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PubMed2001

Queensland public sector nurse executives: job satisfaction and career opportunities.

During the past decade, economic and political forces have caused radical transformations in health care systems resulting in changed circumstances within which nursing executives must function. This paper provides an understanding of nursing executives' roles and responsibilities and the impact changes in the health industry have had on their careers. One hundred and forty-seven (52%) of the 281 nursing executives employed in the Queensland Public Health Sector completed a postal self-administered survey. The findings of this study demonstrate their role has expanded to include not only nursing administration, but also responsibility for financial, human resources, strategic and resource management, staff development and quality improvement. The impact of these role changes has affected the health and well-being of nursing executives, with nearly half reporting increased stress, frustration and irritation. Their workload has increased and some reported deterioration in their health, specifically, exhaustion, fatigue and insomnia. Respondents reported they now have less time to spend with families and friends, which has had a negative impact on family relationships. Overall, nursing executives were satisfied with their current position, the work itself and their relationships with their co-workers, but dissatisfied with organisational aspects, especially the quality of mentorship and opportunities for promotion.

Adult↗
PubMed2002

Planning, designing and evaluating a departmental medical illustration website.

The Medical Illustration Department at West Glasgow Hospitals made a decision to construct a departmental website that would not only raise awareness of the department but also demonstrate the expertise in website construction the medical illustration staff had developed. Departmental staff and client base surveys were conducted to define what was required for a successful departmental website. Further investigation was conducted by surveying five existing medical illustration websites. Based on this initial data the website was constructed. A post-construction survey was conducted to assess suitability, usability and to highlight any potential problem areas.

Evaluation Studies as Topic↗
PubMed2001

The problem-based learning tutorial laboratory - a method for training medical teachers.

An extensive staff development program was started in 1998 in the Faculty of Medicine at the University of Helsinki. A problem-based learning method was introduced as a new style of teaching in the curriculum reform. This paper describes a teaching method 'Problem-based learning - tutorial laboratory' for training medical teachers to act as tutors and to understand their roles as facilitators of learning and the dynamics of a small group. The method was based on learning cycles: teachers had a possibility to experience tutoring, to get feedback about it from an educational expert and from a peer teacher and also they were able to reflect on their views in the group. The teachers were content with the training. Sessions improved teacher cooperation across the departments and brought new teaching ideas for shared use. It also helped to cope with the resistance related to the curriculum change process.

Journal Article↗
PubMed2002

Information-sharing strategies to support practising clinicians in their clinical teaching roles.

If the involvement of practising clinicians in undergraduate clinical teaching is to be retained, strategies that inform them of student expectations and show how their contribution can be integrated to the wider clinical teaching programme must be identified. A variety of information-sharing strategies has been designed and used to communicate with clinicians teaching in Phase 2 of the undergraduate medical curriculum in Dundee. Evaluation of these by the clinical teaching staff has indicated that briefing by students, posters and tutor manuals are more successful information-sharing strategies than formal staff-development sessions.

Cooperative Behavior↗
PubMedDate not supplied

Lessons learned from providing transition services to adolescents with special health care needs.

This article provides insight and information about obstacles adolescents with special health care needs (ASHCNs) face as they progress to adulthood. Descriptions of these challenges are based upon clinical experiences in providing transition services to youth by the service coordinator seen through the Creating Healthy Futures transition clinic. These obstacles were classified as those related to health care, employment, education, independent living, social and recreational skills, and the service system. Information is also provided on the strategies project staff developed to assist youth in dealing with the challenges of the transition obstacles they faced.

Adolescent↗
PubMed1990

Student healthcare needs, attitudes, and behavior: marketing implications for college health centers.

This article presents the findings of a 1987 cross-institutional study of the healthcare needs, attitudes, and behavior of college students, based on a comprehensive survey of 1,050 students at three different institutions. The paper focuses on student health concerns, use of facilities, and healthcare knowledge and outlook. For each of these topics, the authors present their findings and discuss the marketing implications of these findings for college health centers. In order to increase utilization rates, match services with student needs, and make maximum use of resources, the authors suggest that college health centers may need to develop and promote programs and services that better address student healthcare concerns; investigate media alternatives and effectiveness; develop aggressive promotion messages; consider joint interinstitutional development of healthcare advertising; and train and develop staff through internal marketing seminars.

