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At least 1,063 records · Page 59Linked to original sources
PubMed1998

Tracking case management accountability: a systems approach.

A review of the evaluation of case management programs in the last two decades reveals a lack of consistency in showing outcome effectiveness. In addition, program evaluation models do not reflect the most prevalent theoretical foundation of case management practice, systems theory. It was the purpose of this article to conceptually establish an evaluation model that reflects systems theory in case management practice, to develop evaluation instruments congruent to collecting data in this model, and then to field-test this evaluation model.

Case Management↗
PubMed2001

Middle school reform through data and dialogue. Collaborative evaluation with 17 leadership teams.

This report describes a 2-year, longitudinal study of one school district's effort to link site-based, collaborative evaluation with formal, centralized program evaluation. Participants formed a research team in partnership with a local university. Team members assisted leadership teams in identifying issues for informal, site-based assessments and then used the information to monitor progress toward established goals. Participants collaborated in designing and conducting informal assessments of student achievement, school climate and safety, discipline, and parent involvement. Leadership teams used these data in developing their school improvement plans. Researchers and administrators used these data to revise the districtwide survey. At the end of the 2-year cycle, analysis of school improvement plans showed that collaborative evaluation is creating a connection between dialogue and data. These 17 middle schools are approaching school improvement in a more integrated fashion by actively involving key stakeholders (students, parents, and teachers) in the evaluation process.

Adult↗
PubMed1998

Nursing research conferences: benefit or burden.

The benefits for presenters and participants of three annual nursing research conferences were investigated. Results from 133 on-site program evaluations were compared to results of surveys developed to capture presenter and participant perspectives, 6-22 months post conference. Data from surveys revealed that descriptive exploratory studies (the majority of presentations) were evaluated as least useful. One third of participants reported that they attempted to apply research findings or clinical innovations to their area of practice. A unique finding of this study was that presenters experience post-conference benefits, such as publishing, consulting, presenting, and project expansion. The results of the post conference evaluations differed from the surveys some months after the conferences. Planners of continuing education programs are cautioned against future conference development based solely on the initial "glow" of on-site program evaluations. Study findings clearly suggest that the benefits of nursing research conferences to both participants and presenters far outweigh the burdens.

Attitude of Health Personnel↗
PubMed1988

A microcomputer program to evaluate the saturation of complex solutions with respect to biominerals.

The program described is written in BASIC and enables calculation of ionic activity products and degrees of saturation for solutions with respect to minerals of biological interest. The program takes into account ion-pair formation by association of anions and cations. The number of constituent species, whether or not involved in mineral formation or in ion-pair formation, appears to be unlimited. The computation fulfils the conditions of conservation of matter and electrical neutrality. Successful computation is achieved even for systems with highly unfavourable ratios between cations and anions with high affinities. The program is easily re-orientated towards any mineral/solution system.

Algorithms↗
PubMed1984

Evaluative research in community mental health.

This paper compares evaluative research to program evaluation by defining and describing each. A case example using the scientific design and methodology of evaluative research to evaluate a specific community mental health program is also presented. Project design is discussed in light of the awareness that the mental health needs of communities do not always bend to fit the requisite of precise scientific procedure. Some ideas on methodological considerations reflect that normal research tools can be useful to achieve a valid study. Implications for the application of evaluative research to community mental health needs are also identified.

Community Mental Health Services↗
PubMed2004

[Microbiological external quality assurance program (MEQAP)--evaluation of results obtained in sanitary epidemiological laboratories in 2002].

The aim of this study was to evaluate reliability of identification and determination of sensitivity to antibiotics and chemotherapeutics of some Gram positive cocci strains in 34 sanitary-epidemiological stations. All laboratories engaged in this study received 3 strains: S. aureus (S. aureus SC+ CF+, resistant to methicillin., or S. aureus SC - CF+, sensitive to methicillin), coagulase-negative staphylococci (S. epidermidis or S. haemolyticus or S. saprophyticus) and Enterococcus sp. (E. faecalis HLAR-positive or E. faecalis HLAR-negative or E. faecium or E. gallinarum). All these strains previously were identified in Department of Bacteriology of National Institute of Hygiene. Of the 68 staphylococci strains tested, 66 isolates were correctly identified. Among the 34 enterococcal strains studied the greatest difficulty in identification was caused by E. gallinarum strain--(8 out of 13 strains were incorrectly recognised). The determination of the sensitivity of the control strains to antibiotics and chemotherapeutic agents, generally was performed correctly in accordance with to the NCCLS and national recommendations. Some incorrect results of the antibiograms were caused by an erroneous interpretation of the zones of inhibition.

