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PubMed1992

Project Team grapples with organizational structure.

The Project Team is analyzing mandatory chapter membership as well as the present committee structure to determine the best model to meet the needs of AORN members and to facilitate the accomplishment of AORN's mission. Pros and cons can be identified for each structural arrangement. The key is for the constituency to identify a clear mission statement and a mutually agreed upon set of values and choose a structure that will best support that mission. AORN's mission statement emphasizes enhancing professionalism of perioperative nurses, promoting standards of perioperative nursing practice, and providing a forum for interaction and exchange of ideas. Its structure must be one that is not only in concert with that mission but facilitates it.

Humans↗

PubMed1989

Modeling for scaling to humans: time to get serious.

The subject matter for this 26th Annual Hanford Life Sciences Symposium evolved from the deliberations of a Task Group on Modeling for Scaling to Humans, which was established in January 1986 through the efforts of the Office of Health and Environmental Research of the Department of Energy (OHER/DOE). Several laboratories that utilize animals in radiobiological research sponsored by the OHER/DOE were extensively reviewed in the spring of 1985, and, as a result, OHER recommended establishment of eight task groups designed for selected purposes. The current membership of the Task Group on Modeling for Scaling to Humans is shown in Table 1; Dr. James A. Mewhinney of the Lovelace Inhalation Toxicology Research Institute has been Chairman since these Task Groups were established. Ms. Judy Mahaffey of Battelle. Pacific Northwest Laboratories served as chairperson for this symposium, and the Task Group membership has served as the Program Committee. The OHER/DOE thanks all of them for their work as members of the Task Group as well as for their arranging such a potentially productive and informative meeting.

Animals↗

PubMed2005

Improving resident outcomes with GAPN organization level interventions.

This research tested the effectiveness of the second tier of interventions in a two-tiered nursing intervention model designed to improve quality of care for residents in long-term care facilities (LTCFs). The first tier of the model called for gerontological advanced practice nurses (GAPNs) to provide direct care and to teach staff to implement care protocols for residents with incontinence, pressure ulcers, depression, and aggression. Results of the first-tier study indicated significant improvement in resident outcomes in incontinence, pressure ulcers, and aggression. In the second tier, GAPNs added a set of organization-level (OL) interventions including membership on the LTCF quality assurance committee and collaborating with staff on problem-solving teams. Analysis following the addition of OL interventions revealed significant improvement in both depression scores and in the trajectory of depression in residents of the LTCF where OL interventions were used.

Aged↗

PubMed1989

Report of dental society program activity regarding liaison with dental assisting, hygiene, and laboratory technology organizations. Council on Dental Practice.

With underlying changes in population demographics and dental practice patterns, as discussed in the joint report (Reports 1988: 117), there appears to be an increased need to continue to monitor and develop activities related to dental staff manpower. Results of this liaison survey can be used to assist in that manpower planning. It can be seen from these survey responses that constituent and component dental societies are logically dividing the program activities among the ADA, state, and local groups. For example, ADA and national resources are available for overall problem identification and membership surveys. States are primarily conducting committee meetings with organizations, publishing articles and presenting seminars. Activities such as health fairs and scholarship programs are easily developed and conducted locally. States are urged to communicate freely with local and ADA organizations to ensure that duplication of activities and resources is minimized.

American Dental Association↗

PubMed1985

Trustee survey: trends in board committee structure.

How are changes in the health care environment and in the roles and responsibilities of governing boards affecting board committee structures? This article, based on a recent survey of board chairmen, looks at the latest trends in standing board committees, from which type of committees are most prevalent to recent changes in nonboard membership.

Data Collection↗

PubMed1998

Infection control: past, present, and future issues.

Primary care providers serve as role models for the prevention of nosocomial infections through membership on hospital infection-control committees and daily patient care. This article will review five fundamental infection control measures: surveillance, isolation, hand washing, disinfection, and sterilization.

Cross Infection↗

PubMed1998

[American and European legislation on bioethics evaluation of clinical experimentation].

