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Accountability: unpacking the suitcase.

https://arctichealth.org/en/permalink/ahliterature168409
Source
Healthc Q. 2006;9(3):72-5, 4
Publication Type
Article
Date
2006
Author
Adalsteinn D Brown
Christina Porcellato
Jan Barnsley
Author Affiliation
Ontario Ministry of Health and Long-term Care.
Source
Healthc Q. 2006;9(3):72-5, 4
Date
2006
Language
English
Publication Type
Article
Keywords
Canada
Decision Making, Organizational
Health Policy
Health Services Research
Humans
Information Services
Management Audit
National health programs - organization & administration
Program Evaluation
Quality Assurance, Health Care
Quality Indicators, Health Care
Social Responsibility
Abstract
"Accountability" is the suitcase word in Canadian healthcare. As policy-makers, managers, researchers and providers, we pack accountability with meaning, carry it around with us and open it up to explain everything from the quality of our relationships with and expectations of one another, to our requirements for more transparency in the use of resources, to our diagnosis of problems and remedies for improving our healthcare system.
PubMed ID
16826770 View in PubMed
Less detail

Administrative decision making in response to sudden health care agency funding reductions: is there a role for ethics?

https://arctichealth.org/en/permalink/ahliterature204203
Source
Nurs Ethics. 1998 Jul;5(4):319-29
Publication Type
Article
Date
Jul-1998
Author
D M Wilson
Source
Nurs Ethics. 1998 Jul;5(4):319-29
Date
Jul-1998
Language
English
Publication Type
Article
Keywords
Alberta
Cost Control
Decision Making, Organizational
Ethics, Institutional
Financing, Government - organization & administration
Health Facility Administrators - psychology
Humans
Questionnaires
Resource Allocation
Abstract
In October 1993, a survey of health care agency administrators was undertaken shortly after they had experienced two sudden reductions in public funding. The purpose of this investigation was to gain insight into the role of ethics in health administrator decision making. A mail questionnaire was designed for this purpose. Descriptive statistics and content analysis were used to summarize the data. Staff reductions and bed closures were the two most frequently reported mechanisms for addressing the funding reductions. Most administrators did not believe that these changes would have a negative public impact. In contrast, the majority indicated that future changes in reaction to additional funding reductions would have a negative public impact. Approximately one-third of the administrators reported ethics to be an element of recent administrative decision making, and one-half could foresee that ethics would be important in the future if reductions continued. These findings are discussed in relation to ethics. Issues for additional research are outlined.
PubMed ID
9782919 View in PubMed
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Adoption of an innovation to repair aortic aneurysms at a Canadian hospital: a qualitative case study and evaluation.

https://arctichealth.org/en/permalink/ahliterature160317
Source
BMC Health Serv Res. 2007;7:182
Publication Type
Article
Date
2007
Author
Nathalie M Danjoux
Douglas K Martin
Pascale N Lehoux
Julie L Harnish
Randi Zlotnik Shaul
Mark Bernstein
David R Urbach
Author Affiliation
Department of Health, Policy, Management and Evaluation, University of Toronto, Toronto, Canada. nathalie.danjoux@utoronto.ca
Source
BMC Health Serv Res. 2007;7:182
Date
2007
Language
English
Publication Type
Article
Keywords
Academic Medical Centers - organization & administration
Aortic Aneurysm, Abdominal - surgery
Blood Vessel Prosthesis Implantation - methods - utilization
Decision Making, Organizational
Diffusion of Innovation
Hospitals, Urban - organization & administration
Humans
Ontario
Organizational Case Studies
Organizational Innovation
Qualitative Research
Vascular Surgical Procedures - methods - utilization
Abstract
Priority setting in health care is a challenge because demand for services exceeds available resources. The increasing demand for less invasive surgical procedures by patients, health care institutions and industry, places added pressure on surgeons to acquire the appropriate skills to adopt innovative procedures. Such innovations are often initiated and introduced by surgeons in the hospital setting. Decision-making processes for the adoption of surgical innovations in hospitals have not been well studied and a standard process for their introduction does not exist. The purpose of this study is to describe and evaluate the decision-making process for the adoption of a new technology for repair of abdominal aortic aneurysms (endovascular aneurysm repair [EVAR]) in an academic health sciences centre to better understand how decisions are made for the introduction of surgical innovations at the hospital level.
A qualitative case study of the decision to adopt EVAR was conducted using a modified thematic analysis of documents and semi-structured interviews. Accountability for Reasonableness was used as a conceptual framework for fairness in priority setting processes in health care organizations.
There were two key decisions regarding EVAR: the decision to adopt the new technology in the hospital and the decision to stop hospital funding. The decision to adopt EVAR was based on perceived improved patient outcomes, safety, and the surgeons' desire to innovate. This decision involved very few stakeholders. The decision to stop funding of EVAR involved all key players and was based on criteria apparent to all those involved, including cost, evidence and hospital priorities. Limited internal communications were made prior to adopting the technology. There was no formal means to appeal the decisions made.
The analysis yielded recommendations for improving future decisions about the adoption of surgical innovations. ese empirical findings will be used with other case studies to help develop guidelines to help decision-makers adopt surgical innovations in Canadian hospitals.
Notes
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PubMed ID
18005409 View in PubMed
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[A dynamic expert system for making organizational decisions in eliminating the aftereffects of disasters].