Adult↗
PubMed1992

Relationship marketing and service quality.

The delivery of services in college health centers is improved through the use of relationship marketing and service quality advancement. Relationship marketing works to attract, maintain, and enhance customer or client relationships with the healthcare provider. The facets of relationship marketing are explored, with the greatest emphasis placed on internal marketing. Higher quality health services come from continuous improvement, a focus on process, and intensive staff development and participation, which build a service culture.

Hospital-Patient Relations↗
PubMed1998

Substance Abuse in Hawaii: Perspectives of Key Local Human Service Organizations.

Available evidence suggests that substance abuse in Hawaii is a substantial problem. The three major objectives of this study were to determine qualitatively Hawaii's human service organizations' perspective regarding (1) the magnitude of the statewide substance abuse problem, (2) the unmet needs of the state's substance abuse treatment system, and (3) the features of the problem unique to Hawaii's many ethnic and other subgroups. The study targeted those human service organizations most burdened by the substance abuse problem. Respondents from 55 human service organizations were interviewed using a series of 21 open-ended questions. Respondents perceived the magnitude of the Hawaii substance abuse problem to be at least comparable to that of the mainland United States. Although most respondents viewed the problem using a medical model, the problem was generally thought to be exacerbated by a community context in which substance abuse is accepted, excused, or denied. Increasing use of crystal methamphetamine and heroin were cited as the most worrisome trends. Systems issues identified were unstable funding, insufficient detoxification services, and limited availability of residential treatment and supportive services following treatment, such as housing and aftercare. Service delivery problems frequently associated with rural areas were identified, such as transportation, staff development, outreach, and difficulty providing a full range of services, particularly on neighbor islands. Cultural alienation, exacerbated by the state's prevailing multiculturalism, was thought to contribute to the substance abuse problem among all ethnic groups, but especially among Native Hawaiians. Cultural factors were thought to have a major impact on seeking care and subsequent acceptance of such care. Further study is needed to understand better the content of care, therapeutic elements, and efficacy of culturally specific treatment and prevention programs. To initiate change, concerted efforts are needed to inform Hawaii residents about the statewide substance abuse problem and local treatment system needs. Future studies should compare human service organization perceptions to those of individuals abusing substances and using these services.

Journal Article↗
PubMed1994

Young offender drug use: knowledge and perceptions of Juvenile Justice Centre youth workers.

Juvenile Justice Centre youth workers in New South Wales (n = 106) were surveyed by questionnaire as to their knowledge and perceptions of alcohol and other drug issues of those in their care. Some background variables were also collected. About 30% of the sample reported having (had) a problem with alcohol and/or other drugs and approximately the same percentage came from families with such a problem. Over 50% had received some form of drug education. There was an overestimation of the level of use of narcotics, sedative/hypnotics, anti-anxiety agents and hallucinogens of the youth workers and an underestimation of the level of use of analgesics, alcohol, cannabis and inhalants. Peer pressure was perceived as central in the initiation of use and "denial" in not gaining assistance; the style and belief systems of agencies were not seen as crucial in retaining young people in treatment. Youth workers, who are not required to have any specific education or training prior to employment, did not see themselves as well equipped to assist drug-affected or detoxifying detainees and requested more training/education. It is recommended that this could be provided through tertiary courses and/or in-service staff development.

Journal Article↗
PubMed2006

Secondary syringe exchange as a model for HIV prevention programs in the Russian Federation.

