Thesis (D.P.H.)--University of Michigan, 1996.

This study was designed to evaluate the planning process in hospitals. The specific problem of concern in this investigation was the pressing need for planning by hospitals that focuses upon the constraints imposed by governmental regulation and by resource limitations. The purpose of this study was to identify marketing concepts that have application to the hospital planning process and to make a general evaluation of their current utilization in North Central Texas area.

The components of a quality assurance program for smaller hospitals in British Columbia have been defined. These components have been defined by a comparison of the normative standards as determined in the literature and by a survey of administrators. Sixteen administrators of predominantly acute-care, accredited, 20-50-bed hospitals in B.C. were surveyed. Twelve of these administrators were surveyed twice. A new requirement for accreditation was introduced by the Canadian Council on Hospital Accreditation (C.C.H.A.) called the Quality Assurance Standard (1985). This Standard required that quality assurance (QA) programs be established in every department or service in the hospital. The Standard does not give a clear description of the QA functions for each individual department in a smaller hospital. An important and relevant list of specific functions for a QA program were identified at various C.C.H.A. seminars held across Canada in late 1983 and early 1984. The literature review indicated that there were a number of controversial issues affecting the implementation of the QA Standard. In spite of many methodological problems associated with quality measurement and assurance, most hospitals will adopt a quality assurance model. The first survey asked the administrators to define the purpose, goals and objectives of a QA program. They were also asked to determine the QA functions for four areas: hospital board, dietary, nursing and pharmacy. Administrators were asked to identify who in the hospital is primarily responsible for the overall QA program and for the QA program in four areas; the problems and benefits encountered when trying to implement a QA program; and their opinion of the new QA requirements for accreditation. The second survey asked the administrators to assign a priority to those functions identified in Round I. The empirical findings were then compared with the normative standards. With some exceptions, the empirical data were consistent with the normative standards. The empirical findings shows that there are problems related to implementing a QA program but at the same time there are a number of benefits related to the program. The priority ratings of the functions indicated areas of high or low importance to the administrator. It is likely that these priority ratings are useful for planning when alternatives must be considered during this time of fiscal restraint. Government policies along with the strong voluntary support of accreditation programs make it vitally important that suitable models for implementing QA are developed. The Doll model is suggested as a basis for implementing QA. Further areas for research are presented. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

by Chan Wai Kei Victoria. / Thesis (M.B.A.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (leaves 75-79). / ABSTRACT --- p.3 / Chapter CHAPTER I: --- INTRODUCTION --- p.4 / Chapter CHAPTER II: --- GLOBAL AND LOCAL HEALTHCARE REFORM --- p.7 / Chapter CHAPTER III: --- HEALTHCARE REFORM AND TEAMWORK --- p.12 / Chapter CHAPTER IV : --- LITERATURE REVIEW OF RESEARCH ON TEAMWORK --- p.15 / Chapter CHAPTER V : --- CONCEPTUAL FRAMEWORK OF THE STUDY --- p.24 / Chapter CHAPTER VI: --- METHODOLOGY --- p.32 / Chapter CHAPTER VII : --- INTERVIEW RESULTS --- p.37 / Chapter CHAPTER VIII : --- ANALYSIS --- p.53 / Chapter CHAPTER IX : --- RECOMMENDATION --- p.61 / Chapter CHAPTER X : --- CONCLUSION --- p.71 / APPENDIX : GUIDELINE FOR INTERVIEWING HEALTH PROFESSIONALS IN HEALTHCARE INSTITUTIONS IN HONG KONG --- p.72 / REFERENCES --- p.75

This research explores whether differences in ethical reasoning levels exist between senior hospital managers and top level general industry executives. Similar comparisons are made between not-for-profit hospital managers and their peers in for-profit hospitals. Also examined are the ethical reasoning levels used most often by practicing executives, regardless of industry affiliation.

