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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
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Agreement between virtual and in-the-field environmental audits of assisted living sites.

https://arctichealth.org/en/permalink/ahliterature103081
Source
J Aging Phys Act. 2014 Jul;22(3):414-20
Publication Type
Article
Date
Jul-2014
Author
Anna M Chudyk
Meghan Winters
Erin Gorman
Heather A McKay
Maureen C Ashe
Author Affiliation
Dept. of Medicine, University of British Columbia, Vancouver, BC, Canada.
Source
J Aging Phys Act. 2014 Jul;22(3):414-20
Date
Jul-2014
Language
English
Publication Type
Article
Keywords
Aged
Assisted Living Facilities - standards
British Columbia
Decision Support Systems, Management
Environment Design
Geographic Information Systems
Humans
Internet
Management Audit - methods - standards
Reproducibility of Results
Residence Characteristics
User-Computer Interface
Abstract
The authors investigated the use of Google Earth's Street View option to audit the presence of built environment features that support older adults' walking. Two raters conducted virtual (Street View) and in-the-field audits of 48 street segments surrounding urban and suburban assisted living sites in metropolitan Vancouver, BC, Canada. The authors determined agreement using absolute agreement. Their findings indicate that Street View may identify the presence of features that promote older adults' walking, including sidewalks, benches, public washrooms, and destinations. However, Street View may not be as reliable as in-the-field audits to identify details associated with certain items, such as counts of trees or street lights; presence, features, and height of curb cuts; and sidewalk continuity, condition, and slope. Thus, the appropriateness of virtual audits to identify microscale built environment features associated with older adults' walking largely depends on the purpose of the audits-specifically, whether the measurer seeks to capture highly detailed features of the built environment.
PubMed ID
24085399 View in PubMed
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Allocation of labour to somatic and psychiatric specialist care--the effects of earmarked grants.

https://arctichealth.org/en/permalink/ahliterature82779
Source
Health Policy. 2006 Oct;78(2-3):115-27
Publication Type
Article
Date
Oct-2006
Author
Halsteinli Vidar
Ose Solveig Osborg
Torvik Heidi
Hagen Terje P
Author Affiliation
SINTEF Health Services Research, NO-7465 Trondheim, Norway. vidar.halsteinli@sintef.no
Source
Health Policy. 2006 Oct;78(2-3):115-27
Date
Oct-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Aged
Financing, Organized - economics
Health Care Rationing
Humans
Management Audit
Norway
Psychiatric Somatic Therapies - manpower
Resource Allocation - economics
Specialties, Medical
State Medicine
Abstract
Until 2002, counties were responsible for providing both somatic and psychiatric specialized health care services in Norway. The financing arrangement of the counties consisted of fixed local taxes, a general block grant and different types of earmarked grants from the national government. Since 1997, earmarked conditional grants related to DRG-activity have been used for somatic services, whereas earmarked unconditional grants have been used for mental health care services from approximately the same time. This paper analyse the price and revenue effects of grants on the allocation of labour, with special attention to the two types of earmarked grants: conditional and unconditional. Theoretically, labour (as an index of production output) is assumed to be allocated to somatic and psychiatric services dependent upon revenues (taxes, block grants and earmarked unconditional grants), price per labour-year (that among other things are affected by earmarked conditional grants) and the preferences of the local government (which relate to the age structure and population density of the county). We assume that a conditional grant reduces the net price of labour and thereby increases the (relative) demand, whereas an unconditional grant adds to the other revenues of the county and do not affect the relative allocation of labour. Data from a panel of 18 counties for the period 1992-2001 is analysed using OLS with fixed effects. The results show revenue effects and direct price effects as expected. However, the assumption that unconditional grants do not affect relative allocation of labours is not supported. We find a positive effect of the unconditional grant to psychiatric care on the demand for labour in this sector. We interpret this as an effect of hierarchical governance such as supervision and monitoring that were remedies that were used together with the unconditional grant.
PubMed ID
16472885 View in PubMed
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Applying the balanced scorecard to local public health performance measurement: deliberations and decisions.