Effective prevention of syringe-borne transmission of HIV and the hepatitis viruses can be undermined if contact between injection drug users and the staff of prevention programs is impeded by police harassment, limited program resources, and the absence of an open "drug scene." All these are commonplace in the Russian Federation. In response, "Project Renewal," the harm reduction program of the AIDS Prevention and Control Center of the Tatarstan Ministry of Health in Kazan, has created a hybrid syringe exchange program that as its primary focus recruited and trained volunteers to provide secondary syringe exchange. To compensate for operational barriers, the program staff identified private venues and trained responsible individuals to work through their own and related networks of injectors to provide clean syringes, other harm reduction supplies, and educational materials, while facilitating the collection and removal of used and potentially contaminated syringes. Program staff developed a detailed set of tracking instruments to monitor, on a daily and weekly basis, the locations and types of contacts and the dissemination of trainings and materials to ensure that the secondary distribution network reaches its target audience. Data show that these secondary exchange sites have proven more productive than the primary mobile and fixed-site syringe exchanges in Kazan. Beginning in 2001, Project Renewal has trained other harm reduction programs in the Russian Federation to use this model of reaching injectors, identifying and training volunteers, and monitoring results of secondary syringe exchange.

Adult↗
PubMedDate not supplied

Development of a software for the design of custom-made hip prostheses using an open-source rapid application development environment.

The present work describes a technology transfer project called HIPCOM devoted to the re-engineering of the process used by a medical devices manufacturer to design custom-made hip prostheses. Although it started with insufficient support from the end-user management, a very tight scheduling and a moderate budget, the project developed into what is considered by all partners a success story. In particular, the development of the design software, called HIPCOM Interactive Design Environment (HIDE) was completed in a time shorter than any optimistic expectation. The software was quite stable since its first beta version, and once introduced at the user site it fully replaced the original procedure in less than two months. One year after the early adoption, more than 80 custom-made prostheses had been designed with HIDE and the user had reported only two bugs, both cosmetics. The scope of the present work was to report the development experience and to investigate the reasons for these positive results, with particular reference to the development procedure and the software architecture. The choice of TCL/TK as development language and the adoption of well-defined software architecture were found to be the success key factors. Other important determinants were found to be the adoption of an incremental software engineering strategy, well suited for small to medium projects and the presence in the development staff of a technology transfer expert.

Computer-Aided Design↗
PubMed1995

Cost of pharmaceutical services in U.S. hospitals in 1992.

The results of a 1992 national survey of hospital-based pharmaceutical services are reported and compared with data collected during a similar survey in 1989. A questionnaire was mailed to pharmacy directors at all 3756 medical-surgical hospitals in the United States that had 50 or more licensed beds. Cost results were evaluated both as unadjusted data and as data adjusted for severity of illness with the case mix index. The response rate was 43% (1597 usable responses). Mean +/- S.D. unadjusted medication costs per occupied bed were $9850 +/- 4744 (a 46% increase over 1989 costs); significant differences were observed for geographic region, hospital ownership, drug delivery system, and pharmacy director's education. Mean +/- S.D. unadjusted total pharmacy costs per occupied bed were $16,550 +/- 6,249 (a 40% increase over 1989 costs); significant differences were observed for geographic region, hospital ownership, drug delivery system, and pharmacy director's education. Other mean +/- S.D. unadjusted pharmacy cost components were as follows: injectable solution costs, $2627 +/- 2191 (a 38% increase over 1989 costs); inventory costs, $2029 +/- 2593 (70% increase); pharmacist salary costs per occupied bed, $2997 +/- 1267 (33% increase); pharmacy technician costs per occupied bed, $995 +/- 876 (24% increase); pharmacist salary costs per full-time equivalent (FTE), $43,791 +/- 12,206 (14% increase); pharmacy technician salary costs per FTE, $18,953 +/- 6,154 (15% increase); and pharmacy staff development costs per occupied bed, $45 +/- 41 (29% increase). Pharmacist salary costs associated with centrally based clinical pharmacy services ranged from a high of $361 per occupied bed per year for drug-use evaluation to a low of $15 per occupied bed per year for inservice education. Pharmacist salary costs for patient-specific pharmaceutical services ranged from $3 per patient for medical rounds to $8 per patient for cardiopulmonary resuscitation team participation and drug protocol management. A 1992 survey provided comprehensive data on the cost structure of hospital-based pharmaceutical services and a basis for comparison with 1989 cost data.

Geography↗
PubMed1997

Pharmaceutical services in the Department of Veterans Affairs.

