Journal of health and human services administration
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This article reviews quality of health care initiatives beginning with the quality assessment/quality assurance movement of the 1970s. Conceptually, modern quality of care management is rooted in the intellectual work of Avedis Donabedian who defined quality of care as a combination of structure, process, and outcome. Donabedian's model is presented and some limitations are pointed out. ⋯ More recently, the pursuit of health care quality has led to substantial performance measurement initiatives such as ORYX by the Joint Commission on Accreditation of Healthcare Organizations and MEDIS by the National Commission of Quality Assurance. The importance of CONQUEST, a freely available performance measurement database developed at the Harvard School of Public Health, is noted and discussed. The article concludes with a list of challenges facing public and private parties interests in health care quality improvement.
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Today we stand in a vortex of technological, economic, and cultural changes that altered dramatically the world of labor and with it the psychological contract between employers and employees. While the effects of the changed contract at work are usually addressed from an organizational, social or economic perspective, the current article addresses it from a psychological perspective from which one noteworthy cost of the changed psychological contract is employee burnout. The article describes burnout, differentiates it from stress, and proposes an existential perspective to explain its underlying dynamic, using the results of a cross-cultural study of Israeli and American managers as an example. Recent studies on gender differences in management are used to point in the recommended for preventing employee burnout, despite the new psychological contract, namely--a democratic, egalitarian management style.