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Results for “Mandatory Programs”

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At least 55 records · Page 3Linked to original sources
PubMed1989

Multidisciplinary response of San Francisco General Hospital to the AIDS epidemic.

Acquired immunodeficiency syndrome (AIDS)-related services offered by San Francisco General Hospital (SFGH); programs to protect employees who are at occupational risk for infection with human immunodeficiency virus (HIV); and the legal, ethical, and economic implications of such infection are discussed. Support from public officials, health-care professionals, and the community has enabled SFGH to develop an extensive program of AIDS-related services. The program consumes 10% of SFGH's budget and was responsible for treating 1693 patients between January 1981 and June 1988. The hospital has two internationally recognized units dedicated to the care of AIDS patients. Many of the medical and support departments at SFGH contribute expertise directly; clinical and basic research are also conducted. Other services sponsored by the hospital include HIV testing and counseling; special training for physicians and nurses; assisting patients with finances, housing, and home care; emotional support; and community education. Expenses per patient are lower at SFGH than nationally because of contributions from the private and public sectors, but costs are not fully recovered. Hospital employees are protected by a body substance precautions program, a comprehensive needle-stick program, mandatory reporting and evaluation of all exposures, and enrollment in a study to document seroconversions. Confidentiality and compensation remain major concerns. San Francisco General Hospital has a model program of caring for patients with AIDS and protecting its workers, but the issue of compensating those employees who do become infected with HIV has not yet been resolved.

AIDS Serodiagnosis↗
PubMed2002

Compliance testing of medical diagnostic x-ray equipment: three years' experience at a major teaching hospital in Western Australia.

The impact of a formal compliance testing program has been evaluated three years post-implementation on a major teaching hospital (Sir Charles Gairdner Hospital) with 46 x-ray tubes located throughout 37 rooms. The mandatory program, implemented by the statutory authority in January 1997, called for all medical (including chiropractic and dental) equipment used in human diagnosis to be tested at prescribed frequencies using established protocols. The application of the required test methods demonstrated various non-compliance issues. Notices of non-compliance were received for approximately 60% of the equipment in the hospital following the equipment's first annual test. The reasons for, and the significance of, failure varied according to equipment category, test category, equipment use and equipment age. However, at the end of the third year of testing, approximately 75% of the tested x-ray units satisfied the compliance criteria. The main reasons for non-compliance were found to be design limitations of old technology and the current radiation legislation that makes it difficult for some older equipment to meet the relatively stringent criteria.

Equipment Safety↗
PubMedDate not supplied

Staff survey of organizational structure and process for a Public Health Department.

A survey of 227 North York Public Health Department (NYPHD) staff provided their perspective on the organizational structure. They perceived that (a) the departmental and divisional organizational structures are effective for program delivery, (b) the Central Resources structure and divisional and departmental reporting structures are moderately effective for program delivery, (c) the decentralized office structure is an advantage for service delivery but less so for administration and intra-division and inter-division communication, (d) the mandatory program structure involves low to moderate interdisciplinary teamwork and moderately impacts service delivery, (e) intra-division and management-staff communication are fair but inter-division and office communication are between poor and fair, (f) education, research, and service are moderately integrated, and (g) the divisional and departmental work atmospheres are a little positive. Management perceived greater participation in program planning, more frequent communication with other divisions, a number of education and research opportunities from various divisions/units, and more management recognition than front line staff did.

Attitude of Health Personnel↗
PubMed2005

Evaluation of the mandatory child abuse course for physicians: do we need to repeat it?

INTRODUCTION: Child abuse is one of the most common disorders affecting children of all ages. The objective of this study was to measure and assess the effectiveness of the mandated New York State child abuse and maltreatment course, and to identify and define the need for a refresher course. METHODS: This study was conducted in two parts. Part 1 consisted of a web-based survey among the paediatric members of 'Physicians Online' in New York State, and Part 2 consisted of an anonymous questionnaire survey using conventional US mail among the registered physicians in New York State who took the mandatory 'Recognition of Child Abuse and Maltreatment Course' between January 1988 and December 1998. The questionnaire included demographic information, test questions, and opinions of the physicians regarding the need for a refresher course. RESULTS: The web survey yielded 239/664 (36%) responses in 1 week. Approximately 45% of the respondents agreed that participation in the course produced a significant difference in their knowledge base and recommended that the course should be repeated every 5 years. The response rate for the mail survey was 56% (424/756). Among the respondents, 88% agreed that participation in the course produced an increased source of knowledge and practice (mean score of 3.2 +/- 1.2 using a scale of 1-5; where 1 = disagree and 5 = agree). The time since the course was taken (1-5 years vs >5 years ago) did not significantly influence their responses. Although 84% of the respondents answered the test questions correctly, significant differences were noted across practice specialty (P<0.05). In response to the question regarding the necessity for a refresher course, the mean score was 2.55 +/- 1.6 using a linear scale of 0-5 (where 0 = strongly disagree and 5 = strongly agree). CONCLUSIONS: These data suggest that practice specialty, not the time since the course was taken, made a significant difference in the knowledge of recognition and reporting of child abuse.