This paper describes the existing legislation for evaluating the bioethics of clinical trials (drug studies conducted on humans after completion of drug testing on animals). The legislation is presented in chronologic order; thus that of the United States is presented first, followed by a description of the European Union legislation, which includes a brief comment on Italian legislation. The rationale for informed consent and the specific requirements are addressed. Ethical committees are discussed in terms of their membership, responsibilities, and methods of revision. The paper concludes with a comparison between the USA and the European Union legislations.

Bioethics↗

PubMed2004

Local research ethics committees of the Mexican Institute of Social Security: results of a national survey.

OBJECTIVE: To identify the structure, composition and work of the local research ethics committees (LRECs) of the Mexican Institute of Social Security (IMSS) in Mexico. DESIGN: A descriptive cross-sectional study was performed that included all LRECs of the IMSS. METHODS: A total of 335 questionnaires coded in advance were posted to each LREC secretary. The requested information was from January to December 2001. RESULTS: The response rate was 100%. Two hundred and thirty-eight (71%) LRECs were reported as 'active' during the evaluation period. Although almost all LRECs were composed of diverse professionals, physicians dominated the LRECs' membership. The rejection rate for research projects was lower than 1 per 1000, and less than half of the LRECs held meetings to issue a report of projects' evaluation. CONCLUSIONS: LRECs need to foster good ethical research; implementation of an audit system to examine their work might help improve LRECs' performance and accountability.

Committee Membership↗

PubMedDate not supplied

Recommended tissue list for histopathologic examination in repeat-dose toxicity and carcinogenicity studies: a proposal of the Society of Toxicologic Pathology (STP).

The Executive Committee of the Society of Toxicologic Pathology (STP) appointed an ad hoc task force to devise and recommend a standard list of tissues to be evaluated histopathologically in repeat-dose toxicity and carcinogenicity studies that are used to support the registration of new pharmaceutical products. The recommended tissue list is intended to be a minimum core list that can be used for all types of repeat-dose toxicity and carcinogenicity studies, regardless of route of administration, species or strain of mammalian laboratory animal, duration, or class of drug to be tested. The resulting recommendations of the task force, presented here, were subsequently reviewed by the STP membership and endorsed by the STP Executive Committee.

Advisory Committees↗

PubMed2002

The establishment of a hospital clinical ethics committee.

In the Republic of Ireland the establishment of Clinical Ethics Committees (CECs) are relatively new. The need for such committees has occurred due to the fact that the consideration of ethical issues in healthcare has become an important and frequent part of discussions by individuals and institutions. A number of factors have contributed to this growth of ethical considerations. The Bon Secours Health System (BSHS) decided to establish a CEC and appointed a co-ordinating team to draw up terms of reference for such a committee. During this process the co-ordinating team drew on the experience of other countries and of its own staff. Potential criticisms of how such a committee would function were examined. A representative membership of the CEC was also arrived at. The following functions were identified for a CEC: the need to provide a mechanism for the identification, discussion and resolution of medical ethical issues; the need to identify medical ethical issues which may create challenges to the health system and to monitor the responses of the health system to these areas, and the provision of education. Policy development was seen as a primary function of the CEC. Ethical case review also emerged as one area of potential involvement by the CEC. During the staff consultation a large number of ethical issues emerged which the staff requested the CEC to address. A methodology necessary for coping with the differences within the BSHS was developed by the CEC. It is evident that CECs are here to stay and how they develop and function will have an impact on the quality of healthcare.

Ethics Committees, Clinical↗

PubMed1996

Rationing health care: views from general practice.

General practitioners (GPs) in the United Kingdom are central to the commissioning of health care services. A qualitative study of their views was therefore designed, which incorporated an in-depth (open) interview technique carried out on a 20% sample of all GPs (n = 100) in one United Kingdom Health District. The data from these interviews indicated that GPs were aware of, but had mixed feelings about the need for rationing. They expressed disquiet about the dilemma faced in rationing health care at the time of the consultation and readily associated issues of cost in their practice with rationing. Some of the currently adopted methods of rationing (waiting lists, co-payments and ability to pay) were commented upon. The respondents also made suggestions on how rationing could be carried out, which included: maximizing efficiency to reduce the need for rationing; using a third party committee to make rationing decisions, with a membership of clinicians, managers, and possibly public representatives, and; being explicit about how rationing is done. Fundholding brought rationing decisions to the fore, and worried most who discussed it in the context of rationing. The conclusion of this paper is that current implicit rationing policies in the National Health Service are flawed as they assume that GPs will ration health care at the time of the consultation. The involvement of GPs in the rationing process is important (particularly given the present expansion of GP fundholding), so there is a need for an alternative to the present system.

