Applying change management metaphors to a national e-Health strategy.

PubMed

Saunders, Chad; Scott, Richard E

2014-01-01

Recent attempts at a collective understanding of how to develop an e-Health strategy have addressed the individual organisation, collection of organisations, and national levels. At the national level the World Health Organisation's National eHealth Strategy Toolkit serves as an exemplar that consolidates knowledge in this area, guides practical implementations, and identifies areas for future research. A key implication of this toolkit is the considerable number of organisational changes required to successfully apply their ideas in practice. This study looks critically at the confluence of change management and e-Health strategy using metaphors that underpin established models of change management. Several of Morgan's organisational metaphors are presented (highlighting varied beliefs and assumptions regarding how change is enacted, who is responsible for the change, and guiding principles for that change), and used to provide a framework. Attention is then directed to several prominent models of change management that exemplify one or more of these metaphors, and these theoretical insights are applied to evaluate the World Health Organisation's National eHealth Strategy Toolkit. The paper presents areas for consideration when using the WHO/ITU toolkit, and suggestions on how to improve its use in practice. The goal is to seek insight regarding the optimal sequence of steps needed to ensure successful implementation and integration of e-health into health systems using change management models. No single model, toolkit, or guideline will offer all the needed answers, but clarity around the underlying metaphors informing the change management models being used provides valuable insight so potentially challenging areas can be avoided or mitigated.

Leadership and management skills of general practice nurses: experience or education?

PubMed

Lau, Rosalind; Cross, Wendy; Moss, Cheryle; Campbell, Annie; De Castro, Magali; Oxley, Victoria

2014-12-01

A key finding of this qualitative exploratory descriptive study into advanced nursing for general practice nurses (Australian setting) revealed that participants viewed leadership and management as best learnt 'apprenticeship' style on the job by years of experience. Participants (48) comprised of general practice nurses, practice managers and general practitioners from metropolitan Melbourne were interviewed. Other findings demonstrated that the participants generally had limited awareness that postgraduate education can assist in the development of leadership and management in advanced nursing practice. The participants lacked clarity about professional competencies and generally did not connect these to leadership and management. Professional bodies need to take the opportunity to promote awareness of the national competency standards. All three groups of participants expressed hopes about the future provision of professional development opportunities and support by the Medicare Local for leadership and management aspirations within advanced practice nursing.

Landscape Scale Management in the Ouachita Mountains - Where Operational Practices Meet Research

Treesearch

Hunter Speed; Ronald J. Perisho; Samuel Larry; James M. Guldin

1999-01-01

Implementation of ecosystem management on National Forest System lands in the Southern Region requires that the best available science be applied to support forest management practices. On the Ouachita National Forest in Arkansas, personnel from the Jessieville and Winona Ranger Districts and the Southern Research Station have developed working relationships that...

Clinical Practices in Collegiate Concussion Management.

PubMed

Baugh, Christine M; Kroshus, Emily; Stamm, Julie M; Daneshvar, Daniel H; Pepin, Michael J; Meehan, William P

2016-06-01

In recent years, sports leagues and sports medicine experts have developed guidelines for concussion management. The extent to which current clinical practice is consistent with guideline recommendations is unclear. At the collegiate level, there have been few examinations of concussion management practices and the extent to which meaningful differences across divisions of competition exist. The purposes of this study were to (1) examine current practices in concussion diagnosis and management at National Collegiate Athletic Association (NCAA) member colleges, (2) explore the extent to which current practices reflect current recommendations for concussion diagnosis and management, and (3) determine whether there are differences in management patterns across divisions of competition. Descriptive epidemiology study. An electronic questionnaire was sent to sports medicine clinicians at all NCAA member colleges during September and October 2013. Clinicians were asked about baseline assessments, diagnosis and management practices, return-to-play protocols, the perceived prevalence of underdiagnosis, and basic demographic information. Approximately 30% (n = 866) of contacted clinicians, representing nearly 50% (n = 527) of NCAA member colleges, responded to the questionnaire. Preparticipation baseline examinations were administered at the majority of schools (95%), but most (87.5%) administered baseline assessments only to selected high-risk athletes. Computerized neurocognitive testing and balance assessments were most commonly used as preseason baseline and postinjury assessments. Multimodal examination in line with NCAA and other guidance was used only at a minority of institutions. Athletic trainers most commonly administered and interpreted the preseason baseline examination. Most clinicians reported that their institutions' practices were in line with NCAA guidelines during the first 24 hours of an athlete's concussion diagnosis, with exact percentages varying

The National Study of Charter Management Organization (CMO) Effectiveness. Report on Interim Findings

ERIC Educational Resources Information Center

Lake, Robin; Dusseault, Brianna; Bowen, Melissa; Demeritt, Allison; Hill, Paul

2010-01-01

The National Study of CMO (charter management organizations) Effectiveness is a national, longitudinal research effort designed to measure how nonprofit charter school management organizations (CMOs) affect student achievement, and to examine the internal structures, practices, and policy contexts that may influence these outcomes. The study began…

Fever Management Practices of Neuroscience Nurses, Part II: Nurse, Patient, and Barriers

PubMed Central

Thompson, Hilaire J.; Kirkness, Catherine J.; Mitchell, Pamela H.

2008-01-01

Fever is frequently encountered by neuroscience nurses in patients with neurological insults and often results in worsened patient outcomes when compared with similar patients who do not have fever. Best practices in fever management are then essential to optimizing patient outcomes. Yet the topic of best nursing practices for fever management is largely ignored in the clinical and research literature, which can complicate the achievement of best practices. A national survey to gauge fever management practices and decision making by neuroscience nurses was administered to members of the American Association of Neuroscience Nurses. Results of the questionnaire portion of the survey were previously published. This report presents a content analysis of the responses of neuroscience nurses to the open–ended-question portion of the survey (n = 106), which revealed a dichotomous primary focus on nursing- or patient-related issues. In addition, respondents described barriers and issues in the provision of fever-management care to neuroscience patients. In order to advance national best practices for fever management in neurologically vulnerable patients, further work needs to be conducted, particularly with regard to necessary continuing education for staff, facilitation of interdisciplinary communication, and development of patient care protocols. Neuroscience nurses are in an excellent position to provide leadership in these areas. PMID:17847665

Workplace road safety risk management: An investigation into Australian practices.

PubMed

Warmerdam, Amanda; Newnam, Sharon; Sheppard, Dianne; Griffin, Mark; Stevenson, Mark

2017-01-01

In Australia, more than 30% of the traffic volume can be attributed to work-related vehicles. Although work-related driver safety has been given increasing attention in the scientific literature, it is uncertain how well this knowledge has been translated into practice in industry. It is also unclear how current practice in industry can inform scientific knowledge. The aim of the research was to use a benchmarking tool developed by the National Road Safety Partnership Program to assess industry maturity in relation to risk management practices. A total of 83 managers from a range of small, medium and large organisations were recruited through the Victorian Work Authority. Semi-structured interviews aimed at eliciting information on current organisational practices, as well as policy and procedures around work-related driving were conducted and the data mapped onto the benchmarking tool. Overall, the results demonstrated varying levels of maturity of risk management practices across organisations, highlighting the need to build accountability within organisations, improve communication practices, improve journey management, reduce vehicle-related risk, improve driver competency through an effective workplace road safety management program and review organisational incident and infringement management. The findings of the study have important implications for industry and highlight the need to review current risk management practices. Copyright © 2016 Elsevier Ltd. All rights reserved.

Independent practice associations and physician-hospital organizations can improve care management for smaller practices.

PubMed

Casalino, Lawrence P; Wu, Frances M; Ryan, Andrew M; Copeland, Kennon; Rittenhouse, Diane R; Ramsay, Patricia P; Shortell, Stephen M

2013-08-01

Pay-for-performance, public reporting, and accountable care organization programs place pressures on physicians to use health information technology and organized care management processes to improve the care they provide. But physician practices that are not large may lack the resources and size to implement such processes. We used data from a unique national survey of 1,164 practices with fewer than twenty physicians to provide the first information available on the extent to which independent practice associations (IPAs) and physician-hospital organizations (PHOs) might make it possible for these smaller practices to share resources to improve care. Nearly a quarter of the practices participated in an IPA or a PHO that accounted for a significant proportion of their patients. On average, practices participating in these organizations provided nearly three times as many care management processes for patients with chronic conditions as nonparticipating practices did (10.4 versus 3.8). Half of these processes were provided only by IPAs or PHOs. These organizations may provide a way for small and medium-size practices to systematically improve care and participate in accountable care organizations.

Human resource management in general practice: survey of current practice.

PubMed Central

Newton, J; Hunt, J; Stirling, J

1996-01-01

BACKGROUND: The organization and management of general practice is changing as a result of government policies designed to expand primary health care services. One aspect of practice management which has been underresearched concerns staffing: the recruitment, retention, management and motivation of practice managers. AIM: A study set out to find out who is routinely involved in making decisions about staffing matters in general practice, to establish the extent to which the human resource management function is formalized and specialized, and to describe the characteristics of the practice managers. METHOD: A postal questionnaire was sent to a stratified random sample of 750 general practices in England and Wales in February 1994 enquiring about the practice (for example, the fundholding status and number of general practitioner partners), how the practice dealt with a range of staffing matters and about the practice manager (for example, employment background and training in human resource management). Practices were classed as small (single-handed and two or three general practitioner partners), medium (four or five partners) or large (six or more partners). RESULTS: Replies were received from 477 practices (64%). Practice managers had limited authority to make decisions alone in the majority of practices although there was a greater likelihood of them taking independent action as the size of practice increased. Formality in handling staffing matters (as measured by the existence and use of written policies and procedures) also increased with practice size. Larger practices were more likely than smaller practices to have additional tiers in their management structure through the creation of posts with the titles assistant practice manager, fund manager and senior receptionist. Most practice managers had been recruited from within general practice but larger practices were more likely than smaller practices to recruit from outwith general practice. Three quarters

Managing visitor impacts in parks: A multi-method study of the effectiveness of alternative management practices

USGS Publications Warehouse

Park, L.O.; Marion, J.L.; Manning, R.E.; Lawson, S.R.; Jacobi, C.

2008-01-01

How can recreation use be managed to control associated environmental impacts? What management practices are most effective and why? This study explored these and related questions through a series of experimental ?treatments? and associated ?controls? at the summit of Cadillac Mountain in Acadia National Park, a heavily used and environmentally fragile area. The treatments included five management practices designed to keep visitors on maintained trails, and these practices ranged from ?indirect? (information/education) to ?direct? (a fence bordering the trail). Research methods included unobtrusive observation of visitors to determine the percentage of visitors who walked off-trail and a follow-up visitor survey to explore why management practices did or didn?t work. All of the management practices reduced the percentage of visitors who walked off-trail. More aggressive applications of indirect practices were more effective than less aggressive applications, and the direct management practice of fencing was the most effective of all. None of the indirect management practices reduced walking off-trail to a degree that is likely to control damage to soil and vegetation at the study site. Study findings suggest that an integrated suite of direct and indirect management practices be implemented on Cadillac Mountain (and other, similar sites) that includes a) a regulation requiring visitors to stay on the maintained trail, b) enforcement of this regulation as needed, c) unobtrusive fencing along the margins of the trail, d) redesign of the trail to extend it, widen it in key places, and provide short spur trails to key ?photo points?, and e) an aggressive information/education program to inform visitors of the regulation to stay on the trail and the reasons for it. These recommendations are a manifestation of what may be an emerging principle of park and outdoor recreation management: intensive use requires intensive management.

Development of the private practice management standards for psychology.

PubMed

Mathews, Rebecca; Stokes, David; Littlefield, Lyn; Collins, Leah

2011-01-01

This paper describes the process of developing a set of private practice management standards to support Australian psychologists and promote high quality services to the public. A review of the literature was conducted to identify management standards relevant to psychology, which were further developed in consultation with a panel of experts in psychology or in the development of standards. Forty-three psychologists in independent private practice took part in either a survey (n=22) to provide feedback on the relevance of, and their compliance with, the identified standards, or a 6-month pilot study (n=21) in which a web-based self-assessment instrument evaluating the final set of standards and performance indicators was implemented in their practice to investigate self-reported change in management procedures. The pilot study demonstrated good outcomes for practitioners when evaluation of compliance to the standards was operationalized in a self-assessment format. Study results are based on a small sample size. Nevertheless, relevance and utility of the standards was found providing an initial version of management standards that have relevance to the practice of psychology in Australia, along with a system for evaluating psychological service provision to ensure best practice in service delivery. © 2010 National Association for Healthcare Quality.

Managing chronic illness: physician practices increased the use of care management and medical home processes.

PubMed

Wiley, James A; Rittenhouse, Diane R; Shortell, Stephen M; Casalino, Lawrence P; Ramsay, Patricia P; Bibi, Salma; Ryan, Andrew M; Copeland, Kennon R; Alexander, Jeffrey A

2015-01-01

The effective management of patients with chronic illnesses is critical to bending the curve of health care spending in the United States and is a crucial test for health care reform. In this article we used data from three national surveys of physician practices between 2006 and 2013 to determine the extent to which practices of all sizes have increased their use of evidence-based care management processes associated with patient-centered medical homes for patients with asthma, congestive heart failure, depression, and diabetes. We found relatively large increases over time in the overall use of these processes for small and medium-size practices as well as for large practices. However, the large practices used fewer than half of the recommended processes, on average. We also identified the individual processes whose use increased the most and show that greater use of care management processes is positively associated with public reporting of patient experience and clinical quality and with pay-for-performance. Project HOPE—The People-to-People Health Foundation, Inc.

Treating without Seeing: Pain Management Practice in a Thai Context.

PubMed

Chatchumni, Manaporn; Namvongprom, Ampaporn; Eriksson, Henrik; Mazaheri, Monir

2016-01-01

Pain management is a core nursing function, and it plays a key role in postoperative care. It is important to understand the cultural context of nursing practices and how this affects effective pain management. The aim of this study was to describe the professional and cultural framework within which pain management is practiced on a Thai surgical ward. Spradley's ethnographic methodology was used. Data were collected through 98.5 hours of field observations and interviews at a surgical ward in Thailand. Three themes were constructed that describe the way Thai nurses practiced pain management: (i) complex communications system to address pain and to respond to it, (ii) the essence of Thai-ness, and (iii) a passive approach to pain management. The results indicate that, in the response to discomfort and pain, better pain management will result if there is a shift from functional to patient-centered care. The nursing culture needs to be further researched and discussed, in order to set priorities in line with the goals of national and international organizations for improving postoperative care and promoting patient comfort.

Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives.

PubMed

Buckley, Thomas A; Burdette, Glenn; Kelly, Kassandra

2015-08-01

The National Collegiate Athletic Association (NCAA) has published concussion-management practice guidelines consistent with recent position and consensus statements. Whereas NCAA Division I athletic trainers appear highly compliant, little is known about the concussion-management practice patterns of athletic trainers at smaller institutions where staffing and resources may be limited. To descriptively define the concussion-management practice patterns of NCAA Division II and III athletic trainers. Cross-sectional study. Web-based questionnaire. A total of 755 respondents (response rate = 40.2%) from NCAA Division II and Division III institutions. The primary outcome measures were the rate of multifaceted concussion-assessment techniques, defined as 3 or more assessments; the specific practice patterns of each assessment battery; and tests used during a clinical examination. Most respondents indicated using a multifaceted assessment during acute assessment (Division II = 76.9%, n = 473; Division III = 76.0%, n = 467) and determination of recovery (Division II = 65.0%, n = 194; Division III = 63.1%, n = 288) but not at baseline (Division II = 43.1%, n = 122; Division III = 41.0%, n = 176). Typically, when a postconcussion assessment was initiated, testing occurred daily until baseline values were achieved, and most respondents (80.6% [244/278]) reported using a graded exercise protocol before return to participation. We found limited use of the multifaceted assessment battery at baseline but higher rates at both acute assessment and return-to-participation time points. A primary reason cited for not using test-battery components was a lack of staffing or funding for the assessments. We observed limited use of neuropsychologists to interpret neuropsychological testing. Otherwise, most respondents reported concussion-management protocols consistent with recommendations, including a high level of use of objective measures and incorporation of a progressive return

What Case Managers Should Know About Their Roles and Functions: A National Study From the Commission for Case Manager Certification: Part 1.

PubMed

Tahan, Hussein M; Watson, Annette C; Sminkey, Patrice V

2015-01-01

The purpose of this national role and function study was to identify the essential activities and necessary knowledge areas for effective case manager practice from the perspective of those currently functioning in various care settings and across diverse professional disciplines. The national study covered all case management practices and/or work settings across the full continuum of health care. This cross-sectional descriptive study used the practice analysis method and online survey research design. It employed a purposive sample of case managers, in which 52,370 individuals received an invitation to participate. Data collection completed over a 4-week period, resulting in 7,668 useable survey responses (nearly a 15% response rate). The study identified the common activities and knowledge areas necessary for competent and effective performance of case managers, as is highlighted in this article, which is the first of a 2-part series on the role and function study. The results informed the needed update of the test specifications for the Certified Case Manager (CCM) certification examination, as will be delineated in Part 2 of the article series, to ensure that it continues to be substantiated in current practice. Of special note are the emergence of specific activity and knowledge domains in the area of case management ethical, legal, and practice standards, and an increase in the number of employers requiring certified case managers to fill vacant positions and compensating them financially for such qualifications. This study helps keep the CCM credentialing examination evidence-based and maintain its validity for evaluating competency of case managers. Specifically, the study identified essential activities and knowledge domains that define competent case management practice. Findings can be used for developing programs and curricula for the training and development of case managers. The study instrument also can be used for further research of case

Dermatology practice management assures practice development and efficiency.

PubMed

Wagener, D L

2000-09-01

This article provides an overview of the disciplines involved in managing a dermatology practice today. Several key management processes, including strategic planning, financial analysis, advertising and public relations, information systems management, and compliance program development and monitoring are addressed. This article explores several possible tactics that can be used to help guide your practice in the right direction without overtaxing your resources. Also offered are possible solutions for creating an organization that is poised for success, and a management team capable of steering the practice through the sea of change ahead.

National best management practices monitoring summary report, program phase-in period fiscal years 2013-2014

Treesearch

Joan Carlson; Pam Edwards; Todd Ellsworth; Michael Eberle

2015-01-01

The National BMP Program provides National Core BMPs, standardized monitoring protocols to evaluate implementation and effectiveness of the National Core BMPs, and a data management system to store and analyze the resulting monitoring data. BMP evaluations are completed by interdisciplinary teams of resource specialists and include assessments of whether BMP...

7 CFR 205.206 - Crop pest, weed, and disease management practice standard.

Code of Federal Regulations, 2013 CFR

2013-01-01

... (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Organic Production and Handling... rotation and soil and crop nutrient management practices, as provided for in §§ 205.203 and 205.205; (2... substance included on the National List of synthetic substances allowed for use in organic crop production...

7 CFR 205.206 - Crop pest, weed, and disease management practice standard.

Code of Federal Regulations, 2014 CFR

2014-01-01

... (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Organic Production and Handling... rotation and soil and crop nutrient management practices, as provided for in §§ 205.203 and 205.205; (2... substance included on the National List of synthetic substances allowed for use in organic crop production...

7 CFR 205.206 - Crop pest, weed, and disease management practice standard.

Code of Federal Regulations, 2012 CFR

2012-01-01

... (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Organic Production and Handling... rotation and soil and crop nutrient management practices, as provided for in §§ 205.203 and 205.205; (2... substance included on the National List of synthetic substances allowed for use in organic crop production...

Soil water management practices (terraces) helped to mitigate the 2015 drought in Ethiopia.

PubMed

Kosmowski, Frédéric

2018-05-31

While the benefits of soil water management practices relative to soil erosion have been extensively documented, evidence regarding their effect on yields is inconclusive. Following a strong El-Niño, some regions of Ethiopia experienced major droughts during the 2015/16 agricultural season. Using the propensity scores method on a nationally representative survey in Ethiopia, this study investigates the effect of two widely adopted soil water management practices - terraces and contour bunds - on yields and assesses their potential to mitigate the effects of climate change. It is shown that at the national level, terraced plots have slightly lower yields than non-terraced plots. However, data support the hypothesis that terraced plots acted as a buffer against the 2015 Ethiopian drought, while contour bunds did not. This study provides evidence that terraces have the potential to help farmer deal with current climate risks. These results can inform the design of climate change adaptation policies and improve targeting of soil water management practices in Ethiopia.

Practice management. Gender offenders.

PubMed

Gosling, Jennifer

2002-09-26

A postal survey of practice managers in London found that women earned 5,000 Pounds a year less than men, on average. Women who had previously worked as receptionists in the practice were particularly poorly paid. Practice management remains a female-dominated profession. Primary care trusts should seek to standardise rates of pay and promote greater equality.

Practice management companies improve practices' financial position.

PubMed

Dupell, T

1997-11-01

To maintain control over healthcare delivery and financial decisions, as well as increase access to capital markets, some group practices are forming their own physician practice management companies. These companies should be organized to balance the expectations of physicians with the values of capital markets. This organization should include retained earnings, financial reporting in accordance with generally accepted accounting principles (GAAP), predictable earnings and cash flow, physician ownership and leadership, and incentives for high-quality management. Three large, primary care and multispecialty clinics that merged to form a new physician practice management company increased their access to capital markets and improved their overall financial position, which will help them achieve long-term survival.

Physicians' perspectives and practices regarding the fertility management of obese patients.

PubMed

Harris, Isiah D; Python, Johanne; Roth, Lauren; Alvero, Ruben; Murray, Shona; Schlaff, William D

2011-10-01

To assess the practice patterns and personal beliefs of fertility physicians who care for obese patients seeking assisted reproduction, we conducted a national survey of fertility program directors from both private and academic practices and discovered that although few practices have firm guidelines regarding the management of obese patients, the overwhelming majority of providers believe that body mass index guidelines or cutoffs should exist. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Reflective practices at the Security Council: Children and armed conflict and the three United Nations

PubMed Central

Bode, Ingvild

2017-01-01

The United Nations Security Council passed its first resolution on children in armed conflict in 1999, making it one of the oldest examples of Security Council engagement with a thematic mandate and leading to the creation of a dedicated working group in 2005. Existing theoretical accounts of the Security Council cannot account for the developing substance of the children and armed conflict agenda as they are macro-oriented and focus exclusively on states. I argue that Security Council decision-making on thematic mandates is a productive process whose outcomes are created by and through practices of actors across the three United Nations: member states (the first United Nations), United Nations officials (the second United Nations) and non-governmental organizations (the third United Nations). In presenting a practice-based, micro-oriented analysis of the children and armed conflict agenda, the article aims to deliver on the empirical promise of practice theories in International Relations. I make two contributions to practice-based understandings: first, I argue that actors across the three United Nations engage in reflective practices of a strategic or tactical nature to manage, arrange or create space in Security Council decision-making. Portraying practices as reflective rather than as only based on tacit knowledge highlights how actors may creatively adapt their practices to social situations. Second, I argue that particular individuals from the three United Nations are more likely to become recognized as competent performers of practices because of their personality, understood as plural socialization experiences. This adds varied individual agency to practice theories that, despite their micro-level interests, have focused on how agency is relationally constituted. PMID:29782586

Reflective practices at the Security Council: Children and armed conflict and the three United Nations.

PubMed

Bode, Ingvild

2018-06-01

The United Nations Security Council passed its first resolution on children in armed conflict in 1999, making it one of the oldest examples of Security Council engagement with a thematic mandate and leading to the creation of a dedicated working group in 2005. Existing theoretical accounts of the Security Council cannot account for the developing substance of the children and armed conflict agenda as they are macro-oriented and focus exclusively on states. I argue that Security Council decision-making on thematic mandates is a productive process whose outcomes are created by and through practices of actors across the three United Nations: member states (the first United Nations), United Nations officials (the second United Nations) and non-governmental organizations (the third United Nations). In presenting a practice-based, micro-oriented analysis of the children and armed conflict agenda, the article aims to deliver on the empirical promise of practice theories in International Relations. I make two contributions to practice-based understandings: first, I argue that actors across the three United Nations engage in reflective practices of a strategic or tactical nature to manage, arrange or create space in Security Council decision-making. Portraying practices as reflective rather than as only based on tacit knowledge highlights how actors may creatively adapt their practices to social situations. Second, I argue that particular individuals from the three United Nations are more likely to become recognized as competent performers of practices because of their personality, understood as plural socialization experiences. This adds varied individual agency to practice theories that, despite their micro-level interests, have focused on how agency is relationally constituted.

Nurse managers describe their practice environments.

PubMed

Warshawsky, Nora E; Lake, Sharon W; Brandford, Arica

2013-01-01

Hospital work environments that support the professional practice of nurses are critical to patient safety. Nurse managers are responsible for creating these professional practice environments for staff nurses, yet little is known about the environments needed to support nurse managers. Domains of nurse managers' practice environment have recently been defined. This is a secondary analysis of 2 cross-sectional studies of organizational characteristics that influence nurse manager practice. Content analysis of the free text comments from 127 nurse managers was used to illustrate the 8 domains of nurse managers' practice environments. Nurse managers valued time spent with their staff; therefore, workloads must permit meaningful interaction. Directors demonstrated trust when they empowered nurse managers to make decisions. Administrative leaders should build patient safety cultures on the basis of shared accountability and mutual respect among the health care team. The expectations of nurse managers have greatly expanded in the volume and complexity of direct reports, patient care areas, and job functions. The nurse managers in this analysis reported characteristics of their practice environments that limit their role effectiveness and may negatively impact organizational performance. Further research is needed to understand the effects of nurse managers' practice environments on staff and patient outcomes.

Practice management for academic dermatology departments.

PubMed

Eaglstein, W H

2000-09-01

Practice management in the academic medical center (AMC) is different than in other environments. Practice is only a part of the practitioner's mission within an AMC. Practice revenue will be subject to a tax or overhead by both the school and the department. Contract and practice guidelines cannot be tailored to the needs of the dermatology practice, because contracts and guidelines are negotiated globally for all of the practices within the AMC. Personnel, on which the practice depends, may report to hospitals and clinics rather than to the practice's management. Even control of the practice's manager may be diluted by a dual or "dotted line" reporting relationship between the department manager and the school practice manager. Although more constraints exist within the AMC, there are some strategic and operational choices that affect a practice's success. Among these are: (1) selection of services offered; (2) creation of satellites; (3) stimulation of faculty effort; (4) enhancement of faculty billing knowledge; and (5) creation of a "tie" between staff and the practice.

Idaho National Laboratory Cultural Resource Management Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Julie Braun Williams

As a federal agency, the U.S. Department of Energy has been directed by Congress, the U.S. president, and the American public to provide leadership in the preservation of prehistoric, historic, and other cultural resources on the lands it administers. This mandate to preserve cultural resources in a spirit of stewardship for the future is outlined in various federal preservation laws, regulations, and guidelines such as the National Historic Preservation Act, the Archaeological Resources Protection Act, and the National Environmental Policy Act. The purpose of this Cultural Resource Management Plan is to describe how the Department of Energy, Idaho Operations Officemore » will meet these responsibilities at Idaho National Laboratory in southeastern Idaho. The Idaho National Laboratory is home to a wide variety of important cultural resources representing at least 13,500 years of human occupation in the southeastern Idaho area. These resources are nonrenewable, bear valuable physical and intangible legacies, and yield important information about the past, present, and perhaps the future. There are special challenges associated with balancing the preservation of these sites with the management and ongoing operation of an active scientific laboratory. The Department of Energy, Idaho Operations Office is committed to a cultural resource management program that accepts these challenges in a manner reflecting both the spirit and intent of the legislative mandates. This document is designed for multiple uses and is intended to be flexible and responsive to future changes in law or mission. Document flexibility and responsiveness will be assured through regular reviews and as-needed updates. Document content includes summaries of Laboratory cultural resource philosophy and overall Department of Energy policy; brief contextual overviews of Laboratory missions, environment, and cultural history; and an overview of cultural resource management practices. A series of

Translating National Level Forest Service Goals to Local Level Land Management: Carbon Sequestration

NASA Astrophysics Data System (ADS)

McNulty, S.; Treasure, E.

2017-12-01

The USDA Forest Service has many national level policies related to multiple use management. However, translating national policy to stand level forest management can be difficult. As an example of how a national policy can be put into action, we examined three case studies in which a desired future condition is evaluated at the national, region and local scale. We chose to use carbon sequestration as the desired future condition because climate change has become a major area of concern during the last decade. Several studies have determined that the 193 million acres of US national forest land currently sequester 11% to 15% of the total carbon emitted as a nation. This paper provides a framework by which national scale strategies for maintaining or enhancing forest carbon sequestration is translated through regional considerations and local constraints in adaptive management practices. Although this framework used the carbon sequestration as a case study, this framework could be used with other national level priorities such as the National Environmental Protection Act (NEPA) or the Endangered Species Act (ESA).

Public-on-private dual practice among physicians in public hospitals of Tigray National Regional State, North Ethiopia: perspectives of physicians, patients and managers.

PubMed

Abera, Goitom Gigar; Alemayehu, Yibeltal Kiflie; Herrin, Jeph

2017-11-10

Physicians who work in the private sector while also holding a salaried job in a public hospital, known as "dual practice," is one of the main retention strategies adopted by the government of Ethiopia. Dual practice was legally endorsed in Tigray National Regional State, Ethiopia in 2010. Therefore, the aim of this study was to explore the extent of dual practice, reasons why physicians engage in it, and its effects on public hospital services in this state in northern Ethiopia. A cross-sectional study using mixed methods was conducted from February to March 2011 in six geographically representative public hospitals of Tigray National Regional State. A semi-structured, self-administered questionnaire was distributed to all physicians working in the study hospitals, and an interviewer-administered, structured questionnaire was used to collect data from admitted patients. Focus group discussions were conducted with hospital governing boards. Quantitative and qualitative data were used in the analysis. Data were collected from 31 physicians and 449 patients in the six study hospitals. Six focus group discussions were conducted. Twenty-eight (90.3%) of the physicians were engaged in dual practice to some extent: 16 (51.6%) owned private clinics outside the public hospital, 5 (16.1%) worked part-time in outside private clinics, and 7 (22.6%) worked in the private wing of public hospitals. Income supplementation was the primary reason for engaging in dual practice, as reported by 100% of the physicians. The positive effects of dual practice from both managers' and physicians' perspectives were physician retention in the public sector. Ninety-one patients (20.3%) had been referred from a private clinic immediately prior to their current admission-a circular diversion pattern. Eighteen (19.8%) of the diverted patients reported that health workers in the public hospitals diverted them. Circular diversion pattern of referral system is the key negative consequence of dual

Translating knowledge into best practice care bundles: a pragmatic strategy for EBP implementation via moving postprocedural pain management nursing guidelines into clinical practice.

PubMed

Saunders, Hannele

2015-07-01

To describe quantitative and qualitative best evidence as sources for practical interventions usable in daily care delivery in order to integrate best evidence into clinical decision-making at local practice settings. To illustrate the development, implementation and evaluation of a pain management nursing care bundle based on a clinical practice guideline via a real-world clinical exemplar. Successful implementation of evidence-based practice requires consistent integration of best evidence into daily clinical decision-making. Best evidence comprises high-quality knowledge summarised in systematic reviews and translated into guidelines. However, consistent integration of guidelines into care delivery remains challenging, partly due to guidelines not being in a usable form for daily practice or relevant for the local context. A position paper with a clinical exemplar of a nurse-led, evidence-based quality improvement project to design, implement and evaluate a pain management care bundle translated from a national nursing guideline. A pragmatic approach to integrating guidelines into daily practice is presented. Best evidence from a national nursing guideline was translated into a pain management care bundle and integrated into daily practice in 15 medical-surgical (med-surg) units of nine hospitals of a large university hospital system in Finland. Translation of best evidence from guidelines into usable form as care bundles adapted to the local setting may increase implementation and uptake of guidelines and improve quality and consistency of care delivery. A pragmatic approach to translating a nursing guideline into a pain management care bundle to incorporate best evidence into daily practice may help achieve more consistent and equitable integration of guidelines into care delivery, and better quality of pain management and patient outcomes. © 2015 John Wiley & Sons Ltd.

40 CFR 63.11561 - What are my standards and management practices?

Code of Federal Regulations, 2013 CFR

2013-07-01

... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Area Sources: Asphalt Processing and Asphalt Roofing Manufacturing Standards and Compliance Requirements § 63.11561 What are my standards and management practices? (a) For asphalt processing operations, you must meet the emission limits...

40 CFR 63.11561 - What are my standards and management practices?

Code of Federal Regulations, 2012 CFR

2012-07-01

... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Area Sources: Asphalt Processing and Asphalt Roofing Manufacturing Standards and Compliance Requirements § 63.11561 What are my standards and management practices? (a) For asphalt processing operations, you must meet the emission limits...

40 CFR 63.11561 - What are my standards and management practices?

Code of Federal Regulations, 2014 CFR

2014-07-01

... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Area Sources: Asphalt Processing and Asphalt Roofing Manufacturing Standards and Compliance Requirements § 63.11561 What are my standards and management practices? (a) For asphalt processing operations, you must meet the emission limits...

40 CFR 63.11561 - What are my standards and management practices?

Code of Federal Regulations, 2011 CFR

2011-07-01

... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Area Sources: Asphalt Processing and Asphalt Roofing Manufacturing Standards and Compliance Requirements § 63.11561 What are my standards and management practices? (a) For asphalt processing operations, you must meet the emission limits...

Health care waste management practice in a hospital.

PubMed

Paudel, R; Pradhan, B

2010-10-01

Health-care waste is a by-product of health care. Its poor management exposes health-care workers, waste handlers and the community to infections, toxic effects and injuries including damage of the environment. It also creates opportunities for the collection of disposable medical equipment, its re-sale and potential re-use without sterilization, which causes an important burden of disease worldwide. The purpose of this study was to find out health care waste management practice in hospital. A cross-sectional study was conducted in Narayani Sub-Regional Hospital, Birgunj from May to October 2006 using both qualitative and quantitative methods. Study population was four different departments of the hospital (Medical/Paediatric, Surgical/Ortho, Gynae/Obstetric and Emergency), Medical Superintendent, In-charges of four different departments and all sweepers. Data was collected using interview, group discussion, observation and measurement by weight and volume. Total health-care waste generated was 128.4 kg per day while 0.8 kg per patient per day. The composition of health care waste was found to be 96.8 kg (75.4%) general waste, 24.1 kg (8.8%) hazardous waste and 7.5 kg (5.8%) sharps per day by weight. Health staffs and sweepers were not practicing the waste segregation. Occupational health and safety was not given due attention. Majority of the sweepers were unaware of waste management and need of safety measures to protect their own health. Health care waste management practice in the hospital was unsatisfactory because of the lack of waste management plan and carelessness of patients, visitors and staffs. Therefore the hospital should develop the waste management plan and strictly follow the National Health Care Waste Management Guideline.

Governance and management of national telehealth programs in Asia.

PubMed

Marcelo, Alvin; Ganesh, Jai; Mohan, Jai; Kadam, D B; Ratta, B S; Kulatunga, Gumindu; John, Sheila; Chandra, Andry; Primadi, Oscar; Mohamed, Athika Abdul Sattar; Khan, Muhammad Abdul Hannan; Azad, Abul Alam; Marcelo, Portia

2015-01-01

Telehealth and telemedicine are increasingly becoming accepted practices in Asia, but challenges remain in deploying these services to the farthest areas of many developing countries. With the increasing popularity of universal health coverage, there is a resurgence in promoting telehealth services. But while telehealth that reaches the remotest part of a nation is the ideal endpoint, such goals are burdened by various constraints ranging from governance to funding to infrastructure and operational efficiency. enumerate the public funded national telehealth programs in Asia and determine the state of their governance and management. Review of literature, review of official program websites and request for information from key informants. While there are national telehealth programs already in operation in Asia, most experience challenges with governance and subsequently, with management and sustainability of operations. It is important to learn from successful programs that have built and maintained their services over time. An IT governance framework may assist countries to achieve success in offering telehealth and telemedicine to their citizens.

Selective nonoperative management of blunt splenic injury: an Eastern Association for the Surgery of Trauma practice management guideline.

PubMed

Stassen, Nicole A; Bhullar, Indermeet; Cheng, Julius D; Crandall, Marie L; Friese, Randall S; Guillamondegui, Oscar D; Jawa, Randeep S; Maung, Adrian A; Rohs, Thomas J; Sangosanya, Ayodele; Schuster, Kevin M; Seamon, Mark J; Tchorz, Kathryn M; Zarzuar, Ben L; Kerwin, Andrew J

2012-11-01

During the last century, the management of blunt force trauma to the spleen has changed from observation and expectant management in the early part of the 1900s to mainly operative intervention, to the current practice of selective operative and nonoperative management. These issues were first addressed by the Eastern Association for the Surgery of Trauma (EAST) in the Practice Management Guidelines for Non-operative Management of Blunt Injury to the Liver and Spleen published online in 2003. Since that time, a large volume of literature on these topics has been published requiring a reevaluation of the current EAST guideline. The National Library of Medicine and the National Institute of Health MEDLINE database was searched using Pub Med (www.pubmed.gov). The search was designed to identify English-language citations published after 1996 (the last year included in the previous guideline) using the keywords splenic injury and blunt abdominal trauma. One hundred seventy-six articles were reviewed, of which 125 were used to create the current practice management guideline for the selective nonoperative management of blunt splenic injury. There has been a plethora of literature regarding nonoperative management of blunt splenic injuries published since the original EAST practice management guideline was written. Nonoperative management of blunt splenic injuries is now the treatment modality of choice in hemodynamically stable patients, irrespective of the grade of injury, patient age, or the presence of associated injuries. Its use is associated with a low overall morbidity and mortality when applied to an appropriate patient population. Nonoperative management of blunt splenic injuries should only be considered in an environment that provides capabilities for monitoring, serial clinical evaluations, and has an operating room available for urgent laparotomy. Patients presenting with hemodynamic instability and peritonitis still warrant emergent operative intervention

Nonoperative management of blunt hepatic injury: an Eastern Association for the Surgery of Trauma practice management guideline.

PubMed

Stassen, Nicole A; Bhullar, Indermeet; Cheng, Julius D; Crandall, Marie; Friese, Randall; Guillamondegui, Oscar; Jawa, Randeep; Maung, Adrian; Rohs, Thomas J; Sangosanya, Ayodele; Schuster, Kevin; Seamon, Mark; Tchorz, Kathryn M; Zarzuar, Ben L; Kerwin, Andrew

2012-11-01

During the last century, the management of blunt force trauma to the liver has changed from observation and expectant management in the early part of the 1900s to mainly operative intervention, to the current practice of selective operative and nonoperative management. These issues were first addressed by the Eastern Association for the Surgery of Trauma in the Practice Management Guidelines for Nonoperative Management of Blunt Injury to the Liver and Spleen published online in 2003. Since that time, a large volume of literature on these topics has been published requiring a reevaluation of the previous Eastern Association for the Surgery of Trauma guideline. The National Library of Medicine and the National Institutes of Health MEDLINE database were searched using PubMed (http://www.pubmed.gov). The search was designed to identify English-language citations published after 1996 (the last year included in the previous guideline) using the keywords liver injury and blunt abdominal trauma. One hundred seventy-six articles were reviewed, of which 94 were used to create the current practice management guideline for the selective nonoperative management of blunt hepatic injury. Most original hepatic guidelines remained valid and were incorporated into the greatly expanded current guidelines as appropriate. Nonoperative management of blunt hepatic injuries currently is the treatment modality of choice in hemodynamically stable patients, irrespective of the grade of injury or patient age. Nonoperative management of blunt hepatic injuries should only be considered in an environment that provides capabilities for monitoring, serial clinical evaluations, and an operating room available for urgent laparotomy. Patients presenting with hemodynamic instability and peritonitis still warrant emergent operative intervention. Intravenous contrast enhanced computed tomographic scan is the diagnostic modality of choice for evaluating blunt hepatic injuries. Repeated imaging should be

40 CFR 503.24 - Management practices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Management practices. 503.24 Section... FOR THE USE OR DISPOSAL OF SEWAGE SLUDGE Surface Disposal § 503.24 Management practices. (a) Sewage... the permitting authority that through management practices public health and the environment are...

