PubMed · 8410640
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C L Betz. 1993. An uncertain future.. https://pubmed.ncbi.nlm.nih.gov/8410640/
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This paper delineates important considerations for having a better understanding of quality in maternity care. High quality requires providing a minimum level of care to all pregnant women and their new born babies and a higher level of care to those who need it; obtaining the best possible medical outcome of mother and baby; providing care which satisfies users and providers; and maintaining sound managerial and financial performance. While all these aspects are important, prioritizing among interventions to improve them will be influenced by cultural values, expectations and available resources.
For the implementation of the proposed European standardized vaccination, total quality management (TQM) and reengineering could be powerful tools with a potentially synergistic effect. In the case examined, nonexplicit TQM prepared the organization in several ways for reengineering: providing the human capital, making people think beyond their daily tasks, and pulling the inertial professional organization in the direction of an "adhocracy." The quiet role management played, the incentive supplied by a high authority, the quick creation of solutions, and the existence of a realistic crisis represent other success factors.
PURPOSE: To review the literature on barriers to availability, access, and utilization of preventive health care for young children three to five years of age and their families and to discuss the role of nurse practitioners (NPs) in future research, education, and practice in this area. DATA SOURCES: A comprehensive literature search was conducted of online material and CINAHL and Medline (CD-ROM 1990 to present). In addition, experts in this area were asked to recommend extra reading materials. Additional references in textbooks and articles were examined. CONCLUSIONS: The literature review supports that there are major barriers to be addressed in the areas of availability, access, and utilization of preventive health care services for young children and their families. Major concerns include mandatory system for preventative health care, lack of health insurance coverage, cultural issues, and parental effects. IMPLICATIONS FOR PRACTICE: Health professionals in the community will need to work together to reevaluate current preventive health care practices for young children. Alternative methods for approaching and providing preventive health care services may become increasingly important if these services for young children are to be provided at current or increased levels.