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Application of Lean Six Sigma for patients presenting with ST-elevation myocardial infarction: the Hamilton Health Sciences experience.

https://arctichealth.org/en/permalink/ahliterature170153
Source
Healthc Q. 2006;9(1):56-61, 2
Publication Type
Article
Date
2006
Author
Ayad Aldarrab
Author Affiliation
Royal College Residency Training Program, McMaster University, Hamilton, Ontario. Edarrab@hotmail.com
Source
Healthc Q. 2006;9(1):56-61, 2
Date
2006
Language
English
Publication Type
Article
Keywords
Benchmarking
Crowding
Electric Countershock - utilization
Electrocardiography - utilization
Emergency Service, Hospital - standards - utilization
Humans
Institutional Management Teams
Models, organizational
Myocardial Infarction - diagnosis - drug therapy
Ontario
Practice Guidelines as Topic
Process Assessment (Health Care)
Quality Assurance, Health Care
Software Design
Thrombolytic Therapy - utilization
Time Factors
Abstract
Most patients with symptomatic acute myocardial infarction (AMI), the leading cause of death in western industrialized nations, use the emergency department (ED) as their point of entry. Yet, one identified barrier to early recognition of patients with AMI is ED overcrowding. In this paper, the author presents a quality improvement model that applies Lean Six Sigma guidelines to the clinical setting.
Notes
Erratum In: Healthc Q. 2006;9(2):16
PubMed ID
16548435 View in PubMed
Less detail

Computer supported visualisation of quality systems developed by network teams.

https://arctichealth.org/en/permalink/ahliterature185469
Source
Appl Ergon. 2003 May;34(3):239-47
Publication Type
Article
Date
May-2003
Author
Mikael Blomé
Curt R Johansson
Per Odenrick
Author Affiliation
Lund University Centre for Research on People, Technology and Change at Work, Lund, Sweden. mikael.blome@design.lth.se
Source
Appl Ergon. 2003 May;34(3):239-47
Date
May-2003
Language
English
Publication Type
Article
Keywords
Cooperative Behavior
Human Engineering
Humans
Institutional Management Teams
Internet
Pilot Projects
Sweden
Total Quality Management - organization & administration
Abstract
This paper reports a pilot study and three case studies to examine aimed at studying if a quality system, according to the ISO 9000 quality standard, can be visualised, exploring how the visualisation should be designed in order to support continuous improvements and evaluating the design process for development of prototypes. By discussing with the research team, three companies in southern Sweden set up design teams to establish principles for visualisations of their quality systems on their intranets. Together with one of the researchers, the design teams created and evaluated computer supported prototypes and exchanged ideas between the teams via the Internet. The results show that quality systems can be adequately visualised and that the companies preferred descriptions of the physical plant layout containing symbols that connect to further information by hyperlinks. A quality system based on computer supported visualisation will make the quality system more understandable and have better possibilities to engage personnel in the quality work; it will be faster, easier, and more interesting to use than systems with only paper documents. The use of design teams with access to each other's prototypes via the Internet supported the design process by stimulating generation of ideas and solutions to visualise a quality system.
PubMed ID
12737924 View in PubMed
Less detail

Conflict management in a hospital: designing processing structures and intervention methods.

https://arctichealth.org/en/permalink/ahliterature193336
Source
J Manag Med. 2001;15(2):156-66
Publication Type
Article
Date
2001
Author
M. Skjørshammer
Author Affiliation
Diakonhjemmet College, Oslo, Norway.
Source
J Manag Med. 2001;15(2):156-66
Date
2001
Language
English
Publication Type
Article
Keywords
Conflict (Psychology)
Employee Grievances
Health Services Research
Hospitals, Urban - manpower - organization & administration
Humans
Institutional Management Teams
Interprofessional Relations
Leadership
Negotiating - methods
Norway
Organizational Culture
Organizational Innovation
Personnel Administration, Hospital - methods
Personnel, Hospital - psychology
Professional Competence
Abstract
This article presents a case study describing the development, structure and operation of a comprehensive system for managing conflicts in a Norwegian city hospital. This was done in an effort to further develop the dispute mechanisms available in the hospital and to strengthen the management skills of clinical leaders and managers in general. By changing the ways managers and professionals handle their disputes, the hospital hopes to reduce the cost of conflicts and realize its benefits. The new conflict management system includes new procedures for managers and professionals to process disputes. The design process of the new system was framed according to an action research approach characterized by creating change through dialogue and the use of local expertise.
PubMed ID
11547823 View in PubMed
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Construction-related nosocomial infections in patients in health care facilities. Decreasing the risk of Aspergillus, Legionella and other infections.