Management of Dentin Hypersensitivity by National Dental Practice-Based Research Network practitioners: results from a questionnaire administered prior to initiation of a clinical study on this topic.

PubMed

Kopycka-Kedzierawski, Dorota T; Meyerowitz, Cyril; Litaker, Mark S; Chonowski, Sidney; Heft, Marc W; Gordan, Valeria V; Yardic, Robin L; Madden, Theresa E; Reyes, Stephanie C; Gilbert, Gregg H

2017-01-13

Dentin hypersensitivity (DH) is a common problem encountered in clinical practice. The purpose of this study was to identify the management approaches for DH among United States dentists. One hundred eighty five National Dental Practice-Based Research Network clinicians completed a questionnaire regarding their preferred methods to diagnose and manage DH in the practice setting, and their beliefs about DH predisposing factors. Almost all dentists (99%) reported using more than one method to diagnose DH. Most frequently, they reported using spontaneous patient reports coupled with excluding other causes of oral pain by direct clinical examination (48%); followed by applying an air blast (26%), applying cold water (12%), and obtaining patient reports after dentist's query (6%). In managing DH, the most frequent first choice was desensitizing, over-the-counter (OTC), potassium nitrate toothpaste (48%), followed by fluorides (38%), and glutaraldehyde/HEMA (3%). A total of 86% of respondents reported using a combination of products when treating DH, most frequently using fluoride varnish and desensitizing OTC potassium nitrate toothpaste (70%). The most frequent predisposing factor leading to DH, as reported by the practitioners, was recessed gingiva (66%), followed by abrasion, erosion, abfraction/attrition lesions (59%) and bruxism (32%). The majority of network practitioners use multiple methods to diagnose and manage DH. Desensitizing OTC potassium nitrate toothpaste and fluoride formulations are the most widely used products to manage DH in dental practice setting.

Management practices that concentrate visitor activities: Camping impact management at Isle Royale National Park, USA

USGS Publications Warehouse

Marion, J.L.; Farrell, T.A.

2002-01-01

This study assessed campsite conditions and the effectiveness of campsite impact management strategies at Isle Royale National Park, USA. Protocols for assessing indicators of vegetation and soil conditions were developed and applied to 156 campsites and 88 shelters within 36 backcountry campgrounds. The average site was 68 m2 and 83% of sites lost vegetation over areas less than 47 m2. Results reveal that management actions to spatially concentrate camping activities and reduce camping disturbance have been highly successful. Comparisons of disturbed area/overnight stay among other protected areas reinforces this assertion. These reductions in area of camping disturbance are attributed to a designated site camping policy, limitation on site numbers, construction of sites in sloping terrain, use of facilities, and an ongoing program of campsite maintenance. Such actions are most appropriate in higher use backcountry and wilderness settings.

Music therapy services in pediatric oncology: a national clinical practice review.

PubMed

Tucquet, Belinda; Leung, Maggie

2014-01-01

This article presents the results of a national clinical practice review conducted in Australia of music therapy services in pediatric oncology hospitals. Literature specifically related to music therapy and symptom management in pediatric oncology is reviewed. The results from a national benchmarking survey distributed to all music therapists working with children with cancer in Australian pediatric hospitals are discussed. Patient and family feedback provided from a quality improvement activity conducted at a major pediatric tertiary hospital is summarized, and considerations for future growth as a profession and further research is proposed. © 2014 by Association of Pediatric Hematology/Oncology Nurses.

STORMWATER BEST MANAGEMENT PRACTICES DESIGN GUIDE VOLUME 3 - BASIN BEST MANAGEMENT PRACTICES

EPA Science Inventory

This manual provides design guidelines for a group of stormwater management (SWM) best management practices (BMPs) broadly referred to as basin or pond BMPs. Basin BMPs are the mainstay of stormwater management. Water resources engineers have designed small and large ponds for ma...

Participatory approaches to understanding practices of flood management across borders

NASA Astrophysics Data System (ADS)

Bracken, L. J.; Forrester, J.; Oughton, E. A.; Cinderby, S.; Donaldson, A.; Anness, L.; Passmore, D.

2012-04-01

The aim of this paper is to outline and present initial results from a study designed to identify principles of and practices for adaptive co-management strategies for resilience to flooding in borderlands using participatory methods. Borderlands are the complex and sometimes undefined spaces existing at the interface of different territories and draws attention towards messy connections and disconnections (Strathern 2004; Sassen 2006). For this project the borderlands concerned are those between professional and lay knowledge, between responsible agencies, and between one nation and another. Research was focused on the River Tweed catchment, located on the Scottish-English border. This catchment is subject to complex environmental designations and rural development regimes that make integrated management of the whole catchment difficult. A multi-method approach was developed using semi-structured interviews, Q methodology and participatory GIS in order to capture wide ranging practices for managing flooding, the judgements behind these practices and to 'scale up' participation in the study. Professionals and local experts were involved in the research. The methodology generated a useful set of options for flood management, with research outputs easily understood by key management organisations and the wider public alike. There was a wide endorsement of alternative flood management solutions from both managers and local experts. The role of location was particularly important for ensuring communication and data sharing between flood managers from different organisations and more wide ranging stakeholders. There were complex issues around scale; both the mismatch between communities and evidence of flooding and the mismatch between governance and scale of intervention for natural flood management. The multi-method approach was essential in capturing practice and the complexities around governance of flooding. The involvement of key flood management organisations was

The National Practice Benchmark for Oncology: 2015 Report for 2014 Data

PubMed Central

Balch, Carla; Ogle, John D.

2016-01-01

The National Practice Benchmark (NPB) is a unique tool used to measure oncology practices against others across the country in a meaningful way despite variations in practice demographics, size, and setting. In today’s challenging economic environment, each practice positions service offerings and competitive advantages to attract patients. Although the data in the NPB report are primarily reported by community oncology practices, the business structure and arrangements with regional health care systems are also reflected in the benchmark report. The ability to produce detailed metrics is an accomplishment of excellence in business and clinical management. With these metrics, a practice should be able to measure and analyze its current business practices and make appropriate changes, if necessary. In this report, we build on the foundation initially established by Oncology Metrics (acquired by Flatiron Health in 2014) over years of data collection and refine definitions to deliver the NPB, which is uniquely meaningful in the oncology market. PMID:27006357

Broad-Based National Education in Globalisation: Conceptualisation, Multiple Functions and Management

ERIC Educational Resources Information Center

Cheng, Yin Cheong; Yuen, Timothy W. W.

2017-01-01

Purpose: The purpose of this paper is to contribute to the worldwide discussion of conceptualization, multiple functions and management of national education in an era of globalisation by proposing a new comprehensive framework for research, policy analysis and practical implementation. Design/Methodology/Approach: Based on a review of the…

Best Practices for Real Property Management

DTIC Science & Technology

2016-04-21

organizations and are experienced in creating reliable and actionable solutions to complex management issues guided by proven best business practices...DEFENSE BUSINESS BOARD For the Secretary of Defense Best Practices for Real Property Management DBB...FY16-02 Recommendations on the best practices for management of Department of Defense real property assets Defense Business

Country differences of psychosocial working conditions in Europe: the role of health and safety management practices.

PubMed

Lunau, Thorsten; Dragano, Nico; Siegrist, Johannes; Wahrendorf, Morten

2017-10-01

In times of demographic change, maintaining health and employability of older employees is important. In this context, studies show that stressful working conditions differ by countries. Yet, it is unclear if specific national management practices to deal with these conditions contribute towards explaining country differences. This study combines two different data sources. The first one provides detailed information on psychosocial working conditions in 17 European countries, based on 12,284 employees from the Survey of Health, Ageing and Retirement in Europe (SHARE) and the English Longitudinal Study of Ageing (ELSA). We link this information to the second data source that provides information on health and safety management practices in each of the countries under study (collected among 17,477 managers at the level of companies in the Enterprise survey on new and emerging risks (ESENER)). We distinguish six different types of risk management procedures in the analysis. Results show that levels of psychosocial risks are generally lower in countries with more developed management practices, in particular if national management practices are marked by (1) procedures to deal with work stress, (2) information about whom to address in case of work-related psychosocial problems, and (3) health and safety services provided by psychologists. The findings underline the importance of a comprehensive psychosocial risk management approach in reducing work-related stress, as lower levels of psychosocial risks are linked to specific psychosocial risk management practices within companies, in particular those pointing to clear responsibilities and coordinated procedures in dealing with psychosocial risks.

National data elements for the clinical management of acute coronary syndromes.

PubMed

Chew, Derek P B; Allan, Roger M; Aroney, Constantine N; Sheerin, Noella J

2005-05-02

Patients with acute coronary syndromes represent a clinically diverse group and their care remains heterogeneous. These patients account for a significant burden of morbidity and mortality in Australia. Optimal patient outcomes depend on rapid diagnosis, accurate risk stratification and the effective implementation of proven therapies, as advocated by clinical guidelines. The challenge is in effectively applying evidence in clinical practice. Objectivity and standardised quantification of clinical practice are essential in understanding the evidence-practice gap. Observational registries are key to understanding the link between evidence-based medicine, clinical practice and patient outcome. Data elements for monitoring clinical management of patients with acute coronary syndromes have been adapted from internationally accepted definitions and incorporated into the National Health Data Dictionary, the national standard for health data definitions in Australia. Widespread use of these data elements will assist in the local development of "quality-of-care" initiatives and performance indicators, facilitate collaboration in cardiovascular outcomes research, and aid in the development of electronic data collection methods.

Asthma management practices in adults--findings from the German Health Update (GEDA) 2010 and the German National Health Interview and Examination Survey (DEGS1) 2008-2011.

PubMed

Steppuhn, Henriette; Langen, Ute; Mueters, Stephan; Dahm, Stefan; Knopf, Hildtraud; Keil, Thomas; Scheidt-Nave, Christa

2016-01-01

In Germany, population-wide data on adherence to national asthma management guidelines are lacking, and performance measures (PM) for quality assurance in asthma care are systematically monitored for patients with German national asthma disease management program (DMP) enrollment only. We used national health survey data to assess variation in asthma care PM with respect to patient characteristics and care context, including DMP enrollment. Among adults 18-79 years with self-reported physician-diagnosed asthma in the past 12 months identified from a recent German National Health Interview Survey (GEDA 2010: N = 1096) and the German National Health interview and Examination Survey 2008-2011 (DEGS1: N = 333), variation in asthma care PM was analyzed using logistic regression analysis. Overall, 38.4% (95% confidence interval: 32.5-44.6%) of adults with asthma were on current inhaled corticosteroid therapy. Regarding non-drug asthma management, low coverage was observed for inhaler technique monitoring (35.2%; 31.2-39.3%) and for provision of an asthma management plan (27.3%; 24.2-30.7%), particularly among those with low education. Specific PM were more complete among persons with than without asthma DMP enrollment (adjusted odds ratios ranging up to 10.19; 5.23-19.86), even if asthma patients were regularly followed in a different care context. Guideline adherence appears to be suboptimal, particularly with respect to PM related to patient counseling. Barriers to the translation of recommendations into practice need to be identified and continuous monitoring of asthma care PM at the population level needs to be established.

Perceived safety management practices in the logistics sector.

PubMed

Auyong, Hui-Nee; Zailani, Suhaiza; Surienty, Lilis

2016-03-09

Malaysia's progress on logistics has been slowed to keep pace with its growth in trade. The Government has been pressing companies to improve the safety of their activities in order to reduce society's loss due to occupational accidents and illnesses. Occupational safety and health is a crucial part of a workplace because every worker has to take care of his/her own safety and health. The main occupational safety and health (OSH) national policy in Malaysia is the enactment of the Occupational Safety and Health Act (OSHA) 1994. Only those companies which have excellent health and safety care have good quality and productive employees. This study investigated safety management practices in the logistics sector. The present study is concerned with the human factors to safety in the logistics industry. The authors examined the perceived safety management practices of workers in the logistics sector. The purpose was to identify the perception of safety management practices of Malaysian logistics personnel. Survey questionnaires were distributed to assess logistics personnel about management commitment. The quantitative method using the availability sampling method was applied. The data gathered from the survey were analysed using SPSS software. The responses to the survey were rated according to the Likert scale type, with '1' indicating strongly disagree and '5' indicating strongly agree. One hundred and three employees of logistics functions completed the survey. The highest mean scores were found for fire apparatus, prioritisation of safety, and safety policy. The results from this study also emphasise the importance of the management's commitment in enhancing workplace safety. Specifically, companies should maintain good relations between the employer and the employee to help reduce workplace injuries.

The role of practical wisdom in nurse manager practice: why experience matters.

PubMed

Cathcart, Eloise Balasco; Greenspan, Miriam

2013-10-01

To illustrate through the interpretation of one representative nurse manager's narrative how the methodology of practice articulation gives language to the ways practical wisdom develops in leadership practice and facilitates learning. Patricia Benner's corpus of research has demonstrated that reflection on clinical narratives comes closer than other pedagogical methods to replicating and enhancing the experiential learning required for the development of practical wisdom. Using Benner's methodology of practice articulation, 91 nurse managers wrote and read to a peer group a narrative of their lived experience in the role. The groups interpreted the narratives to extract the skilled knowledge and ethics embedded in the practice of the nurse manager authors. One narrative was chosen for this paper because it is a particularly clear exemplar of how practical wisdom develops in nurse manager practice. Articulating and reflecting on experiential learning led to an understanding of how practical wisdom developed in one nurse manager's practice. Interpretation of the narrative of one nurse manager illustrated how reflection on a complex ethical dilemma was a source of character development for the individual and the peer group. Describing and interpreting how practical wisdom develops for individual nurse managers can be a source of learning for the narrative author and other role incumbents who need to make sound decisions and take prudent action in ethically challenging situations. © 2013 John Wiley & Sons Ltd.

Dairy operation management practices and herd milk production.

PubMed

Losinger, W C; Heinrichs, A J

1996-03-01

A national US survey collected data on herd milk production and management of Holstein herds. Step-wise selection identified management practices that were related to herd milk production using only operations that calculated herd milk production as well as using data from all operations. Results were similar. Milk production was highest in the West. Operations with < 100 dairy cows had lower production than did larger operations. Operations with > 25% registered cattle had higher production than operations with no registered cattle. Dairy operations that reported a mean BW > 545 kg at first calving had higher mean milk production than operations with a mean BW < or = 545 kg at first calving. Operations that reported mean age at first calving < 27 mo had higher mean milk production than operations with a mean age > or = 27 mo at first calving. In addition, use of the following management practices was associated with higher rolling herd average milk production: calves born in individual areas in buildings, calves hand-fed first colostrum, starter grain fed to preweaned calves, ionophores fed to heifers from birth to first calving, DHIA record-keeping system used, computerized records, and no new cattle introduced in the previous 12 mo.

Idaho National Laboratory Cultural Resource Management Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lowrey, Diana Lee

As a federal agency, the U.S. Department of Energy has been directed by Congress, the U.S. president, and the American public to provide leadership in the preservation of prehistoric, historic, and other cultural resources on the lands it administers. This mandate to preserve cultural resources in a spirit of stewardship for the future is outlined in various federal preservation laws, regulations, and guidelines such as the National Historic Preservation Act, the Archaeological Resources Protection Act, and the National Environmental Policy Act. The purpose of this Cultural Resource Management Plan is to describe how the Department of Energy, Idaho Operations Officemore » will meet these responsibilities at the Idaho National Laboratory. This Laboratory, which is located in southeastern Idaho, is home to a wide variety of important cultural resources representing at least 13,500 years of human occupation in the southeastern Idaho area. These resources are nonrenewable; bear valuable physical and intangible legacies; and yield important information about the past, present, and perhaps the future. There are special challenges associated with balancing the preservation of these sites with the management and ongoing operation of an active scientific laboratory. The Department of Energy, Idaho Operations Office is committed to a cultural resource management program that accepts these challenges in a manner reflecting both the spirit and intent of the legislative mandates. This document is designed for multiple uses and is intended to be flexible and responsive to future changes in law or mission. Document flexibility and responsiveness will be assured through annual reviews and as-needed updates. Document content includes summaries of Laboratory cultural resource philosophy and overall Department of Energy policy; brief contextual overviews of Laboratory missions, environment, and cultural history; and an overview of cultural resource management practices. A series of

Idaho National Laboratory Cultural Resource Management Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lowrey, Diana Lee

2009-02-01

As a federal agency, the U.S. Department of Energy has been directed by Congress, the U.S. president, and the American public to provide leadership in the preservation of prehistoric, historic, and other cultural resources on the lands it administers. This mandate to preserve cultural resources in a spirit of stewardship for the future is outlined in various federal preservation laws, regulations, and guidelines such as the National Historic Preservation Act, the Archaeological Resources Protection Act, and the National Environmental Policy Act. The purpose of this Cultural Resource Management Plan is to describe how the Department of Energy, Idaho Operations Officemore » will meet these responsibilities at the Idaho National Laboratory. This Laboratory, which is located in southeastern Idaho, is home to a wide variety of important cultural resources representing at least 13,500 years of human occupation in the southeastern Idaho area. These resources are nonrenewable; bear valuable physical and intangible legacies; and yield important information about the past, present, and perhaps the future. There are special challenges associated with balancing the preservation of these sites with the management and ongoing operation of an active scientific laboratory. The Department of Energy, Idaho Operations Office is committed to a cultural resource management program that accepts these challenges in a manner reflecting both the spirit and intent of the legislative mandates. This document is designed for multiple uses and is intended to be flexible and responsive to future changes in law or mission. Document flexibility and responsiveness will be assured through annual reviews and as-needed updates. Document content includes summaries of Laboratory cultural resource philosophy and overall Department of Energy policy; brief contextual overviews of Laboratory missions, environment, and cultural history; and an overview of cultural resource management practices. A series of

Strategic directions for developing the Australian general practice nurse role in cardiovascular disease management.

PubMed

Halcomb, Elizabeth J; Davidson, Patricia M; Yallop, Julie; Griffiths, Rhonda; Daly, John

2007-08-01

Practice nursing is an integral component of British and New Zealand primary care, but in Australia it remains an emerging specialty. Despite an increased focus on the Australian practice nurse role, there has been limited strategic role development, particularly relating to national health priority areas. This paper reports the third stage of a Project exploring the Australian practice nurse role in the management of cardiovascular disease (CVD). This stage involved a consensus development conference, undertaken to identify strategic, priority recommendations for practice nurse role development. 1. Practice nurses have an important role in developing systems and processes for CVD management; 2. A change in the culture of general practice is necessary to promote acceptance of nurse-led CVD management; 3. Future research needs to evaluate specific models of care, incorporating outcome measures sensitive to nursing interventions; 4. Considerable challenges exist in conducting research in general practice; and 5. Changes in funding models are necessary for widespread practice nurse role development. The shifting of funding models provides evidence to support interdisciplinary practice in Australian general practice. The time is ripe, therefore, to engage in prospective and strategic planning to inform development of the practice nurse role.

Reverse quality management: developing evidence-based best practices in health emergency management.

PubMed

Lynch, Tim; Cox, Paul

2006-01-01

The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management.

Health spending in the 1980's: Integration of clinical practice patterns with management

PubMed Central

Freeland, Mark S.; Schendler, Carol E.

1984-01-01

Health care spending in the United States more than tripled between 1972 and 1982, increasing from $94 billion to $322 billion. This growth substantially outpaced overall growth in the economy. National health expenditures are projected to reach approximately $690 billion in 1990 and consume roughly 12 percent of the gross national product. Government spending for health care is projected to reach $294 billion by 1990, with the Federal Government paying 72 percent. The Medicare prospective payment system and increasing competition in the health services sector are providing incentives to integrate clinical practice patterns with improved management practices. PMID:10310595

End-of-life care practices of critical care nurses: A national cross-sectional survey.

PubMed

Ranse, Kristen; Yates, Patsy; Coyer, Fiona

2016-05-01

The critical care context presents important opportunities for nurses to deliver skilled, comprehensive care to patients at the end of life and their families. Limited research has identified the actual end-of-life care practices of critical care nurses. To identify the end-of-life care practices of critical care nurses. A national cross-sectional online survey. The survey was distributed to members of an Australian critical care nursing association and 392 critical care nurses (response rate 25%) completed the survey. Exploratory factor analysis using principal axis factoring with oblique rotation was undertaken on survey responses to identify the domains of end-of-life care practice. Descriptive statistics were calculated for individual survey items. Exploratory factor analysis identified six domains of end-of-life care practice: information sharing, environmental modification, emotional support, patient and family centred decision-making, symptom management and spiritual support. Descriptive statistics identified a high level of engagement in information sharing and environmental modification practices and less frequent engagement in items from the emotional support and symptom management practice areas. The findings of this study identified domains of end-of-life care practice, and critical care nurse engagement in these practices. The findings highlight future training and practice development opportunities, including the need for experiential learning targeting the emotional support practice domain. Further research is needed to enhance knowledge of symptom management practices during the provision of end-of-life care to inform and improve practice in this area. Copyright © 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Management of venous leg ulcers in general practice - a practical guideline.

PubMed

Sinha, Sankar; Sreedharan, Sadhishaan

2014-09-01

Chronic venous leg ulcers are the most common wounds seen in general practice. Their management can be both challenging and time-consuming. To produce a short practical guideline incorporating the TIME concept and A2BC2D approach to help general practitioners and their practice nurses in delivering evidence-based initial care to patients with chronic venous leg ulcers. Most chronic venous leg ulcers can be managed effectively in the general practice setting by following the simple, evidence-based approach described in this article. Figure 1 provides a flow chart to aid in this process. Figure 2 illustrates the principles of management in general practice. Effective management of chronic ulcers involves the assessment of both the ulcer and the patient. The essential requirements of management are to debride the ulcer with appropriate precautions, choose dressings that maintain adequate moisture balance, apply graduated compression bandage after evaluation of the arterial circulation and address the patient's concerns, such as pain and offensive wound discharge.

Evaluating Emergency Department Asthma Management Practices in Florida Hospitals.

PubMed

Nowakowski, Alexandra C H; Carretta, Henry J; Dudley, Julie K; Forrest, Jamie R; Folsom, Abbey N

2016-01-01

To assess gaps in emergency department (ED) asthma management at Florida hospitals. Survey instrument with open- and closed-ended questions. Topics included availability of specific asthma management modalities, compliance with national guidelines, employment of specialized asthma care personnel, and efforts toward performance improvement. Emergency departments at 10 large hospitals in the state of Florida. Clinical care providers and health administrators from participating hospitals. Compliance with national asthma care guideline standards, provision of specific recommended treatment modalities and resources, employment of specialized asthma care personnel, and engagement in performance improvement efforts. Our results suggest inconsistency among sampled Florida hospitals' adherence to national standards for treatment of asthma in EDs. Several hospitals were refining their emergency care protocols to incorporate guideline recommendations. Despite a lack of formal ED protocols in some hospitals, adherence to national guidelines for emergency care nonetheless remained robust for patient education and medication prescribing, but it was weaker for formal care planning and medical follow-up. Identified deficiencies in emergency asthma care present a number of opportunities for strategic mitigation of identified gaps. We conclude with suggestions to help Florida hospitals achieve success with ED asthma care reform. Team-based learning activities may offer an optimal strategy for sharing and implementing best practices.

Hearing conservation and noise management practices in professional orchestras.

PubMed

O'Brien, Ian; Driscoll, Tim; Ackermann, Bronwen

2012-01-01

Hearing conservation and noise exposure management for professional orchestras is a difficult issue resistant to standard control measures as used in other industries with excessive noise problems. Although there has been a great deal of research into this area in terms of the audiological status of musicians and their exposure to noise, there are relatively few industry-specific strategies that can be adopted by an orchestra looking to address these issues. Australia does not have a uniform approach to hearing conservation management in its orchestras; however, each orchestra actively grapples with the challenges of balancing legal, practical, and artistic concerns. This study systematically investigated hearing conservation practices, noise exposure management, and audiological screening protocols in eight professional orchestras. The research involved personal interviews with staff at each orchestra, including inspection of venues and facilities. While all these orchestras were aware of the risks and were actively taking significant steps to reduce noise exposure, a range of approaches, with varying degrees of effectiveness and understanding of the issue, were found across the sector. There was limited evidence of educational programs for either the musicians at risk of excessive noise exposure or the staff responsible for devising and implementing control measures. In addition, the reported use of adequate personal hearing protection by musicians was poor. As Australia has recently introduced a national approach to workplace health and safety, a similar approach to noise and audiological management across the country's orchestral sector is proposed, drawn from existing research and practice. This will enable both consistent procedures and meaningful dialogue between the orchestras on the topics of hearing conservation, audiological monitoring, and educational practices.

Sandia National Laboratories, California Environmental Management System program manual.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Larsen, Barbara L.

2012-03-01

The Sandia National Laboratories, California (SNL/CA) Environmental Management System (EMS) Program Manual documents the elements of the site EMS Program. The SNL/CA EMS Program conforms to the International Standard on Environmental Management Systems, ISO 14001:2004and Department of Energy (DOE) Order 436.1. Sandia National Laboratories, California (SNL/CA) has maintained functional environmental programs to assist with regulatory compliance for more than 30 years. During 2005, these existing programs were rolled into a formal environmental management system (EMS) that expands beyond the traditional compliance focus to managing and improving environmental performance and stewardship practices for all site activities. An EMS is a setmore » of inter-related elements that represent a continuing cycle of planning, implementing, evaluating, and improving processes and actions undertaken to achieve environmental policy and goals. The SNL/CA EMS Program conforms to the International Standard for Environmental Management Systems, ISO 14001:2004 (ISO 2004). The site first received ISO 14001 certification in September 2006 and recertification in 2009. SNL/CA's EMS Program is applicable to the Sandia, Livermore site only. Although SNL/CA operates as one organizational division of the overall Sandia National Laboratories, the EMS Program is site-specific, with site-specific objectives and targets. SNL/CA (Division 8000) benefits from the organizational structure as it provides corporate level policies, procedures, and standards, and established processes that connect to and support elements of the SNL/CA EMS Program. Additionally, SNL/CA's EMS Program benefits from two corporate functional programs (Facilities Energy and Water Resource Management and Fleet Services programs) that maintain responsibility for energy management and fleet services for all Sandia locations. Each EMS element is further enhanced with site-specific processes and standards. Division 8000 has

Reflective practice: a framework for case manager development.

PubMed

Brubakken, Karen; Grant, Sara; Johnson, Mary K; Kollauf, Cynthia

2011-01-01

The role of a nurse case manager (NCM) incorporates practice that is built upon knowledge gained in other roles as well as components unique to case management. The concept of reflective practice was used in creating a framework to recognize the developmental stages that occur within community based case management practice. The formation of this framework and its uses are described in this article. The practice setting is a community based case management department in a large midwestern metropolitan health care system with Magnet recognition. Advanced practice nurses provide care for clients with chronic health conditions. Twenty-four narratives were used to identify behaviors of community based case managers and to distinguish stages of practice. The behaviors of advanced practice found within the narratives were labeled and analyzed for similarities. Related behaviors were grouped and descriptor statements were written. These statements grouped into 3 domains of practice: relationship/partnership, coordination/collaboration, and clinical knowledge/decision making. The statements in each domain showed practice variations from competent to expert, and 3 stages were determined. Reliability and validity of the framework involved analysis of additional narratives. The reflective practice process, used for monthly case review presentations, provides opportunity for professional development and group learning focused on improving case manager practice. The framework is also being used in orientation as new case managers acclimate to the role. Reflective writing has unveiled the richness and depth of nurse case manager practice. The depth of knowledge and skills involved in community-based case management is captured within this reflective practice framework. This framework provides a format for describing community based case manager practice development over the course of time and has been used as a tool for orientation and peer review.

Independent extended and supplementary nurse prescribing practice in the UK: a national questionnaire survey.

PubMed

Courtenay, Molly; Carey, Nicola; Burke, Joanna

2007-09-01

Nurses are able to prescribe independently from a list of nearly 250 prescription only medicines for a range of over 100 medical conditions or, from the whole British National Formulary as a supplementary prescriber. There is some evidence available on the prescribing practices of district nurses and health visitors and early independent extended prescribers. Little or no attention has focussed on supplementary nurse prescribing. To provide an overview of the prescribing practices of independent extended/supplementary nurse prescribers and the factors that facilitate or inhibit prescribing. National questionnaire survey. United Kingdom. A convenience sample of 868 qualified independent extended/supplementary nurse prescribers self-completed a written questionnaire. A total of 756 (87%) used independent extended prescribing; 304 (35%) used supplementary prescribing to treat a range of chronic conditions (including asthma, diabetes and hypertension); 710 (82%) nurses worked in primary care. Nurses in general practice reported the largest number of reasons preventing prescribing. Reasons included the inability to computer generate prescriptions and to implement the Clinical Management Plan. Nurses in primary care reported more continuing professional development needs. These needs included update on prescribing policy and the treatment management of conditions. A total of 277 (32%) nurses were unable to access continuing professional development. Independent extended/supplementary nurse prescribers work predominantly in primary care and do prescribe medicines. These nurses are highly qualified and have many years clinical experience. Supplementary prescribing is used by a minority of nurses. Implementing the Clinical Management Plan is a barrier preventing the use of this mode of prescribing. The continuing professional development needs of independent extended/supplementary nurse prescribers are frequently unmet. It will become increasingly important that these needs

Implications of workforce and financing changes for primary care practice utilization, revenue, and cost: a generalizable mathematical model for practice management.

PubMed

Basu, Sanjay; Landon, Bruce E; Song, Zirui; Bitton, Asaf; Phillips, Russell S

2015-02-01

Primary care practice transformations require tools for policymakers and practice managers to understand the financial implications of workforce and reimbursement changes. To create a simulation model to understand how practice utilization, revenues, and expenses may change in the context of workforce and financing changes. We created a simulation model estimating clinic-level utilization, revenues, and expenses using user-specified or public input data detailing practice staffing levels, salaries and overhead expenditures, patient characteristics, clinic workload, and reimbursements. We assessed whether the model could accurately estimate clinic utilization, revenues, and expenses across the nation using labor compensation, medical expenditure, and reimbursements databases, as well as cost and revenue data from independent practices of varying size. We demonstrated the model's utility in a simulation of how utilization, revenue, and expenses would change after hiring a nurse practitioner (NP) compared with hiring a part-time physician. Modeled practice utilization and revenue closely matched independent national utilization and reimbursement data, disaggregated by patient age, sex, race/ethnicity, insurance status, and ICD diagnostic group; the model was able to estimate independent revenue and cost estimates, with highest accuracy among larger practices. A demonstration analysis revealed that hiring an NP to work independently with a subset of patients diagnosed with diabetes or hypertension could increase net revenues, if NP visits involve limited MD consultation or if NP reimbursement rates increase. A model of utilization, revenue, and expenses in primary care practices may help policymakers and managers understand the implications of workforce and financing changes.

AGRICULTURAL BEST MANAGEMENT PRACTICE EFFECTIVENESS DATABASE

EPA Science Inventory

Resource Purpose:The Agricultural Best Management Practice Effectiveness Database contains the results of research projects which have collected water quality data for the purpose of determining the effectiveness of agricultural management practices in reducing pollutants ...

Management of tinnitus in English NHS audiology departments: an evaluation of current practice

PubMed Central

Hoare, Derek J; Gander, Phillip E; Collins, Luke; Smith, Sandra; Hall, Deborah A

2012-01-01

Rationale, aim and objective In 2009, the UK Department of Health formalized recommended National Health Service practices for the management of tinnitus from primary care onwards. It is timely therefore to evaluate the perceived practicality, utility and impact of those guidelines in the context of current practice. Methods We surveyed current practice by posting a 36-item questionnaire to all audiology and hearing therapy staff that we were able to identify as being involved in tinnitus patient care in England. Results In total, 138 out of 351 clinicians responded (39% response rate). The findings indicate a consensus opinion that management should be tailored to individual symptom profiles but that there is little standardization of assessment procedures or tools in use. Conclusions While the lack of standardized practice might provide flexibility to meet local demand, it has drawbacks. It makes it difficult to ascertain key standards of best practice, it complicates the process of clinical audit, it implies unequal patient access to care, and it limits the implementation of translational research outcomes. We recommend that core elements of practice should be standardized, including use of a validated tinnitus questionnaires and an agreed pathway for decision making to better understand the rationale for management strategies offered. PMID:21087449

Perspectives on Past and Present Waste Disposal Practices: A Community-Based Participatory Research Project in Three Saskatchewan First Nations Communities

PubMed Central

Zagozewski, Rebecca; Judd-Henrey, Ian; Nilson, Suzie; Bharadwaj, Lalita

2011-01-01

The impact of current and historical waste disposal practices on the environment and human health of Indigenous people in First Nations communities has yet to be adequately addressed. Solid waste disposal has been identified as a major environmental threat to First Nations Communities. A community-based participatory research project (CBPR) was initiated by the Saskatoon Tribal Council Health and Family Services Incorporated to investigate concerns related to waste disposal in three Saskatchewan First Nations Communities. Utilizing a qualitative approach, we aimed to gain an understanding of past and present waste disposal practices and to identify any human and environmental health concerns related to these practices. One to one interviews and sharing circles were conducted with Elders. Elders were asked to share their perspectives on past and present waste disposal practices and to comment on the possible impacts these practices may have on the environment and community health. Historically waste disposal practices were similar among communities. The homeowner generated small volumes of waste, was exclusively responsible for disposal and utilized a backyard pit. Overtime waste disposal evolved to weekly pick-up of un-segregated garbage with waste disposal and open trash burning in a community dump site. Dump site locations and open trash burning were identified as significant health issues related to waste disposal practices in these communities. This research raises issues of inequity in the management of waste in First Nations Communities. It highlights the need for long-term sustainable funding to support community-based waste disposal and management strategies and the development of First Nations centered and delivered educational programs to encourage the adoption and implementation of waste reduction, reutilization and recycling activities in these communities. PMID:21573032

Developing a framework of, and quality indicators for, general practice management in Europe.

PubMed

Engels, Yvonne; Campbell, Stephen; Dautzenberg, Maaike; van den Hombergh, Pieter; Brinkmann, Henrik; Szécsényi, Joachim; Falcoff, Hector; Seuntjens, Luc; Kuenzi, Beat; Grol, Richard

2005-04-01

To develop a framework for general practice management made up of quality indicators shared by six European countries. Two-round postal Delphi questionnaire in the setting of general practice in Belgium, France, Germany, The Netherlands, Switzerland and the United Kingdom. Six national expert panels, each consisting of 10 members, primarily primary care practitioners and experts in the field of quality in primary care participated in the study. The main outcome measures were: (a) a European framework with indicators for the organization of primary care; and (b) ratings of the face validity of the usefulness of the indicators by expert panels in six countries. Agreement was reached about a definition of practice management across five domains (infrastructure, staff, information, finance, and quality and safety), and a common set of indicators for the organization of general practice. The panellist response rate was 95%. Sixty-two indicators (37%) were rated face valid by all six panels. Examples include out of hours service, accessibility, the content of doctors' bags and staff involvement in quality improvement. No indicators were rated invalid by all six panels. It proved to be possible to develop a European set of indicators for assessing the quality of practice management, despite the differences in health care systems and cultures in the six different countries. These indicators will now be used in a quality assessment procedure of practice management in nine European countries. While organizational indicators are part of the new GMS contract in the UK, this research shows that many practice management issues within primary care are also of relevance in other European countries.

Best practices in specialty pharmacy management.

PubMed

Patterson, Courtney J

2013-01-01

Specialty pharmacy is a growing area of research, utilization, and cost. Because of the unique nature of the diseases treated by specialty pharmaceuticals, such as cancer and rheumatoid arthritis, novel management approaches are needed. Advocate Physician Partners (APP) is an entity within the Advocate Health Care Health System in the Chicago and the central Illinois area. It coordinates the care management and managed care contracting between the Advocate Health Care System and more than 4,000 physicians on the medical staffs of Advocate hospitals. APP has experienced a per-member-per-month (PMPM) increase of less than  3% in oncology intravenous medications spend in 2012. This spend refers to the intravenous medications covered under the medical benefits for APP's health maintenance organization (HMO) population. The spend has consistently been less than national projections, and we believe this is tied to the adoption of several key best practices. Prior to instituting the best practices, the yearly percentage increases for oncology spending were 5.52% (2007 to 2008), 9.39% (2008 to 2009), and 5.29% (2009 to 2010). After instituting best practices during the first quarter of 2011, the increases in PMPM were 3.11% (2010 to 2011) and 2.11% (2011 to 2012), which were below previous years. To describe the best practices of specialty pharmacy management adopted by APP, specifically (a) establishing a content expert and governing bodies, (b) ensuring compliance with policies, and (c) providing educational resources. APP has several key result areas (KRAs). One KRA was compliance with appropriate utilization of intravenous oncology protocols for its HMO population. The protocols for each medication outline the appropriate indication and patient population. These protocols were developed and reviewed by the APP Pharmacy and Technology (PT) committee. The PT-approved indications reflect FDA indications and indications found in national guidelines. The APP KRA target

Managing hospital doctors and their practice: what can we learn about human resource management from non-healthcare organisations?

PubMed

Trebble, Timothy M; Heyworth, Nicola; Clarke, Nicholas; Powell, Timothy; Hockey, Peter M

2014-11-21

Improved management of clinicians' time and practice is advocated to address increasing demands on healthcare provision in the UK National Health Service (NHS). Human resource management (HRM) is associated with improvements in organisational performance and outcomes within and outside of healthcare, but with limited use in managing individual clinicians. This may reflect the absence of effective and transferrable models. The current systems of managing the performance of individual clinicians in a secondary healthcare organisation were reviewed through the study of practice in 10 successful partnership organisations, including knowledge worker predominant, within commercial, public and voluntary sector operating environments. Reciprocal visits to the secondary healthcare environment were undertaken. Six themes in performance related HRM were identified across the external organisations representing best practice and considered transferrable to managing clinicians in secondary care organisations. These included: performance measurement through defined outcomes at the team level with decision making through local data interpretation; performance improvement through empowered formal leadership with organisational support; individual performance review (IPR); and reward, recognition and talent management. The role of the executive was considered essential to support and implement effective HRM, with management of staff performance, behaviour and development integrated into organisational strategy, including through the use of universally applied values and effective communication. These approaches reflected many of the key aspects of high performance work systems and strategic HRM. There is the potential to develop systems of HRM of individual clinicians in secondary healthcare to improve practice. This should include both performance measurement and performance improvement but also engagement at an organisational level. This suggests that effective HRM and

Physicians' opinions and clinical practice patterns for actinic keratosis management in Italy.

