Health care delivery systems are under careful and systematic scrutiny. Particular concerns are the availability and access of health care to those in the lower and middle income groups and the escalating costs of health care which until quite recently have exceeded annual inflationary rates of increase. Efforts in social work in the health field have reflected these developments. Programmatic trends in health and social work now emphasize ambulatory care and are reflected in the concept of primary care medicine. Deinstitutionalization as a preferred program for patients is under review with particular emphas -is on providing adequate supportive services to maintain patients in a home care environment. Social work is a major discipline contributing to these programs through appropriate interventive measures. Moreover, the role of the social worker, because of involvement with front line community activities, is particularly suited to make a substantial contribution to this trend.

Ambulatory Care↗

PubMedDate not supplied

Collaboration works: the experience of developing a high dependency-nursing course.

Staff in an NHS trust and a university faculty worked collaboratively to develop a specific course for nurses working in high dependency areas. Initial evaluation suggested that there has been a positive impact on practice in that nurses who had completed the course were willing to share new knowledge and undertake teaching; management of patient care had become more effective; and the nurses were more willing to care for sicker patients. Nurses had also developed critical and reflective skills and were keen to review and develop practices through activities such as audit. This project has highlighted not only the need for practice based experience in caring for the critically/acutely ill patient but also the need for formal educational input from expert staff. It is concluded that advances in practice must be supported by appropriate education and training, and organisations need to work collaboratively in order to respond to the needs of staff and patients.

Cooperative Behavior↗

PubMedDate not supplied

Not all plain sailing.

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Atlantic Islands↗

PubMedDate not supplied

Use of the debate format journal club to teach critical appraisal.

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Conflict of Interest↗