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At least 487 records · Page 27Linked to original sources
PubMed2006

Better access to psychology services in primary mental health care: an evaluation.

INTRODUCTION: The Access to Allied Psychological Services program was introduced as part of the Better Outcomes in Mental Health Care initiative in 2001-2002. Divisions of General Practice are funded to establish programs that allow GPs to refer patients for psychological treatments. The University of New South Wales evaluated programs run by the Southern Highlands and Illawarra Divisions of General Practice. This paper presents the findings of these evaluations. METHOD: Both evaluations analysed process and patient outcomes. This was obtained from a combination of program data and qualitative satisfaction data. RESULTS: The two program models differed in the mechanism of retention of the psychologists and the method of referral of patients. Anxiety and depression were the main reasons for referral, and clinical data showed there was improvement in patient outcomes. Patients, GPs and psychologists expressed satisfaction with the programs. DISCUSSION: The Access to Allied Psychological Services programs in both Divisions have proven popular. Flexibility in the program structure allows Divisions to develop a model which suits their local circumstances. There is support for ongoing Commonwealth funding and the challenge is to find the most effective and financially sustainable model of delivery for psychological services in primary care.

Adult↗
PubMed1994

The media/information richness model as prescription for some health care service ills.

Because consumers are demanding more and better information from their health care providers, improving effectiveness and efficiency of communications is one way that health care providers can gain a competitive edge. The authors propose that health care communication effectiveness and efficiency can be improved by using the Media/Information Richness Model (MIR) in planning service delivery systems.

Communication↗
PubMed1975

Role of behavior modification in community mental health.

This paper briefly reviews the original concept of the community mental health movement; points to ways in which current service delivery systems deviate from this; offers and alternative framework for service delivery, that is, a behavioral model; and argues that its implementation would move community services closer to this conception. The implications of this model for intervention in the natural environment as well as for transitional and prosthetic facilities are described and examples given of its use. Emphasis is placed on working in the natural environment whenever possible via the use and cultivation of significant others as well as via provision of training in self-directed behavior change in addition to the blending of case management with careful evaluation of service.

Behavior Therapy↗
PubMed1996

Tricare: the military's version of managed care.

The Tricare program is a triple-option health delivery model that integrates health services for the nation's military. The author reviews the newest incarnation of the Department of Defense's attempts at providing managed care to CHAMPUS beneficiaries.

Catchment Area, Health↗
PubMed1996

Youth at risk: definitions and implications for service delivery.

The literature on adolescent risk is reviewed, a model of risk that emphasizes risk antecedents and markers is proposed, and an overview is presented of an emergency service delivery strategy that integrates services, emphasizes interagency coordination, and addresses the full range of service needs for youth at risk. Highlights of programs currently in operation are described.

Adolescent↗
PubMed1987

Revitalizing the district model for the delivery of prevention-focused community health nursing services.

The Block Nurse Program addresses the need to contain health care costs, prevent disability resulting from chronic illness, and promote the health of the elderly population. It provides community-based care and focuses on disease prevention and decreased use of institutional care. Because the block nurse model is neighborhood based, the program is decentralized and geographically specific. These characteristics, when juxtaposed with the often depersonalized and fragmented megacorporate health maintenance organizations and preferred provider organizations, have great public appeal. Block nursing allows for the individualized care that many fear will be lost in the current corporate organization of our health care system.

Aged↗
PubMed2000

Design evaluation: illuminating social work practice for better outcomes.

One of the difficulties in social work lies in finding forms of evaluation that suit the various kinds of work people actually do. There is a need for methods that allow a valid and rigorous evaluation of process as well as outcomes, particularly in new areas of work. A valuable example of such evaluation evolved at St. Luke's, a voluntary agency in Victoria, Australia, that used design evaluation to articulate a new model of practice. Design evaluation involved having the evaluator work with staff to describe work practices as a series of stages with associated principles. This process of documenting, clarifying, and illuminating the model led to its progressive refinement and concurrent improved services delivery to clients. Testing the program model with clients provided some valuable feedback about its effectiveness. This form of evaluation is complementary to outcomes evaluation and can also provide the information needed for a subsequent outcomes evaluation.

Australia↗
PubMed2005

Fixing the system? The experience of service users of the quasi-market in disability services in Australia.