Enterococcus↗
PubMed2002

[Microbiological External Quality Assurance Program (MEQAO)--evaluation of results obtained in 2001 of sanitary-epidemiological station laboratories].

The aim of this study was to evaluate reliability of identification and determination of sensitivity to antibiotics and chemotherapeutics of some Enterobacteriaceae strains in 49 sanitary-epidemiological stations. All laboratories engaged in this study received 4 strains each (S. marcescens phenotype ESBL+, K. pneumoniae phenotype ESBL+, S. Typhimurium and S. Newport) previously identified in the Department of Bacteriology of National Institute of Hygiene. The laboratories included in the survey were asked to determine the genus (serovar) of each control strain using the lowest number of biochemical test recommended by Institute and to determine of the sensitivity of the identified strains to antibiotics in accordance with the guidelines of the NCCLS and domestic recommendations. Only in 2 participating laboratories the identification of one of studied strains (K. pneumoniae) was completely bad and in 9 laboratories the serological identification of S. Newport was incomplete or serological type was not correctly recognised. In the determination of the sensitivity of the control strains to chemotherapeutic agents abnormalities were found in the technique of antibiogram and test for ESBL performing and incorrect selection of disc for antibiograms as well as erroneous interpretation of the results.

Clinical Laboratory Techniques↗
PubMed1995

Dynamic patient data bases: the foundation of an integrated approach to outcome measures for the healthcare professionals.

In recent years there has been a tremendous need among healthcare professionals to assess the effectiveness, efficiency, and appropriateness of the patient care services being provided through criteria-based outcome and program evaluation. Although the need for a tool which could evaluate the effectiveness of patient care is widely recognized, such an undertaking has been severely limited due to the lack of any automated means to collect and analyze patient data on a routine, continuous basis within a clinical setting. We have developed and implemented at Mineral Springs Hospital, Banff, Alberta an integrated and automated hospital information system that not only continuously collects administrative, financial, and patient data, but also contains an intelligent component for automated outcome measure and program evaluation. The system collects various non-duplicated data elements from each routine work process within the facility on a continuous basis. Through the creation of a dynamic patient database, data is transformed into information--a powerful decision support tool. The system provides flexible user-defined reports in patient-specific resource utilization, direct and/or indirect specific financial costs, result reporting of each intervention, service provided and user-defined criteria-based outcome, and program evaluation. The system design incorporates expert rules, dynamic data entry forms, quantitative models, and user-defined access control. Using information derived from the dynamic common database, managers and front-line clinicians can easily evaluate and modify management decisions or careplans on a macro or micro level. An external review is planned to evaluate whether the system has helped the assessment of effectiveness, efficiency and appropriateness of healthcare services being provided at the hospital. The fundamental concept behind the system design is that the patient is the center of activity for data collection. The system provides the answers to the 5 W's (who, what, where, when, and why) together with intervention and service result reports. A dynamic common patient database is the center of the system and is accessible to all with proper authorization. Common data elements are collected from routine work flow without extra data entry and this information is subsequently shared. Data collection is a continuous process. We believe that every process is the outcome of another sub-process or event. The design of the dynamic patient database incorporates patient-specific costing and outcome evaluation, user-defined flexible data entry forms, user-defined access control, outcome evaluation rules and information semantic rules. Such a patient database would provide the flexibility needed to accommodate diverse methodologies to evaluate outcomes whether it they be medical, cost, access and/or other combination of measures. The system was developed on a PC-based Network technology, using FOXPRO (XBase) as the database development tool incorporating advanced technology such as distributed processing and fault tolerant computing. We chose PC-based technology because it is economical, having relatively low maintenance costs and requires no major dependency on vendors. The developed system produces patient-specific reports with many dimensions. The reports are user-defined. The system reports general data, CMG, RGN, LOS, Expected LOS, and other user-defined demographic data. Resource utilization, financial costs, and result reportings are produced together with rule-based outcome assessments of any type of measures, including, but not limited to, pre-set functional/health goals, user satisfaction, clinicianUs text or codified comments etc. It provides the framework for continually capturing data at a practical, work-flow level. The incorporation of a dynamic patient database as the driving forece of an integrated, rule-based administration, financial and patient data system will provdie the tools for healthcar

Databases, Factual↗
PubMed2003

Microsystems in health care: Part 8. Developing people and improving work life: what front-line staff told us.