A governança na hotelaria hospitalar, atualmente, tem se mostrado como tendência. Considerando, na atualidade, a realidade dos serviços e as perspectivas sobre a implantação do serviço de governança hospitalar, voltada para a melhoria no processo de gestão, constata- se que ainda são incipientes as publicações científicas sobre a temática. A interface entre o serviço de governança em higiene e limpeza e o trabalho da equipe de enfermagem justificou a investigação das implicações da implantação do serviço de governança em higiene e limpeza, para o trabalho da equipe de enfermagem. O objetivo deste estudo foi caracterizar a implantação do serviço de governança em higiene e limpeza de unidade, em um hospital público, e as implicações positivas e negativas para o trabalho de enfermagem. Trata-se de pesquisa exploratória, realizada em hospital de ensino, nas enfermarias de clínica médica, pesquisa essa desenvolvida em duas fases, a primeira com o levantamento documental que possibilitou a análise sobre a dificuldade de reposição do quadro de pessoal e os fatos cronológicos do processo de implantação da governança. A segunda, um estudo de caso descritivo, adotou-se a Técnica do Incidente Crítico como norteadora dos procedimentos metodológicos, realizada com 11 enfermeiros, 28 auxiliares e dois técnicos de enfermagem. Os resultados foram agrupados em 82 incidentes críticos extraídos dos relatos. A análise dos dados constou da identificação e do agrupamento de 146 comportamentos, \"demonstrar desconhecimento sobre o controle de infecção\" (13%) obteve a maior frequência negativa. Foram extraídas e agrupadas 166 consequências. As referências negativas redundaram em aspectos que influenciam a qualidade da assistência prestada ao paciente, ou seja, aspectos relativos à supervisão e à padronização do trabalho da equipe de governança em higiene e limpeza de unidade, que podem comprometer a assistência ao paciente. As referências positivas dizem respeito ao âmbito operacional, como agilidade na admissão de pacientes na unidade, que tem implicação no trabalho de enfermagem. Os resultados permitem entender a implantação do serviço de governança em higiene e limpeza hospitalar como possibilidade de reposição do quadro de recursos humanos, mas é presente o desafio de se avançar nesse processo no tocante à qualificação de pessoal para o trabalho em governança em higiene e limpeza, supervisão e interação com a equipe de enfermagem. / Governance in hospital hotel services is a current trend. Considering the current reality of services and perspectives on the implementation of hospital governance service aimed at improving the management process, there are still few scientific publications on the subject. The interface between the service of governance in hygiene and housekeeping and the work of the nursing team justified the study of the implications of implementing the service of governance in hygiene and housekeeping to the work of the nursing team. This study aimed to characterize the implementation of the service of governance in hygiene and housekeeping of a unit in a public hospital and the positive and negative implications for nursing work. This exploratory research was carried out in a teaching hospital, in the wards of clinical medicine, and was developed in two phases, the first using documentary survey that allowed the analysis of the difficulty to replace the staff and the chronological facts of the process of implementing the governance. The second was a descriptive case study, and the Critical Incident Technique was adopted to guide the methodological procedures, performed with 11 nurses, 28 nursing auxiliaries and two nursing technicians. Results were grouped into 82 critical incidents drawn from the reports. Data analysis consisted of identifying and grouping 146 behaviors, \"demonstrate ignorance on infection control\" (13%) had the highest negative frequency. In total, 166 consequences were extracted and grouped, negative references resulted in factors that influence the quality of care provided to patients, that is, aspects related to the supervision and standardization of the work of the unit\'s team of governance in hygiene and housekeeping, which can interfere in care to patient. Positive references were related to the operational area such as the agility in the admission of patients to the unit, which has implications for the nursing work. Results allows to understand the implementation of the service of governance in hospital hygiene and housekeeping as a possibility to replace the human resources workforce, but it still is a challenge to advance in this process regarding the qualification of personnel to work on governance in hygiene and housekeeping, supervision and interaction with the nursing team.

