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PubMed1995

Guidelines for the structure and function of an interdisciplinary team for persons with brain injury. Joint Committee on Interprofessional Relations between Division 40 (Clinical Neuropsychology) of the American Psychological Association and the American Speech-Language-Hearing Association.

This report provides guidelines for the structure and function of interdisciplinary teams assembled for the delivery of clinical services to individuals with brain injury. Specifically, the report addresses issues concerning team membership, skills required of the team coordinator, and the processes that facilitate the attainment of team goals. These general suggestions are designed to give rehabilitation professionals and health care administrators some guiding principles for interdisciplinary teams involved in the clinical management of individuals with brain injury.

American Speech-Language-Hearing Association↗
PubMed1993

Guidelines for the transfer of critically ill patients. Guidelines Committee, American College of Critical Care Medicine, Society of Critical Care Medicine and the Transfer Guidelines Task Force.

OBJECTIVE: The development of practice guidelines for the conduct of intra- and interhospital transport of the critically ill patient. DATA SOURCES: A task force of experts in the field of patient transport drawn from the membership of the Society of Critical Care Medicine and the American Association of Critical-Care Nurses provided the personal experience and published literature from which these guidelines were developed. STUDY SELECTION: Study design was not a factor in selecting the literature to validate the experts' personal experience. The lack of well-designed clinical outcome studies was an important factor in determining the method of practice policy development utilized. DATA EXTRACTION: The expert task force met and developed a draft of these guidelines based on their experiences and the available literature. This draft document was then reviewed by an additional group of experts whose input was used by the task force to develop this final consensus report. RESULTS OF DATA SYNTHESIS: Each hospital should have a formalized plan for intra- and interhospital transport that addresses the following elements: pretransport coordination and communication, transport equipment, accompanying personnel, monitoring during the transport and documentation. The transport plan should be developed by a multidisciplinary team and should be evaluated and refined by the continuous quality improvement process. CONCLUSION: The available data has allowed the authors to develop an evidence-based practice policy for the intra- and interhospital transport of the critically ill.

Algorithms↗
PubMed1999

Research ethics committees: a comparative study of assessment of ethical dilemmas.

Research ethics committees (REC) constitute an important instrument for the regulation of biomedical research involving human beings. The purposes of this work were to study the ethical reasoning in RECs and to ascertain whether the composition of RECs has any bearing on the decisions subsequently made by them. We used a postal questionnaire, containing authentic cases of research ethical dilemmas, sent to the ten RECs in Sweden (n = 124) and to comparison groups consisting of 200 randomly selected medical researchers, 200 randomly selected healthcare politicians and 200 randomly selected district nurses. The average response rate was 68%. A difference was found in how REC members assess a project in comparison with researchers, healthcare politicians and district nurses. Differences depended on the type of project assessed. The study indicates that membership in RECs may exert a normative influence on its members. It is proposed that this investigation should be followed up by a study with a qualitative design.

Adult↗
PubMed2005

The development and outcomes of a statewide network of hospital-based palliative care teams.

BACKGROUND: Health care systems need to be developed that meet the palliative care needs of patients and their families. OBJECTIVE: The West Virginia Initiative to Improve End-of-Life Care charged its Palliative Care Delivery System Task Force with developing hospital-based palliative care teams in West Virginia. SETTING/SUBJECTS: A descriptive study of a state-community partnership to improve palliative care. MEASUREMENTS: Numbers of member hospitals, number and nature of palliative care consultations, number of patients referred to hospice programs. RESULTS: What began as a palliative care network of five hospitals has grown into a network of 16. Network members advise one another on financing, staffing, and obtaining administrative buy-in, and the network leaders provide educational programs to prepare physicians and nurses to serve as consultants on hospital-based palliative care teams. There was a 300% increase in the number of palliative care consultations between 2000 and 2003 in 49 of West Virginia's 55 counties. Analysis of the submitted data collections forms has allowed the network to promote improvement in palliative care consultations in member hospitals and to initiate interventions on a statewide basis to improve decision-making with the appropriate legal agent, treatment of pain, and referral of patients for hospice care. CONCLUSION: Hospital participation in the Palliative Care Delivery System Task Force led to a sustained membership organization, the West Virginia Palliative Care Network that promotes hospital-based palliative care.

Advisory Committees↗
PubMed1988

A survey of hospital pharmacy research in Canada.

