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At least 415 records · Page 23Linked to original sources
PubMed1995

Transformation toward teamwork: a methodical approach to change. Three disparate cultures come together.

In January 1995, following a 19-month planning process, Fanny Allen Hospital, Medical Center Hospital of Vermont, and the University Health Center formed Fletcher Allen Health Care, a single operating entity. The University of Vermont is linked by contract to the new organization. From the beginning, the organizations' leaders approached the planning process with the human dimension in mind. Although the process was led by top leaders of the four entities, they relied on input from physicians and multidisciplinary teams of professionals. To gain employees' acceptance of the transition by making them feel secure, in December 1993, the organizations announced that no one would involuntarily lose his or her job for the next year. And managers have gained acceptance of the transition planning process by gaining input from employees and making it clear that the plans are not cast in stone. Nevertheless, both leaders and employees face anxiety and discomfort with change. In addition to fears about job security, they fear loss of control, quality, and a feeling of mission fulfillment. Communication has been fundamental to easing the transition. Leaders have delivered the same message to everyone, using a newsletter, employee meetings, management meetings, and a telephone hotline. Leadership education, development, and selection are other critical issues in helping employees adjust to change.

Anxiety↗
PubMed1995

Impact of the development of a multidisciplinary adverse drug reaction committee.

A multidisciplinary Adverse Drug Reaction (ADR) committee consisting of pharmacists, nurses, and physician was formed. The committee developed an ADR Reporting Form and a 24-hour ADR Reporting Hotline to simplify ADR Reporting throughout the hospital. An ADR Newsletter and an extensive inservice education program was also implemented. Suspected ADRs are investigated by a pharmacist and presented to committee. A formal report is then forwarded to the Pharmacy and Therapeutics Committee, as well as the clinical departments within the hospital. The establishment of a formalized multidisciplinary ADR committee was successful in generating 2.1 ADR reports per 100 hospital admissions. These ADRs were reported from a variety of healthcare professionals.

Adverse Drug Reaction Reporting Systems↗
PubMedDate not supplied

The Philadelphia Health Insurance Organization: the results of managed health care for 96,000 medical assistance recipients.

On March 1, 1986, an innovative Medicaid program serving 96,000 recipients began operation in Philadelphia, Pennsylvania. Known as the HealthPASS program, it changed the previous fee for service Medicaid program into a capitated, managed care "gatekeeper" system. The plan was administered through a Health Insurance Organization (HIO) designed cooperatively by the Pennsylvania Department of Welfare and a for-profit health maintenance organization. In its first year, the program enrolled over 500 physician case managers, saved the Commonwealth of Pennsylvania $20 million, instituted a quality assurance program with on-site audit of primary care physician office facilities and medical records, provided a 24-hour hotline, made available central case management for mental health care, and began to compile a comprehensive database to support medical case management.

Cost Control↗
PubMed1999

Designing compliance programs that foster ethical behavior.

The federal government continues to expand its initiatives to uncover healthcare fraud, waste, and abuse. It is therefore more important than ever that healthcare organizations have an effective compliance program in place. The organization should have a compliance officer with adequate authority and staff to carry out the compliance program's functions. The program should include an ethics code, an internal hotline that employees can use to report compliance concerns, and education and training for all employees. In addition, the program should be audited periodically to ensure its viability. To be successful, a compliance program also needs the support of the healthcare organization's senior management.

Communication↗
PubMed2000

Making corporate compliance programs work.

Healthcare organizations have created corporate compliance programs in an effort to adhere to Federal government recommendations, minimize the risk of wrongful behavior, and possibly reduce fines that may result from a government investigation. Compliance programs may have undetected weaknesses. Corporate compliance officers, executives, and board members need to be certain that their organization's program has sufficient infrastructure, oversight, and resources; effective education and training; an effective mechanism (hotline) to receive reports of compliance problems; and ongoing auditing and monitoring capabilities.

Government↗
PubMed2001

Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis.