https://arctichealth.org/en/permalink/ahliterature151095
Source
BMC Public Health. 2009;9:127
Publication Type
Article
Date
2009
Author
Erica Weir
Nadine d'Entremont
Shelley Stalker
Karim Kurji
Victoria Robinson
Author Affiliation
Public Health Branch, Community and Health Services Department, Regional Municipality of York, Newmarket, Canada. erica.weir@york.ca
Source
BMC Public Health. 2009;9:127
Date
2009
Language
English
Publication Type
Article
Keywords
Consumer Participation
Health Status Indicators
Humans
Management Audit - methods
Ontario
Public Health - methods - standards
Public Health Administration - standards
Quality Assurance, Health Care - methods - organization & administration
Staff Development
Abstract
All aspects of the heath care sector are being asked to account for their performance. This poses unique challenges for local public health units with their traditional focus on population health and their emphasis on disease prevention, health promotion and protection. Reliance on measures of health status provides an imprecise and partial picture of the performance of a health unit. In 2004 the provincial Institute for Clinical Evaluative Sciences based in Ontario, Canada introduced a public-health specific balanced scorecard framework. We present the conceptual deliberations and decisions undertaken by a health unit while adopting the framework.
Posing, pondering and answering key questions assisted in applying the framework and developing indicators. Questions such as: Who should be involved in developing performance indicators? What level of performance should be measured? Who is the primary intended audience? Where and how do we begin? What types of indicators should populate the health status and determinants quadrant? What types of indicators should populate the resources and services quadrant? What type of indicators should populate the community engagement quadrant? What types of indicators should populate the integration and responsiveness quadrants? Should we try to link the quadrants? What comparators do we use? How do we move from a baseline report card to a continuous quality improvement management tool?
An inclusive, participatory process was chosen for defining and creating indicators to populate the four quadrants. Examples of indicators that populate the four quadrants of the scorecard are presented and key decisions are highlighted that facilitated the process.
Notes
Cites: J Health Organ Manag. 2006;20(4):335-4316921817
Cites: Can J Public Health. 2003 Sep-Oct;94(5):391-614577752
Cites: Healthc Q. 2008;11(2):52-6, 218362520
Cites: Can J Public Health. 2008 Mar-Apr;99(2):8518457277
PubMed ID
19426508 View in PubMed
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Auditing dietetic services in a psychiatric facility.

https://arctichealth.org/en/permalink/ahliterature244357
Source
Dimens Health Serv. 1981 Jul;58(7):16-8
Publication Type
Article
Date
Jul-1981

Audit matrix for evaluating Finnish occupational health units.