During the past two years, the CSHP Research Committee was given the tasks of evaluating the present status of hospital pharmacy research and developing positive recommendations for future action. In order to determine the specific needs and interests of Canadian hospital pharmacists, a survey of the CSHP membership was conducted in April of 1987. Two hundred and twenty-two members (13.1%) responded to the survey. Fifty-six percent (124) of the respondents had completed one or more research projects and 30 percent (66) served as supervisors of at least one research study. Clinical drug studies, particularly DUR and pharmacokinetic projects, were the focus of most of the present research efforts. In addition to DUR and pharmacokinetics, the most popular "wish to do" research topics included pharmaceutics, cost benefit/analysis and other pharmacy practice research topics. The survey respondents indicated a strong desire for CSHP to sponsor research similar to the Workload Measurement Study. The Canadian Society of Hospital Pharmacists was also requested to provide educational programs and other methods of information dissemination for training in the field of research methodology.

Canada↗
PubMed1982

World Association for the Advancement of Veterinary Parasitology (W.A.A.V.P.) guidelines for evaluating the efficacy of anthelmintics in ruminants (bovine and ovine).

During the 8th International Conference of the World Association for the Advancement of Veterinary Parasitology (W.A.A.V.P.) held in Sydney, Australia, in 1977, President S. Gaafr appointed a committee to prepare international guidelines for evaluating the efficacy of anthelmintic products. The goal was to develop uniform testing standards and registration requirements to expedite the testing and approval of effective products with a minimum of labor, money, and experimental animals without sacrificing scientific validity. Achievement of such a goal would mean that data from investigators in one country could be used in registering drugs in another country. These guidelines, which were approved by the membership at the general meeting of the 9th International Conference of the W.A.A.V.P. on July 16, 1982 in Budapest, Hungary, are only a beginning in the development of uniform international methods for testing the efficacy of anthelmintics. We now propose that they be used by the scientific community recognizing that, at this time, these guidelines have not been officially reviewed or accepted by any government regulatory authority. Investigators are encouraged to evaluate this document critically and to recommend modifications promptly to the Committee so that they may be incorporated in these guidelines before the 10th International Conference to be held in Perth, Australia in 1983.

Animals↗
PubMed2003

Midwifery and the enlarged European Union.

The freedom of movement of midwives within the European Union has been guaranteed by the application of midwives' sectoral directives signed in 1980 and applied in 1983. Since then the size of the European Union has grown from 9 to 15 members and is due for a next wave of enlargement of another 10 member states in 2004. The rules and regulations that govern the European Union are being revisited to accommodate this change. Midwifery will be affected and some changes are potentially worrying, in particular the proposed loss of the Advisory Committee on the Training of Midwives. Six other professions regulated in a very similar way are also to lose their own advisory committees. The European Commission has proposed the adoption of a single directive for all professions, together with the setting up of an expert group whose function would be to deal principally with health professions. However, neither its remit nor its membership has been determined. Whereas previous movement of midwives within Europe has been minimal, it is anticipated that this may well be changed at the next enlargement stage. Without clear directives and some form of controlling power at European level, public health may be threatened. In this paper the developments to date and the concerns that have emerged from the recent proposals are outlined.

Education, Nursing↗
PubMed1993

Corporate and philanthropic models of hospital governance: a taxonomic evaluation.

OBJECTIVE: We assess the theoretical integrity and practical utility of the corporate-philanthropic governance typology frequently invoked in debates about the appropriate form of governance for nonprofit hospitals operating in increasingly competitive health care environments. DATA SOURCES: Data were obtained from a 1985 national mailed survey of nonprofit hospitals conducted by the American Hospital Association (AHA) and the Hospital Research and Educational Trust (HRET). STUDY DESIGN: A sample 1,577 nonprofit community hospitals were selected for study. Representativeness was assessed by comparing the sample with the population of non-profit community hospitals on the dimensions of bed size, ownership type, urban-rural location, multihospital system membership, and census region. DATA COLLECTION: Measurement of governance types was based on hospital governance attributes conforming to those cited in the literature as distinguishing corporate from philanthropic models and classified into six central dimensions of governance: (1) size, (2) committee structure and activity, (3) board member selection, (4) board composition, (5) CEO power and influence, and (6) bylaws and activities. PRINCIPAL FINDINGS: Cluster analysis and ANCOVA indicated that hospital board forms adhered only partially to corporate and philanthropic governance models. Further, board forms varied systematically by specific organizational and environmental conditions. Boards exhibiting more corporate governance forms were more likely to be large, privately owned, urban, and operating in competitive markets than were hospitals showing more philanthropic governance forms. CONCLUSIONS: Findings suggest that the corporate-philanthropic governance distinction must be seen as an ideal rather than an actual depiction of hospital governance forms. Implications for health care governance are discussed.

