Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Partnership Practice”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 721 records · Page 40Linked to original sources
PubMed2000

Reviewing audit: barriers and facilitating factors for effective clinical audit.

OBJECTIVE: To review the literature on the benefits and disadvantages of clinical and medical audit, and to assess the main facilitators and barriers to conducting the audit process. DESIGN: A comprehensive literature review was undertaken through a thorough review of Medline and CINAHL databases using the keywords of "audit", "audit of audits", and "evaluation of audits" and a handsearch of the indexes of relevant journals for key papers. RESULTS: Findings from 93 publications were reviewed. These ranged from single case studies of individual audit projects through retrospective reviews of departmental audit programmes to studies of interface projects between primary and secondary care. The studies reviewed incorporated the experiences of a wide variety of clinicians, from medical consultants to professionals allied to medicine and from those involved in unidisciplinary and multidisciplinary ventures. Perceived benefits of audit included improved communication among colleagues and other professional groups, improved patient care, increased professional satisfaction, and better administration. Some disadvantages of audit were perceived as diminished clinical ownership, fear of litigation, hierarchical and territorial suspicions, and professional isolation. The main barriers to clinical audit can be classified under five main headings. These are lack of resources, lack of expertise or advice in project design and analysis, problems between groups and group members, lack of an overall plan for audit, and organisational impediments. Key facilitating factors to audit were also identified: they included modern medical records systems, effective training, dedicated staff, protected time, structured programmes, and a shared dialogue between purchasers and providers. CONCLUSIONS: Clinical audit can be a valuable assistance to any programme which aims to improve the quality of health care and its delivery. Yet without a coherent strategy aimed at nurturing effective audits, valuable opportunities will be lost. Paying careful attention to the professional attitudes highlighted in this review may help audit to deliver on some of its promise.

Attitude of Health Personnel↗
PubMed2001

Primary health care services provided by nurse practitioners and family physicians in shared practice.

BACKGROUND: Collaborative practice involving nurse practitioners (NPs) and family physicians (FPs) is undergoing a renaissance in Canada. However, it is not understood what services are delivered by FPs and NPs working collaboratively. One objective of this study was to determine what primary health care services are provided to patients by NPs and FPs working in the same rural practice setting. METHODS: Baseline data from 2 rural Ontario primary care practices that participated in a pilot study of an outreach intervention to improve structured collaborative practice between NPs and FPs were analyzed to compare service provision by NPs and FPs. A total of 2 NPs and 4 FPs participated in data collection for 400 unique patient encounters over a 2-month period; the data included reasons for the visit, services provided during the visit and recommendations for further care. Indices of service delivery and descriptive statistics were generated to compare service provision by NPs and FPs. RESULTS: We analzyed data from a total of 122 encounters involving NPs and 278 involving FPs. The most frequent reason for visiting an NP was to undergo a periodic health examination (27% of reasons for visit), whereas the most frequent reason for visiting an FP was cardiovascular disease other than hypertension (8%). Delivery of health promotion services was similar for NPs and FPs (11.3 v. 10.0 instances per full-time equivalent [FTE]). Delivery of curative services was lower for NPs than for FPs (18.8 v. 29.3 instances per FTE), as was provision of rehabilitative services (15.0 v. 63.7 instances per FTE). In contrast, NPs provided more services related to disease prevention (78.8 v. 55.7 instances per FTE) and more supportive services (43.8 v. 33.7 instances per FTE) than FPs. Of the 173 referrals made during encounters with FPs, follow-up with an FP was recommended in 132 (76%) cases and with an NP in 3 (2%). Of the 79 referrals made during encounters with NPs, follow-up with an NP was recommended in 47 (59%) cases and with an FP in 13 (16%) (p < 0.001). INTERPRETATION: For the practices in this study NPs were underutilized with regard to curative and rehabilitative care. Referral patterns indicate little evidence of bidirectional referral (a measure of shared care). Explanations for the findings include medicolegal issues related to shared responsibility, lack of interdisciplinary education and lack of familiarity with the scope of NP practice.

Cooperative Behavior↗
PubMed1993

Restrictive covenants--everything you wanted to know but were afraid to ask.

Principal/associate relationships are very common in dental practice today, and significant value is now associated with patient lists and practice locations. Therefore, principal dentists must take steps to protect valuable practice goodwill. The inclusion and proper use of restrictive covenants in associateship agreements should help to protect principal dentists.

Economic Competition↗
PubMed1996

Patient satisfaction with collaborative practice.

