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PubMed2006

Sociopolitical determinants of an AIDS prevention program: multiple actors and vertical relationships of control and influence.

In every country, health and prevention "come down" from the authorities responsible for this mission by way of planners, local authorities, and peer educators until it reaches the target population. International and national systems function on the premise of a top-down transmission, with little room for integrating local information that might provide a better understanding of the implementation process. This analysis is based on an empirical evaluative research of HIV/AIDS prevention projects with sex workers in a remote area of northern Brazil. It illustrates how nursing sociopolitical analysis can reveal how political interests can have perverse effects by contaminating the group's internal relations and with established partnerships, thereby weakening the impact of prevention programs. These effects can seriously affect community relations and social practices, far beyond the technical division of work and political hierarchies in the sociosanitary network.

Brazil↗
PubMed2001

Interaction analysis of stakeholders in water supply systems.

An analysis of the characteristic goals, strategies and rules of behavior of relevant stakeholders allows the efficacy and potential risks of past and current engineering and management concepts to be estimated. The study is driven by the observable shift from security to cost-centered strategies by water utilities and the difficulties of balancing technical and financial needs in an uncertain future. Its benefits include a methodology with a twofold result. With the aid of domain knowledge from experts involved in a participatory process, the interactions of a subset of stakeholders are quantified and documented in a rule catalog. This leads to an improved understanding of their decision-making rules. An agent-based model comprising these stakeholders' rules of behavior in subsequently development. Once the model is validated with data sets from a real utility, multiple-scenario testing helps to explore different strategies and can be used to generate ideas for developing flexible management and design schemes. Despite the complexity of the system described, simple model rules which are repeated annually can replicate the general development of both capacity and cost-related parameters. Scenario simulations show the effects of different management strategies on key parameters such as capacity, water price and financial debt.

Cities↗
PubMed1999

Ecological factors impacting provider attitudes towards human service delivery reform.

Although reform efforts are substantially altering the structural operations and guiding ideological framework of the human service delivery system, little empirical work has been done to systematically examine these transformations. This study examines providers' attitudes regarding two reform elements that are being widely implemented: an increased emphasis on interagency collaboration and a shift from a medical model service delivery philosophy, that focuses on client deficits, to one that emphasizes consumer strengths. Through survey data collected from 186 providers from 32 human service agencies in one county, the relationship between providers' perceptions of contextual support for human service delivery reform and providers' attitudes towards these initiatives is explored. The findings from this study support the importance of attending to the ecology in which we initiate system reform efforts. For both reform elements, working within contexts that are perceived as providing ideological and functional support for change was associated with positive provider attitudes towards those changes. Staffs' perceptions of the external environment played the most critical role in shaping staff attitudes. Interestingly, unique aspects of providers' work environments were related to positive attitudes towards the two different reforms. The implications of these findings for the success of human service delivery reform are discussed.

Attitude↗
PubMedDate not supplied

ModelDB: an environment for running and storing computational models and their results applied to neuroscience.

Research groups within the Human Brain Project are developing technologies to help organize and make accessible the vast quantities of information being accumulated in the neurosciences. The goal of this work is to provide systems that enable this complex information from many diverse sources to be synthesized into a coherent theory of nervous system function. Our initial approach to this problem has been to create several small databases. While addressing the issues of each individual database, we are also considering how each might be incorporated into an integrated cluster of databases. In this paper, we describe a pilot project in which we construct a database of computational models of neuronal function. This database allows models to be created and run and their results reviewed through a World Wide Web interface. Because models encapsulate knowledge in a formal manner about how neuronal systems function, we also discuss how this database forms a natural center for our initial attempts at creating a cluster of related databases. General issues of database development in the context of the Web are also discussed.

Brain↗
PubMed1993

Keys to effective regional health planning--an organizational behaviour approach.

Given its political appeal, economic logic and community-based focus, regional planning has re-emerged as a significant strategic initiative in our shifting health care system. As regional planning becomes more prevalent in Canada, it is increasingly necessary to establish a framework of sound organizational behaviour principles in which it can succeed. These principles--which relate to human relations and group interactions--are especially relevant in a complex undertaking such as regional health planning which is often encumbered by stakeholder self-interest, philosophical differences and a tradition of autonomy and independent initiative.

