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PubMed2002

Systematic review of involving patients in the planning and development of health care.

OBJECTIVE: To examine the effects of involving patients in the planning and development of health care. DATA SOURCES: Published and grey literature. STUDY SELECTION: Systematic search for worldwide reports written in English between January 1966 and October 2000. DATA EXTRACTION: Qualitative review of papers describing the effects of involving patients in the planning and development of health care. RESULTS: Of 42 papers identified, 31 (74%) were case studies. Papers often described changes to services that were attributed to involving patients, including attempts to make services more accessible and producing information leaflets for patients. Changes in the attitudes of organisations to involving patients and positive responses from patients who took part in initiatives were also reported. CONCLUSIONS: Evidence supports the notion that involving patients has contributed to changes in the provision of services across a range of different settings. An evidence base for the effects on use of services, quality of care, satisfaction, or health of patients does not exist.

Attitude to Health↗
PubMed1990

The future of psychiatry. Council on Long Range Planning and Development.

The American Medical Association Council on Long Range Planning and Development has been publishing a series of reports that assess trends in the environment of medicine and their impact on physicians and health care provision. The Council believes each specialty in medicine will respond differently to changes in the health care arena. This report, developed in cooperation with the American Psychiatric Association, provides an overview and environmental analysis of the specialty of psychiatry. Socioeconomic data pertinent to psychiatry are reviewed first, followed by a review of scientific and clinical developments in the specialty. Next, the changing provision patterns of psychiatric care, the emerging patient populations served by psychiatrists, and recent developments in graduate medical education in psychiatry are reviewed. The Council also addresses changes in the financing of psychiatric care. In conclusion, the Council suggests implications of these and other environmental trends for psychiatry.

American Medical Association↗
PubMed1987

The future of pathology. Council on Long Range Planning and Development.

The American Medical Association Council on Long Range Planning and Development has identified trends in the environment of medicine and has assessed their likely implications for the pathology specialty. Competition and economic pressures focused on the hospital setting are likely to continue to affect the choice of delivery site for pathology practice. During the past decade, the pathology specialty has been subject to extensive regulation, placing a new focus on the role of the laboratory within the hospital and generating new ventures for the provision of pathology services. A continuing challenge to the specialty is management innovation and adaptation in the face of regulatory restrictions and cost-containment experiments. The significant forces for change affecting the demand for services and the shape of future provision of pathology services include rapid advances in technology and scientific knowledge, funding for biomedical research, training for research pathologists, demographic trends in the population, and medical liability trends. Finally, with renewed emphasis on quality of care in the health professions, the pathology specialty has the potential to make substantial contributions to the quality and art of medical practice and is likely to remain at the center of efforts to refine methods of quality assessment and implementation.

American Medical Association↗
PubMed1988

General practitioners' plans for developments in the inner city: a review by a primary care project.

This paper describes part of the work of a development project, working in Tower Hamlets in east London in 1983-87, with the wider remit for facilitating primary care development in the inner city. Thirty-nine of the 43 practices in the district were visited and general practitioners discussed their plans for development and the problems they encountered. The paper presents the results of the discussions and the follow-up work, which explored how further developments could be brought about. It concludes that many general practitioners are considering and introducing a wide range of new developments in their inner city practices. Planning for development of primary care in the inner city should focus more closely at local levels on what practices are already planning and provide more encouragement and practical help than at present.

Adult↗
PubMed2001

Career planning and development for nurses: the time has come.

Developments in how the nursing profession is perceived by nurses and by society, along with unparalleled changes in health care systems, have created an environment in which individual nurses must take control of their careers and futures. Educators, employers and professional organizations also have a key role to play in fostering the career planning and development of nurses, usually the largest employee group in most health care organizations. This article provides an overview of what career planning and development is and why it is important for nurses. A career planning and development model is described that provides nurses with a focused strategy to take greater responsibility for engaging in the ongoing planning process that is crucial throughout the major stages of their career. Finally, educators, employers and professional organizations are challenged to collaborate with individual nurses on career-development activities that will enable nurses to continue to provide high-quality care in ever-changing health care systems.

Career Choice↗
PubMed1992

A universal precautions monitoring system adaptable to any health care department.

The Occupational Safety and Health Administration has proposed monitoring employee compliance with universal precautions, as recommended by the Centers for Disease Control. Our respiratory care department, following a four-step system development plan, has developed and implemented a universal precautions monitoring system that is easy to adapt to any health care department. The results from monitoring can be used for educational planning, quality assurance purposes, and employee performance reviews.

Cooperative Behavior↗
PubMed1980

Public Health Service--Health systems agency and state health planning and development agency reviews: certificate of need programs. Final regulation.

These rules amend the Public Health Service regulations on health systems agency and State health planning and Development agency (State Agency) certificate of need reviews. These final regulations implement changes to Title XV of the Public Health Service Act made by the Health Planning and Resources Development Amendments of 1979 (Pub L. 96-79). Under the amended provisions of the Public Health Service Act, the planning agencies are required to review and determine the need for proposed capital expenditures, institutional health services and major medical equipment. These regulations set forth the minimum requirements for satisfactory certificate of need programs.

Certificate of Need↗
PubMed2004

Substance Use Disorders and Neurologic Illness.

