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At least 19 recordsLinked to original sources
PubMedDate not supplied

[Interprofessional and interinstitutional relations of power at a hospital].

The purpose of this article is to make a critical analysis about power relationships, which permeate daily professional and/or institutional actions in the hospital environment. This reflection is based on a concrete situation experienced by a group of nursing professors from a state university in Paraná, which unleashed conflicts concerning interprofessional and interinstitutional power relationships. This study focuses on power relationships in the hospital emphasizing the interrelations that characterize nursing practice. We believe that these relationships can only be understood, reflected upon and rebuilt in the context of daily practice, as new ways of collective action are sought.

Brazil↗
PubMed2001

The German strategy for quality improvement in health care: still to improve.

One basic aim of German Health Policy is to secure a high quality of medical services financed by Statutory Health Insurance (SHI). Due to the specific relationships among patients, insurance funds and medical providers this aim is in a potential conflict with various cost-containment efforts introduced within the last 10 years. This article outlines a general theoretical framework to analyze the possible effects of these efforts on the quality of health care. It then analyzes the actual regulation approach strategy taken by German Health Policy for quality assurance in health care. Finally, it outlines a two-tier strategy based on regulation and competition as a means to ensure a high quality of care.

Cost Control↗
PubMed2002

The functional relationships of medical schools and health services.

Medical schools need good functional relationships with the health systems in which their students, graduates and staff will learn and work. With increasing complexity and rising costs of health delivery the 2 types of organisation have become more interdependent but not always as collaborating partners. Recent changes in the organisation of undergraduate medical education have been reactive to re-structuring of health services. For example, traditional teaching hospitals have become more specialised and less suitable for general medical education. While this has helped to decentralise medical education into appropriate clinical environments, these and other changes have generally been adaptive to the health systems rather than being instigated by the medical schools for educational reasons. This discussion paper examines the nature of the relationships and their contributory elements. A taxonomy of functional relationships is proposed with primary categories of (i) autonomy (ii) contiguity (iii) interdependence (iv) collaboration, and (v) obligation. It is suggested that medical schools should become more assertive in application of their creative talents and educational resources throughout the environment in which their graduates will use their medical skills, and in which they will work with other health care professionals.

Alberta↗
PubMed1995

Divisions of general practice: a status review.

This paper looks at the emergence of divisions of general practice in Australia. Divisions are local groups of general practitioners working to integrate general practice into the wider health system and to explore opportunities for improving service delivery, teaching and research. There are now 116 divisions of general practice, covering over 95 per cent of the Australian population. Projects and infrastructure funding was approximately $35 million in 1994-95. Divisions have enabled general practitioners to retain their autonomy while responding to a government health reform process which depends on their participation. They are a uniquely Australian solution to the problems confronting general practice in the 1990s, bridging the gap that previously existed between individual general practitioners and the health system as a whole. The Divisions and Projects program is being evaluated using a variety of methods which allow feedback into the program in a timely way. The program thus remains sensitive to new strategies and directions, either from the general practitioners themselves or from other stakeholders.

Accreditation↗
PubMed1994

The perceived benefits and problems associated with intergenerational exchanges in day care settings.

The universe of current adult day care center administrators (n = 36) and a stratified random sample of child day care center administrators (n = 300) in Virginia were surveyed to gather information about professionals' perceptions of the benefits and problems associated with providing regular intergenerational exchanges in day care settings. Findings of a qualitative analysis revealed that problems attributed to generational differences and organizational/service delivery issues were counterbalanced by sociocultural and organizational benefits.

Administrative Personnel↗
PubMed1990

Warfare or partnership: which way for health care?

There are many voices urging health care organizations to adopt aggressive competitive warfare, but a careful look at the dynamics affecting health care suggests that partnership may be at least as promising a strategy as warfare to promote mission and survival.

Community-Institutional Relations↗
PubMed2001

Telemedical work and cooperation.

