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Organization and information at the ...

Hughes, James J.

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Organization and information at the bed-side: The experience of the medical division of labor by university hospital's inpatients. (Volumes I and II).

紀錄類型:	書目-語言資料,印刷品 : Monograph/item
正題名/作者:	Organization and information at the bed-side: The experience of the medical division of labor by university hospital's inpatients. (Volumes I and II)./
作者:	Hughes, James J.
面頁冊數:	315 p.
附註:	Chair: Edward Laumann.
Contained By:	Dissertation Abstracts International56-03A.
標題:	Business Administration, Management. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=9523502

Organization and information at the bed-side: The experience of the medical division of labor by university hospital's inpatients. (Volumes I and II).
Hughes, James J.

Organization and information at the bed-side: The experience of the medical division of labor by university hospital's inpatients. (Volumes I and II). - 315 p.

Chair: Edward Laumann.

Thesis (Ph.D.)--The University of Chicago, 1995.

Nursing culture also appears to mediate expansion of work roles: nursing schools are correlated with expanded nursing roles, while nursing unions are related with more limited nursing roles.Subjects--Topical Terms:

626628
Business Administration, Management.

Organization and information at the bed-side: The experience of the medical division of labor by university hospital's inpatients. (Volumes I and II).
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245 1 0 $a Organization and information at the bed-side: The experience of the medical division of labor by university hospital's inpatients. (Volumes I and II).
300 $a 315 p.
500 $a Chair: Edward Laumann.
500 $a Source: Dissertation Abstracts International, Volume: 56-03, Section: A, page: 1146.
502 $a Thesis (Ph.D.)--The University of Chicago, 1995.
520 $a Nursing culture also appears to mediate expansion of work roles: nursing schools are correlated with expanded nursing roles, while nursing unions are related with more limited nursing roles.
520 $a In this study, I test for evidence of, and predictors of, nurse substitution for physicians in patient counseling, education and case-management. I review the doctor-patient relationship, doctor-hospital relationship, and the doctor-nurse relationships in the context of academic medical centers strategically adapting to the growth of managed health care. I propose that the division of labor between doctors and nurses will develop curvilinearly with managed care growth and hospital administrative rationalization.
520 $a Three years of patient surveys (N = 50,000) in 45 university hospitals provide parallel measures of reported amounts of patient care performed by nurses and doctors, and the percent of patients reporting they had a physician case-manager. To complement this quantitative analysis, I conducted three case studies in academic medical centers with widely varying characteristics, interviewing administrators, physicians and nurses in these academic medical centers about the key concepts and dynamics of this study.
520 $a The data reveal that managed care growth in local markets is related to variations in the inpatient experience of doctors and nurses, and that staffing ratios appear to be a key intermediate variable between managed care growth and the reported division of labor. The more nurses per bed, the more patients perceive that nurses do, and the less they say doctors do; the more housestaff per bed, the less nurses and doctors are perceived to do.
520 $a "Institutional characteristics," specifically state-ownership, university-ownership, prestige, payor case-mix and hospital size are correlated to the patients' reports of labor, and appear to mediate the relationship of managed care and staffing ratios. On the other hand, "strategic adaptations," specifically Total Quality Management (TQM), hospital automation, case-management nursing, and the internal segregation of the indigent, are not correlated to market evolution, the patients' experience of labor, or the staffing ratios.
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791 $a Ph.D.
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