Because of the high rates of substance use disorders among the general and clinical populations, and the abuse potential of many medications commonly used in the treatment of neurologic illnesses, the treating neurologist must deal with drug misuse and abuse in practice. The most important tool neurologists must have in their arsenal is the ability to assess for and recognize substance use disorders in their patients. Any treatment plan developed for such patients must include ongoing management of substance abuse issues. After a substance use disorder is diagnosed, the neurologist must make proper referrals to adjunctive support interventions (Alcoholics Anonymous or Narcotics Anonymous) and chemical dependency specialists, and work closely and in collaboration with these components of the patient's overall treatment. The treating neurologist should be aware of the myriad neurologic sequelae of drug use, because most drugs of abuse, including alcohol, can have neurologic manifestations resulting from acute intoxication, acute withdrawal, or chronic use. Drug use (past and present) should be included in the differential diagnosis for any patient with an atypical constellation of symptoms or with isolated neurologic deficits. If the treatment of a neurologic condition requires the use of a potentially addictive substance, particularly when the patient has a history of substance use disorders, then the clinician must minimize the risk of addiction by giving the least addictive substances and developing a plan to manage the use of the drug throughout the treatment period.

Journal Article↗
PubMed2003

Using burden of disease information for health planning in developing countries: the experience from Uganda.

Given the growing interest in both the use of evidence in planning and in using the burden of disease measure (BOD) and cost-effectiveness analysis, we explored health planners' perception of the usefulness of the BOD in priority setting and planning in developing countries, using Uganda as an example. An exploratory qualitative approach involving in-depth interviews with key policy makers in health at district and national levels was employed. Interviews were supplemented with a review of relevant documents. Analysis involved identification of key concepts from the interviews. Concepts were grouped into categories, namely, the appeal of quantitative data, data limitations, opaque methodology, planning as a political process and opportunity costs. These form the basis of this article. We found that the BOD study results have been used as the basis for the national health policy and in defining the contents of the national essential health care package. The quantification and ranking of disease burden is appreciated by politicians and used for advocacy, resource mobilization and re-allocation. The results have also provided information for priority setting and strategic planning. Limitations to its use included poor understanding of the methodology, poor quality of data in-puts, low involvement of stakeholders, inability of the methodology to capture key non-economic issues, and the costs of carrying out the study. There is commitment, by Ugandan planners to using evidence in priority setting. Since this was an exploratory study, there is a need for more studies in developing countries to document their experiences with the use of evidence, and specifically, the BOD approach in planning and priority setting. Such information would contribute to further synthesis of the approach.

Cost of Illness↗
PubMed1981

A case-mix method for developing health planning criteria for hospital services.

The principal concern of this article is the inadequacy of the planning criteria currently being used by existing federally funded health planning agencies. A case-mix method was created for developing appropriate criteria. Chart-abstract data from New Jersey were used to create a list of those diagnoses eligible for treatment in the cardiac care unit (CCU), select a sample of hospitals for study and analyze the relationship between CCU bed need and CCU clinical practice. It was shown that existing bed-need criteria for CCU planning represent current CCU clinical practice patterns, which are probably not cost effective. The method was also used to develop empirical values of these criteria, which do represent cost-effective practice. It is recommended that the method be used to strengthen and update continuously all hospital-service need criteria used in current planning activities, including Plan Development and Certificate of Need Review.

Bed Occupancy↗
PubMed1980

Public Health Service--health systems agencies and state health planning and development agencies; certificate of need reviews. Notice regarding certificate of need programs.

This Notice sets forth advance information regarding amendments to the regulations governing certificate of need reviews by health systems agencies and State health planning and development agencies. This Notice is intended to provide early guidance to States prior to publication of interim final regulations implementing the amendments to certificate of need provisions of the Public Health Service Act made by the Health Planning and Resources Development Amendments of 1979 (Pub. L 96-79). This early guidance will assist the States in beginning to revise their certificate of need laws. Under the amended provisions of the Public Health Service Act, the planning agencies are required to review and determine the need for proposed capital expenditures, institutional health services and major medical equipment. The Secretary intends to publish these interim final regulations within a few weeks. Following consideration of comments which will be solicited with regard to the interim regulations, the Secretary will publish an analysis of the comments and will revise those regulations as appropriate.

Certificate of Need↗
PubMed1990

The future of general surgery. AMA council on long range planning and development.

During the past several years, the American Medical Association's Council on Long Range Planning and Development has identified trends in the environment of medicine that are likely to affect physicians, their practices, and the provision of medical care in the future. In the course of its environmental analysis studies, the Council has recognized that each medical specialty is uniquely subject to anticipated changes in the environment of medicine. As part of an ongoing series of analyses prepared by the Council, this report focuses on environmental trends that are likely to influence the practice of general surgery. The report outlines the current state of general surgery, the forces for change in the environment, and the implications regarding these changes. The Council concludes that there are certain challenges and many positive indicators for the future of general surgery.

American Medical Association↗
PubMed1989

The future of general surgery. Council on Long Range Planning and Development.

During the past several years, the American Medical Association's Council on Long Range Planning and Development has identified trends in the environment of medicine that are likely to affect physicians, their practices, and the provision of medical care in the future. In the course of its environmental analysis studies, the Council has recognized that each medical specialty is uniquely subject to anticipated changes in the environment of medicine. As part of an ongoing series of analyses prepared by the Council, this report focuses on environmental trends that are likely to influence the practice of general surgery. The report outlines the current state of general surgery, the forces for change in the environment, and the implications regarding these changes. The Council concludes that there are certain challenges and many positive indicators for the future of general surgery.

Adult↗