Using customer input to improve managed care performance

How do you get the information you need to manage your company's health care plans effectively? Consider a "customer satisfaction survey" that gathers data from the people who use the plans every day: employees. Make the data work for you when you negotiate costs, communicate key plan features, and look for ways to improve health care quality and upgrade the service you and your employees get from your health plans. American Express and the Chicago Health Plan Value Project (a unique group of 14 companies and 7 health plans) tried this approach, and they now expect a "win-win-win" situation all around.     

A novel technique for identifying opportunities to improve environmental hygiene in the operating room

Environmental cleaning and disinfection is essential for optimizing safe patient care in the OR; however, perioperative staff members have not had an easy-to-use, objective method for determining whether high-touch, potentially contaminated surfaces have been cleaned during terminal room cleaning. To address this issue, members of the Healthcare Environmental Hygiene Study Group used a transparent, removable, environmentally stable disclosing agent and handheld ultraviolet light to determine whether potentially contaminated surfaces had been contacted by a wet disinfection cleaning cloth during terminal cleaning of ORs. Results from the project showed that 237 of 946 targeted surfaces (25%) had the disclosing agent removed (ie, were cleaned). The use of the disclosing agent for staff education and process monitoring has led to significant improvements in the disinfection cleaning process.     

Using software to direct test construction and improve test performance

Over the past 5 years, a test analysis software program was developed and is being successfully used to modify faculty-constructed nursing tests administered to small classes.The interplay of instruction, students, and test items were variables considered while developing a practical, efficient program to produce test performance printouts designed to be used with little need for statistical interpretation.This test performance profile software is now available as freeware for individual nursing faculty.     

Enhancing work climate to improve performance and retain valued employees

Organizational climate is the perception of how it "feels" to work in a particular work environment. Climate is one of the most powerful, yet overlooked, factors when determining the performance of a particular organization or work team. Studies have consistently linked climate to individual and organizational performance. The author discusses the 6 key dimensions of climate, how to evaluate it in an organization, and methods to enhance it.     

手工折纸对提高精神分裂症患者社会技能的研究

目的　探讨手工折纸对精神分裂症患者康复治疗的作用。方法　采用1∶1匹配病例对照研究方法,将康复期精神分裂症患者分为观察组和对照组各30例。对照组给予常规行为康复治疗,观察组给予手工折纸训练,8周为1疗程。两组用阴性症状量表、住院精神病患者康复疗效评定量表进行治疗前后自身对照。结果　观察组阴性症状量表分明显降低,而住院精神病患者康复疗效评定分明显提高,治疗前后差异有显著性(P <0 . 0 5 )。对照组治疗前后无显著性差异。结论　手工折纸训练是一项对精神分裂症患者康复有效的辅助疗法,通过非语言性的训练,可恢复患者动手、动脑能力,提高社会技能。     

Optimizing the hydrophobicity of GDL to improve the fuel cell performance

The gas diffusion layer (GDL) is an important component in the proton exchange membrane fuel cell (PEMFC), and the main function of GDL is to transfer water and gas. This paper explores the effect of the gradient hydrophobicity of GDL on the proton exchange membrane fuel cell (PEMFC). The gradient GDL design uses two microporous layers (MPL). First, polytetrafluoroethylene (PTFE) : carbon black in MPL near the carbon paper side was fixed at 3 : 7, and then the content of PTFE : carbon black in MPL near the catalyst layer (CL) was set to 3 : 7, 2 : 8 and 1 : 9. Second, the fixed PTFE : carbon black in MPL near the carbon paper side was 2 : 8, and the PTFE : carbon black in MPL near CL was 2 : 8 and 1 : 9. We found that, when near the carbon paper side and PTFE : carbon black = 3 : 7, GDL can obtain good cell performance through gradient hydrophobic treatment. Moreover, when near the carbon paper side and PTFE : carbon black = 2 : 8, the cell performance did not change much after GDL gradient hydrophobic treatment. We found that when GDL is subjected to a gradient hydrophobic treatment, the content of PTFE and carbon black must be rationally allocated to obtain good water management capabilities.

The gas diffusion layer (GDL) is an important component in the proton exchange membrane fuel cell (PEMFC), and the main function of GDL is to transfer water and gas.     

Building an idealized measurement system to improve clinical office practice performance

The aim of this article is to introduce key concepts and approaches for building a better practice-based measurement. Physicians are being challenged to produce measurably higher quality of services, lower costs, and better clinical outcomes to remain viable. In the absence of provider-driven practice improvements and independent measurement systems, office practices will remain dependent on performance data from external forces as drivers of change. Three key questions will be addressed in our pursuit of better measurement systems for continuous improvement and competitive advantage: (1) What do we want a measurement system to tell us in the first place? (2) What might an idealized measurement system look like if we had one? (3) What are some of the challenges that office practices face in closing the gap between building an idealized measurement system and the current state of office practice measurement?     

成立护理技术小组提高全院护士临床护理技能

目的对全院护士进行统一培训,提高全院护士的整体技术水平。方法由护理部负责,成立护理技术小组,对常见护理技术制定培训计划,培训、考核全院护士。结果全院所有护士的护理操作水平得到很大的提高。结论加强对护士的临床技术培训,是提高全院护士的临床技能的关键。     

成立护理技术小组提高全院护士临床护理技能

目的 对全院护士进行统一培训,提高全院护士的整体技术水平.方法 由护理部负责,成立护理技术小组,对常见护理技术制定培训计划,培训、考核全院护士.结果 全院所有护士的护理操作水平得到很大的提高.结论 加强对护士的临床技术培训,是提高全院护士的临床技能的关键.     

Role-play using SBAR technique to improve observed communication skills in senior nursing students

Patients in the care of clinically expert professionals suffer medical errors with alarming frequency. The Joint Commission's National Patient Safety Goals strives to improve the effectiveness of communication among caregivers by recommending the implementation of a standardized tool known as SBAR (Situation, Background, Assessment, and Recommendation). This experimental study evaluated data from undergraduate nursing students (N = 115) on their performance using a standardized communication tool SBAR. The mean performance scores of the didactic plus role-play students were significantly higher than those who had didactic instruction alone (t = -2.6, p = 0.005). Findings suggest role-play may have a place in teaching communication skills in nursing schools as well as continuing education and training in hospitals and other health care settings. Interdisciplinary communication training may provide even more effective learning. The link between effective communication and improved patient outcomes also should be studied.