Managerial attitude to the implementation of quality management systems in Lithuanian support treatment and nursing hospitals.
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BACKGROUND: The regulations of the Quality Management System (QMS) implementation in health care organizations were approved by the Lithuanian Ministry of Health in 1998. Following the above regulations, general managers of health care organizations had to initiate the QMS implementation in hospitals. As no research on the QMS implementation has been carried out in Lithuanian support treatment and nursing hospitals since, the objective of this study is to assess its current stage from a managerial perspective. METHODS: A questionnaire survey of general managers of Lithuanian support treatment and nursing hospitals was carried out in the period of January through March 2005. Majority of the items included in the questionnaire were measured on a seven-point Likert scale. During the survey, a total of 72 questionnaires was distributed, out of which 58 filled-in ones were returned (response rate 80.6 per cent; standard sampling error 0.029 at 95 per cent level of confidence). RESULTS: Quality Management Systems were found operating in 39.7 per cent of support treatment and nursing hospitals and currently under implementation in 46.6 per cent of hospitals (13.7% still do not have it). The mean of the respondents' perceived QMS significance is 5.8 (on a seven-point scale). The most critical issues related to the QMS implementation include procedure development (5.5), lack of financial resources (5.4) and information (5.1), and development of work guidelines (4.6), while improved responsibility and power sharing (5.2), better service quality (5.1) and higher patient satisfaction (5.1) were perceived by the respondents as the key QMS benefits. The level of satisfaction with the QMS among the management of the surveyed hospitals is mediocre (3.6). However it was found to be higher among respondents who were more competent in quality management, were familiar with ISO 9000 standards, and had higher numbers of employees trained in quality management. CONCLUSION: QMSs are perceived to be successfully running in one third of the Lithuanian support treatment and nursing hospitals. Its current implementation stage is dependent on the hospital size - the bigger the hospital the more success it meets in the QMS implementation. As to critical Quality Management (QM) issues, hospitals tend to encounter such major problems as lack of financial resources, information and training, as well as difficulties in procedure development. On the other hand, the key factors that assist to the success of the QMS implementation comprise managerial awareness of the QMS significance and the existence of employee training systems and audit groups in hospitals. (+info)
Information needs of nurse care managers.
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Unmet information needs of physicians and patients are common, but those of nurse care managers - defined as collaborative care planners for with chronic conditions - are less well understood. We taped and transcribed daily activities and conducted semi-structured interviews of 7 care managers, and analyzed questions elicited through this work through a variety of frameworks. (+info)
Case study: leading change across two sites: introduction of a new documentation system.
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Leading change initiatives across multiple geographic locations has become increasingly frequent among nursing leaders as hospitals merge to form more effective and powerful organizations. This case study illustrates how strong nursing leadership, in conjunction with a transformational change approach, led to the successful implementation of a new documentation system at two hospitals within one organization. The project process is described in detail, including a discussion of lessons learned, and recommendations are provided for the leadership of future multi-site projects. (+info)
The role of the nurse coordinator in spina bifida clinics.
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There are numerous multidisciplinary spina bifida (SB) clinics (typically including urology, orthopedics, neurosurgery, developmental pediatrics, physiatry, nursing, social work, and physical and occupational therapy) throughout the U.S. Many SB clinics have a nurse coordinator. The coordinator's role is truly multifaceted. It goes far beyond coordinating the clinic visit in which patients and families are seen for care. The frequency of clinical visits varies from program to program, from a few hours once a month to a full day every week. This role encompasses many aspects of care for this complex patient population, which will be described. (+info)
Effect of guideline implementation on costs of hand hygiene.
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Hands of health care personnel frequently serve as vectors for the transmission of organisms between patients and are also a major reservoir for pathogens with antimicrobial resistance. Hand hygiene is one effective strategy to reduce health care associated infections. The purposes of this study were to (a) compare the costs of hand hygiene in hospitals with high and low hand hygiene compliance as well as high and low frequency of alcohol hand rub use; and (b) examine associations between hospital characteristics and hand hygiene compliance as well as frequency of alcohol hand rub use. Nursing and health care policy leaders should look for ways to promote sustained adherence to hand hygiene recommendations. (+info)
Restructuring in response to case mix reimbursement in nursing homes: a contingency approach.
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At the recent Academy of Canadian Executive Nurses (ACEN) Annual Meeting in November 2008 in Ottawa, I had the privilege and honour of becoming president of this dynamic organization. Founded more than 30 years ago, ACEN represents the voice of senior academic nursing leadership in Canada, helping to set directions for healthcare policy and contributing to the alignment and advancement of the national agendas for nursing practice, education, research and leadership. (+info)
Nurse labor data: the collection and interpretation of nurse-to-patient ratios.
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