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PubMed2000

Providing quality medical care at a remote, isolated duty station.

The U.S. armed forces deploy active duty personnel to virtually every region of the world. Family members accompany the service member at many of these remote, isolated assignments. This discussion highlights the barriers to the provision of medical care to these active duty personnel, their families, and other eligible beneficiaries, such as government service and Department of Defense civilians. To succeed in this endeavor, the isolated military medical treatment facility must first consider the critical resources available that will enable it to overcome known barriers. Next, careful deliberation will identify the necessary components of a health care network suitable for the remote duty station. The facility must then recognize and address its responsibility to conduct ongoing evaluation of the quality of care and of customer satisfaction with its network. This discussion concludes with a description of a successfully implemented health care network at a remote, isolated duty station.

Community Networks↗
PubMed2000

The Critical Care Research Network: a partnership in community-based research and research transfer.

The objectives of this study were to present a short history of the Critical Care Research Network (CCR-Net), describe its approach to health services research and to summarize completed and current research projects. In doing this, we explored the question is this research network accomplishing its goals? We reviewed the medical literature to identify studies on similar types of Networks and also the evidence supporting the methodology used by CCR-Net to conduct research using MEDLINE, HEALTHSTAR, CINAHL and the keywords network and health care or healthcare, benchmarking and health care or healthcare, and research transfer or research utilization. We also reviewed the bibliographies of retrieved articles and our personal files. In addition, we summarized the results of studies conducted by CCR-Net and outlined those currently in progress. A review of the literature identified studies on two similar networks that appeared to be succeeding. In addition, the literature was also supportive of the general process used by CCR-Net, although the level of evidence varied. Finally, the studies conducted to date within CCR-Net follow the suggested methodology. At the time of this preliminary communication CCR-Net appears to have adopted a valid approach to health services research within the area of Critical Care Medicine. Further direct evidence is required and appropriate studies are planned.

Canada↗
PubMed2003

A multicentre collaboration to investigate the cause of severe acute respiratory syndrome.

Severe acute respiratory syndrome is a new disease in human beings, first recognised in late February, 2003, in Hanoi, Vietnam. The severity of the disease, combined with its rapid spread along international air-travel routes, prompted WHO to set up a network of scientists from 11 laboratories around the world to try to identify the causal agent and develop a diagnostic test. The network unites laboratories with different methods and capacities to rapidly fulfil all postulates for establishing a virus as the cause of a disease. Results are shared in real time via a secure website, on which microscopy pictures, protocols for testing, and PCR primer sequences are also posted. Findings are discussed in daily teleconferences. Progress is further facilitated through sharing between laboratories of samples and test materials. The network has identified a new coronavirus, consistently detected in samples of SARS patients from several countries, and conclusively named it as the causative agent of SARS; the strain is unlike any other known member of the genus Coronavirus. Three diagnostic tests are now available, but all have limitations.

Animals↗
PubMed2002

Continuity and quality of care in type 2 diabetes: a Residency Research Network of South Texas study.

OBJECTIVE: We investigated the relationship between continuity of care and the quality of care received by patients with type 2 diabetes mellitus. STUDY DESIGN: We used a cross-sectional patient survey and medical record review. POPULATION: Consecutive patients with an established diagnosis of type 2 diabetes mellitus presented to 1 of 6 clinics within the Residency Research Network of South Texas, a network of 6 family practice residencies affiliated with the University of Texas Health Science Center at San Antonio. OUTCOMES MEASURED: Continuity was measured as the proportion of visits within the past year to the patient's usual primary care provider. A quality of care score was computed based on the American Diabetes Association's Provider Recognition Program criteria from data collected through medical record review and patient surveys. Each patient was awarded points based on the presence or absence of each criterion. RESULTS: The continuity score was associated significantly with the quality of care score in the anticipated direction (r =.15, P =.04). Patients who had seen their usual providers within the past year were significantly more likely to have had an eye examination, a foot examination, 2 blood pressure measurements, and a lipid analysis. CONCLUSIONS: Continuity of care is associated with the quality of care received by patients with type 2 diabetes mellitus. Continuity of care may influence provider and patient behaviors in ways that improve quality. Further research on how continuity contributes to improved quality is needed.

Academic Medical Centers↗