Adolescent↗
PubMed2000

Selection bias in HMOs: a review of the evidence.

Early reviews found that health maintenance organizations (HMOs) attracted healthier beneficiaries in the Medicare program and healthier employees in the market for employer-based insurance. This review finds that HMOs still attract healthier Medicare beneficiaries, that HMOs no longer attract healthier employees, and that HMOs attract healthier Medicaid recipients. This review also found conflicting evidence about whether Medicare HMOs are overpaid, no evidence that HMOs are overpaid in the market for employer-based insurance, and evidence that concerns about overpaying Medicaid HMOs have diminished because many states are adopting mandatory programs.

Fees and Charges↗
PubMed1998

CMA says no to mandatory hepatitis B vaccination, screening for MDs.

Should vaccination of physicians against hepatitis B, as well as subsequent screening for the virus, be mandatory? The CMA says no: the voluntary route is the way to go. But Health Canada disagrees. Its new guidelines call for mandatory vaccination and subsequent screening of exposure-prone physicians for the virus.

Canada↗
PubMed1994

Child abuse: is there a mandate for researchers to report?

During the past 20 years, states have increasingly expanded the lists of individuals who are obligated to report their suspicions of child abuse and neglect. These legal requirements are juxtaposed with ethical considerations in research and professional practice. The ethical issues include the obligation to maintain both confidentiality of information provided by human participants and the safety and protection of these participants. This article reviews the types of state child abuse reporting statutes and outlines the categories of mandated reporters. I develop a model of how individual researchers should approach deciding whether they are mandated reporters of child abuse and neglect.

Behavioral Research↗
PubMed1999

Disclosing physician financial incentives.

Federal and state regulatory initiatives as well as court decisions increasingly require managed care organizations to disclose physician financial incentives and have raised the issue of disclosure by physicians themselves. These mandates are based on ethical and legal principles arising from the patient-physician relationship and the relationship between health plan sponsors and enrollees. Disclosing incentives also serves important policy objectives: it can inform enrollees' choice of plan, reinforce enrollees' capacity to understand and exercise other rights under managed care, and discourage use of compensation methods that might compromise patients' access to treatment. However, significant conceptual and practical questions remain about implementing a disclosure mandate. Unresolved issues include the timing, content, and scope of disclosure, the relationship of disclosure to patients' substantive rights, and the impact of disclosure on trust between patients and physicians. These uncertainties exemplify the challenges facing policymakers, plans, and physicians as they determine how best to inform patients about managed care.

Conflict of Interest↗
PubMed2004

The learning curve in sentinel node biopsy: the ALMANAC experience.

Sentinel node biopsy (SNB) is a minimally invasive procedure to stage the axilla in patients with breast cancer. Like any new surgical procedure, it is associated with a learning curve. This article describes the learning curve as part of the ALMANAC trial. The first phase of this trial is a validation phase in which surgeons perform SNB followed by an immediate axillary dissection in a consecutive series of 40 patients with invasive breast cancer. Each surgeon completes a mandatory program of proctored training during this phase. Surgeons who achieve a localization rate of 90% or more and a false-negative rate of 5% or less are eligible to proceed to the randomized phase. All 13 surgeons who completed 40 procedures as part of the validation phase of the ALMANAC trial achieved the set target. This study shows that a standardized training program allows surgeons to achieve a satisfactory localization rate and an acceptable false-negative rate after 40 SNBs.

Adult↗
PubMed1997

Immunization for prevention and treatment of cocaine abuse: legal and ethical implications.

A cocaine vaccine, currently under investigation by several laboratories, would be an innovative and exciting means of treating and preventing cocaine addiction. However, an approved vaccine will raise at least two major areas of concern. (1) Loss of privacy: cocaine antibodies might be used as a marker to identify, penalize, and stigmatize vaccinated individuals. (2) Selection for vaccination: should immunization be voluntary or compelled: should immunization be restricted to addicts, to those at risk of addiction, or should it be universal; should immunization be used in children? I propose to analogize cocaine addiction to an infectious disease which poses a major public health problem. This approach can provide an ethical and legal foundation on which we may begin to formulate a societal approach to the use of the cocaine vaccine.

Adult↗