Retirements at risk: employees lack a comprehensive, realistic view of resources and needs

Employees who are following conventional retirement-planning advice will be in for a rude awakening as they approach retirement and discover that they can't afford to retire just yet or are likely to outlive their retirement funds. The article discusses how we have arrived at this point, what the implications are, and what both employers and employees can do to remedy the situation.     

The health care employee with an "attitude"

Health care managers may encounter employees who seem to have an "attitude." The employee may have a pattern of ingrained, inflexible, maladaptive responses to anxiety indicative of a personality disorder. When the employee has a pervasive sense of self-importance, is preoccupied with fantasies of unlimited success, and requires excessive admiration, a narcissistic personality disorder or traits may be present. Although this individual can cause havoc in the workplace, an alert manager who uses specific management techniques can enable the narcissistic employee to be productive and to be an asset in the work setting. This article provides a look at the etiology, symptoms, and management of the narcissistic employee. When the employee is willing to be assisted, the behavior can be modified and the necessary level of adaptation can occur. This can result in a more productive, less chaotic workplace.     

Outcomes from use of an evidence-based practice guideline

The aim of evidence-based guidelines is primarily to improve patient outcomes without adding to the existing cost of care because both payers and policymakers want to identify health care costs that do not result in benefit to the patient. The purpose of the reported project was to generate a practice guideline for the treatment of uncomplicated acute cystitis in a female population, to determine the extent to which the guideline would be used by providers and to measure the cost and quality of outcomes from its use. A retrospective chart review was used to gather pre-guideline practice and cost data. Measurements included the type, frequency, and duration of antibiotic therapy and the use of urine cultures and both complications and routine followup visits. The implementation of an outpatient practice guideline resulted in a significant change in antibiotic prescribing and a trend toward a change in ordering cultures and clinic followup. There was also a significant decrease in treatment costs.