PubMed

Peris, K; Neri, L; Calzavara Pinton, P; Catricalà, C; Pellacani, G; Pimpinelli, N; Peserico, A

2014-04-01

We report dermatologists' opinions and clinical practice patterns about clinical factors driving decision making in the management of actinic keratosis (AK) in Italy. We carried out a cross-sectional survey among 33 Italian dermatologists. Physicians were asked to report their management choices in consecutive patients with AK seen at their practice within 2 weeks since study initiation. We collected patients' clinical and socio-demographic characteristics with a standardized data collection form and assessed physicians' opinions on AK management with a self-reported questionnaire. Six hundred fifty-seven patients with new, single AK lesions without evidence of photo-damaged skin in the surrounding areas, were predominantly treated with lesion-directed therapies (primarily cryotherapy). In contrast, physicians preferentially prescribed field-directed therapies to patients with multiple lesions and evidence of photo-damaged skin in AK surrounding areas. However we observed a wide variation in treatment choices and physicians' opinions on AK management. Dermatologists underlined the importance of fostering patients' adherence and minimize therapy side effects. Overall, our results show that current guidelines regarding management of AK are only partially integrated in dermatology practice. The active dissemination of up-to-date national guidelines might help harmonize clinical decision making in this complex and fast growing therapeutic area.

Management practices in substance abuse treatment programs.

PubMed

McConnell, K John; Hoffman, Kim A; Quanbeck, Andrew; McCarty, Dennis

2009-07-01

Efforts to understand how to improve the delivery of substance abuse treatment have led to a recent call for studies on the "business of addiction treatment." This study adapts an innovative survey tool to collect baseline management practice data from 147 addiction treatment programs enrolled in the Network for the Improvement of Addiction Treatment 200 project. Measures of "good" management practice were strongly associated with days to treatment admission. Management practice scores were weakly associated with revenues per employee but were not correlated with operating margins. Better management practices were more prevalent among programs with a higher number of competitors in their catchment area.

Atypical forest products, processes, and uses: a developing component of National Forest management

Treesearch

Mike Higgs; John Sebelius; Mike Miller

1995-01-01

The silvicultural practices prescribed under an ecosystem management regimen will alter the volume and character of National Forests' marketable raw material base. This alteration will affect forest-dependent communities that have traditionally relied upon these resources for their economic and social well being. Community based atypical forest products, processes...

Managing Money in Marriage: Multilevel and Cross-National Effects of the Breadwinner Role

ERIC Educational Resources Information Center

Yodanis, Carrie; Lauer, Sean

2007-01-01

We examine whether institutionalized practices and beliefs regarding breadwinning roles are associated with the choice of more or less equal money management strategies in marriage. Using cross-national data from 21 country contexts in the International Social Survey Programme and multilevel modeling, we find that in contexts of shared…

Clinical practice guidelines for the management of acute limb compartment syndrome following trauma.

PubMed

Wall, Christopher J; Lynch, Joan; Harris, Ian A; Richardson, Martin D; Brand, Caroline; Lowe, Adrian J; Sugrue, Michael

2010-03-01

Acute compartment syndrome is a serious and not uncommon complication of limb trauma. The condition is a surgical emergency, and is associated with significant morbidity if not managed appropriately. There is variation in management of acute limb compartment syndrome in Australia. Clinical practice guidelines for the management of acute limb compartment syndrome following trauma were developed in accordance with Australian National Health and Medical Research Council recommendations. The guidelines were based on critically appraised literature evidence and the consensus opinion of a multidisciplinary team involved in trauma management who met in a nominal panel process. Recommendations were developed for key decision nodes in the patient care pathway, including methods of diagnosis in alert and unconscious patients, appropriate assessment of compartment pressure, timing and technique of fasciotomy, fasciotomy wound management, and prevention of compartment syndrome in patients with limb injuries. The recommendations were largely consensus based in the absence of well-designed clinical trial evidence. Clinical practice guidelines for the management of acute limb compartment syndrome following trauma have been developed that will support consistency in management and optimize patient health outcomes.

Variations in guideline use and practice relating to diagnosis and management of infection in paediatric burns services in England and Wales: A national survey.

PubMed

Davies, Anna; Spickett-Jones, Francesca; Brock, Paula; Coy, Karen; Young, Amber

2017-02-01

Wound infection causes morbidity and mortality in burns. UK National Burns Care Standards state that guidance should be used to diagnose and treat burn wound infection. However, surveys of senior staff about standard operating procedures or guidance in UK burns services indicate that they are infrequently available (Papini et al., 1995; Lymperopoulos et al., 2015). Staff may have differing views and experiences of guidance use according to their role. This survey investigated the extent to which guidance is available, and current practices used for diagnosis and treatment of burn wound infection, both within and between paediatric burns services. Staff from paediatric burns services in England and Wales were individually interviewed by two nurses about guidance and practices around antibiotic prophylaxis, diagnosis and management of burn wound infection and toxic shock syndrome, and antibiotic use. In each service staff from three categories were interviewed: lead consultant/burns specialist nurse, junior doctor/senior nurse, ward based nurse. Data were subjected to content analysis and reliably coded by two researchers using a coding frame. Guidance documents were also requested. Thirteen services took part. Staff in fewer than half of services reported that they had guidance for antibiotic prophylaxis, diagnosis, and management of burn wound infection. In nine services at least one staff member reported that they had guidance for antibiotic use. Guidance was available for diagnosis and management of toxic shock syndrome in ten services, and staff in five were consistently aware of it. One service routinely used antibiotic prophylaxis, but had no written guidance for it. In five services where at least one member of staff reported that they had guidance for diagnosing infection, at least one interviewed staff member was unaware of it. Swabbing practice varied between and within services, with 10 staff across six services cleaning before swabbing, and four staff in

Practice management: observations, issues, and empirical evidence.

PubMed

Wong, H M; Braithwaite, J

2001-02-01

The primary objective of this study is to provide objective, empirical, evidence-based practice management information. This is a hitherto under-researched area of considerable interest for both the practitioner and educator. A questionnaire eliciting a mix of structured and free text responses was administered to a random sample of 480 practitioners who are members of the American Academy of Periodontology. Potential respondents not in private practice were excluded and the next listed person substituted. The results provide demographic and descriptive information about some of the main issues and problems facing practice managers, central to which are information technology (IT), financial, people management, and marketing. Human resource and marketing management appear to represent the biggest challenges. Periodontists running practices would prefer more information, development, and support in dealing with IT, finance, marketing, and people management. The empirical evidence reported here suggests that although tailored educational programs on key management issues at both undergraduate and postgraduate levels have become ubiquitous, nevertheless some respondents seek further training opportunities. Evidence-based practice management information will be invaluable to the clinician considering strategic and marketing planning, and also for those responsible for the design and conduct of predoctoral and postdoctoral programs.

Summary Report of the NASA Management Study Group: Recommendations to the Administrator, National Aeronautics and Space Administration

NASA Technical Reports Server (NTRS)

Phillips, Samuel C.

1986-01-01

The NASA Management Study Group (NMSG) was established under the auspices of the National Acedamy of Public Administration at the request of the Administrator of NASA to assess NASA's management practices and to evaluate the effectiveness of the NASA organization. This report summarizes the conclusions and recommendations of the NMSG on the overall management and organization of NASA.

40 CFR 503.14 - Management practices.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 31 2013-07-01 2013-07-01 false Management practices. 503.14 Section 503.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SEWAGE SLUDGE STANDARDS FOR THE USE OR DISPOSAL OF SEWAGE SLUDGE Land Application § 503.14 Management practices. (a) Bulk...

40 CFR 503.45 - Management practices.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 31 2013-07-01 2013-07-01 false Management practices. 503.45 Section 503.45 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SEWAGE SLUDGE STANDARDS FOR THE USE OR DISPOSAL OF SEWAGE SLUDGE Incineration § 503.45 Management practices. (a)(1) An...

40 CFR 503.14 - Management practices.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Management practices. 503.14 Section 503.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SEWAGE SLUDGE STANDARDS FOR THE USE OR DISPOSAL OF SEWAGE SLUDGE Land Application § 503.14 Management practices. (a) Bulk...

40 CFR 503.14 - Management practices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Management practices. 503.14 Section 503.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SEWAGE SLUDGE STANDARDS FOR THE USE OR DISPOSAL OF SEWAGE SLUDGE Land Application § 503.14 Management practices. (a) Bulk...

40 CFR 503.45 - Management practices.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Management practices. 503.45 Section 503.45 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SEWAGE SLUDGE STANDARDS FOR THE USE OR DISPOSAL OF SEWAGE SLUDGE Incineration § 503.45 Management practices. (a)(1) An...

40 CFR 503.14 - Management practices.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 30 2014-07-01 2014-07-01 false Management practices. 503.14 Section 503.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SEWAGE SLUDGE STANDARDS FOR THE USE OR DISPOSAL OF SEWAGE SLUDGE Land Application § 503.14 Management practices. (a) Bulk...

40 CFR 503.45 - Management practices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Management practices. 503.45 Section 503.45 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SEWAGE SLUDGE STANDARDS FOR THE USE OR DISPOSAL OF SEWAGE SLUDGE Incineration § 503.45 Management practices. (a)(1) An...

40 CFR 503.45 - Management practices.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 30 2014-07-01 2014-07-01 false Management practices. 503.45 Section 503.45 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SEWAGE SLUDGE STANDARDS FOR THE USE OR DISPOSAL OF SEWAGE SLUDGE Incineration § 503.45 Management practices. (a)(1) An...

40 CFR 503.14 - Management practices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Management practices. 503.14 Section 503.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SEWAGE SLUDGE STANDARDS FOR THE USE OR DISPOSAL OF SEWAGE SLUDGE Land Application § 503.14 Management practices. (a) Bulk...

40 CFR 503.45 - Management practices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Management practices. 503.45 Section 503.45 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SEWAGE SLUDGE STANDARDS FOR THE USE OR DISPOSAL OF SEWAGE SLUDGE Incineration § 503.45 Management practices. (a)(1) An...

Identifying wood utilization options for ecosystem management : summary of a national research project

Treesearch

K. E. Skog; R. J. Barbour; J. E. Baumgras; A. Clark

1997-01-01

Using an ecosystem approach to forest management will change silvicultural practices, thus requiring utilization options to provide revenue and to help offset the costs of the silviculture treatments. The Forest Service, university cooperators, and several industry mills in the southern, western, and northeastern United States have been involved in a national...

National Board Certification and Developmentally Appropriate Practices: Perceptions of Impact

ERIC Educational Resources Information Center

McKenzie, Ellen Nancy

2013-01-01

The study investigated a relationship between National Board certification and perceived use of developmentally appropriate practices (DAP). A self-developed survey, the Early-childhood Teacher Inventory of Practices, was e-mailed to participants. Participants included 246 non-National Board-certified (non-NBCT) and 135 National Board-certified…

Clinical terminology support for a national ambulatory practice outcomes research network.

PubMed

Ricciardi, Thomas N; Lieberman, Michael I; Kahn, Michael G; Masarie, F E

2005-01-01

The Medical Quality Improvement Consortium (MQIC) is a nationwide collaboration of 74 healthcare delivery systems, consisting of 3755 clinicians, who contribute de-identified clinical data from the same commercial electronic medical record (EMR) for quality reporting, outcomes research and clinical research in public health and practice benchmarking. Despite the existence of a common, centrally-managed, shared terminology for core concepts (medications, problem lists, observation names), a substantial "back-end" information management process is required to ensure terminology and data harmonization for creating multi-facility clinically-acceptable queries and comparable results. We describe the information architecture created to support terminology harmonization across this data-sharing consortium and discuss the implications for large scale data sharing envisioned by proponents for the national adoption of ambulatory EMR systems.

Use Management Techniques in Office Practice

ERIC Educational Resources Information Center

Holehan, E. Lee

1977-01-01

Notes that authenticity can be added to student work projects in an office practice class by having the teacher assume the role of the office manager or supervisor and putting office management techniques into practice. Ways in which such techniques may be infused into classes are examined. (TA)

Developing intelligent transportation systems using the national ITS architecture : an executive edition for senior transportation managers

DOT National Transportation Integrated Search

1998-07-01

This document has been produced to provide senior transportation managers of state and local departments of transportation with practical guidance for deploying Intelligent Transportation Systems (ITS) consistent with the National ITS Architecture. T...

Views of practice managers and general practitioners on implementing NHS Health Checks.

PubMed

Krska, Janet; du Plessis, Ruth; Chellaswamy, Hannah

2016-03-01

As part of an evaluation of a contract with general practices to deliver the national NHS Health Checks programme in Sefton, North West England, we surveyed general practitioners (GPs) and practice managers (PMs) in all 55 practices. The contract required practices to identify individuals from their practice registers with potentially high cardiovascular disease risk, and provide annual reviews. Responses were obtained from 43/178 GPs and 40/55 PMs representing 56 and 73% of practices, respectively. There was variation in many aspects of implementation. Time and software were viewed as barriers to implementation, the increased nurse workload impacted on other services and payments were insufficient to cover costs. The main enabler for successful implementation was IT support. Fewer than half the respondents viewed the programme as beneficial to their practice. Findings have been used to address many issues raised. Practices need more support from commissioners to help implement NHS Health Checks.

40 CFR Table 1 to Subpart Cccccc... - Applicability Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000 Gallons of Gasoline or More1... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Source Category: Gasoline... Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000...

40 CFR Table 1 to Subpart Cccccc... - Applicability Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000 Gallons of Gasoline or More1... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Source Category: Gasoline... Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000...

40 CFR Table 1 to Subpart Cccccc... - Applicability Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000 Gallons of Gasoline or More1... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Source Category: Gasoline... Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000...

40 CFR Table 1 to Subpart Cccccc... - Applicability Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000 Gallons of Gasoline or More1... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Source Category: Gasoline... Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000...

Benchmarking management practices in Australian public healthcare.

PubMed

Agarwal, Renu; Green, Roy; Agarwal, Neeru; Randhawa, Krithika

2016-01-01

The purpose of this paper is to investigate the quality of management practices of public hospitals in the Australian healthcare system, specifically those in the state-managed health systems of Queensland and New South Wales (NSW). Further, the authors assess the management practices of Queensland and NSW public hospitals jointly and globally benchmark against those in the health systems of seven other countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. In this study, the authors adapt the unique and globally deployed Bloom et al. (2009) survey instrument that uses a "double blind, double scored" methodology and an interview-based scoring grid to measure and internationally benchmark the management practices in Queensland and NSW public hospitals based on 21 management dimensions across four broad areas of management - operations, performance monitoring, targets and people management. The findings reveal the areas of strength and potential areas of improvement in the Queensland and NSW Health hospital management practices when compared with public hospitals in seven countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. Together, Queensland and NSW Health hospitals perform best in operations management followed by performance monitoring. While target management presents scope for improvement, people management is the sphere where these Australian hospitals lag the most. This paper is of interest to both hospital administrators and health care policy-makers aiming to lift management quality at the hospital level as well as at the institutional level, as a vehicle to consistently deliver sustainable high-quality health services. This study provides the first internationally comparable robust measure of management capability in Australian public hospitals, where hospitals are run independently by the state-run healthcare systems. Additionally, this research study contributes to the empirical evidence base on the quality of

CWLA Best Practice Guidelines: Behavior Management.

ERIC Educational Resources Information Center

Child Welfare League of America, Inc., Washington, DC.

In the context of a national discussion regarding behavior management in child and youth care settings, and in an effort to address the need to care safely and appropriately for children and youth, the Child Welfare League of America (CWLA) formed the National Task Force on Behavior Management. The task force includes representatives of advocacy…

Framework for a National Testing and Evaluation Program Based Upon the National Stormwater Testing and Evaluation for Products and Practices (STEPP) Initiative (WERF Report INFR2R14)

EPA Science Inventory

Abstract:The National STEPP Program seeks to improve water quality by accelerating the effective implementation and adoption of innovative stormwater management technologies. Itwill attempt to accomplish this by establishing practices through highly reliable, and cost-effective S...

"Getting Practical" and the National Network of Science Learning Centres

ERIC Educational Resources Information Center

Chapman, Georgina; Langley, Mark; Skilling, Gus; Walker, John

2011-01-01

The national network of Science Learning Centres is a co-ordinating partner in the Getting Practical--Improving Practical Work in Science programme. The principle of training provision for the "Getting Practical" programme is a cascade model. Regional trainers employed by the national network of Science Learning Centres trained the cohort of local…

Ungulate management in national parks of the United States and Canada

USGS Publications Warehouse

Demarais, S.; Cornicelli, L.; Kahn, R.; Merrill, E.; Miller, C.; Peek, J.M.; Porter, W.F.; Sargeant, G.A.

2012-01-01

Enabling legislation—that which gives appropriate officials the authority to implement or enforce the law—impacts management of ungulates in national parks of Canada and the United States (U.S.). The initial focus of such legislation in both countries centered on preserving natural and culturally significant areas for posterity. Although this objective remains primary, philosophies and practices have changed. A Canadian vision for ungulate management emerged during the latter half of the 20th century to protect and maintain or restore the ecological integrity of representative samples of the country’s 39 distinct landscapes, and to include provisions for traditional hunting and fishing practices representative of past cultural impacts on the environment. The current ungulate management approach in the U.S. relies on natural (ecological) processes, as long as normal conditions are promoted and there is no impairment of natural resources. Emphasizing natural processes as the basis has been a challenge because ecosystem dynamics are complex and management is multi-jurisdictional. Additionally, natural regulation typically will not prevent ungulates from reaching and sustaining densities that are incompatible with preservation or restoration of native flora and fauna, natural processes, or historical landscapes.

Error Management Practices Interacting with National and Organizational Culture: The Case of Two State University Departments in Turkey

ERIC Educational Resources Information Center

Göktürk, Söheyda; Bozoglu, Oguzhan; Günçavdi, Gizem

2017-01-01

Purpose: Elements of national and organizational cultures can contribute much to the success of error management in organizations. Accordingly, this study aims to consider how errors were approached in two state university departments in Turkey in relation to their specific organizational and national cultures. Design/methodology/approach: The…

Reducing visitor noise levels at Muir Woods National Monument using experimental management.

PubMed

Stack, David W; Peter, Newman; Manning, Robert E; Fristrup, Kurt M

2011-03-01

Noise impacts resources and visitor experience in many protected natural areas, and visitors can be the dominant source of noise. This experimental study tested the efficacy and acceptability of signs asking visitors to be quiet at Muir Woods National Monument, California. Signs declaring a "quiet zone" (at the park's Cathedral Grove) or a "quiet day" (throughout the park) were posted on a randomized schedule that included control days (no signs). Visitor surveys were conducted to measure the cognitive and behavioral responses of visitors to the signs and test the acceptability of these management practices to visitors. Visitors were highly supportive of these management practices and reported that they consciously limited the amount of noise they produced. Sound level measurements showed substantial decreases on days when signs were posted. © 2011 Acoustical Society of America

Time management strategies in nursing practice.

PubMed

Waterworth, Susan

2003-09-01

With the increasing emphasis on efficiency and effectiveness in health care, how a nurse manages her time is an important consideration. Whilst time management is recognized as an important component of work performance and professional nursing practice, the reality of this process in nursing practice has been subject to scant empirical investigation. To explore how nurses organize and manage their time. A qualitative study was carried out, incorporating narratives (22 nurses), focus groups (24 nurses) and semi-structured interviews (22 nurses). In my role as practitioner researcher I undertook observation and had informal conversations, which provided further data. Study sites were five health care organizations in the United Kingdom during 1995-1999. Time management is complex, with nurses using a range of time management strategies and a repertoire of actions. Two of these strategies, namely routinization and prioritizing, are discussed, including their implications for understanding time management by nurses in clinical practice. Ignoring the influence of 'others', the team and the organization perpetuates a rather individualistic and self-critical perspective of time management. This may lead to a failure to address problems in the organizing of work, and the co-ordinating of care involving other health care workers.

Ministry of Health clinical practice guidelines: Management of Rhinosinusitis and Allergic Rhinitis.

PubMed

Siow, J K; Alshaikh, N A; Balakrishnan, A; Chan, K O; Chao, S S; Goh, L G; Hwang, S Y; Lee, C Y; Leong, J L; Lim, L; Menon, A; Sethi, D S; Tan, H; Wang, D Y

2010-03-01

The Ministry of Health publishes national clinical practice guidelines to provide doctors and patients in Singapore with evidence-based guidance on managing important medical conditions. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the Ministry of Health clinical practice guidelines on Management of Rhinosinusitis and Allergic Rhinitis, for the information of readers of the Singapore Medical Journal. Chapters, page and figure numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website (http://www.moh.gov.sg/mohcorp/publications.aspx?id=24046). The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.

'Am I covered?': an analysis of a national enquiry database on scope of practice.

PubMed

Brady, Anne-Marie; Fealy, Gerard; Casey, Mary; Hegarty, Josephine; Kennedy, Catriona; McNamara, Martin; O'Reilly, Pauline; Prizeman, Geraldine; Rohde, Daniela

2015-10-01

Analysis of a national database of enquiries to a professional body pertaining to the scope of nursing and midwifery practice. Against a backdrop of healthcare reform is a demand for flexibility in nursing and midwifery roles with unprecedented redefinition of role boundaries and/or expansion. Guidance from professional regulatory bodies is being sought around issues of concern that are arising in practice. Qualitative thematic analysis. The database of telephone enquiries (n = 9818) made by Registered Nurses and midwives to a national regulatory body (2001-2013) was subjected to a cleaning process and examined to detect those concerns that pertained to scope of practice. A total of 978 enquiries were subjected to thematic analysis. Enquiries were concerned with three main areas: medication management, changing and evolving scope of practice and professional role boundaries. The context was service developments, staff shortages and uncertainty about role expansion and professional accountability. Other concerns related to expectations around responsibility and accountability for other support staff. Efforts by employers to maximize the skill mix of their staff and optimally deploy staff to meet service needs and/or address gaps in service represented the primary service context from which many enquiries arose. The greatest concern for nurses arises around medication management but innovation in healthcare delivery and the demands of service are also creating challenges for nurses and midwives. Maintaining and developing competence is a concern among nurses and midwives particularly in an environment of limited resources and where re-deployment is common. © 2015 John Wiley & Sons Ltd.

Teaching interpersonal skills in family practice: results of a national survey.

PubMed

Kahn, G; Cohen, B; Jason, H

1979-02-01

The increasing recognition of the importance of a well-developed set of interpersonal skills to the competent family physician has resulted in a rapid growth in the formal teaching of interpersonal skills within family practice residencies. Of the 168 programs responding to a national survey of family practice residencies, 88 percent indicated that they have formal programs in interpersonal skills. It is estimated that there are well over 500 family practice faculty members who have special responsibilities in teaching interpersonal skills. While most programs address the component skills of the interpersonal process (eg, demonstrating empathy, information gathering, information giving, and psychological intervention), it is of concern that only about half offer explicit training in patient education (53 percent), specific types of counseling (eg, family counseling, 55 percent), or some of the specific interpersonal skills important in team practice and practice management (eg, supervisory skills). One of the most striking findings was that 88 percent of the reporting programs use videotechnology, with 77 percent of these planning to increase their use. Although most programs evaluate their interpersonal skills training using both indirect and direct assessment methods, only 25 percent attempt to use patient outcome as a measure of teaching effectiveness.

National disease management plans for key chronic non-communicable diseases in Singapore.

PubMed

Tan, C C

2002-07-01

In Singapore, chronic, non-communicable diseases, namely coronary heart disease, stroke and cancer, account for more than 60% of all deaths and a high burden of disability and healthcare expenditure. The burden of these diseases is likely to rise with our rapidly ageing population and changing lifestyles, and will present profound challenges to our healthcare delivery and financing systems over the next 20 to 30 years. The containment and optimal management of these conditions require a strong emphasis on patient education and the development of integrated models of healthcare delivery in place of the present uncoordinated, compartmentalised way of delivering healthcare. To meet these challenges, the Ministry of Health's major thrusts are disease control measures which focus mainly on primary prevention; and disease management, which coordinates the national effort to reduce the incidence of these key diseases and their predisposing factors and to ameliorate their long-term impact by optimising control to reduce mortality, morbidity and complications, and improving functional status through rehabilitation. The key initiatives include restructuring of the public sector healthcare institutions into two clusters, each comprising a network of primary health care polyclinics, regional hospitals and tertiary institutions. The functional integration of these healthcare elements within each cluster under a common senior administrative and professional management, and the development of common clinical IT systems will greatly facilitate the implementation of disease management programmes. Secondly, the Ministry is establishing National Disease Registries in coronary heart disease, cancer, stroke, myopia and kidney failure, which will be valuable sources of clinical and outcomes data. Thirdly, in partnership with expert groups, national committees and professional agencies, the Ministry will produce clinical practice guidelines which will assist doctors and healthcare

Changes in the monitoring and oversight practices of not-for-profit hospital governing boards 1989-2005: evidence from three national surveys.

PubMed

Alexander, Jeffrey A; Lee, Shoou-Yih D; Wang, Virginia; Margolin, Frances S

2009-04-01

Despite the legal and practical importance of monitoring and oversight of management by hospital governing boards, there is little empirical evidence of how hospital boards fulfill these roles and the extent to which these practices have changed over time. We utilize data from three national surveys of hospital governance to examine how oversight and monitoring practices in public and private not-for-profit (NFP) hospital boards have changed over time. Findings suggest that board relations with CEOs in NFP hospitals display important but potentially contradictory patterns. On the one hand, NFP hospital boards appear to be exercising more stringent oversight of management and hospital performance. On the other hand, management is more actively involved with governance matters with less separation of board and management. This general pattern varies by the dimension of oversight and monitoring practice and by specific characteristics of NFP hospitals.

[Quality system in cardiology: practical example to develop an organizational model for management certification without bureaucracy].

PubMed

Colonna, Paolo; Pasini, Evasio; Pitocchi, Oreste; Bovenzi, Francesco; Sorino, Margherita; de Luca, Italo

2003-04-01

It is a difficult task to define practical guidelines and a pragmatic achievement for the new document of the Italian Ministry of Health for structures of the national health system obtaining a quality system according to the ISO 9000 standard. The present article illustrates the different steps to accomplish the quality management in our cardiology department, recently internationally certified, and it gives several practical examples of the path followed in the different sections of the department to obtain the best management of all the Operative Units, identifying customer requests and measuring customer satisfaction.

A Secondary Analysis of the Impact of School Management Practices on School Performance

ERIC Educational Resources Information Center

Talbert, Dale A.

2009-01-01

The purpose of this study was to conduct a secondary analysis of the impact of school management practices on school performance utilizing a survey design of School and Staffing (SASS) data collected by the National Center for Education Statistics (NCES) of the U.S. Department of Education, 1999-2000. The study identifies those school management…

Effects of Landscape Conditions and Management Practices ...

EPA Pesticide Factsheets

Lakes continue to face escalating pressures associated with land cover change and growing human populations. The U.S. EPA National Lakes Assessment, which sampled 1,028 lakes during the summer of 2007 using a probabilistic survey, was the first large scale effort to determine the condition of lakes across the country. In addition to broad trends, these data offer an abundance of new opportunities to examine biodiversity patterns, drivers of ecosystem change, and effectiveness of management practices that aim to reduce adverse effects of land cover change. Here, we use 2006 National Land Cover Data and sediment diatom samples collected from the tops of cores to examine how land cover at different spatial extents affects the habitat and diatom communities of lakes. We are examining the effects of land cover in basins, buffers in upstream networks, and buffers adjacent to 188 lakes in regions extending from the Mid-Atlantic to New England. Identifying relationships of diatom communities with land cover and physico-chemical parameters, along with generating stressor-response curves, will help with (1) developing diatom indicators responsive to anthropogenic impacts, (2) identifying how spatial locations of land cover affect lake conditions and diatoms, (3) informing future assessments and management efforts, and (4) characterizing potentially different patterns across regions and the effects of natural variation. Comparisons of study lakes to reference lake conditio

Educational Management: Theory and Practice.

ERIC Educational Resources Information Center

Bush, Tony

This document is a chapter in "The Principles and Practice of Educational Management," which aims to provide a systematic and analytical introduction to the study of educational management. The structure of the book reflects the main substantive areas of educational leadership and management, and most of the major themes are covered in the…

The National QAAMS Program – A Practical Example of PoCT Working in the Community

PubMed Central

Shephard, Mark DS; Gill, Janice P

2010-01-01

The Quality Assurance for Aboriginal and Torres Strait Islander Medical Services (QAAMS) Program is the largest and longest-standing national point-of-care testing (PoCT) program in Australia. With a focus on PoCT for diabetes management, it now operates in 115 Indigenous medical services and has been funded continuously by the Australian Government for 11 years. A recent independent evaluation of the QAAMS Program concluded that the program continues to meet best practice standards for Indigenous healthcare, diabetes management and PoCT. PMID:24150514

Practice management education during surgical residency.

PubMed

Jones, Kory; Lebron, Ricardo A; Mangram, Alicia; Dunn, Ernest

2008-12-01

Surgical education has undergone radical changes in the past decade. The introductions of laparoscopic surgery and endovascular techniques have required program directors to alter surgical training. The 6 competencies are now in place. One issue that still needs to be addressed is the business aspect of surgical practice. Often residents complete their training with minimal or no knowledge on coding of charges or basic aspects on how to set up a practice. We present our program, which has been in place over the past 2 years and is designed to teach the residents practice management. The program begins with a series of 10 lectures given monthly beginning in August. Topics include an introduction to types of practices available, negotiating a contract, managed care, and marketing the practice. Both medical and surgical residents attend these conferences. In addition, the surgical residents meet monthly with the business office to discuss billing and coding issues. These are didactic sessions combined with in-house chart reviews of surgical coding. The third phase of the practice management plan has the coding team along with the program director attend the outpatient clinic to review in real time the evaluation and management coding of clinic visits. Resident evaluations were completed for each of the practice management lectures. The responses were recorded on a Likert scale. The scores ranged from 4.1 to 4.8 (average, 4.3). Highest scores were given to lectures concerning negotiating employee agreements, recruiting contracts, malpractice insurance, and risk management. The medical education department has tracked resident coding compliance over the past 2 years. Surgical coding compliance increased from 36% to 88% over a 12-month period. The program director who participated in the educational process increased his accuracy from 50% to 90% over the same time period. When residents finish their surgical training they need to be ready to enter the world of business

Clinical Terminology Support for a National Ambulatory Practice Outcomes Research Network

PubMed Central

Ricciardi, Thomas N.; Lieberman, Michael I.; Kahn, Michael G.; Masarie, F.E. “Chip”

2005-01-01

The Medical Quality Improvement Consortium (MQIC) is a nationwide collaboration of 74 healthcare delivery systems, consisting of 3755 clinicians, who contribute de-identified clinical data from the same commercial electronic medical record (EMR) for quality reporting, outcomes research and clinical research in public health and practice benchmarking. Despite the existence of a common, centrally-managed, shared terminology for core concepts (medications, problem lists, observation names), a substantial “back-end” information management process is required to ensure terminology and data harmonization for creating multi-facility clinically-acceptable queries and comparable results. We describe the information architecture created to support terminology harmonization across this data-sharing consortium and discuss the implications for large scale data sharing envisioned by proponents for the national adoption of ambulatory EMR systems. PMID:16779116

Managing human resources in healthcare: learning from world class practices--Part I.

PubMed

Zairi, M

1998-01-01

This paper, which is presented in two parts, is intended to demonstrate that practices related to the area of human resources management, adopted by model organisations that have dominated their markets consistently, can lend themselves very well to the healthcare sector, which is primarily a "people-oriented" sector. As change in a modern business context is set to continue in an unrelenting way, most organisations will be presented with the challenge of developing the necessary skills and areas of expertise to enable them to cope with the demands on them, master technological opportunities at their disposal, learn how to exploit modern management concepts and optimise value to all the stakeholders they intend to serve. This paper draws from best practices using the experiences of quality recognised organisations and many admired names through pioneering human resource policies and practices and through clear demonstrations on the benefits of relying on people as the major "asset". Part I of this article addresses the importance of human resources as revealed through models of management for organisational excellence. In particular, the paper refers to the criteria for excellence in relation to people management using the following prestigious and integrative management models: Deming Prize (Japan); European Quality Award Model (Europe); and Malcolm Baldrige National Quality Award (USA). In addition, this paper illustrates several case studies using organisations known for their pioneering approaches to people management and which led them to win very prestigious quality awards and various international accolades. The paper concludes by reinforcing the point that human resource management in a healthcare context has to be viewed as an integrated set of processes and practices which need to be adhered to from an integrated perspective in order to optimise individuals' performance levels and so that the human potential can be exploited fully.

Tuberculosis management practices of private practitioners in Pune municipal corporation, India.

PubMed

Bharaswadkar, Sandeep; Kanchar, Avinash; Thakur, Narendra; Shah, Shubhangi; Patnaik, Brinda; Click, Eleanor S; Kumar, Ajay M V; Dewan, Puneet Kumar

2014-01-01

Private Practitioners (PP) are the primary source of health care for patients in India. Limited representative information is available on TB management practices of Indian PP or on the efficacy of India's Revised National Tuberculosis Control Programme (RNTCP) to improve the quality of TB management through training of PP. We conducted a cross-sectional survey of a systematic random sample of PP in one urban area in Western India (Pune, Maharashtra). We presented sample clinical vignettes and determined the proportions of PPs who reported practices consistent with International Standards of TB Care (ISTC). We examined the association between RNTCP training and adherence to ISTC by calculating odds ratios and 95% confidence intervals. Of 3,391 PP practicing allopathic medicine, 249 were interviewed. Of these, 55% had been exposed to RNTCP. For new pulmonary TB patients, 63% (158/249) of provider responses were consistent with ISTC diagnostic practices, and 34% (84/249) of responses were consistent with ISTC treatment practices. However, 48% (120/249) PP also reported use of serological tests for TB diagnosis. In the new TB case vignette, 38% (94/249) PP reported use of at least one second line anti-TB drug in the treatment regimen. RNTCP training was not associated with diagnostic or treatment practices. In Pune, India, despite a decade of training activities by the RNTCP, high proportions of providers resorted to TB serology for diagnosis and second-line anti-TB drug use in new TB patients. Efforts to achieve universal access to quality TB management must account for the low quality of care by PP and the lack of demonstrated effect of current training efforts.

Tuberculosis Management Practices of Private Practitioners in Pune Municipal Corporation, India

PubMed Central

Bharaswadkar, Sandeep; Kanchar, Avinash; Thakur, Narendra; Shah, Shubhangi; Patnaik, Brinda; Click, Eleanor S.; Kumar, Ajay M. V.; Dewan, Puneet Kumar

2014-01-01

Background Private Practitioners (PP) are the primary source of health care for patients in India. Limited representative information is available on TB management practices of Indian PP or on the efficacy of India’s Revised National Tuberculosis Control Programme (RNTCP) to improve the quality of TB management through training of PP. Methods We conducted a cross-sectional survey of a systematic random sample of PP in one urban area in Western India (Pune, Maharashtra). We presented sample clinical vignettes and determined the proportions of PPs who reported practices consistent with International Standards of TB Care (ISTC). We examined the association between RNTCP training and adherence to ISTC by calculating odds ratios and 95% confidence intervals. Results Of 3,391 PP practicing allopathic medicine, 249 were interviewed. Of these, 55% had been exposed to RNTCP. For new pulmonary TB patients, 63% (158/249) of provider responses were consistent with ISTC diagnostic practices, and 34% (84/249) of responses were consistent with ISTC treatment practices. However, 48% (120/249) PP also reported use of serological tests for TB diagnosis. In the new TB case vignette, 38% (94/249) PP reported use of at least one second line anti-TB drug in the treatment regimen. RNTCP training was not associated with diagnostic or treatment practices. Conclusion In Pune, India, despite a decade of training activities by the RNTCP, high proportions of providers resorted to TB serology for diagnosis and second-line anti-TB drug use in new TB patients. Efforts to achieve universal access to quality TB management must account for the low quality of care by PP and the lack of demonstrated effect of current training efforts. PMID:24897374

Abortion and neonaticide: ethics, practice, and policy in four nations.

PubMed

Gross, Michael L

2002-06-01

Abortion, particularly later-term abortion, and neonaticide, selective non-treatment of newborns, are feasible management strategies for fetuses or newborns diagnosed with severe abnormalities. However, policy varies considerably among developed nations. This article examines abortion and neonatal policy in four nations: Israel, the US, the UK and Denmark. In Israel, late-term abortion is permitted while non-treatment of newborns is prohibited. In the US, on the other hand, later-term abortion is severely restricted, while treatment to newborns may be withdrawn. Policy in the UK and Denmark bridges some of these gaps with liberal abortion and neonatal policy. Disparate policy within and between nations creates practical and ethical difficulties. Practice diverges from policy as many practitioners find it difficult to adhere to official policy. Ethically, it is difficult to entirely justify perinatal policy in these nations. In each nation, there are elements of ethically sound policy, while other aspects cannot be defended. Ethical policy hinges on two underlying normative issues: the question of fetal/newborn status and the morality of killing and letting die. While each issue has been the subject of extensive debate, there are firm ethical norms that should serve as the basis for coherent and consistent perinatal policy. These include 1) a grant of full moral and legal status to the newborn but only partial moral and legal status to the late-term fetus 2) a general prohibition against feticide unless to save the life of the mother or prevent the birth of a fetus facing certain death or severe pain or suffering and 3) a general endorsement of neonaticide subject to a parent's assessment of the newborn's interest broadly defined to consider physical harm as well as social, psychological and or financial harm to related third parties. Policies in each of the nations surveyed diverging from these norms should be the subject of public discourse and, where possible

National audit of continence care for older people: management of urinary incontinence.

PubMed

Wagg, Adrian; Potter, Jonathan; Peel, Penny; Irwin, Penny; Lowe, Derek; Pearson, Michael

2008-01-01

the Department of Health report 'Good practice in continence services' highlights the need for proper assessment and management of urinary incontinence. The National Service Framework for Older People required service providers to establish integrated continence services by April 2004. A national audit was conducted to assess the quality of continence care for older people and whether these requirements have been met. the audit studied incontinent individuals of 65 years and over. Each site returned data on organisational structure and the process of 20 patients' care. Data were submitted via the internet, and all were anonymous. the national audit was conducted across England, Wales and Northern Ireland. Data on the care of patients/residents with bladder problems were returned by 141/326 (43%) of primary care trusts (PCT), by 159/196 (81%) of secondary care trusts (involving 198 hospitals) and by 29/309 (9%) of invited care homes. In all 58% of PCT, 48% of hospitals and 74% of care homes reported that integrated continence services existed in their area. Whilst basic provision of care appeared to be in place, the audit identified deficiencies in the organisation of services, and in the assessment and management of urinary incontinence in the elderly. the results of this audit indicate that the requirement for integrated continence services has not yet been met. Assessment and care by professionals directly looking after the older person were often lacking. There is an urgent need to re-establish the fundamentals of continence care into the practice of medical and nursing staff and action needs to be taken with regard to the establishment of truly integrated, quality services in this neglected area of practice.

The virtual practice: using the residents' continuity clinic to teach practice management and systems-based practice.

