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Health plans and integrated networks increasingly want the "gold star" of accreditation. Find out how a Joint Commission seal of approval can enhance quality--and how the on-site review team evaluates your health promotion and disease prevention efforts.
The main goal of this research is to better understand age differences in the effects of social networks on mental health. Using a social network approach to revise the convoy of social support model (Kahn and Antonucci, 1980), we examine specifically how two aspects of social support networks (kin composition and convoy dimensions) influence psychological distress for older and younger samples (18-59 and 60+). We hypothesize that kin composition will influence distress in general but especially for the younger sample, while two competing hypotheses for the convoy of social support model are tested. Using data from a three-wave panel health study, structural equation models (LISREL 8.20) indicate that a greater proportion of kin in the perceived support network and the presence of family members in the inner circle of the convoy significantly reduce distress, primarily for the younger sample. Implications for the convoy model are discussed.
If institutional systems that provide end-of-life care are to survive the demands of managed care, they will need to tie together methods of assessing the needs of the dying, leading to a new understanding of the functioning of a patient's existing helping networks. This paper presents the preliminary findings of a research project conducted at a Midwest hospice. The study utilized a cross sectional correlational survey of patients' needs via the Early Risk and Resiliency Inventory (ERRI), while mapping their helping networks with a Circles of Care Ecomap. It addressed the question, "What is the relationship between the needs of the dying and the formal and informal support provided?" Study findings supported the contention that higher need patients utilized the more expensive institutional services rather than relying on available natural networks; and statistical analysis of the study instrument suggested the creation of a new conceptual domain of psychospiritual need.
A community-based programme to ensure prompt and adequate treatment of presumptive episodes of clinical malaria in children has been established in a rural province of Burkina Faso. The implementation strategy was based on training a core group of mothers in every village and supplying community health workers with essential antimalarial drugs specially packed in age-specific bags containing a full course of treatment. Drugs were sold under a cost-recovery scheme. The programme was run in 1994 by the national malaria control centre (CNLP), and in 1995 it was developed to the provincial health team (PHT). Knowledge and awareness of malaria increased with the intervention. Drug consumption by age group was compatible with the distribution of disease, and no major problem of misuse emerged. The actual implementation costs of the intervention were US$ 0.06 per child living in the province. An evaluation of the impact of the intervention on the severity of malaria, using routine data from the health information system and taking as an indicator the proportion of malaria cases which were recorded as severe in health centres, was performed. In 1994, when the intervention was implemented on a provincial scale by CNLP, this proportion was lower than the average of the 4 preceding years (3.7% vs. 4.9%). In 1995, when the programme was implemented by the PHT, the proportion of severe cases was lower in health centres achieving a programme coverage of > or = 50% in their catchment area compared with the others (4.2% vs. 6.1%). Our experience shows that a low-cost, community-based intervention aimed at providing children with prompt and adequate treatment of presumptive episodes of clinical malaria is feasible, and suggests that it may lead to a reduction in the morbidity from severe malaria.
Nursing staff in Scotland have access to five local multidisciplinary health services research Networks. These offer nurses guidance, advice and support on relevant but unanswered questions relating to their clinical practice, thus helping them to take forward their enquiry. This article explores the origin, usefulness and developing role of these Networks with particular reference to the North of Scotland Network. Networking is recommended as an effective intervention to facilitate the development of research, to promote the quality, quantity and usefulness of research, and to place research into patient care at the heart of nursing practice.
The increasing demand for treatment by alternative care practitioners has resulted in MCOs marketing networks of acupuncturists, herbalists, massage therapy specialists, and others to their members. However, before an alternative provider network is considered, one must understand the comparisons and differences between conventional biomedical-based therapy and alternative care techniques. This is the first part of a two-part article exploring these issues.
BACKGROUND: The movement of public health professionals from health authorities to primary care trusts has increased their isolation and dependence on public health networks for communication. METHODS: A cross sectional survey of 60 public health professionals working in England was performed to determine their understanding of the term "public health network" and to explore the functions that they would like these networks to perform. It also assessed their attitudes towards a national network and towards individual, local, and national web sites to support these networks. RESULTS: The most popular functions were the support of CPD/education, the identification of expertise and maximisation of scarce resources, information sharing, and efficient information/knowledge management. The local and national networks and their web sites should provide information on current projects of the network and searches to identify people, expertise, and reports. CONCLUSION: Public health professionals have a similar but broader understanding of the term "public health network" than that of the government with greater emphasis on sharing of information. The network is more likely to be successful if its priorities are maximising scarce resources, identification of expertise, CPD/education, and knowledge management.
What do physician executives need to know about antitrust guidelines? This article presents an overview of the revised "Statements of Antitrust Enforcement Policy in the Health Care Area," released in late 1996. Antitrust concepts and implicated federal statutes are described, and implications for forming physician network joint ventures are explored. Requirements of the revised standards used by the agencies to determine a permissible integration are addressed, as well as the factors considered in antitrust scrutiny of physician ventures.
Home care provider networks can help agencies serve more people more effectively. Before joining a health care provider network, however, agencies must analyze several factors and find partners who share the same business and health care philosophies. Using the guidelines in this article, agencies can be confident of better decisions for their businesses.
