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At least 739 records · Page 41Linked to original sources
PubMed2001

Why tuberculosis control in an unstable country is essential: desperate TB patients embrace DOTS in Angola.

After decades of war, the tuberculosis situation in Angola is alarming. The author describes his experiences with the implementation of a DOTS TB programme adapted to the difficult circumstances in a town partly inhabited by displaced people. The high motivation of both patients and health care workers is an important factor for its successful implementation. The need for international support of tuberculosis control programmes also in war-ridden countries is stressed.

Adult↗
PubMed1994

Delivering services to the rural elderly: a study of policy implementation.

This article presents an analysis of two demonstration projects designed to improve delivery of services to elderly residents of rural Nebraska. One project employs a statewide system of care management focused on individual clients. In the other, local agencies in four communities coordinate services by using the local senior center as a focal point. This article uses established theory of policy implementation to illustrate problems encountered in starting new social programs that require state-local cooperation. Four guidelines are suggested for policymakers: (a) if local agencies are responsible for implementation, local managers must be involved in all the planning activities for new programs; (b) clear guidelines are needed to be sure that there is consensus concerning the details of implementation; (c) all health care providers should be involved in implementation when health care services are being coordinated; and (d) community coordinating councils can be effective.

Aged↗
PubMed2003

Nursing Minimum Data Set development and implementation in Thailand.

BACKGROUND: In 1997, the Thai Ministry of Public Health began planning to implement a national health information system. Development of the nursing component of this system is an ongoing process. The first step in developing a nursing information system is to identify an essential Nursing Minimum Data Set (NMDS). AIM: To describe the development of a NMDS in Thailand and explore the challenges of implementing it, including the issue of the comparability with data sets in other countries, primarily the United States of America. METHODS: The process of developing a NMDS specific to Thailand is reviewed. Strategies for implementing this data set and important issues related to it are then discussed. FINDINGS: Although a preliminary Thai NMDS has been identified, challenges associated with its development and implementation within the Thai National health information system remain. CONCLUSION: A Thai NMDS and its elements have been identified. The International Classification of Nursing Practice was translated and is to be used to implement the data set describing the nursing care of patients and their families. However, many issues, such as the need for conceptual translation and increasing nurses' involvement in the process, still need to be addressed in order to implement the data set successfully.

Data Collection↗
PubMed2006

Adverse outcomes in surgical patients: implementation of a nationwide reporting system.

PROBLEM: Lack of comparable data on adverse outcomes in hospitalised surgical patients. DESIGN: A Plan-Do-Study-Act (PDSA) cycle to implement and evaluate nationwide uniform reporting of adverse outcomes in surgical patients. Evaluation was done within the Reach Efficacy-Adoption Implementation Maintenance (RE-AIM) framework. SETTING: All 109 surgical departments in The Netherlands. KEY MEASURES FOR IMPROVEMENT: Increase in the number of departments implementing the reporting system and exporting data to the national database. STRATEGIES FOR CHANGE: The intervention included (1) a coordinator who could mediate in case of problems; (2) participation of an opinion leader; (3) a predefined plan of action communicated to all departments (including feedback of results during implementation); (4) connection with existing hospital databases; (5) provision of software and a helpdesk; and (6) an instrument based on nationwide standards. EFFECTS OF CHANGE: Implementation increased from 18% to 34% in 1.5 years. The main reason for not implementing the system was that the Information Computer Technology (ICT) department did not link data with the hospital information system (lack of time, finances, low priority). Only 5% of the departments exported data to the national database. Export of data was hindered mainly by slow implementation of the reporting system (so that departments did not have data to export) and by concerns regarding data quality and public availability of data from individual hospitals. LESSONS LEARNED: Hospitals need incentives to realise implementation. Important factors are financial support, sufficient manpower, adequate ICT linkage of data, and clarity with respect to public availability of data.

Benchmarking↗
PubMed2005

Sustainability of teacher implementation of school-based mental health programs.

Evidence-based prevention and intervention programs are increasingly being implemented in schools and it therefore is becoming increasingly important to understand the complexities of program implementation under real-world conditions. Much research has focused on the contextual factors that influence program implementation but less work has attempted to provide an integrated understanding of mechanisms (e.g., teacher-training processes) that affect teachers' program implementation. In this paper, we review literature on factors related to teachers' implementation of school-based prevention and intervention programs, then from this review abstract what we believe are four basic ingredients that characterize potentially sustainable teacher-implemented classroom programs. Finally, we present a sequential model, based on these ingredients, of the naturalistic processes underlying sustainability of teachers' program implementation and describe how this sustainability can be enhanced through provision of teacher training and performance feedback from a classroom consultant.

