Strategic re-design of team-based patient-focused health care services.

PURPOSE: This paper proposes an organizational change process to prepare physicians and other health professionals for their new roles in patient-centered medical homes (PCMHs). It provides physician-centered tools, models, concepts, and the language to implement transformational patient-centered medical care. DESIGN/METHODOLOGY/APPROACH: To improve care delivery, quality, and patient engagement, a systems approach to care is required. This paper examines a systems approach to patient care where all inputs that influence patient interactions and participation are considered in the design of health care delivery and follow-up treatment plans. Applying systems thinking, organizational change models, and team-building, we have examined the continuum of this change process from ideation through the diffusion of new methods and behaviors. FINDINGS: PCMHs make compelling business sense. Studies have shown that the PCMH improves patient satisfaction, clinical outcomes and reduces underuse and overuse of medical services. Patient-centered care necessitates transitioning from an adversarial to a collaborative culture. It is a transformation process predicated on strong leadership able to align an organization toward a vision of patient-centered care, creating a collaborative culture committed to health-goal achievement. ORIGINALITY/VALUE: This paper proposes that the PCMH is a rigorous team-building transformational organizational change, a radical departure from the current hierarchical, silo-oriented, medical practice model. It requires that participants within and across health care organizations learn new skills and behaviors to achieve the anticipated quality and efficiency improvements. It is an innovative health care organization model of the future whose success is premised on teams supplanting the individual as the building block and unit of health care performance.

Fast saturable absorption and 10 GHz wavelength conversion in Al-quaternary multiple quantum wells.

We measured the absorption recovery times in reverse biased AlInGaAs multiple quantum well material designed to emit at around 1.5 µm wavelength. Absorption recovery times as low as 2.5 ps were found at -4V bias, with values below 5 ps consistently found for biases above 3 V. The short absorption recovery times obtained under reverse bias were confirmed by using cross-absorption modulation in the material to demonstrate wavelength conversion of a 10 GHz pulse train, showing both up and down conversion of the incident pulses.

Resonant tuning fork detector for THz radiation.

THz-sensing is an emerging technology that would be advantageous for a variety of applications in industry, biology, biochemistry and security, if small and convenient to use sources and detectors would be readily available. However, most of them are bulky, complicate to operate, and need cryogenic cooling. Here we present a new detection scheme that is versatile enough to detect electro-magnetic radiation within the whole spectrum, can be easily applied to the THz-range, and operates at room temperature. The mechanism is based on the resonant excitation of a quartz tuning fork.