Ours is, at its heart, a profession of service predicated on mutual trust. All too often policies aimed at resolving a particular problem in health care are inadequate not because they fail at what they were intended to do, but rather because of the unintended consequences, both direct and indirect, that are inevitable in complex systems where competing interests preclude unity of purpose. Ulti...

BACKGROUND Incidents and quality problems are a prime cause why health care leaders are calling to redesign health care delivery. One of the concepts used is lean thinking. Yet, lean often leads to resistance. Also, there is a lack of high quality evidence supporting lean premises. In this paper, we present an overview of lean thinking and its application to health care. DEVELOPMENT, THEORY A...

In the past decade, the teaching of surgery in the undergraduate curriculum has undergone considerable changes in quantity, mode and method of delivery. This is a result of the radical reforms of higher education, the health service and the undergraduate medical curriculum. These reforms are often interrelated and are occurring in conjunction with major changes in healthcare delivery. In this a...

abstract background: client satisfaction is an important indicator for assessment of the quality of care provided. detecting patients dissatisfaction and trying to find the most effective and costly services is the basic way for improvement of service quality. the purpose of this study was to determine the satisfaction level of women in the maternity care centers (hospitals) of lorestan univers...

BACKGROUND There is significant need for physician innovation and leadership in health care as we adapt to bundled payment models of health care delivery. METHODS We engaged a collective of 16 different private company orthopedic physician groups to apply to become episode initiators under BPCI models 2 and 3. The application process itself provided historical cost data, enabling each group t...

Inequalities in health and health care are caused by different factors. Measuring "unfair" inequalities implies that a distinction is introduced between causal variables leading to ethically legitimate inequalities and causal variables leading to ethically illegitimate inequalities. An example of the former could be life-style choices, an example of the latter is social background. We show how ...

LEATT, PINK AND GUERRIERE advocate creating integrated healthcare delivery systems in Canada, founded upon primary healthcare. They argue that integration involves organizational structures, financial incentives and information systems. They point to the need to focus on the types of integration occurring at different levels within a system of healthcare and the need to examine the performance ...

Despite a significant global investment in continuing professional education (CPE) in nursing and health care (Jordan, 2000) and a lack of empirical evidence of its effectiveness (Clark, 2005; Attree, 2006), it has nevertheless continued to be a focus of UK government lifelong learning strategies. For example, the Department of Health in England asserted that ‘Every aspect of healthcare deliver...

Scope and Standards of Practice) is a vital resource for every wound, ostomy and continence (WOC) nurse (WOCN, 2010). Recognition as a specialty nursing practice validates the contributions that WOC nursing brings to the health care delivery system in the United States. Accessible to all members of the health care community, the WOCN Scope and Standards of Practice is a reference that documents...