Improving patient satisfaction with waiting time

Waiting times are a significant component of patient satisfaction. A patient satisfaction survey performed in the author's health center showed that students rated waiting time lowest of the listed categories--A ratings of 58% overall, 63% for scheduled appointments, and 41% for the walk-in clinic. The center used a quality improvement process and instituted schedule and reception area changes. A follow-up survey 3 months later showed A ratings of 73% overall, 81% for scheduled appointments, and 56% for the walk-in clinic. A repeat survey 4 months later showed A satisfaction ratings of 79% overall, 85% for scheduled appointments, and 68% for the walk-in clinic. The author discusses strategies the center used to improve patient satisfaction with waiting time.     

Correspondence

Abstract

Ralph Nader Presents Civics for Democracy, A Journey for Teachers and Students, by Katherine Isaac. A project of the Center for Study of Responsive Law and Essential Information. Washington, DC: Essential Books, 1992. 390 pages. Paperbound. ISBN 0-936758-32-5. Reviewed by Gregory A. Levitt.     

Delabeling and relabeling in Gamblers Anonymous: Problems with transferring the Alcoholics Anonymous paradigm

Exploratory data from both structured and unstructured interviews with members of Alcoholics Anonymous and Gamblers Anonymous, as well as additional data from previous observations, suggest that the recovery rate of A.A. is higher than that of G.A.. Since the programs are virtually the same an examination of the social context of the labeling process reveals that the more readily available use of the medical model for both the alcoholic and the significant others of the alcoholic are likely significant differences between the compulsive gambler and the compulsive drinker.An embryonic version of this paper was presented at the Second Annual Conference on Gambling, Lake Tahoe, August 1975. The authors thank Henry Lesieur, Robert Custer, and the anonymous reviewers ofThe Journal of Gambling Behavior for their comments and suggestions. We give special thanks to Dan, Howie, Jeanne, Berdell, Barbara, John, Swede, Happy Jack, Nancy, Skip, and many other anonymous members of G.A. and A.A. for their help and cooperation in this study.     

Book Reviews

Book Reviewed in this Article:
Adamson, William C. & Adamson, Katherine K. A handbook for specific learning disabilities .
Bateson, Gregory. Mind and nature: A necessary unity .
Broderick, Carlfred. Couples: How to confront problems and maintain relationships .
Cameron-Bandler, Leslie. They lived happily ever after .
Douthwaite, Graham. Unmarried couples and the law .
Dubbert, Joe L. A man's place: Masculinity in transition .
Fabe, Marilyn & Wikler, Norma. Up against the clock .
Fersch, Ellsworth A. Law, Psychology and the Courts .
Finklehor, David. Sexually Victimized Children .
Fleming, Jennifer Baker. Stopping Wife Abuse: A Guide to the Emotional, Psychological, and Legal Implications for the Abused Woman and Those Helping Her .
Gordon, Sol. The new you: A book of life .
Justice, Blair & Justice, Rita. The broken taboo .
Puryear, Douglas A. Helping People in Crisis .
Rabkin, Brenda. Growing up dead: A hard look at why adolescents commit suicide .
Saul, Leon J. The childhood emotional pattern and maturity .     

A‐Way Express Courier

This article examines the social return on investment (SROI) of A‐Way Express Courier for the major stakeholder group of the organization, its employees. Specifically, it explores the mental health, employment, and standard of living outcomes that A‐Way provides for the employees who are consumer/survivors of the mental health system. Overall, the impacts of the organization contributed significantly to improvements in the health and quality of life of the employees. They also translate into economic benefits for the employees and the community. Because of A‐Way's roots in the consumer/survivor movement of the 1970s, the article suggests that positive psychology could be a valuable framework with which to explain A‐Way's impact.     

Spousal Roles on Motivations for Entrepreneurship: A Qualitative Study in New Zealand

Little is known about the role the spouse plays in an entrepreneur’s motivations for entrepreneurship. A gender comparative qualitative study is presented, based on interviews with 68 entrepreneurs (45 men and 23 women) in New Zealand. A continuum of spousal support is described—those whose spouses are co-founders, supportive spouses, and unsupportive/ambivalent spouses. Findings show that women and men tend to have different expectations of their spouse when contemplating starting a business. A woman looks to her husband for business advice, for support, and encouragement and considers the effects that starting a business may have on her spouse. A man tends to assume support is forthcoming, and some men start businesses without explicit spousal support. Contributions to theories of family business are made.     