Adolescent↗
PubMedDate not supplied

Four-State FAS Consortium: model for program implementation and data collection.

The Four-State Fetal Alcohol Syndrome (FAS) Consortium on the Studies of the Prevention of FAS is an effort to bring together resources, both human and material, across the states of Minnesota, Montana, North Dakota, and South Dakota to decrease the prevalence of births affected by prenatal alcohol exposure. Beginning in September 2000, the Consortium received 3 years of funding and operates through a cooperative agreement with funding from the Center for Substance Abuse Prevention (CSAP) at the Substance Abuse and Mental Health Services Administration (SAMHSA). Three primary objectives are addressed through the Consortium structure. These include: to develop and evaluate the formation of the Consortium itself; to develop an information base that systematizes data collection that helps determine populations and areas considered high risk; and to implement and test a scientific-based prevention/intervention model for women considered high risk of abusing alcohol during their childbearing years.

Adolescent↗
PubMed2005

The clinical strategies implementation scale to measure implementation of treatment in mental health services.

OBJECTIVE: The authors describe the development of the Clinical Strategies Implementation Scale (CSI), an instrument designed to help providers measure the extent to which evidence-based strategies have been implemented in the treatment of persons with schizophrenia spectrum disorders. METHODS: Nine ordinal scales were devised to measure key aspects of treatment strategies that have been associated with clinical and social recovery from schizophrenia: goal- and problem-oriented assessment, medication strategies, assertive case management, mental health education, caregiver-based problem solving, living skills training, psychological strategies for residual problems, crisis prevention and intervention, and booster sessions. A study of interrater reliability was conducted with 15 trained raters from participating centers in Athens, Auckland, Bonn, Budapest, Gothenburg, and Tokyo who assessed 54 cases. Each treatment strategy was weighted according to its effect size in clinical trials. Correlation analyses were conducted to explore associations between the total CSI score and ratings of clinical, social, and caregiver outcomes each year over four years of continued treatment of 51 patients. RESULTS: Interrater reliability ranged from .93 to .99. Four annual total CSI ratings were significantly correlated with impairment, disability, functioning, work activity, and an index of recovery. Most correlations were stronger in years 3 and 4 than in years 1 and 2. CONCLUSIONS: Reliable and valid assessment of the implementation of evidence-based strategies in clinical practice is feasible. The quality of integrated program implementation may be associated with improved clinical and social recovery from schizophrenic disorders.

Evidence-Based Medicine↗
PubMed1992

Implementing the framework directive.

The Management of Health and Safety Regulations will be operative from the beginning of 1993. While duties for employers are similar to those laid out by previous legislation, Gillian Howard suggests that aspects of the new Regulations will see a new role for occupational health practitioners.

Health Plan Implementation↗
PubMed2000

The Oregon experience: a point of view.

What has not been addressed is how Oregon will maintain and expand the early breakthrough of the statewide consensus dialogue that created the "list" of prioritized medical conditions.

Health Plan Implementation↗
PubMed1993

[Development, organization and evaluation of a public health surveillance system].

Health professionals who set health policies and manage prevention and disease control programs are committed to the goals of reducing disease and injury related morbidity and mortality and improving the public's health and quality of life. To determine what health policies are needed and what specific actions should be taken and which epidemiological investigations should be carried out in order to identify lack of coverage of public health programs, decision makers need continuous information in order to tackle upcoming technical questions and to identify the most serious existing and emerging health problems of today's society. Both, political decision makers and health professionals have to ask themselves how those health problems can be prevented and which are the most cost-effective prevention and control strategies for this purpose. Other important issues for the implementation of public health surveillance is the feasibility of available control strategies and their possible impact on different health outcomes. Alternative prevention and control activities have to be evaluated as how they meet the proposed objectives. Finally, remains the question, how scarce economic, material and human recourses should be allocated and targeted in order to achieve maximum impact for health goals. Only a sophisticated public health surveillance system can give answers to all those issues. Surveillance is defined as the ongoing systematic collection, analysis and interpretation of date on specific health events for use in planning, implementation and evaluation of public health programs. Timely dissemination of these data to persons who need to know is essential to effective prevention and control.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost-Benefit Analysis↗
PubMed1998

Implementation principles and strategies for Title XXI (State Children's Health Insurance Program). Academy of Pediatrics. Committee on Child Health Financing.

