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At least 163 records · Page 9Linked to original sources
PubMed1988

Strengthening physician bonds through practice development planning.

As the delivery of health care continues to evolve in an increasingly competitive environment, the alliances between healthcare institutions and physician providers become an important key to the prosperity and ultimate survival of both parties. In this first article of a two-part series, a case study of one healthcare system's program of physician practice development is presented, focusing on the events leading up to the inception of the program, goals of the program, and the protocol and rationale of a physician practice enhancement project. The second article in this series will discuss the operational process as well as the pitfalls to be avoided in developing and establishing a medical practice for management.

Cost-Benefit Analysis↗
PubMed1996

Planning, development, and execution of an international training program in laparoscopic surgery.

In the late 1980s, minimally invasive surgery experienced unprecedented growth. Centers appeared worldwide, providing a variety of training opportunities and laboratory experiences. Because standard surgical training varies greatly from country to country, it became apparent that this variety was even more pronounced in the area of minimally invasive and laparoscopic surgery, posing significant credentialling difficulties for professional standards committees wishing to certify surgical staff who submit unevaluable credentials from all over the world. In January 1993, the Center for Minimally Invasive Surgery at New England Medical Center and Tufts University School of Medicine was asked to plan and execute a program of education, training, and credentialling for a multispecialty surgical staff in the Eastern province of Saudi Arabia. A four-stage program was designed and developed to provide credentialling from the technician level through the instructor surgeon level. A multidisciplinary course was developed and a team placed on site for 1 month to execute the program. This program began with an 8-h didactic/video session in basic laparoscopy, covering areas common to the involved subspecialties: surgery, urology, and gynecology. This session was followed by hands-on training sessions in general surgery and urology and credentialling in gynecology. Physicians who successfully completed the examination in basic laparoscopy were later eligible for credentialling at one of three clinical specialty levels: basic clinical laparoscopy, advanced clinical laparoscopy, or instructor in clinical laparoscopy. Education and credentialling in minimally invasive surgery can be accomplished by executing a program of basic science and clinical training for physicians, technicians, and nurses that accommodates a wide range of experience of participants, from novice to master surgeon. Support from the hospital administrators and department chairs was instrumental in the program's success. Among the goals we accomplished was identification of persons in an institution who could serve as future instructors and certifiers for the hospital's self-sustaining program as well as providing a relationship in which international institutions can serve as a resource for further continuing medical education and clinical and laboratory training. This program may well serve as the model template for international credential standards of the future.

Education, Medical, Continuing↗
PubMed1998

The Oregon Health Plan: development and implementation of an innovative method of delivery of health care services to the medically indigent.

BACKGROUND: Health care for the medically indigent under the federal Medicaid system often provides care for only a fraction (ranging from 20% to 80%) of the poor who nominally qualify for care. Oregon has developed a unique system that replaces such a system with one that provides a comprehensive complement of medical care for all the poor but limits the care to conditions and procedures on a prioritized list. METHODS: The Health Services Commission, a group of physicians, nurses, and public representatives, developed a list of over 740 diagnoses-treatment pairs and, with considerable public input, prioritized them in order of importance. The principal values used to develop the list were the prevention of death and the cost of the disease and its treatment. In the final ordering of the diagnosis-treatment pairs, public health and prevention of morbidity was also considered. Cancer diagnoses, and indeed all diseases, were not singled out for special consideration in this process. The Oregon Health Plan was implemented in 1994 with funds to cover 606 of 743 listed diagnoses. Diagnoses involving cancer were nearly all covered within these 606 items. The principal exception was coverage for Curative Treatment for Cancer when the likelihood for success was less than 5%. RESULTS: The prioritized list has met its goal of comprehensive medical care for the indigent population. The number of medically uninsured Oregonians has fallen significantly, and there have been few complaints about the Plan. Cancer care has been delivered to Oregon Health Plan clients with very few complaints or appeals of decisions concerning coverage. Palliative care is provided under a number of covered lines, as are curative medical and surgical treatment. CONCLUSIONS: The Oregon Health Plan represents an alternative method for delivering medical care, including the full range of cancer care, to the indigent. As there are limited funds in all state systems, the citizens of Oregon have decided to provide care using a prioritized list to allow provision of medical care to the entire Medicaid population. Such a plan represents a viable alternative to the more common method of providing everything but only to a limited number of poor citizens.