https://arctichealth.org/en/permalink/ahliterature192970
Source
Can Commun Dis Rep. 2001 Jul;27 Suppl 2:i-x, 1-42, i-x, 1-46
Publication Type
Article
Date
Jul-2001
Source
Can Commun Dis Rep. 2001 Jul;27 Suppl 2:i-x, 1-42, i-x, 1-46
Date
Jul-2001
Language
English
French
Publication Type
Article
Keywords
Aspergillosis - etiology - prevention & control
Canada - epidemiology
Cross Infection - epidemiology - etiology - prevention & control
Disease Outbreaks - prevention & control
Facility Design and Construction - standards
Humans
Infection Control - organization & administration
Institutional Management Teams
Legionnaires' Disease - epidemiology - etiology - prevention & control
Risk Assessment - methods
Risk factors
Abstract
Construction and renovation projects in health care facilities are a risk for certain patients, particularly those who are immunocompromised. A proactive approach must be taken to limit construction-related nosocomial infections. This requires having a multidisciplinary team, supported by administration, to plan and implement preventive measures throughout the duration of the construction project. The ICP should be an active team member in all phases of the project. The ICP plays a major role by providing education to personnel; ensuring that preventive measures are identified, initiated, and maintained; and carrying out surveillance for infections in patients. By ensuring that the appropriate preventive measures are in place and clear lines of communication exist among the personnel, patient safety will be enhanced.
PubMed ID
11593827 View in PubMed
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Co-operation as a strategy for provision of welfare services--a study of a rehabilitation project in Sweden.

https://arctichealth.org/en/permalink/ahliterature164403
Source
Eur J Public Health. 2007 Oct;17(5):532-6
Publication Type
Article
Date
Oct-2007
Author
Christina Norman
Runo Axelsson
Author Affiliation
Nordic School of Public Health, P.O. Box 12133, SE-402 42 Göteborg, Sweden.
Source
Eur J Public Health. 2007 Oct;17(5):532-6
Date
Oct-2007
Language
English
Publication Type
Article
Keywords
Cooperative Behavior
Documentation
Focus Groups
Health Plan Implementation - organization & administration
Humans
Institutional Management Teams
Interinstitutional Relations
Organizational Case Studies
Organizational Culture
Program Evaluation - methods
Rehabilitation - organization & administration
Social Welfare
Social Work - organization & administration
State Medicine - organization & administration
Sweden
Abstract
During the past 15 years, there have been many initiatives to improve the integration between different welfare agencies. This study is describing and analysing the co-operation between agencies involved in a rehabilitation project in Sweden, and discussing such inter-agency co-operation as a strategy for provision of complex welfare services.
The study is based on a process evaluation, where the co-operation between the agencies was followed and documented during the time of the project. Different kinds of data were collected through interviews, focus groups and diaries. The contents of these data were analysed in order to evaluate the process of co-operation. In addition, there was also an evaluation of the effects of the co-operation, based on official documents, statistics, etc.
The evaluation shows that it was possible to co-operate across the organizational boundaries of the different agencies, but there were obstacles related to organizational and cultural differences of the agencies, divided loyalties of the officials and limited resources available to deal with the complex needs of the clients. At the same time, the commitment and the relations between the officials were facilitating the co-operation.
Based on the evaluation of this project, it seems that co-operation could be an effective strategy to deal with clients who need services from different welfare agencies. At the same time, however, it is clear that inter-agency co-operation requires a lot of time and energy and should therefore be used with caution.
PubMed ID
17392292 View in PubMed
Less detail

