Using personal digital assistants to enhance outcomes.

Personal digital assistants (PDA) are attaining increased functionality in the medical community. Physicians can use PDAs to track patient information (namely, outcome parameters and medication errors). ePhysician's ePad is demonstrated here as a successful technology for tracking and analyzing both patient and practice data.

Understanding and managing integrated delivery networks.

This article presents a guide for "managing managed care." To be successful in the transition from the fee-for-service payment system to capitation, the manager first needs to understand the five roles (the players), and their integration. The five roles are the employer, the insurer, the primary care physician, the specialist physician, and the hospital. Once a health care manager understands the dynamics between these roles and their involvement in operations such as finance, contracting, and utilization review, managed care can then be managed. This guide is also beneficial to managers for understanding how to work with someone in another role.

Physician practice reengineering as attributed to managed care contracting.

With capitation presenting an economically viable alternative to traditional fee-for-service plans, physicians must come to grips with the finer points of contracting with MCOs. Physicians and their practices need to consider not only the reimbursement process but other factors that will determine the success or failure of the contract.

Managing data in a managed care environment.

Since managed care differs from fee-for-service systems, practices should use this environment as an opportunity to examine their present data collection processes and think of the best way to integrate them into their daily operations. The power of marketing, financial, and quality-management data will be realized when managed care contract negotiations arise and when practices operate from a position of financial strength.

Using data to reduce employee turnover.

Turnover in the health care industry is a major detriment to the delivery of cost-efficient, quality care. But by analyzing specific data on an ongoing basis, a manager can determine the rationale for turnover and implement measures to improve it. This article examines the issue of turnover based on three years of data from a medium-sized, long-term care facility. Specifically it will focus on what data were examined and what they revealed, how the organization responded to the data, and what was resultant to the organization. Managers can replicate these processes for improvement in their facility.

The importance of budgeting with nontraditional staffing patterns.

Are nontraditional staffing patterns cost effective? The advantages qualitatively seem to outweigh the disadvantages, but the numbers, when examined quickly, present an opposing view. Each institution is individual and thus the hospital administrators must assess the real reasons for their staffing and budgetary problems. Nontraditional staffing patterns have been shown to decrease the use and cost of agency personnel; therefore, the schedules are cost effective if a hospital frequently utilizes these services. A blanket statement cannot be made for all institutions. Another fact attributed to these innovative staffing patterns, the decrease in the turnover rate, needs to be further assessed. For although hospital employees in general considered inflexible scheduling a common reason for dissatisfaction, each institution must examine itself before changing schedules. For some hospitals, turnover can be decreased by using other benefits. An example taken from a New York City hospital that had a moderately high turnover rate found turnover rate due to inaccessibility to public transportation. A change with the scheduling would not have greatly decreased the turnover rate, but a shuttle service from the major subway and bus stations did. Thus the point is that nontraditional staffing patterns may not appear cost effective upon first looking at the numbers, but after an individual assessment of each institution the real need for change in scheduling patterns can be determined. Also benefit percentages and use of overtime must be calculated carefully. Last, with the present and projected hospital personnel shortages, cost effectiveness may sometimes be overlooked in order to meet staffing requirements. This fact exemplifies the need for hospital administrators to acquire budgeting knowledge in order to assess cost effectiveness and prevent hospital losses.