Quality improvement in patient distribution at a major university student health center

Healthcare in a major university setting poses unusual challenges and great opportunities. Two traditionally challenging areas in patient distribution are the initial intake of allergy/immunization patients and the triage of outpatients in the general medical clinic. The authors describe the use of the FOCUS-PDCA quality improvement (QI) problem-solving process for each situation. After identifying major problems, the health center established cross-functional teams of experts representing the allergy/immunization and general medical clinics. The teams analyzed the problems with a flow chart and undertook studies to further elucidate causes and potential solutions. They listed potential solutions in order of priority and submitted them to the student health center director for review and initiation. Each team then used the PDCA (plan-do-check-act) cycle to put approved solutions into effect. Permanent improvements made in each area resulted in a more effective and efficient patient distribution system, favorable staff comment, and greater patient satisfaction.     

Unraveling the Relationship of Distress Levels Within Couples: Common Stressors, Empathic Reactions, or Crossover via Social Interaction?

Using structural equation modeling analyses weexamined the correlation in levels of depressionsymptoms within couples to determine whether theunderlying mechanism is due to common stressors,empathic reactions, or crossover via social interaction.The analyses were based on two waves of data collectionfrom a sample of 354 male Vietnam veterans, Era veterans(veterans who served elsewhere during the period of the Vietnam War), and nonveterans andfrom their wives or committed partners. The resultsdemonstrated that the correlation in depression symptomswithin couples is due primarily to common stressors and crossover via negative social interaction.Common stressful life events increase depression in bothspouses, and this in turn increases social undermining,which further increases depression.     

Quality Improvement in Patient Distribution at a Major University Student Health Center

Abstract

Healthcare in a major university setting poses unusual challenges and great opportunities. Two traditionally challenging areas in patient distribution are the initial intake of allergy/immunization patients and the triage of outpatients in the general medical clinic. The authors describe the use of the FOCUS-PDCA quality improvement (QI) problem-solving process for each situation. After identifying major problems, the health center established cross-functional teams of experts representing the allergy/immunization and general medical clinics. The teams analyzed the problems with a flow chart and undertook studies to further elucidate causes and potential solutions. They listed potential solutions in order of priority and submitted them to the student health center director for review and initiation. Each team then used the PDCA (plan-do-check-act) cycle to put approved solutions into effect. Permanent improvements made in each area resulted in a more effective and efficient patient distribution system, favorable staff comment, and greater patient satisfaction.     

The inverted-U relationship between stress and performance: A field study

To investigate the shape of the relationship between stress resulting from excessive demand and performance, 306 officer cadets in the Israel Defence Forces completed stress questionnaires during their training. Stress was consistently negatively related to various measures of performance. The prediction derived from the inverted-U hypothesis, that those whose ability exceeded demand and those who felt that demands taxed their ability would perform worse than those whose ability matched their demands, was not supported. Until all the requisite conditions for testing the inverted-U hypothesis are met, the authors propose relegating it to the laboratory.     

Corporate Social Responsibility through Cross‐sector Partnerships: Implications for Civil Society,the State,and the Corporate Sector in India

Corporations are increasingly forced to widen their agendas to include social and environmental concerns, or corporate social responsibility (CSR). This development has been recorded in the current academic debate, and the views regarding its implications for business, the state, and civil society diverge. However, there is agreement within the CSR and corporate governance literatures that there is a lack of thorough empirical studies of these effects. Based on a case study of the multinational wind energy company Suzlon Energy's CSR projects in rural India, this article contends that CSR projects implemented through cross‐sector partnerships can help to build the capacities of civil society organizations (CSOs). Although the risk of corporate steering of the civil society agenda is reduced when CSR prioritizes community needs over business imperatives, CSOs tend to bear the highest costs in partnerships, through credibility losses and insecurity concerning project terms and funding, reinforcing the importance of critical cooperation and complementary core competencies in cross‐sector partnerships. The results have implications for the strategies of corporations, CSOs, and governments as well as for the planning of national and international development aid.     

Teachers' Occupation‐Specific Work‐Family Conflict

To expand work‐family conflict (WFC) research to specific occupations, this study investigated how work and family generic and occupation‐specific stressors and support variables related to family interfering with work (F → W) and work interfering with family (W → F) among 230 Israeli high school teachers. Further expanding WFC research, the authors assessed WFC effects on burnout and vigor. Results indicated that W → F conflict was related to generic variables and more so to distinctive teaching characteristics (e.g., investment in student behavior and parent‐teacher relations). Both W → F and F → W predicted burnout, whereas only F → W predicted vigor. Implications for WFC research and occupational health programs are discussed.     

The Effects of Pay Systems on Blue-Collar Employees' Emotional Distress: The Mediating Effects of Objective and Subjective Work Monotony

We hypothesized that employees' emotionaldistress would be affected by the degree to which theirpayment was contingent upon individual performance.Respondents were 2747 blue-collar employees in 21factories in Israel. They completed questionnaires oncompany time. We found that, in comparison with thosewho were paid only according to time worked, being on aperformance-contingent pay system was associated with higher levels of depression and somaticcomplaints, but not of anxiety. As expected, theseeffects were partially mediated by the extent to whichthe respondents' work was monotonous.     

The Reverse Gender Gap in Ethnic Discrimination: Employer Stereotypes of Men and Women with Arabic Names,

We examine differences in the intensity of employer stereotypes of men and women with Arabic names in Sweden by testing how much work experience is needed to eliminate the disadvantage of having an Arabic name on job applications. Employers are first sent curriculum vitaes (CVs) of equal merit in a field experiment setup. Arabic‐named CVs are thereafter enhanced with more relevant work experience than Swedish‐named CVs. The results indicate a reverse gender gap in employer stereotypes because initial differences in the number of callbacks disappear for female applicants when Arabic‐named CVs are enhanced but remain strong and significant for male applicants. Thus, contrary to what is often assumed about the interaction of gender and ethnicity, we find that Arabic men face stronger discrimination in the labor market than Arabic women.     

Patterns of working and living conditions: a holistic, multivariate approach to occupational health studies

The objective of the study was to develop a multivariate approach to occupational health studies that is: capable of identifying groups with similar working conditions; relevant for studies of associations between working and living conditions and health; and an appropriate basis for preventive actions. Data at the individual level were obtained through measurements, observations, interviews and questionnaires, and at the organizational level, through interviews with managers. Cluster analyses were applied with the purpose of identifying groups of individuals with small, within-group differences. Eighty work sites and a sample of employees at each site were strategically selected. The study group comprised 203 men and women, and was characterized by large variation. The final analysis produced eight clusters of individuals, denoted according to their best-defining characteristic, i.e. 'decent', 'boundary-less', 'locked', 'exposed', 'heavy and monotonous', 'changed', 'mobile' and 'restrained'. The clusters differed with regard to 'what' characterized working conditions, 'where' on the labour market they were found, and 'who' clustered in these groups. The holistic approach revealed conditions that were important for health and had higher explanatory power in relation to ill-health than applying socio-economic groupings or the demand-control-support model. It showed how psychosocial, ergonomic-physical and occupational hygiene factors combine and interact to create settings with different risks of ill-health. The chosen strategy is recommended for future occupational health studies and is particularly suitable as guidance for preventive actions relevant to specific clusters of working and living conditions.