A major provision of the Balanced Budget Act of 1997 established the State Children's Health Insurance Program (Title XXI of the Social Security Act). This program is a historic milestone in the financing of health care for children. Not since the enactment of Medicaid has there been a greater investment in children's health care. Title XXI does not create universal coverage for all children, but this program does offer an unprecedented opportunity to expand insurance ot a large portion of uninsured children. Title XXI of the Social Security Act makes >$40 billion in federal grants available to states over the next 10 years to provide health insurance coverage, including Medicaid. However, states mus contribute a defined share of funds to obtain federal matching funds. The legislation gives great flexibility to states in designing and implementing their programs, and it is critical that they do this in a timely manner. If states fail to use all State Children's Health Insurance Program funds available, it is possible that future federal funding will be reduced. If this happens, a major opportunity to improve health insurance coverage of America's children will be diminished.

Child↗
PubMed2002

[A DRG based future hospital funding scheme: state of implementation and impact in the field of rehabilitation].

With the statutory health insurance reform act 2000 the German government started to introduce a new hospital funding system based on an internationally used diagnosis related groups (DRGs) system. In June 2000 the German self-administration board (consisting of the German hospital federation, the German statutory health insurance funds and the association of private health insurers), which is in charge of realizing this project, decided to develop the future German (Refined) DRG System (G-DRG) with reference to the Australian Refined DRG System (AR-DRG) Version 4.1. Replacement of the previous German hospital reimbursement system by the new DRG-based hospital funding system is planned for January 2003 on a voluntary basis. From January 2004 on, the change of the reimbursement system is to become mandatory for all hospitals with the exception of psychiatry. The new reimbursement system is intended to not only cover acute hospital care but also parts of early rehabilitation, palliative and sub-acute care. Because of its economic incentives the effects of DRG introduction in Germany will not only be limited to the hospital scene but will also affect rehabilitation.

Cost Control↗
PubMed2005

Implementing trauma-informed alcohol and other drug and mental health services for women: lessons learned in a multisite demonstration project.

On the basis of the 9-site, Substance Abuse and Mental Health Services Administration-funded Women, Co-Occurring Disorders, and Violence Study, this article discusses recommendations for implementing trauma-informed mental health, substance abuse, and other support services. These guidelines for best practices represent the consensus of a diverse trauma work group that drew on both cross-site and site-specific qualitative data.

Adult↗
PubMed1990

A case for social marketing and education for acceptance and implementation of preventive health and occupational safety measure programs for rural communities.

The environment in which acceptance and implementation of preventive health and occupational safety occurs is not conducive to the message being heard, nor are people acting upon the message. Diffusion of innovation and community development models are explored for possible approaches to health education in the rural community. In particular, the community-oriented primary care approach to medical practice is discussed. In addition, the responsibility of the rural community is outlined.

Agriculture↗
PubMed2005

Improving quality of care for depression: the German Action Programme for the implementation of evidence-based guidelines.

ISSUE: Depressive disorders are of great medical and political significance. The potential inherent in achieving better guideline orientation and a better collaboration between different types of care is clear. Throughout the 1990s, educational initiatives were started for implementing guidelines. Evidence-based guidelines on depression have been formulated in many countries. PURPOSE: This article presents an action programme for structural, educational, and research-related measures to implement evidence-based care of depressive disorders in the German health system. The starting points of the programme are the 'Guidelines Critical Appraisal Reports' of the 'Guideline Clearing House' and measures from the 'Competence Network on Depression and Suicidality' (CNDS) funded by the Federal Ministry of Education and Research. The article gives an overview of the steps achieved as recommended by the Guidelines Critical Appraisal Reports and the ongoing transfer process into the German health care system. RESULTS: The action programme shows that comprehensive interventions to develop and introduce evidence-based guidelines for depression can achieve benefits in the care of depression, e.g. in recognition, management, and clinical outcome. CONCLUSION: It was possible to implement the German Action Programme in selected care settings, and initial evaluation results suggest some improvements. The action programme provides preliminary work, materials, and results for developing a future 'Disease Management Programme' (DMP) for depression.

Depressive Disorder↗