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At least 865 records · Page 48Linked to original sources
PubMed2006

International Primary Care Respiratory Group (IPCRG) Guidelines: dissemination and implementation--a proposed course of action.

There is growing evidence that good implementation of evidence-based guidelines can result in improvement in health outcomes. This paper on Dissemination and Implementation constitutes the final paper of the IPCRG Guidelines on the management of chronic respiratory diseases in primary care. It highlights the historical development of these guidelines following the formation of the International Primary Care Airways Group (IPAG) in 2001 together with its dissemination and implementation subgroup, and the subsequent transfer of this dissemination and implementation role to the IPCRG. It covers the main factors within the IPCRG workplan, including the issues of governance, launch, dissemination, implementation, and evaluation.

Delivery of Health Care↗
PubMed1993

National health policy: back to the future. Ad Hoc Committee on National Health Policy American Speech-Language-Hearing Association.

After an extensive review of the literature and discussion of both national and state proposed health plans, the committee arrived at the following conclusions: 1. The issues that prompted development of the 1971 American Speech-Language-Hearing Association's (ASHA) Position Statement on National Health Care have not been resolved or altered. 2. Few significant national health plans or policies are being supported by the Bush Administration other than managed-care plans. 3. A national health policy will be driven by the development of state health policies and plans. 4. Implementation of national or state health plans will affect both professions at all service provision sites, including public schools. 5. Five general models apply to all existing or proposed national and state health policies or plans: single payer (e.g., a Canadian-style plan) minimum basic benefits ("play or pay") expanded Medicare or Medicaid benefits rationed healthcare (e.g., Oregon plan) managed care (e.g., health maintenance organizations) 6. There will be continued efforts to eliminate Medicaid mandates. 7. ASHA needs to advocate for the inclusion of rehabilitative services as basic rather than optional services in all health plans. 8. ASHA must advocate for adequate access to quality care regardless of healthcare or education provider setting.

American Speech-Language-Hearing Association↗
PubMed1994

Malaria paradigms in India and control strategies.

The paper gives a brief history of malaria control in India through the National Malaria Control Programme (NMCP), National Malaria Eradication Programme (NMEP), implementation of the Modified Plan of Operation (MPO), strengthening of malaria control by launching P. falciparum Containment Programme (PfCP) and the Urban Malaria Scheme (UMS). Making reference to various evaluations of the NMEP, the paper analyses the present malaria situation and brings out reasons demanding change in the strategy of malaria control in consonance with the global malaria control strategy of the World Health Organization (WHO). The epidemiological analysis has revealed that the present adverse malaria situation concentrates mostly under the following five epidemiological paradigms viz. (i) tribal malaria, (ii) rural malaria, (iii) urban malaria, (iv) industrial malaria, and (v) border malaria. Malaria control requires specific approaches and control strategies for each paradigm. We have suggested changes/augmentation in the organizational set-up beginning from NMEP Directorate to the most peripheral health units. The primary responsibility of malaria prevention and control including cost in developmental projects should be shared by the corporate sectors through intersectoral coordination. Residual problems during maintenance phase of the project would come under the general health services. International and bilateral cooperation increases resources availability. The available tools and their rational use for malaria control in different epidemiological paradigms has been discussed with emphasis on integrated control, selective use of chemical insecticides and adoption of cost-effective and sustainable malaria control methods. In this context, intersectoral collaboration, community participation, training, operational research and health education have been discussed as the vital components for effective malaria control.

Communicable Disease Control↗
PubMed2001

[Implementation of DRGs in German hospitals].

Although a lot of objective information about DRGs in Australia is available, German hospitals need practical instructions for their implementation. The process beginning with the treatment of the patient to the classification in DRGs will be discussed. A to-do-list will be presented as a conclusion of the described facts.

Diagnosis-Related Groups↗
PubMed2006

The implementation of quality management systems in hospitals: a comparison between three countries.