PubMed

Perez, Jose A; Faust, Cheryl; Kenyon, Angie

2009-09-01

Education in systems-based practice is a required component of all postgraduate medical education programs in the United States. Competency in this area requires that trainees have an understanding of the health care system sufficient to provide optimal care to patients. Most trainees in residency programs have little understanding of the complexities and challenges of present-day practice in the current system of care and consider themselves unprepared to undertake this activity following completion of training. Training in practice management in residency programs has not been emphasized as an important component of systems-based practice. Historically, practice management training in residency programs has been done using a fully didactic model, and residents have expressed a desire to learn this skill by becoming more directly involved in the operations and management of a practice. The patient visit touches many aspects of the health care system, including clinic operations, insurance, quality, and finances. At our institution, we used the residents' continuity clinic practices as a vehicle to provide education in practice management and systems-based practice by creating a curriculum that included the residents' perceived gaps in knowledge regarding going into practice. This is known as the virtual practice. This curriculum is taught using data obtained from residents' practice to illustrate concepts in many areas, including primary practice operations, malpractice insurance, financial benchmarks, and career planning. Resident self-assessed knowledge of these areas increased after participating in the curriculum, and resident testimonials indicate satisfaction with the project. In addition, residents have become engaged and interested in how their effort translates into performance and how they participate in the health care system.

Best Practices for Management of Biocontaminated Waste ...

EPA Pesticide Factsheets

Report The purpose of these best practices is to provide federal, state, territorial, and local waste management entities information on techniques and methodologies that have the potential to improve the handling and management of biocontaminated waste streams after a biological agent incident. These best practices are intended to be general in nature serving as a resource to a variety of biological agents in a variety of situations; however, these best practices also present a specific homeland security scenario – a biological attack with Bacillus anthracis (B. anthracis) – to help illustrate specific waste management considerations.

The Blood Stocks Management Scheme, a partnership venture between the National Blood Service of England and North Wales and participating hospitals for maximizing blood supply chain management.

PubMed

Chapman, J F; Cook, R

2002-10-01

The Blood Stocks Management Scheme (BSMS) has been established as a joint venture between the National Blood Service (NBS) in England and North Wales and participating hospitals to monitor the blood supply chain. Stock and wastage data are submitted to a web-based data-management system, facilitating continuous and complete red cell data collection and 'real time' data extraction. The data-management system enables peer review of performance in respect of stock holding levels and red cell wastage. The BSMS has developed an innovative web-based data-management system that enables data collection and benchmarking of practice, which should drive changes in stock management practice, therefore optimizing the use of donated blood.

Risk-informed Management of Water Infrastructure in the United States: History, Development, and Best Practices

NASA Astrophysics Data System (ADS)

Wolfhope, J.

2017-12-01

This presentation will focus on the history, development, and best practices for evaluating the risks associated with the portfolio of water infrastructure in the United States. These practices have evolved from the early development of the Federal Guidelines for Dam Safety and the establishment of the National Dam Safety Program, to the most recent update of the Best Practices for Dam and Levee Risk Analysis jointly published by the U.S. Department of Interior Bureau of Reclamation and the U.S. Army Corps of Engineers. Since President Obama signed the Water Infrastructure Improvements for the Nation Act (WIIN) Act, on December 16, 2016, adding a new grant program under FEMA's National Dam Safety Program, the focus has been on establishing a risk-based priority system for use in identifying eligible high hazard potential dams for which grants may be made. Finally, the presentation provides thoughts on the future direction and priorities for managing the risk of dams and levees in the United States.

Nurses in Australian general practice: implications for chronic disease management.

PubMed

Halcomb, Elizabeth J; Davidson, Patricia M; Salamonson, Yenna; Ollerton, Richard; Griffiths, Rhonda

2008-03-01

The purpose of this study was to describe the demographic and employment characteristics of Australian practice nurses and explore the relationship between these characteristics and the nurses' role. Nursing in general practice is an integral component of primary care and chronic disease management in the United Kingdom and New Zealand, but in Australia it is an emerging specialty and there is limited data on the workforce and role. National postal survey embedded in a sequential mixed method design. 284 practice nurses completed a postal survey during 2003-2004. Descriptive statistics and factor analysis were utilized to analyse the data. Most participants were female (99%), Registered Nurses (86%), employed part-time in a group practice, with a mean age of 45.8 years, and had a hospital nursing certificate as their highest qualification (63%). The tasks currently undertaken by participants and those requiring further education were inversely related (R2 = -0.779). Conversely, tasks perceived to be appropriate for a practice nurse and those currently undertaken by participants were positively related (R2 = 0.8996). There was a mismatch between the number of participants who perceived that a particular task was appropriate and those who undertook the task. This disparity was not completely explained by demographic or employment characteristics. Extrinsic factors such as legal and funding issues, lack of space and general practitioner attitudes were identified as barriers to role expansion. Practice nurses are a clinically experienced workforce whose skills are not optimally harnessed to improve the care of the growing number of people with chronic and complex conditions. Relevance to clinical practice. Study data reveal a need to overcome the funding, regulatory and interprofessional barriers that currently constrain the practice nurse role. Expansion of the practice nurse role is clearly a useful adjunct to specialist management of chronic and complex disease

Chronic disease management in general practice: results from a national study.

PubMed

Darker, C; Martin, C; O'Dowd, T; O'Kelly, F; O'Shea, B

2012-04-01

The aim of this study was to provide baseline data on chronic disease management (CDM) provision in Irish general practice (GP). The survey instrument was previously used in a study of primary care physicians in 11 countries, thus allowing international comparisons. The response rate was 72% (380/527).The majority of GPs (240/380; 63%) reported significant changes are needed in our health care system to make CDM work better. Small numbers of routine clinical audits are being performed (95/380; 25%). Irish GPs use evidence based guidelines for treatment of diabetes (267/380; 71%), asthma / COPD (279/380; 74%) and hypertension (297/380; 79%), to the same extent as international counterparts. Barriers to delivering chronic care include increased workload (379/380; 99%), lack of appropriate funding (286/380; 76%), with GPs interested in targeted payments (244/380; 68%). This study provides baseline data to assess future changes in CDM.

Strategic Information Resources Management: Fundamental Practices.

ERIC Educational Resources Information Center

Caudle, Sharon L.

1996-01-01

Discusses six fundamental information resources management (IRM) practices in successful organizations that can improve government service delivery performance. Highlights include directing changes, integrating IRM decision making into a strategic management process, performance management, maintaining an investment philosophy, using business…

Linking Theory with Practice in Basic Management

ERIC Educational Resources Information Center

Carroll, Archie B.

1974-01-01

Instructors of management in higher education have not been cautious in explaining the relation between practice and theory in their basic courses. The author distinguished between the two in suggesting that management theory is based on observed practices and may or may not have broader application. (AG)

Oncology practice trends from the national practice benchmark.

PubMed

Barr, Thomas R; Towle, Elaine L

2012-09-01

In 2011, we made predictions on the basis of data from the National Practice Benchmark (NPB) reports from 2005 through 2010. With the new 2011 data in hand, we have revised last year's predictions and projected for the next 3 years. In addition, we make some new predictions that will be tracked in future benchmarking surveys. We also outline a conceptual framework for contemplating these data based on an ecological model of the oncology delivery system. The 2011 NPB data are consistent with last year's prediction of a decrease in the operating margins necessary to sustain a community oncology practice. With the new data in, we now predict these reductions to occur more slowly than previously forecast. We note an ease to the squeeze observed in last year's trend analysis, which will allow more time for practices to adapt their business models for survival and offer the best of these practices an opportunity to invest earnings into operations to prepare for the inevitable shift away from historic payment methodology for clinical service. This year, survey respondents reported changes in business structure, first measured in the 2010 data, indicating an increase in the percentage of respondents who believe that change is coming soon, but the majority still have confidence in the viability of their existing business structure. Although oncology practices are in for a bumpy ride, things are looking less dire this year for practices participating in our survey.

Oncology Practice Trends From the National Practice Benchmark

PubMed Central

Barr, Thomas R.; Towle, Elaine L.

2012-01-01

In 2011, we made predictions on the basis of data from the National Practice Benchmark (NPB) reports from 2005 through 2010. With the new 2011 data in hand, we have revised last year's predictions and projected for the next 3 years. In addition, we make some new predictions that will be tracked in future benchmarking surveys. We also outline a conceptual framework for contemplating these data based on an ecological model of the oncology delivery system. The 2011 NPB data are consistent with last year's prediction of a decrease in the operating margins necessary to sustain a community oncology practice. With the new data in, we now predict these reductions to occur more slowly than previously forecast. We note an ease to the squeeze observed in last year's trend analysis, which will allow more time for practices to adapt their business models for survival and offer the best of these practices an opportunity to invest earnings into operations to prepare for the inevitable shift away from historic payment methodology for clinical service. This year, survey respondents reported changes in business structure, first measured in the 2010 data, indicating an increase in the percentage of respondents who believe that change is coming soon, but the majority still have confidence in the viability of their existing business structure. Although oncology practices are in for a bumpy ride, things are looking less dire this year for practices participating in our survey. PMID:23277766

The role of management in an in vitro fertilization practice.

PubMed

Masler, Steve; Strickland, Robert R

2013-05-01

An in vitro fertilization (IVF) practice is an enterprise. Like any enterprise, it has management that plays a major role, forming the structure, framework, and components that make the practice viable. Management of an IVF practice consists of two key teams: the fertility team and the management team. Management activities of the teams fall into eight core areas: business operations, financial, human resources, information technology, organizational governance, risk management, patient care systems, and quality management. Shady Grove Fertility Centers and Huntington Reproductive Center are two examples of professionally managed large fertility practices, one managed mostly centrally and the other largely managed in a decentralized way. Management is what takes a physician's IVF practice and converts it to a professional enterprise. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Integrating GIS Technology With Forest Management And Habitat Assessment Efforts On Our National Forests

Treesearch

Joan M. Nichols; S. Arif Husain; Christos Papadas

2000-01-01

Research was conducted on a section of the Superior National Forest to develop and examine potential methods or approaches that may be used to integrate non-timber resources in multiple-use planning. An indicator species for old-growth conifer forests, pine marten (Martes americana), was chosen to examine potential conflicts between specific forest management practices...

Evidence-based safety (EBS) management: A new approach to teaching the practice of safety management (SM).

PubMed

Wang, Bing; Wu, Chao; Shi, Bo; Huang, Lang

2017-12-01

In safety management (SM), it is important to make an effective safety decision based on the reliable and sufficient safety-related information. However, many SM failures in organizations occur for a lack of the necessary safety-related information for safety decision-making. Since facts are the important basis and foundation for decision-making, more efforts to seek the best evidence relevant to a particular SM problem would lead to a more effective SM solution. Therefore, the new paradigm for decision-making named "evidence-based practice (EBP)" can hold important implications for SM, because it uses the current best evidence for effective decision-making. Based on a systematic review of existing SM approaches and an analysis of reasons why we need new SM approaches, we created a new SM approach called evidence-based safety (EBS) management by introducing evidence-based practice into SM. It was necessary to create new SM approaches. A new SM approach called EBS was put forward, and the basic questions of EBS such as its definition and core were analyzed in detail. Moreover, the determinants of EBS included manager's attitudes towards EBS; evidence-based consciousness in SM; evidence sources; technical support; EBS human resources; organizational culture; and individual attributes. EBS is a new and effective approach to teaching the practice of SM. Of course, further research on EBS should be carried out to make EBS a reality. Practical applications: Our work can provide a new and effective idea and method to teach the practice of SM. Specifically, EBS proposed in our study can help safety professionals make an effective safety decision based on a firm foundation of high-grade evidence. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

77 FR 50985 - National Advisory Committee for Implementation of the National Forest System Land Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-23

... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The National Advisory Committee for Implementation of the National Forest System Land... implementation of the National Forest System Land Management Rule. The meeting is open to the public. The purpose...

Current Ketamine Practice: Results of the 2016 American Society of Pain Management Nursing Survey on Ketamine.

PubMed

Klaess, Cynthia C; Jungquist, Carla R

2018-06-01

Ketamine is increasingly utilized for a variety of pain management challenges. Audience comments from a ketamine presentation at the 2015 American Society of Pain Management Nursing (ASPMN) Conference reflected wide variation in ketamine practices as well as barriers to use. The goal was to gain a greater understanding of ASPMN member practice patterns and barriers related to ketamine as adjunctive therapy for pain management. A questionnaire survey design was used. Respondents represented 35 states and 2 countries. The participants were 146 respondents from ASPMN membership (1,485 members). The survey was distributed by ASPMN on SurveyMonkey. Practice setting and ketamine administration practices were assessed with areas for comments. Results were reviewed using frequencies to describe responses and formatted into tables. Comments were individually reviewed and grouped into common themes. Administration of ketamine as an analgesic was reported by 63% of respondents. Continuous intravenous ketamine infusions were the most common route of administration (65%); however, wide variability in dosing and length of therapy was reported. A wide variety of practices and challenges related to ketamine utilization were noted. Numerous studies have indicated the analgesic benefits of ketamine in pain management. The lack of practice standardization has created challenges to its consistent use and outcome measurement. Additionally, the off-label use of ketamine for pain management creates its own unique challenges. However, given the current national climate with intense focus on pain management, interdisciplinary practitioners have an ideal opportunity to evaluate ketamine's use in a comprehensive approach to pain management. Copyright © 2018 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

A Review of Cash Management Policies, Procedures and Practices of Mississippi's Institutions of Higher Learning.

ERIC Educational Resources Information Center

Mississippi State Legislature, Jackson. Performance Evaluation and Expenditure Review Committee.

This report to the Mississippi Legislature presents the findings of a review of the cash management policies, procedures, and practices of the State Board of Trustees of Institutions of Higher Learning (IHL). The methodology involved review of: applicable Mississippi statutes; standards promulgated by the National Association of College and…

Civil Forensic Psychiatry - part 3: practical aspects of managing a medico-legal practice.

PubMed

Samuels, Anthony H

2018-06-01

This is the third in a series of papers on Civil Forensic Psychiatry and provides practical advice for forensic psychiatrists, general psychiatrists and trainees who are expanding or contemplating a medico-legal aspect to their practice. Attention to the practice setting, office layout, recording of information, management of documentation, screening of briefs and proper timetabling can improve safety, quality, reliability and workload manageability.

Journey to the Patient-Centered Medical Home: A Qualitative Analysis of the Experiences of Practices in the National Demonstration Project

PubMed Central

Nutting, Paul A.; Crabtree, Benjamin F.; Miller, William L.; Stewart, Elizabeth E.; Stange, Kurt C.; Jaén, Carlos Roberto

2010-01-01

PURPOSE We describe the experience of practices in transitioning toward patient-centered medical homes (PCMHs) in the National Demonstration Project (NDP). METHODS The NDP was launched in June 2006 as the first national test of a model of the PCMH in a diverse sample of 36 family practices, randomized to facilitated and self-directed intervention groups. An independent evaluation team used a multimethod evaluation strategy, analyzing data from direct observation, depth interviews, e-mail streams, medical records, and patient and practice surveys. The evaluation team reviewed data from all practices as they became available and produced interim summaries. Four 2- to 3-day evaluation team retreats were held during which case summaries of all practices were discussed and patterns were described. RESULTS The 6 themes that emerged from the data reflect major shifts in individual and practice roles and identities, as well as changes in practices’ management strategies. The themes are (1) practice adaptive reserve is critical to managing change, (2) developmental pathways to success vary considerably by practice, (3) motivation of key practice members is critical, (4) the larger system can help or hinder, (5) practice transformation is more than a series of changes and requires shifts in roles and mental models, and (6) practice change is enabled by the multiple roles that facilitators play. CONCLUSIONS Transformation to a PCMH requires more than a sequence of discrete changes. The practice transformation process may be fostered by promoting adaptive reserve and local control of the developmental pathway. PMID:20530394

Chronic Disease Management in Family Practice: Clinical Note.

DTIC Science & Technology

1998-03-01

disease management in the family practice selling. This paper discusses chronic disease management in the family practice selling....Chronic disease management is the process of evaluating and treating a medical condition or disease state which can not be readily cured so as to...minimize it’s negative impact on the individual. Examples of chronic disease management include the treatment of hypertension, diabetes, osteoporosis

Overview of practice management in child and adolescent psychiatry.

PubMed

Schreter, Robert K

2010-01-01

The manager of a psychiatric practice must create and direct a clinical delivery system, design and oversee the administrative services necessary to support the system, and guide the business operations that contribute to its success. Regardless of the size of the practice, the psychiatrist administrator must handle seven core administrative responsibilities and oversee individual functions and capabilities within each domain. These responsibilities include practice development, clinical services management, medical office operations, clinical management, information management, business management, and risk management. This article provides a roadmap for creating and sustaining successful clinical and administrative endeavors. It can also be used by existing practices as an audit instrument to provide a snapshot of current capabilities so that strengths as well as opportunities for continued growth can be identified.

Photo series for quantifying forest residues in managed lands of the Medicine Bow National Forest

Treesearch

John B. Popp; John E. Lundquist

2006-01-01

This photo series presents a visual representation of a range of fuel loading conditions specifically found on the Medicine Bow National Forest. The photos are grouped by forest type and past management practices. This field guide describes the distribution of different types of woody fuels and includes some vegetation data.

Hospital administrative characteristics and volunteer resource management practices.

PubMed

Intindola, Melissa; Rogers, Sean; Flinchbaugh, Carol; Della Pietra, Doug

2016-05-16

Purpose - The purpose of this paper is to explore the links between various characteristics of hospital administration and the utilization of classes of volunteer resource management (VRM) practices. Design/methodology/approach - This paper uses original data collected via surveys of volunteer directors in 122 hospitals in five Northeastern and Southern US states. Findings - Structural equation modeling results suggest that number of paid volunteer management staff, scope of responsibility of the primary volunteer administrator, and hospital size are positively associated with increased usage of certain VRM practices. Research limitations/implications - First, the authors begin the exploration of VRM antecedents, and encourage others to continue this line of inquiry; and second, the authors assess dimensionality of practices, allowing future researchers to consider whether specific dimensions have a differential impact on key individual and organizational outcomes. Practical implications - Based on the findings of a relationship between administrative characteristics and the on-the-ground execution of VRM practice, a baseline audit comparing current practices to those VRM practices presented here might be useful in determining what next steps may be taken to focus investments in VRM that can ultimately drive practice utilization. Originality/value - The exploration of the dimensionality of volunteer management adds a novel perspective to both the academic study, and practice, of volunteer management. To the authors' knowledge, this is the first empirical categorization of VRM practices.

Survey of Records Management Practices in Wisconsin.

ERIC Educational Resources Information Center

Blue, Richard I.; Schramm, Robert M.

A 1990 survey of 68 records management operations in Wisconsin indicates current practices regarding records retention schedules, retention audits, use of computers, record destruction practices, and the effects of federal legislation on records management operations. The 1990 survey results are compared to similar surveys in the 1970s and 1980s.…

Incident Management: Process into Practice

ERIC Educational Resources Information Center

Isaac, Gayle; Moore, Brian

2011-01-01

Tornados, shootings, fires--these are emergencies that require fast action by school district personnel, but they are not the only incidents that require risk management. The authors have introduced the National Incident Management System (NIMS) and the Incident Command System (ICS) and assured that these systems can help educators plan for and…

Financial Management: Cash Management Practices in Florida Community Colleges.

ERIC Educational Resources Information Center

Spiwak, Rand S.

A study was conducted to identify those variables appearing to affect cash management practices in Florida community colleges, and recommend prescriptive measures concerning these practices. The study methodology included informal discussions with the chief fiscal officers of each Florida community college and appropriate state board staff,…

Best Management Practices for sediment control in a Mediterranean agricultural watershed

NASA Astrophysics Data System (ADS)

Abdelwahab, Ossama M. M.; Bingner, Ronald L.; Milillo, Fabio; Gentile, Francesco

2015-04-01

Soil erosion can lead to severe destruction of agricultural sustainability that affects not only productivity, but the entire ecosystem in the neighboring areas. Sediments transported together with the associated nutrients and chemicals can significantly impact downstream water bodies. Various conservation and management practices implemented individually or integrated together as a system can be used to reduce the negative impacts on agricultural watersheds from soil erosion. Hydrological models are useful tools for decision makers when selecting the most effective combination of management practices to reduce pollutant loads within a watershed system. The Annualized Agricultural Non-point Source (AnnAGNPS) pollutant loading management model can be used to analyze the effectiveness of diverse management and conservation practices that can control or reduce the impact of soil erosion processes and subsequent sediment loads in agricultural watersheds. A 506 km2 Mediterranean medium-size watershed (Carapelle) located in Apulia, Southern Italy was used as a case study to evaluate the model and best management practices (BMPs) for sediment load control. A monitoring station located at the Ordona bridge has been instrumented to continuously monitor stream flow and suspended sediment loads. The station has been equipped with an ultrasound stage meter and a stage recorder to monitor stream flow. An infrared optic probe was used to measure suspended sediment concentrations (Gentile et al., 2010 ). The model was calibrated and validated in the Carapelle watershed on an event basis (Bisantino et al., 2013), and the validated model was used to evaluate the effectiveness of BMPs on sediment reduction. Various management practices were investigated including evaluating the impact on sediment load of: (1) converting all cropland areas into forest and grass covered conditions; (2) converting the highest eroding cropland areas to forest or grass covered conditions; and (3

Comparing Practice Management Courses in Canadian Dental Schools.

PubMed

Schonwetter, Dieter J; Schwartz, Barry

2018-05-01

Practice management has become an increasingly important aspect of dental education over the years in order to better prepare students for the reality of practice. The aim of this study was to quantify and describe practice management courses taught at the ten Canadian dental schools in order to identify common approaches, compare hours, determine types of instructors, and assess the relationship between courses' learning objectives and the Association of Canadian Faculties of Dentistry (ACFD) competencies and Bloom's cognitive levels. The academic deans at these ten schools were surveyed in 2016; all ten schools responded for a 100% response rate. The authors also gathered syllabi and descriptions of the courses and analyzed them for themes. The results showed a total of 22 practice management courses in the ten Canadian dental schools. The courses provided 27 to 109 hours of teaching and were mostly taught in the third and fourth years and by dentists on three main topics: ethics, human resource management, and running a private practice. The courses were correlated to the ACFD competencies related to ethics, professionalism, application of basic principles of business practices, and effective interpersonal communication. Most of the courses' learning objectives addressed comprehension and knowledge in Bloom's cognitive levels of learning. These results can help to guide discussions on how practice management courses can be developed, improved, and refined to meet the challenges of preparing students for dental practice.

Aquatic Trash Prevention National Great Practices Compendium

EPA Pesticide Factsheets

The National Great Practice Compendium highlights outstanding activities, technologies, and programs that prevent trash from entering the aquatic environment and/or that reduce the overall volume of trash that is generated.

Best Practices for Managing Organizational Diversity

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kreitz, Patricia A.; /SLAC

2007-05-18

? What role should human resource specialists play in creating and managing diverse organizations? What are the best practices they should apply? The purpose of this review is to define workplace diversity, to identify best practices, and to identify how diversity management best practices can be applied in academic libraries. Finally, this review will provide a resource list for HR managers and leaders to learn more about those best practices with the goal of optimizing their organization's approach to diversity.« less

[After seven years of National Disease Management Guidelines: quo vadis?].

PubMed

Weinbrenner, Susanne; Conrad, Susann; Weikert, Beate; Kopp, Ina

2010-01-01

After seven years the National Disease Management Guidelines Programme (German DM-CPG Programme) that was established under the auspices of the German Medical Association, the National Association of Statutory Health Insurance Physicians and the Association of the Scientific Medical Societies in Germany has been widely accepted by both health care professionals and patients. DM-CPGs are available as tools for knowledge and quality management for widespread chronic diseases showing need for improvement in treatment pathways and coordination between health care providers. The main objective of the German DM-CPG Programme is to establish consensus among the medical professions on evidence-based key recommendations covering all sectors of health care provision and facilitating the coordination of care for the individual patient over time and across interfaces. German DM-CPGs provide a conceptual basis for disease management and integrative care aiming at the implementation of best practice recommendations for prevention, acute care, rehabilitation, chronic care and management aspects for high priority health care topics. Thus, representatives of all disciplines, professions and patients concerned with the topic of an individual German DM-CPG are involved in the development process. The methodology of guideline development is in accordance with international standards. However, the improvement of strategies for effective implementation and continuous update remain challenging. Future work will also focus on content-related aspects such as co-morbidity, gender and migration background. Copyright © 2010. Published by Elsevier GmbH.

Management of asthma in Australian general practice: care is still not in line with clinical practice guidelines.

PubMed

Barton, Christopher; Proudfoot, Judith; Amoroso, Cheryl; Ramsay, Emmae; Holton, Christine; Bubner, Tanya; Harris, Mark; Beilby, Justin

2009-06-01

We investigated the quality of primary care asthma management in a sample of Australian general practices. 247 general practitioners (GPs) from 97 practices completed a structured interview about management of asthma, diabetes and hypertension/heart disease. A further structured interview with the senior practice principal and practice manager was used to collect information about practice capacity for chronic disease management. Just under half of GPs (47%) had access to an asthma register and the majority (76%) had access to spirometry in their practice. In terms of routine management of asthma, 12% of GPs reported using spirometry routinely, 13% routinely reviewed written asthma action plans, 27% routinely provided education about trigger factors, 30% routinely reviewed inhaler technique, 24% routinely assessed asthma severity, and 29% routinely assessed physical activity. Practice characteristics such as practice size (p=1.0) and locality (rural/metropolitan) (p=0.7) did not predict quality of asthma management nor did indicators of practice capacity including Business maturity, IT/IM maturity, Multidisciplinary teamwork, and Clinical linkages. Gaps remain in the provision of evidence-based care for patients with asthma in general practice. Markers of practice capacity measured here were not associated with guideline-based respiratory care within practices.

Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan : ASC software quality engineering practices Version 3.0.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Turgeon, Jennifer L.; Minana, Molly A.; Hackney, Patricia

2009-01-01

The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in the US Department of Energy/National Nuclear Security Agency (DOE/NNSA) Quality Criteria, Revision 10 (QC-1) as 'conformance to customer requirements and expectations'. This quality plan defines the SNL ASC Program software quality engineering (SQE) practices and provides a mapping of these practices to the SNL Corporate Process Requirement (CPR) 001.3.6; 'Corporate Software Engineering Excellence'. This plan also identifies ASC management's and themore » software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals. This SNL ASC Software Quality Plan establishes the signatories commitments to improving software products by applying cost-effective SQE practices. This plan enumerates the SQE practices that comprise the development of SNL ASC's software products and explains the project teams opportunities for tailoring and implementing the practices.« less

Integrating policy, disintegrating practice: water resources management in Botswana

NASA Astrophysics Data System (ADS)

Swatuk, Larry A.; Rahm, Dianne

Botswana is generally regarded as an African ‘success story’. Nearly four decades of unabated economic growth, multi-party democracy, conservative decision-making and low-levels of corruption have made Botswana the darling of the international donor community. One consequence of rapid and sustained economic development is that water resources use and demands have risen dramatically in a primarily arid/semi-arid environment. Policy makers recognize that supply is limited and that deliberate steps must be taken to manage demand. To this end, and in line with other members of the Southern African Development Community (SADC), Botswana devised a National Water Master Plan (NWMP) and undertook a series of institutional and legal reforms throughout the 1990s so as to make water resources use more equitable, efficient and sustainable. In other words, the stated goal is to work toward Integrated Water Resources Management (IWRM) in both policy and practice. However, policy measures have had limited impact on de facto practice. This paper reflects our efforts to understand the disjuncture between policy and practice. The information presented here combines a review of primary and secondary literatures with key informant interviews. It is our view that a number of constraints-cultural, power political, managerial-combine to hinder efforts toward sustainable forms of water resources use. If IWRM is to be realized in the country, these constraints must be overcome. This, however, is no small task.

Report on the APNA National Psychiatric Mental Health Advanced Practice Registered Nurse Survey.

PubMed

Delaney, Kathleen R; Drew, Barbara L; Rushton, Amy

2018-06-01

Further exploration of the practice roles of psychiatric mental health (PMH) advanced practice registered nurses (APRNs) is warranted. In March of 2016, the American Psychiatric Nurses Association (APNA) conducted a national survey to gather data on the demographics, practice roles, and activities of certified PMH APRNs. The e-mail survey contained 46 questions consistent with minimum data set requirements of the Forum of State Nursing Workforce Centers. The data indicate that PMH APRNs are a clinically active workforce; the majority deliver a wide variety of mental health services including diagnosis and management of both acute and chronic mental illness, prescribing, and providing psychotherapy. PMH APRNs are delivering care to clients dealing with a range of serious mental illnesses across the life span in a variety of roles. It will be critical to monitor the activities and outcomes of this expanding behavioral health care workforce.

Managing the culturally diverse medical practice team: twenty-five strategies.

PubMed

Hills, Laura

2014-01-01

A common misconception is that the phrase workplace diversity means meeting certain quotas in employee race or gender categories. In fact, diversity is much more than that. This article explores the unique benefits and challenges of managing a culturally diverse medical practice team and offers practice managers 25 practical strategies. It describes the two types of diversity training that are beneficial to practice managers and the kinds of policies, practices, and procedures that foster and promote diversity. This article also explores ethnocentrism, racism, ageism, sexism, stereotyping, and other potentially divisive issues among a diverse medical practice team. It provides an assessment instrument practice managers can use to evaluate their own diversity management skills. Finally, this article defines specifically what is meant by the term diversity and explores the top 10 diversity issues in workplaces today.

Teaching residents practice-management knowledge and skills: an in vivo experience.

PubMed

Williams, Laurel Lyn

2009-01-01

This article explores the relevant data regarding teaching psychiatric residents practice management knowledge and skills. This article also introduces a unique program for teaching practice management to residents. A literature search was conducted through PubMed and Academic Psychiatry. Additionally residents involved in the training program for practice management were given an anonymous survey to complete. There were no randomized, controlled trials in the academic psychiatric field concerning the topic of practice management. The responses to the resident survey (n=10) indicated a modest improvement in residents' perception of receiving adequate training and exposure to practice management knowledge and skills. The available research suggests that many residents and faculty believe that practice management knowledge and skills are still not adequately addressed. The Baylor Clinic practice management program may be one possible solution for integrating the teaching of practice management knowledge and skills. More research on this topic is needed.

Impact of access management practices to pedestrian safety.

DOT National Transportation Integrated Search

2017-03-31

This study focused on the impact of access management practices to the safety of pedestrians. Some : of the access management practices considered to impact pedestrian safety included limiting direct : access to and from major streets, locating signa...

Adaptive management in the U.S. National Wildlife Refuge System: Science-management partnerships for conservation delivery

USGS Publications Warehouse

Moore, C.T.; Lonsdorf, E.V.; Knutson, M.G.; Laskowski, H.P.; Lor, S.K.

2011-01-01

Adaptive management is an approach to recurrent decision making in which uncertainty about the decision is reduced over time through comparison of outcomes predicted by competing models against observed values of those outcomes. The National Wildlife Refuge System (NWRS) of the U.S. Fish and Wildlife Service is a large land management program charged with making natural resource management decisions, which often are made under considerable uncertainty, severe operational constraints, and conditions that limit ability to precisely carry out actions as intended. The NWRS presents outstanding opportunities for the application of adaptive management, but also difficult challenges. We describe two cooperative programs between the Fish and Wildlife Service and the U.S. Geological Survey to implement adaptive management at scales ranging from small, single refuge applications to large, multi-refuge, multi-region projects. Our experience to date suggests three important attributes common to successful implementation: a vigorous multi-partner collaboration, practical and informative decision framework components, and a sustained commitment to the process. Administrators in both agencies should consider these attributes when developing programs to promote the use and acceptance of adaptive management in the NWRS. ?? 2010 .

Interventions to manage dual practice among health workers.

PubMed

Kiwanuka, Suzanne N; Rutebemberwa, Elizeus; Nalwadda, Christine; Okui, Olico; Ssengooba, Freddie; Kinengyere, Alison A; Pariyo, George W

2011-07-06

Dual practice, whereby health workers hold two or more jobs, is a common phenomenon globally. In resource constrained low- and middle-income countries dual practice poses an ongoing threat to the efficiency, quality and equity of health services, especially in the public sector. Identifying effective interventions to manage dual practice is important. To assess the effects of regulations implemented to manage dual practice. Databases searched included: The Cochrane Central Register of Controlled Trials (CENTRAL) 2011, Issue 4, part of The Cochrane Library. www.thecochranelibrary.com, including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register (searched 26 May 2011); MEDLINE In-Process & Other Non-Indexed Citations May 24, 2011 (searched 26 May 2011); MEDLINE, Ovid (1948 to May week 2 2011) (searched 26 May 2011); EMBASE, Ovid (1980 to 2011 week 20) (searched 26 May 2011); Science Citation Index and Social Sciences Citation Index, ISI Web of Science (1975 to present) (searched 04 December 2009); LILACS (searched January 2010); and AIM (December 2009) (searched 18 December 2009). Randomized controlled trials, non-randomized controlled trials, controlled before-and-after studies and interrupted-time-series studies. Dual practice was defined as holding more than one job. Studies for inclusion were those focusing on interventions to manage dual practice among health professionals employed in the public health sector. Two review authors independently applied the criteria for inclusion and exclusion of studies when scanning the identified titles and abstracts. The same two review authors independently screened full reports of selected citations. At each stage, results were compared and discrepancies settled through discussion. No studies were found which were eligible for inclusion in this review. There is a need to rigorously evaluate the effects of interventions implemented to manage dual practice among health workers. However

Hospital solid waste management practices in Limpopo Province, South Africa: A case study of two hospitals

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nemathaga, Felicia; Maringa, Sally; Chimuka, Luke

2008-07-01

The shortcomings in the management practices of hospital solid waste in Limpopo Province of South Africa were studied by looking at two hospitals as case studies. Apart from field surveys, the generated hospital waste was weighed to compute the generation rates and was followed through various management practices to the final disposal. The findings revealed a major policy implementation gap between the national government and the hospitals. While modern practices such as landfill and incineration are used, their daily operations were not carried according to minimum standards. Incinerator ash is openly dumped and wastes are burned on landfills instead ofmore » being covered with soil. The incinerators used are also not environmentally friendly as they use old technology. The findings further revealed that there is no proper separation of wastes according to their classification as demanded by the national government. The mean percentage composition of the waste was found in the following decreasing order: general waste (60.74%) > medical waste (30.32%) > sharps (8.94%). The mean generation rates were found to be 0.60 kg per patient per day.« less

Managing Further Education: Learning Enterprise. Educational Management: Research and Practice.

ERIC Educational Resources Information Center

Lumby, Jacky

Based on a national survey of college managers, this book discusses how incorporation of colleges in England has changed working lives of middle and senior managers. Chapter 1 describes the context in which colleges have worked since 1993 and the research rationale and methodology. Chapter 2 analyzes how far senior and middle managers' leadership…

Management of Barrett's high-grade dysplasia: initial results from a population-based national audit.

PubMed

Chadwick, Georgina; Groene, Oliver; Taylor, Angelina; Riley, Stuart; Hardwick, Richard H; Crosby, Tom; Greenaway, Kimberley; Cromwell, David A

2016-04-01

Previous studies reported significant variation in the management of patients with Barrett's esophagus. However, these are based on self-reported clinical practice. The aim of this study was to examine the management of high-grade dysplasia in Barrett's esophagus in England by using patient-level data and to compare practice with guidelines. From April 2012 to March 2013, National Health Service (NHS) trusts in England prospectively collected data on patients newly diagnosed with high-grade dysplasia (HGD) of the esophagus as part of the National Oesophago-Gastric Cancer Audit. Data were collected on patient characteristics, diagnosis and endoscopic findings, treatment planning, and therapy. Between April 2012 and March 2013, NHS trusts reported 465 cases of HGD. Diagnosis was confirmed by a second pathologist in 79.4% of cases (270/340), and 86.0% (374/465) had their treatment planned at a multidisciplinary team meeting. A total of 290 patients (62.4%) were managed endoscopically (frequently with endoscopic resection or radiofrequency ablation), whereas 26 patients (5.6%) had esophagectomy. The proportion of patients managed by surveillance varied by age (P < .001), ranging from 19.5% in patients aged <65 years to 63.8% in patients aged ≥85 years. More patients received active treatment if their cases were discussed at a multidisciplinary meeting (73.5% vs 44.3%; P < .001) or managed at higher-volume trusts (87.8% vs 55.4%; P < .001). There was marked variation in the management of HGD across England, with a third of patients receiving no active treatment. Patients discussed at a specialist multidisciplinary meeting or managed in high-volume trusts were more likely to receive active treatment. Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Contemporary management of pericardial effusion: practical aspects for clinical practice.

PubMed

Imazio, Massimo; Gaido, Luca; Battaglia, Alberto; Gaita, Fiorenzo

2017-03-01

A pericardial effusion (PE) is a relatively common finding in clinical practice. It may be either isolated or associated with pericarditis with or without an underlying disease. The aetiology is varied and may be either infectious (especially tuberculosis as the most common cause in developing countries) or non-infectious (cancer, systemic inflammatory diseases). The management is essentially guided by the hemodynamic effect (presence or absence of cardiac tamponade), the presence of concomitant pericarditis or underlying disease, and its size and duration. The present paper reviews the current knowledge on the aetiology, classification, diagnosis, management, therapy, and prognosis of PE in clinical practice.

"Another Link in the Chain" Update: State Policies and Practices for Case Management and Environmental Investigation for Lead-Poisoned Children.

ERIC Educational Resources Information Center

McLaine, Pat; Gaitens, Joanna

This report details a national survey, conducted in 2000, to document changes since 1998 in policies and practices for case management and environmental investigation for lead poisoned children; the study also investigated the impact of the previous national survey in precipitating change. Participating in the survey were program directors or…

2017 National Standards for Diabetes Self-Management Education and Support.

PubMed

Beck, Joni; Greenwood, Deborah A; Blanton, Lori; Bollinger, Sandra T; Butcher, Marcene K; Condon, Jo Ellen; Cypress, Marjorie; Faulkner, Priscilla; Fischl, Amy Hess; Francis, Theresa; Kolb, Leslie E; Lavin-Tompkins, Jodi M; MacLeod, Janice; Maryniuk, Melinda; Mensing, Carolé; Orzeck, Eric A; Pope, David D; Pulizzi, Jodi L; Reed, Ardis A; Rhinehart, Andrew S; Siminerio, Linda; Wang, Jing

2018-02-01

Purpose The purpose of this study is to review the literature for Diabetes Self-Management Education and Support (DSMES) to ensure the National Standards for DSMES (Standards) align with current evidence-based practices and utilization trends. Methods The 10 Standards were divided among 20 interdisciplinary workgroup members. Members searched the current research for diabetes education and support, behavioral health, clinical, health care environment, technical, reimbursement, and business practice for the strongest evidence that guided the Standards revision. Results Diabetes Self-Management Education and Support facilitates the knowledge, skills, and ability necessary for diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage their condition on an ongoing basis. The evidence indicates that health care providers and people affected by diabetes are embracing technology, and this is having a positive impact of DSMES access, utilization, and outcomes. Conclusion Quality DSMES continues to be a critical element of care for all people with diabetes. The DSMES services must be individualized and guided by the concerns, preferences, and needs of the person affected by diabetes. Even with the abundance of evidence supporting the benefits of DSMES, it continues to be underutilized, but as with other health care services, technology is changing the way DSMES is delivered and utilized with positive outcomes.