A qualitative study involving semi-structured interviews with 31 people with disabilities and 32 carers in the state of Queensland, Australia, found that their experience of supportive service delivery had not improved despite reforms of the service delivery system driven by a version of the quasi-market model. Instead of delivering increased consumer choice and improved efficiency in service delivery, service users experienced inadequate service supply, service cutbacks, and an increased emphasis on cost subsidisation and assessment processes. Additionally, few consumers felt that individualised funding arrangements had personally delivered the benefits which the quasi-market model and associated policy paradigm had indicated that they should receive. For many consumers, the notion of consumer 'choice' around service provision was fictitious and they felt that any efficiency gains were at the agency level, largely at the consumers' cost. It is concluded that there appears to be no particular benefit to service users of quasi-market reforms, particularly in policy contexts where service delivery systems are historically under-funded.

Community Health Services↗
PubMed1998

A model for achieving total quality-management information technology infrastructure within an integrated delivery system.

The strategic development and deployment of a health management information technology infrastructure is discussed from two perspectives for radiologists and for other medical technologists: the integrated delivery system (IDS) perspective and a total quality-management (TQM) perspective. On the one hand, an IDS perspective is important because of the need to prepare radiologists and other medical practitioners to thrive within rapidly changing health organizational models and evolving health service delivery partnership systems. On the other, a TQM perspective is important due to the need to realize an appropriate, efficient, and cost-effective health information infrastructure for developing seamless, integrated radiological and other medical imaging services. Apart from intelligently pursuing an aligned organizational business strategy with the organizational information system strategy, senior radiological managers and medical technologists of health organizations need to pay particular attention to key quality principles for effecting changes in organizational structures and processes to fit changes in information technological requirements, implementations, and innovations.

Computer Communication Networks↗
PubMed1996

Nutrition education in rural Australia: why, who and how?

Improving nutrition knowledge through nutrition education had been a major strategy used by nutritionists and health educators to improve the dietary intake of Australians. This approach continues to be supported by contemporary practice, and nutrition and health policy documents at a national and state level. In Australia, the delivery of nutrition education services to rural and remote populations is limited by a scarcity of nutrition specialists such as dietitian/ nutritionists. This review highlights the importance of nutrition education in promoting the nutritional health of Australians in rural and remote areas, and describes a model for nutrition education service delivery based on generalists supported by specialists.

Allied Health Personnel↗
PubMed2002

Telepsychiatry: an overview for psychiatrists.

Telepsychiatry, in the form of videoconferencing and other modalities, brings enormous opportunities for clinical care, education, research and administration to the field of medicine. A comprehensive review of the literature related to telepsychiatry - specifically videoconferencing - was conducted using the MEDLINE, Embase, Science Citation Index, Social Sciences Citation Index and Telemedicine Information Exchange databases (1965 to June 2001). The keywords used were telepsychiatry, telemedicine, videoconferencing, Internet, primary care, education, personal digital assistant and handheld computers. Studies were selected for review if they discussed videoconferencing for patient care, satisfaction, outcomes, education and costs, and provided models of facilitating clinical service delivery. Literature on other technologies was also assessed and compared with telepsychiatry to provide an idea of future applications of technology. Published data indicate that telepsychiatry is successfully used for a variety of clinical services and educational initiatives. Telepsychiatry is generally feasible, offers a number of models of care and consultation, in general satisfies patients and providers, and has positive and negative effects on interpersonal behaviour. More quantitative and qualitative research is warranted with regard to the use of telepsychiatry in clinical and educational programmes and interventions.

Communication↗
PubMed1990

Improving the physical health-mental health interface for the chronically mentally ill: could nurse case managers make a difference?

Although the increased incidence and prevalence of medical illnesses among the chronically mentally ill has been well documented, access and use of general health care services by this population remains problematic despite the implementation of case management. This article describes the problems experienced in meeting physical health care needs through the five core case-management components of client identification and outreach, assessment, service planning, monitoring of service delivery, and advocacy. A model of case management is proposed that uses psychiatric nurse clinical specialists in supervisory and consultative rôles, and nurse practitioners to deliver primary care.

Health Services Accessibility↗
PubMed1997

Peer intervention in case management practice.