BACKGROUND: Is the implementation of Quality Management (QM) in health care proceeding satisfactorily and can national health care policies influence the implementation process? Policymakers and researchers in a country need to know the answer to this question. Cross country comparisons can reveal whether sufficient progress is being made and how this can be stimulated. The objective of the study was to investigate agreement and disparities in the implementation of QMS between The Netherlands, Hungary and Finland with respect to the evaluation model used and the national policy strategy of the three countries. METHODS: The study has a cross sectional design, based on measurements in 2000. Empirical data about QM-activities in hospitals were gathered by a self-administered questionnaire. The questionnaires were answered by the directors of the hospitals or the quality coordinators. The analyses are based on data from 101 hospitals in the Netherlands, 116 hospitals in Hungary and 59 hospitals in Finland. Outcome measures are the developmental stage of the Quality Management System (QMS), the development within five focal areas, and distinct QM-activities which were listed in the questionnaire. RESULTS: A mean of 22 QM-activities per hospital was found in the Netherlands and Finland versus 20 QM-activities in Hungarian hospitals. Only a small number of hospitals has already implemented a QMS (4% in The Netherlands,0% in Hungary and 3% in Finland). More hospitals in the Netherlands are concentrating on quality documents, whereas Finnish hospitals are concentrating on training in QM and guidelines. Cyclic quality improvement activities have been developed in the three countries, but in most hospitals the results were not used for improvements. All three countries pay hardly any attention to patient participation. CONCLUSION: The study demonstrates that the implementation of QM-activities can be measured at national level and that differences between countries can be assessed. The hypothesis that governmental legislation or financial reimbursement can stimulate the implementation of QM-activities, more than voluntary recommendations, could not be confirmed. However, the results show that specific obligations can stimulate the implementation of QM-activities more than general, framework legislation.

Cross-Cultural Comparison↗
PubMed1993

Issues in the consumer choice of health care coverage plans.

Developing and implementing successful marketing strategies for prepaid health care coverage plans is becoming an important issue as managers of these plans struggle to remain competitive in the market place. This paper provides insight into the reasons why consumers make choices among varying types of health care coverage plans. Some suggestions are made to plan managers for incorporating these results into the development of marketing strategies for prepaid health care coverage plans.

Arkansas↗
PubMed1998

Theory and practice for the implementation of 'in-house', continuous improvement participatory ergonomic programs.

This paper presents a case study of an implementation of a participatory ergonomics program in a public service agency. The objective of the study was to develop a theoretical model and related design principles for the implementation of 'in-house', continuous improvement participatory programs. The proposed model is based on the behavioral cybernetic theory of learning (Smith and Smith, 1966, Cybernetic Principles of Learning and Educational Design held, Rhinehart and Winsten, New York) and emphasizes the concepts of action, feedback, feedback control, and individual learning as essential for a progression from external regulation (by outside experts) to internal regulation (by organizational members) of participatory programs. Results support the proposed model, but do suggest an expansion of the model to include macro-level organizational variables as additional factors necessary for developing internally regulated participatory programs. Results have led to the specification of several design principles for implementing 'in-house', continuous improvement participatory programs.

Ergonomics↗
PubMed2005

["Integrated care"--the Essen concept: organizational strategies in the treatment of acute myocardial infarction].

The German "GKV-Modernisierungsgesetz" offers new opportunities for patient care. The concept of "integrated care" provides organizational structures for an standardized treatment of myocardial infarction by bridging the different sectors of the German health care system. Apart from guideline-based therapy, innovative diagnostic (cardiac MRI) and therapeutic (drug-eluting stents) techniques are implemented in the "integrated care" model as well. The "Herzinfarktverbund Essen" is the first national real world experience of the integrated care concept in the treatment of myocardial infarction.

Delivery of Health Care, Integrated↗
PubMed1996

Evaluation of a national health promotion program in South Australia.

This paper reports the findings of the evaluation of the South Australian component of the National Better Health Program. The evaluation used analysis of focus-group interviews and key documents to assess the value of the state program. The evaluation demonstrated that for a relatively small investment ($2.4 million was allocated to the project over four years, representing only 0.5 per cent of the annual budget for teaching hospitals in South Australia), much can be achieved by harnessing the energy of local communities. The evaluation concluded that more attention should be directed to structural change, with an emphasis on collaboration across sectors, and community participation. Some key issues for the planning and implementation of health promotion were highlighted: the challenge of marrying local initiatives based on community development with national health promotion objectives; the importance of dedicated and assured funding; the need for increased training and support for health promotion workers; and the importance of continuing a focus on equity in the implementation of health promotion. The paper concludes by questioning the value of the current Australian goals, targets and strategies for health, given the findings from this evaluation.