2017 National Standards for Diabetes Self-Management Education and Support.

PubMed

Beck, Joni; Greenwood, Deborah A; Blanton, Lori; Bollinger, Sandra T; Butcher, Marcene K; Condon, Jo Ellen; Cypress, Marjorie; Faulkner, Priscilla; Fischl, Amy Hess; Francis, Theresa; Kolb, Leslie E; Lavin-Tompkins, Jodi M; MacLeod, Janice; Maryniuk, Melinda; Mensing, Carolé; Orzeck, Eric A; Pope, David D; Pulizzi, Jodi L; Reed, Ardis A; Rhinehart, Andrew S; Siminerio, Linda; Wang, Jing

2017-10-01

Purpose The purpose of this study is to review the literature for Diabetes Self-Management Education and Support (DSMES) to ensure the National Standards for DSMES (Standards) align with current evidence-based practices and utilization trends. Methods The 10 Standards were divided among 20 interdisciplinary workgroup members. Members searched the current research for diabetes education and support, behavioral health, clinical, health care environment, technical, reimbursement, and business practice for the strongest evidence that guided the Standards revision. Results Diabetes Self-Management Education and Support facilitates the knowledge, skills, and ability necessary for diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage their condition on an ongoing basis. The evidence indicates that health care providers and people affected by diabetes are embracing technology, and this is having a positive impact of DSMES access, utilization, and outcomes. Conclusion Quality DSMES continues to be a critical element of care for all people with diabetes. The DSMES services must be individualized and guided by the concerns, preferences, and needs of the person affected by diabetes. Even with the abundance of evidence supporting the benefits of DSMES, it continues to be underutilized, but as with other health care services, technology is changing the way DSMES is delivered and utilized with positive outcomes.

Management of infection control in dental practice.

PubMed

Smith, A; Creanor, S; Hurrell, D; Bagg, J; McCowan, M

2009-04-01

This was an observational study in which the management policies and procedures associated with infection control and instrument decontamination were examined in 179 dental surgeries by a team of trained surveyors. Information relating to the management of a wide range of infection control procedures, in particular the decontamination of dental instruments, was collected by interview and by examination of practice documentation. This study found that although the majority of surgeries (70%) claimed to have a management policy on infection control, only 50% of these were documented. For infection control policies, 79% of surgeries had access to the British Dental Association Advice Sheet A12. Infection control policies were claimed to be present in 89% of surgeries, of which 62% were documented. Seventy-seven per cent of staff claimed to have received specific infection control training, but for instrument decontamination this was provided mainly by demonstration (97%) or observed practice (88%). Many dental nurses (74%) and dental practitioners (57%) did not recognise the symbol used to designate a single-use device. Audit of infection control or decontamination activities was undertaken in 11% of surgeries. The majority of surgeries have policies and procedures for the management of infection control in dental practice, but in many instances these are not documented. The training of staff in infection control and its documentation is poorly managed and consideration should be given to development of quality management systems for use in dental practice.

New challenges for grizzly bear management in Yellowstone National Park

USGS Publications Warehouse

van Manen, Frank T.; Gunther, Kerry A.

2016-01-01

A key factor contributing to the success of grizzly bear Ursus arctos conservation in the Greater Yellowstone Ecosystem has been the existence of a large protected area, Yellowstone National Park. We provide an overview of recovery efforts, how demographic parameters changed as the population increased, and how the bear management program in Yellowstone National Park has evolved to address new management challenges over time. Finally, using the management experiences in Yellowstone National Park, we present comparisons and perspectives regarding brown bear management in Shiretoko National Park.

Integration of a nationally procured electronic health record system into user work practices.

PubMed

Cresswell, Kathrin M; Worth, Allison; Sheikh, Aziz

2012-03-08

Evidence suggests that many small- and medium-scale Electronic Health Record (EHR) implementations encounter problems, these often stemming from users' difficulties in accommodating the new technology into their work practices. There is the possibility that these challenges may be exacerbated in the context of the larger-scale, more standardised, implementation strategies now being pursued as part of major national modernisation initiatives. We sought to understand how England's centrally procured and delivered EHR software was integrated within the work practices of users in selected secondary and specialist care settings. We conducted a qualitative longitudinal case study-based investigation drawing on sociotechnical theory in three purposefully selected sites implementing early functionality of a nationally procured EHR system. The complete dataset comprised semi-structured interview data from a total of 66 different participants, 38.5 hours of non-participant observation of use of the software in context, accompanying researcher field notes, and hospital documents (including project initiation and lessons learnt reports). Transcribed data were analysed thematically using a combination of deductive and inductive approaches, and drawing on NVivo8 software to facilitate coding. The nationally led "top-down" implementation and the associated focus on interoperability limited the opportunity to customise software to local needs. Lack of system usability led users to employ a range of workarounds unanticipated by management to compensate for the perceived shortcomings of the system. These had a number of knock-on effects relating to the nature of collaborative work, patterns of communication, the timeliness and availability of records (including paper) and the ability for hospital management to monitor organisational performance. This work has highlighted the importance of addressing potentially adverse unintended consequences of workarounds associated with the

Best practices in nursing homes. Clinical supervision, management, and human resource practices.

PubMed

Dellefield, Mary Ellen

2008-07-01

Human resource practices including supervision and management are associated with organizational performance. Evidence supportive of such an association in nursing homes is found in the results of numerous research studies conducted during the past 17 years. In this article, best practices related to this topic have been culled from descriptive, explanatory, and intervention studies in a range of interdisciplinary research journals published between 1990 and 2007. Identified best practices include implementation of training programs on supervision and management for licensed nurses, certified nursing assistant job enrichment programs, implementation of consistent nursing assignments, and the use of electronic documentation. Organizational barriers and facilitators of these best practices are described. Copyright 2009, SLACK Incorporated.

Managing Transnational Education: Does National Culture Really Matter?

ERIC Educational Resources Information Center

Eldridge, Kaye; Cranston, Neil

2009-01-01

This article reports on an exploratory study that examined the effect of national culture upon the management of Australia's provision of transnational higher education in Thailand. In particular, using Hofstede's national cultural value dimensions as an analytical tool, interviews with managers responsible for Australia's provision of…

Several problems in regard to national land management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dong Wenlang

1983-09-21

This article examines several problems with regard to land management in China. National land management is defined as development of the territorial land (including the earth's surface and underground), territorial waters and territorial air space under the jurisdiction of a sovereign country. The Chinese State Council established the Bureau of National Land Management in 1981. Areas of concern include natural resources, or land resources (including continental land, rivers and lakes, territorial waters and what is beneath the waters and the airspace above the waters, also the continental shelves), mineral resources and biological resources; social resources, which include human resources, intellectualmore » resources, social and cultural traditions, and the material and technical foundations of a society. Untapped resources of land, waters, forests, grasslands and minerals are to be developed through reclamation, mining, and engineering projects. Geography and national land economics are the theoretical and applied sciences directly related to national land management.« less

Understanding Supply Chain Management Practices for Small and Medium-Sized Enterprises

NASA Astrophysics Data System (ADS)

Thoo, AC; Sulaiman, Z.; Choi, SL; Kohar, UHA

2017-06-01

Small and medium enterprises (SMEs) are a major source of dynamism, innovation and flexibility for emerging and developing countries, as well as for the economies of the most industrialised nations. However, the survival and growth of SMEs can be difficult in the current competitive business environment and global marketplace. It can be a real challenge to deliver the right product and service at the most opportune time and at the lowest possible cost to the right customer. The challenge stresses the importance of managing cross-boundary relationships between business partners. For gaining a competitive advantage, supply chain management (SCM) is an effective tool to SMEs. Therefore, this paper aims to review the tenet of SCM, its benefits and practices to SMEs.

NATIONAL SURVEY ON ENVIRONMENTAL MANAGEMENT OF ASTHMA

EPA Science Inventory

The National Survey on Environmental Management of Asthma is a nation-wide survey on awareness of and existing attitudes toward asthma and its environmental triggers. The survey will generate data which can be used as a benchmark to measure national awareness and action related ...

7 CFR 205.271 - Facility pest management practice standard.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Facility pest management practice standard. 205.271... MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED... Requirements § 205.271 Facility pest management practice standard. (a) The producer or handler of an organic...

Regional cancer centre demonstrates voluntary conformity with the national Radiation Oncology Practice Standards

PubMed Central

Manley, Stephen; Last, Andrew; Fu, Kenneth; Greenham, Stuart; Kovendy, Andrew; Shakespeare, Thomas P

2015-01-01

Radiation Oncology Practice Standards have been developed over the last 10 years and were published for use in Australia in 2011. Although the majority of the radiation oncology community supports the implementation of the standards, there has been no mechanism for uniform assessment or governance. North Coast Cancer Institute's public radiation oncology service is provided across three main service centres on the north coast of NSW. With a strong focus on quality management, we embraced the opportunity to demonstrate conformity with the Radiation Oncology Practice Standards. The Local Health District's Clinical Governance units were engaged to perform assessments of our conformity with the standards and this was signed off as complete on 16 December 2013. The process of demonstrating conformity with the Radiation Oncology Practice Standards has enhanced the culture of quality in our centres. We have demonstrated that self-assessment utilising trained auditors is a viable method for centres to demonstrate conformity. National implementation of the Radiation Oncology Practice Standards will benefit individual centres and the broader radiation oncology community to improve the service delivered to our patients. PMID:26229680

Regional cancer centre demonstrates voluntary conformity with the national Radiation Oncology Practice Standards.

PubMed

Manley, Stephen; Last, Andrew; Fu, Kenneth; Greenham, Stuart; Kovendy, Andrew; Shakespeare, Thomas P

2015-06-01

Radiation Oncology Practice Standards have been developed over the last 10 years and were published for use in Australia in 2011. Although the majority of the radiation oncology community supports the implementation of the standards, there has been no mechanism for uniform assessment or governance. North Coast Cancer Institute's public radiation oncology service is provided across three main service centres on the north coast of NSW. With a strong focus on quality management, we embraced the opportunity to demonstrate conformity with the Radiation Oncology Practice Standards. The Local Health District's Clinical Governance units were engaged to perform assessments of our conformity with the standards and this was signed off as complete on 16 December 2013. The process of demonstrating conformity with the Radiation Oncology Practice Standards has enhanced the culture of quality in our centres. We have demonstrated that self-assessment utilising trained auditors is a viable method for centres to demonstrate conformity. National implementation of the Radiation Oncology Practice Standards will benefit individual centres and the broader radiation oncology community to improve the service delivered to our patients.

Social media best practices in emergency management.

PubMed

Siskey, Ashley; Islam, Tanveer

2016-01-01

Social media platforms have become popular as means of communications in emergency management. Many people use social media sites such as Facebook and Twitter on a daily basis including during disaster events. Emergency management agencies (EMAs) need to recognize the value of not only having a presence on social media but also actively engaging stakeholders and the public on these sites. However, identifying best practices for the use of social media in emergency management is still in its infancy. The objective of this article is to begin to create or further define best practices for emergency managers to use social media sites particularly Facebook and Twitter in four key areas: 1) implementation, 2) education, 3) collaboration, and 4) communication. A list of recommendations of best practices is formulated for each key area and results from a nationwide survey on the use of social media by county EMAs are discussed in this article.

40 CFR 430.28 - Best management practices (BMPs).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Best management practices (BMPs). 430.28 Section 430.28 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT... Soda Subcategory § 430.28 Best management practices (BMPs). The definitions and requirements set forth...

Volcanic Ash Soils: Sustainable Soil Management Practices, With Examples of Harvest Effects and Root Disease Trends

Treesearch

Mike Curran; Pat Green; Doug Maynard

2007-01-01

Sustainability protocols recognize forest soil disturbance as an important issue at national and international levels. At regional levels continual monitoring and testing of standards, practices, and effects are necessary for successful implementation of sustainable soil management. Volcanic ash-cap soils are affected by soil disturbance and changes to soil properties...

Best Practices for Managing Organizational Diversity

ERIC Educational Resources Information Center

Kreitz, Patricia A.

2008-01-01

Organizations with increasingly diverse workforces and customer populations face challenges in reaping diversity's benefits while managing its potentially disruptive effects. This article defines workplace diversity and identifies best practices supporting planned and positive diversity management. It explores how academic libraries can apply…

A review of legal framework applicable for the management of healthcare waste and current management practices in Ethiopia.

PubMed

Haylamicheal, Israel Deneke; Desalegne, Solomon Akalu

2012-06-01

The management of healthcare waste (HCW) requires special attention due to the risk posed by the presence of hazardous waste. The first step towards this is the issuance of national legislation complemented by policy documents, regulations and technical guidelines. In Ethiopia there is no specific legislation for healthcare waste management (HCWM). However, there are various legislations which may provide a legal framework for the management of HCW. This review assesses the various legislations that are relevant to HCWM. It also looks into the institutional arrangements put in place and waste management practices that prevail in the country. It was found that, although the existing legislations have provisions that may provide a legal framework for the management of HCW in Ethiopia, they are not comprehensive and lack specificity in terms of defining hazardous HCW and its categories; in indicating legal obligations of healthcare facilities (HCFs) in handling, transporting, treating and disposing HCW, and record keeping and reporting. There is overlapping of mandates and lackof co-ordination among various government institutions that are responsible for HCWM. The HCWM practices also do not conform to the principles of waste management in general and HCWM in particular. Thus, to better manage HCW in Ethiopia, a specific and comprehensive legislation and policy document on HCWM with clear designation of responsibilities to various stakeholders should be issued immediately. Moreover, training and awareness raising activities on proper HCWM should be undertaken targeting medical staffs, HCF administrators, waste handlers, policy and decision makers and the general public.

My career - from a youth training scheme to practice manager.

PubMed

Rickard, Renay

2017-04-01

Renay Rickard is practice manager of Kernow Veterinary Group in Cornwall. Her entry to the veterinary profession was as a veterinary nurse, but her role evolved into a management one as the practice grew into a group. She is president of the Veterinary Practice Management Association. British Veterinary Association.

Public lands - from concept to practice

Treesearch

John J. Vrablec

1977-01-01

Intensive timber management can and is practiced on National Forest lands in the Northeast. There are, however many constraints and limitations which are placed upon the public lands manager. The key issue here is that the National Forests are PUBLIC lands which must be managed for the public.

Total quality management in orthodontic practice.

PubMed

Atta, A E

1999-12-01

Quality is the buzz word for the new Millennium. Patients demand it, and we must serve it. Yet one must identify it. Quality is not imaging or public relations; it is a business process. This short article presents quality as a balance of three critical notions: core clinical competence, perceived values that our patients seek and want, and the cost of quality. Customer satisfaction is a variable that must be identified for each practice. In my practice, patients perceive quality as communication and time, be it treatment or waiting time. Time is a value and cost that must be managed effectively. Total quality management is a business function; it involves diagnosis, design, implementation, and measurement of the process, the people, and the service. Kazien is a function that reduces value services, eliminates waste, and manages time and cost in the process. Total quality management is a total commitment for continuous improvement.

Impact of managed MediCal on California family practice programs.

PubMed

Zweifler, J A

2001-05-01

An important source of patients for California's family practice program is MediCal. During the past 5 years, MediCal has established a variety of capitated managed care plans. To assess the impact of California's managed MediCal program on the state's 38 family practice training programs. A cross-sectional, retrospective descriptive survey. A 3-page, 11-question survey was developed by family practice residency directors and staff from the California Academy of Family Physicians, San Francisco. The 38 family practice programs in existence in California in September 1997 were stratified by type of managed MediCal in their county and by type of sponsoring institution--university, county, community based, staff-model health maintenance organization, or managed care system. Of the 38 family practice programs, 27 responded; 19 of 27 programs participated in managed MediCal. The total number of family health center patients, and the percentage of MediCal patients (48%-60%) at family practice programs was similar when stratified by programs with and without managed MediCal and by type of sponsorship. Most programs reported that they were able to compete effectively, although most also reported increased administrative, nursing, and front office costs. Managed MediCal patients were directly assigned to residents in only 3 of 19 programs. The introduction of managed MediCal has not adversely affected the number of patients cared for in California's family practice programs. Continued vigilance regarding California family practice programs' involvement in managed MediCal, including collection of accurate data on the number of MediCal patients and the financial and educational implications for California's family practice programs, is warranted.

Relationships between Electronic Information Media and Records Management Practices: Results of a Survey of United Nations Organizations. A Rand Note.

ERIC Educational Resources Information Center

Bikson, T. K.; Schieber, L.

A Technical Panel on Electronic Records Management (TP/REM), which was established by the Advisory Committee for the Co-ordination of Information Systems (ACCIS), conducted a survey of existing electronic records management practices and standards related to new information and communication technologies and their interrelationships within the…

40 CFR 430.58 - Best management practices (BMPs).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Best management practices (BMPs). 430.58 Section 430.58 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT... § 430.58 Best management practices (BMPs). The definitions and requirements set forth in 40 CFR 430.03...

Business and Practice Management Knowledge Deficiencies in Graduating Orthopedic Residents.

PubMed

Miller, D Joshua; Throckmorton, Thomas W; Azar, Frederick M; Beaty, James H; Canale, S Terry; Richardson, David R

2015-10-01

We conducted a study to determine the general level of knowledge that orthopedic residents have on business and practice management topics at graduation and to evaluate the level of knowledge that practicing orthopedic surgeons need in order to function effectively in a medical practice. Residency graduates from a single training program were asked to complete a survey that gathered demographic information and had surgeons rate their understanding of 9 general business and practice management skills and the importance of these skills in their current practice situation. The amount of necessary business knowledge they lacked at graduation was defined as a functional knowledge deficiency (FKD) and was calculated as the difference between the reported importance of a topic in current practice and the level of understanding of that topic at graduation (larger FKD indicates greater deficiency). Those in physician-managed practices reported significantly higher levels of understanding of economic analytical tools than those in nonphysician-managed practices. There were no other statistically significant differences among groups. Hospital-employed physicians had the lowest overall FKD (4.0), followed by those in academic practices (5.1) and private practices (5.9). Graduating orthopedic surgeons appear to be inadequately prepared to effectively manage business issues in their practices, as evidenced by the low overall knowledge levels and high FKDs.

Critical leadership and management skills for pathology practice.

PubMed

Brimhall, Bradley B; Wright, Louis D; McGregor, Kelli L; Hernandez, James S

2007-10-01

Managed care has changed the nature of medical practice. The practice of pathology has also changed and is likely to undergo further modification. Additional skills in leadership and management are needed to perform optimally in the current medical marketplace. To determine whether pathologists view business and informatics skills as being important and valuable in their practices. A survey was sent electronically (via e-mail) to 2566 pathologists and pathology administrators. Two hundred sixteen survey recipients (8.4%) responded to the survey. The response rate to individual questions ranged from 86% to 99% (186 to 214 of 216 total respondents). Most who took the survey ranked communication (203/209; 97%), leadership skills (165/209; 79%), and systems thinking skills (155/209; 74%) as either "very important" or "essential." Fewer respondents were willing to offer salary premiums for marketing (108/196; 55%), business or finance (92/196; 47%), or staff leadership (95/196; 48%) skills unless the candidate had a track record of measurable achievement using these skills. Those practicing in academia as well as those making hiring decisions by themselves were more likely to value leadership and management skills. Fewer than 1% of respondents in any category considered current pathology residency training in leadership and management to be adequate. Prospective employers value leadership and management skills. Pathology residency programs must include meaningful training in pathology practice management and informatics to satisfy the demand for these skills in the modern pathology marketplace.

Generating Co-Management at Kasha Katuwe Tent Rocks National Monument, New Mexico

NASA Astrophysics Data System (ADS)

Pinel, Sandra Lee; Pecos, Jacob

2012-03-01

Collaborative planning theory and co-management paradigms promise conflict prevention and the incorporation of indigenous knowledge into plans. Critics argue that without devolved power to culturally legitimate institutions, indigenous perspectives are marginalized. Co-management practice in North America is largely limited to treaty-protected fish and wildlife because federal agencies cannot devolve land management authority. This paper explores why the Pueblo de Cochiti, a federally recognized American Indian Tribe, and the U.S. Bureau of Land Management sustained an rare joint management agreement for the Kasha-Katuwe Tent Rocks National Monument in New Mexico despite a history of conflict over federal control of customary tribal lands that discouraged the Pueblo from working with federal agencies. Based on the participant interviews and documents, the case suggests that clear agreements, management attitudes, and the direct representation of indigenous forms of government helped achieve presumed co-management benefits. However, parties enter these agreements strategically. We should study, not assume, participant goals in collaborative processes and co-management institutions and pay special attention to the opportunities and constraints of federal laws and institutional culture for collaborative resource management with tribal and local communities.

Impact of Stand Management Practices on Beetle Diversity

Treesearch

Stephen P. Cook

2004-01-01

Abstract - Insects are useful indicators of change within ecosystems because of their abundance, richness and functional importance. Stand management practices impact the insect community within a forest. Therefore, the objective of the project is to determine the impact of various stand management practices on the diversity of beetles within...

76 FR 39857 - Alaska Coastal Management Program Withdrawal From the National Coastal Management Program Under...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-07

.... SUMMARY: By operation of Alaska State law, the federally approved Alaska Coastal Management Program... partner in the National Coastal Management Program. The ACMP expired by operation of Alaska Statutes 44.66... DEPARTMENT OF COMMERCE National Oceanic Atmospheric Administration Alaska Coastal Management...

Practical Side of the Bibliographic Information Retrieval System in the National Museum of Ethnology

NASA Astrophysics Data System (ADS)

Kondo, Katsuichi

The information retrieval system of the National Museum of Ethnology made its debut in 1979 and now enables us to search the books not only in the Museum but in the country and abroad by means of JAPAN MARC & LC MARC. The author presents the outline and the development of the information managing system including the above briefly and secondly the practical case of using our retrieval system in particular. The problems to be solved in the course of the future plan are also mentioned.

Advanced practice physiotherapy-led triage in Irish orthopaedic and rheumatology services: national data audit.

PubMed

Fennelly, Orna; Blake, Catherine; FitzGerald, Oliver; Breen, Roisin; Ashton, Jennifer; Brennan, Aisling; Caffrey, Aoife; Desmeules, François; Cunningham, Caitriona

2018-06-01

Many people with musculoskeletal (MSK) disorders wait several months or years for Consultant Doctor appointments, despite often not requiring medical or surgical interventions. To allow earlier patient access to orthopaedic and rheumatology services in Ireland, Advanced Practice Physiotherapists (APPs) were introduced at 16 major acute hospitals. This study performed the first national evaluation of APP triage services. Throughout 2014, APPs (n = 22) entered clinical data on a national database. Analysis of these data using descriptive statistics determined patient wait times, Consultant Doctor involvement in clinical decisions, and patient clinical outcomes. Chi square tests were used to compare patient clinical outcomes across orthopaedic and rheumatology clinics. A pilot study at one site identified re-referral rates to orthopaedic/rheumatology services of patients managed by the APPs. In one year, 13,981 new patients accessed specialist orthopaedic and rheumatology consultations via the APP. Median wait time for an appointment was 5.6 months. Patients most commonly presented with knee (23%), lower back (22%) and shoulder (15%) disorders. APPs made autonomous clinical decisions regarding patient management at 77% of appointments, and managed patient care pathways without onward referral to Consultant Doctors in more than 80% of cases. Other onward clinical pathways recommended by APPs were: physiotherapy referrals (42%); clinical investigations (29%); injections administered (4%); and surgical listing (2%). Of those managed by the APP, the pilot study identified that only 6.5% of patients were re-referred within one year. This national evaluation of APP services demonstrated that the majority of patients assessed by an APP did not require onward referral for a Consultant Doctor appointment. Therefore, patients gained earlier access to orthopaedic and rheumatology consultations in secondary care, with most patients conservatively managed.

Harm reduction and women in the Canadian national prison system: policy or practice?

PubMed

Rehman, Laurene; Gahagan, Jacqueline; DiCenso, Anne Marie; Dias, Giselle

2004-01-01

Applying the principles of harm reduction within the context of incarcerated populations raises a number of challenges. Although some access to harm reduction strategies has been promoted in general society, a divide between what is available and what is advocated continues to exist within the prison system. This paper explores the perceptions and lived experiences of a sample of nationally incarcerated women in Canada regarding their perceptions and experiences in accessing HIV and Hepatitis C prevention, care, treatment and support. In-depth interviews were conducted with 156 women in Canadian national prisons. Q.S.R. Nudist was used to assist with data management. A constant comparison method was used to derive categories, patterns, and themes. Emergent themes highlighted a gap between access to harm reduction in policy and in practice. Despite the implementation of some harm reduction techniques, women in Canadian prisons reported variable access to both education and methods of reducing HIV/HCV transmission. Concerns were also raised about pre-and post-test counseling for HIV/HCV testing. Best practices are suggested for implementing harm reduction strategies within prisons for women in Canada.

A preliminary report of an educational intervention in practice management

PubMed Central

Crites, Gerald E; Schuster, Richard J

2004-01-01

Background Practice management education continues to evolve, and little information exists regarding its curriculum design and effectiveness for resident education. We report the results of an exploratory study of a practice management curriculum for primary care residents. Methods After performing a needs assessment with a group of primary care residents at Wright State University, we designed a monthly seminar series covering twelve practice management topics. The curriculum consisted of interactive lectures and practice-based application, whenever possible. We descriptively evaluated two cognitive components (practice management knowledge and skills) and the residents' evaluation of the curriculum. Results The mean correct on the knowledge test for this group of residents was 74% (n = 12) and 91% (n = 12) before and after the curriculum, respectively. The mean scores for the practice management skill assessments were 2.62 before (n = 12), and 3.65 after (n = 12) the curriculum (modified Likert, 1 = strongly disagree, 5 = strongly agree). The residents rated the curriculum consistently high. Conclusions This exploratory study suggests that this curriculum may be useful in developing knowledge and skills in practice management for primary care residents. This study suggests further research into evaluation of this curriculum may be informative for practice-based education. PMID:15380023

Determinants of practice patterns in pediatric UTI management.

PubMed

Selekman, R E; Allen, I E; Copp, H L

2016-10-01

Urinary tract infection (UTI) affects 10% of girls and 3% of boys by age 16. Both the American Academy of Pediatrics and National Institute for Health and Clinical Excellence Guidelines recommend urine testing prior to initiation of antibiotic treatment and the use of local antibiograms to guide empiric antibiotic therapy. Urine culture results not only provide the opportunity to halt empiric therapy if there is no bacterial growth, but also allow for tailoring of broad-spectrum therapy. Additionally, the use of antiobiograms improves empiric antibiotic selection based on local resistance patterns. However, execution of guideline recommendations has proved challenging. Understanding barriers in implementation is critical to developing targeted interventions aimed to improve adherence to these guidelines. The present study sought to investigate practice patterns and factors that influence urine testing and antibiogram use in the setting of empiric antibiotic treatment of UTI in children to ultimately improve adherence to UTI management guidelines. A random, national sample of physicians caring for children was surveyed from the American Medical Association Masterfile. Participants were queried regarding practice type, length of time in practice, factors influencing urine testing, urine specimen collection method, and antibiogram utilization. Logistic regression was used to assess factors associated with use of urine testing, bagged specimens, and antibiograms. Of respondents who acknowledged contact by surveyors, 47% completed the survey (n = 366). Most respondents (84%) obtain urinalysis and culture prior to treatment for UTI. Physicians report they would more likely order testing if the specimen were easier to collect (46%) and if results were available immediately (48%) (Table). Urine collection by bag was more common in circumcised boys (>30%) compared with girls (20%) and uncircumcised boys (20%) (P = 0.02). The most common reasons for collection by bag

Characteristics of medical practices in three developed managed care markets.

PubMed

Landon, Bruce E; Normand, Sharon-Lise T; Frank, Richard; McNeil, Barbara J

2005-06-01

To describe physician practices, ranging from solo and two-physician practices to large medical groups, in three geographically diverse parts of the country with strong managed care presences. Surveys of medical practices in three managed care markets conducted in 2000-2001. We administered questionnaires to all medical practices affiliated with two large health plans in Boston, MA, and Portland, OR, and to all practices providing primary care for cardiovascular disease patients admitted to five large hospitals in Minneapolis, MN. We offer data on how physician practices are structured under managed care in these geographically diverse regions of the country with a focus on the structural characteristics, financial arrangements, and care management strategies adopted by practices. A two-staged survey consisting of an initial telephone survey that was undertaken using CATI (computerized assisted telephone interviewing) techniques followed by written modules triggered by specific responses to the telephone survey. We interviewed 468 practices encompassing 668 distinct sites of care (overall response rate 72 percent). Practices had an average of 13.9 member physicians (range: 1-125). Most (80.1 percent) medium- (four to nine physicians) and large-size (10 or more physicians) groups regularly scheduled meetings to discuss resource utilization and referrals. Almost 90 percent of the practices reported that these meetings occurred at least once per month. The predominant method for paying practices was via fee-for-service payments. Most other payments were in the form of capitation. Overall, 75 percent of physician practices compensated physicians based on productivity, but there was substantial variation related to practice size. Nonetheless, of the practices that did not use straight productivity methods (45 percent of medium-sized practices and 54 percent of large practices), most used arrangements consisting of combinations of salary and productivity formulas. We

Current practice of radioiodine treatment in the management of differentiated thyroid cancer in Germany.

PubMed

Hoelzer, S; Steiner, D; Bauer, R; Reiners, C; Farahati, J; Hundahl, S A; Dudeck, J

2000-10-01

This prospective, observational study of a cohort of thyroid cancer patients in Germany focusses on the "real-world" practice in the management of thyroid cancer patients. This report includes data from 2376 patients with primary differentiated thyroid carcinoma first diagnosed in the year 1996. The study reveals considerable differences in actual practice concerning surgery and radioiodine treatment. The results indicate that consensus is lacking with respect to the multimodality treatment approach for differentiated thyroid carcinoma. Our analysis represents the most current and comprehensive national assessment of presenting patient characteristics, diagnostic tests, treatment and complications for thyroid cancer.

A Practical Decision-Analysis Process for Forest Ecosystem Management

Treesearch

H. Michael Rauscher; F. Thomas Lloyd; David L. Loftis; Mark J. Twery

2000-01-01

Many authors have pointed out the need to firm up the 'fuzzy' ecosystem management paradigm and develop operationally practical processes to allow forest managers to accommodate more effectively the continuing rapid change in societal perspectives and goals. There are three spatial scales where clear, precise, practical ecosystem management processes are...

Building chronic disease management capacity in General Practice: The South Australian GP Plus Practice Nurse Initiative.

PubMed

Fuller, Jeffrey; Koehne, Kristy; Verrall, Claire C; Szabo, Natalie; Bollen, Chris; Parker, Sharon

2015-01-01

This paper draws on the implementation experience of the South Australian GP Plus Practice Nurse Initiative in order to establish what is needed to support the development of the chronic disease management role of practice nurses. The Initiative was delivered between 2007 and 2010 to recruit, train and place 157 nurses across 147 General Practices in Adelaide. The purpose was to improve chronic disease management in General Practice, by equipping nurses to work as practice nurses who would coordinate care and establish chronic disease management systems. Secondary analysis of qualitative data contained in the Initiative evaluation report, specifically drawing on quarterly project records and four focus groups conducted with practice nurses, practice nurse coordinators and practice nurse mentors. As evidenced by the need to increase the amount of support provided during the implementation of the Initiative, nurses new to General Practice faced challenges in their new role. Nurses described a big learning curve as they dealt with role transition to a new work environment and learning a range of new skills while developing chronic disease management systems. Informants valued the skills development and support offered by the Initiative, however the ongoing difficulties in implementing the role suggested that change is also needed at the level of the Practice. While just over a half of the placement positions were retained, practice nurses expressed concern with having to negotiate the conditions of their employment. In order to advance the role of practice nurses as managers of chronic disease support is needed at two levels. At one level support is needed to assist practice nurses to build their own skills. At the level of the Practice, and in the wider health workforce system, support is also needed to ensure that Practices are organisationally ready to include the practice nurse within the practice team.

Practice Management: The Game Changer

PubMed Central

Pessis, Paul

2016-01-01

The reimbursement landscape is undergoing significant changes. Practice management, which encompasses reimbursement, is becoming increasingly more important in securing business success. Each practitioner within a facility is responsible for fortifying the practice through thoughtful business protocols. Knowing legislation that impacts health care along with understanding the foundational components of reimbursement is key for keeping a practice financially healthy. Change is good, but making the changes is what counts! Legislation such as the Medicare Access and Chip Reauthorization Act defines the new payment models. Correcting current business practices might seem difficult on the surface, but implementing change is rewarding and an obligation of the practitioners within a facility to their patients. Financial stability for a practice occurs when sound business practices are routine. Today's audiologist must not only be proficient at performing his or her scope of practice, but must also accept that performing best business practices is part of the job. In the end, the patients seeking the services of the audiologist benefit most when a practice has the financial stability to be best in its class. PMID:28028326

The Potential Importance of Conservation, Restoration and Altered Management Practices for Water Quality in the Wabash River Watershed

EPA Science Inventory

The Potential Importance of Conservation, Restoration and Altered Management Practices for Water Quality in the Wabash River Watershed Guoxiang Yang1, Elly P.H. Best2, Staci Goodwin3 1 ORISE Postdoc Research Associate at U.S. Environmental Protection Agency, National Risk...

Knowledge, Attitude and Practice of Healthcare Managers to Medical Waste Management and Occupational Safety Practices: Findings from Southeast Nigeria.

PubMed

Anozie, Okechukwu Bonaventure; Lawani, Lucky Osaheni; Eze, Justus Ndulue; Mamah, Emmanuel Johnbosco; Onoh, Robinson Chukwudi; Ogah, Emeka Onwe; Umezurike, Daniel Akuma; Anozie, Rita Onyinyechi

2017-03-01

Awareness of appropriate waste management procedures and occupational safety measures is fundamental to achieving a safe work environment, and ensuring patient and staff safety. This study was conducted to assess the attitude of healthcare managers to medical waste management and occupational safety practices. This was a cross-sectional study conducted among 54 hospital administrators in Ebonyi state. Semi-structured questionnaires were used for qualitative data collection and analyzed with SPSS statistics for windows (2011), version 20.0 statistical software (Armonk, NY: IBM Corp). Two-fifth (40%) of healthcare managers had received training on medical waste management and occupational safety. Standard operating procedure of waste disposal was practiced by only one hospital (1.9%), while 98.1% (53/54) practiced indiscriminate waste disposal. Injection safety boxes were widely available in all health facilities, nevertheless, the use of incinerators and waste treatment was practiced by 1.9% (1/54) facility. However, 40.7% (22/54) and 59.3% (32/54) of respondents trained their staff and organize safety orientation courses respectively. Staff insurance cover was offered by just one hospital (1.9%), while none of the hospitals had compensation package for occupational hazard victims. Over half (55.6%; 30/54) of the respondents provided both personal protective equipment and post exposure prophylaxis for HIV. There was high level of non-compliance to standard medical waste management procedures, and lack of training on occupational safety measures. Relevant regulating agencies should step up efforts at monitoring and regulation of healthcare activities and ensure staff training on safe handling and disposal of hospital waste.

National and International Guidelines for Patient Blood Management in Obstetrics: A Qualitative Review

PubMed Central

Shaylor, Ruth; Weiniger, Carolyn F.; Austin, Naola; Tzabazis, Alexander; Shander, Aryeh; Goodnough, Lawrence T.; Butwick, Alexander J.

2016-01-01

In developed countries, rates of postpartum hemorrhage (PPH) requiring transfusion have been increasing. As a result, anesthesiologists are being increasingly called upon to assist with the management of patients with severe PPH. First responders, including anesthesiologists, may adopt Patient Blood Management (PBM) recommendations of national societies or other agencies. However, it is unclear whether national and international obstetric societies’ PPH guidelines account for contemporary PBM practices. We performed a qualitative review of PBM recommendations published by the following national obstetric societies and international groups: the American College of Obstetricians and Gynecologists; The Royal College of Obstetricians and Gynecologists, United Kingdom; The Royal Australian and New Zealand College of Obstetricians and Gynecologists; The Society of Obstetricians and Gynecologists of Canada; an interdisciplinary group of experts from Austria, Germany, and Switzerland; an international multidisciplinary consensus group; and the French College of Gynaecologists and Obstetricians. We also reviewed a PPH bundle, published by The National Partnership for Maternal Safety. On the basis of our review, we identified important differences in national and international societies’ recommendations for transfusion and PBM. In the light of PBM advances in the nonobstetric setting, obstetric societies should determine the applicability of these recommendations in the obstetric setting. Partnerships among medical, obstetric, and anesthetic societies may also help standardize transfusion and PBM guidelines in obstetrics. PMID:27557476

Evaluative Thinking in Practice: The National Asthma Control Program

PubMed Central

Fierro, Leslie A.; Codd, Heather; Gill, Sarah; Pham, Phung K.; Grandjean Targos, Piper T.; Wilce, Maureen

2018-01-01

Although evaluative thinking lies at the heart of what we do as evaluators and what we hope to promote in others through our efforts to build evaluation capacity, researchers have given limited attention to measuring this concept. We undertook a research study to better understand how instances of evaluative thinking may present in practice-based settings—specifically within four state asthma control programs funded by the Centers for Disease Control and Prevention’s National Asthma Control Program. Through content analyses of documents as well as interviews and a subsequent focus group with four state asthma control programs’ evaluators and program managers we identified and defined twenty-two indicators of evaluative thinking. Findings provide insights about what practitioners may wish to look for when they intend to build evaluative thinking and the types of data sources that may be more or less helpful in such efforts. PMID:29950803

Evaluative Thinking in Practice: The National Asthma Control Program.

PubMed

Fierro, Leslie A; Codd, Heather; Gill, Sarah; Pham, Phung K; Grandjean Targos, Piper T; Wilce, Maureen

2018-01-01

Although evaluative thinking lies at the heart of what we do as evaluators and what we hope to promote in others through our efforts to build evaluation capacity, researchers have given limited attention to measuring this concept. We undertook a research study to better understand how instances of evaluative thinking may present in practice-based settings-specifically within four state asthma control programs funded by the Centers for Disease Control and Prevention's National Asthma Control Program. Through content analyses of documents as well as interviews and a subsequent focus group with four state asthma control programs' evaluators and program managers we identified and defined twenty-two indicators of evaluative thinking. Findings provide insights about what practitioners may wish to look for when they intend to build evaluative thinking and the types of data sources that may be more or less helpful in such efforts.

Case management: developing practice through action research.

PubMed

Smith, Annetta; Mackay, Seonaid; McCulloch, Kathleen

2013-09-01

This article is a report of an action research study carried out with community nurses to help develop case management within their practice. Using action research principles, nurses reviewed and analysed their current practice and developed recommendations for further embedding case management as a means of supporting patients with complex care needs in their own homes. Findings indicate that a number of factors can influence the community nurse's ability to implement case management. These factors include approaches to case finding, availability of resources and interprofessional working. Important considerations for nurses were the influence of the context of care, the geographical location and the health needs of the local patient population, which meant that case management may need to be adapted to meet local circumstances.

Two-age silviculture on the Monongahela National Forest - managers and scientists assess 17 years of communication

Treesearch

Gary Miller; James E. Johnson; John E. Baumgras; R. Gary Bustamente

1997-01-01

This report describes the development of two-age silviculture on the Monongahela National Forest and provides an assessment of the practice as it is applied today. Silviculturists at each ranger district provided a chronology of the communication process between managers and scientists that led to current stand treatment prescriptions. In addition, data were collected...

Risk management in clinical practice. Part 10. Periodontology.

PubMed

Baker, P; Needleman, I

2010-12-11

A sizeable proportion of patients in clinical practice will have some form of periodontal disease and most of these patients can be well managed in primary care. Unfortunately, dento-legal claims regarding inappropriate periodontal care are increasing rapidly and are now one of the most common reasons for litigation in dentistry. In this paper we will look at aspects of contemporary management of periodontal disease in clinical practice and offer guidance for examination, management and referral.

