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At least 631 records · Page 35Linked to original sources
PubMed1999

An academic-community partnership: a model of service and education.

To meet the challenge of preparing nurses for delivery of health care that is directed toward health promotion and focused on populations at the community level, it is critical that academicians develop new methods to educate their students. In this article, I describe an innovative clinical practice model in which an academic-community partnership was created between a college of nursing and a neighborhood grade school and parish. The purpose of the partnership is to provide needed health services to clients, at the same time giving students the opportunity to practice population-focused care in the community. The benefits of the partnership are numerous, including improved client health status, increased access to health promotion services, and enhanced student learning.

Adolescent↗
PubMed1998

An ecological model for school-based mental health services for urban low-income aggressive children.

An ecological model for school-based mental health services that targets urban low-income aggressive children--a highly vulnerable and underserved population--is presented. The goals of the model are to increase children's and teachers' involvement in the delivery of services and to increase the integration of these services into existing school resources and activities. The model proposes that mental health service providers work in collaboration with teachers to deliver services that (1) can be managed by existing school resources and personnel, (2) are related to empirically based factors associated with reduced aggression and increased social functioning, and (3) are group administered to increase the number of children served and to reduce stigmatization associated with mental health services. The model is individualized and flexible by acknowledging that contexts for aggression differ across classrooms and children and by providing services specific to those contexts. Two studies are presented illustrating the application of this model to decrease aggression and increase academic engagement in low-income urban public schools.

Achievement↗
PubMed1979

Basic Health Services in Nigeria: models for primary care in America.

The basic problems in delivery of health care in the United States and in Nigeria are similar; the major differences are in magnitude. Nigeria's Basic Health Services Scheme, now being implemented, is a bold effort to make quality health care accessible to the entire population. American health planners should look to such developing countries for concepts adaptable to our own health care delivery system. In developing primary care programs in particular, they should consider three basic components of the Nigerian scheme: (1) delegation of appropriate responsibilities to non-physician health providers in order to augment physician manpower in underserved areas; (2) location of training centers in environments similar to those where the trainees will serve; and (3) use of home-based care records to increase patient participation in health care.

Delivery of Health Care↗
PubMed1997

Integrated networks and health care provider cooperatives: new models for rural health care delivery and financing.

Minnesota's 1994 health care reform legislation authorized the establishment of community integrated service networks (CISNs) and health care provider cooperatives, which were envisioned as new health care delivery models that could be successfully implemented in rural areas of the state. Four CISNs are licensed, and three organizations are incorporated as health care provider cooperatives. Many of the policy issues Minnesota has faced regarding the development of CISNs and health care provider cooperatives in rural areas are similar to those raised by current Medicare reform proposals.

Community Networks↗
PubMedDate not supplied

How Fidelity invests in service professionals.

If you're in the business of service delivery, investment in the training and development of your staff is one of the keys to your company's success. But what's the best way to design and implement your investment? In 1994, Fidelity Institutional Retirement Services Company (FIRSCo) needed to ensure that its rapidly expanding staff maintained the company's high levels of customer satisfaction. The solution, according to Ellyn McColgan, formerly an executive vice president of FIRSCo and now the president of Fidelity Investments Tax-Exempt Services Company, was to reach out to its service associates with a powerful new model for training and development called Service Delivery University. SDU is a virtual university with a content-based core curriculum and five colleges that focus on business concepts and skills. It is driven by three principles. First, all training must be directly aligned with the company's strategic and financial objectives and focused on customer needs. Second, service delivery is a profession and should be taught as such. And finally, professional development should be the primary responsibility of line managers rather than the human resources department. McColgan explains how FIRSCo overcame resistance to this sweeping change in employee education. (Time was one obstacle: each associate receives 80 hours of training per year.) In addition, the author discusses the fine art of measuring the success of a program like SDU. She finds that the company's investment has paid dividends to the staff, to the organization as a whole, and to FIRSCo's customers.

Commerce↗
PubMedDate not supplied

Integrated delivery networks: a detour on the road to integrated health care?

