A public/private partnership: the Royal Ottawa Hospital experience

The last few years have seen some provincial governments introduce public/private partnerships (P3s) for the development and operation of healthcare facilities. One such case involves the redevelopment of the Royal Ottawa Hospital.     

Leading for quality in healthcare: development and validation of a competency model

Increased attention to healthcare quality and impending changes due to health reform are calling for healthcare leaders at all levels to strengthen their skills in leading quality improvement initiatives. To address this need, the National Association for Healthcare Quality spearheaded the development and validation of a competency model to support healthcare leaders in assessing their strengths and planning appropriate steps for development. Initial development took place over the course of several days of meetings by an advisory panel of quality professionals. The draft model was then validated via electronic survey of a national sample of 883 quality professionals. Follow-up analyses indicated that the model was content valid for each of the target samples and also distinguished differing levels of job scope and experience. The resulting model contains six domains spanning three organizational levels.     

The development of a consumer guide on the quality of obstetrical services: the Missouri experience.

Missouri published a consumer guide on obstetric in the spring of 1994. This article describes the events and processes that led to the publication of the guide. The guide provided obstetrical quality-of-care indicators on structure, process, and outcomes for each facility doing deliveries. The article describes the principles followed in developing the guide, how the indicators were chosen, how the guide was constructed, and what data sources were used. Several lessons were learned including: a guide opens communication within the provider community, development of a guide is a long process, an advisory committee and preliminary review of findings by providers are necessary, and strong technical expertise is essential.     

The development of a successful physician compensation plan

Physician compensation plans are critical to the success of a physician group or may lead to the demise of the group. Essential components of the development and implementation of a successful physician compensation plan include: strategic planning, physician understanding and buy-in, appropriate incentives, objective performance measurement, and a specific funding source or mechanism. There are two basic philosophies to consider for use: the market-based model and the net economic contribution model. Advantages and disadvantages of each are discussed. Methods of incorporating these multiple aspects into a single plan are described.     

Hospital quality: a PRIDIT approach

BACKGROUND: Access to high quality medical care is an important determinant of health outcomes, but the quality of care is difficult to determine. OBJECTIVE: To apply the PRIDIT methodology to determine an aggregate relative measure of hospital quality using individual process measures. DESIGN: Retrospective analysis of Medicare hospital data using the PRIDIT methodology. SUBJECTS: Four-thousand-two-hundred-seventeen acute care and critical access hospitals that report data to CMS' Hospital Compare database. MEASURES: Twenty quality measures reported in four categories: heart attack care, heart failure care, pneumonia care, and surgical infection prevention and five structural measures of hospital type. RESULTS: Relative hospital quality is tightly distributed, with outliers of both very high and very low quality. The best indicators of hospital quality are patients given assessment of left ventricular function for heart failure and patients given beta-blocker at arrival and patients given beta-blocker at discharge for heart attack. Additionally, teaching status is an important indicator of higher quality of care. CONCLUSIONS: PRIDIT allows us to rank hospitals with respect to quality of care using process measures and demographic attributes of the hospitals. This method is an alternative to the use of clinical outcome measures in measuring hospital quality. Hospital quality measures should take into account the differential value of different quality indicators, including hospital "demographic" variables.     

New graduate program at UNISINOS: sharing the experience of a pedagogical act

In this article we present the process of creation of an innovative proposal for undergraduate teaching, developed by an interdisciplinary group at "Universidade do Vale do Rio dos Sinos--UNISINOS". Besides pointing out the theoretical-epistemological referential supporting this proposal, we will also be discussing the implications some paradigm ruptures have brought to the educational process presently being used at this University. We would like to introduce the reader to the process behind this way of understanding and living the educational practice, as well as to follow the account of an experience a group of teachers has had, when confronted with the task of pondering a new undergraduate program.     

医院财务制度规划与建设

1 医院财务制度规划与建设的意义 1.1 是贯彻执行国家有关法律法规的需要 国家为了对社会经济进行管理,出台了很多关于国家预算、政府采购、资产管理、税收、会计、内控等内容的法律法规和规章,这些法律法规和规章是医院进行经济活动应遵循的一般准则,执行具有强制性,如何贯彻执行这些法律法规和规章,是摆在医院管理者面前的一个问题.     

The development of a corporate philosophy in a mental health organization

The importance of a corporate philosophy for a mental health organization is addressed in light of concepts such as organizational climate and corporate culture. The functions, benefits, and potential drawbacks of a corporate philosophy are discussed along with a review of some of the executive skills required to manage a corporate culture. A case study of the development of an organizational philosophy in a mental health organization is presented along with a sample statement of philosophy and organizational credo. Outcomes are described and implications for decision making, service delivery, and management are discussed.