A national survey of 105 healthcare organizations conducted by Longshore & Simmons found that most IDSs' networks of acquired physician practices are losing money. The survey examined a variety of issues related to management and structure of IDS physician networks and physician compensation. In addition to finding that most networks were unprofitable, the survey found that for 75 percent of respondents, capitation revenue represented 25 percent or less of total revenue. The survey also disclosed there was no single, preferred method for allocating capitation revenue among physicians; 43 percent of physician networks were organized as hospital departments, cost centers, or divisions; and only 21 percent of respondents were using relative value units as a means to measure physician productivity, despite the proven effectiveness of this approach.
Although hospital-owned primary care practices have been unprofitable for most hospitals, some hospitals are achieving competitive advantage and sustainable practice operations. A key to the success of some has been a net income reporting tool that separates practice operating expenses from the costs of creating and operating a network of practices to help healthcare organization managers, physicians, and staff to identify opportunities to improve the network's financial performance. This "Net One, Net Two" reporting allows operations leadership to be held accountable for Net One expenses and strategic leadership to be held accountable for Net Two expenses.
VTMEDNET is the health information network for the state of Vermont. In response to a needs assessment of rural health care providers, it supports e-mail, access to knowledge-bases, and the ability to request library services for health care providers across the state, regardless of their location or affiliation. For Fletcher Allen Health Care affiliates, it also supports access to in-patient hospital records. Two thirds of the state's physicians are using the network as well as many other health care providers, and, with minimal cost, it has begun to meet its goal of improving health care delivery to many of Vermont's citizens.
Provider networks are being created at a furious pace, often without regard for the accompanying risks. The sixth annual Excellence in Healthcare Risk Management Awards showcase three organizations that have successfully, and innovatively, addressed risk management concerns.
Group practices have enhanced the accessibility and quality of care through continuous innovation and performance improvement initiatives. However, sustaining a quality infrastructure can be costly. Will purchasers and consumers demand a group-model delivery system that provides accessible, effective, accountable, efficient, and coordinated care when network-models with little overhead can provide basic services for less? Here's how groups in the Institute for Behavioral Healthcare's (IBH) Council of Behavioral Group Practices are innovating to sustain excellence and superior performance.
BACKGROUND: Practice based research networks enable the study of primary care problems in a primary care setting. To be successful, our experience indicates that a network will need to incorporate a number of key components. In South Australia, a University Family Practice Network has been established to undertake primary health care research and teaching and to contribute to the general practice workforce. The University Family Practice Network is composed of five practices and is managed jointly by the Department of General Practice, Adelaide University and the South Australian Centre for Rural and Remote Health, Adelaide University and the University of South Australia. OBJECTIVE: This article details the successful establishment of the University Family Practice Network in the hope of providing a model for other universities who may be interested in setting up a practice based research network. DISCUSSION: The characteristics of this network include fractional academic positions for general practitioners, computerised medical records, location in rural and urban sites, regular meetings and the appointment of a research fellow. A number of benefits have arisen since the network's establishment that will assist its future development and sustainability. These include collocation with allied health services, development of local expertise and workforce support.
School health education is one of the primary missions of the educational system which is characterised by the involvement of numerous professional institutions, associations, and others, at the heart of academic establishments. The need for partnership within this complex domain has been recognised and affirmed by the official publications of the national Ministry of Education as it has been in actions. In so far as the move towards the recourse of external intervention, should this be considered as the result of a true partnership or an act of simple delegation (or subcontracting)? Firstly, this article proposes to define the concept of partnership. Secondly, it presents the results of a study on the implementation of drug-use prevention in high schools who underline the importance of the problems associated with partnership in this field and attempt to put into perspective the respective points of view of the educational teams and external actors. On the basis of these results, it proposes a typology of the networks from which the activities are built, then analyses the conditions necessary in order that health education be implemented within a framework of partnership established on the competencies, differences and contributions of each partner.
Tremendous debate has developed over the efficacy of primary percutaneous coronary intervention (PCI) compared with fibrinolysis as the preferred treatment for acute ST segment elevation myocardial infarction (STEMI). In 2002, the Ontario Ministry of Heath and Long-Term Care commissioned the Cardiac Care Network of Ontario to develop consensus recommendations regarding the provincial coordination and provision of urgent PCI for STEMI patients. The panel's work has provided important insights into the acute treatment of STEMI that may be useful to other jurisdictions and may provide a reference for other regions considering the implementation of primary PCI for the management of STEMI patients in their community. In the present report, the evidence for primary PCI is reviewed, the important barriers to implementing this strategy are summarized and several recommendations and models of care for the delivery of primary PCI for STEMI on a wide scale are presented.
This report describes the development and implementation of a pilot intervention project designed to determine the economic, logistic, behavioral, and attitudinal variables that influence rural women's participation in a community-based breast cancer screening program. This paper reports on survey responses of women who registered for this pilot breast cancer screening program. It includes information on all women who registered for the project--both those who received breast cancer screening and those who did not. The study is a pilot intervention project, the overall goal of which was to develop a network of community providers, organizations, and volunteers to facilitate breast cancer screening among rural women. Of the 159 women registered for this pilot program, 101 (63.5%) were screened (receiving both a clinical breast examination and mammogram). The attitudes of women surveyed through the project confirm the importance of a physician recommendation for breast cancer screening. More than 90 percent of both the screened and unscreened groups of women stated that a doctor's recommendation to have breast cancer screening is important. Further, nearly 42 percent of the unscreened group had never had a physician recommend breast cancer screening. Despite existing barriers to screening, this pilot study demonstrated that health care professionals and regional organizations that have not traditionally been associated with delivering health care in this particular community setting can successfully work together to implement breast cancer screening programs.