Using peers as case managers in dealing with current and chronic public health problems such as substance abuse, gang violence, or the HIV/AIDS crisis has been shown to improve outreach efforts, monitoring, and outcomes in hard-to-reach populations. This article focuses on a case management strategy that uses peer modeling interventions to assist people in renegotiating their present life circumstances. Peer modeling engages peers of the client population as case managers and employs group-mediated, social control intervention strategies in the community to bring about positive changes in lifestyle and living conditions. The peer approach is an enhanced version of case management, utilizing the core activities of outreach, assessment, planning, linking, monitoring, and advocacy but adding peer-led, skill-based training activities, coupled with a system of positive incentives designed to encourage a more healthful lifestyle. To clarify this enhanced approach to case management, the authors present a matrix to illustrate how key case management activities might be enhanced through peer modeling interventions. We conclude by suggesting the circumstances in which an organization responsible for service delivery might consider using peer modeling in addressing difficult public health problems, and we discuss the advantages and disadvantages of such a strategy.

Case Management↗
PubMed2006

Nursing in tele-mental health.

This article discusses a cooperative project involving an academic health sciences center, a state university, a women's shelter, and a community mental health center in East Texas, a medically underserved, rural region of Texas. The U.S. Department of Commerce provided grant funding to develop a telehealth network to provide an evaluation, referral, and treatment program for victims of domestic violence. Nurses were involved in all phases of the project, from initial conception through development, implementation, and evaluation. The authors concluded that all of the women involved in the study had significant mental health issues and other health concerns that were not being addressed by the existing health care delivery system. Without the use of telehealth, these women would have had limited access to primary health care and virtually no access to mental health services. The East Texas Tele-Mental Health Network demonstrates the value of the clinical and organizational skills that nurses bring to innovative models of mental health service delivery.

Adult↗
PubMed1992

Longitudinal analysis of patient satisfaction among Medicare beneficiaries in different models of health maintenance organizations and fee-for-service care.

Based on a randomly selected nationwide sample of Medicare beneficiaries, this study analyzes changes in patient satisfaction over a one year period for beneficiaries receiving care in a variety of delivery settings: fee for service, group model HMO, staff model HMO, and Independent Practice Association model HMO. The findings reveal the patient satisfaction changes significantly over a one year period, from lower levels of satisfaction to higher levels of satisfaction. The primary explanation for this change in satisfaction is a decline in health status over the same one year period. Additional differences in satisfaction with care were observed for Medicare beneficiaries served by different types of delivery settings with varying degrees of utilization controls.

Aged↗
PubMed2002

Planning for Canada's health workforce; past, present and present.

In a service enterprise, the front line is the product. Health human resources issues, however, continue to be treated as simple input problems. More data, in and of itself, will not solve health human resources planning challenges. The definition of how many and what types of healthcare providers are needed first requires a model of delivery of professional services built around professional healthcare workers. If we do not get this right, soon the shortage of healthcare workers will get even worse as young people choose careers in fields other than health services.

Canada↗
PubMed2005

Organisation of neoplastic haematopathology services: a UK perspective.

The diagnosis of haematological malignancies has begun to emerge as a distinct pathological discipline in the United Kingdom. This has been driven by the recommendation of the National Institute for Clinical Excellence that diagnosis of leukaemia and lymphoma should take place in a specialist laboratory and in most cases this should be organised on a regional basis. The reason for this guidance was the perception that there was a considerable level of diagnostic inaccuracy and that this could be improved by better integration of the currently available technologies. This is one of a number of major changes in the way that services to patients are being delivered, all of which are centred on the development of multidisciplinary teams responsible for the provision of local services. The introduction of the WHO classification of haematological malignancy provides a structure for the development of integrated haemtopathology laboratories, with its emphasis on definition of disease entities based on clinical, morphological, phenotypical and molecular features. This means that these diagnostic modalities can be used systematically and in parallel to provide effective cross validation of a diagnosis. One of the challenges raised by this approach is the selection of the most informative panels of investigations both at presentation and subsequent follow up from the wide range of options that are now available. The introduction of specialist haematopathology services in the United Kingdom has highlighted a number of scientific and organisational issues that in time may have a wider impact on diagnostic laboratories in general. These include the relationship between size and cost effectiveness and the future role of clinical scientists and medically trained pathologists. Integrated laboratories of the type being developed challenge the prevailing model for delivery of pathological services in the United Kingdom, which is based around the traditional pathology disciplines. These speciality boundaries will become less relevant as long established diagnostic techniques are replaced by the new generation of diagnostic technologies and it is important to establish frameworks of service delivery that can deploy these developments for the benefit of patients.

Flow Cytometry↗