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At least 163 records · Page 9Linked to original sources
PubMed1994

The fungible facility: constructing an ideal setting for restructuring.

In summary, the ideal facility for a restructured hospital is highly flexible and adaptive. It is fungible. The more fungible, the more it will promote optimal performance in the long-term. Let's face it. Whether you are constructing a new or even launching a major renovation of an existing floor plan, a chance like this doesn't come along every day. For the sake of your restructuring initiative, and your hospital, make the most of it. Don't stop at what the facility should look like--allowing it to be merely the cosmetic by-product of other restructuring action steps. Go for what the facility should be like--giving it an important action step of its own. The Fungible Facility. With this, you'll make the most of that chance!

Architecture↗
PubMed1997

Oregon hospital saves big by dumping departments, creating patient-focused clusters.

Redesign of management structure, care delivery saves more than $600,000 annually. See how an Oregon hospital restructured its management to better reflect its newly-revamped delivery of care, and ended up dramatically cutting labor expenses, LOS, and patient care costs. Learn how this new cluster and council model was designed to see if it makes sense for your organization.

Communication↗
PubMed2002

Implementing hospital reform in central and eastern Europe.

The countries emerging from the Soviet sphere of influence in the early 1990s inherited Soviet style hospital-dominated health care systems. The countries that were part of the Soviet Union, in particular, had much higher levels of provision, as assessed by numbers of hospital beds, than the countries of western Europe. This capacity has been reduced, forced in large part by shrinking health budgets, but the development of a modern, co-ordinated, hospital system that is appropriate to the health needs of populations has proved difficult to achieve. A paradigm that assumed that most treatment would take place in hospital, supported by powerful vested interests in the health bureaucracy and medical profession, produced many obstacles to change. A tradition in which change took place through bureaucratic central plans took no account of the many actors in the policy process, the steps required to implement change, and the need to involve more people in the new and more pluralist context. This paper explores the experiences of attempts to restructure hospital systems in countries of central and eastern Europe and the former Soviet Union. It identifies a series of challenges that have often been addressed inadequately. These are a failure to take account of the specific context within which reform is taking place, an over reliance on market mechanisms to bring about change, insufficient recognition of the wide range of stakeholders involved, a failure to ensure that incentives and policies are aligned, and a lack of appropriate human resources to implement change.

Europe↗
PubMed1994

Physicians in health care management: 2. Managing performance: who, what, how and when?

Physicians are becoming more involved in performance management as hospitals restructure to increase effectiveness. Although physicians are not hospital employees, they are subject to performance appraisals because the hospitals are accountable to patients and the community for the quality of hospital services. The performance of a health care professional may be appraised by the appropriate departmental manager, by other professionals in a team or program or by peers, based on prior agreement on expectations. Appraisal approaches vary. They include behavioural approaches such as rating scales, peer rating, ranking or nomination and outcome approaches such as management by objectives and goal setting. Professionals should give and receive timely feedback on a flexible schedule. Feedback can be provided one-on-one, by a group assessing quality of care or through an anonymous survey.

Canada↗
PubMedDate not supplied

Factors influencing job satisfaction on specialty nursing units.

In the midst of downsizing, restructuring, layoffs, hospital closures, mergers, and the beginning cycle of shortages in specialty units, nursing administrators must extend their understanding of the factors influencing job satisfaction and the implications these findings may have for nursing practice, in order to enhance the quality of worklife for nurses in a hospital setting and create competitive work environments. The Causal Model of Job Satisfaction for Nurses (Blegen & Mueller, 1987), including Leatt and Schneck's (1981) technology variable, was the conceptual framework used to look at the effect of the 14 variables (opportunity, routinization, autonomy, job communication, social integration, distributive justice, promotional opportunity, motivation, pay, workload, general training, kinship responsibility, unit size, technology) on job satisfaction. This study demonstrated a statistically significant positive correlation between autonomy, motivation and job satisfaction and a statistically significant negative correlation between routinization and job satisfaction.

Adult↗
PubMed1996

Downsizing in the hospital system: a restructuring process.

In an effort to maintain fiscal viability, hospitals have been undergoing major restructuring. This article reports on a study that examined innovative downsizing strategies used by 20 acute care hospitals in Ontario. The study team reviewed hospital operating plans and analysed the results of interviews conducted with administrators and employees about the downsizing process. Results revealed no uniformity of approach to downsizing. Although many administrators expressed the need for a cooperative approach, downsizing was typically conducted in a top down fashion, and was perceived very differently by staff and administrators. The authors suggest ways to improve restructuring efforts and put forward questions to guide future research.

Attitude of Health Personnel↗
PubMed2001

Effects of changing hospital units during organizational restructuring.

This study examined the effects on work experience, satisfaction, and psychological well-being when hospital-based nursing staff change nursing units during a period of major health care system and hospital restructuring. Data were collected from 1,362 staff nurses using anonymous questionnaires. Fourteen percent (n = 194) had changed units in the preceding year. Although the effects of changing units were small, staff nurses who had changed units generally reported higher levels of work stressors, less satisfaction, and more negative emotional well-being.

Adult↗
PubMed1989

Redesigning hospital nursing practice: the Professionally Advanced Care Team (ProACT) model, Part 2.

The pressures of the current nursing shortage have created an unparalleled opportunity to restructure hospital nursing practice and care delivery. The potential exists to create new systems which simultaneously advance the goals of the profession and solve the problems of the shortage. Part 1 of this article (JONA, July/August, 1989) examined the similarities and differences among existing models and described the Robert Wood Johnson University Hospital ProACT model. Part 2 outlines the process of developing and implementing ProACT, an alternative nursing practice and care delivery model.

Costs and Cost Analysis↗