An ISO perspective: implement voluntary programs rather than full regulation.
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Economic Competition↗
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Results for “Voluntary Programs”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
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Voluntary protection programs to supplement enforcement and to provide safe and healthful working conditions--OSHA. Notice of implementation of revised voluntary protection programs.
OSHA announces the implementation of three Voluntary Protection Programs. The programs, revised from the January 19, 1982, notice in the Federal Register (47 FR 2796), seek out and recognize exemplary safety and health programs as a means of expanding worker protection. Companies, general contractors, and small business organizations which meet specified programmatic safety and health criteria, which go beyond OSHA standards in providing safe and healthful workplaces for their employees, and which want to do more than is required to help the agency accomplish the goals of the Act are the applicants OSHA seeks for these voluntary programs. In return, OSHA will remove participants from general schedule inspection lists and give priority attention to any which request a variance. The programs are called "Star." "Try," and "Praise."
Occupational Health Services↗
An integrated approach for improving occupational health and safety management: the voluntary protection program in Taiwan.
A voluntary compliance program for occupational health and safety management, Voluntary Protection Programs (VPP), was implemented with a strategy of cooperation and encouragement in Taiwan. Due to limitations on increasing the human forces of inspection, a regulatory-based guideline addressing the essence of Occupational Health and Safety Management Systems (OHSMS) was promulgated, which combined the resources of third parties and insurance providers to accredit a self-improving worksite with the benefits of waived general inspection and a merit contributing to insurance premium payment reduction. A designated institute accepts enterprise's applications, performs document review and organizes the onsite inspection. A final review committee of Council of Labor Affairs (CLA) confers a two-year certificate on an approved site. After ten years, the efforts have shown a dramatic reduction of occupational injuries and illness in the total number of 724 worksites granted certification. VPP worksites, in comparison with all industries, had 49% lower frequency rate in the past three years. The severity rate reduction was 80% in the same period. The characteristics of Taiwan VPP program and international occupational safety and health management programs are provided. A Plan-Do-Check-Act management cycle was employed for pursuing continual improvements to the culture fostered. The use of a quantitative measurement for assessing the performance of enterprises' occupational safety and health management showed the efficiency of the rating. The results demonstrate that an employer voluntary protection program is a promising strategy for a developing country.
Cooperative Behavior↗
CMS program P4P precursor. The Physician Voluntary Reporting Program looks to get providers in a pay-for-performance state of mind.
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Centers for Medicare and Medicaid Services, U.S.↗
An explanation of the Medicaid Voluntary Contribution Program.
The Engler Medicaid Voluntary Contribution Program provides a vehicle to address the current economic pressures on the state and hospitals, while committing all parties to work on reform of the current system.
Fund Raising↗
Regulation of animal experimentation: Canada's program of voluntary control.
The Canadian Council on Animal Care (CCAC), is an autonomous advisory and supervisory body responsible for surveillance of experimental animal care and use in Canada's universities, government laboratories and pharmaceutical houses. Its 20-organization membership includes representatives of government, industry, academia and the humane movement. CCAC's voluntary peer review program depends heavily on institutional animal care committees who evaluate the ethical aspects of animal study protocols, and provide day-to-day surveillance of animal care. Its scientific teams, each of which also includes an appointee of the Canadian Federation of Humane Societies (CFHS), conduct assessments based on CCAC's "Guide to the Care and Use of Experimental Animals" (Volume 1, 1980; Volume 2, 1984). Canada's two major funding agencies, the Medical Research Council (MRC) and the Natural Sciences and Engineering Research Council (NSERC), have recently stated that, in the event of an institution's continued non-compliance with CCAC requirements, sanctions may include the "freezing or withdrawal of any or all research programs funded by either or both Research Councils in an institution". This presentation describes the CCAC program of voluntary peer review and examines historic aspects of animal issues in Canada, from that country's early reliance on the fur trade, to today's almost defunct harp seal fishery, from Banting and Best's discovery of insulin, to development of the pacemaker.
Animal Testing Alternatives↗
Chronometric analysis of the posturo-kinetic programming of voluntary movement.
Posturo-kinetic programming was investigated in a simple reaction time paradigm. Standing subjects performed voluntary upper limb elevations under three conditions differing by the importance of their destabilizing effect on the initial balance. Three indexes were considered: the reaction time (RT) corresponding to delay between the response signal (RS) and the onset of the upper limb acceleration at wrist level (Aw); the motor latency (ML) corresponding to delay between RS and onset of the earlier of the two accelerations at shank level (As) which was previously shown to indicate the onset of postural adjustments; and the postural anticipation (PA) corresponding to the delay between the onset of the earliest As and the onset of Aw. The results showed that the RT varied in relation to parameters of the forthcoming movement. RT variations were essentially due to differences in the PA. It appeared that the ML depended on cognitive factors while the PA depended on biomechanical ones. it is concluded that ML corresponds to the "true" reaction time while PA covers the earliest part of the motor response.