In the states

The Coalition of Medication‐Assisted Treatment Providers and Advocates of New York State (COMPA) issued support and further encouragement to New York legislators last week for the passage of a package of bills to combat the opioid addiction epidemic by increasing access to medication‐assisted treatment (MAT). “We applaud the Senate and Assembly passing A2904 Quart/S4808 Harckham, which eliminates prior authorizations for all MAT medications for commercial insurance policies,” said Allegra Schorr, president of COMPA. “This will increase access to treatment and reduce barriers for delivering care.” She added, “We urge the passage of A7246 Rosenthal/S5935 Harckham, which provides critical access to all medications to vulnerable Medicaid populations during this opioid crisis. Moreover, in order to ensure that all New Yorkers can access care, we urge the state to implement the policy outlined in A833 Rosenthal/S2161 Bailey that would establish a patient‐centered MAT program for incarcerated individuals in jails and prisons, and COMPA supports A972A Rosenthal/S4643A Harckham, which would prohibit copays during the course of treatment at an opioid treatment program.” COMPA is a nonprofit membership organization dedicated to treating addiction through the use of pharmacotherapy as a part of a comprehensive biopsychosocial approach to treatment. COMPA's program members include both opioid treatment programs and office‐based opioid treatment providers. COMPA is the New York state member program of the American Association for the Treatment of Opioid Dependence.     

The selective adaptation of the alcoholics anonymous program by Gamblers Anonymous

This paper is largely based on a year long observation study of Gamblers Anonymous and Alcoholics Anonymous meetings in northern California. The paper argues, contrary to popular assumption, that Gamblers Anonymous is significantly different from Alcoholics Anonymous. Differences, in members' consciousness for example, are discussed. The paper contends that although there is some12 step consciousness in G.A., the dominant consciousness ispage 17 consciousness. The significant differences are attributed to the selective adaptation of the Alcoholics Anonymous program. Several consequences of these differences, such as the central role of a language of the self in A.A. and not in G.A., are highlighted.This research was supported by NIAAA post-doctoral grant, 2 T32 AA07240-11, at the Alcohol Research Group, Berkeley, California. I would like to thank everyone at ARG for the wonderfully supportive and intellectually stimulating atmosphere at ARG. I would like to thank especially Mary Phillips, Ron Roizen, Kim Bloomfield, Robin Room, Mike Hilton, Laura Schmidt, John Rumbarger and David Newmark for listening patiently to the unfolding story. I would also like to thank Rachel Volberg and Richard Rosenthal, M.D. for comments on an earlier draft. Comments from the anonymous reviewers and the editor ofJournal of Gambling Studies were also quite useful. Most of all, though, I would like to thank the anonymous members of A.A. and G.A. I, however, take responsibility for the arguments advanced in the paper. This paper is a revision of one presented at theEighth International Conference on Risk and Gambling in London, England, August, 1990.     

Accountability Agreements in Ontario Hospitals: Are They Fair?

Governments can be accountable for improving the fairness oftheir priority setting through enhanced transparency and stakeholderengagement. A case analysis is conducted of priority settingin a government health care context in Ontario, Canada, assessinghow implementation of hospital accountability agreements meetsthe conditions of a leading international ethical frameworkfor priority setting, "accountability for reasonableness" (A4R).Hospital accountability agreements provide a mechanism for governmentto ensure that public funding achieves desired performance inhospitals. A key goal of priority setting is fairness. A4R linkspriority setting, legitimacy, and fairness to theories of democraticdeliberation, making a claim for fairness if the four conditionsof relevance, publicity, revision/appeals, and enforcement aresatisfied. Regarding the relevance condition, this analysissuggests that government only partially met the relevance conditionproviding limited stakeholder engagement but with evidence ofpolicy learning and movement toward the establishment of inclusivestakeholder arrangements. Evidence suggests that governmenteventually progressed toward meeting the publicity condition.Government only partially met the revision/appeals conditionand did not meet the enforcement condition, as the other conditionswere only partially met. It is our view that regional governancestructures in Ontario (i.e., Local Health Integration Networksor LHINs) provide an opportunity for the province to improvethe fairness of their accountability agreement processes throughenhancing transparency and stakeholder engagement. More broadly,this case study provides a guide for government to enhance accountabilityby focusing on A4R to improve the fairness of its priority setting.     

