Journal of management in medicine
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Describes a study of sex operating theatres in a modern hospital where management was concerned about the throughput of the system. Senior medical staff were of the opinion that insufficient recovery spaces had been provided when the suite of theatres had been built which, if correct, was a physical constraint requiring considerable financial investment to remedy. They also thought that shortage of porters (¿You can never find a porter when you need one!¿) and recovery nurses were current operational problems. The relationship issues encountered when interfacing with the staff involved, the collection and analyses of relevant data and the building of a visual interactive simulation model are described.
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Discusses the utilization of an instrument--SERVQUAL--as a means of assessing patient satisfaction with service quality. Patients treated (174) for a variety of health problems in a number of departments completed the SERVQUAL questionnaire. There is a dearth of knowledge in this important field and the authors note that the results indicate the need for improvement in service quality as identified by the study population.
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There has been considerable discussion of the nature and scope of information that purchasers and providers must acquire and use in the post-review NHS. Somewhat surprisingly, this has not been complemented by discussion of the potential for computer systems to support information management. This in spite of the publication of the NHS Information Management and Technology Strategy, which seems set to shape the way in which purchasers and providers manage data into the next century, and expenditure on computer systems which will be in the order of hundreds of millions of pounds over the next few years. Discusses some of the key challenges involved in implementing an IT infrastructure across the NHS, and identifies five issues which will substantially determine the success of the strategy.
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Reports on the research concerning the current debate surrounding the maturity of clinical directorates. Indicates that there is some ambiguity as to how directorates should be structured and strategically managed. Finds evidence that trust executive boards need to involve clinicians in setting strategy and to support clinical directors with suitable business managers to manage the boundary between strategic and operational issues.
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The rising cost of US health care has precipitated some close examination as to the supply, distribution, and specialty choice of the physician workforce. It is an issue of considerable concern as America struggles to control health-care expenditures by shifting resources away from specialty medicine. Central to this problem are the various programmes and incentives which have encouraged an excess number of residency positions and specialty training. Examines the consequences of an unregulated medical school structure and provides an overview of current policy alternatives designed to increase the number of primary care physicians, correct the problems of physician maldistribution, and limit the overall number of medical school graduates.