https://arctichealth.org/en/permalink/ahliterature203513
Source
Scand J Work Environ Health. 1998 Oct;24(5):439-43
Publication Type
Article
Date
Oct-1998
Author
K P Martimo
Author Affiliation
Research and Development Centre for Occupational Health Services, Finnish Institute of Occupational Health, Helsinki. kari-pekka.martimo@metsaserla.fi
Source
Scand J Work Environ Health. 1998 Oct;24(5):439-43
Date
Oct-1998
Language
English
Publication Type
Article
Keywords
Evaluation Studies as Topic
Finland
Guidelines as Topic
Health Services Research
Humans
Management Audit - methods
Medical Audit - methods
Occupational Health Services - standards
Abstract
The aim of this article is to describe how an audit matrix for occupational health units was formulated, what the preliminary results tell about its applicability, and how the matrix can help to implement the principles of "good practice in occupational health services".
Twelve areas eligible for auditing were selected for the matrix. According to the recently issued principles of good practice, the principles of total quality management and continuous quality improvement, each area was divided into descriptions of 4 quality levels, the lowest being given 0 points and the highest 5-6 points. The maximum total score was 72 points.
Of the 30 external audits, no unit had less than 18 points. Nine units had 19-36 points, 17 units had 37-54 points, and 4 units had over 54 points. "Maintenance of work ability" received the highest mean of the given points (4.1), followed by "curative care"(4.0) and "multidisciplinarity"(3.9). The lowest means were for "planning of activities" (3.1), "customer orientation"(3.2), and "quality improvement"(3.2).
The audit matrix proved to be a practical method for auditing occupational health units, revealing both the most common flaws and strengths in the quality of Finnish occupational health services. Because the matrix has been accepted well by occupational health professionals and it manages to classify the units, it is probably a useful instrument for evaluating the performance of occupational health units and promoting good practice.
PubMed ID
9869317 View in PubMed
Less detail
Source
Can Vet J. 1997 Apr;38(4):217-25
Publication Type
Article
Date
Apr-1997
Author
J. Van Donkersgoed
G. Jewison
M. Mann
B. Cherry
B. Altwasser
R. Lower
K. Wiggins
R. Dejonge
B. Thorlakson
E. Moss
C. Mills
H. Grogan
Author Affiliation
Alberta Agriculture, Food and Rural Development, Alberta.
Source
Can Vet J. 1997 Apr;38(4):217-25
Date
Apr-1997
Language
English
Publication Type
Article
Keywords
Abattoirs - economics - standards
Animal Husbandry - economics - organization & administration
Animals
Body Composition - physiology
Body Weight - physiology
Canada
Cattle - physiology
Female
Financial Audit
Food-Processing Industry - economics - organization & administration
Humans
Male
Management Audit
Meat - economics - standards
Pregnancy
Pregnancy Rate
Quality Control
Abstract
A study was conducted in 4 Canadian processing plants in 1995-96 to determine the prevalence of quality defects in Canadian cattle. One percent of the annual number of cattle processed in Canada were evaluated on the processing floor and 0.1% were graded in the cooler. Brands were observed on 37% and multiple brands on 6% of the cattle. Forty percent of the cattle had horns, 20% of which were scurs, 33% were stubs, 10% were tipped, and 37% were full length. Tag (mud and manure on the hide) was observed on 34% of the cattle. Bruises were found on 78% of the carcasses, 81% of which were minor in severity. Fifteen percent of the bruises were located on the round, 29% on the loin, 40% on the rib, 16% on the chuck, and 0.02% on the brisket. Grubs were observed in 0.02% of the steers, and injection sites were observed in 1.3% of whole hanging carcasses. Seventy percent of the livers were passed for human food and 14% for pet food; 16% were condemned. Approximately 71% of the liver condemnations were due to liver abscesses. Four percent of the heads, 6% of the tongues, and 0.2% of whole carcasses were condemned. The pregnancy rate in female cattle was approximately 6.7%. The average hot carcass weight was 357 kg (s = 40) in steers, 325 kg (s = 41) in heifers, 305 kg (s = 53) in cows, 388 kg (s = 62) in virgin bulls and 340 kg (s = 39) in mature bulls. The average ribeye area in all cattle was 84 cm2 (s = 12); range 29 cm2 to 128 cm2. Grade fat was highly variable and averaged 9 mm (s = 4) for steers and heifers, 6 mm (s = 6) for cows, 5 mm (s = 1) for virgin bulls, and 4 mm (s = 0.5) for mature bulls. The average lean meat yield was 59.7% in cattle (s = 3.4); range 39% to 67%. One percent of the carcasses were devoid of marbling, 1% were dark cutters, and 0.05% of the steer carcasses were staggy. Six percent of the carcasses had poor conformation, 3.7% were underfinished, and 0.7% were overfinished. Yellow fat was observed in 4% of the carcasses; 10% of carcasses were aged. Based on January 1996 prices, the economic analysis showed that the Canadian beef industry lost $70.52 per head or $189.6 million annually from quality nonconformities. Methods identified to reduce these nonconformities included improvements in management, animal identification, handling, genetic selection, marketing, grading, and information transfer.
Notes
Cites: J Anim Sci. 1990 May;68(5):1201-72365638
Cites: J Anim Sci. 1994 Apr;72(4):824-78014146
Cites: J Anim Sci. 1995 Dec;73(12):3510-88655423
Comment In: Can Vet J. 1997 Jun;38(6):3319187799
PubMed ID
9105719 View in PubMed
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Continuous quality improvement reduces length of stay for fast-track patients in an emergency department.

