Autonomy and the Medical profession: Medical Audit and Management Control

1996 ◽  
pp. 65-87
Author(s):  
Mike Dent
Keyword(s):  
Medical Profession ◽  
Management Control ◽  
Medical Audit

scholarly journals Audit in psychiatry: “failed discharges”

1991 ◽  
Vol 15 (1) ◽  
pp. 26-27 ◽  
Author(s):  
E. Jones
Keyword(s):  
Critical Analysis ◽  
Medical Profession ◽  
Psychosocial Care ◽  
Medical Audit ◽  
Department Of Health ◽  
Use Of Resources ◽  
Quality Of Medical Care ◽  
Methodological Problems ◽  
Medical Specialities

Medical audit has been defined as the systematic, critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources, and the resulting outcome and quality of life for the patients (Department of Health, 1989). The medical profession has been under pressure to extend and improve audit procedures in recent years (McKee et al, 1989), but there have been doubts about the most satisfactory methods, particularly in psychiatry (Garden & Oyebode, 1989). There are numerous methodological problems in measuring the outcome of psychosocial care (Shaw, 1989; Royal College of Psychiatrists, 1989). Indicators of outcome which have been used in medicine include incidence of adverse events. Reintervention rates do offer some measure of outcome, and have been used widely in other medical specialities.

Up-Skilling and the Intensification of Work: The ‘Extended Role’ in Intensive Care Nursing and Midwifery

1995 ◽  
Vol 43 (4) ◽  
pp. 765-781 ◽  
Author(s):  
Janet Harvey
Keyword(s):  
Intensive Care ◽  
Medical Profession ◽  
Division Of Labour ◽  
Management Control ◽  
Intensive Care Nurses ◽  
Seminal Work ◽  
Sexual Division ◽  
Core Theory ◽  
Intensive Care Nursing ◽  
Care Nursing

In his seminal work Braverman (1974) suggested that, like manual workers, the majority of ‘non-productive’ workers are equally subject to scrutiny and Tayloristic methods of rationalisation and differentiation (sub-division of work into simple, repetitive operations) of the tasks they perform. The result is ‘de-skilling’ whereby labour is reduced to the repetitive performance of mechanical tasks and an intensification of work is achieved. Following the debate that has arisen from Braverman's work, concentrating largely on either de-skilling and/or strategies of management control, there have been wide-ranging qualifications to Braverman's core theory. I wish to suggest that ‘up-skilling’ (as opposed to de-skilling) may also represent an intensification of work, since the terms and conditions under which skill is enhanced is centrally relevant. This is argued in relation to the ‘extended role’ functions of midwives and Intensive Care nurses, whereby the tasks normally carried out by doctors are performed in a proxy capacity by nurses/midwives, while remaining in the ‘ownership’ of the medical profession. In the course of the above discussion, the article explores the way in which the sexual division of labour (between the female gendered profession of nursing and the male gendered medical profession) changed but survived in a negotiated form.

scholarly journals Setting up district audit meetings in psychiatry

1991 ◽  
Vol 15 (7) ◽  
pp. 417-418 ◽  
Author(s):  
David Roy
Keyword(s):  
Quality Of Care ◽  
Length Of Stay ◽  
Adverse Events ◽  
Medical Profession ◽  
Medical Audit ◽  
Day Hospital ◽  
Process Of Care ◽  
Face To Face ◽  
Record Review

Charles Shaw, in a number of articles and his Hospital Handbook (Shaw, 1989, 1990) has played a key role in outlining the principles of medical audit. He arbitrarily divides the process of medical audit into four phases. The philosophical phase which seems to have been negotiated, is whether the medical profession should be involved; the organisational phase; who should lead the process, and the resources required; the practical phase, what should be audited and the methods used; and the invasive phase, how the general concepts and the details of audit are communicated through publication. He goes on to describe a variety of methods of audit including the review of adverse events and general statistics, the assessment of randomly selected records, and finally the review of a topic (which includes medical record review). Another approach in planning audit is through understanding of the organisation itself (Donabedian, 1966) and evaluating quality of care in terms of the structure of the organisation (bricks and mortar, staffing, beds, technology etc.), the process of care, and this may include length of stay, broad out-patients statistics, and perhaps more controversially, face to face contact, group interaction, home visits, day hospital attendance and so on. Finally, and most complex, is outcome.

Quality assurance from the perspective of health economics

1993 ◽  
Vol 101 ◽  
pp. 105-114
Author(s):  
Alan Williams
Keyword(s):  
Quality Assurance ◽  
Health Economics ◽  
Professional Practice ◽  
Medical Profession ◽  
Medical Audit ◽  
Further Training ◽  
The Uk

SynopsisThere are two distinct views about the purpose of quality assurance by means of medical audit. The first is that it is a job requirement, to be backed by sanctions where necessary. The second is that it is a desirable attribute of professional practice, backed only by exhortation and opportunities for further training. This difference of view lies at the heart of much of the dispute as to how medical audit should be pursued in the UK at present. It explains why the medical profession insists that such audit should be conducted by peers, for peers, and accountable only to peers, whereas managers want some say in what is audited, how it is audited, and also want the reports of such audit made available to them, so that they can act upon the findings in their role as employers (e.g. in organising workloads, contracts, etc.). In this chapter the ‘job requirement’ view is supported, and its implications explored. It is argued that unless this route is chosen, it is unlikely that medical audit will deliver improvements in the health of the population that are commensurate with its costs.

The Diagnosis of Viral Disease by Electron Microscopy

1982 ◽  
Vol 40 ◽  
pp. 270-273
Author(s):  
William B. McCombs ◽  
Cameron E. McCoy
Keyword(s):  
Electron Microscopy ◽  
Hospital Stay ◽  
Viral Infections ◽  
Medical Profession ◽  
Bacterial Pathogens ◽  
Viral Disease ◽  
Viral Pathogens ◽  
Academic Interest ◽  
The Past

Recent years have brought a reversal in the attitude of the medical profession toward the diagnosis of viral infections. Identification of bacterial pathogens was formerly thought to be faster than identification of viral pathogens. Viral identification was dismissed as being of academic interest or for confirming the presence of an epidemic, because the patient would recover or die before this could be accomplished. In the past 10 years, the goal of virologists has been to present the clinician with a viral identification in a matter of hours. This fast diagnosis has the potential for shortening the patient's hospital stay and preventing the administering of toxic and/or expensive antibiotics of no benefit to the patient.

Amputation in fictional literature: the case of Hippolyte in Madame Bovary

VASA ◽  
2001 ◽  
Vol 30 (Supplement 58) ◽  
pp. 3-5 ◽  
Author(s):  
Kauss
Keyword(s):  
Surgical Procedure ◽  
Medical Profession ◽  
Major Amputation ◽  
Madame Bovary

In his famous novel, published in 1856, Flaubert describes the circumstances of a failed surgical procedure ending up in a major amputation. Flaubert, whose father was a physician in Rouen/France, mocks at the medical profession and its victims and proves himself to be compassionate at the same time. About his writing, he explained: "I only measure shit into doses." ("Je ne fais autre chose que de doser de la merde.")

Psychiatry as a Medical Profession

1987 ◽  
Author(s):  
R. Pasnau ◽  
Keyword(s):  
Medical Profession

Stress factors in the medical profession. Measure of the imbalance in assistance relationships. TEEM questionnaire

2010 ◽  
Author(s):  
S. Gascon ◽  
J. P. Pereira ◽  
M. J. Cunha ◽  
M. A. Santed ◽  
B. Martinez-Jarreta
Keyword(s):  
Medical Profession ◽  
Stress Factors
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