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Focuses on the impact of the United States Joint Commission on Accreditation of Healthcare Organizations on the development of performance improvement. Comparison of performance improvement and health care services standards; Importance of program credibility; Factors of credibility.

In an attempt to increase efficiency and reduce costs in the provision of nursing care, many hospitals across the United States have introduced new models of care delivery. In a survey of hospitals conducted by the American Hospital Association, 97% of the institutions surveyed reported that they had introduced some type of nurse-extender program. The article analyzes the effects of restructuring nursing care by introducing nurses' aides to a primarily registered nurse (RN) staff, increasing the RN to patient ratios, and initiating an automated IV drug administration system.

The article focuses on the Fifth Annual Conference on the topic "Greater Resourcefulness with Fewer Resources: The Challenge for Nurse Executives," organized by the journal "Nursing Economic$," to be held at J.W. Marriott Hotel in Washington D.C. in October 1988. Nancy K. Austin, coauthor of the book "A Passion for Excellence: The Leadership Difference," will start off the conference with a motivational keynote speech addressing excellence for executives. The conference will help participants to identify creative ways of delivering patient care within an environment of shrinking resources and other venues in health care.

The article reports on the additional methods to support the Culturally and Linguistically Appropriate Services (CLAS) Standards within the health care organizations through the use of a freely available Internet resource in the U.S. National standards have been developed suggesting methods for meeting the need and systems changes are either mandated or recommended within health care delivery organizations to assure movement toward the goal of effective patient-provider communication.