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The Pan American Health Organization (PAHO) supports performance evaluation programs in clinical chemistry, Caribbean. Much more work remains to be done before many labs in this part of the world can be certified as providing accurate results, but PAHO has taken an important first step toward establishing benchmarks and rallying for labs to improve test quality.
This article presents normative data on the day-to-day operation of partial hospitalization programs affiliated with mental health centers in the State of Indiana. This network of programs was surveyed with regard to (1) the community settings and locations of their facilities as well as their accessibility to patients, (2) the organizational structure within which the programs operate, (3) their staffing, (4) the characteristics of the patient population they serve, (5) their admission and case management procedures and the nature of their clinical programming, (6) their referral source network, (7) their funding sources, and (8) the extent and nature of their program evaluation and program promotion efforts. Generalizations suggested by the survey data are discussed in an attempt to highlight possible trends in the field at large.
Results of educational research which were realized in 1996 are presented. The effective use of available schedule in each discipline of medical curriculum in FMUSP was registered by previously prepared students. In global analysis 13.9% of available hours were not utilized. Research results were compared with those ones registered in Curricular Evaluation Program (PAC); final figures revealed that better utilization in available schedule is correlated with better assessment in PAC model.
The goal of the Vesalius Project is a high-resolution, interactive 3-D atlas of human/animal anatomy, stored on a laser videodisc and displayed on graphics workstations--an an "electronic Gray's Anatomy." Students will use this computerized atlas interactively to learn the structure of the body and to understand their own bodies in health and disease. The Human Factors Research Laboratory at Colorado State University has designed and is conducting a comprehensive evaluation program for the project.
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Theoretical models that may be useful to research studies in school health education are reviewed. Selected, well-defined theories include social learning theory, problem-behavior theory, theory of reasoned action, communications theory, coping theory, social competence, and social and family theories. Also reviewed are multiple theory models including models of health related-behavior, the PRECEDE Framework, social-psychological approaches and the Activated Health Education Model. Two major reviews of teaching models are also discussed. The paper concludes with a brief outline of the general applications of theory to the field of school health education including applications to basic research, development and design of interventions, program evaluation, and program utilization.
The author examines the role of mediators and moderators in the evaluation of programs for children. The terms are defined and examples of each are presented. Using bibliometric analysis, the author examines how evaluators use mediators and moderators in treatment studies in education, juvenile justice, health care, child protection, and mental health. The use of mediators and moderators is sporadic and vague at best. An agenda for improvement is outlined that includes greater use of program theory and intensive case studies to find out why researchers in prevention and health promotion incorporate mediators and moderators more effectively in their evaluations.
OBJECTIVE: To develop a questionnaire to evaluate the quality of training programs on occupational health and safety. METHODS: A questionnaire comprising five subscales and 21 items was developed. The reliability and validity of the questionnaire was tested. Final validation of the questionnaire was undertaken in 700 workers in an oil refining company. RESULTS: The Cronbach's alpha coefficients of the five subscales ranged from 0.6194 to 0.6611. The subscale-scale Pearson correlation coefficients ranged from 0.568 to 0.834 . The theta coefficients of the five subscales were greater than 0.7. The factor loadings of the five subscales in the principal component analysis ranged from 0.731 to 0.855. Use of the questionnaire in the 700 workers produced a good discriminability, with excellent, good, fair and poor comprising 22.2%, 31.2%, 32.4% and 14.1 respectively. Given the fact that 18.7% of workers had never been trained and 29.7% of workers got one-off training only, the training program scored an average of 57.2. CONCLUSION: The questionnaire is suitable to be used in evaluating the quality of training programs on occupational health and safety. The oil refining company needs to improve training for their workers on occupational health and safety.
BACKGROUND: Assessment of resident performance is a complex task. PURPOSE: To correlate performance on a 4th-year objective structured clinical examination (OSCE) with residency program director assessment, class rank, and U.S. Medical Licensing Examination (USMLE) scores. METHODS: We surveyed program directors about the performance of 50 graduates from our medical school chosen to represent the highest (OSCEHI) and lowest (OSCELO) 25 performers on our required 4th-year OSCE. Program directors were unaware of the OSCE scores of the graduates. RESULTS: OSCE scores did not correlate with Likert scores for any survey parameter studied (r < .23, p > .13 for all comparisons). Similarly, program director evaluations did not correlate with class rank or USMLE scores (r < .26, p > .09 for all comparisons). CONCLUSIONS: We concluded that program director evaluations of resident performance do not appear to correlate with objective tests of either clinical skills or knowledge taken during medical school. These findings suggest that more structured and objective evaluative tools might improve postgraduate training program assessment of trainees.
Evaluation of potential donors for heart transplantation is an important part of any heart transplantation program. Standard guidelines are being refined constantly to expand the donor pool. We present a case of carbon monoxide poisoning that led to severe myocardial damage in the transplanted heart.
Program management as a way to structure hospital management has been attracting growing interest. Numerous hospitals are introducing it. West Park Hospital was one of the first hospitals to adopt program management in 1991 and mount a rigorous evaluation of the new approach, one which relied on external evaluators. This article reviews the emergence of program management in the hospital sector and reports on the evaluation of West Park's experience.