https://arctichealth.org/en/permalink/ahliterature212551
Source
Acad Emerg Med. 1996 Mar;3(3):258-63
Publication Type
Article
Date
Mar-1996
Author
C M Fernandes
J M Christenson
A. Price
Author Affiliation
Department of Emergency Medicine, St. Paul's Hospital, Vancouver, BC, Canada.
Source
Acad Emerg Med. 1996 Mar;3(3):258-63
Date
Mar-1996
Language
English
Publication Type
Article
Keywords
British Columbia
Emergencies
Emergency Service, Hospital - organization & administration - standards - utilization
Hospitals, Urban
Humans
Length of Stay
Management Audit
Organizational Innovation
Retrospective Studies
Total Quality Management
Triage
Abstract
To demonstrate how continuous quality improvement (CQI) can identify rational and effective means to reduce length of stay for minor illness/injury in an ED.
A CQI team documented the process of fast-track (FT) patient flow and prioritized the causes of delay. In Phase I, two solutions were implemented. In this Phase II of the study, three changes were implemented, including expansion of the FT area, realignment to provide a full-time FT nurse, and a detailed, stricter triage classification. The outcome was assessed by examining the interval from presentation to release from the ED (length of stay; LOS). Differences were ascertained by analysis variance for consecutive FT patients not requiring radiography, ECG, or blood testing. Intervals from three pre-Phase II intervention 48-hour periods and one post-Phase II intervention 48-hour period were analyzed.
Before the Phase I changes, the mean +/- SD LOS was 92 +/- 46 min. After the Phase I changes, the LOS was 67 +/- 31 min. After the Phase II changes, this was reduced to 57 +/- 34 min (p
PubMed ID
8673783 View in PubMed
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Do global indicators of protected area management effectiveness make sense? A case study from Siberia.

https://arctichealth.org/en/permalink/ahliterature269578
Source
Environ Manage. 2015 Jul;56(1):176-92
Publication Type
Article
Date
Jul-2015
Author
Brandon P Anthony
Elena Shestackova
Source
Environ Manage. 2015 Jul;56(1):176-92
Date
Jul-2015
Language
English
Publication Type
Article
Keywords
Conservation of Natural Resources - methods
Environmental monitoring
Humans
Management Audit
Siberia
Abstract
Driven by the underperformance of many protected areas (PAs), protected area management effectiveness (PAME) evaluations are increasingly being conducted to assess PAs in meeting specified objectives. A number of PAME tools have been developed, many of which are based on the IUCN-WCPA framework constituting six evaluative elements (context, planning, input, process, output, and outcomes). In a quest for a more universal tool and using this framework, Leverington et al. (Environ Manag 46(5):685-698, 2010) developed a common scale and list of 33 headline indicators, purported to be representative across a wide range of management effectiveness evaluation tools. The usefulness of such composite tools and the relative weighting of indicators are still being debated. Here, we utilize these headline indicators as a benchmark to assess PAME in 37 PAs of four types in Krasnoyarsk Kray, Russia, and compare these with global results. Moreover, we review the usefulness of these indicators in the Krasnoyarsk context based on the opinions of local PA management teams. Overall, uncorrected management scores for studied PAs were slightly better (mean = 5.66 ± 0.875) than the global average, with output and outcome elements being strongest, and planning and process scores lower. Score variability is influenced by PA size, location, and type. When scores were corrected based on indicator importance, the mean score significantly increased to 5.75 ± 0.858. We emphasize idiosyncrasies of Russian PA management, including the relative absence of formal management plans and limited efforts toward local community beneficiation, and how such contextual differences may confound PAME scores when indicator weights are treated equal.
PubMed ID
25850615 View in PubMed
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40 records – page 1 of 4.