In telemedicine, cooperation occurs via telecommunication. This represents a new situation for medical cooperation. Whether such cooperation works poorly or well will be important with an increasing volume of telemedicine. When personnel are involved in external cooperation, as in telemedicine, the question of cooperation within one's own organization also arises. To investigate these matters, qualitative interviews were performed with 30 persons working in teledermatology, telepsychiatry, a telepathology frozen-section service and tele-otolaryngology. The results showed that cooperating by telecommunication mainly worked well. The cooperation may be influenced by factors such as personality, knowing each other personally, preparation and experience. Telemedical teamwork may be improved by factors like experience and education. Working with telemedicine did not reduce the personnel's cooperation within their own organizations, but rather improved it, although this effect was slight and most commonly involved improved knowledge of others. In general, the findings concerning cooperation and telemedicine were positive.

Humans↗
PubMed1991

Body, mind, and soul. The parish nurse offers physical, emotional, and spiritual care.

Many hospitals see the parish nurse program as a way to bring their mission to the community and collaborate with area parishes. Because people are finding it increasingly difficult to access our nation's complex healthcare system, the parish nurse program is becoming more popular with hospitals, parishes, and the communities they serve. The parish nurse is a resource person--a health educator, a personal health counselor, a volunteer coordinator and support group organizer, a community liaison, and a role model for the relationship between one's faith and health. Parish nurses do not provide invasive treatments. Parish nurse programs that have been most successful have been developed through the hospital's pastoral care department in conjunction with the nursing department. The hospital establishes a steering committee to guide the program's formation. Daily, the faculty, a group made up of a physician and representatives from nursing and from pastoral care, supervise and monitor the parish nurse program.

Catholicism↗
PubMed1991

Values, cohesiveness, and volunteers: icons for our future.

Newly installed MHA Chairman Edward B. McRee, president of Ingham Medical Center in Lansing, addressed MHA members and guests during the association's 1991 Annual Corporate Membership Meeting on Mackinac Island this summer, saying the key to success for the association, and for the health care industry in general, lies in our cohesiveness. Following is the text of his remarks to the group.

Community-Institutional Relations↗
PubMed1992

Boundary fighting: territorial conflicts in health organizations.

If health institutions are to be healthy places to work and study, managers in these institutions will have to take the lead to revamp old tradition-based boundaries. Health problems now rarely require the exclusive care of one specialist. Health care and rehabilitation require that many health care specialists work together. And, prevention crosses all disciplinary boundaries. Similarly, our changing society requires a more flexible workplace with job sharing, teaming, multicompetent personnel, and an environment that is dedicated more to meeting the needs of consumers than those of health professionals. Boundaries in health institutions must change if these institutions are to meet the needs of a changing society and attract and retain health care professionals who want to experience the opportunities of new, more permeable boundaries without the ordeal of warfare.

Conflict, Psychological↗
PubMed1993

Developing a collaborative culture in a hospital setting. Interview by Donald E.L. Johnson.

Moving an organization from "me"to "we" can be a frightening proposition for any organization. Tim Harrington, chief executive officer of Victory Hospital, Waukegan, IL, offers his perspectives to Health Care Strategic Management publisher, Donald E. L. Johnson. Harrington found that a collaborative environment within Victory hospital and Baxter enabled the introduction of total quality management and continuous quality improvement concepts to be freely introduced into the system. He also provides guidance for establishing and fostering collaboration among hospital departments, especially amid middle-management personnel.

Chief Executive Officers, Hospital↗
PubMed1993

Adoption and abandonment of matrix management programs: effects of organizational characteristics and interorganizational networks.

Organizational design theorists argue that organizations adopt matrix (departmentalized) structures for technical reasons, to solve problems of internal coordination and information processing. Research on interorganizational networks suggests that organizations adopt new structures because of mimetic forces and normative pressures. We examined the effects of both sets of factors on the adoption of matrix management in a group of hospitals. Multivariate analyses revealed that matrix adoption is influenced not only by task diversity, but also by sociometric location, the dissemination of information, and the cumulative force of adoption in interorganizational networks. Such variables exert little influence on decisions to abandon matrix programs, however.

Decision Making, Organizational↗
PubMed1994

Find your department's rung on the ladder of sophistication.

How highly evolved is your materials management department? Those on the lower rungs of the evolutionary ladder have passive, non-strategic roles and simply react to input from other departments; those that have evolved to higher levels are more active and involved in the organization's strategic decisions.

Decision Making, Organizational↗