Chronic disease management for depression in US medical practices: results from the Health Tracking Physician Survey.

PubMed

Zafar, Waleed; Mojtabai, Ramin

2011-07-01

Chronic care model (CCM) envisages a multicomponent systematic remodeling of ambulatory care to improve chronic diseases management. Application of CCM in primary care management of depression has traditionally lagged behind the application of this model in management of other common chronic illnesses. In past research, the use of CCM has been operationalized by measuring the use of evidence-based organized care management processes (CMPs). To compare the use of CMPs in treatment of depression with the use of these processes in treatment of diabetes and asthma and to examine practice-level correlates of this use. Using data from the 2008 Health Tracking Physician Survey, a nationally representative sample of physicians in the United States, we compared the use of 5 different CMPs: written guidelines in English and other languages for self-management, availability of staff to educate patients about self-management, availability of nurse care managers for care coordination, and group meetings of patients with staff. We further examined the association of practice-level characteristics with the use of the 5 CMPs for management of depression. CMPs were more commonly used for management of diabetes and asthma than for depression. The use of CMPs for depression was more common in health maintenance organizations [adjusted odds ratios (AOR) ranging from 2.45 to 5.98 for different CMPs], in practices that provided physicians with feedback regarding quality of care to patients (AOR range, 1.42 to 1.69), and in practices with greater use of clinical information technology (AOR range, 1.06 to 1.11). The application of CMPs in management of depression continues to lag behind other common chronic conditions. Feedbacks on quality of care and expanded use of information technology may improve application of CMPs for depression care in general medical settings.

Evaluation of Integrated Coastal Zone Management Plan Practices in the Turkish Case

NASA Astrophysics Data System (ADS)

Doruk Özügül, M.; Yerliyurt, Bora; Seçilmişler, Töre

2017-10-01

In terms of both international and national contexts, mostly coastal zones are the place of complexity, vulnerability and competition, so that they have to be well-planned and managed. Diversity in users, land uses, investments, sectoral plans and policies make coastal areas highly complex and problematic zones where competition also takes place. Unless these dimensions of pressure aren’t balanced with precautionary actions, coastal zones transform into more vulnerable geographies. Within this context “Integrated Coastal Zone Management (ICZM) Plan” appears as a major tool where “integration” becomes a vital keyword for such diversifying environments. This integration challenge covers sectoral, administrative, spatial, interdisciplinary (in terms of scientific research fields) and internationality dimensions. A set of basic principles could also be obtained from the literature in order to reach a better ICZM Plan practice. These could be summarized as; “a broader perspective”, “a long-term perspective”, “adaptive management and monitoring”, “local specificities, specific solutions and flexible measures”, “carrying capacity of ecosystems”, “a participatory process”, “well coordination of policies and partners” and “coherence between sectoral policy objectives, planning and management”. A similar problematic conceptualization is also viable for Turkey, where approximately 76% of the total border length and 27 of 81 provinces are coastal. Naturally, both ICZM and coastal zone planning are within the emerging planning issues of national agenda. The purpose of this paper is to examine the Turkish practices depending on the above-mentioned principles by comparing various official ICZM plans of selected provinces. As a general conclusion it is seen that ICZM -to be an integrative and multi-dimensional tool- is contextually misunderstood. From this perspective “the determination of the plan borders”, “unsuitability of the

Qualitative insights into practice time management: does 'patient-centred time' in practice management offer a portal to improved access?

PubMed Central

Buetow, S; Adair, V; Coster, G; Hight, M; Gribben, B; Mitchell, E

2002-01-01

BACKGROUND: Different sets of literature suggest how aspects of practice time management can limit access to general practitioner (GP) care. Researchers have not organised this knowledge into a unified framework that can enhance understanding of barriers to, and opportunities for, improved access. AIM: To suggest a framework conceptualising how differences in professional and cultural understanding of practice time management in Auckland, New Zealand, influence access to GP care for children with chronic asthma. DESIGN OF STUDY: A qualitative study involving selective sampling, semi-structured interviews on barriers to access, and a general inductive approach. SETTING: Twenty-nine key informants and ten mothers of children with chronic, moderate to severe asthma and poor access to GP care in Auckland. METHOD: Development of a framework from themes describing barriers associated with, and needs for, practice time management. The themes were independently identified by two authors from transcribed interviews and confirmed through informant checking. Themes from key informant and patient interviews were triangulated with each other and with published literature. RESULTS: The framework distinguishes 'practice-centred time' from 'patient-centred time.' A predominance of 'practice-centred time' and an unmet opportunity for 'patient-centred time' are suggested by the persistence of five barriers to accessing GP care: limited hours of opening; traditional appointment systems; practice intolerance of missed appointments; long waiting times in the practice; and inadequate consultation lengths. None of the barriers is specific to asthmatic children. CONCLUSION: A unified framework was suggested for understanding how the organisation of practice work time can influence access to GP care by groups including asthmatic children. PMID:12528583

Qualitative insights into practice time management: does 'patient-centred time' in practice management offer a portal to improved access?

PubMed

Buetow, S; Adair, V; Coster, G; Hight, M; Gribben, B; Mitchell, E

2002-12-01

Different sets of literature suggest how aspects of practice time management can limit access to general practitioner (GP) care. Researchers have not organised this knowledge into a unified framework that can enhance understanding of barriers to, and opportunities for, improved access. To suggest a framework conceptualising how differences in professional and cultural understanding of practice time management in Auckland, New Zealand, influence access to GP care for children with chronic asthma. A qualitative study involving selective sampling, semi-structured interviews on barriers to access, and a general inductive approach. Twenty-nine key informants and ten mothers of children with chronic, moderate to severe asthma and poor access to GP care in Auckland. Development of a framework from themes describing barriers associated with, and needs for, practice time management. The themes were independently identified by two authors from transcribed interviews and confirmed through informant checking. Themes from key informant and patient interviews were triangulated with each other and with published literature. The framework distinguishes 'practice-centred time' from 'patient-centred time.' A predominance of 'practice-centred time' and an unmet opportunity for 'patient-centred time' are suggested by the persistence of five barriers to accessing GP care: limited hours of opening; traditional appointment systems; practice intolerance of missed appointments; long waiting times in the practice; and inadequate consultation lengths. None of the barriers is specific to asthmatic children. A unified framework was suggested for understanding how the organisation of practice work time can influence access to GP care by groups including asthmatic children.

US Registered Dietitian Nutritionists' Knowledge and Attitudes of Intuitive Eating and Use of Various Weight Management Practices.

PubMed

Schaefer, Julie T; Zullo, Melissa D

2017-09-01

Researchers have been advocating for a new weight-inclusive paradigm that focuses on health rather than weight. One important component of this model is intuitive eating. Although registered dietitian nutritionists (RDNs) are the nation's food and nutrition experts, RDNs' knowledge of and attitudes toward intuitive eating and use of traditional or restrictive strategies are unknown. The purpose of this study was to characterize RDNs' knowledge of and attitudes toward an intuitive eating lifestyle and describe use of traditional weight management and nonrestrictive lifestyle practices with clients. This was a cross-sectional study. A validated survey was distributed using online survey software to 88,834 RDNs. There were 18,622 respondents who completed the survey (25%). The majority of RDNs were knowledgeable about intuitive eating, answering 71% of items correctly. The majority of RDNs had a positive view on each attitude item. RDNs who work in weight management reported using nonrestrictive/intuitive eating practices more than traditional/restrictive practices. RDNs who were women (P<0.001), had advanced education (P<0.001), worked in a private practice setting (P<0.001), completed at least one certificate of training in weight management (P<0.001), had more experience in weight management counseling (P<0.001), and had greater intuitive eating knowledge (P<0.001) were more likely to report greater use of nonrestrictive/intuitive eating practices. This study provides evidence that RDNs are using an intuitive eating approach more often than traditional weight management practices. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

76 FR 75860 - National Forest System Invasive Species Management Policy

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-05

..., scope, roles, principles, and responsibilities associated with NFS invasive species management for... threatening the National Forest System. Final Policy or Principles The management of aquatic and terrestrial...-AC77 National Forest System Invasive Species Management Policy AGENCY: Forest Service, USDA. ACTION...

Best Management Practices, Policies and Programs

EPA Pesticide Factsheets

The National Great Practice Compendium highlights outstanding activities, technologies, and programs that prevent trash from entering the aquatic environment and/or that reduce the overall volume of trash that is generated.

Clinical Practice Patterns and Beliefs in the Management of Hamstrings Strain Injuries.

PubMed

Di Trani Lobacz, Andrea; Glutting, Joseph; Kaminski, Thomas W

2016-02-01

Hamstrings strain injuries (HSIs) are among the most commonly occurring injuries in sport and are top causes of missed playing time. Lingering symptoms, prolonged recovery, and a high reinjury rate (12%-34%) make HSI management a frustrating and challenging process for the athletic trainer (AT). The clinical practice patterns and opinions of ATs regarding HSI treatment and rehabilitation are unknown. To examine the frequency of method use and opinions about current HSI management among ATs. Cross-sectional study. Survey administered to registrants at the 2013 National Athletic Trainers' Association Clinical Symposia and AT Expo. A total of 1356 certified ATs (691 men, 665 women; age = 35.4 ± 10.5 years, time certified = 11.92 ± 9.75 years). A survey was distributed electronically to 7272 registrants and on paper to another 700 attendees. Validity and reliability were established before distribution. Participants reported demographic information and rated their frequency of treatment and rehabilitation method use and agreement with questions assessing confidence, satisfaction, and desire for better clinical practice guidelines. Exploratory factor analysis and principal axis factor analysis were used. We also calculated descriptive statistics and χ(2) tests to assess practice patterns. The response rate was 17% (n = 1356). A 2-factor solution was accepted for factor analysis (r = 0.76, r = 0.70), indicating that ATs follow either a contemporary or traditional management style. Various practice patterns were evident across employment settings and years of clinical experience. Satisfaction with the current HSI management plan was high (73.6%), whereas confidence in returning an athlete to play was lower (62.0%). Rates of use were associated with belief in effectiveness for all methods assessed (P < .001). Higher confidence levels were associated with high use of several methods; we observed increased satisfaction (χ(2)2 = 22.5, P = .002) but not increased

Enhancing the strategic management of practice learning through the introduction of the role of Learning Environment Manager.

PubMed

Congdon, Graham; Baker, Tracey; Cheesman, Amanda

2013-03-01

This paper describes a process evaluation project designed to enhance the strategic management of practice learning within a large Hospital in the North of England. The aim of the project was to introduce the role of the Learning Environment Manager with dedicated responsibility for practice learning of undergraduate student nurses within the Hospital's 49 practice-settings. Whilst aspects of this role were already evident in several of these settings, the project sought to locate and standardise responsibilities related to the organisation and management of learning and teaching in practice explicitly within the existing staffing structure of each practice-setting. Focus group interviews were used to explore significant aspects of the project with key stakeholder groups comprising Learning Environment Managers, the Hospital Clinical Educator, Hospital Department Managers, Ward Managers, Mentors, University Link Lecturers and undergraduate Student Nurses. Interview data were analysed using thematic content analysis. The findings of the project suggest that the Learning Environment Manager role affords providers of practice learning with a robust approach to establish organisation-wide benchmarks that standardise the strategic management of practice learning in collaboration with partner Universities. The role incorporated many operational activities previously undertaken by the Hospital Clinical Educator, thus enabling the Hospital Clinical Educator to make a more strategic contribution to the on-going quality monitoring and enhancement of practice learning across the Hospital. The Learning Environment Manager role was found to provide mentors with high levels of support which in turn helped to promote consistent, positive and holistic practice learning experiences for undergraduate student nurses across the Hospital. Importantly, the role offers a potent catalyst for nurses in practice to regain responsibility for practice learning and re-establish the value of

Analysis of Management Practices in Lagos State Tertiary Institutions through Total Quality Management Structural Framework

ERIC Educational Resources Information Center

AbdulAzeez, Abbas Tunde

2016-01-01

This research investigated total quality management practices and quality teacher education in public tertiary institutions in Lagos State. The study was therefore designed to analyse management practices in Lagos state tertiary institutions through total quality management structural framework. The selected public tertiary institutions in Lagos…

Initial development of a practical safety audit tool to assess fleet safety management practices.

PubMed

Mitchell, Rebecca; Friswell, Rena; Mooren, Lori

2012-07-01

Work-related vehicle crashes are a common cause of occupational injury. Yet, there are few studies that investigate management practices used for light vehicle fleets (i.e. vehicles less than 4.5 tonnes). One of the impediments to obtaining and sharing information on effective fleet safety management is the lack of an evidence-based, standardised measurement tool. This article describes the initial development of an audit tool to assess fleet safety management practices in light vehicle fleets. The audit tool was developed by triangulating information from a review of the literature on fleet safety management practices and from semi-structured interviews with 15 fleet managers and 21 fleet drivers. A preliminary useability assessment was conducted with 5 organisations. The audit tool assesses the management of fleet safety against five core categories: (1) management, systems and processes; (2) monitoring and assessment; (3) employee recruitment, training and education; (4) vehicle technology, selection and maintenance; and (5) vehicle journeys. Each of these core categories has between 1 and 3 sub-categories. Organisations are rated at one of 4 levels on each sub-category. The fleet safety management audit tool is designed to identify the extent to which fleet safety is managed in an organisation against best practice. It is intended that the audit tool be used to conduct audits within an organisation to provide an indicator of progress in managing fleet safety and to consistently benchmark performance against other organisations. Application of the tool by fleet safety researchers is now needed to inform its further development and refinement and to permit psychometric evaluation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Influencing the practice and outcome in acute upper gastrointestinal haemorrhage. Steering Committee of the National Audit of Acute Upper Gastrointestinal Haemorrhage.

PubMed

Rockall, T A; Logan, R F; Devlin, H B; Northfield, T C

1997-11-01

To assess changes in practice and outcome in acute upper gastrointestinal haemorrhage following the feedback of data, the reemphasis of national guidelines, and specific recommendations following an initial survey. A prospective, multicentre, audit cycle. Forty five hospitals from three health regions participated in two phases of the audit cycle. Phase I: 2332 patients with acute upper gastrointestinal haemorrhage; phase II: 1625 patients with upper gastrointestinal haemorrhage. Patients were evaluated with respect to management (with reference to the recommendations in the national guidelines), mortality, and length of hospital stay. Following the distribution of data from the first phase of the National Audit and the formulation of specific recommendations for improving practice, the proportion of hospitals with local guidelines or protocols for the management of upper gastrointestinal haemorrhage rose from 71% (32/45) to 91% (41/45); 12 of the 32 hospitals with guidelines during the first phase revised their guidelines following the initial survey. There was a small but significant increase in the proportion of all patients who underwent endoscopy (from 81% to 86%), the proportion who underwent endoscopy within 24 hours of admission (from 50% to 56%), and the use of central venous pressure monitoring in patients with organ failure requiring blood transfusion or those with profound shock (from 30% to 43%). There was, however, no change in the use of high dependency beds or joint medical/surgical management in high risk cases. There was no significant change in crude or risk standardised mortality (13.4% in the first phase and 14.4% in the second phase). Although many of the participating hospitals have made efforts to improve practice by producing or updating guidelines or protocols, there has been only a small demonstrable change in some areas of practice during the National Audit. The failure to detect any improvement in mortality may reflect this lack of

Supporting near-peer teaching in general practice: a national survey.

PubMed

van de Mortel, Thea F; Silberberg, Peter L; Ahern, Christine M; Pit, Sabrina W

2016-05-12

Training bodies see teaching by junior doctors and vocational trainees in general practice (family medicine) as integral to a doctor's role. While there is a body of literature on teacher training programs, and on peer and near-peer teaching in hospitals and universities, there has been little examination of near-peer teaching in general practice. Near-peer teaching is teaching to those close to oneself but not at the same level in the training continuum. This study investigated the perceptions of key stakeholders on near-peer teaching in general practice, their current near-peer teaching activities, and methods of recruitment and support. A national anonymous online survey was used to obtain data on Australian stakeholders' perceptions of, and processes related to, near-peer teaching in general practice. Recruitment occurred via electronic invitations sent by training providers and stakeholder associations. Separate questionnaires, which were validated via several cycles of review and piloting, were developed for supervisors and learners. The survey included both fixed response and open response questions. Responses (n = 1,122) were obtained from 269 general practitioner supervisors, 221 general practice registrars, 319 prevocational trainees, and 313 medical students. All stakeholder groups agreed that registrars should teach learners in general practice, and 72% of registrars, 68% of prevocational trainees, and 33% of medical students reported having done some teaching in this setting. Three-quarters of supervisors allowed learners to teach. Having another learner observe their consultations was the most common form of teaching for registrars and prevocational trainees. Eight percent of registrars received some remuneration for teaching. The approach used to determine teaching readiness and quality varied greatly between supervisors. Near-peer teaching was supported by the majority of stakeholders, but is underutilised and has poor structural support

Improving and ensuring best practice continence management in residential aged care.

PubMed

Heckenberg, Gayle

2008-06-01

Background  Continence Management within residential aged care is an every day component of care that requires assessment, implementation of strategies, resource allocation and evaluation. At times the management of incontinence of aged residents can be challenging and unsuccessful. The project chosen through the Clinical Fellowship program was Continence Management with the aim of raising awareness of best practice to assist in improving and providing person-centred resident care. Aims/objectives •  Review the literature on best practice management of incontinence •  Evaluate current practice in continence management for elderly residents within residential aged care services •  Improve adherence to best practice strategies of care for incontinence •  Raise awareness within the nursing home of the best practice management of incontinence •  Promote appropriate and effective use of resources for continence management •  Deliver individualised person-centred care to residents. •  Ensure best practice in continence management Methods  The Joanna Briggs Institute (JBI) Practical Application of Clinical Evidence System clinical audit tool was utilised to measure current practice against best practice. The results identify gaps that require improvement. The Getting Research into Practice process then allowed analysis of the level of compliance with each of the audit criteria, which would identify any barriers in implementing a selected course of action and aim to improve compliance. The project team was consulted with additional stakeholder consultation to form an action plan and implement strategies to improve practice. Results  Although 100% compliance with all audit criteria in audit 1 and 2 was not achieved, there was improvement in the criteria concerning the documented fluid intake for residents. Further strategies have been identified and implemented and this continues to be a 'work in progress'. Staff now have an acute awareness

Good governance in national solid waste management policy (NSWMP) implementation: A case study of Malaysia

NASA Astrophysics Data System (ADS)

Wee, Seow Ta; Abas, Muhamad Azahar; Mohamed, Sulzakimin; Chen, Goh Kai; Zainal, Rozlin

2017-10-01

The National Solid Waste Management Policy (NSWMP) was introduced in 2007 under the Act 672. The execution of NSWMP involves stakeholders from various government agencies and a collaboration with the private sectors. Despite the initiatives taken by the stakeholders, the objectives of NSWMP failed to materialise. One of the major constraints is weak governance among stakeholders with regards to the NSWMP implementation. This paper will explore the good governance practices implemented by the stakeholders. Identifying the current good governance practices implemented by the stakeholders is crucial as it will serve as a guideline to improve good governance practice in the future. An exploratory research approach is applied in this study through in-depth interviews with several government agencies and concessionaires involved in the NSWMP implementation. A total of six respondents took part in this study. The findings of this study show that there are several good governance practices implemented in policy promotion, participation of stakeholders, and capacity enhancement programme for the staff. This study also proposed some points on good governance practices in the context of policy promotion and staff development. A paradigm shift by the stakeholders is imperative so as to enhance the good governance practice in NSWMP implementation towards an efficient solid waste management in Malaysia.

Characteristics of Medical Practices in Three Developed Managed Care Markets

PubMed Central

Landon, Bruce E; Normand, Sharon-Lise T; Frank, Richard; McNeil, Barbara J

2005-01-01

Objective To describe physician practices, ranging from solo and two-physician practices to large medical groups, in three geographically diverse parts of the country with strong managed care presences. Data Sources/Study Design Surveys of medical practices in three managed care markets conducted in 2000–2001. Study Design We administered questionnaires to all medical practices affiliated with two large health plans in Boston, MA, and Portland, OR, and to all practices providing primary care for cardiovascular disease patients admitted to five large hospitals in Minneapolis, MN. We offer data on how physician practices are structured under managed care in these geographically diverse regions of the country with a focus on the structural characteristics, financial arrangements, and care management strategies adopted by practices. Data Collection A two-staged survey consisting of an initial telephone survey that was undertaken using CATI (computerized assisted telephone interviewing) techniques followed by written modules triggered by specific responses to the telephone survey. Principal Findings We interviewed 468 practices encompassing 668 distinct sites of care (overall response rate 72 percent). Practices had an average of 13.9 member physicians (range: 1–125). Most (80.1 percent) medium- (four to nine physicians) and large-size (10 or more physicians) groups regularly scheduled meetings to discuss resource utilization and referrals. Almost 90 percent of the practices reported that these meetings occurred at least once per month. The predominant method for paying practices was via fee-for-service payments. Most other payments were in the form of capitation. Overall, 75 percent of physician practices compensated physicians based on productivity, but there was substantial variation related to practice size. Nonetheless, of the practices that did not use straight productivity methods (45 percent of medium-sized practices and 54 percent of large practices), most

Best practices in bus dispatch.

DOT National Transportation Integrated Search

2012-06-01

In 2007, the National Center for Transit Research (NCTR) sponsored a study to examine best practices in : extraboard operator management. In most transit agencies, extraboard manpower is managed by the : dispatch function, but extraboard management i...

75 FR 6700 - National Park Service Concessions Management Advisory Board Reestablishment

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-10

... DEPARTMENT OF THE INTERIOR National Park Service Concessions Management Advisory Board Reestablishment AGENCY: National Park Service, Interior. ACTION: Notice of reestablishment of the National Park... administratively reestablish the National Park Service Concessions Management Advisory Board. This action is...

Current practice in airway management: A descriptive evaluation.

PubMed

Kjonegaard, Rebecca; Fields, Willa; King, Major L

2010-03-01

Ventilator-associated pneumonia, a common complication of mechanical ventilation, could be reduced if health care workers implemented evidence-based practices that decrease the risk for this complication. To determine current practice and differences in practices between registered nurses and respiratory therapists in managing patients receiving mechanical ventilation. A descriptive comparative design was used. A convenience sample of 41 registered nurses and 25 respiratory therapists who manage critical care patients treated with mechanical ventilation at Sharp Grossmont Hospital, La Mesa, California, completed a survey on suctioning techniques and airway management practices. Descriptive and inferential statistics were used to analyze the data. Significant differences existed between nurses and respiratory therapists for hyperoxygenation before suctioning (P =.03). In the 2 groups, nurses used the ventilator for hyper-oxygenation more often, and respiratory therapists used a bag-valve device more often (P =.03). Respiratory therapists instilled saline (P <.001) and rinsed the closed system with saline after suctioning (P =.003) more often than nurses did. Nurses suctioned oral secretions (P <.001) and the nose of orally intubated patients (P =.01), brushed patients' teeth with a toothbrush (P<.001), and used oral swabs to clean the mouth (P <.001) more frequently than respiratory therapists did. Nurses and respiratory therapists differed significantly in the management of patients receiving mechanical ventilation. To reduce the risk of ventilator-associated pneumonia, both nurses and respiratory therapists must be consistent in using best practices when managing patients treated with mechanical ventilation.

Traditional vs. Contemporary Management Control Practices for Developing Public Health Policies

PubMed Central

Naranjo-Gil, David; Sánchez-Expósito, María Jesús; Gómez-Ruiz, Laura

2016-01-01

Public health policies must address multiple goals and complex community health needs. Recently, management control practices have emerged to provide a broader type of information for evaluating the effectiveness of healthcare policies, and relate activities and processes to multiple strategic outcomes. This study compares the effect of traditional and contemporary management control practices on the achievement of public health policies. It is also analyzed how two different uses of such practices (enabling vs. coercive) facilitate the achievement of public health policies. Relationships are explored using data collected from managers from public health agencies and public hospitals in Spain. The findings show that contemporary management control practices are more suitable than traditional practices to achieve public health policies. Furthermore, results show that public health policies are better achieved when managers use management control practices in an enabling way rather than in a coercive way. PMID:27428985

Regional cancer centre demonstrates voluntary conformity with the national Radiation Oncology Practice Standards

DOE Office of Scientific and Technical Information (OSTI.GOV)

Manley, Stephen, E-mail: stephen.manley@ncahs.health.nsw.gov.au; Last, Andrew; Fu, Kenneth

Radiation Oncology Practice Standards have been developed over the last 10 years and were published for use in Australia in 2011. Although the majority of the radiation oncology community supports the implementation of the standards, there has been no mechanism for uniform assessment or governance. North Coast Cancer Institute's public radiation oncology service is provided across three main service centres on the north coast of NSW. With a strong focus on quality management, we embraced the opportunity to demonstrate conformity with the Radiation Oncology Practice Standards. The Local Health District's Clinical Governance units were engaged to perform assessments of ourmore » conformity with the standards and this was signed off as complete on 16 December 2013. The process of demonstrating conformity with the Radiation Oncology Practice Standards has enhanced the culture of quality in our centres. We have demonstrated that self-assessment utilising trained auditors is a viable method for centres to demonstrate conformity. National implementation of the Radiation Oncology Practice Standards will benefit individual centres and the broader radiation oncology community to improve the service delivered to our patients.« less

Weight management practices associated with PCOS and their relationships with diet and physical activity.

PubMed

Moran, L J; Brown, W J; McNaughton, S A; Joham, A E; Teede, H J

2017-03-01

Do weight management practices differ in women with and without PCOS? Women in the general population with self-reported PCOS are more likely to be using healthy weight management practices and alternative non-lifestyle measures for weight management than women without PCOS. Lifestyle management is the first-line treatment in PCOS. However, the specific weight management practices used by women with PCOS and their effect on diet and physical activity are unclear. The study was a population-based observational cross-sectional study involving women in the 1973-1978 cohort (n = 7767 total; n = 556 with PCOS, n = 7211 without PCOS). Women with and without self-reported PCOS were included. Self-reported outcome measures included healthy lifestyle-related or alternative non-lifestyle-related (e.g. laxatives or smoking) weight management practices, dietary intake and physical activity. Women with PCOS were more likely to be following both healthy [reducing meal or snack size (odds ratio (OR) 1.50, 95% CI 1.14, 1.96, P = 0.004) and reducing fat or sugar intake (OR 1.32, 95% CI 1.03, 1.69, P = 0.027) or following a low glycaemic index diet (OR 2.88, 95% CI 2.30, 3.59, P < 0.001)] and alternative [smoking (OR 1.60, 95% CI 1.02, 2.52, P = 0.043) or use of laxative, diet pills, fasting or diuretics (OR 1.45, 95% CI 1.07, 1.97, P = 0.017)] weight management practices than women without PCOS. In PCOS, the use of a range of healthy weight management practices was associated with increases in physical activity (P < 0.001), diet quality (P < 0.001), percentage protein intake (P < 0.001) and decreases in glycaemic index (P < 0.001), and percentages of fat (P = 0.001), saturated fat (P < 0.001) or fibre (P = 0.003). Use of alternative weight management practices was associated with decreases in diet quality. Limitations include the use of self-reported data for PCOS, height, weight, diet, physical activity and weight management behaviours. In PCOS, we should focus on improving

The national biennial RCRA hazardous waste report (based on 1997 data) : national analysis

DOT National Transportation Integrated Search

1999-09-01

National Analysis presents a detailed look at waste-handling practices in the EPA Regions, States, and largest facilities nationally, including (1) the quantity of waste generated, managed, shipped and received, and imported and exported between Stat...

Management practices to support donor transition: lessons from Avahan, the India AIDS Initiative.

PubMed

Bennett, Sara; Rodriguez, Daniela; Ozawa, Sachiko; Singh, Kriti; Bohren, Meghan; Chhabra, Vibha; Singh, Suneeta

2015-06-13

During 2009-2012, Avahan, a large donor funded HIV/AIDS prevention program in India was transferred from donor support and operation to government. This transition of approximately 200 targeted interventions (TIs), occurred in three tranches in 2009, 2011 and 2012. This paper reports on the management practices pursued in support of a smooth transition of the program, and addresses the extent to which standard change management practices were employed, and were useful in supporting transition. We conducted structured surveys of a sample of 80 TIs from the 2011 and 2012 rounds of transition. One survey was administered directly before transition and the second survey 12 month after transition. These surveys assessed readiness for transition and practices post-transition. We also conducted 15 case studies of transitioning TIs from all three rounds, and re-visited 4 of these 1-3 years later. Considerable evolution in the nature of relationships between key actors was observed between transition rounds, moving from considerable mistrust and lack of collaboration in 2009 toward a shared vision of transition and mutually respectful relationships between Avahan and government in later transition rounds. Management practices also evolved with the gradual development of clear implementation plans, establishment of the post of "transition manager" at state and national levels, identified budgets to support transition, and a common minimum programme for transition. Staff engagement was important, and was carried out relatively effectively in later rounds. While the change management literature suggests short-term wins are important, this did not appear to be the case for Avahan, instead a difficult first round of transition seemed to signal the seriousness of intentions regarding transition. In the Avahan case a number of management practices supported a smooth transition these included: an extended and sequenced time frame for transition; co-ownership and planning of

40 CFR 63.11550 - What are my standards and management practices?

Code of Federal Regulations, 2013 CFR

2013-07-01

... of the management practices that they must follow. You may use your standard operating procedures as the management practices plan provided the standard operating procedures include the required... my standards and management practices? (a) If you own or operate new or existing affected sources at...

40 CFR 63.11550 - What are my standards and management practices?

Code of Federal Regulations, 2012 CFR

2012-07-01

... of the management practices that they must follow. You may use your standard operating procedures as the management practices plan provided the standard operating procedures include the required... my standards and management practices? (a) If you own or operate new or existing affected sources at...

40 CFR 63.11550 - What are my standards and management practices?

Code of Federal Regulations, 2011 CFR

2011-07-01

... of the management practices that they must follow. You may use your standard operating procedures as the management practices plan provided the standard operating procedures include the required... my standards and management practices? (a) If you own or operate new or existing affected sources at...

40 CFR 63.11550 - What are my standards and management practices?

Code of Federal Regulations, 2014 CFR

2014-07-01

... of the management practices that they must follow. You may use your standard operating procedures as the management practices plan provided the standard operating procedures include the required... my standards and management practices? (a) If you own or operate new or existing affected sources at...

40 CFR 63.11550 - What are my standards and management practices?

Code of Federal Regulations, 2010 CFR

2010-07-01

... of the management practices that they must follow. You may use your standard operating procedures as the management practices plan provided the standard operating procedures include the required... my standards and management practices? (a) If you own or operate new or existing affected sources at...

A National Informatics Agenda for Nursing Education and Practice. Report to the Secretary of the Department of Health & Human Services.

ERIC Educational Resources Information Center

National Advisory Council on Nurse Education and Practice, Rockville, MD.

Nursing informatics is a specialty whose activities center around information management and processing for the nursing profession. The Division of Nursing of the U.S. Department of Health and Human Services and the National Advisory Council on Nurse Education and Practice (NACNEP) recognized a need to identify initiatives that would more…

Performance Management in Education: Improving Practice. British Educational Management Series.

ERIC Educational Resources Information Center

Reeves, Jenny; Forde, Christine; O'Brien, Jim; Smith, Pauline; Tomlinson, Harry

This book explores managing the performance of education staff in England and Wales and in Scotland. It compares the different policies of performance management as practiced in England and Wales and in Scotland. (The Scottish system of education is independent of that of England and Wales.) Chapter 1 provides an introduction to performance…

Evidence-based Management: From Theory to Practice in Health Care

PubMed Central

Walshe, Kieran; Rundall, Thomas G.

2001-01-01

The rise of evidence-based clinical practice in health care has caused some people to start questioning how health care managers and policymakers make decisions, and what role evidence plays in the process. Though managers and policymakers have been quick to encourage clinicians to adopt an evidence-based approach, they have been slower to apply the same ideas to their own practice. Yet, there is evidence that the same problems (of the underuse of effective interventions and the overuse of ineffective ones) are as widespread in health care management as they are in clinical practice. Because there are important differences between the culture, research base, and decision-making processes of clinicians and managers, the ideas of evidence-based practice, while relevant, need to be translated for management rather than simply transferred. The experience of the Center for Health Management Research (CHMR) is used to explore how to bring managers and researchers together and promote the use of evidence in managerial decision-making. However, health care funders, health care organizations, research funders, and academic centers need wider and more concerted action to promote the development of evidence-based managerial practice. PMID:11565163

Implementing practice management strategies to improve patient care: the EPIC project.

PubMed

Attwell, David; Rogers-Warnock, Leslie; Nemis-White, Joanna

2012-01-01

Healthcare gaps, the difference between usual care and best care, are evident in Canada, particularly with respect to our aging, ailing population. Primary care practitioners are challenged to identify, prevent and close care gaps in their practice environment given the competing demands of informed, litigious patients with complex medical needs, ever-evolving scientific evidence with new treatment recommendations across many disciplines and an enhanced emphasis on quality and accountability in healthcare. Patient-centred health and disease management partnerships using measurement, feedback and communication of practice patterns and outcomes have been shown to narrow care gaps. Practice management strategies such as the use of patient registries and recall systems have also been used to help practitioners better understand, follow and proactively manage populations of patients in their practice. The Enhancing Practice to Improve Care project was initiated to determine the impact of a patient-centred health and disease management partnership using practice management strategies to improve patient care and outcomes for patients with chronic kidney disease (CKD). Forty-four general practices from four regions of British Columbia participated and, indeed, demonstrated that care and outcomes for patients with CKD could be improved via the implementation of practice management strategies in a patient-centred partnership measurement model of health and disease management.

Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1: ASC software quality engineering practices, Version 2.0.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sturtevant, Judith E.; Heaphy, Robert; Hodges, Ann Louise

2006-09-01

The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR 1.3.2 and 1.3.6 and to a Department of Energy document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines. This document also identifies ASC management and software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

Improving access for patients – a practice manager questionnaire

PubMed Central

Meade, James G; Brown, James S

2006-01-01

Background The administrative and professional consequences of access targets for general practices, as detailed in the new GMS contract, are unknown. This study researched the effect of implementing the access targets of the new GP contract on general practice appointment systems, and practice manager satisfaction in a UK primary health care setting. Methods A four-part postal questionnaire was administered. The questionnaire was modified from previously validated questionnaires and the findings compared with data obtained from the Western Health and Social Services Board (WHSSB) in N Ireland. Practice managers from the 59 general practices in the WHSSB responded to the questionnaire. Results There was a 94.9% response rate. Practice managers were generally satisfied with the introduction of access targets for patients. Some 57.1% of responding practices, most in deprived areas (Odds ratio 3.13 -95% CI 1.01 – 9.80, p = 0.0256) had modified their appointment systems. Less booking flexibility was reported among group practices (p = 0.006), urban practices (p < 0.001) and those with above average patient list sizes (p < 0.001). Receptionists had not received training in patient appointment management in a quarter of practices. Practices with smaller list sizes were more likely than larger ones to utilise nurses in seeing extra patients (p = 0.007) or to undertake triage procedures (p = 0.062). Conclusion The findings demonstrated the ability of general practices within the WHSSB to adjust to a demanding component of the new GP contract. Issues relating to the flexibility of patient appointment booking systems, receptionists' training and the development of the primary care nursing role were highlighted by the study. PMID:16784530

Impoverishment of practice: analysis of effects of economic discourses in home care case management practice.

PubMed

Ceci, Christine

2006-03-01

Home care is a health sector under increasing pressure. Demand is often said to be outstripping capacity, with constant change and retrenchment distinguishing features of the current context. This paper takes a reading of the current conditions of home care using data gathered during a field study of home care case management practices conducted in 2004. As economic discourses become increasingly influential in determining responses to client situations, case managers (and their managers) find themselves with limited capacity to exercise control over their practices. A growing gap between professionally influenced discourses--those presumably intended to guide practice--and organizational priorities creates a dissonance for case managers as the political-ethical dimensions of their practices are displaced by budget "realities." For front-line workers, such displacement cannot be sustained in their face-to-face encounters with clients, leading to a growing sense of frustration and powerlessness among these highly skilled practitioners.

Emergency management training program: Guide to good practice

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1991-07-01

The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate componentsmore » of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager`s point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.« less

Practical recommendations for strengthening national and regional laboratory networks in Africa in the Global Health Security era.

PubMed

Best, Michele; Sakande, Jean

2016-01-01

The role of national health laboratories in support of public health response has expanded beyond laboratory testing to include a number of other core functions such as emergency response, training and outreach, communications, laboratory-based surveillance and data management. These functions can only be accomplished by an efficient and resilient national laboratory network that includes public health, reference, clinical and other laboratories. It is a primary responsibility of the national health laboratory in the Ministry of Health to develop and maintain the national laboratory network in the country. In this article, we present practical recommendations based on 17 years of network development experience for the development of effective national laboratory networks. These recommendations and examples of current laboratory networks, are provided to facilitate laboratory network development in other states. The development of resilient, integrated laboratory networks will enhance each state's public health system and is critical to the development of a robust national laboratory response network to meet global health security threats.

Practical recommendations for strengthening national and regional laboratory networks in Africa in the Global Health Security era

PubMed Central

2016-01-01

The role of national health laboratories in support of public health response has expanded beyond laboratory testing to include a number of other core functions such as emergency response, training and outreach, communications, laboratory-based surveillance and data management. These functions can only be accomplished by an efficient and resilient national laboratory network that includes public health, reference, clinical and other laboratories. It is a primary responsibility of the national health laboratory in the Ministry of Health to develop and maintain the national laboratory network in the country. In this article, we present practical recommendations based on 17 years of network development experience for the development of effective national laboratory networks. These recommendations and examples of current laboratory networks, are provided to facilitate laboratory network development in other states. The development of resilient, integrated laboratory networks will enhance each state’s public health system and is critical to the development of a robust national laboratory response network to meet global health security threats. PMID:28879137

Associations among School Characteristics and Foodservice Practices in a Nationally Representative Sample of U.S. Schools

PubMed Central

Thomson, Jessica L.; Tussing-Humphreys, Lisa M.; Martin, Corby K.; LeBlanc, Monique M.; Onufrak, Stephen J.

2012-01-01

Objective Determine school characteristics associated with healthy/unhealthy foodservice offerings or healthy food preparation practices. Design Retrospective analysis of cross-sectional data. Setting Nationally representative sample of public and private elementary, middle and high schools. Participants 526 and 520 schools with valid data from the 2006 School Health Policies and Practices Study (SHPPS) Food Service School Questionnaire. Main Outcome Measure(s) Scores for healthy/unhealthy foodservice offerings and healthy food preparation practices. Analysis Multivariable regression to determine significant associations among school characteristics and offerings/preparation practices. Results Public schools and schools participating in USDA Team Nutrition reported more healthy offerings and preparation than private or non-participating schools, respectively. Elementary schools reported less unhealthy offerings than middle or high schools; middle schools reported less unhealthy offerings than high schools. Schools requiring foodservice managers to have a college education reported more healthy preparation while those requiring completion of a foodservice training program reported less unhealthy offerings and more healthy preparation than schools without these requirements. Conclusions and Implications Results suggest the school nutrition environment may be improved by requiring foodservice managers to hold a nutrition-related college degree and/or successfully pass a foodservice training program, and by participating in a school-based nutrition program, such as USDA Team Nutrition. PMID:22963956

Campsite impact management: A survey of National Park Service backcountry managers

USGS Publications Warehouse

Marion, J.L.; Stubbs, C.J.; Vander Stoep, Gail A.

