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Staffing requirements for infection control programs in US health care facilities: Delphi project

AMERICAN JOURNAL OF INFECTION CONTROL 2002年第6期30卷 321-333页

作者： O'Boyle, C Jackson, M Henly, SJ Univ Minnesota Sch Nursing Minneapolis MN 55455 USA Univ Calif San Diego Dept Educ Dev & Res Med Ctr La Jolla CA 92093 USA

Background: The guideline for staffing infection control programs of I infection control professional (ICP) for every 250 occupied acute care beds has been used in many health care facilities in the United States since 1985. Since that time, the health care system, patient populations, and expectations about the work of infection prevention and control programs have changed substantially. Methods: The Delphi method was used;data were obtained from a group of ICPs through a series of 10 surveys. Through this iterative process, participant responses were progressively synthesized and areas of agreement and disagreement identified. These surveys were conducted by electronic and paper mail to identify the personal ICP characteristics and structural variables associated with performance of activities required for contemporary infection prevention and control programs in a variety of health care settings. Results: Delphi panel members (n = 32) from 20 states and who represented acute care, long-term care, and community care settings reported tasks in addition to those identified in earlier task analyses as well as expanded responsibilities. Competing responsibilities and lack of adequate resources were the most frequently cited reasons for nonperformance of essential infection control tasks. A ratio of 0.8 to 1.0 ICP for every 100 occupied acute care beds was suggested as adequate staffing by the Delphi panel. Conclusions: Infection control responsibilities have expanded beyond the traditional acute care setting. Recommendations for staffing must not only consider the number of occupied beds (average daily census) but also include the scope of the program, the complexity of the health care facility or system, the characteristics of the patient population, and the unique or urgent needs of the facility and community.

关键词：病床利用率数据收集德尔菲技术卫生设施/组织和管理卫生服务需求医院病床数感染控制/方法感染控制/组织和管理感染控制人员/组织和管理人员配备和时间安排/组织和管理可重复性结果时间因素时间安排美国人类中年人

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ZERO-BASED BUDGETING IN FOOD-SERVICE DEPARTMENTS OF HEALTH-CARE FACILITIES

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JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1979年第2期74卷 146-148页

作者： OLSEN, M Virginia Polytechnic Institute and State University Blacksburg

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Bioterrorism preparedness: A survey of Nebraska health care institutions

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AMERICAN JOURNAL OF INFECTION CONTROL 2002年第1期30卷 46-48页

作者： Helget, V Smith, PW Nebraska Infect Control Network Omaha NE 68106 USA Univ Nebraska Med Ctr Omaha NE USA

In March 2001, a 6-question survey was mailed to all hospitals and long-term care facilities in Nebraska to assess preparedness for bioterrorism. Only half of the respondents at that time believed that bioterrorism was something their community was likely to experience, we found that most facilities (98%) believed that they were unprepared for a bioterrorism event. and many did not know whom to contact in the event of such an emergency. We concluded from the results of the survey that the greatest needs to facilitate preparation were policies and procedures, identification of contacts, medications, protective equipment, laboratory support, and communication.

关键词：生物恐怖民防救灾计划/组织和管理救灾计划/统计学和数值数据卫生保健调查卫生设施/组织和管理卫生设施/统计学和数值数据内布拉斯加组织方针问卷调查人类

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RE-THINKING WHAT AND HOW OF MANAGEMENT EDUCATION FOR HEALTH PROFESSIONALS

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JOURNAL OF APPLIED BEHAVIORAL SCIENCE 1978年第3期14卷 348-365页

作者： PLOVNICK, MS FRY, RE RUBIN, IM CASE WESTERN RESERVE UNIV CLEVELANDOH 44106 SITUAT MANAGEMENT SYSTEMS BOSTONMA

Described are some of the obstacles to the use of Organization Development (OD) approaches in health care systems & the advantages of utilizing training or educational strategies to facilitate organization change efforts in health care. Health system characteristics encouraging the use of training-oriented intervention strategies include: (1) the absence of & need for more managerial expertise & perspective in health organizations, (2) the value ascribed to training, education, & knowledge acquisition in general in these systems, & (3) training sessions circumvent the normal difficulties involved in bringing relevant members of health organizations together for problem-solving activities. The design of effective educational interventions involves consideration of (A) what to teach, (B) whom to teach, & (C) how to teach. In response to (A), health systems have been responsive to topics providing them with better organizational diagnostic skills, & subjects enabling them to organize & structure their systems more effectively. As to (B), Physicians are identified as the most significant ones to teach. The (C) question depends on two considerations: (a) the learning styles of participants & (b) the educational objectives of the program (ie, knowledge-, skill-, or attitude-based). These design concepts combine to yield four distinct teaching strategies for different combinations of learners & learning objectives. Two case illustrations utilizing the above-mentioned educational design approaches are discussed: one for physicians, the other for administrative staffs. 1 Figure. AA.

关键词：行政管理人员/教育课程卫生设施/组织和管理卫生职业/教育医师的作用教学/方法人类

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Selecting a healthcare consultant, Part I: How to get started.

