Learning how to learn: the key to CQI

All CQI/TQM efforts share a common purpose: to learn something that can correct past mistakes and/or to create better futures. Because learning is a dynamic circular process, the information about a problem or an opportunity will be limited unless four perceptions of the truth--each valid, and each incomplete--are accepted. These four types of learning styles or ways of perceiving are: abstract conceptualizers, active experimenters, concrete experiencers, and reflective observers. Unless all the stages of the learning process have been fully completed, unless all the strokes work in harmony, we cannot be confident that a CQI effort has added its full value. A CQI team's interpersonal process, the tools by which individually limited truths are forged into a consensual holistic truth, must ensure that the group's effort goes "around in circles."     

Making the journey into the networked enterprise, Part 2

In the May issue of Physician Executive, the authors described the difficulties other industries have had with vertical integration and why so many corporations have abandoned it for other organizational structures. In this second part of the series, they explore the ways health care organizations can make the shift into integrated delivery systems, avoiding the trap of the hierarchical, vertically integrated monolithic structures that will become the dinosaurs of the future.     

Clinical supervision: Its role in “Containing” countertransference responses to a filicidal patient

This paper illustrates the role of supervision in processing countertransference responses with might have disrupted the therapist's empathy with a patient who had killed her child. The clinical material demonstrates how the therapist's responses of initial denial and subsequent disgust and fear were dealt with in supervision. As a result, the treatment process led to genuine, albeit limited, therapeutic change in a patient with severe character pathology.This paper is developed from a presentation of the case of Mrs. Jay at Department of Psychiatry Grand Rounds, University of Cincinnati College of Medicine, on May 2, 1989.     

Social determinants of life expectancy]

"Life expectancy and mortality increasingly are analyzed in the context of social factors. This study analyzes the impact of social position, marital status, and religious confession on cohort life expectancy. The analysis is based on [German data from the] Socio-Economic Panel Survey, wherein proxy-interviewee's parents have been used to estimate cohort mortality. Results confirm a lower mortality risk of the upper classes and of married persons. However, as opposed to other studies, Catholics do not have a lower, but even a higher mortality risk." (SUMMARY IN ENG)     

The NTEE classification system: tests of reliability/validity in the field of higher education

An analysis of the field of higher education reveals a surprisingly large number of classification errors within the (US) National Taxonomy of Exempt Entities database. Of the nearly 4,000 non-profit entities coded within the universe of institutions of higher education, we estimate that approximately 60 per cent were incorrectly included (Type II errors). Institutions incorrectly excluded from the higher education universe (Type I errors) represent roughly 10 per cent of the institutions coded correctly. These errors result primarily from assigning codes on the basis of the names of organisations (for example, College Park Towers is classified as a college, when it is in fact a housing complex for senior citizens) and from trying too hard to assign codes in ambiguous situations. The consequences can be significant for the users of these data, and we recommend raising bright warning flags while simultaneously enlisting the help of the entire non-profit sector in improving the classification coding process.The authors are with The Andrew W. Mellon Foundation. In addition to our colleagues on the staff of the Foundation, we wish to thank Helmut Anheier, Ted Bozovich, Harvey Dale, Virginia Hodgkinson, Stephen Noga and Christopher Toppe for helpful suggestions.     

A method of computing the marital composition of the population between population censuses

A method for calculating the marital status distribution of the population of the USSR between censuses is outlined. The method is based on the use of population census and vital statistics data.