Cancer Care Facilities↗
PubMed1985

Documentation of hospice care plan development and team meetings.

The interdisciplinary team meeting documentation system as described in this article meets the documentation requirements specified by JCAH and Medicare. The goal of the system is to provide necessary documentation in a format that is easy to use. Because of the generic content and format of this system, hospices in any setting or from any provider can adapt the forms to their particular needs. Delaware Hospice has shared this documentation system together with the interdisciplinary care plan form with numerous hospices who have also found them practical and instrumental in providing high-quality patient care.

Delaware↗
PubMedDate not supplied

A staff development plan for the graying of America's hospital patients.

In this article, the authors describe a program created by a nursing inservice department to address the graying of America's hospital patients. The increased number of aging patients presents a challenge that hospitals must confront. Elderly patients who take longer to get well and consume more resources make unprecedented demands on nursing staff members. Because basic nursing education programs fail to address the problem, the task of preparing nursing personnel to care for aging patients falls to the hospital's department of staff development.

Aged↗
PubMed1979

A regional cardiac care program: planning & development.

Five hospitals in northeastern Massachusetts joined together to provide a cardiac care nursing educational program for staff nurses. Their mutual effort reduced costs for each hospital and maximized the use of human and material resources. The endeavor has been successful, based upon a number of evaluation factors.

Coronary Care Units↗
PubMedDate not supplied

A structured approach to expert financial management: a financial development plan for nurse managers.

Faced with tighter budgets and diminishing resources, the success of nurse managers will be measured by their ability to identify and balance cost/quality issues effectively while managing staffing under variable patient census and demanding patient acuity. A structured approach to expert financial management can insure that nursing departments meet financial targets while maintaining integrity of clinical care.

Budgets↗
PubMed1988

Plan development for a nurse recruitment-retention program.

The key to resolving the nursing shortage starts with the long-term commitment and support of hospital administrators. Many articles address the reasons for registered nurse turnover and for job dissatisfaction. They also address recruitment and retention incentives, motivators, and hygienes. This discussion focuses on what hospital administrators can do to create and to monitor a nurse recruitment-retention program that addresses the long-term problem of nurse turnover and job dissatisfaction, based on the concept that retention of nurses begins at the time of recruitment.

Feedback↗
PubMed2004

Remote sensing as a tool for mapping mosquito breeding habitats and associated health risk to assist control efforts and development plans: a case study in Wadi El Natroun, Egypt.

Limited mosquito ground surveys were combined with remote sensing and GIS technologies to identify mosquito breeding habitats in Natroun lakes area and to delineate associated health risks. Mosquito larval surveys were carried out in a small area to characterize positive breeding habitats and determine their geographic coordinates. Mosquitoes (Anopheles multicolor, Culex antennatus and Cx. theileri) were found breeding in water-flooded habitats with dense vegetation cover spatially associated to existing lakes. Chemical analysis indicated that mosquito breeding water was found to be polluted by several sources including agriculture, industrial and domestic sources. This information served as a training set to characterize the spectral signature of mosquitogenic (mosquito-producing) habitats using reflectance data of the Thematic Mapper (TM) sensor aboard Landsat 5 satellite. Following characterization of the spectral signature, satellite data were used to predict, potential mosquito breeding patches over the whole study area. Field surveys were then carried out to assess the accuracy of predicted habitats and those surveys have indicated that all checked sites were positive for mosquito larvae demonstrating an accuracy of 100%. Based on an average adult mosquito flight range of 2 km, GIS was used to create buffer zones around breeding habitats describing areas at risk from mosquito nuisance and disease transmission. The obtained results could thus provide a new basis for directing the control of mosquito vectors as they provide health authorities with precise maps of mosquito breeding habitats in a timely manner. Moreover, the generated map delineating risk areas could be used by project developers to either re-site the project or invest in mosquito control activities in order to avoid health risks and ensure sustainability of their development. The approach adopted in this investigation demonstrated the practical and successful application of remote sensing and GIS in assisting health and development decision making.

Animals↗