Osteoporosis is an age related metabolic disease that primarily affects women and causes bone demineralization that results in fractures. Early identification of risk factors for osteoporosis and development of prevention programs is needed to halt the increasing incidence of the disease. Public health nurses (PHNs), with their emphasis on primary, secondary, and tertiary prevention with individuals and families, are in a unique position to protect the health of these vulnerable populations who are at risk for osteoporosis. This article describes the implementation and program evaluation of three osteoporosis prevention educational programs that use three levels of intensity of design. Each design is based upon the learning needs of the targeted audience. The goals of each program were to increase knowledge of osteoporosis, increase health beliefs, and increase the frequency of osteoporosis preventing behaviors. Theoretical aspects from adult learning and the Health Belief Model (HBM) were used to develop the programs. For the program evaluation, participants completed evaluation instruments before and 3 weeks after participating in an osteoporosis health education program. Participants in all programs had significantly higher levels of knowledge after completing the programs; however, overall, there was no change in health beliefs or behaviors. Implications of these findings are discussed.
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BACKGROUND: There has been a proliferation of quality use of medicines activities in Australia since the 1990s. However, knowledge of the nature and extent of these activities was lacking. A mechanism was required to map the activities to enable their coordination. AIMS: To develop a geographical mapping facility as an evaluative tool to assist the planning and implementation of Australia's policy on the quality use of medicines. METHODS: A web-based database incorporating geographical mapping software was developed. Quality use of medicines projects implemented across the country was identified from project listings funded by the Quality Use of Medicines Evaluation Program, the National Health and Medical Research Council, Mental Health Strategy, Rural Health Support, Education and Training Program, the Healthy Seniors Initiative, the General Practice Evaluation Program and the Drug Utilisation Evaluation Network. In addition, projects were identified through direct mail to persons working in the field. RESULTS: The Quality Use of Medicines Mapping Project (QUMMP) was developed, providing a Web-based database that can be continuously updated. This database showed the distribution of quality use of medicines activities by: (i) geographical region, (ii) project type, (iii) target group, (iv) stakeholder involvement, (v) funding body and (vi) evaluation method. At September 2001, the database included 901 projects. Sixty-two per cent of projects had been conducted in Australian capital cities, where approximately 63% of the population reside. Distribution of projects varied between States. In Western Australia and Queensland, 36 and 73 projects had been conducted, respectively, representing approximately two projects per 100,000 people. By comparison, in South Australia and Tasmania approximately seven projects per 100,000 people were recorded, with six per 100,000 people in Victoria and three per 100,000 people in New South Wales. Rural and remote areas of the country had more limited project activity. CONCLUSIONS: The mapping of projects by geographical location enabled easy identification of high and low activity areas. Analysis of the types of projects undertaken in each region enabled identification of target groups that had not been involved or services that had not yet been developed. This served as a powerful tool for policy planning and implementation and will be used to support the continued implementation of Australia's policy on the quality use of medicines.
This paper examines the data requirements for impact evaluation in the light of recent federal efforts to improve the evaluation of health programs. Typically, new health programs are launched before there is sufficient time or administrative interest in devising appropriate evaluation methodology. Therefore, any evaluation of such a program must be designed retrospectively. We argue that the best and typically only sources of data appropriate for such evaluations are pre-existing administrative statistics and archival records. The potential and limitations of these data sources are reviewed.
This chapter presents a discussion of the specific steps undertaken when the Waltz approach is employed for the evaluation of nursing programs. Discussion is organized in terms of: (1) who is responsible for the evaluation; (2) why the evaluation is conducted, (3) what is evaluated, (4) how judgments are made on the basis of findings, (5) how the evaluation proceeds, (6) when evaluation occurs, (7) reporting and recording findings and results, and (8) evaluating the evaluation. Specific strategies and techniques for developing and implementing the Master Plan for Evaluation and for managing the conduct of the ongoing evaluation are described. Specific topics regarding "who" include the following: establishing and maintaining the internal evaluator role, operationalizing the internal evaluator role, ethical and political aspects of the role, essential characteristics of internal evaluators, maintaining an outsider perspective in the insider role, and determining significant others to be involved. In the section on "why," attention is given to explaining the purposes for the evaluation and identifying the potential audiences for results. Regarding "what," the focus is on examining program inputs, processes, outcomes, and the setting in which the evaluation occurs, rendering goals and objectives measurable, and explicating questions of concern to the respective audiences. Attention in the section on "how" emphasizes the following: establishing a procedure for decision making, constructing a variable matrix, categorizing evaluation activities, assigning responsibility for evaluation activities using responsibility charting, determining the cost of evaluation activities via engineering cost analysis, and establishing priorities. Gantt Charts are discussed in terms of "when," and essential components and considerations in reporting and recording are elaborated. Meta-evaluation, evaluating the evaluation, is discussed as it relates to the Master Plan, the implementation of specific activities, and strategies and techniques for managing the evaluation.
Evaluations of the early phases of state efforts to control hospital costs led to discouraging conclusions about the effectiveness of such programs. To determine whether cost regulation has improved since then, we compared the experience of the six states that have comprehensive, legally mandated hospital rate-setting programs with that of the states without such programs during the period from 1970 to 1978. During the last three years of this period, the average annual rate of increase in hospital costs in rate-setting states has been 11.2 per cent, as compared with an average annual rate of increase of 14.3 per cent in states without such programs (P < 0.05). We conclude that much of the initial pessimism regarding the effectiveness of hospital rate-setting programs, based on studies that covered earlier reporting periods, may be unwarranted.