term.subject="administration"

Summary: Addresses one step in the process of moving from teamwork training to teamwork practices that improve outcomes of care: identifying outcomes that are most likely to be affected as teamwork practices improve in an implementing organization. Discusses a literature search, methods for selecting and testing candidate measures, measures highly rated by clinical experts, and results of measure testing on administrative data of the DoD health system

Summary: This report is one of several that document a broad, two-year study by RAND Health to better understand the role and importance of Electronic Medical Record Systems (EMR-S) in improving health and reducing healthcare costs, and to help inform government actions that could maximize EMR-S benefits and increase its use. It provides the technical details and results of one component of that study that analyzes interventions in the healthcare system that use EMR-S to affect patient trajectories-i.e., the sequence of encounters a patient has with the healthcare system. The interventions are to improve patient safety, increase preventive services, expand chronic disease management, and foster healthier lifestyles. We identified four classes of trajectory-changing interventions and we selected some important interventions in each class: --Implement Computerized Physician Order Entry (CPOE) as a means to reduce adverse drug events (ADEs). --Increase the provision of the following preventive services: influenza and pneumococcal vaccinations and screening for breast, cervical, and colorectal cancer. --Enroll people with one of four chronic illnesses-asthma, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), or diabetes-in disease management programs. --Persuade people to adopt healthy lifestyles and estimate the health outcomes if everyone did so: controlled their weight, stopped smoking, ate a healthy diet, exercised, and controlled their blood pressure and cholesterol as necessary with medications. We estimated the effects of each intervention on healthcare utilization (e.g., hospital stays, office visits, prescription drug use), healthcare expenditures, and population health outcomes (workdays or schooldays missed, days spent sick in bed, mortality). These interventions generally affect trajectories by improving health and thereby reducing healthcare utilization, or by reducing a costly form of utilization (e.g., inpatient stays) and increasing a more economical form (e.g., office visits to physicians, or prescription medications). The report should be of interest to healthcare IT professionals, other healthcare executives and researchers, and officials in the government responsible for health policy

Summary: Dissatisfied with the results of earlier efforts to improve educational outcomes in U.S. schools, the Ford Foundation developed a program called the Collaborating for Education Reform Initiative (CERI) that provided grants to collaboratives of community-based organizations in urban settings as a way to address systemic barriers to high-quality teaching and learning. Eight collaboratives signed on, and, over four years, the RAND Corporation assessed the progress of the program. The authors of this report found that the eight sites made varying degrees of progress and, while none had reached the final outcomes desired, some of the collaboratives offered considerable promise. Although success is far from certain, by adopting such techniques as clear communication of expectations, engaging school staff, and using data to alter strategies as necessary, collaboratives stand a better chance of becoming self-sustaining and positively affecting student learning

Summary: Discussions about reducing the harms associated with drug use and antidrug policies are often politicized, infused with questionable data, and unproductive. This paper provides a nonpartisan primer that should be of interest to those who are new to the field of drug policy, as well as those who have been working in the trenches. It begins with an overview of problems and policies related to illegal drugs in the United States, including the nonmedical use of prescription drugs. It then discusses the efficacy of U.S. drug policies and programs, including long-standing issues that deserve additional attention. Next, the paper lists the major funders of research and analysis in the area and describes their priorities. By highlighting the issues that receive most of the funding, this discussion identifies where gaps remain. Comparing these needs, old and new, to the current funding patterns suggests eight opportunities to improve understanding of drug problems and drug policies in the United States: (1) sponsor young scholars and strengthen the infrastructure of the field, (2) accelerate the diffusion of good ideas and reliable information to decision-makers, (3) replicate and evaluate cutting-edge programs in an expedited fashion, (4) support nonpartisan research on marijuana policy, (5) investigate ways to reduce drug-related violence in Mexico and Central America, (6) improve understanding of the markets for diverted pharmaceuticals, (7) help build and sustain comprehensive community prevention efforts, and (8) develop more sensible sentencing policies that reduce the excessive levels of incarceration for drug offenses and address the extreme racial disparities. The document offers some specific suggestions for researchers and potential research funders in each of the eight areas