Decentralization of management responsibility: the case of Danish hospitals.

https://arctichealth.org/en/permalink/ahliterature51193
Source
Int J Health Plann Manage. 1993 Oct-Dec;8(4):275-94
Publication Type
Article
Author
T. Pallesen
L D Pedersen
Author Affiliation
Institute of Political Science, University of Aarhus, Denmark.
Source
Int J Health Plann Manage. 1993 Oct-Dec;8(4):275-94
Language
English
Publication Type
Article
Keywords
Budgets - statistics & numerical data - trends
Cost Savings - statistics & numerical data - trends
Decision Making, Organizational
Denmark
Efficiency, Organizational
Financial Management, Hospital - trends
Health Services Research
Hospital Costs - statistics & numerical data - trends
Hospital Departments - economics - trends
Hospital Restructuring - economics
Hospitals, County - economics - organization & administration
Institutional Management Teams
Interdepartmental Relations
Abstract
This article examines a specific management reform at three hospitals in a Danish county. Management reform at the hospital level implies a decentralization of responsibility and power to the departmental level. Along with increased responsibility and power, departments get the message: keep your budgets and keep your output level. This preliminary analysis indicates that departmental budgets can be a way of containing costs in clinical departments. Non-staff expenditures especially are subjected to reductions. The system still seems to 'favour' doctors and nurses, but less than in a system with traditional budgetary institutions. The behaviour of the top-management teams shows that the output constraint is not seriously meant. Departments are allowed to reduce capacity, with declining output, with the knowledge of the top-management team. The declining output makes it easier to departments ceteris paribus to keep within their budgets. And that makes it easier for the top-management team to keep the overall hospital budget. The obligation to keep the overall hospital budget is thus an important criterion of success in the eyes of the political masters of hospitals.
PubMed ID
10134931 View in PubMed
Less detail

Effectiveness in political--administrative decision-making in specialized healthcare.

https://arctichealth.org/en/permalink/ahliterature150495
Source
Scand J Public Health. 2009 Jul;37(5):494-502
Publication Type
Article
Date
Jul-2009
Author
Outi Simonen
Elina Vtanen
Anne Konu
Marja Blom
Author Affiliation
Tampere School of Public Health, University of Tampere, Tampere, Finland. outi.simonen@pp.inet.fi
Source
Scand J Public Health. 2009 Jul;37(5):494-502
Date
Jul-2009
Language
English
Publication Type
Article
Keywords
Cost-Benefit Analysis
Data Collection
Decision Making, Organizational
Documentation
Efficiency, Organizational
Evidence-Based Medicine
Finland
Health Policy
Hospital Administration
Hospital Administrators
Hospital Planning
Humans
Institutional Management Teams
Outcome Assessment (Health Care)
Abstract
To investigate the occurrence of the word ;;effectiveness'' in the political-administrative decision-making minutes in specialized healthcare as presented to board and council meetings by top management teams.
The occurrence and intended use of ;;effectiveness'' were identified from all council and board meeting minutes (n = 190) of five Finnish university hospital districts in 2001 and 2006. Data were collected from the Internet pages of the hospital districts. For analysis, deductive content analysis combining qualitative and quantitative methodologies was used.
The word ;;effectiveness'' occurred in the planning, organization and evaluation of service activities and in the definitions and justifications for the goal states of research and development work. Although objectives were justified by effectiveness, the occurrence and use of the term were not grounded on proven effectiveness but rather represented an ideal being pursued. Use of the word ;;effectiveness'' increased from 2001 to 2006, particularly in the political-administrative decision-making of large hospital districts. This article gives useful information regarding the benefits of effectiveness in political-administrative decision-making.
Healthcare is under pressure to increase effectiveness, which is manifested by rhetoric presentations of the term in the political-administrative decision-making in specialized healthcare. There is a need for focused collection and systematic follow-up of easily available effectiveness information in healthcare.
PubMed ID
19506006 View in PubMed
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The effects of teamwork on staff perception of empowerment and job satisfaction.