Canada↗
PubMed2005

Nurse scholars program.

The Nurse Scholars Program was developed for two reasons: to attract highly qualified students to nursing, and to increase the retention of graduates as they enter employment in local agencies following graduation. Scholars receive dollar 10,000 for each of their junior and senior years and are asked to work for 1 year at the agency for each dollar 10,000 received. Additional monies are set aside to assist graduate and doctoral students through stipends. Scholars are paired with Mentors, nurses selected for their expertise and experience and brought into the "family" of the hospital through special events. Mentors are included in educational activities and related programs. To date, dollar 840,000 has been committed to the program, and data regarding the success of the program are continually being assessed.

Education, Nursing, Baccalaureate↗
PubMed1992

Running as fast as they can: organizational changes in home health care.

During the 1980s, as the health care industry experienced what observers have dubbed a revolution, the home health industry also experienced its own transformation. Utilizing three organizational theories (neoinstitutional, resource dependency and population ecology), the authors report on a study of a probability sample of 163 home health agencies (HHAs) that were interviewed in 1986 and again in 1987 on the effects of Medicare policy changes including prospective payment (DRGs). This study tests hypotheses concerning the influence of environmental factors (e.g., state policy and characteristics of the local market) and organizational characteristics of the HHA (e.g., tax status and Medicare reliance) in explaining the propensity of HHAs to be (or become) parts of chains and/or multi-facility systems; and to develop particular types of interorganizational relations. The paper discusses the results in the context of public policy changes and the implications for future research and practice.

Data Collection↗
PubMed1990

Promoting nursing's health care agenda through collaboration.

Hawken, NLN's President, and Hillestad, confirm the wave of nursing practice and education collaboration that has grown over the last decade. They describe the movement of one school and its related practice settings in achieving true colleagueship within the nursing community. Goals of practice and education, once seen as separate if not conflicting, are seen to be coming together in this era.

Education, Nursing↗
PubMedDate not supplied

Licensing web-based nursing programs, courses, and course materials.

With the advent of the digital information age, schools of nursing are developing and using web-based programs, courses, and course materials to meet students' needs for access and high-quality learning experiences. In an attempt to maximize scant resources, including faculty, many schools are seeking grant funding, joining consortia, or forming partnerships that require sharing of web-based course materials. Entering such collaborative arrangements usually requires licensing agreements to transfer intellectual capital. This article explains licensing and the related concepts of intellectual property, copyright, and technology transfer. It also identifies the advantages and disadvantages of licensing and describes a licensing process.

Computer-Assisted Instruction↗
PubMed2005

Mental health care in Berlin.

AIM: To provide information on the mental health care system in Berlin, Germany. METHOD: Using available data we report on the spectrum of mental health care services provided in Berlin, the number of professionals working in these sectors, funding arrangements, pathways into care, and user/carer involvement. RESULTS: The health care system in Berlin consists of a network of inpatient, outpatient, ancillary, and rehabilitative facilities, all of which are meant to work in a synergistic fashion. However, although the individual treatment options are generally well-planned, there is still a lack of co-ordination between them. Currently, the entire network is threatened by cuts in state funding for ancillary and rehabilitative services, by further reductions in the number of hospital beds, and by insurance company cuts in prescription drug budgets, such as those used for atypical antipsychotics in outpatient care. DISCUSSION: Despite many similarities with the situation in other European capitals, the system of mental health care in Berlin suffers from a variety of problems related to co-ordination and costs that are unique to the German capital.

Berlin↗
PubMedDate not supplied

A collaborative health promotion effort: nursing students and Wendy's Team Up.

Community health nursing students, faculty, and Wendy's fast food restaurant conducted a 2-day health fair that provided health screening, counseling, and educational opportunities for the community, an exciting learning experience for the students, funds for the school of nursing, and good public relations for Wendy's. The authors describe the planning, implementation, and evaluation of this health fair as a student learning activity.

Community Health Nursing↗
PubMed2002

Making the most of collaboration: exploring the relationship between partnership synergy and partnership functioning.

