Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Health Plan Implementation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,135 records · Page 63Linked to original sources
PubMed2002

Social norms marketing: a prevention strategy to decrease high-risk drinking among college students.

We describe a social-norms marketing approach to moderating college student drinking behaviors and correcting student misperceptions about campus drinking. The intervention has the potential to be applied to other health behaviors where misperceptions abound, such as those related to cigarette smoking, eating disorders, sexual health, and sexual assault. Even though nurses are actively working on alcohol and other drug (AOD) prevention efforts on college campuses, little data based research have been published. Collaborative efforts between faculty from different disciplines, including nursing and nurse health educators, can be an effective combination for preventing alcohol abuse and for initiating sound research-based campus prevention programs.

Alcohol Drinking↗
PubMedDate not supplied

Effects of a replication of a multicomponent model for preventing adolescent pregnancy in three Kansas communities.

CONTEXT: A significant amount of attention has been devoted to the complex issue of teenage pregnancy and to programs for reducing pregnancy among adolescents. Careful evaluations of such programs are needed to ascertain what strategies will be most effective at reducing teenage pregnancy. METHODS: A pretest-posttest comparison group design was used to analyze the effects of a comprehensive multicomponent school and community intervention on estimated pregnancy rates and birthrates among young people in three Kansas communities: Geary County, Franklin County and selected neighborhoods of Wichita. RESULTS: There were high levels of program activity in all three communities during the intervention period, including teacher training and sexuality education for students. Survey respondents rated highly such project interventions as the extension of school-linked clinic hours to accommodate student schedules and support groups established in middle schools. Between 1994 and 1997, the proportions of adolescents reporting that they had ever had sex decreased significantly among all ninth and 10th graders in Geary County, from 51% to 38% among females and from 63% to 43% among males. In Franklin County, more males in grades 11 and 12 reported using condoms in 1996 (55%) than had done so in 1994 (39%). Age at first intercourse remained relatively stable in Franklin and Geary counties during the intervention period. The estimated pregnancy rate among adolescents aged 14-17 decreased between 1994 and 1997 in Geary Country, while it increased in comparison areas. The estimated pregnancy rates among 14-17-year-olds decreased in both Franklin County and its comparison communities. The birthrate declined both in one target area of Wichita and in its comparison area from 1991-1993 to 1994-1996. Over the same time period, the birthrate increased in a second target area of Wichita, while it decreased in the comparison community. CONCLUSIONS: This evaluation of a comprehensive multicomponent program for adolescent pregnancy prevention contributes to our understanding of this model and its replicability in diverse communities. Ongoing program evaluation is important for developing initiatives and for refining strategies so they respond to local conditions.

Adolescent↗
PubMed2002

[Hospital morbidity in Mazowian voivodeship in the first year of the new health care system].

The aim of this study was to analyse the frequency hospitalisation in Mazowian voivodeship by sex, age, place of residence (urban-rural), and major causes of hospitalisation in the first year of the new health care system in compare with the period 1991-1996. Data used in the study covered a 10% sample of hospitalised persons discharged or deceased in hospitals operating under Ministry of Health or Polish State Railways. The outcome measures were age-standardised hospital discharge rates. Obtained results showed a systematic increase of the discharge rates between 1991 and 1999 of both men and women. It was found that frequency of hospitalisation in urban areas was higher then in rural ones and that the difference was remarkable increasing in 1999.

Adolescent↗
PubMedDate not supplied

Medicine in Mississippi.

Adequate health care represents an issue that has always troubled rural America. From the earliest days of this country, affordable and quality health care has often been harder to find for those who those to live on the farm or in a small town or any place off the beaten path than it has for residents in urban areas. The State of Mississippi has undertaken an intensive program to widen access to health care--and, especially, to preventive health measures--by utilizing fully all available financial resources, including private foundations, by encouraging increased cooperation from our physicians and hospitals in caring for patients insured by Medicaid, and by involving the community in emphasizing the use of health care practitioners in delivering inexpensive but effective support to our rural population.

Delivery of Health Care↗
PubMed2003

Progress and challenges toward poliomyelitis eradication in Indonesia.

Poliomyelitis is one of few diseases that can be eradicated. The virus cannot survive outside the body and effective vaccine is available to protect children and stop transmission. Today, there are 3 million children each year saved by the oral polio vaccine (OPV) and globally the reported cases have declined from 50,000 to 7,000 in 1999. At present, 20 countries may remain at risk of continued transmission, mostly in Africa and Asia. In the region of SEARO, wild poliovirus is still transmitted in India, Nepal and Bangladesh. Efforts to eradicate polio had been made in Indonesia, through a four-pronged strategy; routine immunization, National Surveillance Days (NIDs), surveillance of Acute Onset of Flaccid Paralysis (AFP) cases, and supplementary immunizations. No polio cases have been detected in Indonesia since 1995, but some problem will remain until the whole SEARO region is certified polio-free. Filling the immunization gap and revitalizing the AFP surveillance program are among the highest priority activities.