https://arctichealth.org/en/permalink/ahliterature207935
Source
Healthc Manage Forum. 1997;10(2):12-24
Publication Type
Article
Date
1997
Author
L I Kutzscher
J A Sabiston
H K Laschinger
M. Nish
Source
Healthc Manage Forum. 1997;10(2):12-24
Date
1997
Language
English
French
Publication Type
Article
Keywords
Decision Making, Organizational
Health Services Research - methods
Hospital Bed Capacity, 300 to 499
Hospitals, University - organization & administration
Humans
Institutional Management Teams - organization & administration
Job Satisfaction
Leadership
Models, organizational
Ontario
Organizational Innovation
Personnel, Hospital - education - psychology
Power (Psychology)
Questionnaires
Staff Development
Abstract
Rosabeth Moss Kanter's model of organizational empowerment was used to examine the effects of a multidisciplinary teamwork project initiated in preparation for a 1995 Canadian Council on Health Services Accreditation survey. Kanter maintains that work structures such as teams foster opportunities to learn and grow, provide access to information, support and resources, empower employees, and result in increased work satisfaction and effectiveness. Staff who participated on multidisciplinary teams to prepare for the accreditation survey (n = 210) and a random sample of staff who did not participate on the teams (n = 348) were surveyed to ascertain their perceptions of work-related empowerment and job satisfaction. Consistent with Kanter's propositions, members participating on teams had higher empowerment scores and perceived access to empowerment structures to be more important than members not participating on these teams. Overall, perceived access to empowerment structures was found to be significantly lower than perceived importance of access to the empowerment structures. The results of this study support the use of multidisciplinary teams as one work redesign strategy for enhancing work effectiveness in the health care environment.
PubMed ID
10169566 View in PubMed
Less detail

Getting going together: can clinical teams and managers collaborate to identify problems and initiate improvement?

https://arctichealth.org/en/permalink/ahliterature180239
Source
Qual Manag Health Care. 2004 Apr-Jun;13(2):130-42
Publication Type
Article
Author
Johan Thor
Bo Herrlin
Karin Wittlöv
John Skår
Mats Brommels
Olle Svensson
Author Affiliation
Medical Management Center, Karolinska Institute, Nobels väg 15 A, S-171 77 Stockholm, Sweden. johan.thor@cmi.ki.se
Source
Qual Manag Health Care. 2004 Apr-Jun;13(2):130-42
Language
English
Publication Type
Article
Keywords
Cooperative Behavior
Decision Making, Organizational
Hip Fractures - surgery
Hospital Administrators
Hospitals, University - standards
Humans
Institutional Management Teams - organization & administration
Patient Care Team - organization & administration
Pilot Projects
Problem Solving
Process Assessment (Health Care) - organization & administration
Quality Assurance, Health Care - organization & administration
Sweden
Waiting Lists
Abstract
A clear aim is key for the success of improvement projects, yet many fail already at this stage. We studied how clinical teams and managers at a university hospital in Sweden identified problems and defined aims as they initiated 24 process improvement projects. Categorizing and comparing problems at 3 stages of problem definition, we found that the majority of problems fell into 1 of 3 categories: information issues, poor procedures, and waiting times. Going through these stages, managers and clinical teams prioritized waiting-time problems. We show how managers can ask such teams to quickly identify problems suited for improvement projects through this step-wise, facts-based approach. We conclude that they can add their management perspective when giving specific assignments, to harness the combined benefits of both a bottom-up and a top-down approach to improvement.
PubMed ID
15127692 View in PubMed
Less detail

35 records – page 1 of 4.