O crescimento dos custos no setor de saúde é decorrente de vários fatores, entre eles, a falta de capacitação administrativa dos gerentes e a não implementação de sistemas de controle de custos. Hoje, as instituições de saúde se esforçam para manter elevado o nível de qualidade da assistência prestada ao paciente, e ao mesmo tempo, apresentar um rendimento contábil. Para que haja um equilíbrio entre estes dois fatores, há necessidade de controle de gastos e custos e é fundamental que estes tenham início na área operacional, com a equipe de enfermagem que atua no registro, prescrição e realização dos cuidados. A enfermeira é a profissional apontada como tendo potencial para a realização deste gerenciamento, pois ao mesmo tempo em que possui domínio dos conhecimentos específicos da assistência de enfermagem, é membro integrante do grupo de profissionais que estuda desde a graduação o gerenciamento de custos podendo com isto, aprofundar seus conhecimentos na área e atuar com segurança no gerenciamento. Diante disto, este estudo teve como objetivos analisar a participação das enfermeiras no gerenciamento de custos em organizações hospitalares no município de São Paulo, levantar as atividades desenvolvidas por estas relacionadas à gestão de custos, apresentar o conhecimento destas sobre custos e métodos de custeio, verificar as dificuldades e as facilidades destas relacionadas às atividades de gerenciamento de custos e identificar as vantagens que essa participação tem trazido para o gerenciamento do serviço de enfermagem. O estudo foi de cunho exploratório-descritivo comparativo e correlacional, com abordagem quantitativa e os resultados mostraram que 138 (73,8%) enfermeiras não conhecem os custos do seu setor, 151 (81,2%) enfermeiras não conhecem o sistema de custeio utilizado na instituição, 167 (89,8%) enfermeiras não conhecem o orçamento do serviço de enfermagem, 162 (87,1%) enfermeiras não conhecem o orçamento do seu setor, 168 (89,8%) enfermeiras não participam da elaboração do orçamento do setor, 171 (91,9%) enfermeiras não possuem acesso às informações necessárias para elaboração deste orçamento. Com relação à análise do conhecimento das enfermeiras sobre principais conceitos de custos hospitalares, os resultados identificaram que 76 (40,6%) enfermeiras possuem conhecimento geral sobre custos, 66 (35,3%) enfermeiras possuem conhecimento mínimo sobre os conceitos de custos, 111 (59,4%) enfermeiras possuem conhecimento mínimo sobre as classificações de custos, 70 (37,4%) enfermeiras possuem conhecimento mínimo sobre a departamentalização dos custos, 70 (37,4%) enfermeiras possuem conhecimento mínimo sobre os métodos de apropriação de custos. Analisando as condições institucionais para a realização do gerenciamento de custos, os resultados encontrados apontaram que 161 (86,1%) enfermeiras não se sentem preparadas para gerenciar custos, 140 (74,9%) encontram dificuldades neste gerenciamento entre elas 65 (36%) referem falta de conhecimento específico no assunto, 134 (71,35%) encontram vantagens no gerenciamento de custos, pois possibilita identificar desperdícios, avaliar o custo dos materiais e novos investimentos, 148 (79,15%) acreditam que o gerenciamento de custos é uma atribuição da enfermeira. Assim, os resultados deste estudo demonstraram a necessidade de utilização das ferramentas gerenciais em custos e o aprimoramento das enfermeiras sobre o assunto para contribuir com a participação destas no gerenciamento de custos hospitalares. / The growth of costs in the healthcare industry is due to several factors, among them the lack of administrative training of managers and the non-implementation of cost control systems. Today, healthcare institutions strive to maintain a high level of quality of care provided to the patient, and at the same time, submit an accounting income. So to get a balance between these two factors, there is need for control of spending and costs and it is vital that these operations beginning in the operational area, with the nursing team that plays in the registry, prescription and realization of care. The nurse is professional singled out as having potential for realization of this management, because while she has specific knowledge of the field of nursing assistance is an integral member of the group of professionals that studies since graduating managing costs and with this deepen their knowledge in the area and acting safely in management. Before this, this study had as objectives to analyze the participation of nurses in cost management in hospital organizations in São Paulo, raise the activities developed by these related to cost management, presenting the knowledge of these about costs and costing methods, check the difficulties and the facilities of these related to cost management activities and identify the benefits that such participation has brought to the management of nursing service. The study was exploratory-descriptive purposes and comparative correlacional study, with quantitative approach and the results showed that 138 (73.8%) nurses do not know the costs of your industry, 151 (81.2%) nurses do not know the costing system used at the institution, 167 (89.8%) nurses do not know the budget of the nursing service, 162 (87.1%) nurses do not know the budget of your sector, 168 (89.8%) nurses do not participate in the budget sector, 171 (91.9%) nurses do not have access to information necessary for drawing up this budget. With respect to the review of the knowledge of the main concepts of nurses on hospital costs, the results identified that 76 (40.6%) nurses have general knowledge about costs, 66 (35.3%) nurses have minimum knowledge about the concepts of costs, 111 (59.4%) nurses have minimum knowledge about the sorts of costs, 70 (37.4%) nurses have minimum knowledge about the departmentalization of costs, 70 (37.4%) nurses possess minimal knowledge on methods of ownership costs. Analyzing the institutional conditions for the realization of cost management, the results found pointed out that 161 (86.1%) nurses do not feel prepared to manage costs, 140 (74.9%) encounter difficulties in managing among them 65 (36%) concern the lack of specific knowledge on the subject, 134 (71.35%) find advantages in cost management, because it makes it possible to identify waste, assess the cost of materials and new investments, 148 (79.15%) believe that managing costs is an assignment of the nurse. Thus, the results of this study demonstrated the need for use of managerial tools in cost and improvement of nurses on the subject to

Thesis (Ph. D.)--Virginia Commonwealth University, 2006. / Prepared for: Dept. of Health Administration. Bibliography: leaves 132-140. Also available online.

Thesis (Ph. D.)--Virginia Commonwealth University, 2006. / Prepared for: Dept. of Health Administration. Bibliography: leaves 239-260. Also available online.

Thesis--University of Minnesota. / Photocopy of typescript. Ann Arbor, Mich. : University Microfilms International, 1977. -- 21 cm. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves [119]-125).