Sexual compliance: gender,motivational, and relationship perspectives

This paper provides a systematic review of research on sexual compliance in heterosexual relationships. Three perspectives shed light on which individuals are the most likely to comply with a sexually interested partner's desire for sex and why. A gender perspective highlights the common male-female asymmetry in compliant sexual behavior and identifies factors that contribute to women's greater likelihood of being the sexually compliant partner. A motivational perspective distinguishes between approach and avoidance motives for compliance and considers the possible consequences of these motives for emotional reactions, sexual risk taking, and sexual violence. A relationship maintenance perspective views sexual compliance as illustrative of broader patterns of sacrifice in committed relationships. Each perspective suggests important new directions for empirical research.     

Models for theory-based M.A. and Ph.D. programs

In response to growing demand for advanced public relations education, this article suggests integrated models of outcomes, curriculum, pedagogy and assessment for theory-based M.A. and Ph.D. programs. Because public relations has commonly been approached as a professional rather than theoretical subject, this article begins with a short explanation of why theoretical education is becoming an increasingly important part of public relations education. It then reports the integration team's recommendations for a flexible educational framework allowing for practical constraints and providing for institutional individuality at both the M.A. and Ph.D. levels. Assumptions underlying efforts of the team are outlined and specifics that might be included in M.A. and Ph.D. programs are presented with rationales for each.     

中国企业海外并购中知识产权的风险识别

知识产权作为企业抢占竞争优势的关键性资源,已经成为中国企业开展海外并购活动的重要目的。然而,涉及知识产权的海外并购是一个十分复杂且高风险的过程,即便是大型跨国公司也都曾出现过重大失误。基于知识产权获取的并购活动包括并购前、并购中和并购后3个阶段,对3个阶段中知识产权并购风险的准确甄别,将有助于企业保护自身权益,有效实现知识产权转移和价值创造。     

BOOK REVIEWS

Book reviewed in this article:
Commitee on the Family of the Group for the Advancement of Psychiatry. The family, the patient, and the psychiatric hospital: Toward a new model .
Segal, Lynn. The dream of reality: Heinz von Foerster's constructivism .
Combrinck-Graham, Lee (Vol. Ed.). Treating young children in family therapy
Hafner, R. Julian. Marriage and mental illness: A sex-roles perspective .
Schultz, Stephen J. Family systems therapy: An integration .
Nerin, William F. Family reconstruction: Long day's journey into light .
Wallas, Lee. Stories for the third ear .
Beavers, W. Robert. Successful marriage: A family systems approach to couples therapy .
Bornstein, Philip H. & Bornstein, Marcy T. Marital therapy: A behavioral-communications approach .
Slipp, Samuel. Object relations: A dynamic bridge between individual and family treatment .     

In Search of Modifiable Risk and Protective Factors for Teen Dating Violence

The present research explores the additive and interactive effects of anger or hostility (A/H), acceptance of violence (AoV), and constructive conflict resolution strategies (CRS) on the perpetration of physical and sexual teen dating violence (TDV). Adolescents completed surveys assessing physical and sexual TDV perpetration, A/H, AoV, and positive CRS. While the findings require replication with longitudinal data, the results suggest that developing interventions to modify AoV and A/H may have the potential to prevent instances of TDV perpetration among both boys and girls. The results for CRS were mixed and necessitate further exploration. These cross‐sectional data provide insight into potentially fruitful areas of exploration for the development and tailoring of prevention strategies for teens at risk for physical and sexual TDV perpetration.     

