Financial challenges and complexity in the management of an intensive care/coronary care unit: a case study
Bibliographic record
Abstract
This case study, written by the manager of an intensive/coronary care unit of an Ontario hospital, demonstrates the difficulties faced by health care managers in controlling costs and dealing with complexity in the current health care and hospital environment. The case describes actions taken to reduce staffing expenditures in an intensive care unit through a rearrangement of nursing duties and the introduction of a different level of nursing staff to take over some of the nursing duties previously carried out by registered nurses. Although the actions were unsuccessful, the careful documentation and analysis of the results of the actions brings to the fore the multi‐faceted nature of the problems faced by hospitals in managing their costs and at the same time meeting their medical mandate. Concludes by pointing to the ongoing nature of the cost problem as nursing professionals are caught in the squeeze between providing the service they are trained for, and their need for appropriate compensation under conditions of increasing work pressure.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.017 | 0.005 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.006 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".