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PubMed1992

M-I-D-D-L-E-G-R-O-U-N-D: Part II. Developing partnerships in practice.

This article describes the process for creating partnerships in nursing. It is Part II of the development of M-I-D-D-L-E-G-R-O-U-N-D, a model for the integration of nursing education and nursing service. Collaboration and community building are the activities that occur as nurses who are "Futuremakers" create the new partnership paradigm. Seven capacities (7 Cs) needed to develop these dynamic partnerships are defined. These capacities can advance caring and healing in nursing.

Communication↗
PubMed2003

Partnership in practice.

Modern health care has increasingly focused on prescriptive, outcomes-oriented, and cost-effective practices concomitantly obscuring the humanness of the health experience. A reconsideration of partnership between nurse and client as the core of the discipline might call nurses back to what is essential to nursing: a caring relationship centered on that which is meaningful as health. This article points to the significance of the relational nature of partnership, differentiating its features and form from the prevalent understanding associated with prescriptive interventions to achieve predetermined goals and outcomes. The meaning of partnership is presented as nursing practice as it unfolds: a process of nurse and client relationship through which the caring presence of the nurse becomes integral to the health experience of the client as the potential for action. Exemplars provide illustration of this emerging view in practice and research. The article is intended to contribute to the expanding dialogue on nursing practice, inviting discussion of the relevance of partnership in different health systems.

Adult↗
PubMed1978

Surgeons in the United States. Practice characteristics.

Data on practice characteristics were obtained as part of a national questionnaire study of surgeons in the United States. These included location and organization of surgeons' practices, use of nonphysician personnel, provision of ambulatory care, other professional activities, and variables associated with work load volume. A multivariate analysis was done to examine the relation between operative work loads and various practice characteristics. The variables associated with larger operative work loads were group or partnership practice, principal office not in a hospital, more nonphysician assistants in direct contact with patients, more hospitals in which operations were regularly done, and smaller proportions of nonsurgical patients. Group or partnership practice and nonsurgical practice were found to be most strongly related to operative work load.

Ambulatory Care↗
PubMedDate not supplied

Sharing in practice: new partnerships for health.

A vital part of health care, sharing in practice is not a vision for the future but the reality of today. Below, the meaning and implications of sharing in practice not just for nursing but for health care.

Asia, Southeastern↗
PubMed2005

Developmental stages in public health partnerships: a practical perspective.

Health education practitioners often form and provide support to partnerships directed toward public health goals. The authors viewed the start-up of a state health department/multiuniversity partnership for the evaluation of the state's tobacco settlement pilot project using the lens of the Tuckman four-stage model of group development. The four stages--forming, storming, norming, and performing--occurred in sequence but with pronounced overlap. Two types of performing--institutional and group performing--were observed. An awareness of group developmental stages can allow leaders and members to improve the ways their partnership works together. Applying Tuckman's model also can allow expectations about the group's progress and members' interactions to be managed so that tasks are aligned with the appropriate stage of development. Finally, for partnerships that have a long life span, understanding that the stages may occur several times throughout the group's existence can acclimate members to shifting responsibilities and relationships over time.

Community-Institutional Relations↗
PubMed2003

Team structure, team climate and the quality of care in primary care: an observational study.

OBJECTIVES: To determine whether practice structure (for example, list size, number of staff) predicts team processes and whether practice structure and team process in turn predict team outcomes DESIGN: Observational study using postal questionnaires and medical note audit. Team process was assessed through a measure of "climate" which examines shared perceptions of organisational policies, practices, and procedures. SETTING: Primary care. SUBJECTS: Members of the primary health care team from 42 practices. MAIN OUTCOME MEASURES: Objective measures of quality of chronic disease management, patients' evaluations of practices, teams' self-reported ratings of effectiveness, and innovation. RESULTS: Team climate was better in singlehanded practices than in partnerships. Practices with longer booking intervals provided superior chronic disease management. Higher team climate scores were associated with superior clinical care in diabetes, more positive patient evaluations of practice and self-reported innovation and effectiveness. CONCLUSIONS: Although the conclusions are preliminary because of the limited sample size, the study suggests that there are important relationships between team structure, process, and outcome that may be of relevance to quality improvement initiatives in primary care. Possible causal mechanisms that might underlie these associations remain to be determined.

Angina Pectoris↗
PubMed1990

Variety and views in general practice.