Adult↗

PubMed1978

The Medical Library Association's international fellowship programs.

This article describes the two international fellowship programs administered by the International Cooperation Committee of the Medical Library Association: (1) the program supported by the Rockfeller Foundation from 1948 to 1963; (2) the Eileen R. Cunningham program, supported by Mrs. Cunningham's bequest to the association, from 1971 to date. Comments and suggestions received from Cunningham Fellows in response to a letter sent to each by the author in the summer of 1977 are listed. The cost of the fellowship program, not only in terms of financial support but also in terms of human resources, is documented. While the program receives enthusiastic support from the International Cooperation Committee and many members of MLA, the membership needs to examine its mission with regard to the training of medical librarians from other countries, to determine whether future funding is to be sought.

Fellowships and Scholarships↗

PubMed1993

How are we doing?

Following a recent review of the efficiency and direction of this publication, the Society's board directed that a summary of an evaluation completed by the Publication Committee be made available to the entire membership. For new members, this is an explanation of this publication's purpose and form; for all members, this is an open accounting and request for comments.

Pennsylvania↗

PubMed1986

Regulation of animal experimentation: United States of America.

Two national mechanisms regulate the humane treatment of the 20-40 million laboratory animals that are used annually for experimental purposes in the United States each year. They are: the Public Health Service policy (commonly called the National Institutes of Health (NIH) policy) of 1985, and the Animal Welfare Act of 1966 as amended, a federal law. National policies are constantly being strengthened. Until 1984, national policies covered mainly animal husbandry practices. But the 1985 revised NIH policy directly involves the laboratory for the first time by requiring protocol review for humane concerns. Protocol review of proposed experiments is to be conducted by Animal Care and Use Committees--the institutional oversight committees. It is with effective protocol review that the Refinement, Reduction, and Replacement (of Russell and Burch's three Rs) to reduce ethical costs of experiments can be made an everyday reality. With this new authority for Animal Care and Use Committees, and a mandate for broader representation in membership, the revised NIH policy should bring improvements. Proposals are currently being considered by the U.S. Congress to strengthen the Animal Welfare Act. This law is in need of revision since about 90% of the laboratory animals are currently excluded from its coverage. The Scientists Center for Animal Welfare has been active in identifying ways in which national policies can be strengthened. In particular, focus has been made on meaningful protocol review by institutional oversight committees. Some recommendations for effective oversight committees based on recent workshops conducted by the Scientists Center for Animal Welfare are described.

Animal Testing Alternatives↗

PubMed1976

Mobilization of membership for legislative action.

Background and structure of the New York State Occupational Therapy Association and the committees assigned to implement legislative procedures are explored, followed by a description of the methods used to mobilize the membership to secure legislation to license occupational therapists. Workshops were given to educate the membership in the legislative process and a communication system was set up among the members, state legislators, other health agencies, and special interest groups. Support of legislators for the licensure bill was solicited, as well as support from others contacted through the communication system. The members continued to solicit support and to monitor the progress of the bill during a two-year period. The bill was passed in August 1975. Based on their recent experiences with the legislative process. NYSOTA concludes that to secure licensure logical and judicious organization, education, constant feedback of information among participants, and hard work, determination, perseverance, and dedication of the group involved are necessary.

Legislation as Topic↗

PubMed2001

Guidelines for malaria prevention in travellers from the United Kingdom for 2001.