This report updates and consolidates all previous U.S. Public Health Service recommendations for the management of health-care personnel (HCP) who have occupational exposure to blood and other body fluids that might contain hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV). Recommendations for HBV postexposure management include initiation of the hepatitis B vaccine series to any susceptible, unvaccinated person who sustains an occupational blood or body fluid exposure. Postexposure prophylaxis (PEP) with hepatitis B immune globulin (HBIG) and/or hepatitis B vaccine series should be considered for occupational exposures after evaluation of the hepatitis B surface antigen status of the source and the vaccination and vaccine-response status of the exposed person. Guidance is provided to clinicians and exposed HCP for selecting the appropriate HBV PEP. Immune globulin and antiviral agents (e.g., interferon with or without ribavirin) are not recommended for PEP of hepatitis C. For HCV postexposure management, the HCV status of the source and the exposed person should be determined, and for HCP exposed to an HCV positive source, follow-up HCV testing should be performed to determine if infection develops. Recommendations for HIV PEP include a basic 4-week regimen of two drugs (zidovudine [ZDV] and lamivudine [3TC]; 3TC and stavudine [d4T]; or didanosine [ddI] and d4T) for most HIV exposures and an expanded regimen that includes the addition of a third drug for HIV exposures that pose an increased risk for transmission. When the source person's virus is known or suspected to be resistant to one or more of the drugs considered for the PEP regimen, the selection of drugs to which the source person's virus is unlikely to be resistant is recommended. In addition, this report outlines several special circumstances (e.g., delayed exposure report, unknown source person, pregnancy in the exposed person, resistance of the source virus to antiretroviral agents, or toxicity of the PEP regimen) when consultation with local experts and/or the National Clinicians' Post-Exposure Prophylaxis Hotline ([PEPline] 1-888-448-4911) is advised. Occupational exposures should be considered urgent medical concerns to ensure timely postexposure management and administration of HBIG, hepatitis B vaccine, and/or HIV PEP.

Anti-HIV Agents↗
PubMedDate not supplied

Are we having fun yet?

Are you stressed out? Is your in box taller than you are? Do you have suicide hotline on speed dial? If you're not having fun at work, you're not alone.

Adaptation, Psychological↗
PubMed2002

[Perioperative assessment of body temperature in elderly patients during thoracic surgery].

Within the last years there is observed the increase in number of elder patients operated in planned terms. Perioperative disorders of thermoregulation are strongly expressed in the group of patients, and the number of complications rises significantly during inadvertent perioperative hypothermia. The aim of this study was estimation of body temperature in patients subjected to thoracosurgical operations. The study was performed in 23 patients older than 65 years, which were divided into 2 groups. In the group I (12 persons) we used usual methods of heat loss prevention. In group II there were used: passive methods of protection against heat loss as well as Hotline blood and fluids warmer with the possibility of intravenous fluids warming. The body temperature was estimated every 30 minutes. The temperature detectors were located on plantar surface of hallux and in nasopharynx. We observed statistically significant decrease in body temperature values in group I. We conclude that there is the necessarity of the using of accessory methods of heat loss prevention in elder patients subjected to thoracosurgery.

Aged↗
PubMed1993

"Mr. Health" programme on sex education for the adolescents.

30 years ago, late Premier Zhou Enlai pointed out: "Adolescents must be informed about sex knowledge." But unfortunately, for many years, authorities were too timid to popularize sex education among adolescents. According to a survey, only 37.6% of sex education was provided through formal ways. Another survey of 2071 sex offenders showed that 89.3% of them were teenagers. Besides, the cases of early romance increased dramatically in recent years. According to a survey in Beijing, Shanghai, Guangzhou and Chengdu, half of the high school students have had love affairs. Many of the adolescents have a hazy understanding of sex. Lacking contraceptive knowledge and measures, girls are likely to get pregnant, which make them feel so uneasy that some even committed suicide. Facing the above situation, "Mr. Health" Program on Sex Education for the Adolescents is underway. The program will comprise various activities. A column of "Mailbox of Mr. Health" is to be developed in the Science and Technology of Chinese Youth, a journal with national influence. Specialists will introduce the systematic knowledge of and proper attitudes toward sex in that column. Special educational radio programs are to be produced in the China Central Broadcasting Station to popularize the "Mr. Health" Program on Sex Education for the Adolescents. A hotline of counseling on sex knowledge is to be set by the Service Center of the Adolescents under the Central Committee of the Communist Youth League. And a large-scale exhibition of the "Mr. Health" Program on Popularizing Sex Education will be held throughout the country.