Ninety general practitioners described their practices and gave their views on their work. The differences between urban and rural general practices were found to be greater than those between single practices, partnerships and group practices. Rural doctors were on call more frequently (50% being on call more than 11 nights per month and 54% at least every third weekend), had lower adult fees, were more likely to have hospital appointments (54%) and expressed more concern about their independence than urban doctors. Most of the general practitioners (94.5%) said that their surgeries usually ran over time (44% up to an hour, 5.5% longer), longer consultations and extra patients being seen as the prime causes. The general practitioners particularly enjoyed their involvement with people and the variety in their work (34% and 22% of comments respectively), but felt overworked and found difficulties with particular people (33% and 20% of comments respectively). In their general comments the general practitioners wanted to see an improved image for family doctors (23%) and more support for doctors (17%). Fifteen percent of the comments affirmed the quality of general practice.

Attitude of Health Personnel↗
PubMed2003

Putting partnership into practice: participatory wellbeing assessment on a south London housing estate.

PURPOSE: Bridging the gap between professionals and communities and establishing new forms of partnership is essential if service provision is to be made more responsive and accountable. This article describes an innovative approach to creating the basis for partnerships to address community wellbeing on an estate in south London. METHODS: Drawing on participatory appraisal and action planning methods, and drawing together residents and professionals within and beyond the health service, a participatory wellbeing assessment exercise was carried out on a housing estate with a population of around 6,000 people, involving just under 10% of residents. RESULTS: The participatory wellbeing assessment exercise served as a means of seeking to bridge different perceptions, priorities and perspectives on wellbeing and forge new relationships, alliances and partnerships for change. Creating this vehicle for change also created opportunities for local people to participate in community wellbeing issues. This, in turn, strengthened connections between health policy, provision and grassroots community health development, broadening opportunities for service responsiveness and citizen involvement. CONCLUSION: Broadening involvement in assessing and determining priorities for improving wellbeing can serve to do more than enable citizens to engage more directly in making and shaping the policies that affect their lives. It can also serve as a way of establishing new kinds of partnerships across and within the statutory and non-statutory services, opening up space for new, more 'joined up' forms of work that help to bridge the gap between citizens and services.

Community Health Planning↗
PubMed1983

The practice-research partnership: is it compatible with teaching?

This commentary discusses possible conflicts that can develop among the needs of students, those of a school of social work's faculty, and those of health care agencies involved in a joint practice-research model. It also discusses the needs for schools of social work and the profession as a whole to develop funded research for social work in health care.

Boston↗
PubMed1982

Why physicians choose different types of practice settings.

This paper presents an extension of Freidson's typology concerning the four medical practice settings which physicians may enter. First, Freidson's typology is modified to contain only three medical practice settings: 1) solo practices; 2) small group practices (partnerships or associations consisting of two to seven physicians); and, 3) large group practices (having eight or more physicians). Then, it is argued that the most interesting sociological difference between these three medical practice settings is the differential probability for effective peer regulation, with that probability lowest in solo practices, highest in large group practices, and lying somewhere between these extremes in small group practices. Finally, it is argued that because physicians recognize these differential probabilities for peer regulation, they seek out those niches (i.e., medical practice settings) which most closely reflect their preferences. This extended version of Freidsonian theory is then incorporated into an analytic model using the sociodemographic, environmental, and attitudinal characteristics of physicians to predict their practice choices. Data from a 1979 national survey of approximately 4,500 physicians are used to assess the model empirically. The results obtained from these analyses conform quite well with both our general and specific expectations. The implications of these findings for the future configuration of the American health care delivery system are discussed with special reference to health maintenance organizations.

Career Choice↗
PubMed2005

Nevada's academic-practice collaboration: public health preparedness possibilities outside an academic center.

The Nevada State Health Division developed a local academic-practice partnership with the University of Nevada Reno's Master of Public Health Program to assess the bioterrorism risk communication, information, response, and training needs of professional and public stakeholder groups throughout Nevada. Between October 16, 2002, and April 13, 2004, 22 needs assessment focus groups and 125 key informant interviews were conducted to gather information on the diverse needs of the stakeholders. The themes that emerged from these activities included the need for effective pre-event education and training; a coordinated and responsive public health preparedness infrastructure; honest, accurate, and timely communication in the event of a bioterrorism situation; and appropriate information dissemination methods and technology. The data collected through this needs assessment gave the Nevada State Health Division vital information to plan public health preparedness initiatives. The establishment of local academic-practice partnerships for states without a Centers for Disease Control and Prevention-funded Academic Center for Public Health Preparedness is an effective way for health departments to develop their public health preparedness infrastructure while simultaneously training the future public health workforce.

Bioterrorism↗