Analysis of Variance↗
PubMed1993

A national survey of ethics committees in state mental hospitals.

In June 1992, a national mail survey was directed to 204 state inpatient psychiatric institutions. This study was implemented following the 1992 Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requirement that hospitals put in place some means with which to address ethical issues. The goals of the study were: 1. to examine state mental hospital characteristics and their response to the JCAHO requirements; 2. to describe healthcare ethics committee (HEC) composition, function, and role; 3. to study patient and family access to a HEC; and 4. to discover ethical issues most frequently addressed. The survey response rate was 71%. Of the 145 responders, 62 had HECs in place, and 53 were in the process of implementing HECs. There were no differences between JCAHO accredited institutions and non-accredited facilities with regard to having HECs. Physicians accounted for 22% of HEC membership, followed by nurses (15%), and administrators (12%). Twenty-six percent of facilities systematically notified patients about existence of the HEC; 71% of facilities had no patient request for HEC services in the last year. A patient's danger to others, and resuscitation policy were issues most frequently (23%) heard by HECs.

Accreditation↗
PubMed1996

Cost-effectiveness of prescription recommendations for cholesterol-lowering drugs: a survey of a representative sample of American cardiologists.

OBJECTIVES: We sought to determine the cost-effectiveness of the recommendations of cardiologists for the pharmacologic treatment of hypercholesterolemia. BACKGROUND: Despite the publication of guidelines such as the report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, little is known about the national prescribing practices of physicians and how they compare with the recommendations of cost-effectiveness analyses. METHODS: Under the auspices of the Cardiovascular Norms Committee of the American College of Cardiology, a nationally representative sample of cardiologists was surveyed, and their recommendations for the pharmacologic treatment of hypercholesterolemia were assessed to determine cost-effectiveness. RESULTS: The 346 responding cardiologists were reasonably representative of the membership of the American College of Cardiology. For the 12 hypothetical patients, the cardiologists recommended pharmacologic treatment more commonly in cases in which previously published studies estimated the treatment to be more cost-effective, although there was a tendency to recommend such treatment for primary prevention even when it was estimated to cost well over $100,000/year of life saved. CONCLUSIONS: These findings suggest that the cardiologists' pharmacologic recommendations for lowering lipids are correlated with published cost-effectiveness analyses. However, substantial variation in their recommendations remains, with somewhat less aggressive treatment for secondary prevention and more aggressive treatment for primary prevention than would be recommended on the basis of cost-effectiveness analyses.

Adult↗
PubMedDate not supplied

CLMA position on laboratory direction. Clinical Laboratory Management Association.

In July 1991, CLMA's National Affairs Committee (NAC) developed a proposed position statement on the laboratory director standard. The proposed statement was submitted to the 24-member National Affairs Reactor Panel and, based on their input, appropriate revisions were made. In August 1991, CLMA surveyed the full membership, and, as a result, the following position was adopted. NAC members include Royal A. Crystal, Chair; Linda D. Bielitzki, J.D., Vice Chair; Michael G. Bissell, M.D., Ph.D.; Earl C. Buck; Michael A. Maffetone, D.A.; Timothy Murray; Laurence J. Peterson; Marianne C. Watters; and Martha A. Feichter, National Affairs Analyst.

Hospital Administrators↗
PubMed2003

Keep your nurses from choosing another ED.

Emergency department (ED) nurses are increasingly choosing to work at hospitals certified by the Magnet Nursing Recognition Program of the American Nurses Credentialing Center, and more than 60 hospitals have this certification. To avoid losing nurses, adopt some of their ideas. Use committees with ED nursing representation to develop policies. Offer nursing grand rounds to give nurses the opportunity to present on a variety of topics. If nurses don't want to complete a degree, offer incentives, such as reimbursement for health club memberships, for completed projects.

Emergency Service, Hospital↗
PubMedDate not supplied

A historical progression of the Midwest Regional Chapter of the SQA.