Journal Article↗
Chemical industry voluntary test program for phthalate esters: health effects studies.
The Chemical Manufacturers' Association voluntary test program on phthalate esters is described, and the results of certain key aspects of the program are presented. Representative phthalate esters were chosen for genotoxicity testing and peroxisome proliferation screening, and di-2-ethylhexyl phthalate (DEHP) and its initial metabolic products were tested in the genotoxicity battery. A comparative metabolism study was performed with DEHP in the mouse, rat, and cynomologus monkey, together with a study of the metabolism of DEHP in the rodent at several dose levels, and after prolonged feeding. A standard test for peroxisome proliferation in the rat, employing 21 days of feeding and several end points is described, based on DEHP as a reference compound. DEHP is shown to be nongenotoxic in the test battery, and its initial major metabolites are also nongenotoxic. A nonlinear dose response with respect to the beta-oxidation of DEHP in the rodent is demonstrated. Quantitative differences exist between the mouse and rat, and the cynomologus monkey with respect to the beta-oxidation of DEHP, beta-oxidation being a much less used pathway in the monkey. The significance of these results in interpreting the hepatocellular carcinogenesis of DEHP in the Fischer 344 rat is discussed.
Animals↗
OSHA's voluntary protection programs. The benefits to occupational health nurses and their companies.
The Voluntary Protection Programs (VPP) consist of three different programs: Star, Merit, and Demonstration. Each is designed with different criteria to allow the opportunity for a wide range of safety and health programs to be recognized. To be accepted into the Star program it is necessary to have statistics that indicate the program is effective and to have the following six elements incorporated into a comprehensive safety and health program: management commitment; established methods of worksite analysis; established methods of hazard prevention and control; quality safety and health training; employee participation; and annual self evaluation. Because occupational health nurses have daily experience and formal training in hazard prevention and control, safety and health training, and employee health, they are invaluable resources in the VPP application process and in the maintenance of Star level protection. Decreased workers' compensation costs, decreased injury rates, and development of a positive attitude toward OSHA are benefits of the VPP for management, employees, and OSHA.
Accidents, Occupational↗
Integrating simulation into a surgical residency program: is voluntary participation effective?
OBJECTIVE: Surgical training programs nationwide are struggling with the integration of simulation training into their curriculum given the constraints of the 80-h work week. We examine the effectiveness of voluntary training in a simulation lab as part of the surgical curriculum. METHODS: The ProMIS simulator was introduced into the general surgery residency at Boston University Medical Center. All categorical residents (28) and non-categorical residents (23) were offered a 2-h training session and curriculum review. After the introductory session, time spent in the lab was encouraged, but voluntary. Use of the simulator was tracked for all residents. Participation in the simulation curriculum was defined as three or more uses of the simulator. After 3 months, all residents completed a survey regarding the simulation lab and their simulator usage. RESULTS: Twenty-six (93%) categorical residents and three (6%) non-categorical residents completed the introductory simulator training session. Over a 3 month period, use of the simulator at least once was 31% among all eligible residents; 80% of postgraduate year (PGY)1, 40% of PGY2, 60% of PGY3, and 0% of PGY4 and PGY5. Four residents (14%) participated in the simulation curriculum. Overall, 70% of simulator usage was during working hours, and 30% was completed post-call or when the resident was off duty. Most residents agreed that the simulator was easy to use and that its use improved their operative skills, but they did not think it was a good substitute for actual operative experience. Reported reasons for not using the simulator included off-site rotation (44%), no time (30%), and no interest (11%). CONCLUSIONS: Voluntary use of a surgical simulation lab leads to minimal participation in a training curriculum. Participation should be mandatory if it is to be an effective part of a residency curriculum.
Boston↗
The voluntary control program of the Canadian Council on Animal Care.
The Canadian Council on Animal Care (CCAC), founded in 1968, monitors and influences the care and use of animals utilized for experimentation in that country. Its program is one of voluntary peer review stressing control from within the institution exercised by the local animal care committee (ACC). Council's assessment panels evaluate and make recommendations regarding facilities and the effectiveness of the ACC.
Animals↗
Occupational safety & health administration. Building partnerships.
1. The Office of Occupational Health Nursing, within the Occupational Safety & Health Administration (OSHA), actively advocates for workers and occupational health nurses. 2. Although an enforcement agency by law, OSHA has and is in the process of building bridges to the regulated community through its cooperative development of programs intended to enhance employer efforts for improving and maintaining employee health and workplace safety. 3. OSHA's service of consultation is geared toward the small employer seeking assistance in the recognition and correction of workplace hazards, while improving worksite health and safety programs. Voluntary Protection Programs participation, the recognition of exemplary larger employers, often leads to improvements in employee safety motivation while improving product quality, worker productivity, and corporate profits. 4. OSHA produces a wealth of publications, pamphlets, audiovisual, computer access programs and other documents designed to ease compliance while providing a foundation to the understanding of workplace health and safety.
Humans↗
An approach to reviewing the effectiveness of programs.