These guidelines on malaria prevention are designed to aid health care workers who advise travellers, particularly those who will be overseas for less than a year. The present, and any future, revisions are the responsibility of the Advisory Committee on Malaria Prevention in UK travellers (ACMP; membership given at the end of the Guidelines). This has replaced the consensus meetings which produced earlier versions from 1980 to the the 1997 version. The guidelines are in three parts. The first part is a summary that emphasises modifications to the advice given in the last set of guidelines, published in 1997. The second part discusses the issues addressed in formulating the guidelines. Oversimplified lists of recommendations by country can be misleading. The second part also addresses the health care worker's consultation with prospective travellers. Doctors, practice nurses and pharmacists are asked to read this section to ensure that due attention is paid to the traveller's history and destination. The third part gives specific recommendations for travellers to specific destinations and some details of individual drugs. Fuller information on some drugs now less used was given in earlier versions of the guidelines. These guidelines reflect experienced professional opinion. Data are inadequate for unequivocal views to be given on several issues, but all available evidence has been taken into consideration. There is often a range of acceptable options, but to meet the requests of general practitioners the guidelines aim to give one recommended option and state the alternatives, suggesting when and how different regimens can be used to good effect. However, there are now several options for effective prophylaxis of highly chloroquine-resistant falciparum malaria, and the choice between them will depend on details of the journey and individual preferences. Decisions on the terms under which different drugs are licensed for use are the responsibility of the Licensing Authority, advised by the Committee on Safety of Medicines and not of the ACMP. The guidelines should therefore be read as a supplement to and not as a substitute for the relevant data sheets. In concept and practice, chemoprophylaxis lies somewhere between vaccinations (for which people expect governments to lay down schedules) and treatment of ill people (which is determined by individual clinical need and choice). The risks of malaria need to be balanced against the risks of the preventive measures, on the basis of the data available. Travellers may ask for an explanation of these risks and doctors and practice nurses need to be well informed and able to present this information to travellers. The second part of these guidelines may also be of use to prospective travellers who wish to read about the options themselves. All readers are recommended to read part two in its entirety to get a balanced picture.

Antimalarials↗

PubMed1989

Evaluating selected internship candidates and their subsequent performances.

The authors compared selection criteria with subsequent performances of housestaff on a medical service over a 13-year period. The selection criteria studied included class rank, grades in the four major clinical clerkships, scores on the National Board of Medical Examiners Part I examination, Alpha Omega Alpha membership, and numerical ranking by the intern selection committee. Only the last criterion correlated significantly (p = .0015) with subsequent housestaff performance. The synthesis of all available information by an intern selection committee is valuable in choosing candidates with future promise.

Clinical Competence↗

PubMed1999

The effects of group size and group economic factors on collaboration: a study of the financial performance of rural hospitals in consortia.

STUDY QUESTIONS: To determine factors that distinguish effective rural hospital consortia from ineffective ones in terms of their ability to improve members' financial performance. Two questions in particular were addressed: (1) Do large consortia have a greater collective impact on their members? (2) Does a consortium's economic environment determine the degree of collective impact on members? DATA SOURCES AND STUDY SETTING: Based on the hospital survey conducted during February 1992 by the Robert Wood Johnson Hospital-Based Rural Health Care project of rural hospital consortia. The survey data were augmented with data from Medicare Cost Reports (1985-1991), AHA Annual Surveys (1985-1991), and other secondary data. STUDY DESIGN: Dependent variables were total operating profit, cost per adjusted admission, and revenue per adjusted admission. Control variables included degree of group formalization, degree of inequality of resources among members (group asymmetry), affiliation with other consortium group(s), individual economic environment, common hospital characteristics (bed size, ownership type, system affiliation, case mix, etc.), year (1985-1991), and census region dummies. PRINCIPAL FINDINGS: All dependent variables have a curvilinear association with group size. The optimum group size is somewhere in the neighborhood of 45. This reveals the benefits of collective action (i.e., scale economies and/or synergy effects) and the issue of complexity as group size increases. Across analyses, no strong evidence exists of group economic environment impacts, and the environmental influences come mainly from the local economy rather than from the group economy. CONCLUSION: There may be some success stories of collaboration among hospitals in consortia, and consortium effects vary across different collaborations. RELEVANCE/IMPACT: When studying consortia, it makes sense to develop a typology of groups based on some performance indicators. The results of this study imply that government, rural communities, and consortium staff and steering committees should forge the consortium concept by expanding membership in order to gain greater financial benefits for individual hospitals.

Cooperative Behavior↗