BACKGROUND: The articles in the Microsystems in Health Care series have focused on the success characteristics of high-performing clinical microsystems. Realization is growing about the importance of attracting, selecting, developing, and engaging staff. By optimizing the work of all staff members and by promoting a culture where everyone matters, the microsystem can attain levels of performance not previously experienced. CASE STUDY: At Massachusetts General Hospital Downtown Associates (Boston), a primary care practice, the human resource processes are specified and predictable, from a candidate's initial contact through each staff member's orientation, performance management, and professional development. Early on, the new employee receives materials about the practice, including a practice overview, his or her typical responsibilities, the performance evaluation program, and continuous quality improvement. Ongoing training and education are supported with skill labs, special education nights, and cross-training. The performance evaluation program, used to evaluate the performance of all employees, is completed during the 90-day orientation and training, quarterly for one year, and annually. CONCLUSION: Some health care settings enjoy high morale, high quality, and high productivity, but all too often this is not the case. The case study offers an example of a microsystem that has motivated its staff and created a positive and dynamic workplace.

Boston↗
PubMed1998

Program specification: a precursor to program monitoring and quality improvement. A case study from Boysville of Michigan.

As a result of new accreditation standards, diminishing resources, community concern with recidivism, and state agencies and foundations requiring more rigorous evaluations, program accountability is becoming a necessity for social services providers and contractors alike. In the subsequent discussion, Boysville of Michigan's program specification process is described; specifically, the ways in which the process has been useful for monitoring program operations, identifying quality improvement indicators, designing ongoing program evaluations, and developing consensus and continuity with respect to program theory and procedures. In addition, benefits, lessons learned, and implications for services delivery are discussed.

Child↗
PubMedDate not supplied

The Head Start dental component: evaluation of an urban program.

To evaluate the dental portion of a Head Start Program, the investigators determined the degree of compliance in providing children aged 3-5 years with annual examinations, topical fluoride, followup care, and a dental curriculum for their classroom. The study included an audit of the children's health records, a clinical assessment of care needs, oral cleanliness, and restoration quality, and an evaluation in the last month of the school year. The evaluation procedures were standardized, and dual examiners were used for all assessments. Differences of opinion between examiners were settled immediately, and the consensus was noted in the evaluation record for the study. A review was conducted of the health records for the 564 children enrolled in eight Head Start centers in Dallas, TX. According to those records, 74 percent of the children had been examined. Nearly 24 percent had required dental care because of caries--the range among centers was 11 to 43 percent. Of the group requiring care, 85 percent had received all the care needed. With the use of World Health Organization criteria, a mean score of 2.47 for oral cleanliness was determined for a random sample of 178 children. This sample also exhibited 1.45 decayed and 1.18 filled deciduous teeth per child. Restoration quality was rated; 94 percent were judged to be acceptable by Ryge's criteria. At all the centers, the dental health curriculum met the program standards set for Head Start by the Public Health Service, Region VI. This investigation showed that the centers did not uniformly comply with the clinical care standards devised for Head Start by the Public Health Service, but they did provide dental services that otherwise might not be available to children enrolled at the eight centers.

Child, Preschool↗
PubMed2005

Risk factors for and prevention of tobacco use.

This study describes the risk factors for and prevention of tobacco use among young people. Risk factors show differential importance along the course of tobacco use development. The contents of an effective prevention effort vary as a function of the age of target group. However, the mediation of the effects of effective programs is not well known. Various modalities of implementation of prevention programming may be important, though a majority of program evaluation has occurred in the school context. The majority of well-evaluated tobacco use prevention programs that employ a comprehensive social influences model show effects over an average of 6 years post-programming.

Humans↗
PubMed2003

Palliative care management: a Veterans Administration demonstration project.

