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At least 1,621 records · Page 90Linked to original sources
PubMed1998

Outcomes focused service delivery: developing an academic-management partnership.

OBJECTIVE: Current mental health policies emphasise the need for services to be integrated and to develop outcomes-based evaluation systems. An overview of the challenges faced by service managers and clinical academics who develop the appropriate financial, personnel and academic infrastructure for these tasks is presented. METHOD: By drawing on experiences within the St George Service and references to other services, we propose a model for a successful partnership between the academic and management components of a district service. RESULTS: Major logistic impediments to the development of a partnership are identified, although the long-term scientific and service delivery benefits are highlighted. Key areas within both academic practice and managerial approaches requiring transformation are discussed. CONCLUSIONS: A successful long-term partnership between management and an academic department within a district service may provide the opportunity for rapid progress in population-based service evaluation and health outcomes research.

Community Mental Health Services↗
PubMed1996

Collaboration and the practice of nurse-midwifery.

In the United States there are growing examples of physician and certified nurse-midwife collaborations capitalizing on the strengths of both disciplines working in the best interest of the patient and her family. The philosophy and practice of certified nurse-midwives (CNMs), however, are not embraced universally by all physicians, and childbirth continues to be treated and reimbursed as a disease process. As Americans seek to establish a partnership with those providing their care, they will naturally embrace advanced practice nurses and reach a mutually beneficial health outcome.

Cooperative Behavior↗
PubMed2000

Inequalities in access to coronary angiography and revascularisation: the association of deprivation and location of primary care services.

BACKGROUND: Coronary artery surgery reduces re-infarction rates and mortality in patients with ischaemic heart disease. This study examines inequality in relation to primary care services. AIM: To determine the effect of primary care services on access to coronary angiography and revascularisation. METHOD: A cross-sectional survey of all 180 Nottinghamshire practices in the Trent region that were in existence between 1993 and 1997. The numbers of coronary bypass grafts, angioplasties, and angiographies were determined from the regional National Health Service database and linked to a database of general practice characteristics. Poisson regression analysis was used to determine the relationship between the angiography and revascularisation rates and the following practice characteristics: deprivation score, distance from nearest secondary or tertiary referral centre, medical cardiology admission rate for ischaemic heart disease, fundholding status, and partnership size. Multiple linear regression analysis was used to determine the relationship between practice characteristics and the waiting times for revascularisation and angiography. RESULTS: Practices with high deprivation scores had significantly lower rates of utilisation of angiography and revascularisation procedures. Their patients also waited longer for angiography. Practices that were 20 km or further from a revascularisation centre had significantly lower angiography and revascularisation rates. On average, their patients had to wait more than twice as long for an angiography compared with patients from nearer practices. Fundholding practices had higher angiography rates but similar revascularisation rates compared with non-fundholding practices. CONCLUSION: The results suggest that there may be some under-investigation and/or treatment of patients with ischaemic heart disease from 'deprived' practices and for those from practices far from a secondary or tertiary referral centre.

Cardiovascular Diseases↗
PubMedDate not supplied

Demonstrating excellence in practice-based research for public health.

This document explores the opportunity for scholarship to enhance the evidence base for academic public health practice and practice-based research. Demonstrating Excellence in Practice-Based Research for Public Health defines practice-based research; describes its various approaches, models, and methods; explores ways to overcome its challenges; and recommends actions for its stakeholders in both academic and practice communities. It is hoped that this document will lead to new partnership opportunities between public health researchers and public health practitioners to strengthen the infrastructure of public health and add new dimensions to the science of public health practice. Demonstrating Excellence in Practice-Based Research for Public Health is intended for those who produce, participate in, and use practice-based research. This includes academic researchers and educators, public health administrators and field staff, clinical health professionals, community-based organizations and professionals, and interested members of the public.

Evidence-Based Medicine↗
PubMed1998

The future of dentistry--the evidence revolution.

An increasing demand for evidence-based practice will transform the way we treat our patients in the next decade. This represents both a threat and a golden opportunity for GDPs. I believe that we should grasp this opportunity and in partnership with our academic colleagues, develop a national programme of general practice research.

Academic Medical Centers↗
PubMed2002

A successful researcher-practitioner collaboration in substance abuse treatment.

The best efforts to improve substance abuse treatment come from the integration of practice and research. The purpose of this article is to discuss factors that contribute to fruitful research-practice collaborations using the example of our recent successful partnership between a group of treatment researchers and a group of substance abuse recovery houses operated by Fresh Start. The research effort was the Drug Evaluation Network System, a computer assisted method of integrating clinical research and policy relevant information into a standard admission interview. The article discusses several factors that were important in integrating this research effort into the treatment system. These factors included adequate advance preparation of clinical and research staff to employ the new system, overcoming bilateral biases, and determining the degree to which the clinicians' and researchers' missions are matched. The paper also discusses a range of general factors to consider in implementing and maintaining successful research-to-practice integrations.

Humans↗
PubMed1976

Out-of-hours calls in a Leicestershire practice.

In one year, 920 "out-of-hours" calls were received by a partnership of three general practitioners working from a health centre in semi-rural Leicestershire. The partners on duty saw 588 patients. Out of 898 patients on whom information was available only 75 (8-5%) were referred to hospital, mainly as casualties. The results are compared with a study of deputising services, and it is concluded that a partnership covering its own out-of-hours calls can provide a more personal service and appears to make fewer demands on NHS resources.

