Healthc (Amst) - An exploration of management practices in hospitals.

Tópicos

{ care(1570) inform(1187) nurs(1089) }
{ patient(1821) servic(1111) care(1106) }
{ high(1669) rate(1365) level(1280) }
{ framework(1458) process(801) describ(734) }
{ patient(2837) hospit(1953) medic(668) }
{ assess(1506) score(1403) qualiti(1306) }
{ visual(1396) interact(850) tool(830) }
{ import(1318) role(1303) understand(862) }
{ model(2341) predict(2261) use(1141) }
{ system(1976) rule(880) can(841) }
{ state(1844) use(1261) util(961) }
{ perform(999) metric(946) measur(919) }
{ age(1611) year(1155) adult(843) }
{ use(2086) technolog(871) perceiv(783) }
{ data(1737) use(1416) pattern(1282) }
{ data(1714) softwar(1251) tool(1186) }
{ research(1085) discuss(1038) issu(1018) }
{ blood(1257) pressur(1144) flow(957) }
{ health(3367) inform(1360) care(1135) }
{ group(2977) signific(1463) compar(1072) }
{ measur(2081) correl(1212) valu(896) }
{ take(945) account(800) differ(722) }
{ motion(1329) object(1292) video(1091) }
{ problem(2511) optim(1539) algorithm(950) }
{ chang(1828) time(1643) increas(1301) }
{ method(984) reconstruct(947) comput(926) }
{ howev(809) still(633) remain(590) }
{ system(1050) medic(1026) inform(1018) }
{ compound(1573) activ(1297) structur(1058) }
{ model(3480) simul(1196) paramet(876) }
{ ehr(2073) health(1662) electron(1139) }
{ model(2656) set(1616) predict(1553) }
{ sampl(1606) size(1419) use(1276) }
{ first(2504) two(1366) second(1323) }
{ time(1939) patient(1703) rate(768) }
{ analysi(2126) use(1163) compon(1037) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ implement(1333) system(1263) develop(1122) }
{ survey(1388) particip(1329) question(1065) }
{ estim(2440) model(1874) function(577) }
{ decis(3086) make(1611) patient(1517) }
{ process(1125) use(805) approach(778) }
{ activ(1452) weight(1219) physic(1104) }
{ model(3404) distribut(989) bayesian(671) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ inform(2794) health(2639) internet(1427) }
{ imag(1057) registr(996) error(939) }
{ bind(1733) structur(1185) ligand(1036) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ patient(2315) diseas(1263) diabet(1191) }
{ studi(2440) review(1878) systemat(933) }
{ treatment(1704) effect(941) patient(846) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ error(1145) method(1030) estim(1020) }
{ learn(2355) train(1041) set(1003) }
{ concept(1167) ontolog(924) domain(897) }
{ clinic(1479) use(1117) guidelin(835) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ method(1557) propos(1049) approach(1037) }
{ design(1359) user(1324) use(1319) }
{ control(1307) perform(991) simul(935) }
{ model(2220) cell(1177) simul(1124) }
{ general(901) number(790) one(736) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ data(3963) clinic(1234) research(1004) }
{ studi(1410) differ(1259) use(1210) }
{ risk(3053) factor(974) diseas(938) }
{ perform(1367) use(1326) method(1137) }
{ studi(1119) effect(1106) posit(819) }
{ spatial(1525) area(1432) region(1030) }
{ record(1888) medic(1808) patient(1693) }
{ monitor(1329) mobil(1314) devic(1160) }
{ research(1218) medic(880) student(794) }
{ data(2317) use(1299) case(1017) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ cost(1906) reduc(1198) effect(832) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ intervent(3218) particip(2042) group(1664) }
{ activ(1138) subject(705) human(624) }
{ can(981) present(881) function(850) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ use(1733) differ(960) four(931) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND: Management practices, including, for example, "Lean" methodologies originally developed at Toyota, may represent one mechanism for improving healthcare performance.METHODS: We surveyed 597 nurse managers at cardiac units to score management on the basis of poor, average, or high performance on 18 practices across 4 dimensions (Lean operations, performance measurement, targets, and employee incentives). We assessed the relationship of management scores to hospital characteristics (size, non-profit status) and market level variables.RESULTS: Our findings provide concrete examples of the high degree of management proficiency of some hospitals, as well as wide variation in management practices. Although the exact ways in which these tools have been implemented vary across hospitals, we identified multiple examples of units that use standardization in their care, track performance on a frequent basis and display data in a visual manner, and set aggressive goals and communicate them clearly to their staff. Regression models indicate that higher management scores are associated with hospitals in more competitive markets, teaching hospitals, and hospitals with a higher net income from patient services (p<0.05).CONCLUSIONS: High quality management practices have been successfully adopted by some hospitals in the US, but the ways in which these practices have been implemented may vary, reflecting the specific context or environment of the hospital. The adoption of modern management practices may be driven in part by market pressure.IMPLICATIONS: An improved understanding of key management practices may assist researchers and policy-makers in identifying mutable hospital characteristics that can drive efficiency, safety, and quality.

Resumo Limpo

ckground manag practic includ exampl lean methodolog origin develop toyota may repres one mechan improv healthcar performancemethod survey nurs manag cardiac unit score manag basi poor averag high perform practic across dimens lean oper perform measur target employe incent assess relationship manag score hospit characterist size nonprofit status market level variablesresult find provid concret exampl high degre manag profici hospit well wide variat manag practic although exact way tool implement vari across hospit identifi multipl exampl unit use standard care track perform frequent basi display data visual manner set aggress goal communic clear staff regress model indic higher manag score associ hospit competit market teach hospit hospit higher net incom patient servic pconclus high qualiti manag practic success adopt hospit us way practic implement may vari reflect specif context environ hospit adopt modern manag practic may driven part market pressureimpl improv understand key manag practic may assist research policymak identifi mutabl hospit characterist can drive effici safeti qualiti

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