Health Plan Implementation↗
PubMed2002

Electronic health record.

The chapter covers the electronic health record and electronic health record system that facilitates the use of EHR. The EHR is compared with the traditional handwritten health care record. Definition of Electronic Health Records and its association with the terminology, classification and coding is presented. The architecture of the Electronic Health Record is of strong significance as well as its attributes. Strategic approaches of designing systems supporting the use of electronic health records are depicted. A short presentation of current state of implementation and the obstacles for further implementation are given in the final part of the chapter.

Health Plan Implementation↗
PubMedDate not supplied

[Control of onchocerciasis vectors in West Africa: description of the logistics adapted for a large-scale public health program].

The Onchocerciasis Control Programme (OCP) in West Africa, launched in 1974, includes 11 participating countries and covers more than one million square kilometres. The aim of the OCP is to control blinding onchocerciasis (river blindness) which is caused by the savannah strain of Onchocerca volvulus transmitted by the Simulium damnosum complex. There is no effective macrofilaricide, so vector control to prevent the transmission of the parasite remains the method of choice, despite the availability of ivermectin, a drug which controls ocular morbidity. The potential value of vector control has been demonstrated by the original programme: 14 years activity has eliminated the disease as a public health problem in the areas included. This strategy requires adapted logistical support involving (i) widespread insecticide coverage (27,000 km of river are treated by the OCP during the rainy season), (ii) frequent (weekly) application of larvicide and (iii) prolonged intervention due to the life-span of the worm in the human reservoir, estimated to be approximately 14 years. We describe the vector control operations and their organisation 20 years after the initiation of the OCP. The OCP can be divided into 5 areas of logistic activity. The first covers activities involving insecticide and fuel management for the OCP as a whole: assessment of the requirements for the following year, ordering from insecticide and petrol suppliers, stocking fuel and insecticide at the depots covering the area. The second activity is the treatment of rivers with insecticide. This includes treating the ground with larvicide, the aerial operations run by an independent company supplying 12 helicopters on contract to the OCP, and use of satellite beacons for retransmitting of hydrological data. The third activity is monitoring the impact of larvicides on both the target (adult and larval S. damnosum) and on other fauna (fish, crustaceans and other insects). The fourth activity is field data collection and its processing. This involves a data transmission network to facilitate stock management insecticide application and entomological and hydrological surveillance using computer systems. The fifth activity is the coordination of vector control operations, technical and administrative staff and estimations of the funds available to the Vector Control Unit. The logistic aspects of other large-scale-insect-control programmes world-wide are considered, and the possibility of using the OCP as a model for such programmes (both public health and agricultural) is assessed.

Africa, Western↗
PubMed1997

Breast feeding practices in a teaching hospital of Calcutta before and after the adoption of BFHI (Baby Friendly Hospital Initiative).

A comparative study has been made on two groups of 102 mothers each who delivered children in the postnatal ward of obstetrics and gynaecology department of Calcutta National Medical College before and after the introduction of BFHI (Baby Friendly Hospital Initiative). The study revealed that only 14.3% of the babies who were delivered normally were given their first breast feed in time, the ideal time of half an hour, while not a single baby delivered by caesarean section were given their breast feed within the stipulated time period of 4-6 hours. However, there has been a significant overall reduction in the time gap between the birth and the first breast feed in all types of delivery. BFHI has also made significant reduction of prelacteal feeds and in-between feeds in the newborns especially those delivered normally. The fact that babies of first order and those delivered by caesarean section are lagging behind as far as exclusive breast feeding is concerned has been highlighted in the study.

Breast Feeding↗
PubMed1994

Essential factors in the implementation of an Expanded Program on Immunization in an urban-periurban community in Nigeria.

The aim of this study was to identify some of the factors that affected the implementation of the Expanded Program on Immunization (EPI) in the Local Government Area (LGA). The study covered the three communities in Calabar LGA. Data on vaccine-eligible children and pregnant women were sought with questionnaires; other information on technical and community aspects of the EPI was gathered with specially designed checklists. EPI coverage for most antigens increased between 70-100% in response to highly-organized immunization campaigns initiated in 1985. In subsequent years, up to 1989, similar campaign-induced responses to national, state and local campaign efforts were observed. In contrast, coverage levels attributable to routine immunization remained unsatisfactory. When tested with the Z-statistic using 1985 as the base year (p < 0.05), there was a significant difference between the proportion of eligible children and pregnant women who did not receive their full dose of immunization. Socio-logistic variables found to be important in EPI implementations included scheduling, health staff attitude, intersectoral collaboration, and health education. Lack of community participation was also found to be a crucial constraining factor. As community participation/involvement is critical in sustaining health programs, social marketing techniques are suggested for future use.

Female↗
PubMed1998

[Process-oriented quality management in the hospital].