The status of pharmaceutical services in the Department of Veterans Affairs (VA) is described. The VA health care system is transforming itself from a hospital-based organization into 22 health care networks that emphasize primary and ambulatory care. The impact on VA pharmacy has been substantial. Roles of VA pharmacists and technicians have been enhanced, and a clinical career ladder for pharmacists was created. VA pharmacy officials and leaders from the University of Tennessee College of Pharmacy have been partnering since 1988 in strategic planning to determine how VA pharmacy can do business and serve patients better. Areas targeted for implementation or improvement include staff development, prescribing authority for pharmacists, automation, the physical design of VA pharmacies, residency programs, and a pharmacy benefit management (PBM) product line. The VA PBM is working to enhance the appropriate use of pharmaceuticals in the veteran population, reduce overall health care expenditures, and provide a more consistent quality of care. Specific PBM programs involve the implementation of drug treatment guidelines, a national formulary, and national contracts. There are plans for pharmacoepidemiologic and pharmacoeconomic research in the geriatric veteran population. The VA health care system and its pharmacy service are changing in ways intended to bring about easier access to care, higher quality, and increased responsiveness to patients' needs.

Automation↗
PubMed1996

Advancing social work practice in health care settings: a collaborative partnership for continuing education.

This article describes a model for social work education and research established by a school of social work and the social work department of a metropolitan medical center. Social workers in the health care setting were surveyed on the knowledge and skills they needed to help them respond to new directions for the department. Results of the study identified a number of themes for staff development and research. Implications of the study, together with a description of the education and research programs developed to respond to these themes, are presented.

Academic Medical Centers↗
PubMed2004

Report of a system for diagnosis, categorizing and recording occupational mental ill-health.

BACKGROUND: UK statutory systems for occupational disease recording do not include mental illness resulting from occupational stress. The issue is included within physician reporting systems, but there is no agreed set of criteria for diagnosis of occupational causation and no agreed system of categorization in terms of type of causation by workplace factors. METHOD: A multidisciplinary group of occupational health professionals, in conjunction with human resources staff, developed a system for the diagnosis, categorization and recording of occupational mental ill-health. RESULTS: The developed system was applied as a pilot and the outcome from its first year of use is presented. CONCLUSIONS: The system is considered to have operated well in pilot, and has now been adopted as a standard operating procedure by the occupational health provider who developed it. The system is proposed as a tool in the development of standardized NHS or UK national systems for the recording of occupational mental ill-health.

Humans↗
PubMed2002

International Task Force on Volunteer Cleft Missions.

The International Task Force on Volunteer Cleft Missions was set up to provide a report to be presented at the Eighth International Congress of Cleft Palate and Associated Craniofacial Anomalies on September 12, 1997, in Singapore. The aim of the report was to provide data from a wide range of different international teams performing volunteer cleft missions and, thereafter, based on the collected data, to identify common goals and aims of such missions. Thirteen different groups actively participating in volunteer cleft missions worldwide were selected from the International Confederation of Plastic and Reconstructive Surgery's list of teams actively participating in volunteer cleft missions. Because of the time frame within which the committee had to work, three groups that did not respond by the stipulated deadline were omitted from the committee. The represented members and their respective institutions have undertaken more than 50 volunteer cleft missions to underdeveloped nations worldwide within the last 3 years. They have visited over 20 different countries, treating more than 3,500 patients worldwide. Based on the data collected and by consensus, the committee outlined recommendations for future volunteer cleft missions based on 1) mission objectives, 2) organization, 3) personal health and liability, 4) funding, 5) trainees in volunteer cleft missions, and 6) public relations. The task force believed that all volunteer cleft missions should have well-defined objectives, preferably with long-term plans. The task force also decided that it was impossible to achieve a successful mission without good organization and close coordination. All efforts should be made, and care taken, to ensure that there is minimal morbidity and no mortality. Finally, as ambassadors of goodwill and humanitarian aid, the participants must make every effort to understand and respect local customs and protocol. The main aims are to provide top-quality surgical service, train local doctors and staff, develop and nurture fledgling cleft programs, and, finally, make new friends.

Cleft Palate↗