OBJECTIVE: To gather information on women's perceptions of the services delivered in collaborative obstetrics and gynecology practices and to determine whether patients perceive a difference in the delivery of services in a variety of practice settings. METHODS: A cross-sectional patient satisfaction survey was developed by the Collaborative Practice Advisory Group of ACOG. Ten collaborative practices were selected to participate: five in private offices, two in clinics, two in health maintenance organizations, and one in the military. Between April 15 and May 15, 1994, 3257 completed surveys were obtained for analysis. RESULTS: Between 71% and 92% of women, depending upon the practice setting, agreed with statements regarding the possible benefits from being cared for in a collaborative practice. The majority (75-92%) expected services provided in a collaborative practice to differ from those provided in a noncollaborative practice. Women making their first visit to a collaborative practice expected quicker appointments, more time with the provider, more health information, and more specific diet information than did women who had previously been seen in such a practice. There were minimal differences in comfort levels when discussing issues of sexuality and physical and sexual abuse in either public or private settings with physicians or non-physicians. CONCLUSIONS: Patients in this survey were accepting of the concept of collaborative practice and felt that it offered quicker appointments, more time with the provider, more health information, and more specific diet information than did physician-only practices.

Adult↗
PubMed1992

Management ... practice Manager.

Carole Green became a Practice Manager because she wanted to influence directly what was happening and to see the results of her work; she was the first GMTS I management trainee to work in general practice. Her job combines the roles of business manager, company secretary, contracts negotiator, marketing manager and -- at times -- general factotum.

Administrative Personnel↗
PubMed1997

Nurse practitioner descriptions for primary care centers: opportunities for ownership.

The drastic shift in health care delivery and the accompanying emphasis on health care outcomes has contributed to a rapid proliferation of nurse practitioner services. Prepared as advanced practice nurses with specific assessment skills, primary care nurse practitioners have the opportunity to be participant players rather than observers in business negotiations. To gain a market share of the expanding field, these nurses must assert their position on establishing primary care centers. This qualitative study focused on nurse practitioner descriptions of their needs in a university primary care group practice. Four major response patterns, Vision, Structure, Incentives, and Significance, were clarified by multiple themes defined by explanatory elements for a research-based topology to guide nurse practitioners and schools into positions of ownership of primary care centers in interdisciplinary partnerships.

Commerce↗
PubMed1993

Variation in duration of hospital stay between hospitals and between doctors within hospitals.

Whether one examines the average length of hospital stay at the level of geographic areas, at the level of hospitals, or at the level of doctors, length-of-stay figures are known to vary widely. Even for hospital admissions for comparable surgical procedures among comparable groups of patients, significant length-of-stay variations have been reported. As is the case for variations in the occurrence of common surgical procedures, the overall conclusion is that large variations in duration of hospital stay associated with these common surgical procedures are the rule rather than the exception. The objective of the study is to examine whether variations in hospital medical practice, indicated by the duration of hospital stay in this study, can be reduced to differences in practice style between individual doctors within the same institutional setting or to differences in practice style between groups of doctors within the same institutional setting. The latter is assumed to be the combined effect of restrictions on the (hospital) supply side and the predilection of doctors to conform to the practice of immediate colleagues. It was found out that the variation in length of hospital stay, adjusted for patient case-mix, within hospitals is much smaller than the length-of-stay variation between different hospitals. The within hospital variation between (partnership of) doctors is in most of the cases statistically insignificant. Doctors working in more than one hospital on average choose a length of stay close to the average length of stay prevailing in the different hospitals.

Appendectomy↗
PubMed2004

The partners in care approach to ethics outcomes in quality improvement programs for depression.

OBJECTIVE: Patient centeredness and equity are major quality goals, but little is known about how these goals are affected by efforts to improve the quality of care. The authors describe an approach to addressing these goals in a randomized trial of quality improvement for depressed primary care patients. METHODS: For four ethics goals (autonomy, distributive justice, beneficence, and avoiding harm), the authors identify intervention features, study measures, and hypotheses implemented in Partners in Care, a randomized trial of two quality improvement interventions, relative to usual care and summarize published findings pertinent to these outcomes. RESULTS: To implement an ethics framework, modifications were required in study design and in measures and analysis plans, particularly to address the autonomy and justice goals. Extra resources were needed for sample recruitment, for intervention and survey materials, and to fund an ethics coinvestigator. The interventions were associated with improvements in all four ethics areas. Patients who received the interventions were significantly more likely to receive the treatment they had indicated at baseline as their preferred treatment (autonomy goal). Intervention-associated benefits occurred more rapidly among sicker patients and extended to patients from ethnic minority groups, resulting in a reduction in ethnic-group disparities in health outcomes relative to usual care (distributive justice goal). The interventions were associated with improved quality of care and health outcomes (beneficence goal) and with reduced use of long-term minor tranquilizers (goal of avoiding harm). CONCLUSION: S: It is feasible to explicitly address ethics outcomes in quality improvement programs for depression, but substantial marginal resources may be required. Nevertheless, interventions so modified can increase a practice's ability to realize ethics goals.

Culture↗
PubMed1991

Avoiding the pitfalls of an associateship buy-in: a case.