Procedures and experiences concerning the implementation of quality management in a midsize hospital with 6 medical disciplines are described. Quality of infrastructure was checked with lists and the quality of medical performance assessed by means of standardized numerical audit with all professional groups. Weaknesses were identified by comparing the result to each quality indicator with target standards. As examples, causal relations and consequences of deficiencies in clinical care documentation, scheme of preoperative diagnosis, co-ordination of surgical procedures and handling of complications are given in more detail. Obstacles were rated depending on frequency and risk potential, sometimes cost effectiveness. Members of all professional groups and departments involved participated in trouble solving teams to which external expert assistance was provided. For example, interventions leading to improved co-ordination of surgical activities and their impacts are specified. Improving systematically the quality of clinical procedures is one gateway to establish quality management in hospitals continuously and thoroughly becoming an integrated part of the corporate culture. Investment of resources is necessary but justified by midrange benefits.

Germany↗
PubMed2004

Implementation of the WHO Multicentre Growth Reference Study in Ghana.

The World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) African site was Accra, Ghana. Its sample was drawn from 10 affluent residential areas where earlier research had demonstrated the presence of a child subpopulation with unconstrained growth. This subpopulation could be identified on the basis of the father's education and household income. The subjects for the longitudinal study were enrolled from 25 hospitals and delivery facilities that accounted for 80% of the study area's births. The cross-sectional sample was recruited at 117 day-care centers used by more than 80% of the targeted subpopulation. Public relations efforts were mounted to promote the study in the community. The large number of facilities involved in the longitudinal and cross-sectional components, the relatively large geographic area covered by the study, and the difficulties of working in a densely populated urban area presented special challenges. Conversely, the high rates of breastfeeding and general support for this practice greatly facilitated the implementation of the MGRS protocol.

Child Development↗
PubMed2000

Using root cause analysis to address patient satisfaction and other improvement opportunities.

BACKGROUND: Despite the considerable attention that health care organizations are devoting to the measurement of patient satisfaction, there is often confusion about how to systematically use these data to improve an organization's performance. A model to use in applying traditional quality improvement methods and tools to patient satisfaction problems includes five primary steps: (1) identifying opportunities, (2) prioritizing opportunities, (3) conducting root cause analysis, (4) designing and testing potential solutions, and (5) implementing the proposed solution. PATIENT SATISFACTION SURVEYS: A satisfaction survey serves best as a high-level screening device, not as a tool to provide highly detailed information about the root causes of patient dissatisfaction. The primary purpose of the survey in the model is to identify improvement opportunities and areas of significant improvement or deterioration. Secondary tools such as brief patient interviews or focus groups may better serve to probe intensively into the problem areas identified by the survey. These tools allow for a direct dialog with the patient to uncover root causes of dissatisfaction and establish potential solutions. DISCUSSION: Although the primary focus of this model has been patient satisfaction issues, the basic steps could easily be applied to virtually any improvement opportunity. Improvement teams should commit to a schedule of 90-minute weekly meetings for 7 weeks. The model, a simple translation of traditional improvement methods and tools to address the unique issues facing patient satisfaction improvement teams, can save improvement teams considerable time, resources, and frustration as they design and launch initiatives to improve patient satisfaction.

Causality↗
PubMed1998

Mental health in the Oregon Health Plan: fragmentation or integration?

The Oregon Health Plan was implemented in 1994 with a 50% expansion of Medicaid enrollment to include some of the working poor. Over 75% of Oregon Medicaid clients are now enrolled in health maintenance organizations (HMOs). Outpatient chemical dependency services have been capitated since May 1995. Capitated mental health services have been provided for the 25% of eligibles who live in demonstration counties since January 1995. Expansion and capitation appear to have been achieved without major trauma. More challenging has been the attempted integration of public sector behavioral health services with private sector health plans. Stakeholders interviewed for this study were especially concerned about the long-term impact on Medicaid clients with chronic mental illness. Strong leadership and clear policies regarding the mixture of public, private nonprofit, and private for profit entities are necessary if the state is to achieve its aim of integration without fragmenting a system of care for people with severe mental illness.

Attitude to Health↗
PubMed1999

Auditing the implementation of SIGN (Scottish Intercollegiate Guidelines Network) clinical guidelines.

Clinical practice guidelines are increasingly being recognised as integral to the clinical effectiveness agenda. According to the recent Scottish White Paper, Scotland "leads the way in clinical effectiveness". The Scottish Intercollegiate Guidelines Network (SIGN), established in 1993, has produced over 20 clinical practice guidelines, and plans to produce at least as many more, while reviewing existing guidelines at a minimum of every two years. This represents a substantial investment of NHS resources. This paper investigates whether this investment is being recouped in Scottish NHS acute trusts via the implementation of SIGN guidelines, and whether their implementation is being audited properly. It is argued that without clinical audit, guideline implementation is unlikely to succeed. This has important ramifications for the implementation of clinical governance.

Accreditation↗