Adolescent↗
PubMed2002

Reducing tobacco use: what works in the population?

One-half of those who have ever smoked cigarettes are currently former smokers. This cessation coincided with a forty-year effort to educate and inform smokers about the risks of smoking. This paper examines the effects of several tobacco control interventions for smokers in the general population using population-based survey data. States with large media-led tobacco control programs have higher rates of smoking cessation, suggesting that these comprehensive approaches can alter smoking behavior. This paper also presents evidence supporting effects on smoking cessation for restrictions on where people can smoke, increases in the cost of cigarettes, provision of physician advice to quit coupled with cessation assistance, pharmacological assistance, and telephone hotlines. It also provides evidence that many of these interventions are being implemented in the general population in ways that are less effective than expected based on clinical trials. Increasing the effectiveness of these interventions and linking multiple interventions to provide synergy offer great opportunities to improve rates of population-based cessation.

Age Factors↗
PubMed2000

Resistance testing comes of age.

The Antiviral Drugs Advisory Committee (ADAC) to the Food and Drug Administration (FDA) recently held a two-day meeting to discuss HIV drug resistance testing. The discussion centered on currently available results from drug resistance tests and not on any one specific test or drug. For more information on HIV drug resistance and resistance testing, call Project Inform's Hotline and ask for the Geno- & Phenotypic Resistance Tests Quick Sheet.

Drug Resistance, Viral↗
PubMed2000

1999 National Conference on Women and HIV/AIDS.

The 1999 National Conference on Women and HIV/AIDS, held last October in Los Angeles, convened its largest number of participants. Over 2,000 researchers, clinicians, policymakers, AIDS activists and HIV-positive women came to discuss new treatment, behavioral and political issues affecting women. The strong and diverse turnout provided a lively and sometimes conflicting forum that reflected the growing visibility of women's issues. Following are selected highlights from the conference. For more on the 1999 Conference, call Project Inform's Hotline and ask for WISE Words #5, which fully covers the conference.

Anti-HIV Agents↗
PubMed2003

Malaria surveillance--United States, 2001.

PROBLEM/CONDITION: Malaria is caused by any of four species of intraerythrocytic protozoa of the genus Plasmodium (i.e., P. falciparum, P. vivax, P. ovale, or P. malariae). These parasites are transmitted by the bite of an infective female Anopheles sp. mosquito. The majority of malaria infections in the United States occur among persons who have traveled to areas with ongoing transmission. In the United States, cases can occur through exposure to infected blood products, by congenital transmission, or by local mosquitoborne transmission. Malaria surveillance is conducted to identify episodes of local transmission and to guide prevention recommendations for travelers. PERIOD COVERED: This report covers cases with onset of illness in 2001. DESCRIPTION OF SYSTEM: Malaria cases confirmed by blood film are reported to local and state health departments by health-care providers or laboratory staff. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System (NMSS). Data from NMSS serve as the basis for this report. RESULTS: CDC received reports of 1,383 cases of malaria with an onset of symptoms in 2001 among persons in the United States or one of its territories. This number represents a decrease of 1.4% from the 1,402 cases reported for 2000. P. falciparum, P. vivax, P. malariae, and P. ovale were identified in 50.1%, 27.8%, 4.5%, and 3.6% of cases, respectively. Fourteen patients (1.0% of total) were infected by >/=2 species. The infecting species was unreported or undetermined in 179 (12.9%) cases. Compared with 2000, the number of reported malaria cases acquired in Africa increased by 13.2% (n = 886), whereas the number of cases acquired in Asia (n = 163) and the Americas (n = 240) decreased by 31.5% and 11.4%, respectively. Of 891 U.S. civilians who acquired malaria abroad, 180 (20.2%) reported that they had followed a chemoprophylactic drug regimen recommended by CDC for the area to which they had traveled. Two patients became infected in the United States, one through congenital transmission and one whose infection cannot be linked epidemiologically to secondary cases. Eleven deaths were attributed to malaria, 10 caused by P. falciparum and one caused by P. ovale. INTERPRETATION: The 1.4% decrease in malaria cases in 2001, compared with 2000, resulted primarily from a decrease in cases acquired in Asia and the Americas, but this decrease was offset by an increase in the number of cases acquired in Africa. This decrease probably represents year-to-year variation in malaria cases, but also could have resulted from local changes in disease transmission, decreased travel to malaria-endemic regions, fluctuation in reporting to state and local health departments, or an increased use of effective antimalarial chemoprophylaxis. In the majority of reported cases, U.S. civilians who acquired infection abroad were not on an appropriate chemoprophylaxis regimen for the country in which they acquired malaria. PUBLIC HEALTH ACTIONS: Additional information was obtained concerning the 11 fatal cases and the two infections acquired in the United States. Persons traveling to a malarious area should take one of the recommended chemoprophylaxis regimens appropriate for the region of travel, and travelers should use personal protection measures to prevent mosquito bites. Any person who has been to a malarious area and who subsequently develops a fever or influenza-like symptoms should seek medical care immediately and report their travel history to the clinician; investigation should include a blood-film test for malaria. Malaria infections can be fatal if not diagnosed and treated promptly. Recommendations concerning malaria prevention can be obtained from CDC by calling the Malaria Hotline at 770-488-7788 or by accessing CDC's Internet site at http://www.cdc.gov/travel.