1993-01-01

Though a central purpose for the creation and management of parks, visitation inevitably affects the natural resources of parks. This is particularly true at campsites, where visitation and its effects are concentrated. This paper presents partial results from a survey of National Park Service managers regarding general strategies and specific actions implemented by park managers to address campsite impact problems.

National Board Certification and Developmentally Appropriate Practices: Perceptions of Impact.

PubMed

McKenzie, Ellen Nancy

2013-04-01

The study investigated a relationship between National Board certification and perceived use of developmentally appropriate practices (DAP). A self-developed survey, the Early-childhood Teacher Inventory of Practices, was e-mailed to participants. Participants included 246 non-National Board-certified (non-NBCT) and 135 National Board-certified (NBCT) early childhood teachers. Descriptives were reported for age, years of teaching experience, grade level currently teaching, ethnicity, degree type, certification type, and degree level. Inferential statistics were used to understand the differences between perceived use of DAP. NBCTs scored significantly higher than non-NBCTs in three of the four target areas and on the total of the scale. Pearson product-moment corelations were used to determine a relationship between years of experience or level of education and NBCTs' perceived use of DAP. Years of experience were significantly related, but level of education was not. The findings indicate that NBCT teachers perceive they incorporate more developmentally appropriate practices into their teaching than do non-NBCT teachers.

National Board Certification and Developmentally Appropriate Practices: Perceptions of Impact

PubMed Central

McKenzie, Ellen Nancy

2013-01-01

The study investigated a relationship between National Board certification and perceived use of developmentally appropriate practices (DAP). A self-developed survey, the Early-childhood Teacher Inventory of Practices, was e-mailed to participants. Participants included 246 non-National Board-certified (non-NBCT) and 135 National Board-certified (NBCT) early childhood teachers. Descriptives were reported for age, years of teaching experience, grade level currently teaching, ethnicity, degree type, certification type, and degree level. Inferential statistics were used to understand the differences between perceived use of DAP. NBCTs scored significantly higher than non-NBCTs in three of the four target areas and on the total of the scale. Pearson product-moment corelations were used to determine a relationship between years of experience or level of education and NBCTs’ perceived use of DAP. Years of experience were significantly related, but level of education was not. The findings indicate that NBCT teachers perceive they incorporate more developmentally appropriate practices into their teaching than do non-NBCT teachers. PMID:23626399

A national cohesive wildland fire management strategy

Treesearch

Forest Service U.S. Department of Agriculture; Office of Wildland Fire Coordination Department of the Interior

2011-01-01

Addressing wildfire is not simply a fire management, fire operations, or wildland-urban interface problem - it is a larger, more complex land management and societal issue. The vision for the next century is to: Safely and effectively extinguish fire, when needed; use fire where allowable; manage our natural resources; and as a Nation, live with wildland fire. Three...

Data Management and the National Climate Assessment: Best Practices, Lessons Learned, and Future Applications: A Data Quality Solution

NASA Astrophysics Data System (ADS)

Kunkel, K.; Champion, S.

2015-12-01

Data Management and the National Climate Assessment: A Data Quality Solution Sarah M. Champion and Kenneth E. Kunkel Cooperative Institute for Climate and Satellites, Asheville, NC The Third National Climate Assessment (NCA), anticipated for its authoritative climate change analysis, was also a vanguard in climate communication. From the cutting-edge website to the organization of information, the Assessment content appealed to, and could be accessed by, many demographics. One such pivotal presentation of information in the NCA was the availability of complex metadata directly connected to graphical products. While the basic metadata requirement is federally mandated through a series of federal guidelines as a part of the Information Quality Act, the NCA is also deemed a Highly Influential Scientific Assessment, which requires demonstration of the transparency and reproducibility of the content. To meet these requirements, the Technical Support Unit (TSU) for the NCA embarked on building a system for collecting and presenting metadata that not only met these requirements, but one that has since been employed in support of additional Assessments. The metadata effort for this NCA proved invaluable for many reasons, one of which being that it showcased that there is a critical need for a culture change within the scientific community to support collection and transparency of data and methods to the level produced with the NCA. Irregardless of being federally mandated, it proves to simply be a good practice in science communication. This presentation will detail the collection system built by the TSU, the improvements employed with additional Assessment products, as well as illustrate examples of successful transparency. Through this presentation, we hope to impel the discussion in support of detailed metadata becoming the cultural norm within the scientific community to support influential and highly policy-relevant documents such as the NCA.

Judging adaptive management practices of U.S. agencies.

PubMed

Fischman, Robert L; Ruhl, J B

2016-04-01

All U.S. federal agencies administering environmental laws purport to practice adaptive management (AM), but little is known about how they actually implement this conservation tool. A gap between the theory and practice of AM is revealed in judicial decisions reviewing agency adaptive management plans. We analyzed all U.S. federal court opinions published through 1 January 2015 to identify the agency AM practices courts found most deficient. The shortcomings included lack of clear objectives and processes, monitoring thresholds, and defined actions triggered by thresholds. This trio of agency shortcuts around critical, iterative steps characterizes what we call AM-lite. Passive AM differs from active AM in its relative lack of management interventions through experimental strategies. In contrast, AM-lite is a distinctive form of passive AM that fails to provide for the iterative steps necessary to learn from management. Courts have developed a sophisticated understanding of AM and often offer instructive rather than merely critical opinions. The role of the judiciary is limited by agency discretion under U.S. administrative law. But courts have overturned some agency AM-lite practices and insisted on more rigorous analyses to ensure that the promised benefits of structured learning and fine-tuned management have a reasonable likelihood of occurring. Nonetheless, there remains a mismatch in U.S. administrative law between the flexibility demanded by adaptive management and the legal objectives of transparency, public participation, and finality. © 2015 Society for Conservation Biology.

Soil management practices under organic farming

NASA Astrophysics Data System (ADS)

Aly, Adel; Chami Ziad, Al; Hamdy, Atef

2015-04-01

Organic farming methods combine scientific knowledge of ecology and modern technology with traditional farming practices based on naturally occurring biological processes. Soil building practices such as crop rotations, intercropping, symbiotic associations, cover crops, organic fertilizers and minimum tillage are central to organic practices. Those practices encourage soil formation and structure and creating more stable systems. In farm nutrient and energy cycling is increased and the retentive abilities of the soil for nutrients and water are enhanced. Such management techniques also play an important role in soil erosion control. The length of time that the soil is exposed to erosive forces is decreased, soil biodiversity is increased, and nutrient losses are reduced, helping to maintain and enhance soil productivity. Organic farming as systematized and certifiable approach for agriculture, there is no surprise that it faces some challenges among both farmers and public sector. This can be clearly demonstrated particularly in the absence of the essential conditions needed to implement successfully the soil management practices like green manure and composting to improve soil fertility including crop rotation, cover cropping and reduced tillage. Those issues beside others will be fully discussed highlighting their beneficial impact on the environmental soil characteristics. Keywords: soil fertility, organic matter, plant nutrition

Understanding the Effectiveness of Performance Management Practices

DTIC Science & Technology

2010-03-01

clarity and precision focus defining accomplishments and practices. Jones (1995) research on organizational transformation in the Monsanto Company...Performance managment in a changing context: Monsanto Pioneers a competency-based, developmental approach. Human Resource Management , 34 (3), 425-442

French national wound management survey: choice criteria of dressings.

PubMed

Meaume, Sylvie; Barrois, Brigitte; Faucher, Nathalie

Across Europe, wound care management is organized differently, and in some countries such as the UK or Denmark, wound healing centres have been implemented. In France, a large number of health professionals are not sufficiently educated in wound care management during their vocational training. The rapid evolution of dressings has changed wound management practices and has given rise to new professional recommendations. This national survey was carried out in France in 2009, including 465 health professionals, to determine the criteria they use to choose a dressing and their habits of care with acute or chronic wounds. Around 73% of respondents were nurses and, on average, participants took care of 43 wounds per month. It was also found that 89% of the health professionals who took part prefer the sequential treatment of the wound based on its appearance. Regardless of whether the wound is acute or chronic, the priorities for wound care and the choice of dressing are the management of the exudate and the prevention or treatment of infection. These results put into evidence the adequacy of the recommendations by these practitioners and the good correlation between the choice of dressing and the local therapeutic goal. To reach the same level of expertise, the professional training for health professionals who are less frequently involved in wound care is necessary.

Relevance of Lick Creek ecosystem-based management treatments to National Forest management

Treesearch

Cathy Stewart

1999-01-01

Treatments applied at Lick Creek were the first landscape-scale applications of ecosystem management on the Bitterroot National Forest. The coordinated effort between educators, researchers, resource managers, and the public helped gain acceptance and understanding of new approaches to management, both internally and externally. The longer skidding distances, high...

From blood transfusion to patient blood management: a new paradigm for patient care and cost assessment of blood transfusion practice.

PubMed

Leahy, M F; Mukhtar, S A

2012-03-01

The ageing population in developed countries, including Australia, is putting increasing demands on blood transfusion services. With a falling donor pool there is likely to be a shortage of blood and blood products in the next 20 to 30 years unless there are significant changes in medical practice. The National Health and Medical Research Council/Australasian Society of Blood Transfusion Clinical Practice Guidelines on the Use of Blood Components from 2001 are being redeveloped by the National Health and Medical Research Council/Australian and New Zealand Society of Blood Transfusion as evidence-based patient-focused Patient Blood Management guidelines with the aim of improving patient outcomes by reducing inappropriate blood and blood product use and targeting therapies for improving the management of anaemia and coagulopathies. © 2012 The Authors. Internal Medicine Journal © 2012 Royal Australasian College of Physicians.

Emergency management training program: Guide to good practice

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1991-07-01

The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate componentsmore » of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager's point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.« less

Collaborating to embrace evidence-informed management practices within Canada's health system.

PubMed

Strelioff, Wayne; Lavoie-Tremblay, Mélanie; Barton, Melissa

2007-01-01

In late 2005, 11 major national health organizations decided to work together to build healthier workplaces for healthcare providers. To do so, they created a pan-Canadian collaborative of 45 experts and asked them to develop an action strategy to improve healthcare workplaces. One of the first steps taken by members of the collaborative was to adopt the following shared belief statements to guide their thinking: "We believe it is unacceptable to fund, govern, manage, work in or receive care in an unhealthy health workplace," and, "A fundamental way to better healthcare is through healthier healthcare workplaces." This commentary provides an overview of the Quality Worklife-Quality Healthcare Collaborative action strategy. This strategy embraces the thinking set out by the lead papers (by Shamian and El-Jardali and by Clements, Dault and Priest) and brings to life evidence-informed management practices.

VDOT manual of practice for stormwater management.

DOT National Transportation Integrated Search

2004-01-01

This document is a revision of the VDOT Manual of Practice for Planning Stormwater Management prepared in 1991. The objective of this revised manual is to provide updated information regarding the management of stormwater at VDOT projects and facilit...

Performance Management Practices, Information and Communication Technology (ICT) Adoption and Managed Performance

ERIC Educational Resources Information Center

Kagaari, James R. K.; Munene, John C.; Ntayi, Joseph Mpeera

2010-01-01

Purpose: The purpose of this paper is to demonstrate the need for managers of public universities to pay attention to performance management practices and information communication technology (ICT) adoption in order to achieve successful managed performance. Design/methodology/approach: Using a disproportionate stratified purposive approach, a…

Mental Health Professionals' Suicide Risk Assessment and Management Practices.

PubMed

Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Mitchell, Sean M; Taylor, Nathanael J; Quinnett, Paul; Ries, Richard

2018-01-01

Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. The study utilized a cross-sectional design and self-report questionnaires. Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

A national survey on the initial management of upper gastrointestinal bleeding.

PubMed

Liang, Peter S; Saltzman, John R

2014-01-01

To evaluate the initial management of upper gastrointestinal (GI) bleeding in the United States. Various guidelines have addressed the initial management of upper GI bleeding, but the extent to which these guidelines are followed in clinical practice is unknown. We conducted a national survey of emergency physicians, internists, and gastroenterologists practicing in hospitals affiliated with an ACGME-accredited gastroenterology fellowship. Participants rated their agreement and adherence to 9 preendoscopic quality indicators for the initial management of upper GI bleeding. Awareness, use, and barriers to the use of early prognostic risk scores were also assessed. A total of 1402 surveys were completed, with an estimated response rate of 11.3%. Gastroenterologists and trainees agreed with the quality indicators more than nongastroenterologists and attending physicians, respectively. There was no difference in the application of the quality indicators by specialty or clinical position. Among all physicians, 53% had ever heard of and 30% had ever used an upper GI bleeding risk score. More gastroenterologists than nongastroenterologists had heard of (82% vs. 44%, P<0.001) and used (51% vs. 23%, P<0.001) a risk score. There was no difference between attending physicians and trainees. Gastroenterologists and attending physicians more often cited lack of utility as a reason to not use risk scores, whereas nongastroenterologists and trainees more often cited lack of knowledge. Among emergency physicians, internists, and gastroenterologists in the United States, agreement with upper GI bleeding initial management guidelines was high but adherence--especially pertaining to the use of risk scores--was low.

STORMWATER BEST MANAGEMENT PRACTICE MONITORING

EPA Science Inventory

Implementation of an effective BMP monitoring program is not a straight-forward task. BMPs by definition are devices, practices, or methods used to manage stormwater runoff. This umbrella term lumps widely varying techniques into a single category. Also, with the existence of ...

[The National Programme for Disease Management Guidelines. Goals, contents, patient involvement].

PubMed

Ollenschläger, G; Kopp, I; Lelgemann, M; Sänger, S; Klakow-Franck, R; Gibis, B; Gramsch, E; Jonitz, G

2007-03-01

The Programme for National Disease Management Guidelines (German DM-CPG Programme) aims at the implementation of best practice recommendations for prevention, acute care, rehabilitation and chronic care. The programme, focussing on high priority healthcare topics, has been sponsored since 2003 by the German Medical Association (BAEK), the Association of the Scientific Medical Societies (AWMF), and by the National Association of Statutory Health Insurance Physicians (KBV). It is organised by the German Agency for Quality in Medicine, a founding member of the Guidelines International Network (G-I-N). The main objective of the programme is to establish consensus of the medical professions on evidence-based key recommendations covering all sectors of health care provision and facilitating the coordination of care for the individual patient through time and across disciplines. Within this framework experts from national patient self-help groups have been developing patient guidance based upon the recommendations for healthcare providers. The article describes goals, topics and selected contents of the DM-CPG programme - using asthma as an example.

U.S. National forests adapt to climate change through science-management partnerships

Treesearch

Jeremy S. Littell; David L. Peterson; Constance I. Millar; Kathy A. O' Halloran

2011-01-01

Developing appropriate management options for adapting to climate change is a new challenge for land managers, and integration of climate change concepts into operational management and planning on United States national forests is just starting. We established science-management partnerships on the Olympic National Forest (Washington) and Tahoe National Forest (...

VDOT manual of practice for planning stormwater management.

DOT National Transportation Integrated Search

1992-01-01

The final report is in the form of a manual of practice for the VDOT to use in planning its stormwater management strategies. The manual was proposed to aid in the selection and design of erosion control practices and stormwater control practices for...

Physicians' attitude and practices in sickle cell disease pain management.

PubMed

Labbé, Elise; Herbert, Donald; Haynes, Johnson

2005-01-01

Many physicians believe that patients with sickle cell disease (SCD) are more likely to become addicted to pain medication than are other patient populations. This study hypothesizes that physicians' attitudes towards addiction in patients with SCD affects pain management practices. The Physician Attitudes Survey was sent to 286 physicians at seven National Institutes of Health-funded university-based comprehensive sickle cell centres. The survey assessed demographic information; and physician's attitudes toward and knowledge of pain, pain treatment, and drug addiction and abuse. Significant Pearson product-moment correlations were found between attitudes towards pain and beliefs regarding addiction to prescribed opioids. Physicians reported varied pain management strategies, however, many believe that attitudes toward addiction and to patients in pain crises may result in undertreatment of pain. These results indicate that physicians might benefit from additional education regarding sickle cell disease, addiction to pain medication, the pharmacology of opioids, and the assessment and treatment of pain.

Ecological modeling for forest management in the Shawnee National Forest

Treesearch

Richard G. Thurau; J.F. Fralish; S. Hupe; B. Fitch; A.D. Carver

2008-01-01

Land managers of the Shawnee National Forest in southern Illinois are challenged to meet the needs of a diverse populace of stakeholders. By classifying National Forest holdings into management units, U.S. Forest Service personnel can spatially allocate resources and services to meet local management objectives. Ecological Classification Systems predict ecological site...

National Football League Head, Neck and Spine Committee's Concussion Diagnosis and Management Protocol: 2017-18 season.

PubMed

Ellenbogen, Richard G; Batjer, Hunt; Cardenas, Javier; Berger, Mitchel; Bailes, Julian; Pieroth, Elizabeth; Heyer, Robert; Theodore, Nicholas; Hsu, Wellington; Nabel, Elizabeth; Maroon, Joe; Cantu, Robert; Barnes, Ronnie; Collins, James; Putukian, Margot; Lonser, Russell; Solomon, Gary; Sills, Allen

2018-03-16

One of the National Football League's (NFL) Head, Neck and Spine Committee's principal goals is to create a 'best practice' protocol for concussion diagnosis and management for its players. The science related to concussion diagnosis and management continues to evolve, thus the protocol has evolved contemporaneously. The Fifth International Conference on Concussion in Sport was held in Berlin in 2016, and guidelines for sports concussion diagnosis and management were revised and refined. The NFL Head, Neck and Spine Committee has synthesised the most recent empirical evidence for sports concussion diagnosis and management including the Berlin consensus statement and tailored it to the game played in the NFL. One of the goals of the Committee is to provide a standardised, reliable, efficient and evidence-based protocol for concussion diagnosis and management that can be applied in this professional sport during practice and game day. In this article, the end-of-season version of the 2017-18 NFL Concussion Diagnosis and Management Protocol is described along with its clinical rationale. Immediate actions for concussion programme enhancement and research are reviewed. It is the Committee's expectation that the protocol will undergo refinement and revision over time as the science and clinical practice related to concussion in sports crystallise. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effects of conservation practices on fisheries management

USDA-ARS?s Scientific Manuscript database

Beasley Lake watershed was subjected to a series of conservation management practices with the goal of reducing sediment and nutrients entering the lake via agricultural runoff. Concurrent with the application of conservation practices, the lake was renovated and restocked to produce a sports fishe...

Workshop 2b (synthesis): linking drainage basin management to local action plans and national security--theory and practice in eastern European countries.

PubMed

Söderbaum, P; Tropp, H

2004-01-01

Efforts to link and balance national water policies, local water action and national security issues are discussed. There needs to be greater clarity of water roles, rights and responsibilities among national stakeholders as well as between states. In some cases, insufficient attention has been paid to local concerns and, in balancing national and local actions, it is necessary to address decentralization in the context of a transboundary state. There is a strong need for enhanced stakeholder participation in the formulation and implementation of national and local water management plans.

National survey on the practice of radiation therapists in Australia.

PubMed

Sale, Charlotte; Halkett, Georgia; Cox, Jenny

2016-06-01

Radiation therapy (RT), like many allied health professions, has lacked professional practice clarity, which until 2008 had not been comprehensively investigated. This manuscript describes the first phase of a three-phase project investigating the current and future practices of radiation therapists (RTs) in Australia. The aim of phase 1 was to define the practice of RTs in Australia. A quantitative approach was used to gain an understanding of RT practice. A national survey was distributed to RTs in Australia. Descriptive statistics and content analysis were used to analyse the data. RT practice was analysed in relation to core and non-core roles, where non-core roles were further divided into basic and advanced practices. The data from the national survey were representative of the Australian RT population (n = 525). The current practice of RTs is presented in summary tables for each area of work (treatment, planning, simulation, mould room and general). This study provided clarification of RT practice and indicated there was a desire to relinquish administrative roles to focus on RT-specific practice. There was evidence that some advanced roles were currently practiced in Australia; however, there was no structure to support these roles and they were based only on local need. This study identified that the profession needs to consider how they will maintain core RT practice, while encouraging the development of new roles, and whether some roles need to be relinquished.

Protected area management

USGS Publications Warehouse

Fagre, Daniel B.; Prato, Tony; Wang, Yeqiao

2014-01-01

Designated protected areas are diverse in scope and purpose and have expanded from Yellowstone National Park in the United States, the world’s first national park, to 157,897 parks and protected areas distributed globally. Most are publicly owned and serve multiple needs that reflect regional or national cultures. With ever-increasing threats to the integrity of protected areas, managers are turning to flexible management practices such as scenario planning and adaptive management.

MONITORING OF A BEST MANAGEMENT PRACTICE POND

EPA Science Inventory

The USEPA's Urban Watershed Management Branch has monitored stormwater drainage and best management practices (BMP) as part of its research program. One BMP currently being monitored, a retention pond with wetland plantings, is in the Richmond Creek (RC) watershed part of New Yor...

Destined for indecision? A critical analysis of waste management practices in England from 1996 to 2013

DOE Office of Scientific and Technical Information (OSTI.GOV)

Farmer, T.D.; Shaw, P.J.; Williams, I.D., E-mail: idw@soton.ac.uk

Highlights: • Critical analysis of municipal waste management practices and performance in England. • Trends visualised via innovative ternary plots and changes and reasons explored. • Performance 1996–2013 moved slowly away from landfill dominance. • Large variations in %s of waste landfilled, incinerated and recycled/composted. • Progress to resource efficiency slow; affected by poor planning and hostile disputes. - Abstract: European nations are compelled to reduce reliance on landfill as a destination for household waste, and should, in principle, achieve this goal with due recognition of the aims and principles of the waste hierarchy. Past research has predominantly focused onmore » recycling, whilst interactions between changing waste destinies, causes and drivers of household waste management change, and potential consequences for the goal of the waste hierarchy are less well understood. This study analysed Local Authority Collected Waste (LACW) for England, at national, regional and sub-regional level, in terms of the destination of household waste to landfill, incineration and recycling. Information about waste partnerships, waste management infrastructure and collection systems was collected to help identify and explain changes in waste destinies. Since 1996, the proportion of waste landfilled in England has decreased, in tandem with increases in recycling and incineration. At the regional and sub-regional (Local Authority; LA) level, there have been large variations in the relative proportions of waste landfilled, incinerated and recycled or composted. Annual increases in the proportion of household waste incinerated were typically larger than increases in the proportion recycled. The observed changes took place in the context of legal and financial drivers, and the circumstances of individual LAs (e.g. landfill capacity) also explained the changes seen. Where observed, shifts from landfill towards incineration constitute an approach

Collaborative Development of e-Infrastructures and Data Management Practices for Global Change Research

NASA Astrophysics Data System (ADS)

Samors, R. J.; Allison, M. L.

2016-12-01

An e-infrastructure that supports data-intensive, multidisciplinary research is being organized under the auspices of the Belmont Forum consortium of national science funding agencies to accelerate the pace of science to address 21st century global change research challenges. The pace and breadth of change in information management across the data lifecycle means that no one country or institution can unilaterally provide the leadership and resources required to use data and information effectively, or needed to support a coordinated, global e-infrastructure. The five action themes adopted by the Belmont Forum: 1. Adopt and make enforceable Data Principles that establish a global, interoperable e-infrastructure. 2. Foster communication, collaboration and coordination between the wider research community and Belmont Forum and its projects through an e-Infrastructure Coordination, Communication, & Collaboration Office. 3. Promote effective data planning and stewardship in all Belmont Forum agency-funded research with a goal to make it enforceable. 4. Determine international and community best practice to inform Belmont Forum research e-infrastructure policy through identification and analysis of cross-disciplinary research case studies. 5. Support the development of a cross-disciplinary training curriculum to expand human capacity in technology and data-intensive analysis methods. The Belmont Forum is ideally poised to play a vital and transformative leadership role in establishing a sustained human and technical international data e-infrastructure to support global change research. In 2016, members of the 23-nation Belmont Forum began a collaborative implementation phase. Four multi-national teams are undertaking Action Themes based on the recommendations above. Tasks include mapping the landscape, identifying and documenting existing data management plans, and scheduling a series of workshops that analyse trans-disciplinary applications of existing Belmont Forum

Time management tips, tricks, and exercises for busy medical practice employees.

PubMed

Hills, Laura

2012-01-01

Working in a busy medical practice requires excellent time management skills and an ability to handle those unanticipated emergencies, urgencies, and monkey-wrenches that can and often do throw a well-planned day out of whack. This article offers busy medical practice employees 50 time management tips to help them manage their time well. It focuses specifically on eliminating time wasters, working more efficiently, and developing personal goals and habits that can increase productivity, reduce stress, and make working in the practice more enjoyable. This article also offers several hands-on time management exercises, including a time management self-assessment quiz, a multitasking exercise, and a time drain exercise. These can be completed individually or collaboratively with other members of the medical practice team. Finally, this article explores 12 popular time management myths and how a medical practice employee can increase his or her productivity by identifying and harnessing his or her productivity "happy hour(s)".

Performance management excellence among the Malcolm Baldrige National Quality Award Winners in Health Care.

PubMed

Duarte, Neville T; Goodson, Jane R; Arnold, Edwin W

2013-01-01

When carefully constructed, performance management systems can help health care organizations direct their efforts toward strategic goals, high performance, and continuous improvement needed to ensure high-quality patient care and cost control. The effective management of performance is an integral component in hospital and health care systems that are recognized for excellence by the Malcolm Baldrige National Quality Award in Health Care. Using the framework in the 2011-2012 Health Care Criteria for Performance Excellence, this article identifies the best practices in performance management demonstrated by 15 Baldrige recipients. The results show that all of the recipients base their performance management systems on strategic goals, outcomes, or competencies that cascade from the organizational to the individual level. At the individual level, each hospital or health system reinforces the strategic direction with performance evaluations of leaders and employees, including the governing board, based on key outcomes and competencies. Leader evaluations consistently include feedback from internal and external stakeholders, creating a culture of information sharing and performance improvement. The hospitals or health care systems also align their reward systems to promote high performance by emphasizing merit and recognition for contributions. Best practices can provide a guide for leaders in other health systems in developing high-performance work systems.

MONITORING OF A BEST MANAGEMENT PRACTICE POND

EPA Science Inventory

The USEPA's Urban Stormwater Management Branch has monitored stormwater drainage and best management practices (BMP) as part of its research program. One BMP being monitored, a wetland/retention pond, is in the Richmond Creek (RC) watershed in the New York City Department of Envi...

78 FR 34034 - National Advisory Committee for Implementation of the National Forest System Land Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-06

... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The National Advisory Committee for Implementation of the National Forest System Land... purpose of the Committee is to provide advice and recommendations on the implementation of the National...

A snapshot of current gestational diabetes management practices from 26 low-income and lower-middle-income countries.

PubMed

Utz, Bettina; Kolsteren, Patrick; De Brouwere, Vincent

2016-08-01

To identify screening and management practices for gestational diabetes mellitus (GDM) in low-income and lower-middle-income countries. A cross-sectional survey was conducted between November 12, 2014 and May 11, 2015. Questionnaires were distributed to gynecologists, endocrinologists, and medical doctors who were representatives of national professional societies or were involved in providing care to patients with GDM in low-income or lower-middle-income countries in Africa, South Asia, and Latin America. The data were descriptively analyzed. Questionnaires were sent to 182 individuals and 77 healthcare providers from 26 countries completed the survey. The results demonstrated high diversity in screening and management practices. Only 52 (68%) participants reported that any guidelines were available in their setting. Management of GDM was found to take place mainly at the tertiary level and reported practices, including the frequency of post-diagnosis follow-up, modalities of glucose surveillance, and treatment and practices surrounding delivery, varied and did not always reflect the most recent evidence. Attempts to ensure greater adherence to latest consensus guidelines are required, and should be accompanied by systemic changes to improve the detection and management of GDM at primary- and secondary-level healthcare facilities to facilitate patient access to GDM screening and treatment. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

76 FR 64953 - National Advisory Council on Nurse Education and Practice; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-19

... Advisory Council on Nurse Education and Practice; Notice of Meeting In accordance with section 10(a)(2) of...: Name: National Advisory Council on Nurse Education and Practice (NACNEP). Dates and Times: November 7...-Thomas, Designated Federal Officer, National Advisory Council on Nurse Education and Practice, Parklawn...

Current practices in the management of adverse events associated with targeted therapies for advanced renal cell carcinoma: a national survey of oncologists.

PubMed

Ruiz, Janelle Nicole; Belum, Viswanath Reddy; Creel, Patricia; Cohn, Allen; Ewer, Michael; Lacouture, Mario E

2014-10-01

Oncologists treating patients with targeted therapies encounter adverse events (AEs) that pose management challenges, lead to dosing inconsistencies, and impact patient quality of life. Oncologists' practices and attitudes in the management of targeted therapy-related AEs in patients with renal cell carcinoma (RCC) are poorly understood. We sought to identify unmet needs associated with AE management and understand oncologists' treatment optimization strategies. A 24-item online survey was administered in August 2012 to 119 US oncologists treating patients with advanced RCC. The survey solicited responses regarding demographics, practice settings, AE management practice patterns and beliefs, treatment barriers, and patient education. Respondents indicated that between 25% and 50% of patients require dose modification/discontinuation because of AEs. The greatest barrier to optimizing treatment for RCC is the unpredictability of patient responses to treatment (43%). Most respondents (78%) discuss AE management with patients, but only a minority of them proactively reach out to patients (46%). Most practitioners (70%) refer patients to nononcology specialists when faced with unfamiliar AEs, although finding interested physicians (43%) and time constraints (40%) were the most commonly cited barriers to consulting with other specialties. Results suggest that many patients require dose modification/discontinuation because of AEs and that nononcologists are a frequently utilized resource to manage these events. There is a need for predictive drug toxicity markers to establish counseling and prevention, along with opportunities for increased education on supportive care techniques to maintain health-related quality of life and consistent dosing. Copyright © 2014 Elsevier Inc. All rights reserved.

Impact of intervention on healthcare waste management practices in a tertiary care governmental hospital of Nepal.

PubMed

Sapkota, Binaya; Gupta, Gopal Kumar; Mainali, Dhiraj

2014-09-26

Healthcare waste is produced from various therapeutic procedures performed in hospitals, such as chemotherapy, dialysis, surgery, delivery, resection of gangrenous organs, autopsy, biopsy, injections, etc. These result in the production of non-hazardous waste (75-95%) and hazardous waste (10-25%), such as sharps, infectious, chemical, pharmaceutical, radioactive waste, and pressurized containers (e.g., inhaler cans). Improper healthcare waste management may lead to the transmission of hepatitis B, Staphylococcus aureus and Pseudomonas aeruginosa. This evaluation of waste management practices was carried out at gynaecology, obstetrics, paediatrics, medicine and orthopaedics wards at Government of Nepal Civil Service Hospital, Kathmandu from February 12 to October 15, 2013, with the permission from healthcare waste management committee at the hospital. The Individualized Rapid Assessment tool (IRAT), developed by the United Nations Development Program Global Environment Facility project, was used to collect pre-interventional and post-interventional performance scores concerning waste management. The healthcare waste management committee was formed of representing various departments. The study included responses from focal nurses and physicians from the gynaecology, obstetrics, paediatrics, medicine and orthopaedics wards, and waste handlers during the study period. Data included average scores from 40 responders. Scores were based on compliance with the IRAT. The waste management policy and standard operating procedure were developed after interventions, and they were consistent with the national and international laws and regulations. The committee developed a plan for recycling or waste minimization. Health professionals, such as doctors, nurses and waste handlers, were trained on waste management practices. The programs included segregation, collection, handling, transportation, treatment and disposal of waste, as well as occupational health and safety issues

Evidence-Based Practice: Management of Vertigo

PubMed Central

Nguyen-Huynh, Anh T.

2012-01-01

Synopsis The article focuses on the evidence basis for the management of benign paroxysmal positional vertigo (BPPV), the most common diagnosis of vertigo in both primary care and subspecialty settings. Like all articles in this compilation of evidence-based practice, an overview is presented along with evidence based clinical assessment, diagnosis, and management. Summaries of differential diagnosis of vertigo and outcomes are presented. PMID:22980676

Collaboration Between Academia and Practice: Interprofessional Crises Leadership and Disaster Management.

PubMed

Hoying, Cheryl; Farra, Sharon; Mainous, Rosalie; Baute, Rebecca; Gneuhs, Matthew

2017-02-01

An innovative interprofessional disaster preparedness program was designed and implemented through an academic-practice partnership between a large midwestern children's hospital and a community-based state university. This course was part of a constellation of courses developed in response to Presidential Directive (HSPD) 8, a mandate to standardize disaster response training that was issued after the inefficiencies following Hurricane Katrina. A hybrid immersive and didactic approach was used to train senior leadership and frontline clinicians. Included were simulated experiences at the National Center for Medical Readiness, a workshop, and online modules. The program that focused on crisis leadership and disaster management was developed and implemented to serve patient-centered organizations.

Marsh management plans in practice: Do they work in coastal Louisiana, USA?

NASA Astrophysics Data System (ADS)

Cowan, James H.; Turner, R. Eugene; Cahoon, Donald R.

1988-01-01

Louisiana's coastal wetlands represent about 41% of the nation's total and are extensively managed for fish, fur, and waterfowl. Marsh management plans (MMPs) are currently used to avoid potential user conflicts and are believed to be a best management practice for specific management goals. In this article, we define MMPs and examine their variety, history, impacts, and future. A MMP is an organized written plan submitted to state and federal permitting agencies for approval and whose purpose is to regulate wetland habitat quantity and quality (control land loss and enhance productivity). MMPs are usually implemented by making structural modifications in the marsh, primarily by using a variety of water control structures in levees to impound or semi-impound managed areas. It appears that MMPs using impoundments are only marginally successful in achieving and often contradict management goals. Although 20% of coastal Louisiana may be in MMPs by the year 2000, conflict resolution of public and private goals is compromised by a surfeit of opinion and dearth of data and experience. Based on interpretation of these results, we believe the next phase of management should include scientific studies of actual impacts, utilization of post-construction monitoring data, inventory of existing MMPs, development of new techniques, and determination of cumulative impacts.

78 FR 2275 - National Advisory Council on Nurse Education and Practice; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-10

... Advisory Council on Nurse Education and Practice; Notice of Meeting In accordance with section 10(a)(2) of...: Name: National Advisory Council on Nurse Education and Practice (NACNEP). Dates and Times: January 31... Specialist, National Advisory Council on Nurse Education and Practice, Parklawn Building, Room 9-61, 5600...

Collaboration in national forest management

Treesearch

Susan Charnley; Jonathan W. Long; Frank K. Lake

2014-01-01

National forest management efforts have generally moved toward collaborative and participatory approaches at a variety of scales. This includes, at a larger scale, greater public participation in transparent and inclusive democratic processes and, at a smaller scale, more engagement with local communities. Participatory approaches are especially important for an all-...

BROOKHAVEN NATIONAL LABORATORY WILDLIFE MANAGEMENT PLAN.

DOE Office of Scientific and Technical Information (OSTI.GOV)

NAIDU,J.R.

2002-10-22

The purpose of the Wildlife Management Plan (WMP) is to promote stewardship of the natural resources found at the Brookhaven National Laboratory (BNL), and to integrate their protection with pursuit of the Laboratory's mission.

[Building and implementation of management system in laboratories of the National Institute of Hygiene].

PubMed

Rozbicka, Beata; Brulińska-Ostrowska, Elzbieta

2008-01-01

The rules of good laboratory practice have always been observed in the laboratories of National Institute of Hygiene (NIH) and the reliability of the results has been carefully cared after when performing tests for clients. In 2003 the laboratories performing analyses related to food safety were designated as the national reference laboratories. This, added to the necessity of compliance with work standards and requirements of EU legislation and to the need of confirmation of competence by an independent organisation, led to a decision to seek accreditation of Polish Centre of Accreditation (PCA). The following stages of building and implementation of management system were presented: training, modifications of Institute's organisational structure, elaboration of management system's documentation, renovation and refurbishment of laboratory facilities, implementation of measuring and test equipment's supervision, internal audits and management review. The importance of earlier experiences and achievements with regard to validation of analytical methods and guarding of the quality of the results through organisation and participation in proficiency tests was highlighted. Current status of accreditation of testing procedures used in NIH laboratories that perform analyses in the field of chemistry, microbiology, radiobiology and medical diagnostic tests was presented.

Local, national, and service component cost variations in the management of low back pain: Considerations for the clinician.

PubMed

Babu, Ashwin N; McCormick, Zachary; Kennedy, David J; Press, Joel

2016-11-21

In the past two decades, the cost associated with managing low back pain has increased significantly. Improved consciousness of how clinicians utilize resources when managing low back pain is necessary in the current economic climate. The goal of this review is to examine the component costs associated with managing low back pain and provide practical solutions for reducing healthcare costs. This is accomplished by utilizing examples from a major metropolitan area with several major academic institutions and private health care centers. It is clear that there is considerable local and national variation in the component costs of managing low back pain, including physician visits, imaging studies, medications, and therapy services. By being well informed about these variations in one's environment, clinicians and patients alike can make strides towards reducing the financial impact of low back pain. Investigation of the cost discrepancies for services within one's community of practice is important. Improved public access to both cost and outcomes data is needed.

Practice management companies. Creating sound information technology strategies.

PubMed

Cross, M A

1997-10-01

Practice management companies are becoming more prominent players in the health care industry. To improve the performance of the group practices that they acquire, these companies are striving to use updated information technologies.

5 CFR 10.3 - OPM authority to review personnel management programs and practices.

Code of Federal Regulations, 2010 CFR

2010-01-01

... management programs and practices. 10.3 Section 10.3 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... (RULE X) § 10.3 OPM authority to review personnel management programs and practices. The Office of Personnel Management may review the human resources management programs and practices of any agency and...

Associations among school characteristics and foodservice practices in a nationally representative sample of United States schools.

PubMed

Thomson, Jessica L; Tussing-Humphreys, Lisa M; Martin, Corby K; LeBlanc, Monique M; Onufrak, Stephen J

2012-01-01

Determine school characteristics associated with healthy/unhealthy food service offerings or healthy food preparation practices. Secondary analysis of cross-sectional data. Nationally representative sample of public and private elementary, middle, and high schools. Data from the 2006 School Health Policies and Practices Study Food Service School Questionnaire, n = 526 for Healthy and Unhealthy Offerings analysis; n = 520 for Healthy Preparation analysis. Scores for healthy/unhealthy foodservice offerings and healthy food preparation practices. Multivariable regression to determine significant associations among school characteristics and offerings/preparation practices. Public schools and schools participating in the United States Department of Agriculture (USDA) Team Nutrition reported more healthy offerings and preparation than private or nonparticipating schools, respectively. Elementary schools reported fewer unhealthy offerings than middle or high schools; middle schools reported fewer unhealthy offerings than high schools. Schools requiring foodservice managers to have a college education reported more healthy preparation, whereas those requiring completion of a foodservice training program reported fewer unhealthy offerings and more healthy preparation than schools without these requirements. Results suggest the school nutrition environment may be improved by requiring foodservice managers to hold a nutrition-related college degree and/or successfully pass a foodservice training program, and by participating in a school-based nutrition program, such as USDA Team Nutrition. Copyright © 2012 Society for Nutrition Education and Behavior. All rights reserved.

