Total quality in health care

Quality is at the top of American consumers' demand list, and consequently American manufacturing companies have been forced to assign priority to the development of high-quality products. To improve the quality of what they offer, many manufacturers use the management philosophy known as total quality management (TQM), and now the service sector is following in their footsteps. The health care industry is a good example of a service industry that can benefit greatly from TQM, and it is the purpose of this article to show how a health care provider can implement TQM and evaluate its effects.     

Case management: quality care today

The literature demonstrates that the concept of case management offers quality, patient-centered care. Case management promotes the wise utilization of resources and has economic advantages. The benefits of case management are widespread. Everyone concerned with patient care is affected positively, including the patient, family, caregivers, and the facility itself. The benefits far outweigh the potential problems outlined in the literature, and these problems can be eliminated with proper education. The movement toward the use of case management makes good business sense. It will continue.     

Health care reform and the hospital supply chain

With health care reform, hospitals will be differentiated in the marketplace by how well they manage the costs of services. Because products will be market priced, hospital materiel managers will have to minimize all other related acquisition costs. The key opportunities will be in changing processes to eliminate non-value added administrative, supply chain, and process activities and their attendant costs.     

From chaos to order: health care quality in context

Quality underlies diverse efforts to repair the troubled health care system, yet the many abstract definitions offered are not particularly useful. A better approach is to evaluate quality in an applied or situational context. This article offers six propositions that establish such a context and explain why the current health care environment is so volatile. Some parallels between health care and the emerging field of science called chaos theory are drawn as a possible future basis for recognizing order in the health care system.     

Ten years after: Interference of hospital slack in process performance benefits of quality practices

We investigate the long-term relationship between an organization's quality management practices and process-level performance. Further, we examine whether availability of organizational slack over the study interval interferes with the relationship between quality practices and process performance. Organizational slack consists of the available and accessible resources in an organization; we focus here on unabsorbed slack in the form of financial resources. We investigate the quality practices of U.S. general acute care hospitals, measured by their depth of implementation of practices characterizing a total quality management system, and use them to predict process performance related to four medical conditions. Analysis reveals differing effects that are dependent on hospital slack conditions. In hospitals with high slack, quality practices significantly predict three of four studied process performance measures. In contrast, in hospitals with low slack, quality practices predict only one of the four process performance measures, while other factors outweigh the effects of quality practices. This study lends support to management taking a long-term perspective related to implementation of quality management systems, and highlights the relevance of slack conditions in garnering the benefits of such systems.     

The development of the Indonesian labour movement

The paper examines the development of the labour movement in Indonesia in the context of trade unionism elsewhere in the area of the Asia-Pacific region. The Indonesian labour movement is shown to exhibit a dual nature; consisting of an official sponsored and legal form of unionism, and an independent, quasi-illegal form of unionism. The two have a conflicting yet symbiotic relationship, where the state plays a very significant role in determining the parameters for behaviour in industrial relations. Although the form of state intervention in Indonesia may be different from state intervention in other comparable countries, its aims are broadly similar. In this context the Indonesian independent labour movement is shown to have had some measure of success in resisting the restrictions placed upon it in its attempt to advance its members' terms and conditions of employment.     

城乡融合发展中的农村人口流动

随着乡村中由人口、户籍与土地所形成的三位一体结构关系逐渐被打破,农村人口流动在其嵌入性制度安排的变迁与结构性约束弱化下呈现出新特征,出现一些新问题,对城乡融合发展下农村流动人口的治理提出了新要求。新形势下,农村流动人口的治理应着重保障流动人口主观能动性和自主选择权,切实提高其自我赋能发展的效用水平,实现人口流动的内生性发展和自由全面发展,推动城乡融合战略迈向新阶段。     

Incorporating quality into the measurement of hospital efficiency: a double DEA approach

This paper uses “double DEA” to assess how accounting for quality influences DEA technical efficiency scores of a sample of 1,074 US hospitals. In the first use of DEA, quality indices are estimated using a variety of process and outcome measures of quality. In the second use of DEA, technical efficiency is assessed while controlling for quality. A variety of DEA quality indices and a DEA variety of efficiency models are compared to determine how the treatment of quality influences findings regarding technical efficiency. Controlling for efficiency does matter, with outcome measures having an apparently greater impact than process measures. Given the call for improved quality and better cost containment, controlling for quality is an important contribution to efficiency analysis.     

医院经营管理“1+X+Y”

<正>在医院物业管理的实践中,武汉同济物业越来越深刻地体验到,企业的单打独斗难以发展,强强联合方能抱团取暖。早在上世纪90年代,武汉同济物业管理有限公司(下称武汉同济物业)就瞄准医院后勤管理市场潜力,积极探索医院物业经营管理,从单一的保洁外包服务开始,逐步拓展服务项目,不断增加医院物业经营管理市场的规模和容量,服务产品由保洁、秩序维护、保修、保绿等基本物业服务拓展到电梯操作、水电工程运行维修、导医陪护、物流、餐饮、支     

现代物流业是经济运行的加速器

随着全球经济一体化的迅猛发展,现代经济社会正在由工业型经济向服务型经济迅速转变。在这个过程中,现代物流业的出现是发展的必然趋势。现代物流业推动着经济的发展,是经济运行的加速器。文中对这种加速器的作用进行了详细的分析。     

The mid-life crisis of the American labor movement

Although the US labor movement remains an important part of the nation's organized economic and political life it is now struggling to reverse its decline in power and membership. In this article the author identifies factors explaining this decline and its implications for American labor. This contribution continues the debate begun by Michael Piore in Vol 17 No 3 Autumn 1986.     

提高城市化质量重在改革

中国的城市化发展取得了世人瞩目的成就,但在城市化速度不断提升的同时,质量不高的矛盾日益显露出来。当前,提高城市化质量迫在眉睫,根本出路在于改革。其焦点集中于三个问题:矛盾速度规模与质量;溯源政府与市场;改革功能回归与破除二元结构。