This paper reviews the rationales and evidence for horizontal and vertical integration involving hospitals. We find a disjunction between the integration rationales espoused by providers and those cited in the academic literature. We also generally find that integration fails to improve hospitals' economic performance. We offer seven lessons from hospitals' efforts to integrate and then suggest four alternative models for achieving integrated delivery of health care services.

Conflict, Psychological↗
PubMed2004

The HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study: conceptual foundations and overview.

A growing population of people living with HIV/AIDS have co-morbid psychiatric and substance abuse diagnoses, increasing the need for integrated services for persons with multiple diagnoses. This article reviews models of integrated services for multiply diagnosed persons living with HIV/AIDS. We focus on the HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study to highlight the elements of multifaceted and integrated service delivery systems for people with HIV, substance abuse, and mental health disorders. Study organizational features and models of integrated services are discussed, including details of models for assessing mental health and substance abuse, outcomes, and the cost-effectiveness of integrated services.

Acquired Immunodeficiency Syndrome↗
PubMed1984

General practice, ethnicity and health services delivery.

This paper explores the inter-relationships between the conventional model of general medical practice, a society undergoing the transition from one essentially homogeneous to one that is heterogeneous in composition, and the effects that these changes may have on the mechanisms for the determination and delivery of health care. It is argued that the changing circumstances highlight the inappropriateness of the conventional medical model to primary health care and that an alternative approach for providing care is required.

Delivery of Health Care↗
PubMed2000

External peer review in Europe: an overview from the ExPeRT Project. External Peer Review Techniques.

OBJECTIVE: This paper aims to evaluate the use and development of external peer review models and to identify where the main models are used in European Union member states and countries with reciprocal research agreements with the European Union. DESIGN: The ExPeRT (external peer review techniques) project research team conducted a series of fact-finding missions to all participating European nations. Study participants. I. Blomberg, Sweden; L. Bohigas, Spain; S. Cucic, The Netherlands; P. Morosini, Italy. The Project is led by C. Shaw, UK and is managed by C. Heaton, CASPE Research. RESULTS: We identified four main external peer review models aimed at measuring the quality of service management and delivery: health care accreditation, the International Organization for Standardization ISO 9000 standards, the European Foundation for Quality Management Excellence Model and visitatie, which is Dutch for 'visitation' or peer review-based schemes. DISCUSSION: ExPeRT has demonstrated that in principle, convergence of the four main models in order to gain from each model's key strengths is feasible. Whether convergence is practical, depends upon the willingness of governments, health service providers, health care quality professionals and organizations to come together and adopt the recommendations of the ExPeRT project.

Accreditation↗
PubMed2001

The cycle of homelessness in the lives of young mothers: the diagnostic phase of an action research project.

This paper presents the findings of the first stage of an action research project designed to explore the experience of repeated homelessness in the lives of young women. An action research strategy was selected because it offered a framework within which to work with and for rather than on this vulnerable group of service users. The women participating in the research developed a conceptual model that captured the essence of their experience, which they named 'Our Cycle'. They also proposed a system for service delivery, 'From trauma to recovery: a non-professional model'. The diagnostic phase of the action research has thus resulted in a sound theoretical and practical framework to guide the implementation and evaluation stages of the project, currently being funded through the United Kingdom Department of Health's Health Action Zone initiative.

Adaptation, Psychological↗
PubMed2000

Experiencing change: progress and pitfalls.

A small, rural community takes the effort to make the transition from a skilled nursing facility to an assisted living model of care delivery. These changes are needed because of the cost and access of services available in this setting. The system of care delivery being considered is based on the model called Aging in Place (AIP).

Aged↗
PubMed1998

Innovative community services for rape victims: an application of multiple case study methodology.