Considering the challenges inherent to collaboration and the time it takes to achieve measurable outcomes, partnerships need a way to determine, at an early stage, whether they are making the most of collaboration. The authors have developed a new measure, partnership synergy, which assesses the degree to which a partnership's collaborative process successfully combines its participants' perspectives, knowledge, and skills. This article reports the results of a national study designed to examine the relationship between partnership synergy and six dimensions of partnership functioning: leadership, administration and management, partnership efficiency, nonfinancial resources, partner involvement challenges, and community-related challenges. Data were collected from 815 informants in 63 partnerships. Results of regression analysis conducted with partnership-level data indicated that partnership synergy was most closely related to leadership effectiveness and partnership efficiency. Implications of these findings for research and practice are discussed.

Community Health Planning↗
PubMed2000

Competition is no barrier to cooperation for children's hospital groups.

While many think the competitive nature of modern health care may prevent rival organizations from working together, two groups that specialize in children's hospitals have proven them wrong by joining forces to benchmark on bed control. The National Association of Children's Hospitals and Related Institutions, an association of 150 children's hospitals based in Alexandria, VA, has started a benchmarking project with Medical Management Planning, a Bainbridge Island, WA-based benchmarking and consulting company.

Bed Occupancy↗
PubMed1998

Evaluation: methods and strategy for evaluation--Arizona.

In this report, the author describes a relatively new but novel approach for program evaluation currently underway in Arizona. The author notes the crucial importance of local initiatives in tobacco control buoyed by evaluations integrally connected with day-to-day programs and led by local staff.

Arizona↗
PubMed2006

High-reliability teams and situation awareness: implementing a hospital emergency incident command system.

To enhance disaster preparedness, hospitals are beginning to implement the Hospital Emergency Incident Command System. Although Hospital Emergency Incident Command System provides a template for disaster preparation, its successful implementation requires an understanding of situation awareness (SA) and high-reliability teams. The authors present the concept of SA and how this concept relates to team reliability in dynamic environments. Then strategies for increasing SA and team reliability through education, training, and improved communication systems are discussed.

Disaster Planning↗
PubMed2003

International NGOs and the role of network centrality in humanitarian aid operations: a case study of coordination during the 2000 Mozambique floods.

In February 2000, Mozambique suffered its worst flooding in almost 50 years: 699 people died and hundreds of thousands were displaced. Over 49 countries and 30 international non-governmental organisations provided humanitarian assistance. Coordination of disaster assistance is critical for effective humanitarian aid operations, but limited attention has been directed toward evaluating the system-wide structure of inter-organisational coordination during humanitarian operations. Network analysis methods were used to examine the structure of inter-organisational relations among 65 non-governmental organisations (NGOs) involved in the flood operations in Mozambique. Centrality scores were used to estimate NGO-specific potential for aid coordination and tested against NGO beneficiary numbers. The average number of relief- and recovery-period beneficiaries was significantly greater for NGOs with high relative to low centrality scores (p < 0.05). This report addresses the significance of these findings in the context of the Mozambican 2000 floods and the type of data required to evaluate system-wide coordination.

Altruism↗
PubMed1992

Employee decision making and the successful marketing of hospital wellness products.

Hospitals are beginning to pursue employee wellness services as a promising diversification opportunity. However, a marketing concept approach to new product development may be needed for hospitals to compete and succeed in this unique product area. A model of employee decision making relative to wellness offerings is presented here. The model can serve as a fundamental starting point in hospitals' adoption of a marketing concept approach to developing products for the employee wellness market.

Decision Making↗
PubMed2006

Ethics in public health research: a research protocol to evaluate the effectiveness of public-private partnerships as a means to improve health and welfare systems worldwide.

Public-private partnerships have become a common approach to health care problems worldwide. Many public-private partnerships were created during the late 1990s, but most were focused on specific diseases such as HIV/AIDS, tuberculosis, and malaria. Recently there has been enthusiasm for using public-private partnerships to improve the delivery of health and welfare services for a wider range of health problems, especially in developing countries. The success of public-private partnerships in this context appears to be mixed, and few data are available to evaluate their effectiveness. This analysis provides an overview of the history of health-related public-private partnerships during the past 20 years and describes a research protocol commissioned by the World Health Organization to evaluate the effectiveness of public-private partnerships in a research context.

Clinical Protocols↗