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Traditionally, the provision of hospital services has been based on a set of values very different from those associated with the free market process. Without denying the import of sound financial support and performance, the authors suggest that to maintain "legitimacy", hospitals must examine their values and the relevance of those values to the communities they serve.
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OBJECTIVE: To examine how drug therapy course directors design and deliver drug therapy courses, and whether they employ adult education principles to assure effective education. DESIGN: Analysis of a three-part questionnaire sent to directors of drug therapy courses in Canada. PARTICIPANTS: The questionnaire was sent to all seven directors of drug therapy courses at medical schools that are accredited continuing medical education providers. RESULTS: All directors completed and returned the questionnaires. To decide on course content, most use feedback from previous course attendees, peer consultations, course committee member discussions and their own perceptions of learners' needs. Courses generally use conventional teacher-dominated technology rather than methods that emphasize active learner participation. CONCLUSION: Directors of Canadian continuing medical education drug therapy courses reasonably employ adult education principles when deciding learner needs and designing teaching vehicles.
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Information Technology (IT) is an increasingly important area for all aspects of life in the twenty first century. Computers have an impact on both our home life and our work life with information on many aspects of our lives being held on computer systems, some of which we are unaware. Despite this universal progression towards IT, certain areas within the National Health Service are still considered to be somewhat old fashioned in their tendency to resolutely adhere to recording information on paper. One of these areas is that of the mental health services, which perhaps given the nature of having a number of care sites makes it well suited to having the use of a well designed computer system capable of collating and co-ordinating all aspects of patient's management. This paper describes the development and implementation of a computer system designed to hold information on patients with depressive disorder across all mental health sites within both primary and secondary care. Data were manually input from patients' case notes onto a specially designed system at all sites and were then merged onto a master database by use of a patient's NHS number. Ultimately the master database held data on the entire course and management of 914 patients who suffered from depressive disorder that came within the two general practice catchment area. Professional perceptions of the usefulness of the database are discussed along with suggestions for promoting the implementation of such a system within mental health services nationwide.
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When Robert Wood Johnson Health System challenged a CMS gain-sharing demonstration project, its complaint was that it was excluded. But now a judge has shut down the experiment. The ruling could have ripple effects on other hospitals seeking creative ways to enlist doctors in containing costs. Hunterdon Medical Center had already recruited 75 physicians, says Robert Pickoff, left, chief medical officer.