In today's complex legal environment, healthcare organizations are increasingly implementing voluntary compliance programs as a means of avoiding severe penalties for violations of the law. The Office of the Inspector General has identified legal audits and investigations as key components of effective compliance programs. The author demonstrates the applicability of ...

How can a healthcare organization improve the public's confidence in the conduct of its business operations? What can it do to ensure that it can thrive despite being the subject of public and governmental scrutiny and doubt? Healthcare providers must establish standards of conduct that are above reproach and ensure ...

Two organizations--the Commission on Accreditation for Rehabilitation Facilities (CARF) and the American Accreditation HealthCare Commission/URAC--are developing accreditation standards for case management departments. Both will be available sometime next year. Just as certification has helped establish a benchmark for individual practice, these organizations hope their programs will establish larger-scale benchmarks for ...

A new final rule and a proposed rule published September 2, 1998, by the HHS Office of Inspector General (OIG) outline regulations that implement enforcement provisions of the Health Insurance Portability and Accountability Act of 1996 and the Balanced Budget Act of 1997, respectively. The rules give the OIG discretionary ...

The long-term treatment of Parkinson's disease presents a special challenge in the home healthcare setting. This article describes a successful interdisciplinary home healthcare program that addresses the special needs of patients with Parkinson's disease and associated disorders. The program, which combines skilled assessment, professional healthcare services, patient and family education, ...

In organizations with the power to persist through turbulent eras, one finds leaders who live as if they were stewards of a legacy-the culture, mission, and founding spirit of the organization. These legacy leaders may be physicians, administrators, chief executives, or board members, but they all have the ability to ...

The selection of a healthcare information system is analogous to a big game hunt. The buyers perceive themselves as the hunters while the truth is just the opposite. To strip away the carefully crafted facade of corporate marketing is an art form and requires due diligence on the part of ...

With a basic knowledge of the origin and transport of moisture, psychometrics, and the use of properly calibrated diagnostic tools, an EM can not only determine the origin of many moisture problems (and indoor air quality complaints), but also aid infection control efforts by minimizing microbial growth. In future issues ...

As healthcare organizations become increasingly complex, healthcare administrators and human resource managers face the cost and challenges of employment-related disputes. Litigation and legal costs associated with employment disputes are escalating at a significant rate. Additionally, litigation procedures are drawn out and damage the employer-employee relationship. Alternative dispute resolution (ADR) programs ...

Evaluation research of a caregiver community-based support program is described. Initially, caregiver-participants characterized their lives as being "on hold." They were overwhelmed, isolated, and lacking time for a personal life. Socialization activities and learning to care for themselves were the most powerful and helpful aspects of the program. Suggestions are ...

Within the context of the education of professional healthcare providers, the authors give an overview of the challenges faced by those wishing to introduce telematics as both a mechanism for content delivery and as subject content itself. After presenting a brief overview of the current state of telematics applications to ...

Consumer demand is pushing many healthcare providers and payers to offer complementary and alternative therapies, from chiropractic to acupuncture, even in the absence of conclusive evidence of their efficacy. To keep patients safe, and to limit costs, organizations are setting strict limits about the type and amount of alternative therapy ...

Interest in alternative medicine is growing among healthcare consumers. Health plans and healthcare organizations may be able to improve clinical outcomes and benefit financially by providing patients with access to alternative services. Organizations that can assess their communities' particular needs, draw on interested professional staff to help develop alternative medicine ...

In 1997, the Office of the Inspector General published new procedures that allow requesters to obtain an advisory opinion as to whether a particular arrangement complies with the Federal anti-kickback statute. This process gives healthcare organizations a valuable new means by which to create individualized "safe harbors" for specific business ...

Healthcare construction and design firms are discovering new worlds of opportunity--some domestic, some international and some unconventional. Emergency room renovation and construction work is drawing more attention, as are overseas projects and facilities designed with alternative medicine in mind. The number of projects rose 11% in 1997, but the overall ...

This article describes the work of King's Fund Organisational Audit (KFOA), the UK's premier accreditation and standards based organizational development programme. The article sets the context for the work of organizational audit against the recent change to a Labour government, the increased emphasis on patient/user involvement and the move towards ...

Recent research has demonstrated a clear link between spirituality and health, but it remains a challenge for many organizations to weave spirituality into organizational life and make it an integral component of clinical care. Three dimensions of spirituality work together in healthcare: spiritual well-being of patients and families, spiritual well-being ...