Does identity shape leadership and management practice? Experiences of PHC facility managers in Cape Town, South Africa

PubMed Central

Daire, Judith; Gilson, Lucy

2014-01-01

In South Africa, as elsewhere, Primary Health Care (PHC) facilities are managed by professional nurses. Little is known about the dimensions and challenges of their job, or what influences their managerial practice. Drawing on leadership and organizational theory, this study explored what the job of being a PHC manager entails, and what factors influence their managerial practice. We specifically considered whether the appointment of professional nurses as facility managers leads to an identity transition, from nurse to manager. The overall intention was to generate ideas about how to support leadership development among PHC facility managers. Adopting case study methodology, the primary researcher facilitated in-depth discussions (about their personal history and managerial experiences) with eight participating facility managers from one geographical area. Other data were collected through in-depth interviews with key informants, document review and researcher field notes/journaling. Analysis involved data triangulation, respondent and peer review and cross-case analysis. The experiences show that the PHC facility manager’s job is dominated by a range of tasks and procedures focused on clinical service management, but is expected to encompass action to address the population and public health needs of the surrounding community. Managing with and through others, and in a complex system, requiring self-management, are critical aspects of the job. A range of personal, professional and contextual factors influence managerial practice, including professional identity. The current largely facility-focused management practice reflects the strong nursing identity of managers and broader organizational influences. However, three of the eight managers appear to self-identify an emerging leadership identity and demonstrate related managerial practices. Nonetheless, there is currently limited support for an identity transition towards leadership in this context. Better

Practical Project Management for Education and Training.

ERIC Educational Resources Information Center

Lockitt, Bill

This booklet provides a succinct guide to effective management procedures, including whether and how to take on projects, estimation of costs prior to project bids, project management tools, case studies, and practical exercises for staff development activities. Chapter 1 investigates why institutions take on projects, issues involved, benefits…

Results From the 2014 National Wilderness Manager Survey

Treesearch

Ramesh Ghimire; Ken Cordell; Alan Watson; Chad Dawson; Gary T. Green

2015-01-01

A national survey of managers was developed to support interagency wilderness strategic planning. The focus was on major challenges, perceived needs for science and training, and accomplishments of 1995 Strategic Plan objectives. The survey was administered to managers at the four federal agencies with wilderness management responsibilities: the Bureau of Land...

The work of nurses in Australian general practice: A national survey.

PubMed

Joyce, Catherine M; Piterman, Leon

2011-01-01

Following recent reforms to Australia's health system, nurses now comprise a significant and growing sector of the Australian primary care workforce, but there is little data describing the services they provide. This study aimed to describe the patient consultations of nurses in Australian general practice, including patient characteristics, reasons for the consultation, treatments provided and other actions taken. The study was a national cross-sectional survey, with each participating nurse collecting information about 50 nurse-patient encounters. General practice settings in all regions of Australia. 108 nurses volunteered in response to advertisements and 104 returned completed study materials. Participants included Registered (Division 1) and Enrolled (Division 2) nurses working in a general practice setting. Data were collected between May 2007 and May 2008 using a profile questionnaire and a series of encounter forms. Information was gathered on reasons for encounter, patient characteristics, and actions taken. Data were classified using the International Classification of Primary Care. The final data set included 5,253 nurse-patient encounters. 37.2% of patients (95% CI 33.3-41.2) were aged 65 and over, and 57.1% were female (95% CI 54.9-59.5). The majority of encounters (90.7%) were with existing patients of the practice (95% CI 89.1-92.7). The most common reasons for encounter were general and unspecified problems (35.4 per 100 encounters; 95% CI 31.8-39.1), followed by skin-related problems (20.0; 95% CI 17.3-22.8), and cardiovascular problems (11.0; 95% CI 8.7-13.3). Common management actions included medical examinations (20.7 per 100 encounters), immunisations (22.5), diagnostic tests (10.6), and dressings (15.8). Approximately 30% of encounters involved advice-giving. The findings confirm the generalist nature of the General Practice Nurse role, with a wide range of patient types and clinical conditions. There is a clear influence of current funding

National Security Management Correspondence Course.

ERIC Educational Resources Information Center

Industrial Coll. of the Armed Forces (DOD), Washington, DC.

A course of study on the fundamental aspects of the areas of knowledge which are essential to effective management of national security is presented. The course presents the substance of the Industrial College resident curriculum adapted to the correspondence method of study. The subject matter is designed to impart knowledge and understanding of…

78 FR 19523 - General Management Plan, Draft Environmental Impact Statement, Lake Meredith National Recreation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-01

... Management Plan, Draft Environmental Impact Statement, Lake Meredith National Recreation Area and Alibates... Management Plan, Lake Meredith National Recreation Area and Alibates Flint Quarries National Monument, Texas... management alternatives for Lake Meredith National Recreation Area and three management alternatives for...

77 FR 65374 - Environmental Management Site-Specific Advisory Board, Idaho National Laboratory

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-26

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Idaho National... meeting of the Environmental Management Site-Specific Advisory Board (EM SSAB), Idaho National Laboratory... management in the areas of environmental restoration, waste management, and related activities. Tentative...

Connecting to success: practice management on the Net.

PubMed

Freydberg, B K

2001-08-15

Profound changes in the way dental practices manage data, patient records, and communication are beginning to unfold. Sooner than most of us can imagine, secured patient medical and dental records will reside on the Internet. Additionally, communication between health care providers and patients will become virtually 100% electronic. As the Application Service Provider (ASP) dental models mature, practices will transition from paper to "paperless" to "web-based" management and clinical systems. This article examines and explains these future frontiers.

National Airspace System interface management plan

DOT National Transportation Integrated Search

1986-01-01

This document is intended to implement Interface Management for interfacing subsystems of the National Airspace System (NAS) and for external NAS interfaces by establishing a process which assures that: Interface requirements are agreed to by interfa...

A National Evaluation of the Conservative Management of Uncomplicated Acute Appendicitis: How Common Is This and What Are the Issues.

PubMed

Kelly, Michael E; Khan, Asif; Ur Rehman, Jameel; Waldron, Ronan M; Khan, Waqar; Barry, Kevin; Khan, Iqbal Z

2015-01-01

The management approach for acute appendicitis has been challenged in recent years, with numerous randomized controlled trials demonstrating that antibiotics/conservative management is an efficacious treatment, with lower complication rates. A national survey of all consultant general surgeons evaluating their practices was performed. Reasons for changed practices, choice of antibiotics and follow-up investigations were evaluated. In addition, the role of interval appendicectomy and conservative management in the pediatric population was also assessed. The response rate for this survey was 74.7% (n = 74/99). Over one-fifth (n = 17, 22.9%) routinely treat acute appendicitis conservatively, while another 14.8% (n = 11) consider this approach in selected cases. Main reasons for modified practices included the presence of inflammatory phlegmon (75%), delayed presentation (64%), and recent evidence-based medicine developments (46%). Co-amoxiclav/clavulanic acid was the most popular antibiotic for conservative management (53%). Alternatively, combinations of antibiotics were also utilized. One-third felt interval appendicectomy was warranted, while one-fifth supported conservative management in the paediatric setting. The overwhelming majority (>95%) advocate follow-up colonoscopy ± computed tomography in any patient aged >40 years managed conservatively. Considerable variation in management of uncomplicated appendicitis remains in Ireland despite growing evidence suggesting that the non-operative approach is safe. Reasons for adopting a conservative management practice have been identified and reflect the expanding literature on this subject. © 2015 S. Karger AG, Basel.

European Heritage Landscapes. An Account of the Conference on Planning and Management in European Naturparke/Parcs Naturels/National Parks (U.K.) and Equivalent Category "C" Reserves (Losehill Hall, Castleton, England, September 26-30, 1977).

ERIC Educational Resources Information Center

Smith, Roland

Presented are the proceedings of the Conference on Planning and Management in European National Parks and equivalent Category "C" reserves held at the Peak National Park Study Center, Castleton, England, in 1977. Fifty-two representatives from 16 countries focused practical solutions to management and planning problems in national parks. (BT)

Teaching Laboratory Management Principles and Practices Through Mentorship and Graduated Responsibility: The Assistant Medical Directorship.

PubMed

Hanley, Timothy; Sowder, Aleksandra M; Palmer, Cheryl Ann; Weiss, Ronald L

2016-01-01

With the changing landscape of medicine in general, and pathology in particular, a greater emphasis is being placed on laboratory management as a means of controlling spiraling medical costs and improving health-care efficiency. To meet this challenge, pathology residency programs have begun to incorporate formal laboratory management training into their curricula, using institutional curricula and/or online laboratory management courses offered by professional organizations. At the University of Utah, and its affiliated national reference laboratory, ARUP Laboratories, Inc, interested residents are able to supplement the departmental lecture-based and online laboratory management curriculum by participating in assistant medical directorship programs in one of several pathology subspecialty disciplines. The goals of many of the assistant medical directorship positions include the development of laboratory management skills and competencies. A survey of current and recent assistant medical directorship participants revealed that the assistant medical directorship program serves as an excellent means of improving laboratory management skills, as well as improving performance as a fellow and practicing pathologist.

Association of practice size and pay-for-performance incentives with the quality of diabetes management in primary care.

PubMed

Vamos, Eszter P; Pape, Utz J; Bottle, Alex; Hamilton, Fiona Louise; Curcin, Vasa; Ng, Anthea; Molokhia, Mariam; Car, Josip; Majeed, Azeem; Millett, Christopher

2011-09-06

Not enough is known about the association between practice size and clinical outcomes in primary care. We examined this association between 1997 and 2005, in addition to the impact of the Quality and Outcomes Framework, a pay-for-performance incentive scheme introduced in the United Kingdom in 2004, on diabetes management. We conducted a retrospective open-cohort study using data from the General Practice Research Database. We enrolled 422 general practices providing care for 154,945 patients with diabetes. Our primary outcome measures were the achievement of national treatment targets for blood pressure, glycated hemoglobin (HbA(1c)) levels and total cholesterol. We saw improvements in the recording of process of care measures, prescribing and achieving intermediate outcomes in all practice sizes during the study period. We saw improvement in reaching national targets after the introduction of the Quality and Outcomes Framework. These improvements significantly exceeded the underlying trends in all practice sizes for achieving targets for cholesterol level and blood pressure, but not for HbA(1c) level. In 1997 and 2005, there were no significant differences between the smallest and largest practices in achieving targets for blood pressure (1997 odds ratio [OR] 0.98, 95% confidence interval [CI] 0.82 to 1.16; 2005 OR 0.92, 95% CI 0.80 to 1.06 in 2005), cholesterol level (1997 OR 0.94, 95% CI 0.76 to 1.16; 2005 OR 1.1, 95% CI 0.97 to 1.40) and glycated hemoglobin level (1997 OR 0.79, 95% CI 0.55 to 1.14; 2005 OR 1.05, 95% CI 0.93 to 1.19). We found no evidence that size of practice is associated with the quality of diabetes management in primary care. Pay-for-performance programs appear to benefit both large and small practices to a similar extent.

76 FR 39080 - Environmental Management Site-Specific Advisory Board, Idaho National Laboratory

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-05

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Idaho National... meeting of the Environmental Management Site-Specific Advisory Board (EM SSAB), Idaho National Laboratory... recommendations to DOE-EM and site management in the areas of environmental restoration, waste management, and...

Efficient silvicultural practices for eastern hardwood management

Treesearch

Gary W. Miller; John E. Baumgras

1994-01-01

Eastern hardwood forests are now managed to meet a wide range of objectives, resulting in the need for silvicultural alternatives that provide timber, wildlife, aesthetics, recreation, and other benefits. However, forest management practices must continue to be efficient in terms of profiting from current harvests, protecting the environment, and sustaining production...

Values, Ethics, and Attitudes Toward National Forest Management: An Empirical Study

Treesearch

Robert Manning; William Valliere; Ben Minteer

1999-01-01

This study measures environmental values and ethics and explores their relationships to attitudes toward national forest management. The principal research methods were literature review and a survey of Vermont residents concerning management of the Green Mountain National Forest. Descriptive findings suggest respondents (1) favor nonmaterial values of national forests...

[Management practices in medium-sized private hospitals in São Paulo, Brazil].

PubMed

Brito, Luiz Artur Ledur; Malik, Ana Maria; Brito, Eliane; Bulgacov, Sergio; Andreassi, Tales

2017-04-03

Traditional management practices are sometimes considered merely a necessary condition for superior performance. Other resources and competencies with higher barriers to imitation are assumed to be potential sources of competitive advantage. This study describes and analyzes the effect of traditional management practices on the performance of medium-sized hospitals. Medium-sized companies frequently display the greatest differences in management practices, and only recently did the hospital sector seek ways to develop its competitiveness in the administrative arena. The results generally indicate that basic management practices can make differences in performance, offering support for the new practice-based view (PBV). Hospitals with the highest rate of adoption of practices had the highest occupancy rate, hospital-bed admissions, and accreditation. Lack of adoption of management practices by medium-sized hospitals limits their competitive capacity and can be viewed as a component of the so-called Brazil cost, but in this case an internal component.

Testing of ultra-urban stormwater best management practices.

DOT National Transportation Integrated Search

2001-01-01

Ultra urban areas where conventional best management practices (BMPs) are neither feasible nor cost-effective present a challenge to stormwater management. Although new BMPs have been developed for such space limited environments, the field performan...

Medication management and practices in prison for people with mental health problems: a qualitative study.

PubMed

Bowen, Robert A; Rogers, Anne; Shaw, Jennifer

2009-10-20

Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS). Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore a key marker of the extent to which the health practices in prison settings equate with those of the NHS. The research reported here considers the influences on medication management during the early stages of custody and the impact it has on prisoners. The study employed a qualitative design incorporating semi-structured interviews with 39 prisoners and 71 staff at 4 prisons. Participant observation was carried out in key internal prison locations relevant to the management of vulnerable prisoners to support and inform the interview process. Thematic analysis of the interview data and interpretation of the observational field-notes were undertaken manually. Emergent themes included the impact that delays, changes to or the removal of medication have on prisoners on entry to prison, and the reasons that such events take place. Inmates accounts suggested that psychotropic medication was found a key and valued form of support for people with mental health problems entering custody. Existing regimes of medication and the autonomy to self-medicate established in the community are disrupted and curtailed by the dominant practices and prison routines for the taking of prescribed medication. The continuity of mental health care is undermined by the removal or alteration of existing medication practice and changes on entry to prison which exacerbate prisoners' anxiety and sense of helplessness. Prisoners with a dual diagnosis are likely to be doubly vulnerable because of inconsistencies in substance

Managing Appalachian hardwood stands using four management practices: 60-year results

Treesearch

Thomas M. Schuler; Melissa Thomas-Van Gundy; John P. Brown; Jan Wiedenbeck

2017-01-01

A long-term forest management case study on the Fernow Experimental Forest in West Virginia referred to as the Cutting Practice Level study is evaluated after 60 years. Treatments include a commercial clearcut (one time application), a 39 cm diameter-limit (applied 4 times), uneven-aged management using two variations of single-tree selection (applied 7 and 8 times,...

Silvicultural practices and management of habitat for bats

Treesearch

James M. Guldin; William H. Emmingham; S. Andrew Carter; David A. Saugey

2007-01-01

The twenty-first century has seen a shift in the philosophy and practice of forestry. Historic assumptions that prevailed as recently as three decades ago have been challenged in light of new-concepts and practices, developed through advances in research and lessons from practical experience. The goals of forcst management today encompass a wider array of resources...

Does identity shape leadership and management practice? Experiences of PHC facility managers in Cape Town, South Africa.

PubMed

Daire, Judith; Gilson, Lucy

2014-09-01

In South Africa, as elsewhere, Primary Health Care (PHC) facilities are managed by professional nurses. Little is known about the dimensions and challenges of their job, or what influences their managerial practice. Drawing on leadership and organizational theory, this study explored what the job of being a PHC manager entails, and what factors influence their managerial practice. We specifically considered whether the appointment of professional nurses as facility managers leads to an identity transition, from nurse to manager. The overall intention was to generate ideas about how to support leadership development among PHC facility managers. Adopting case study methodology, the primary researcher facilitated in-depth discussions (about their personal history and managerial experiences) with eight participating facility managers from one geographical area. Other data were collected through in-depth interviews with key informants, document review and researcher field notes/journaling. Analysis involved data triangulation, respondent and peer review and cross-case analysis. The experiences show that the PHC facility manager's job is dominated by a range of tasks and procedures focused on clinical service management, but is expected to encompass action to address the population and public health needs of the surrounding community. Managing with and through others, and in a complex system, requiring self-management, are critical aspects of the job. A range of personal, professional and contextual factors influence managerial practice, including professional identity. The current largely facility-focused management practice reflects the strong nursing identity of managers and broader organizational influences. However, three of the eight managers appear to self-identify an emerging leadership identity and demonstrate related managerial practices. Nonetheless, there is currently limited support for an identity transition towards leadership in this context. Better

Safeguards Knowledge Management & Retention at U.S. National Laboratories.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Haddal, Risa; Jones, Rebecca; Bersell, Bridget

In 2017, four U.S. National Laboratories collaborated on behalf of DOE/NNSA to explore the safeguards knowledge retention problem, identify possible approaches, and develop a strategy to address it. The one-year effort consisted of four primary tasks. First, the project sought to identify critical safeguards information at risk of loss. Second, a survey and workshop were conducted to assess nine U.S. National Laboratories' efforts to determine current safeguards knowledge retention practices and challenges, and identify best practices. Third, specific tools were developed to identify and predict critical safeguards knowledge gaps and how best to recruit in order to fill those gaps.more » Finally, based on findings from the first three tasks and research on other organizational approaches to address similar issues, a strategy was developed on potential knowledge retention methods, customized HR policies, and best practices that could be implemented across the National Laboratory Complex.« less

STORMWATER BEST MANAGEMENT PRACTICES DESIGN GUIDE VOLUME 2 - VEGETATIVE BIOFILTERS

EPA Science Inventory

This document is Volume 2 of a three volume document that provides guidance on the selection and design of stormwater management Best Management Practices (BMPs). This second volume provides specific design guidance for a group of onsite BMP control practices that are referred t...

25 CFR 15.504 - Who may inspect records and records management practices?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Who may inspect records and records management practices... Records § 15.504 Who may inspect records and records management practices? (a) You may inspect the probate... Secretary and the Archivist of the United States may inspect records and records management practices and...

25 CFR 15.504 - Who may inspect records and records management practices?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Who may inspect records and records management practices... Records § 15.504 Who may inspect records and records management practices? (a) You may inspect the probate... Secretary and the Archivist of the United States may inspect records and records management practices and...

25 CFR 15.504 - Who may inspect records and records management practices?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true Who may inspect records and records management practices... Records § 15.504 Who may inspect records and records management practices? (a) You may inspect the probate... Secretary and the Archivist of the United States may inspect records and records management practices and...

25 CFR 15.504 - Who may inspect records and records management practices?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false Who may inspect records and records management practices... Records § 15.504 Who may inspect records and records management practices? (a) You may inspect the probate... Secretary and the Archivist of the United States may inspect records and records management practices and...

25 CFR 15.504 - Who may inspect records and records management practices?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Who may inspect records and records management practices... Records § 15.504 Who may inspect records and records management practices? (a) You may inspect the probate... Secretary and the Archivist of the United States may inspect records and records management practices and...

Prophylaxis and management of acute radiation-induced skin toxicity: a survey of practice across Europe and the USA.

PubMed

O'Donovan, A; Coleman, M; Harris, R; Herst, P

2015-05-01

Radiation-induced toxicity is a common adverse side effect of radiation therapy. Previous studies have demonstrated a lack of evidence to support common skincare advice for radiotherapy patients. The aim of the current study was to investigate the management of radiation-induced skin toxicity across Europe and the USA. Where previous surveys have focused on national practice or treatment of specific sites, the current study aimed to gain a broader representation of skincare practice. An anonymous online survey investigating various aspects of radiotherapy skincare management was distributed to departments across Europe and the USA (n = 181/737 responded i.e. 25%). The UK was excluded as a similar survey was carried out in 2011. The results highlight the lack of consistency in both the prevention and management of radiation-induced skin toxicity. Recommended products are often not based on evidence-based practice. Examples include the continued use of aqueous cream and gentian violet, as well as the recommendations on washing restrictions during treatment. To our knowledge, this is the most extensive survey to date on the current management of radiation-induced skin toxicity. This study highlights significant disparities between clinical practice and research-based evidence published in recent systematic reviews and guidelines. Ongoing large prospective randomised trials are urgently needed. © 2014 John Wiley & Sons Ltd.

78 FR 23219 - National Advisory Committee for Implementation of the National Forest System Land Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-18

... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The National Advisory Committee for Implementation of the National Forest System Land... Federal Advisory Committee Act. The purpose of the committee is to provide advice and recommendations on...

76 FR 81911 - National Advisory Committee for Implementation of the National Forest System Land Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-29

... National Forest System Land Management Planning Rule AGENCY: USDA Forest Service. ACTION: Notice of intent... intends to establish the National Advisory Committee for Implementation of the National Forest System Land... (FACA), the Committee is being established to provide advice and recommendations on the implementation...

78 FR 9883 - National Advisory Committee for Implementation of the National Forest System Land Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The National Advisory Committee for Implementation of the National Forest System Land... Advisory Committee Act. The purpose of the committee is to provide advice and recommendations on the...

National recommendations: Psychosocial management of diabetes in India

PubMed Central

Kalra, Sanjay; Sridhar, G. R.; Balhara, Yatan Pal Singh; Sahay, Rakesh Kumar; Bantwal, Ganapathy; Baruah, Manash P.; John, Mathew; Unnikrishnan, Ambika Gopalkrishnan; Madhu, K.; Verma, Komal; Sreedevi, Aswathy; Shukla, Rishi; Prasanna Kumar, K. M.

2013-01-01

Although several evidence-based guidelines for managing diabetes are available, few, if any, focus on the psychosocial aspects of this challenging condition. It is increasingly evident that psychosocial treatment is integral to a holistic approach of managing diabetes; it forms the key to realizing appropriate biomedical outcomes. Dearth of attention is as much due to lack of awareness as due to lack of guidelines. This lacuna results in diversity among the standards of clinical practice, which, in India, is also due to the size and complexity of psychosocial care itself. This article aims to highlight evidence- and experience-based Indian guidelines for the psychosocial management of diabetes. A systemic literature was conducted for peer-reviewed studies and publications covering psychosocial aspects in diabetes. Recommendations are classified into three domains: General, psychological and social, and graded by the weight they should have in clinical practice and by the degree of support from the literature. Ninety-four recommendations of varying strength are made to help professionals identify the psychosocial interventions needed to support patients and their families and explore their role in devising support strategies. They also aid in developing core skills needed for effective diabetes management. These recommendations provide practical guidelines to fulfill unmet needs in diabetes management, and help achieve a qualitative improvement in the way physicians manage patients. The guidelines, while maintaining an India-specific character, have global relevance, which is bound to grow as the diabetes pandemic throws up new challenges. PMID:23869293

National information network and database system of hazardous waste management in China

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ma Hongchang

1996-12-31

Industries in China generate large volumes of hazardous waste, which makes it essential for the nation to pay more attention to hazardous waste management. National laws and regulations, waste surveys, and manifest tracking and permission systems have been initiated. Some centralized hazardous waste disposal facilities are under construction. China`s National Environmental Protection Agency (NEPA) has also obtained valuable information on hazardous waste management from developed countries. To effectively share this information with local environmental protection bureaus, NEPA developed a national information network and database system for hazardous waste management. This information network will have such functions as information collection, inquiry,more » and connection. The long-term objective is to establish and develop a national and local hazardous waste management information network. This network will significantly help decision makers and researchers because it will be easy to obtain information (e.g., experiences of developed countries in hazardous waste management) to enhance hazardous waste management in China. The information network consists of five parts: technology consulting, import-export management, regulation inquiry, waste survey, and literature inquiry.« less

Collaborating to embrace evidence-informed management practices within Canada's health system.

PubMed

Strelioff, Wayne; Lavoie-Tremblay, Mélanie; Barton, Melissa

2007-01-01

In late 2005, 11 major national health organizations decided to work together to build healthier workplaces for healthcare providers. To do so, they created a pan-Canadian collaborative of 45 experts and asked them to develop an action strategy to improve healthcare workplaces. One of the first steps taken by members of the collaborative was to adopt the following shared belief statements to guide their thinking: "We believe it is unacceptable to fund, govern, manage, work in or receive care in an unhealthy health workplace," and, "A fundamental way to better healthcare is through healthier healthcare workplaces. This commentary provides an overview of the Quality Worklife-Quality Healthcare Collaborative action strategy. This strategy embraces the thinking set out by the lead papers in a recent Special Issue of Healthcare Papers (www.Longwoods.com/special_issues.php) focused on developing healthy workplaces for healthcare workers, and brings to Life evidence-informed management practices.

The Design of a Practical Enterprise Safety Management System

NASA Astrophysics Data System (ADS)

Gabbar, Hossam A.; Suzuki, Kazuhiko

This book presents design guidelines and implementation approaches for enterprise safety management system as integrated within enterprise integrated systems. It shows new model-based safety management where process design automation is integrated with enterprise business functions and components. It proposes new system engineering approach addressed to new generation chemical industry. It will help both the undergraduate and professional readers to build basic knowledge about issues and problems of designing practical enterprise safety management system, while presenting in clear way, the system and information engineering practices to design enterprise integrated solution.

Evaluation of a Pain Management Education Program and Operational Guideline on Nursing Practice, Attitudes, and Pain Management.

PubMed

Bonkowski, Sara L; De Gagne, Jennie C; Cade, Makia B; Bulla, Sally A

2018-04-01

Nurses lack adequate pain management knowledge, which can result in poorly managed postsurgical pain. This study aimed to develop, implement, and evaluate pain management education and operational guidelines to improve nursing knowledge and pain management. This quality improvement project employed convenience samples of surgical oncology nurses and postoperative patients. The intervention involved an online module, live education, and operational guideline for pain management. Nurses completed pre- and postintervention practice and attitudes surveys. Random chart reviews of intravenous narcotic administrations the day before discharge were completed to evaluate whether narcotic administration changed after intervention. Readmissions and Hospital Consumer Assessment of Healthcare Providers and Systems data were collected to determine whether the intervention influenced patient satisfaction. A statistically significant improvement in nursing practice and intravenous narcotic administrations demonstrated changes to pain management practices employed by the nursing staff. Although not statistically significant, fewer pain-related readmissions occurred postintervention. Findings demonstrate that targeted pain management continuing education, paired with operational guidelines, improves nursing practice and decreases intravenous narcotic administrations prior to discharge. J Contin Educ Nurs. 2018;49(4):178-185. Copyright 2018, SLACK Incorporated.

Nontimber forest products management on national forests in the United States.

Treesearch

Rebecca J. McLain; Eric T. Jones

2005-01-01

This study provides an overview of nontimber forest products (NTFP) programs on national forests in the United States. We conducted an email survey in 2003 to obtain data on NTFP management activities on national forests across the country. Program characteristics examined in the study included important NTFPs managed on national forests, presence of NTFP coordinators...

Decentralization's impact on the health workforce: Perspectives of managers, workers and national leaders

PubMed Central

Kolehmainen-Aitken, Riitta-Liisa

2004-01-01

Designers and implementers of decentralization and other reform measures have focused much attention on financial and structural reform measures, but ignored their human resource implications. Concern is mounting about the impact that the reallocation of roles and responsibilities has had on the health workforce and its management, but the experiences and lessons of different countries have not been widely shared. This paper examines evidence from published literature on decentralization's impact on the demand side of the human resource equation, as well as the factors that have contributed to the impact. The elements that make such an impact analysis exceptionally complex are identified. They include the mode of decentralization that a country is implementing, the level of responsibility for the salary budget and pay determination, and the civil service status of transferred health workers. The main body of the paper is devoted to examining decentralization's impact on human resource issues from three different perspectives: that of local health managers, health workers themselves, and national health leaders. These three groups have different concerns in the human resource realm, and consequently, have been differently affected by decentralization processes. The paper concludes with recommendations regarding three key concerns that national authorities and international agencies should give prompt attention to. They are (1) defining the essential human resource policy, planning and management skills for national human resource managers who work in decentralized countries, and developing training programs to equip them with such skills; (2) supporting research that focuses on improving the knowledge base of how different modes of decentralization impact on staffing equity; and (3) identifying factors that most critically influence health worker motivation and performance under decentralization, and documenting the most cost-effective best practices to improve them

Management in general practice: the challenge of the new General Medical Services contract.

PubMed

Checkland, Kath

2004-10-01

Managers in general practice perform a variety of roles, from purely administrative to higher-level strategic planning. There has been little research investigating in detail how they perform these roles and the problems that they encounter. The new General Medical Services (GMS) contract contains new management challenges and it is not clear how practices will meet these. To improve understanding of the roles performed by managers in general practice and to consider the implications of this for the implementation of the new GMS contract. In-depth qualitative case studies covering the period before and immediately after the vote in favour of the new GMS contract. Three general practices in England, chosen using purposeful sampling. Semi-structured interviews with all clinical and managerial personnel in each practice, participant and non-participant observation, and examination of documents. Understanding about what constitutes the legitimate role of managers in general practice varies both within and between practices. Those practices in the study that employed a manager to work at a strategic level with input into the direction of the organisation demonstrated significant problems with this in practice. These included lack of clarity about what the legitimate role of the manager involved, problems relating to the authority of managers in the context of a partnership, and lack of time available to them to do higher-level work. In addition, general practitioners (GPs) were not confident about their ability to manage their managers' performance. The new GMS contract will place significant demands on practice management. These results suggest that it cannot be assumed that simply employing a manager with high-level skills will enable these demands to be met; there must first be clarity about what the manager should be doing, and attention must be directed at questions about the legitimacy enjoyed by such a manager, the limits of his or her authority, and the

Management in general practice: the challenge of the new General Medical Services contract

PubMed Central

Checkland, Kath

2004-01-01

Background: Managers in general practice perform a variety of roles, from purely administrative to higher-level strategic planning. There has been little research investigating in detail how they perform these roles and the problems that they encounter. The new General Medical Services (GMS) contract contains new management challenges and it is not clear how practices will meet these. Aim: To improve understanding of the roles performed by managers in general practice and to consider the implications of this for the implementation of the new GMS contract. Design of study: In-depth qualitative case studies covering the period before and immediately after the vote in favour of the new GMS contract. Setting: Three general practices in England, chosen using purposeful sampling. Method: Semi-structured interviews with all clinical and managerial personnel in each practice, participant and non-participant observation, and examination of documents. Results: Understanding about what constitutes the legitimate role of managers in general practice varies both within and between practices. Those practices in the study that employed a manager to work at a strategic level with input into the direction of the organisation demonstrated significant problems with this in practice. These included lack of clarity about what the legitimate role of the manager involved, problems relating to the authority of managers in the context of a partnership, and lack of time available to them to do higher-level work. In addition, general practitioners (GPs) were not confident about their ability to manage their managers' performance. Conclusion: The new GMS contract will place significant demands on practice management. These results suggest that it cannot be assumed that simply employing a manager with high-level skills will enable these demands to be met; there must first be clarity about what the manager should be doing, and attention must be directed at questions about the legitimacy enjoyed

78 FR 68811 - National Advisory Committee for Implementation of the National Forest System Land Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The National Advisory Committee for Implementation of the National Forest System Land... (FACA) (Pub. L. 92-463). The purpose of the Committee is to provide advice and recommendations on the...

78 FR 46565 - National Advisory Committee for Implementation of the National Forest System Land Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-01

... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The National Advisory Committee for Implementation of the National Forest System Land... Committee Act (FACA) (Pub. L. 92-463). The purpose of the Committee is to provide advice and recommendations...

Environmental management assessment of the National Institute for Petroleum and Energy Research

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1994-08-01

This report documents the results of the environmental management assessment of the National Institute for Petroleum and Energy Research (NIPER), located in Bartlesville, Oklahoma. The assessment was conducted August 15-26, 1994, by the DOE Office of Environmental Audit (EH-24), located within the Office of Environment, Safety and Health. The assessment included reviews of documents and reports, as well as inspections and observations of selected facilities and operations. Further, the team conducted interviews with management and staff from the Bartlesville Project Office (BPO), the Office of Fossil Energy (FE), the Pittsburgh Energy Technology Center (PETC), state and local regulatory agencies, andmore » BDM Oklahoma (BDM-OK), which is the management and operating (M&O) contractor for NIPER. Because of the transition from a cooperative agreement to an M&O contract in January 1994, the scope of the assessment was to evaluate (1) the effectiveness of BDM-OK management systems being developed and BPO systems in place and under development to address environmental requirements; (2) the status of compliance with DOE Orders, guidance, and directives; and (3) conformance with accepted industry management practices. An environmental management assessment was deemed appropriate at this time in order to identify any systems modifications that would provide enhanced effectiveness of the management systems currently under development.« less

Destined for indecision? A critical analysis of waste management practices in England from 1996 to 2013.

PubMed

Farmer, T D; Shaw, P J; Williams, I D

2015-05-01

European nations are compelled to reduce reliance on landfill as a destination for household waste, and should, in principle, achieve this goal with due recognition of the aims and principles of the waste hierarchy. Past research has predominantly focused on recycling, whilst interactions between changing waste destinies, causes and drivers of household waste management change, and potential consequences for the goal of the waste hierarchy are less well understood. This study analysed Local Authority Collected Waste (LACW) for England, at national, regional and sub-regional level, in terms of the destination of household waste to landfill, incineration and recycling. Information about waste partnerships, waste management infrastructure and collection systems was collected to help identify and explain changes in waste destinies. Since 1996, the proportion of waste landfilled in England has decreased, in tandem with increases in recycling and incineration. At the regional and sub-regional (Local Authority; LA) level, there have been large variations in the relative proportions of waste landfilled, incinerated and recycled or composted. Annual increases in the proportion of household waste incinerated were typically larger than increases in the proportion recycled. The observed changes took place in the context of legal and financial drivers, and the circumstances of individual LAs (e.g. landfill capacity) also explained the changes seen. Where observed, shifts from landfill towards incineration constitute an approach whereby waste management moves up the waste hierarchy as opposed to an attempt to reach the most preferred option(s); in terms of resource efficiency, this practice is sub-optimal. The requirement to supply incinerators with a feedstock over their lifespan reduces the benefits of developing of recycling and waste reduction, although access to incineration infrastructure permits short-term and marked decreases in the proportion of LACW landfilled. We

A study of National Health Service management of chronic osteoarthritis and low back pain.

PubMed

Hart, Oliver R; Uden, Ruth M; McMullan, James E; Ritchie, Mark S; Williams, Timothy D; Smith, Blair H

2015-04-01

To describe treatment and referral patterns and National Health Service resource use in patients with chronic pain associated with low back pain or osteoarthritis, from a Primary Care perspective. Osteoarthritis and low back pain are the two commonest debilitating causes of chronic pain, with high health and social costs, and particularly important in primary care. Understanding current practice and resource use in their management will inform health service and educational requirements and the design and optimisation of future care. Multi-centre, retrospective, descriptive study of adults (⩾18 years) with chronic pain arising from low back pain or osteoarthritis, identified through primary care records. Five general practices in Scotland, England (two), Northern Ireland and Wales. All patients with a diagnosis of low back pain or osteoarthritis made on or before 01/09/2006 who had received three or more prescriptions for pain medication were identified and a sub-sample randomly selected then consented to an in-depth review of their medical records (n=264). Data on management of chronic pain were collected retrospectively from patients' records for three years from diagnosis ('newly diagnosed' patients) or for the most recent three years ('established' patients). Patients received a wide variety of pain medications with no overall common prescribing pattern. GP visits represented the majority of the resource use and 'newly diagnosed' patients were significantly more likely to visit their GP for pain management than 'established' patients. Although 'newly diagnosed' patients had more referrals outside the GP practice, the number of visits to secondary care for pain management was similar for both groups. This retrospective study confirmed the complexity of managing these causes of chronic pain and the associated high resource use. It provides an in-depth picture of prescribing and referral patterns and of resource use.

Case study of an anxious child with extensive caries treated in general dental practice: financial viability under the terms of the UK National Health Service.

PubMed

Shelley, A; Mackie, I

2001-10-01

This case study describes the management of Callum, an anxious 7-year-old boy with extensive caries. Callum's dental care was carried out in a general dental practice in the North of England under the terms of the National Health Service. A preventive programme was carried out in conjunction with the restorative philosophy according to guidelines published by the Dental Practice Board in 1997.

Using Civilian Supply Chain Management Best Practices to Improve Army Supply Chain Management Procedures

DTIC Science & Technology

2017-06-09

USING CIVILIAN SUPPLY CHAIN MANAGEMENT BEST PRACTICES TO IMPROVE ARMY SUPPLY CHAIN MANAGEMENT PROCEDURES A thesis presented to......Army Supply Chain Management Procedures 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Chief Warrant

Managing Self-Access Language Learning: Principles and Practice

ERIC Educational Resources Information Center

Gardner, David; Miller, Lindsay

2011-01-01

This paper is based on a research project looking at the management of self-access language learning (SALL) from the perspective of the managers of self-access centres. It looks at the factors which influence the practice of seven managers of self-access language learning in tertiary institutions in Hong Kong. The discussion centres around five…

Molecular testing for cystic fibrosis carrier status practice guidelines: recommendations of the National Society of Genetic Counselors.

PubMed

Langfelder-Schwind, Elinor; Karczeski, Barbara; Strecker, Michelle N; Redman, Joy; Sugarman, Elaine A; Zaleski, Christina; Brown, Trisha; Keiles, Steven; Powers, Amy; Ghate, Sumheda; Darrah, Rebecca

2014-02-01

To provide practice recommendations for genetic counselors whose clients are considering cystic fibrosis (CF) carrier testing or seeking information regarding CF molecular test results. The goals of these recommendations are to: 1) Provide updated information about the natural history, diagnosis, and treatment of CF and related conditions. 2) Supplement genetic counselors' knowledge and understanding of the available carrier screening and diagnostic testing options. 3) Describe the current state of genotype/phenotype correlations for CFTR mutations and an approach to interpreting both novel and previously described variants. 4) Provide a framework for genetic counselors to assist clients' decision-making regarding CF carrier testing, prenatal diagnosis, and pregnancy management. Disclaimer The practice guidelines of the National Society of Genetic Counselors (NSGC) are developed by members of the NSGC to assist genetic counselors and other health care providers in making decisions about appropriate management of genetic concerns; including access to and/or delivery of services. Each practice guideline focuses on a clinical or practice-based issue, and is the result of a review and analysis of current professional literature believed to be reliable. As such, information and recommendations within the NSGC practice guidelines reflect the current scientific and clinical knowledge at the time of publication, are only current as of their publication date, and are subject to change without notice as advances emerge.In addition, variations in practice, which take into account the needs of the individual patient and the resources and limitations unique to the institution or type of practice, may warrant approaches, treatments and/or procedures that differ from the recommendations outlined in this guideline. Therefore, these recommendations should not be construed as dictating an exclusive course of management, nor does the use of such recommendations guarantee a particular

Student Teachers' Management Practices in Elementary Classrooms: A Qualitative Study

ERIC Educational Resources Information Center

Hildenbrand, Susan M.; Arndt, Katrina

2016-01-01

This qualitative study of four student teachers completing certification in elementary and special education investigated the classroom management practices of the student teachers. This is an important area of study because management practices are essential for an effective classroom, and student teachers often lack confidence and skill in the…