A qualitative multiple case study design was used to examine communities across the United States that have developed coordinated community-based programs to assist rape victims. Previous studies have suggested that coordinated community programs help victims obtain needed resources and services. This study provided a follow-up examination of how and why these programs are helpful to rape victims. In-depth interviews were conducted with rape victim advocates, rape crisis center directors, police officers, prosecutors, doctors, nurses, and rape survivors from 22 communities with coordinated programs. A comparison sample of 22 communities with fewer coordinated programs was also obtained. Results indicated that the high coordination communities had three types of programs to address sexual assault: coordinated service programs, interagency training programs, and community-level reform groups. Although not all of these programs directly address service delivery for rape victims, they help create a community culture that is more responsive to victims' needs. The research team and participants developed an explanatory model of why these program are effective in addressing rape victims' needs. This model hypothesizes that coordinated programs reflect an understanding of the multiple contexts of service delivery and embody that knowledge in services that are consistent with victims' needs. Narrative data from the interviews with service providers and rape survivors are used to develop and support this model.

Community Health Services↗
PubMed1995

School-based health centers and managed care health plans: partners in primary care.

School-based clinics provide important access to health care for adolescents. For the past 20 years in St. Paul, Minnesota, Health Start has been a nonprofit organization providing comprehensive primary care services in the city's public high schools. Over the past decade, Minnesota has seen the growth of managed care plans for both the private and public (Medicaid) sectors. For the past several years, Health Start has been building relationships with managed care plans in order to coordinate care for adolescents. Since managed care plans differ in their management, reimbursement, and service delivery methods, Health Start has developed several models of partnership with managed care plans for the delivery of primary care to adolescents enrolled in school.

Adolescent↗
PubMed1996

Implementing child mistreatment risk assessment systems: lessons from theory.

Over the past ten years, public child protective services (CPS) agencies have adopted risk assessment systems in an effort to improve the quality of service delivery to children and their families. Various reviews of the impact of these models suggest that they have not lived up to their expectations and have had little or no impact on broad system indicators of service delivery. Foremost among the findings of existing studies is that these models have not been implemented and used as intended. The risk assessment field has not taken advantage of theoretical principles suggested by the organizational change literature. The researcher applies Lewin's Force Field Analysis to identify the forces for and against effective implementation of risk assessment systems in public agencies. The author suggests that lessons from theory could improve the effectiveness of the implementation of change in CPS agencies.

Child↗
PubMed2006

Oral health in Uganda: the need for a change in focus.

This paper reviews the oral health care system of delivery in Uganda as accurately as possible given the limited research base. The paper looks into the evolution of dentistry in Uganda as well as the havoc wrecked on health care in general by two decades of civil strife in an effort to find explanations for the poor performance of the oral health system. Alternative methods of service delivery are suggested drawing from the rich experiences of countries like Sri Lanka and Tanzania. The alternative model highlights the need for a Primary Health Care approach to oral health service delivery implemented in a systematic manner. The paper concludes with a call to all Ugandan oral health workers to take personal and collective responsibility for the improvement of oral health outcomes of 24 million Ugandans through research, advocacy, adherence to professional ethics and continued education.

Delivery of Health Care↗
PubMed2004

The meaning of life experiences: application of a meta-model to rehabilitation sciences and services.

A motivational, developmental meta-model of the meaning of everyday life experiences is presented. The model proposes that there are 3 fundamental ways in which people establish meaning across the life span: the paths of belonging (relationships), doing (meaningful engagement in activities), and understanding oneself and the world. The principles of the model include intertwined, fundamental meanings of human experience; the indeterminacy of cause and effect; individual differences in preferences for ways of attaining meaning; the importance of commitments in life; and life-long adaptation and changes in meaning. The model provides an organizing framework that clarifies the assumptions of various disciplinary frames of reference with respect to establishing meaning in everyday life. Implications of the model are discussed for the rehabilitation sciences and rehabilitation service delivery.

Activities of Daily Living↗
PubMed1995

Cardiac rehabilitation in the time of health-care reform.

Cardiac rehabilitation has evolved into a medically efficacious, cost-effective intervention for patients with ischemic heart disease. Most aspects of this therapy are well developed, and guidelines for programs exist. As the health-care delivery system undergoes scrutiny and evolution, it would be prudent for the practitioners of cardiac rehabilitation to evaluate the methods they use to deliver their services. Program administrators should reconsider traditional approaches that are largely based on reimbursement criteria. Goal-directed, patient-centered service delivery will allow individualization of care. A model for such an approach to cardiac rehabilitation is presented.

Cost-Benefit Analysis↗