The agenda of the organization. 1: A framework.
It is difficult at times to know if the welfare and well-being of an organization is being best served by the individuals who make decisions on its behalf. Sometimes decisions made are driven more by the needs of individual persons rather than by the needs of the organization. Company politics, conflicts, work relationships, territory and turf, individual status and power and personality issues all influence what happens and how decisions are made. Major decisions in areas such as downsizing, re-organization and corporate strategy are often made by individuals. Do these decisions best suit the agenda of the organization or reflect the agenda of the individual? Who looks after the organizational agenda? Noer's (1993) model is used to illustrate how what is best for the organization, and not just individuals within it, can be attained. (+info)
The agenda of the organization. 2: Interventions.
Many contemporary organizations, though doing well in productivity, are in chaos. Stress amongst managers and employees is still rampant and the assertion that 'people are our best assets' is confirmed more in words than in actions. What interventions are needed to best add value to the agenda of the organization and influence employee performance for the better? A philosophy of employee care includes looking at how managers take responsibility for performance management, deal with their own and others' stress and how the dynamics within organizations can be understood and harnessed for the welfare of the company. It also includes reviewing, articulating and implementing policies and systems that affect individuals in the organization and the organization as a whole. (+info)
The principles of disease elimination and eradication.
The Dahlem Workshop discussed the hierarchy of possible public health interventions in dealing with infectious diseases, which were defined as control, elimination of disease, elimination of infections, eradication, and extinction. The indicators of eradicability were the availability of effective interventions and practical diagnostic tools and the essential need for humans in the life-cycle of the agent. Since health resources are limited, decisions have to be made as to whether their use for an elimination or eradication programme is preferable to their use elsewhere. The costs and benefits of global eradication programmes concern direct effects on morbidity and mortality and consequent effects on the health care system. The success of any disease eradication initiative depends strongly on the level of societal and political commitment, with a key role for the World Health Assembly. Eradication and ongoing programmes constitute potentially complementary approaches to public health. Elimination and eradication are the ultimate goals of public health, evolving naturally from disease control. The basic question is whether these goals are to be achieved in the present or some future generation. (+info)
Disease eradication and health systems development.
This article provides a framework for the design of future eradication programmes so that the greatest benefit accrues to health systems development from the implementation of such programmes. The framework focuses on weak and fragile health systems and assumes that eradication leads to the cessation of the intervention required to eradicate the disease. Five major components of health systems are identified and key elements which are of particular relevance to eradication initiatives are defined. The dearth of documentation which can provide "lessons learned" in this area is illustrated with a brief review of the literature. Opportunities and threats, which can be addressed during the design of eradication programmes, are described and a number of recommendations are outlined. It is emphasized that this framework pertains to eradication programmes but may be useful in attempts to coordinate vertical and horizontal disease control activities for maximum mutual benefits. (+info)
Restructuring the primary health care services and changing profile of family physicians in Turkey.
A new health-reform process has been initiated by Ministry of Health in Turkey. The aim of that reform is to improve the health status of the Turkish population and to provide health care to all citizens in an efficient and equitable manner. The restructuring of the current health system will allow more funds to be allocated to primary and preventive care and will create a managed market for secondary and tertiary care. In this article, we review the current and proposed primary care services models and the role of family physicians therein. (+info)
Camelot or common sense? The logic behind the UCSF/Stanford merger.
Many academic medical centers (AMCs) throughout the United States have established their own community-based integrated delivery systems by purchasing physician groups and hospitals. Other AMCs have merged with existing nonprofit community-based delivery systems. Still other AMCs have been sold to for-profit firms. The AMCs at Stanford and the University of California, San Francisco (UCSF), chose a different strategy: to merge with each other to respond to the unique characteristics of the Bay Area marketplace. (+info)
Regional organisational audit of district departments of public health.
Organisational audit of public health in the United Kingdom is rare. To provide a framework for a structured organisational audit in district public health departments in one region organisational factors contributing to efficient, high quality work were identified and compared between districts, enabling each department to identify its organisational strengths and weaknesses. A draft list of organisational factors, based on the King's Fund organisational audit programme, were rated by 52 public health physicians and trainees in 12 district public health departments in South East Thames region for their importance on a scale of 0 (not relevant) to 5 (vital). Factors with average ratings of > 4, judged to be "vital" and proxies for standards, were then used to compare each district's actual performance, as reported by its director of public health in a self reported questionnaire. In all, 37 responses were received to the rating questionnaire (response rate 71%) and 12 responses to the directors' questionnaire. Of the 54 factors identified as vital factors, 20(37%) were achieved in all 12 districts and 16(30%) in all but one district; 18 were not being achieved by two (33%) districts or more. Overall, vital factors were not being achieved in 9% of cases. The authors concluded that most departments are achieving most vital organisational factors most of the time, but improvement is still possible. The results have been used as a basis for planning the organisation of public health departments in several of the newly formed commissioning agencies. This was the first regional audit of public health of its kind performed in the region and it provided valuable experience for planning future regional audit activity. (+info)
Theoretical framework for implementing a managed care curriculum for continuing medical education--Part I.
Healthcare reform has created a new working environment for practicing physicians, as economic issues have become inseparably intertwined with clinical practice. Although physicians have recognized this change, and some are returning to school for formal education in business and healthcare administration, formal education may not be practical or desirable for the majority of practicing physicians. Other curriculum models to meet the needs of these professionals should be considered, particularly given the growing interest in continuing education for physicians in the areas of managed care and related aspects of practice management. Currently, no theory-based models for implementing a managed care curriculum specifically for working physicians have been developed. This paper will integrate diffusion theory, instructional systems design theory, and learning theory as they apply to the implementation of a managed care curriculum for continuing medical education. Through integration of theory with practical application, a CME curriculum for practicing physicians can be both innovative as well as effective. This integration offers the benefit of educational programs within the context of realistic situations that physicians can apply to their own work settings. (+info)