Cardiopulmonary resuscitation: impact on hospital mortality--a ten-year study

The effectiveness of cardiopulmonary resuscitation as a vital aspect of health care delivery in hospital was the basis for a ten-year study. All instances of cardiac arrest occurring outside the operating room and nursery were included. Variations in degrees of success of cardiopulmonary resuscitation as related to the duration of the program, differences among varying subsets such as patients' type of illness and hospital location (emergency room, coronary care unit, intensive care unit or nursing floor) at the time of cardiopulmonary arrest, are presented. The relationship between cardiopulmonary resuscitation frequency and success with increasing instrumentation is reviewed. A simple technique for expressing effect of cardiopulmonary resuscitation on hospital mortality is presented. The study shows the ability of a community hospital to establish, maintain and document a high level cardiopulmonary resuscitation program.     

Physician-hospital integration strategies: impact on physician involvement in hospital governance

This study investigated the impact of three physician-hospital contractual arrangements (PHCAs)--joint ventures, management service organizations, and not-for-profit foundations--on physician involvement in hospital governance and physician-hospital relationships. Analysis of data collected from a national sample of 1,013 hospitals revealed that PHCAs generate greater physician involvement in hospital decision making and result in lower physician-hospital conflict.     

The impact of financial aid on Native American students.

This paper examines how federal financial aid packages affect college persistence of Native Americans including packages with the Oklahoma's Promise grant. Using a state dataset that includes student-level data for the 2002–2006 time span in the state of Oklahoma, this study showed that motivated Native American women with income above $40,000 thrive in postsecondary education. In addition, students with financial aid packages that included the Oklahoma's Promise grant had the highest probability of retention. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Measuring the financial impact of employee attitudes.

Presents a new approach for attaching behavioral costs to attitudes, based on data from 169 bank tellers (average age, 30 yrs). Attitudes were measured through an employee survey; behavioral measures were constructed based on company records. Behavioral costs per employee were assigned through cost-accounting techniques. Attitudes were correlated with future behavior, the behavioral changes associated with attitudinal shifts were estimated, and new behavioral costs per employee were computed. Results show expected direct-cost savings of $17,664 in absenteeism, turnover, and performance from a .5 standard deviation increase in job satisfaction; savings associated with enhanced job involvement and motivation are also reported. A critical analysis of the approach used is presented, as is a discussion of its usefulness to organizations. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of financial and nonfinancial incentives on business-unit outcomes over time.

Unlike previous behavior management research, this study used a quasi-experimental, control group design to examine the impact of financial and nonfinancial incentives on business-unit (21 stores in a fast-food franchise corporation) outcomes (profit, customer service, and employee turnover) over time. The results showed that both types of incentives had a significant impact on all measured outcomes. The financial incentive initially had a greater effect on all 3 outcomes, but over time, the financial and nonfinancial incentives had an equally significant impact except in terms of employee turnover. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enterocolitis after the surgical treatment of Hirschsprung''s disease: risk factors and financial impact

OBJECTIVE: To determine whether anterograde ejaculation is preserved after transurethral resection of both the prostate and bladder neck (TURP and TURBN). PATIENTS AND METHODS: Between 1994 and 1997, 45 patients (mean age 53.2 years, range 42-62) with bladder neck obstruction and small obstructive adenomas (< 35 g) underwent TURP/TURBN, preserving part of the supramontanal prostate and prostatic urethra for > 1 cm from the verumontanum. They were assessed before and after 0.5-2 years to determine the type of ejaculation, symptom scores and sexual function, and compared with 10 similar patients who had undergone a conventional TURP. RESULTS: With preservation of > 1 cm of the supramontanal prostate, anterograde ejaculation was maintained in 80% of the patients, whereas only one patient in the control group retained anterograde ejaculation. CONCLUSIONS: The preservation of anterograde ejaculation after TURP (in approximately 20% of cases) and after transurethral incision of the prostate (> 90% cases) reported in the literature probably relates more to the presence of an adequate amount of residual prostatic tissue than to the existence of a hypothetical 'pre-prostatic sphincter'.     

Which comes first: Employee attitudes or organizational financial and market performance?