Voluntary funding organizations face increasing public demands for accountability in the use of funds. This article presents a model for evaluating the effectiveness of agency programs and discusses its applicability to the process of allocating funds.
Evaluation Studies as Topic↗
Substance-impaired physicians probationary and voluntary treatment programs compared.
We compared the characteristics and treatment outcomes of substance-impaired physicians monitored by two different programs in Oregon: a probationary program administered by the Oregon Board of Medical Examiners and the confidential, voluntary Diversion Program for Health Professionals. Demographic, substance use, and treatment outcome variables were obtained by a retrospective medical record review from 41 physicians monitored by the Oregon board and 56 physicians monitored by the diversion program during a 3-year study period. Compared with physicians monitored by the Oregon board, physicians in the diversion program were younger, more likely to be in training programs and less likely to be in hospital-based practice settings, more often reported by immediate rather than third-party contacts, more likely to choose in-state inpatient treatment than out-of-state treatment, and less likely to have concurrent mental illness diagnoses (P < .05 for all comparisons). Short-term relapse rates did not differ statistically between the groups (22.0% for the Oregon board group, 14.3% for the diversion program group). The higher number of younger physicians and physicians in training and tendency toward increased reporting by immediate contacts in the diversion program suggested earlier intervention than in the Oregon board group.
Adult↗
An analysis of the effects of prospective reimbursement programs on hospital expenditures.
Prospective reimbursement (PR) programs attempt to restrain increases in hospital expenditures by establishing, in advance of a hospital's fiscal year, limits on the reimbursement the hospital will receive for the services it provides to patients. We used data complied from a sample of approximately 2700 community hospitals in the U.S. for each year from 1969 to 1978 to estimate the effects of prospective reimbursement programs on hospital expenditures per patient day, per admission, and, to a lesser extent, per capita. The statistical evidence indicates that some PR programs have been successful in reducing hospital expenditures per patient day, per admission, and per capita. Eight programs--in Arizona, Connecticut, Maryland, Massachusetts, Minnesota, New Jersey, New York, and Rhode Island--have reduced the rate of increase in expenses by 2 percentage points or more per year and, in some cases, by as much as 4 to 6 percentage points. There are indications, although less strong, that PR programs also reduced expenses in Indiana, Kentucky, Washington, western Pennsylvania, and Wisconsin. There are no indications of cost reductions for programs in Colorado and Nebraska. An analysis of the relative effectiveness of the various programs suggests that mandatory programs have a significantly higher probability of influencing hospital behavior than do voluntary programs. Some voluntary programs, however, are shown to be effective.
Analysis of Variance↗
Proceed (program of continuing education) voluntary continuing education program.
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Education, Dental, Continuing↗
[Hyperventilation syndrome: evaluation of voluntary hypoventilation programs in two rehabilitation centers].
PURPOSE: The effectiveness of a voluntary hypoventilation technique was assessed in two rehabilitation centers in patients with hyperventilation syndrome. METHODS: In the first center, 55 patients participated in an open program determining themselves the frequency and number of their consultations. In the second center 158 patients participated in a 10-week program that imposed five 60-min sessions. RESULTS: In the first center, the patients participated in 4.8 30-min sessions over a 6.1 week period. Their cardinal complaints had declined by 48% (range 14% to 67% depending on the type of complaint) at the end of the program. In the second center the patients experienced an improvement in their comfort of life (less sleep disorders, fatigability, symptoms of severe hypocapnia), increasingly so with each new session, those having completed the program reaching a 62% improvement. DISCUSSION: Due to the strong correlation observed between the clinical improvement (with a longer interval between acute episodes) and the quality of patient participation the beneficial effect of these voluntary hypoventilation rehabilitation programs cannot be attributed solely to the psychological effect of patient care.
Adult↗
Diversity among hospice volunteers: a challenge for the development of a responsive volunteer program.
Voluntary organizations such as hospices are increasingly being called upon to substitute for state health and social welfare delivery at a time when volunteer contributions are threatened because of organizational and demographic changes. These changes include: the adoption by the nonprofit sector of market strategies in response to health and social welfare reforms, increases in the size and complexity of hospices, increasing professionalization of staff, and the move of women away from voluntary work in the health and welfare services to paid employment. With these changes, hospices must be knowledgeable about their volunteer workforce and resourceful if they are to continue to attract and retain volunteers. A survey of volunteers conducted at the Mary Potter Hospice, Wellington, New Zealand, examined differences in volunteers' characteristics, motivations for joining hospice, and factors affecting work satisfaction according to age, gender, and the length of time volunteers had worked. Those findings of particular relevance to program development were: (1) the tendency for the recently recruited volunteers to be in paid employment; (2) the mixed motivations of the younger volunteers, reflecting both altruistic and personal gain needs; and (3) the rewards commonly identified by volunteers, such as feeling their work is of value, being accepted by hospice staff, and feeling like important team members. Practical outcomes of the study are described.
Adult↗