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Within 6 months, a 10-member Nursing Services task force created and administered a literature-based retention survey. Tool development and administration is described. The 33-item tool was completed by 85% of the staff. Responses led to the formation of work groups, charged with addressing dissatisfiers and communicating implementation strategies to the… (More)
Profound changes in policy and reimbursement are ushering in a new era in home care. The transition from fee-for-service reimbursement to prospective payment/managed care and the mandate for outcomes assessment provide opportunities to expand innovative home care models. The authors describe 3 such models: community-based long-term care (exemplified by… (More)
Dr. Porter-O'Grady, in the preceding article, discussed some implications of and a model for bylaws. The author of this article relates her institution's experience in developing nursing staff bylaws. She shares the process as well as the advantages and disadvantages of implementing a system for professional accountability and autonomy.
Organizational change, in the form of work redesign, is widespread in hospitals across the country. How can the resulting patient-focused care models be sustained when "sustaining" means continuously changing and improving? The authors describe one hospital's use of a multidisciplinary shared governance system to provide the structure and process support… (More)
Vocal learning has been defined as the process by which an individual modifies its vocal repertoire as a result of the sound environment (Marler, 1976a; McCowan & Reiss, 1997). Vocal learning has been found in a number of species, including the Atlantic bottlenose dolphin (Tursiops truncatus)(see review: Janik & Slater, 1997). Dolphins mimic sounds heard in… (More)