As part of a Veterans Health Administration (VA) commitment to improve end-of-life care the VA Greater Los Angeles Healthcare System (GLA) implemented Pathways of Caring, a 3-year demonstration project targeting patients with inoperable lung cancer and advanced heart failure and chronic lung disease. The program utilized case-finding for early identification of poor-prognosis patients, interdisciplinary palliative assessment, and intensive nurse care coordination to optimize symptom management, continuity and coordination of services across providers and care settings, and support for families. Program evaluation used patient and family surveys as well as reviews of medical records and administrative databases to assess processes and outcomes of care. Despite significant programmatic challenges including organizational instability and evaluation design issues, the program achieved measurable success including high rates of advance care planning, hospice enrollment, and death at home, and low end-of-life hospital and Intensive Care Unit (ICU) use. As a result of its success, the program will be expanded and its care model extended institution-wide.

Humans↗
PubMed1989

Medical ethics education: coming of age.

Medical ethics education is instruction that endeavors to teach the examination of the role of values in the doctor's relationship with patients, colleagues, and society. It is one front of a broad curricular effort to develop physicians' values, social perspectives, and interpersonal skills for the practice of medicine. The authors define medical ethics education as more clinically centered than human values education and more inclusive of philosophical, social, and legal issues than is interpersonal skills training. The authors review the history of the emergence of medical ethics education over the last 20 years, examine the areas of consensus that have emerged concerning the general objectives and premises for designing medical ethics programs, and describe teaching objectives and methods, course content, and program evaluation used in such programs on both preclinical and clinical levels. The four interrelated requirements for successful institutionalization of medical ethics education programs are defined and discussed, and the paper ends with an overview of the uncertain future of medical ethics education, an accepted but still not fully mature part of physician training in the United States. An extensive reference list accompanies the article.

Bioethical Issues↗
PubMed1996

CEC-CED Joint Knowledge and Skills statement for all becoming teachers of students who are deaf or hard of hearing. Joint Standards Committee of the National Council on Education of the Deaf and the Council for Exceptional Children.

In 1992, the National Council on Education of the Deaf (CED) and the Council for Exceptional Children (CEC) began a collaborative process in which new standards were jointly developed and approved by a representation of members from all organizations engaged in the preparation of teachers and in the delivery of services to deaf and hard of hearing learners, including educational, professional/administrative and consumer organizations. A Joint Standards Committee was appointed, and in 1992 enunciated mutually acceptable standards for the preparation of teachers of students who are deaf and hard of hearing. Fundamental to the entire standards development process was respect for the continuum of educational options available for children who are deaf and hard of hearing. The intent of this committee was to provide standards which were credible for all university and college teacher preparation programs and which could serve as a foundation for the development and maintenance of strong and viable programs according to the specific stated philosophy and practice of each. Information regarding the new standards and University/College Program Evaluation can be obtained from: Dr. Harold Johnson, Program Evaluation Chair, Kent State University, Room 405 White Hall, Kent, Ohio 44242.

Deafness↗
PubMed1982

Increasing the educational value of medical care evaluation: a model program.

A model medical care evaluation (MCE) program, designed to increase the educational value of MCE activities, was implemented in three clinical departments at the Michael Reese Hospital and Medical Center. The program was evaluated by means of quantitative and qualitative observational techniques, questionnaires, and interviews and by comparing committees for which the implementation was highly successful with those for which it was less successful. The results confirmed the educational value of the following features of the model program: (a) a focus on the process of care rather than standards of care, (b) prior review of records and their presentation as case problems, (c) educational emphasis by the committee chairperson, and (d) attendance by at least four physicians. Implications for other types of hospital quality assurance or educational activities are discussed.

Delivery of Health Care↗
PubMed1991

Preterm birth prevention: an evaluation of programs in the United States.

During the last decade several programs were established to prevent the onset of preterm labor and facilitate its early identification and treatment. Although these prevention programs shared a similar goal, they varied in their primary outcome focus, target populations, study designs, and specific intervention components. Their initial reports were promising; however, subsequent evaluations of efforts in the United States produced mixed results. The current literature is suggestive of the benefits of programs to prevent preterm labor and delivery, but methodologic differences among them and deficiencies in the reported evaluations have rendered a final verdict equivocal. Many studies using historical or geographic controls found positive results, whereas randomized, controlled trials did not find a significant impact. Positive results were found in studies using low-risk populations, but investigations of high-risk patients noted little effect. Together with continued research on the factors that underlie the onset of labor, additional assessment of these programs and their individual intervention components appears to be necessary.

Bed Rest↗