https://arctichealth.org/en/permalink/ahliterature222953
Source
Voen Med Zh. 1992 Oct;(10):16-8
Publication Type
Article
Date
Oct-1992

All components of the system must be aligned.

https://arctichealth.org/en/permalink/ahliterature184914
Source
Healthc Pap. 2001;2(1):38-43, discussion 86-9
Publication Type
Article
Date
2001
Author
J E Turnball
Author Affiliation
National Patient Safety Foundation,Chicago, Illinois, USA.
Source
Healthc Pap. 2001;2(1):38-43, discussion 86-9
Date
2001
Language
English
Publication Type
Article
Keywords
Canada
Consumer Participation
Continuity of Patient Care
Decision Making, Organizational
Humans
Medical Errors - prevention & control - statistics & numerical data
National health programs - organization & administration
Organizational Culture
Organizational Innovation
Patient Participation
Safety Management - organization & administration
Systems Integration
Abstract
A culture of safety in healthcare will not be achieved until the fragmentation that currently characterizes the delivery system is replaced by an alignment of the many component parts, including providers, patients and their families and front-line workers on the "sharp end'--physicians, nurses and pharmacists. A systemic approach should be introduced that would recognize the interacting nature of the delivery system's component parts, and that a change in one component of the system will provoke a change in another part. Consumers and their families can be empowered through programs that raise awareness, prevent error and mitigate its effect when error does happen. Within the system, the "safety sciences' can provide guides to effective work processes. Finally, it is critical to capture knowledge of what type of error occurs in what place and to elucidate strategies to prevent the error.
Notes
Comment On: Healthc Pap. 2001;2(1):10-3112811154
PubMed ID
12811156 View in PubMed
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Analysis of the decision-making process leading to appendectomy: a grounded theory study.

https://arctichealth.org/en/permalink/ahliterature70860
Source
Scand J Psychol. 2004 Nov;45(5):449-54
Publication Type
Article
Date
Nov-2004
Author
Gerry Larsson
Henrik Weibull
Bodil Wilde Larsson
Author Affiliation
Department of Leadership and Management, Swedish National Defence College, Karolinen, SE-651 80 Karlstad, Sweden. gerry.larsson@fhs.mil.se
Source
Scand J Psychol. 2004 Nov;45(5):449-54
Date
Nov-2004
Language
English
Publication Type
Article
Keywords
Adult
Appendectomy - utilization
Appendicitis - diagnosis
Attitude of Health Personnel
Clinical Competence
Decision Making
Decision Making, Organizational
Decision Support Techniques
Decision Trees
Female
Hospitals, County
Hospitals, District
Humans
Interviews
Male
Middle Aged
Models, Theoretical
Physician's Role
Physician-Patient Relations
Professional-Family Relations
Risk assessment
Sweden
Abstract
The aim was to develop a theoretical understanding of the decision-making process leading to appendectomy. A qualitative interview study was performed in the grounded theory tradition using the constant comparative method to analyze data. The study setting was one county hospital and two local hospitals in Sweden, where 11 surgeons and 15 surgical nurses were interviewed. A model was developed which suggests that surgeons' decision making regarding appendectomy is formed by the interplay between their medical assessment of the patient's condition and a set of contextual characteristics. The latter consist of three interacting factors: (1) organizational conditions, (2) the professional actors' individual characteristics and interaction, and (3) the personal characteristics of the patient and his or her family or relatives. In case the outcome of medical assessment is ambiguous, the risk evaluation and final decision will be influenced by an interaction of the contextual characteristics. It was concluded that, compared to existing, rational models of decision making, the model presented identified potentially important contextual characteristics and an outline on when they come into play.
PubMed ID
15535813 View in PubMed
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An assessment of the introduction of a multi-skilled worker into an acute care setting.