Adolescent↗
PubMed2004

Learning to work together: developing academic and community research partnerships.

BACKGROUND: Community-based participatory research (CBPR) has been promoted as an important collaborative methodology for addressing local health concerns. However, academic physicians and researchers usually are not trained to work with communities as partners. METHODS: Key characteristics of effective community-academic partnerships are examined based on experiences with 2 CBPR projects in Wisconsin. RESULTS: These 2 projects increasingly have involved the respective communities and researchers in a collaboration. The steps they have taken illustrate the qualities of successful CBPR partnerships: ongoing development of joint community and researcher analysis, communication, and mobilization to search for relevant solutions to important community health problems. To sustain this kind of partnership, it is critical for researchers using the CBPR approach to understand how their academic-scientific perspective differs as well as converges with the community members' practical-experiential perspective. CONCLUSIONS: Health care researchers can effectively make use of partnerships with communities by following defined CBPR steps for developing mutually agreed upon research agendas, timelines, and goals. This, in turn, builds the capacity of communities to initiate and engage in future collaborative research projects concerning health issues.

Academic Medical Centers↗
PubMed1999

The concepts of community care and primary care in the UK: the 1960s to the 1990s.

The concepts of community care and primary care in UK health policy have emerged over a number of decades. This paper uses historical methods to investigate the changing definitions of community care and primary care in health policy since the 1960s. It draws on published primary and secondary sources including government documents, journals and the professional press. While policy makers have tended to separate community and primary care, the roles of the professions have tended to cut across the two sectors. The emergence and substantially separate development of the two concepts in policy and professional practice between 1960 and 1990 is described and analysed, illustrating the structural constraints on integration but noting the increasing tendency for the boundaries to be called into question. The second part of the paper examines the impact of the 1990 NHS and Community Care Act, the implementation of reforms during the 1990s and the policies currently being implemented by the Labour government. Community care and primary care have continued to be treated separately in the minds of policy makers. Policy for the former has been largely driven by governments' concern to control social security and NHS spending, whilst primary care policy largely focused on the role of general practitioners (GPs) in implementing market reforms. The new Labour government has put renewed emphasis on public health and reducing fragmentation, stressing partnership and cooperation. But the continued dominance of general practice in primary care policy may continue to be an obstacle to the integration of community care and primary care.

Journal Article↗
PubMed2006

Challenges and facilitating factors in sustaining community-based participatory research partnerships: lessons learned from the Detroit, New York City and Seattle Urban Research Centers.

In order to address the social, physical and economic determinants of urban health, researchers, public health practitioners, and community members have turned to more comprehensive and participatory approaches to research and interventions. One such approach, community-based participatory research (CBPR) in public health, has received considerable attention over the past decade, and numerous publications have described theoretical underpinnings, values, principles and practice. Issues related to the long-term sustainability of partnerships and activities have received limited attention. The purpose of this article is to examine the experiences and lessons learned from three Urban Research Centers (URCs) in Detroit, New York City, and Seattle, which were initially established in 1995 with core support from the Centers for Disease Control and Prevention (CDC). The experience of these Centers after core funding ceased in 2003 provides a case study to identify the challenges and facilitating factors for sustaining partnerships. We examine three broad dimensions of CBPR partnerships that we consider important for sustainability: (1) sustaining relationships and commitments among the partners involved; (2) sustaining the knowledge, capacity and values generated from the partnership; and (3) sustaining funding, staff, programs, policy changes and the partnership itself. We discuss the challenges faced by the URCs in sustaining these dimensions and the strategies used to overcome these challenges. Based on these experiences, we offer recommendations for: strategies that partnerships may find useful in sustaining their CBPR efforts; ways in which a Center mechanism can be useful for promoting sustainability; and considerations for funders of CBPR to increase sustainability.

Centers for Disease Control and Prevention, U.S.↗
PubMed2001

Measuring and improving patients' and families' perceptions of care in a system of pediatric hospitals.

BACKGROUND: Shriners Hospitals for Children (SHC) is a network of 22 pediatric specialty hospitals that provide medical care free of charge to children up to 18 years of age and that serve as referral centers for children with complex orthopedic and burn problems. In 1998 the SHC system began using The Picker Institute's Patient and Family Perception of Care inpatient survey throughout its hospitals. SYSTEMWIDE IMPLEMENTATION: A broad-based implementation plan was developed to promote acceptance of the perception of care topic and provide education on performance improvement. In 1999 a work group was formed to prioritize areas for improvement, survey benchmark hospitals, and identify best practices in benchmark hospitals. This work group first focused on the dimensions of Partnership Between Families and Clinicians and Information and Education to the Child. In May 1999 the work group began the task of identifying best practices in these two priority dimensions from the SHC benchmark hospitals. Surveys were submitted to those hospitals, asking what they perceived as being the reasons they scored well in those areas. The results of these surveys were used to identify key practices in these benchmark hospitals that are of significant importance in patient and family perceptions of quality care. NEXT STEPS: The challenge is to facilitate cross-facility interactions to understand and adopt best practices. Focus groups will be conducted to further delineate the dimensions with higher problem scores. The SHC system plans to expand the patient surveys to outpatients, to allow for the evaluation of the full complement of hospital patients.

Burn Units↗