Services for children with autism spectrum disorder in three, large urban school districts: Perspectives of parents and educators.

This study used qualitative methods to evaluate the perceptions of parents, educators, and school administrators in three large, urban school districts (Los Angeles, Philadelphia, and Rochester) regarding services for children with autism spectrum disorder within the context of limited district resources. Facilitators followed a standard discussion guide that contained open-ended questions regarding participants' views on strengths and limitations of existing services and contextual factors that would facilitate or inhibit the process of introducing new interventions. Three primary themes were identified: (1) tension between participant groups (teachers and paraprofessionals, staff and administration, teachers and parents, special education and general education teachers), (2) necessity of autism spectrum disorder-specific and behavioral training for school personnel, and (3) desire for a school culture of accepting difference. These themes highlight the importance of developing trainings that are feasible to deliver on a large scale, that focus on practical interventions, and that enhance communication and relationships of school personnel with one another and with families.

Applying science and strategy to operating room workforce management.

The traditional means of planning nurse staffing for operating rooms are either poorly translated to the setting or do not provide decision makers with a platform to defend their needs, especially in an era of health care reform. The surgical operations department of the Cleveland Clinic initiated a quality improvement project aimed at applying a scientific method to operating room staffing. One goal was to provide a defensible plan for allocating direct caregiver positions. A second goal was to provide a quick and easy way for nurse managers and directors to track positions and graphically depict the effect of vacancies and orientation on their staffing budgets. Using an objective, scientific method allows position requests to be approved quickly and allows managers to feel much more comfortable functioning in a "lean" mode because they know needed positions will be approved quickly. Managers and directors also have found that graphically depicting numbers of vacant positions, as well as staff in orientation, could quickly relate a story visually rather than getting "bogged down" in narrative (often losing finance administrators along the way).