https://arctichealth.org/en/permalink/ahliterature209055
Source
Healthc Manage Forum. 1996;9(3):43-8
Publication Type
Article
Date
1996
Author
B. Trerise
L. Lemieux-Charles
Author Affiliation
St. Paul's Hospital, Vancouver, British Columbia.
Source
Healthc Manage Forum. 1996;9(3):43-8
Date
1996
Language
English
Publication Type
Article
Keywords
Decision Making, Organizational
Food Service, Hospital
Hospital Restructuring - manpower
Housekeeping, Hospital
Humans
Job Description
Ontario
Organizational Culture
Organizational Objectives
Patient-Centered Care - organization & administration
Personnel, Hospital - classification - standards
Psychology, Industrial
Quality Assurance, Health Care
Abstract
The first reengineering project undertaken by the Sunnybrook Health Science Centre after adopting a philosophy of patient-focused care was the introduction of a new category of worker: the multi-skilled service assistant. This article describes the experiences of the first two cohorts of service assistants and assesses the changes made to the work itself and the integration of the new workers into the work environment. It concludes by sharing recommendations for introducing a new work role.
PubMed ID
10162424 View in PubMed
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Application of Karasek's demand/control model a Canadian occupational setting including shift workers during a period of reorganization and downsizing.

https://arctichealth.org/en/permalink/ahliterature208209
Source
Am J Health Promot. 1997 Jul-Aug;11(6):394-9
Publication Type
Article
Author
J. Schechter
L W Green
L. Olsen
K. Kruse
M. Cargo
Author Affiliation
University of British Columbia, Vancouver, Canada.
Source
Am J Health Promot. 1997 Jul-Aug;11(6):394-9
Language
English
Publication Type
Article
Keywords
Adult
Burnout, Professional - psychology
Canada
Cross-Sectional Studies
Decision Making, Organizational
Female
Humans
Internal-External Control
Male
Models, Psychological
Organizational Innovation
Questionnaires
Workload
Workplace - organization & administration
Abstract
To apply Karasek's Job Content Model to an analysis of the relationships between job type and perceived stress and stress behaviors in a large company during a period of reorganization and downsizing.
Cross-sectional mail-out, mail-back survey.
A large Canadian telephone/telecommunications company.
Stratified random sample (stratified by job category) of 2200 out of 13,000 employees with a response rate of 48.8%.
Responses to 25 of Karasek's core questions were utilized to define four job types: low-demand and high control = "relaxed"; high demand and high control = "active"; low demand and low control = "passive", and high demand and low control = "high strain." These job types were compared against self-reported stress levels, perceived general level of health, absenteeism, alcohol use, exercise level, and use of medications and drugs. Similar analyses were performed to assess the influence of shift work.
Employees with "passive" or "high strain" job types reported higher levels of stress (trend test p
PubMed ID
10168257 View in PubMed
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The art and science of evidence-based decision-making ... epidemiology can help!

https://arctichealth.org/en/permalink/ahliterature190776
Source
Can J Public Health. 2002 Jan-Feb;93(1):I1-8, I1-8
Publication Type
Article

399 records – page 1 of 40.