership of the principal public health and prevention organizations at a "summit" meeting, but some group must take the initiative to champion the cause. Medical Subject Headings (MeSH): preventive medicine, future, definitions, specialty certification, community medicine, population medicine.
This article reviews the results of a survey of California law enforcement agencies, designed to assess the experience of these agencies with mentally ill offenders (MIOs) and the training of their officers to interact with this population. The results suggest that most law enforcement officers are given insufficient training to identify, manage, and appropriately refer the MIOs they are increasingly likely to encounter. The data indicate that, in contrast to their training and expectations, peace officers are as likely to be called to a mental illness crisis as to a robbery. The MIO is likely to be arrested for nonviolent misdemeanors and to be screened by officers with little of the training or knowledge needed to divert them to appropriate mental health treatment. Respondents report that increased communication and cooperation between law enforcement and mental health professionals is the single greatest improvement needed for handling mental illness crises.
Toxicology and Quality Assurance (QA) at Eli Lilly and Company are well integrated, yet still independent organizations that are aligned with the same overall business objective: to efficiently deliver a high-quality product to the customer. One of the keys to success has been the implementation of a monitoring/metric and trend analysis program of key work processes that are central to the delivery of final product. Our metrics program indicates that the multiple changes that we have made have resulted in a higher quality product. This paper will discuss the practical changes we have made as a part of our Total Quality journey. This article is based solely on the authors' experiences while at Eli Lilly and Company.