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The computer based patient record: a strategic issue in process innovation.

Reengineering of the workplace through Information Technology is an important strategic issue for today's hospitals. The computer-based patient record (CPR) is one technology that has the potential to profoundly modify the work routines of the care unit. This study investigates a CPR project aimed at allowing physicians and nurses to work in a completely electronic environment. The focus of our analysis was the patient nursing care process. The rationale behind the introduction of this technology was based on its alleged capability to both enhance quality of care and control costs. This is done by better managing the flow of information within the organization and by introducing mechanisms such as the timeless and spaceless organization of the work place, de-localization, and automation of work processes. The present case study analyzed the implementation of a large CPR project ($45 million U.S.) conducted in four hospitals in joint venture with two computer firms. The computerized system had to be withdrawn because of boycotts from both the medical and nursing personnel. User-resistance was not the problem. Despite its failure, this project was a good opportunity to understand better the intricate complexity of introducing technology in professional work where the usefulness of information is short lived and where it is difficult to predetermine the relevancy of information. Profound misconceptions in achieving a tighter fit (synchronization) between care processes and information processes were the main problems.

Cost Control↗

Third-party attitudes and strain reactions to the threat of a labor strike.

The authors examined how dispute-related stressors predicted strain experienced by third parties (N = 270) and their perceptions of a potential strike by part-time faculty. Immediately preceding a strike deadline, the authors surveyed students on their support for the union, perceived fairness, perceived effects of the impending strike, and perceived control. The authors also measured perceptions regarding information about the strike and psychological strain. Students facing increased disruptions because of the potential strike had decreased perceived control over their own tasks and over the university policies, and they experienced higher strain. Having more information about the dispute was associated with increased perceived task and policy control but was unassociated with strain. Both task and policy control moderated the relationship between disruptions and strain.

Adolescent↗

Importance of the lay press in the transmission of medical knowledge to the scientific community.

BACKGROUND: Efficient, undistorted communication of the results of medical research is important to physicians, the scientific community, and the public. Information that first appears in the scientific literature is frequently retransmitted in the popular press. Does popular coverage of medical research in turn amplify the effects of that research on the scientific community? METHODS: To test the hypothesis that researchers are more likely to cite papers that have been publicized in the popular press, we compared the number of references in the Science Citation Index to articles in the New England Journal of Medicine that were covered by The New York Times with the number of references to similar articles that were not covered by the Times. We also performed the comparison during a three-month period when the Times was on strike but continued to prepare an "edition of record" that was not distributed; doing so enabled us to address the possibility that coverage in the Times was simply a marker of the most important articles, which would therefore be cited more frequently, even without coverage in the popular press. RESULTS: Articles in the Journal that were covered by the Times received a disproportionate number of scientific citations in each of the 10 years after the Journal articles appeared. The effect was strongest in the first year after publication, when Journal articles publicized by the Times received 72.8 percent more scientific citations than control articles. This effect was not present for articles published during the strike; articles covered by the Times during this period were no more likely to be cited than those not covered. CONCLUSIONS: Coverage of medical research in the popular press amplifies the transmission of medical information from the scientific literature to the research community.

Bibliographies as Topic↗