Humans↗
PubMed2003

Large group crisis intervention for law enforcement in response to the September 11 World Trade Center mass disaster.

University Behavioral HealthCare, University of Medicine and Dentistry of New Jersey in partnership with the New Jersey Department of Personnel established a program entitled "Cop 2 Cop" in 1999 to assist law enforcement personnel within the state. The events of September 11, 2001, demanded an unprecedented response to address the behavioral health care needs of those individuals in New Jersey and New York. Although the Cop 2 Cop program was initiated as a crisis intervention hotline, the legislature which established the program also identified facilitating Critical Incident Stress Management services for New Jersey law enforcement and their families as needed to be within the scope of function. This paper describes the Cop 2 Cop program interventions with the Port Authority Police Department (PAPD) which involved service provision to over 1,200 PAPD officers and an intensified process entitled an "Acute Stress Management Reentry Program" created for over 200 officers with unprecedented exposure to traumatic events.

Crisis Intervention↗
PubMedDate not supplied

Ethical dilemmas and solutions for risk assessment scientists.

A sample survey of U.S. scientists who belong to the Society for Risk Analysis (SRA) was made to ascertain their observations of unethical behavior in the workplace and their opinions of the likely success of programs to prevent misconduct. SRA, an international organization with almost 1,700 U.S. members, includes toxicologists, epidemiologists, industrial hygienists, engineers, and social scientists, as well as experts in exposure assessment, statistics, and risk communications. Respondents reported relatively low rates of clearly unethical acts such as data destruction and fabrication (7%); however, 21% reported at least one observation of plagiarism. Reporting of other problematic behaviors ranged from less than 4% for human subjects violations to 51% observing deliberate overstatement of positive and deliberate understatement of negative results. SRA members did not think that government intervention would be effective in reducing misconduct. They were more supportive of formal education, seminars, videotapes, and a hotline that could be called for advice. We offer suggestions to ISEA and its members for developing a proactive approach to ethical misconduct.

Ethics, Professional↗
PubMed2004

Malaria surveillance--United States, 2002.