The Historical Committee of the Midwest Regional Chapter of the Society of Quality Assurance has recorded and tracked the evolution and historical progression of our chapter from the initial authorization of regional chapters by the national society in 1990, through its growth in membership and area served, to its current status in October 1996. This article describes this growth as well as meeting attendance, location and topics of the training seminars, membership distribution, and the significant milestones accomplished as the chapter journeyed through a whirlwind past.

History, 20th Century↗
PubMed1982

Standards for laboratory accreditation.

After years of review by all of the CAP resource and other committees and councils, the Commission on Laboratory Accreditation developed a revised Standards for Accreditation of Medical Laboratories (Last revision, 1974). They were approved by the House of Delegates and, in the February issue of Pathologist '82, comments were solicited from the entire membership. Presented in the following pages are the final Standards for Laboratory Accreditation, which the Board of Governors adopted as CAP policy at its Sept. 2-4 meeting in Traverse City, Mich.

Accreditation↗
PubMed1992

Back to basics.

The basic strength of the AMCA family is the wide range of expertise and "can do" attitude of its diverse membership. The AMCA is currently experiencing problems with federal legislation and fiscal stability because we have not fully utilized member strengths to reevaluate the association's direction and set new goals to address change. However, the AMCA Board of Directors and many committee chairpersons met, reevaluated direction and clarified goals, and initiated major changes to meet the challenges facing the association and its members. Members of the AMCA are encouraged to contribute their individual talents to ensure that the association prosper and serve the needs of the mosquito and vector control family.

Mosquito Control↗
PubMed1993

Guidelines for the transfer of critically ill patients. Guidelines Committee of the American College of Critical Care Medicine; Society of Critical Care Medicine and American Association of Critical-Care Nurses Transfer Guidelines Task Force.

OBJECTIVE: The development of practice guidelines for the conduct of intra- and interhospital transport of the critically ill patient. DATA SOURCES: A task force of experts in the field of patient transport drawn from the membership of the Society of Critical Care Medicine and the American Association of Critical-Care Nurses provided the personal experience and published literature from which these guidelines were developed. STUDY SELECTION: Study design was not a factor in selecting the literature to validate the experts' personal experience. The lack of well-designed clinical outcome studies was an important factor in determining the method of practice policy development we utilized. DATA EXTRACTION: The expert task force met and developed a draft of these guidelines based on their experiences and the available literature. This draft document was then reviewed by an additional group of experts whose input was used by the task force to develop this final consensus report. DATA SYNTHESIS: Each hospital should have a formalized plan for intra- and interhospital transport that addresses the following elements: pretransport coordination and communication, transport equipment, accompanying personnel, monitoring during the transport, and documentation. The transport plan should be developed by a multidisciplinary team and should be evaluated and refined by the continuous quality improvement process. CONCLUSION: The available data have allowed us to develop an evidence-based practice policy for the intra- and interhospital transport of the critically ill.

Algorithms↗
PubMed1992

Organizational planning: a program evaluation survey of AACE members.

The Long Range Planning Committee of the American Association for Cancer Education (AACE) has completed a comprehensive survey of AACE members. The survey was distributed in July and August 1989 to 592 AACE members, and 360 (61%) returned completed forms. The respondents did not differ markedly from the membership as a whole on selected member characteristics. Survey questions addressed the following aspects of the AACE: Annual Meeting, Special Interest Sections, Liaison Relationships, Journal of Cancer Education (JCE), and Communications. Results showed that the AACE is healthy and responsive to the needs of its members. Several areas needing attention were indicated, but no significant concerns were noted.

Communication↗
PubMedDate not supplied

CLMA position on HIV/HBV testing of health-care workers. Clinical Laboratory Management Association.

In February 1991, CLMA's National Affairs Committee (NAC) developed a proposed position statement on mandatory HIV/HBV testing of health-care workers. The proposed statement was submitted to the 24-member National Affairs Reactor Panel and, based on their input, appropriate revisions were made. In May 1991, CLMA surveyed the full membership, and, as a result, the following position was adopted. Ninety-six percent of the members responding agreed with principles 1, 2, and 3; 88% agreed with 4, 5, and 6. NAC members include Royal A. Crystal, Chair; Linda D. Bielitzki, J.D., Vice Chair; Michael G. Bissell, M.D., Ph.D.; Earl C. Buck; Michael A. Maffetone, D. A.; Timothy Murray; Laurence J. Peterson; Marianne C. Watters; and Martha A. Feichter, National Affairs Analyst.

Blood↗