Summary: "As the U.S. Marine Corps (USMC) has grown in strength, it has needed to add intelligence capabilities. Since the end of the Cold War and, especially, since September 11, 2001, USMC intelligence has had to tailor its organization to meet the evolving demands of the operational environment. This has resulted in a number of ad hoc arrangements, practices, and organizations. A broad review of the organizational design of the USMC intelligence enterprise examined how to align it efficiently and effectively with current and future missions and functions. Specifically, the review, which included interviews with a range of USMC personnel and civilians, considered the organization of (and possible improvements to) the Intelligence Department, the Marine Corps Intelligence Activity, the intelligence organizations within the Marine Expeditionary Forces (specifically, the intelligence and radio battalions), and intelligence structures in the combat elements. A comparison of 48 organizational and functional issues with a series of USMC intelligence and functional issues resulted in a series of recommendations to help improve the "fit" of USMC intelligence organizations with their environmental context. In some cases, the service would benefit not from changing its intelligence structure but by realigning it; in other areas, restructuring would lend greater efficiency and effectiveness to the USMC intelligence enterprise."--Page 4 of cover

Summary: This study tracks the establishment of a single hospital-based integrative medicine center. Although some factors clearly worked in favor of the center, the hospital had few models to guide it and no experience in creating such a clinic. Thus, it made many decisions in the areas of administration, finance, and legal issues that created barriers to the center's success, and the center was ultimately closed

Summary: The U.S. armed services have different methods and processes for promoting enlisted personnel. All of the services, however, aim to ensure that promotion outcomes correspond to substantive differences in personnel quality. This report provides a snapshot of how the Army, Navy, Marines, and Air Force go about measuring duty performance, leadership potential, experience, knowledge, and skills to determine who among its enlisted force merits promotion, when they are eligible for promotion, and at what level promotion decisions are made. This report provides an overview of the enlisted promotion system in the 1990s as retention issues again move to the forefront of Defense Department concerns

Summary: The California Work Opportunity and Responsibility to Kids (CalWORKs) program is California's response to the welfare reforms Congress set in motion in 1996. The most visible features of this program are its emphasis on moving welfare recipients from reliance on government cash assistance to work and toward self-sufficiency; its use of time limits and participation requirements; its provision of certain services, such as child care and job search assistance, to make participation easier; and its devolution of program authority from the state to the county level. This executive summary focuses on the four themes that have emerged from the authors' work to date: (1) Organizations have changed in response to the expanded mission of CalWORKs, despite limited time for planning. (2) Implementation is under way, but recipient compliance is low. (3) Counties currently have sufficient funds, but this may change. (4) Achieving earnings needed to achieve self-sufficiency before time limits expire is a challenge

Summary: Corruption in the Mexican police forces is widely acknowledged and longstanding. The Mexican government has undertaken police reforms in recent years that have focused on professionalizing the Mexican police. Key components of these reforms have been changes in compensation and personnel policies as a way of creating a civil service for police personnel. Whether these reforms are the right ones or have helped are open questions. In this report, we draw on the literature on corruption and personnel incentives and analyze household survey data and other information related to police reform in Mexico. The study's objectives were to address questions about the roots of corruption and the tools that could be used to mitigate corruption, with a focus on compensation and personnel management policies. We also provide an initial assessment, based on available information, about the effectiveness of these policies. The report should be of interest to the broad policy and research communities concerned about police corruption in general and in Mexico specifically

Summary: New American Schools was established in 1991 to help schools transform themselves into high-performing organizations. This report is a formative assessment of the first two years (1995-1997) of the scale-up phase, during which NAS partnered with 10 jurisdictions to implement design-based programs for improving student performance. A series of lessons emerged from this analysis: (1) The effort at school reform is complex because of the multiple actors involved. (2) Design teams do not accomplish implementation by themselves but only with the cooperation of schools and districts. (3) Teachers found stable school and district leadership and clear signals about the effort's priority to be important. Perhaps the most important lesson is that there still are no silver bullets for ensuring the implementation of reforms, but several districts have made significant progress in the two-year period