PROBLEM/CONDITION: Malaria is caused by any of four species of intraerythrocytic protozoa of the genus Plasmodium (i.e., P. falciparum, P. vivax, P. ovale, or P. malariae). These parasites are transmitted by the bite of an infective female Anopheles species mosquito. The majority of malaria infections in the United States occur among persons who have traveled to areas with ongoing transmission. In the United States, cases can occur through exposure to infected blood products, by congenital transmission, or by local mosquitoborne transmission. Malaria surveillance is conducted to identify episodes of local transmission and to guide prevention recommendations for travelers. PERIOD COVERED: This report covers cases with onset of illness in 2002. DESCRIPTION OF SYSTEM: Malaria cases confirmed by blood film are reported to local and state health departments by health-care providers or laboratory staff. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System (NMSS). Data from NMSS serve as the basis for this report. RESULTS: CDC received reports of 1,337 cases of malaria with an onset of symptoms in 2002 among persons in the United States or one of its territories. This number represents a decrease of 3.3% from the 1,383 cases reported for 2001. P. falciparum, P. vivax, P. malariae, and P. ovale were identified in 52.3%, 25.4%, 2.8%, and 2.8% of cases, respectively. Eleven patients (0.8% of total) were infected by > or =2 species. The infecting species was unreported or undetermined in 213 (15.9%) cases. Compared with 2001, the number of reported malaria cases acquired in Asia (n = 171) and Africa (n = 903) increased by 4.3% and 1.9%, respectively, whereas the number of cases acquired in the Americas (n = 141) decreased by 41.2%. Of 849 U.S. civilians who acquired malaria abroad, 317 (37.3%) reported that they had followed a chemoprophylactic drug regimen recommended by CDC for the area to which they had traveled. Five patients became infected in the United States, one through congenital transmission, one probable transfusion-related, and three whose infection cannot be linked epidemiologically to secondary cases. Eight deaths were attributed to malaria. All deaths were caused by P. falciparum. INTERPRETATION: The 3.3% decrease in malaria cases in 2002, compared with 2001, resulted primarily from a marked decrease in cases acquired in the Americas, but this decrease was offset somewhat by an increase in the number of cases acquired in Africa and Asia. This limited decrease probably represents year-to-year variation in malaria cases, but also could have resulted from local changes in disease transmission, decreased travel to malaria-endemic regions, fluctuation in reporting to state and local health departments, or an increased use of effective antimalarial chemoprophylaxis. In the majority of reported cases, U.S. civilians who acquired infection abroad were not on an appropriate chemoprophylaxis regimen for the country in which they acquired malaria. PUBLIC HEALTH ACTION: Additional information was obtained concerning the eight fatal cases and the five infections acquired in the United States. Persons traveling to a malarious area should take one of the recommended chemoprophylaxis regimens appropriate for the region of travel, and travelers should use personal protection measures to prevent mosquito bites. Any person who has been to a malarious area and who subsequently experiences a fever or influenza-like symptoms should seek medical care immediately and report their travel history to the clinician; investigation should include a blood-film test for malaria. Malaria infections can be fatal if not diagnosed and treated promptly. Recommendations concerning malaria prevention can be obtained from CDC by calling the Malaria Hotline at 770-488-7788 or by accessing CDC's Internet site at http://www.cdc.gov/travel.

Antimalarials↗
PubMed2004

[Role of mass media during the severe acute respiratory syndrome epidemic].

OBJECTIVE: To understand the impact of effective interaction between public and media on the prevention and control of severe acute respiratory syndrome (SARS). METHODS: Based on the theory of field epidemiology, the traditional and modern technologies were brought forward. In the late period of SARS epidemic, investigation on knowledge, attitude and practice on SARS prevention and control among general population was conducted. RESULTS: During the 3 month period of SARS epidemic in Shenzhen, techniques of the "E-health and public health informatics" as an emerging fields were used to focus on population to eventually improve the health of entire population. Methods as television, radio, newspapers, magazines, printing and distribution of specific materials on SARS were included, and hotlines of telephone and mobile phone, web-based sites, electronic screening advertisements, and consultation or forum for the public etc. were used. Among 3405 subjects interviewed, more than 95% gave right answers on the SARS related questions. Most of them held the optimistic and scientific attitude. 80% of the population had taken the measures as recommended. 82.4% of the citizens were happy about the local government's action and 93.8% thought hospitals and healthcare workers should be respected and honored. CONCLUSION: Dealing with the urgent public health problems and emerging infectious diseases outbreak, epidemiologists need to keep good relations with media, and making use of modern electronic technologies to communicate with the public.

Adolescent↗