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Journal of quality assurance : a publication of the National Association of Quality Assurance Professionals 1991年第6期13卷 24-24页

作者： Scheuerman, J.L. Smith, V.A. 1Partner Herman Smith Associates a Coopers & Lybrand Division Chicago2Member AAHC Committee on Business Development3President American Association of Healthcare Consultants Fairfax VA

Janet L. Scheuerman and Vaughan A. Smith outline the factors that determine why and when consulting services are appropriate, presenting an overview of the initial steps in consultant selection. The expertise of a consultant is often needed for specialized problems, problems needing immediate assessment, drastic rescue situations, difficulties that defy standard solutions, and changes in the regulatory and competitive environment. Many organizational and planning issues also require outside consulting expertise. Institutions use consultants for specialized information, an independent perspective, as catalysts for change, and for cost-effective service and education. The consulting process consists of five phases;Part I provides a careful analysis of crucial preliminary selection activities. An organizational commitment to the process must be made, and needs, key issues, and expectations defined before selecting a committee and identifying potential consulting sources. Part II will appear in the next issue of the JQA.

关键词：竞争性投标顾问决策组织卫生设施/组织和管理人员选用问题解决专家委员会

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Interorganizational theory and research: implications for health care management, policy, and research.

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Medical care review 1991年第4期48卷 371-409页

作者： Sofaer, S. Myrtle, R.C. George Washington University Medical Center Washington 20037. DC United States

Focuses on the organizational theory of health care environments. Indepth look at the management of health care as a perspective of interorganizational relations; Theoretical aspects of interorganizational relations; ... 详细信息

关键词：癌症医护设施/组织和管理决策组织卫生设施/组织和管理卫生政策卫生服务研究/方法医院管理机构间关系运筹学组织文化政策制订美国

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Managing workers' compensation exposures in healthcare.

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Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management 1998年第3期18卷 28-36页

作者： McDonald, L. North Dakota Insurance Reserve Fund Bismarck USA.

Employees in healthcare are exposed to numerous and varied risks that pose the threat of injury. Management of those exposures by the organization will ultimately help create a safe environment for staff, patients and the public. Incorporating workers' compensation into the risk management program is the first step toward managing and reducing these exposures. This article presents a suggested outline for a written risk management plan for workers' compensation exposures.

关键词：事故预防卫生设施/组织和管理卫生人员人体工程在职培训/组织和管理职务说明职业暴露/预防和控制组织方针规划制订危险处理/方法安全管理/方法美国美国职业安全和卫生署工人补偿金/组织和管理

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A marketing plan for health care in the financial district of san francisco

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Journal of Ambulatory Care Marketing 1987年第1期1卷 31-39页

作者： Evans, Stephanie Department of communication Health Boston MA United States

No abstract available for this article.

关键词：加利福尼亚成本及成本分析数据收集就业卫生设施/组织和管理卫生服务使用研究医学办公室实验室建筑物/组织和管理人类

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The Radically New Medical Care Industry: Implications for Decision Making

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The Journal of Applied Behavioral Science 1978年第3期14卷 266-282页

作者： O'connor John T. Department of Social Science and Policy Studies Worcester Polytechnic Institute Worcester Mass United States

There have been radical changes in the environment which have affected medical care delivery in the U.S. As the population has become better educated and more affluent, the trend has been towards preventive medicine. Tremendous improvements in medical technology have been both beneficial and controversial. Americans now feel that medical care is a basic human right, and third-party financing has made medical care affordable. A series of major pieces of legislation, reflecting the public's attitude, have had a profound effect on heath care delivery. As a result of the social and legal changes of the last 30 years, health care administrators must face new issues in decision-making. The government now plays a major role in planning and regulating the nation's health care systems. Health care administrators have opportunities for leading and influencing the direction of future health care delivery.

关键词：卫生设施/组织和管理人权地区卫生计划社会变迁工艺学医学美国人类

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POWER, AUTHORITY AND STATUS IN HEALTH SYSTEMS - MARXIAN-BASED CONFLICT ANALYSIS

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JOURNAL OF APPLIED BEHAVIORAL SCIENCE 1978年第3期14卷 321-333页

作者： LAMMERT, MH School of Social Work and Community Planning University of Maryland

Behavioral scientists have generally ignored analyses of team settings using a Marxian-based conflict framework. Conflict models are superior to integrative (functional) modes of analysis for settings which are characterized by a differential authority distribution. The differences between modes of analysis may be elaborated. The institutional analysis of conflict may be applied to the case of the East Baltimore Medical Plan, a neighborhood health center which is an extension of Johns Hopkins Medical institute. It was formed in 1969, & was targeted for service to 3,200 low-income families residing in 4 housing projects. In 1972, a reorganizational shift resulted in authority & communication changes. A problem centering on the high rate of disenrollment of residents developed, & Federal Housing Administration questionnaires & interviews (also participant-observation) revealed role & structural organizational insights. Consultation with the director of the neighborhood clinic probably did not make any lasting changes, & the consultation could be analyzed from several perspectives. Power relationships within the East Baltimore Medical Plan may be examined & there is need to consider organizational incentives for interprofessional cooperation. If it is the goal of the medical institution to generate greater power & resources for the poor, then patterns of authority & control within the health care sector will have to be altered. L. Kamel.

关键词：社区卫生中心/组织和管理冲突(心理学) 团体处理卫生设施/组织和管理职业间关系马里兰病人医疗小组社会价值社会主义人类

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