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PubMedDate not supplied

Turning Point's National Excellence Collaboratives: assessing a new model for policy and system capacity development.

This article reviews the factors leading to successful collaborations and observations about the functioning of groups of states in collaborative coalitions by examining one specific collaboration--the Turning Point initiative. Turning Point is an initiative funded by The Robert Wood Johnson Foundation (RWJF) to transform and strengthen the US public health system so that it is more effective, more community based, and more collaborative in protecting and improving the public's health and well-being. A unique aspect of the Turning Point initiative is the creation of 5 National Excellence Collaboratives, with participating members from multiple Turning Point state partnerships, national public health associations, federal agencies, and diverse other organizations appropriate to each Collaborative's focus. Over 5 years, Turning Point Collaboratives developed educational materials, practice tools, and policy recommendations aimed at improving the public health system at the state and local levels and, ultimately, improving the health of the US population. The literature on collaborative partnerships and coalitions describes key elements and factors among successful partnerships. Areas of importance to success in Turning Point Collaboratives that have implications for future efforts include: continuity of leadership and membership, adequate technical assistance, diversity of Collaborative membership, regular feedback, and incentives.

Community Health Planning↗
PubMedDate not supplied

Turning point and public health institutes: vehicles for systems change.

Public Health Institutes are free-standing multisector entities able to function as conveners to improve health status and foster innovations in health systems. Turning Point is a program funded by The Robert Wood Johnson Foundation, involving 21 statewide initiatives and 2 "linked" states that formed multisector collaborative partnerships for public health systems change. In 18 of the Turning Point states, there are also Public Health Institutes, some formed by Turning Point partnerships and some established independently. Both Turning Point and Public Health Institutes represent efforts to reform and enhance public health systems. What has been the relationship between these two organizational forms? This descriptive, qualitative study examined the relationships between state-level Turning Point partnerships and Public Health Institutes in states that have both. Key participants in both institutions were interviewed, and models were developed to represent those relationships. Principal findings suggest that the relationships of Turning Point state partnerships with Public Health Institutes have taken many shapes. Factors that influence the choices and sequencing of these options are largely related to the political and economic resources of each state. Turning Point participants perceived Public Health Institutes to be a useful organizational form for sustaining public health systems change. Public Health Institutes have more administrative and fiscal flexibility than state government and greater opportunities for policy development and advocacy. However, free-standing institutes also have greater financial uncertainty.

Academies and Institutes↗
PubMedDate not supplied

Using information technology to improve the public health system.

Information technology can be both a vital tool and critical link in the modern public health system. This article discusses the role of information technology in public health and the activities of the Information Technology Collaborative, one of the collaboratives that comprise the national Turning Point initiative. Data are presented from a nationwide survey investigating local health department information technology needs and information technology use. This data, and data from an investigation of state-level public health information technology, will be presented in a more complete format on the Information Technology Collaborative's online Public Health Information Systems Catalog, a free resource for individuals interested in public health informatics. Recommendations for future initiatives, policy changes, and information technology standards are discussed.

Catalogs as Topic↗
PubMedDate not supplied

Designing and building new local public health agencies in Nebraska.

Prior to 2001, the local public health system in Nebraska was weak, fragmented, and severely under funded. Local public health departments covered only 22 of the state's 93 counties. The Turning Point project provided the impetus for change by allowing a diverse group of public health stakeholders to develop a strategic plan for strengthening and transforming the public health system. The plan acted as a catalyst to use some of the Nebraska Tobacco Settlement Funds to provide dedicated state funding to build the local public health system. By June 2002, 16 new local public health departments had been organized, ultimately covering all of the 93 counties in the state. Some of the keys to long-term sustainability are creating a network of community health partners that support collaborative decision making, continually seeking input from the community, developing and implementing an education and training plan for public health professionals and local board of health members, and demonstrating accountability by documenting results and communicating them to policy makers and the general public.

Community Health Planning↗
PubMed1977

Treatment approaches with the psychiatric elderly.

In reviewing the literature on treatment approaches with the psychiatric elderly, a large number of studies were found which espouse comprehensive rehabilitation programs that usually require supplementation of existing personnel and expansion of facilities. Although some agencies and institutions are fortunate in securing the needed funds for such program implementation, most others face the reality of limited personnel and funding cutbacks. This paper briefly reviews modalities which do not demand additional expenditures for specialized facilities in the treatment of chronically ill geropsychiatric patients.

Aged↗
PubMed2003

Lessons learned in phase I of the Southern Rural Access Program.

The Robert Wood Johnson Foundation's Southern Rural Access Program has been an important investment of philanthropic funds to augment resources and improve health care access in underserved rural communities. The program's first phase has taught important lessons about building capacity in rural health care. This article uses a variety of data to document the program's major accomplishments and most significant challenges to date. The program's revolving loan fund efforts are promising. The program has also played a catalytic role in stimulating rural health network development in the South and has helped stimulate partnerships with Southern philanthropies and multiple local, state, and federal agencies. Challenges have included the broad geographic and programmatic focus of the initiative as well as changing and often difficult state policy environments. Additional challenges include maintaining interagency coordination over time and managing staff and lead agency turnover. Overall, the experience suggests that a concentrated regional approach has merit.

Community Health Planning↗
PubMed1982

Cost of counselling women who undergo mastectomy.

The psychiatric morbidity associated with mastectomy and brest cancer was substantially reduced by a specialist nurse who counselled women before and after surgery and monitored their progress. A controlled study was, therefore, carried out to determine what this cost. National Health Service costs were almost wholly covered by savings made because counselled subjects who developed psychiatric problems were recognised and treated much earlier than control patients. Counselled and control subjects suffered considerable financial losses, but these were offset in the counselled group by their relatives' earlier return to work. Such counselling schemes are necessary and effective and may be implemented at little extra cost.

Community Health Services↗
PubMed1979

Community mental health centers: returning to basics.

Community mental health centers (CMHCs) have made a significant contribution to making mental health services available to many Americans; in 1977 they served almost two million people. External fiscal constraints and internal service and accountability requirements now test the viability of CMHCs, but the most recent extension of the law allows increased flexibility on implementation, and the President's Commission on Mental Health has reinforced the original purpose of CMHCs by calling for an initiative to give special attention to the needs of children and youth, the elderly, minorities, the chronically mentally ill, and other underserved populations and areas.

Community Mental Health Centers↗
PubMed1992

The relationship between community resources and state hospital recidivism.

OBJECTIVE: The authors examined the propositions that a revolving state hospital door is an inevitable consequence of deinstitutionalization and that enhancing resources for community-based care can limit this phenomenon. METHOD: They analyzed the recidivism patterns of state hospital patients in a region of Massachusetts where, because of a federal court consent decree, the level of funding for community programs was more than twice as high as it was in other regions in the state and compared the pattern of recidivism in this region with that observed in the other areas of the state. RESULTS: Despite the fact that the average daily state hospital census in the resource-rich region was only half that of the other regions, longitudinal data on hospital use showed that the readmission patterns were similar in all state regions. CONCLUSIONS: The authors suggest that attributes of serious and persistent mental illness may have more effect on hospital readmission patterns than service system variables.

Community Mental Health Services↗