Journal of management in medicine
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The orthopaedic trauma session is almost universally adopted as a means of coping with non-elective orthopaedic demand Here patients who can be stabilised are treated in a weekday planned theatre session. It allows for greater consultant involvement and a reduction in out-of-hours operating. ⋯ However, there is an opportunity to make better use of this time by including some "deferrable elective patients" in the session. These are elective patients who have been offered earlier treatment in return for accepting the possibility of postponement, if the trauma demand on the day of the appointment is high Simulation of patient demand was used to explore the balance between maximising the utilisation of the theatre sessions, avoiding too many overruns and ensuring a reasonable quality of care in a typical hospital in the UK.
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This paper reports a national study which investigated the involvement of infection control professionals in (and their views about) the formal processes of contracting for health care in the NHS internal market. Health care professionals needed to be involved contracting, if it was to be effective. The study found that many infection control professionals were not, in fact, involved in contracting, while the importance of both contracts and informal professional networks were recognised But respondents did not think that their professional networks entirely compensated for their lack of involvement in contracting. As formal agreements continue to be central to achieving quality of care in the post-internal market NHS, infection control professionals need to be involved in specification and implementation of these arrangements.
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Comparative Study
Skill mix, doctors and nurses: substitution or diversification?
This commentary surveys the current arguments for and against modifying the work of doctors and nurses by placing the main viewpoints - substitution and diversification - within the policy background, particularly that of the UK. We discuss the forces for modification: cost effectiveness, professional development, quality improvement and pragmatic management and how each provides a stand-point for evaluation of the issues. ⋯ Doctor-nurse substitution is not necessarily cost effective, nor is it unfailingly a gain in nurse professionalism or in quality of care. Of the management perspectives available - advocacy, skepticism or pragmatism - the current evidence and policy base favours pragmatism over evaluations of the rightness or wrongness of a general policy.
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The NHS in the UK has recently adopted a new Performance Assessment Framework (PAF), aiming to provide a broader view of performance within the NHS The PAF is not only a multi-stakeholder approach reflecting various stakeholders' interests across six dimensions, but is also used by the Government as a strategic management tool to ink national strategies with local operation activities. The Government claims that the PAF is a "balanced scorecard" approach This study discusses the concepts of the BSC underlying the NHS PAF.
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In a study of 195 patients visiting the urgent care department of a hospital in the UK, we examined the effects of three elements of process control on patients' fairness and satisfaction perceptions. Patients who believed they had a voice in the triage process had higher fairness perceptions and waited a shorter period of time than those who believed they did not have a voice in the triage process. In addition, patients who were told the expected waiting time and were kept busy while waiting had higher satisfaction perceptions. We identify implications for hospital employees in managing the patient waiting process.