Employee attitude data from 35 companies over 8 years were analyzed at the organizational level of analysis against financial (return on assets; ROA) and market performance (earnings per share: EPS) data using lagged analyses permitting exploration of priority in likely causal ordering. Analyses revealed statistically significant and stable relationships across various time lags for 3 of 7 scales. Overall Job Satisfaction and Satisfaction With Security were predicted by ROA and EPS more strongly than the reverse (although some of the reverse relationships were also significant); Satisfaction With Pay suggested a more reciprocal relationship with ROA and EPS. The discussion of results provides a preliminary framework for understanding issues surrounding employee attitudes, high-performance work practices, and organizational financial and market performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The cost of caring for end-stage kidney disease patients: an analysis based on hospital financial transaction records

The costs of care for end-stage renal disease patients continue to rise because of increased numbers of patients. Efforts to contain these costs have focused on the development of capitated payment schemes, in which all costs for the care of these patients are covered in a single payment. To determine the effect of a capitated reimbursement scheme on care of dialysis patients (both hemodialysis [HD] and peritoneal dialysis [PD]), complete financial records (all reimbursements for inpatient and outpatient care, as well as physician collections) of dialysis patients at a single medical center over 1 year were analyzed. For the period from July 1994 to July 1995, annualized cost per dialysis patient-year averaged $63,340, or 9.8% higher than the corrected estimate from the U.S. Renal Data Service (USRDS; $57,660). The "most expensive" 25% of patients engendered 44 to 48% of the total costs, and inpatient costs accounted for 37 to 40% of total costs. Nearly half of the inpatient costs resulted from only two categories (room charges and inpatient dialysis), whereas other categories each made up a small fraction of the inpatient costs. PD patients were far less expensive to care for than HD patients, due to reduced hospital days and lower cost of outpatient dialysis. Care for a university-based dialysis population was only slightly more expensive than estimates predicted from the USRDS. These results validate the USRDS spending data and suggest that they can be used effectively for setting capitated rates. Efforts to control costs without sacrificing quality of care must center on reducing inpatient costs, particularly room charges and the cost of inpatient dialysis.     

Measuring hospital performance: are we asking the right questions?

The aim of this randomized cross-over trial was to evaluate the dose effect and systemic absorption of epinephrine nebulized at 2 and 5 mg in comparison with salbutamol (5 mg). Thirteen asthmatic patients (29 +/- 15 years, 4 men and 9 women) were randomly assigned to receive one nebulization of each of the three treatment regimens at 24 h interval. The evaluation concerned forced expiratory volume in 1 second (FEV1), heart rate, respiratory rate and arterial pressure. All measurements were done at baseline, every 15 minutes during the first hour, and hourly thereafter until return to baseline FEV1. Serum potassium was measured at baseline (T0) and sixty minutes after (T60). Plasma levels of epinephrine were measured at T0, T20, T60. Fifteen minutes after the beginning of nebulization FEV1 improved significantly over baseline in the three groups. These changes were similar in the three groups until T45, while FEV1 improvement was significantly greater in A5 and S groups than A2 group (+640 +/- 470 ml, +721 +/- 349 ml, +406 +/- 306 ml in A5, S and A2 groups respectively, p < 0.01). Bronchodilation lasted significantly longer with salbutamol than with epinephrine (p < 0.05). No side effects were recorded in spite of substantial and dose-dependent systemic absorption of epinephrine. CONCLUSION: Increasing epinephrine doses produces greater bronchodilation without additional side effects. However this bronchodilation lasts shorter than with salbutamol.     

Trust that binds: The impact of collective felt trust on organizational performance.

The impact of employees' collective perceptions of being trusted by management was examined with a longitudinal study involving 88 retail stores. Drawing on the appropriateness framework (March, 1994; Weber, Kopelman, & Messick, 2004), the authors develop and test a model showing that when employees in an organization perceive they are trusted by management, increases in the presence of responsibility norms, as well as in the sales performance and customer service performance of the organization, are observed. Moreover, the relationship between perceptions of being trusted and sales performance is fully mediated by responsibility norms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of comparison processes on coactors' task performance.