Diversity among healthcare students is increasing as the population of the United States changes in composition. Preparation of the culturally diverse healthcare student presents a challenge for recruitment, education, and retention. The problems of education can be ameliorated by a thorough assessment of the culturally diverse student using the Giger ...

Effective care in hospitals and in the community requires doctors, nurses and other healthcare professionals to work together to achieve the best possible outcomes for patients. In the UK, a shift in emphasis towards a primary care led service and recent changes to the ways in which healthcare is funded ...

Fee-for-service and capitation payment methods create different financial incentives for healthcare providers, and the objectives of utilization management differ under each payment method. These differences can be reconciled, however, by incorporating the strengths of utilization management programs associated with both methods into an overarching program that focuses on the continuum ...

Internet Relay Chat (IRC) program is a medium that can provide low-cost interactive conferencing for healthcare organizations. This article analyzes IRC in the context of the many facets of the Internet, discusses some precautions regarding IRC use, and lists some sources of help for the user. IRC is an extremely ...

As market forces have continued to push healthcare systems toward greater efficiency and lower costs, providers have begun asking for help in balancing ethical concerns. Several organizations are responding by establishing programs to provide guidelines for ethical decisionmaking. Health System Leader talked with these pioneers about their progress, the thinking ...

The risk manager's performance of an educational needs assessment to assist in determining related training and development elements supports a solid, proactive risk management program designed to motivate healthcare professionals. Environmental scanning, needs assessment tool design and development, tool validation, organizational commitment and ethical considerations are examined. A sample needs ...

Netscape and the public Internet have accelerated the acceptance of many different open "Internet standards". Through wide acceptance of its browser, Netscape gave a boost to the Java programming language helping it become truly platform independent. Objects written in Java are ideal building blocks for application components. CORBA gives such ...

Replacing an antiquated computer system with state of the art equipment and software is a lengthy, at times frustrating, and never an easy decision. At Wesley Woods Center on Aging, Atlanta, an integrated provider of healthcare for the elderly affiliated with Emory University, the process consumed more than two and ...

The development and implementation of compliance programs offer HIM professionals perfect opportunities to provide leadership and expertise. HIM professionals should be involved in these processes because the documentation of patient services is an essential part of the investigation and enforcement of compliance. This article outlines the guideposts for developing a ...

Patients delay in responding to stroke as an emergency in part because they have deficient information about the disease and treatment. Healthcare providers may also have a lack of information about stroke assessment and management, which could attribute to delays in patient care. In order to provide early, rapid stroke ...

To keep up with today's constantly changing healthcare needs, organizations are looking for ways to expedite improvements to their systems. Some have adopted one of the nationally recognized methods--blitz improvement teams, the Breakthrough Series, PICOS or interactive accelerated replication. Other organizations are designing their own improvement programs, borrowing concepts from ...

Urinary incontinence is one of the most common problems afflicting older adults and a major contributor to healthcare costs for homebound older individuals. The authors conducted a randomized controlled clinical study examining the effectiveness of biofeedback-assisted pelvic floor muscle training and prompted voiding in treating urinary incontinence in homebound older ...

A study of 11 Academic Health Center Teaching Hospitals (ATHs) in 11 states found that cost reduction programs, internal reorganizations, reengineering, benchmarking, and broadened entrepreneurial activity were prominent among the strategic initiatives reported in dealing with an increasingly turbulent environment. Although none of the ATHs had experienced negative net margins, ...

There have been numerous articles written in detail regarding industrial-based supplier certification programs. These programs generally concentrate on suppliers of raw materials. After reviewing them, it is difficult to visualize how these programs could support the ambulatory or inpatient operations of a healthcare institution. The University of Maryland Medical Center, ...

The authors describe the development of a patient/family education program by a multidisciplinary task force that meets the needs of a culturally diverse population and that complies with current standards of the Joint Commission on Accreditation of Healthcare Organizations. Methods to increase the effectiveness of clinicians as educators are addressed. ...

The evolution of the field of biomedical technology has led to the diffusion of an impressive number of medical devices into healthcare institutions. In this environment, Clinical Engineering Departments (CEDs) are expanding their role in healthcare technology management, by changing their structure and introducing quality systems in order to improve ...

