Application of TQM principles to the utilization management process

Application of the philosophy and principles of TQM and CQI to utilization management within an institution necessitates an in-depth review of the systems and processes of the flow of inpatients throughout their stay. This encompasses a total systems perspective, beginning with the admitting process and going through the discharge process. TQM and CQI philosophies identify that the most significant and costly inefficiencies are due to faulty systems and processes, not individuals. Applying this management strategy to a health care institution requires a detailed review and analysis of processes by which service is delivered and requires evaluation of the outcomes of patient care and patient satisfaction.     

The credit channel of monetary policy transmission: evidence from stock returns

This paper offers a novel test of the credit view of the monetary policy transmission mechanism using stock market returns. We identify Fed policy shocks using newspaper accounts and track daily stock prices immediately following the shocks. If the credit channel is important, then firms that are dependent on bank credit and internal funds should receive a relatively greater benefit (loss) from a Fed easing (tightening) than firms with access to nonbank credit at favorable terms. We identify ten policy shocks during the expansion of 1993-94 and the 'credit crunch' period of the 1990-91 recession and find little evidence supportive of an operative credit channel.     

Implementation and evaluation of an HIV/STD intervention in Peru

This paper presents the lessons learned through a process evaluation (PE) after 1 year of implementation of a 2-year community intervention in Lima, Peru. The intervention consisted of training and motivating community popular opinion leaders (CPOLs) for three marginal population segments to disseminate prevention messages among their peers. PE data included: observations, qualitative interviews with CPOLS, conversations and messages delivered by CPOLs, training facilitators' perceptions about implementation, and a survey of CPOLs. The PE helped to document and enhance the intervention. CPOLs were motivated to talk to their peers. CPOLs perceived that their participation had an effect on their own risk behaviors and saw their role as beneficial to their community. The PE was helpful in examining training delivery and the feasibility and acceptability of the intervention in order to assess the elements related to program success necessary to replicate the CPOL model.