Conducted 2 experiments with 135 female undergraduates to investigate the operation of social comparison processes within coaction. Perceived discrepancies between coactors' performance levels were induced by altering their feedback schedules. An S was paired with a coactor who seemed to be performing either at a superior, inferior, or similar level. The pattern of results suggests that comparison processes are active components within coaction. An expectation/criterion level interpretation is discussed within a social comparison analysis. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Boundary spanning and individual performance: The impact of self-monitoring.

Boundary-spanning positions require occupants to interact with groups whose norms may differ from one another. It was hypothesized that individuals holding these positions would perform better if they were sensitive to social cues and able to adapt their behavior to fit the circumstances. 93 field representatives (average age 30.5 yrs) who acted as boundary spanners were given the Self-Monitoring Scale. Results show that significant relationships existed between job performance and an individual difference variable (self-monitoring) that assessed the ability of respondents to adjust their self-presentation to fit the situation; self-monitoring was most important during the period of early tenure. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding frame-of-reference training: The impact of training on the recall of performance information.

Extends research on the cognitive mechanisms underlying frame-of-reference (FOR) rater training by examining the impact of FOR training on the recall of performance information. It was hypothesized that the shared performance schema fostered by FOR training would serve as the basis for information processing, resulting in better recall for behavioral performance information as well as more accurate ratings of individual ratees. 174 FOR-trained Ss produced more accurate performance ratings, as measured by L. Cronbach's (1955) differential accuracy and differential elevation components, than did 142 control-trained Ss. FOR-trained Ss also recalled more behaviors, representing more performance dimensions, and exhibited less evaluative clustering and a larger relationship between memory and judgment. No differences were found between control and FOR Ss on measures of recognition accuracy. Implications for the evaluative judgment process are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Computer-adaptive testing: The impact of test characteristics on perceived performance and test takers' reactions.

This study examined how specific features of adaptive tests are related to test takers' reactions. Participants took a computer-adaptive test in which 2 features, difficulty of the initial item and difficulty of subsequent items, were manipulated, then responded to questionnaires assessing their reactions to the test. The data show that the relationship between a test's objective difficulty, which was determined by the 2 manipulated test characteristics, and reactions was fully mediated by perceived performance. Additional analyses evaluated the impact of feedback on reactions to the adaptive test. In general, feedback that was consistent with perceptions of performance was positively related to reactions. The results suggest that minor changes to the design of an adaptive test may potentially enhance examinees' reactions, (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Embracing transformational leadership: Team values and the impact of leader behavior on team performance.

The authors investigated the relationship between transformational leadership behavior and group performance in 218 financial services teams that were branches of a bank in Hong Kong and the United States. Transformational leadership influenced team performance through the mediating effect of team potency. The effect of transformational leadership on team potency was moderated by team power distance and team collectivism, such that higher power distance teams and more collectivistic teams exhibited stronger positive effects of transformational leadership on team potency. The model was supported by data in both Hong Kong and the United States, which suggests a convergence in how teams function in the East and West and highlights the importance of team values. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Community perception on OPD performance of a teaching hospital in Gondar town

An empirical study for the effectiveness of recombination in a genetic-based classifier system applied to the field of ion chromatography is presented. From a comparison of the classifier system with and without crossover it followed that recombination was unable to make a significant contribution to the classification results. Despite this ineffectiveness, the genetic algorithm was a legitimate choice for solving the present classification problem because its population-based properties were of greater importance than the issue of whether or not recombination significantly added to the performance. These findings prompt the testing of other classifier systems as well, in order to reveal the extent to which the presented results can be classified.     

Organizational climate configurations: Relationships to collective attitudes, customer satisfaction, and financial performance.

Research on organizational climate has tended to focus on independent dimensions of climate rather than studying the total social context as configurations of multiple climate dimensions. The authors examined relationships between configurations of unit-level climate dimensions and organizational outcomes. Three profile characteristics represented climate configurations: (1) elevation, or the mean score across climate dimensions; (2) variability, or the extent to which scores across dimensions vary; and (3) shape, or the pattern of the dimensions. Across 2 studies (1,120 employees in 120 bank branches and 4,317 employees in 86 food distribution stores), results indicated that elevation was related to collective employee attitudes and service perceptions, while shape was related to customer satisfaction and financial performance. With respect to profile variability, results were mixed. The discussion focuses on future directions for taking a configural approach to organizational climate. (PsycINFO Database Record (c) 2010 APA, all rights reserved)