The two doctors in this case made mistakes that could make it difficult for them to salvage their relationship and accomplish their mutual goal of Dr. Brown buying into Dr. Klein's practice. Such errors can seriously jeopardize a planned buy-in and should be avoided by others who wish to pursue this strategy. Dentists can avoid these mistakes by taking the time to discuss and clarify their intentions, and to specify the details of the arrangement at the beginning of the associateship or soon thereafter. They should also obtain qualified professional assistance to help plan and structure the arrangement. The information, knowledge and expertise is available to do it right, and there is no reason to make the kinds of mistakes made in this case. Successfully implementing an associateship buy-in or buy-out, or the outright sale or purchase of a dental practice, is no longer a mystery. These sorts of arrangements and transactions can be structured to accommodate the interests of both parties.

Financial Management↗
PubMed1990

The aesthetic alliance: nurses and medical facials.

This article introduces and explains methods for integrating services of dermatology nurses and cosmetic dermatologists. Basic aesthetic techniques can be incorporated into the dermatology practice; or a specialist, namely a licensed aesthetician, can perform the medical facial.

Acne Vulgaris↗
PubMed1987

Vicarious liability.

"Vicarious liability" or "imputed negligence" is a doctrine that shifts legal responsibility from one individual to another so that, under the appropriate circumstances, an optometrist may be held responsible for the negligent conduct of agents, employees, partners, and others with whom the optometrist has created the necessary legal relationship. The application of vicarious liability to clinical practice is discussed, with emphasis upon relationships with other professionals, delegation of duties to employees, and referrals to other health care providers.

Humans↗
PubMedDate not supplied

Building capacity for heart health promotion: results of a 5-year experience in Nova Scotia, Canada.

PURPOSE: To present the outcomes of a capacity-building initiative for heart health promotion. DESIGN: Follow-up study combining quantitative and qualitative methods. SETTING: The Western Health Region of Nova Scotia, Canada. SUBJECTS: Twenty organizations, including provincial and municipal agencies and community groups engaged in health, education, and recreation activities. INTERVENTION: Two strategies were used for this study: partnership development and organizational development. Partnership development included the creation of multilevel partnerships in diverse sectors. Organizational development included the provision of technical support, action research, community activation, and organizational consultation. MEASURES: Quantitative data included number and type of partnerships, learning opportunities, community activation initiatives, and organizational changes. Qualitative data included information on the effectiveness of partnerships, organizational consultation, and organizational changes. RESULTS: Results included the development of 204 intersectoral partnerships, creation of a health promotion clearinghouse, 47 workshops attended by approximately 1400 participants, diverse research products, implementation of 18 community heart health promotion initiatives, and increased organizational capacity for heart health promotion via varied organizational changes, including policy changes, fund reallocations, and enhanced knowledge and practices. CONCLUSIONS: Partnership and organizational development were effective mechanisms for building capacity in heart health promotion. This intervention may have implications for large-scale, community-based, chronic-disease prevention projects.

Community Participation↗
PubMed1980

An analysis of dental practice from 1952 to 1976. Council on Dental Practice and Bureau of Economic and Behavioral Research.

From 1952 through 1976, dentists have changed the organization and configuration of their practices in response to several economic, scientific, and personal factors. For instance, there has been an increase in the number of dentists who are shareholders in incorporated practices or who are involved in various cost-sharing arrangements. Technological advances and the increased use of auxiliaries have allowed dentists to provide more dental services in a shorter time, increasing their potential productivity. This is reflected in the increase in the numbers of patients, visits, and visits per hour from 1952 to 1972, and in turn may contribute to the decrease in office hours, allowing dentists to pursue other business or personal interests. Changes in the size of practice may signify innovations in technology and training as well as reflect dentists' personal preferences.

American Dental Association↗
PubMed1980

Practice styles and opportunities in periodontics.

A survey of the 3,048 Active and Affiliate members of the American Academy of Periodontology was conducted by the Task Force on Manpower of the Academy to elicit information concerning practice styles and perceived opportunities for practice. Responses from 1,580 periodontists are presented in tables which include data on general demographics of periodontists, expected age at which partial and full retirement will take place, forms of practice, weeks per year and hours per week spent in practice, number of patient visits per year, number of practice locations, years in present community, population of present community, average distance traveled by patients in the periodontal practice, numbers of dentists referring to the practice, weeks waiting time to examine new patients and to begin new treatment series, patient load, preferences regarding weeks of advance booking, perceptions regarding the supply of periodontal services in the respondent's local area as well as in other areas known to the respondent, and factors which influence selection of a practice location. Data presented were collected between November of 1978 and April, 1979.

Adult↗
PubMed2000

Observations on achieving total practice success.

A doctor or group practice that understands the design of what the practice wants to be and develops a strategy to accomplish that end will invariably achieve a high level of performance. Performance areas in contemporary practice administration cover a wide area including growth, transition, and succession. Due to the wide and demanding areas in practice administration, it is important to address any practice planning effort in a comprehensive manner rather than a piecemeal approach. The foregoing will materially assist any practitioner to achieve the level of success they seek.

Humans↗