Group Therapy for Emotional Dysregulation: Treatment for Adolescents and Their Parents

A dialectical behaviour therapy (DBT) group has been conducted for a number of years at a public outpatient clinic for adolescents suffering with emotional regulation difficulties and their families. A detailed account of the rationale, design, and content of both the adolescent and parent groups are provided. Data from these groups adds to the limited evidence regarding the efficacy of such groups. A retrospective analysis of changes in the adolescent participants’ emotional dysregulation, depression, anxiety and stress, following their participation in the group (N?=?12) was conducted. Several substantial improvements were noted across the measures of psychopathology, following the completion of the group. These findings support the teaching of DBT skills to adolescents and their families, with some modifications being appropriate for their application to this population. Future avenues for research stemming from the group program are also discussed.     

Three-year follow-up of Drug Abuse Resistance Education (D.A.R.E.)

The long-term effectiveness of D.A.R.E. was assessed by contrasting 9th-grade students who received the program in the 6th grade with others who did not receive the program. Of 38 elementary schools eligible for D.A.R.E. programs, 21 received the program and 17 did not. A follow-up survey assessed central D.A.R.E. concepts such as self-esteem, resistance to peer pressure, delay of experimentation with drugs, and drug use. Employing latent variables to represent the concepts, no significant differences were found between D.A.R.E. participants and controls. The authors discuss attenuation of effects and the generally antidrug context of schools.     

Brief psychotherapy with children and adolescents: A developmental perspective

There are factors inherent in the developmental process that make brief therapy a particularly viable intervention for infants, children, adolescents and young adults. A more explicit examination of developmental principles can provide a foundation for better understanding the potential and the efficacy of brief psychotherapy for patients in these age ranges. A case example illustrates these ideas.Clinical Social Worker, Student Counseling and Resource Service, University of Chicago; and in private practice in Chicago.     

BOOK REVIEWS

Book reviewed in this article:
Laird, J., & Green, R. (Eds.). (1996). Lesbians and gays in couples and families: A handbook for therapists.
Levant, R., & Pollack, W. (Eds.). (1995). A new psychology of men.
Combrinkc-Graham, L. (Ed.) (1995). Children in Families at risk: Maintaining the connections.
Dishion, T. J., & Ptterson, S. G. (1996). Preventive Parenting with love, Encouragement, and limits: The preschool years.
Quick, E. E. (1996). Doing what works in brief therapy: A strategic solution focused approach.
Chevalier, A. J. (1995). On the client's path: A manual for the practice o solution-focused therapy.
Carlson, J., Sperry, L., & Lewis, J. A. (1997). family Therapy: Ensuring treatment eficacy.
Rosen, R., & Leiblum, S. (Eds.) (1995). Case studies in sex therapy.
Fenell, D., & Weinhold, B. (1997). Counseling families; An introduction to marriage and family therapy
Hofman, S., Gafni, S., & Laub, B. (Eds.). (1995). Cotherapy with individuals, amilies, and groups.
Bloomquist, M. L. (1996). Skills training for children with behavior disorders: A parent and therapist guidebook.
GENERAL INTEREST BOOKS: Weakland, J. H., & Ray, W. A. (Eds.). (1995). Propagations: Theirty years o inluence from the Mental Research Institute.
GENERAL INTEREST BOOKS: Anderson, C., & Stewart, S., With Dimidjian, S. (1995). Flying solo: single women in midlife.     

The utilisation of the bridging technique during therapy to overcome contact-making barriers in adolescents

This article focuses on the utilisation of a bridging technique to overcome contact-making barriers in adolescents. Interruptions or contact boundary disturbances block contact making, as it becomes fixed and prevents the natural and healthy process of organismic self-regulation. A combination of quantitative and qualitative approaches were followed and a single system experimental design, A–B–A–A, was applied in the original study. Qualitative data were collected by means of semi-structured interviews with parents and teachers, and therapeutic intervention with adolescents. Quantitative data were collected from pre- post- and follow-up-intervention assessments, during which the bridging technique was utilised. Fourteen adolescent participants were selected by school teachers and therapists from three different schools, with their parents and teachers: a mainstream school for high-functioning children, a school for children with learning disabilities and a school for children with intellectual disabilities. These adolescents presented behavioural symptoms: aggression, self-mutilation, personal emotional symptoms: depression, suicidal tendencies, as well as contact-making disturbances. The findings indicated that the bridging technique shows potential in working with adolescents to overcome contact-making barriers.