On average, most healthcare facilities are doing less than they should in the areas of source reduction and recycling, and will likely do so until mandated by law. The main reasons for this are ever-tightening healthcare budgets, limited staffing, and the cost of operating recycling programs compared to the cost ...

On its seventy-fifth anniversary, HBR asked five of the business world's most insightful thinkers to comment on the challenges taking shape for executives as they move into the next century. In "The Future That Has Already Happened," Peter Drucker examines the effects of the increasing underpopulation of the world's developed ...

As religious sponsors increasingly relinquished their CEO positions throughout the 1980s and early 1990s, they established mission integration positions-staffed primarily by women religious-to help ensure the Catholic identity of their facilities. Now that role, too, is undergoing change as sponsors seek to empower the laity in their organizations with responsibility ...

A key element of the 1991 United States Sentencing Commission's guidelines, used in sentencing corporations and business convicted of Federal crimes, is the provision of leniency for organizations that adopt effective corporate compliance programs. Given the increased scrutiny of healthcare organizations by Federal Investigators, the incentive to adopt corporate compliance ...

In recent years the U.S. government has increased its fraud and abuse investigations in all sectors of the healthcare community. Healthcare providers that are successfully prosecuted may be excluded from the Medicare programs and are liable for monetary penalties. The best course of action is for providers to have a ...

The healthcare environment is a dynamic environment and one of the most difficult environments in which to function--let alone prosper. Healthcare requires detailed attention to business disciplines. This article is part of a series discussing the need, components, and skills required to enhance the creation and perception of value in ...

Organizations are bringing disparate groups together to cut costs and integrate services. Ironically, they are finding the very people they look to for success are those who were used to working independently. At a breakout session of the Congress of Integrated Delivery Systems held in Dallas in March, 1997, participants ...

Healthcare organizations are being challenged to find ways to leverage improvement efforts. Collaboration offers an avenue for working together toward a common goal. Healthcare leaders can initiate collaborative projects to analyze common clinical problems and to share best practices. This article describes how a Catholic healthcare system successfully initiated a ...

The new joint Commission on Accreditation of Healthcare Organizations survey requirements make the preparation process more challenging than ever before. In today's competitive healthcare environment, a successful survey is imperative. The authors discuss multiple and innovative ways to prepare for a survey under the 1996 guidelines. Specific examples of processes ...

Massive reorganization in the healthcare industry has created a new series of high-level, multi-talented managers. Many have risen from the ashes of change, taking new positions and shifting from positions with a single focus to managing complex administrative matrices. Seven who have been through the reorganization process comment on where ...

It is well-documented that the resources available to meet the healthcare needs of Americans are limited. Consequently, it is inevitable that limits will have to be set regarding how much can be spent. While such a proposal is obviously controversial, limits are already in place in many areas of healthcare. ...

Occupational exposures to blood-borne pathogens occur regularly in diverse settings and involve multiple groups of healthcare workers. Current compliance of healthcare workers with behavioral controls is poor, and additional engineering and work-practice controls for exposure prevention are inadequate and/or underutilized. Barriers to effective postexposure management include deficient knowledge and fear ...

Provider performance measurement systems come in a variety of approaches, but they all target the daunting management frontier of clinical results. The Joint Commission on Accreditation of Healthcare Organizations has bumped up the visibility of such systems by launching Oryx, a program that will make performance measurement an integral aspect ...

Professional organizations offer healthcare quality management professionals a myriad of opportunities for professional development. Healthcare professionals taking a break from their careers can take advantage of these and other opportunities to build a program for professional development that is not job-specific, with a focus on reentry into the workforce. Options ...

Certain common steps in the planning process are necessary to ensure the success of any construction project in a diagnostic imaging department. Determining the need for the project, analyzing requirements for equipment, space and personnel, and budgeting for the project are necessary steps. They are followed by scheduling and designing ...

The "change" train is headed down the track. You can be on board the train, be under it, or be left at the station, but this train will continue with or without you. Patients, families and healthcare professionals believe that healthcare is delivered in a fragmented fashion. Our silos--our departments, ...

The market turbulence of recent years has made healthcare leaders particularly open to the management tool called "reengineering." Unfortunately, many such efforts fail because they do not go beyond simple cost cutting to create processes that, by adding value to product, attract customers. A healthcare organization planning reengineering should: Find ...