Community Participation↗
PubMed2000

Integrating mental health into the Oregon Health Plan.

Public mental health has long struggled to be accepted as a part of health care. Its interface with social services and its broad spectrum of professionals make a clear definition of public mental health's boundaries difficult, fueling policymakers' skepticism about such acceptance. The Oregon Health Plan was the result of a process that explicitly included mental health but recognized that the tools for doing so need to be carefully developed.

Health Plan Implementation↗
PubMed2004

[Comprehensive health care and integrated health services: challenges for evaluating the implementation of a "system without walls"].

The premise of this paper is that comprehensive health care is a major component in the investigation and evaluation of health services and systems, structured as inter-organizational health care networks articulating clinical, functional, normative, and systemic dimensions in their operationalization and based on the understanding that no organization combines all the necessary resources and capabilities to solve the health problems of a population with its various life cycles. Given the complex nature of this "system without walls", eliminating barriers to access in the various health care levels in response to local and regional health, we take this opportunity to share a few "preliminary lessons" from our experience and from the literature on integrated health services which may interest researchers and managers concerned with the implementation of such services.

Comprehensive Health Care↗
PubMedDate not supplied

Trends in sexually transmitted disease incidence in Papua New Guinea.

A retrospective study of gonorrhoea and syphilis from Health Department records was carried out in Papua New Guinea. During the ten-year period (1974-1983) 101,636 new cases of gonorrhoea and 34,422 of syphilis were reported among the general population of Papua New Guinea. The incidence of both sexually transmitted disease have significantly (P less than 0.005) increased over the decade despite the introduction and implementation of the National Sexually Transmitted Disease (STD) Control Programme. Some which contribute to the present increase in sexually transmitted diseases are segregation of health and non-health services, insufficient staff training and increased immigration to urban centres.

Adolescent↗
PubMed2003

Implementing quality management in psychiatry: from theory to practice--shifting focus from process to outcome.

With the increasing emphasis on the satisfaction of patient-clients balanced by the need for cost-efficient treatment, quality management is an ever-increasing concern for mental health care providers. It is now apparent that psychiatrists must follow treatment progress and outcome to assess and improve the quality of the care they provide. Most quality measurement and management programs to date have been carried out in research settings using process measures; however, it is clear that the focus must shift from research to practice and from process to outcome measurements. We discuss the notion of quality and outcome management and propose a model for selecting outcome measures. This model suggests 5 dimensions that are commonly assessed in outcome management. We successfully implemented a computerized documentation and quality measurement system in a psychiatric outpatient setting.

Canada↗
PubMed1990

Setting community health goals: one District Health Councils experience.

The Niagara District Health Council has embarked on a strategic planning exercise to develop health goals, objectives and preliminary targets for action. This process was approached in three phases: establishment of a Health Goals Task Force and adoption of the five goals developed by the Premier's Council on Health Strategy; planning and implementation of a Health Goals Consultation Day to involve community members in the identification and priority ranking of objectives; and development of measurable and realistic preliminary targets through consultations with expert groups and individuals. This process is a practical planning tool applicable across sectors and communities.

Goals↗
PubMed2006

[Prevention of type 2 diabetes in Germany. Ideas, evidence, implementation].

One of the challenges in clinical diabetology today is to develop and implement diabetes prevention management programs for clinical practice. Recent studies have convincingly demonstrated that lifestyle intervention, addressing diet and exercise, as well as pharmacological preventive strategies reduce the risk of progressing from impaired glucose tolerance to diabetes. With respect to the worldwide burden of diabetes, these studies offer a compelling evidence base for the important translation of the research findings into community-based prevention strategies and the development of a national diabetes prevention program. The work group "diabetes prevention" of the German Diabetes Association together with the National Action Forum Diabetes and the German Diabetes Foundation developed a concept for a national program. This comprises a three-step intervention: in a first step individuals at high risk of developing type 2 diabetes are identified. The second step provides an intensive group intervention to prevent diabetes, and in a third step continuous intervention should facilitate motivation maintenance and evaluation. This third step is the crucial step to maintain the effect in changing lifestyle. Recently, a compendium for diabetes prevention was developed as a practical guideline explaining how to implement prevention programs. This guideline also includes the structure of a national prevention program with a prevention manager having a central role in the concept and suggestions for evaluation and quality control.

Cross-Sectional Studies↗