New partnerships.
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Academies and Institutes↗
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TERMINATION OF PARTNERSHIP UPHELD, DAMAGES DENIED.
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Group Practice↗
Toward a doctor-patient partnership.
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Australia↗
Bradlaw oration, 1979. The medical and dental professions and the state: an uneasy partnership.
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Ethics, Medical↗
Physicians and family caregivers: a model for partnership.
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Caregivers↗
Limited autonomy and partnership: professional relationships in health care.
Principles of autonomy and self-determination have been upheld as vital to modern-day medical and ethical practice. However, the complexities of current health care and changes in the expectation of some patients and their families justify a review of such concepts. Their limitations and relativities may suggest that other descriptions of partnership and negotiated goal-setting, while based on respect for autonomy, reflect more modern and ideal multi-disciplinary practices. Discussion should extend beyond the 'classic' participants of patient and doctor to a more realistic picture where other health carers are included. It is therefore apposite that other professional relationships are considered as they affect areas of doctors' and patients' responsibilities. Such partnership between members of the team may not be without problems and conflict, but the principle of negotiated agreements could result in more long-term harmony, and greater patient welfare.
Allied Health Personnel↗
Physical activity promotion in primary care: bridging the gap between research and practice.
BACKGROUND: While a growing literature supports the effectiveness of physical activity interventions delivered in the primary care setting, few studies have evaluated efforts to increase physician counseling on physical activity during routine practice (i.e., outside the context of controlled research). This paper reports the results of a dissemination trial of a primary care-based physical activity counseling intervention conducted within the context of a larger, multi-strategy, Australian community-based, physical activity intervention, the 10,000 Steps Rockhampton Project. METHODS: All 23 general practices and 66 general practitioners (GPs, the Australian equivalent of family physicians) were invited to participate. Practice visits were made to consenting practices during which instruction in brief physical activity counseling was offered, along with physical activity promotion resources (print materials and pedometers). The evaluation, guided by the RE-AIM framework, included collection of process data, as well as pre- and post-intervention data from a mailed GP survey, and data from the larger project's random-digit-dialed, community-based, cross-sectional telephone survey that was conducted in Rockhampton and a comparison community. RESULTS: Ninety-one percent of practices were visited by 10,000 Steps staff and agreed to participate, with 58% of GPs present during the visits. General practitioner survey response rates were 67% (n =44/66 at baseline) and 71% (n =37/52, at 14-month follow-up). At follow-up, 62% had displayed the poster, 81% were using the brochures, and 70% had loaned pedometers to patients, although the number loaned was relatively small. No change was seen in GP self-report of the percentage of patients counseled on physical activity. However, data from the telephone surveys showed a 31% increase in the likelihood of recalling GP advice on physical activity in Rockhampton (95% confidence interval [CI]=1.11-1.54) compared to a 16% decrease (95% CI=0.68-1.04) in the comparison community. CONCLUSIONS: This dissemination study achieved high rates of GP uptake, reasonable levels of implementation, and a significant increase in the number of community residents counseled on physical activity. These results suggest that evidence-based primary care physical activity counseling protocols can be translated into routine practice, although the initial and ongoing investment of time to develop partnerships with relevant healthcare organizations, and the interest generated by the overall 10,000 Steps program should not be underestimated.
Attitude of Health Personnel↗
Public health nursing partnership: agencies and academe.
The authors describe an approach to bridging the education-practice gap in nursing through a joint venture between a nursing center in a college of nursing and a public health department. The purposes of the cooperative efforts are defined and the services described. Administrative problems and solutions in such a venture are explored and evaluation methods explained. Finally, opportunities for expansion of the venture are considered.
Education, Nursing, Baccalaureate↗
Building community health: the real work of advanced practice.
The future of health care depends on how well health professions join in partnership with community leadership. The challenge that lies ahead for nursing is to become fully invested in the process of building truly healthy communities.
Community Health Nursing↗
Public-private partnerships in health care for developing countries: a new paradigm for change.
The shift in traditional corporate philanthropy policy and practices from one of objective giving to strategic investing is discussed along with the positive impact of these changes as realized through a social awareness and the emerging new paradigm of public private partnerships. Examples of corporate support with focus on a case study concerning HIV/AIDS in Africa are presented within the context of lessons learned. These examples illustrate how public and private sectors working together, can maximize the potential philanthropic endeavor. Using strategically directed, yet humanitarian and culturally sensitive efforts, managed care organizations may find the concepts and negotiations inherent to philanthropic partnerships a familiar setting, and would therefore be suitable candidates to engage in public-private partnerships.
Africa South of the Sahara↗
A community-oriented primary care nursing model in an international setting that emphasizes partnerships.
PURPOSE: To present an interdisciplinary, community-oriented primary care nursing model that effectively draws upon the strengths of advanced practice nurses (APNs), both nurse practitioners and community health nurses. DATA SOURCES: Articles in professional nursing journals, international data sources, and the clinical experiences of the authors, both domestic and international. CONCLUSIONS: The model, developed domestically, was utilized successfully by APNs internationally in a medical mission endeavor in rural Haiti. Many partners, domestic and Haitian, worked as an interdisciplinary team to deliver quality health care to an impoverished population. Graduate nursing students participated in the program, which offered opportunities and challenges for both novice and expert nurses. IMPLICATIONS FOR PRACTICE: Nurse practitioners, community health nurses, and nursing faculty members can use this model to enhance their professional practice. They can learn that clients can be optimally cared for whether the community served is domestic or international. Nursing faculty can teach graduate nursing students about the value of partnerships and collaboration.
Community Health Services↗
Rapport and the hospitalist.
One key issue in the hospitalist movement is the need for hospitalists to establish rapport and maintain relationships with their patients. Rapport is critical in obtaining a thorough history, and then effectively negotiating the diagnosis and treatment plan with patient and family. This article summarizes both the challenges to establishing rapport and the opportunities unique to hospital-based practice. It presents a basic framework for communication skills using the mnemonic PEARLS (partnership, empathy, apology, respect, legitimation, self-efficacy), and a detailed discussion of techniques for use in difficult relationships. The importance of the physical setting and of nonverbal skills cannot be underestimated. Rapport-building techniques can be learned but require practice.
Attitude of Health Personnel↗
Rapport and the hospitalist.
One key issue in the hospitalist movement is the need for hospitalists to establish rapport and maintain relationships with their patients. Rapport is critical in obtaining a thorough history, and then effectively negotiating the diagnosis and treatment plan with patient and family. This article summarizes both the challenges to establishing rapport and the opportunities unique to hospital-based practice. It presents a basic framework for communication skills using the mnemonic PEARLS (partnership, empathy, apology, respect, legitimation, self-efficacy), and a detailed discussion of techniques for use in difficult relationships. The importance of the physical setting and of nonverbal skills cannot be underestimated. Rapport-building techniques can be learned but require practice.
Communication↗
The CITRA research-practice consensus-workshop model: exploring a new method of research translation in aging.
PURPOSE: On the basis of the experience of an extensive community-based research partnership in New York City, we developed an innovative process for bridging the gap between aging-related research and practice, using a consensus-workshop model. DESIGN AND METHODS: We adapted the traditional scientific consensus-workshop model to include translation of the research into nontechnical language and the involvement of practitioners in the process. We then applied the model to the specific issue of falls prevention among community-dwelling older adults. RESULTS: The dialogue and interaction among researchers and practitioners provided new insights beyond a traditional research review. Practitioners offered astute guidance for future research based on their day-to-day field experience. IMPLICATIONS: The recommendations that emerged from the workshop demonstrated the value of close interaction between the aging-related research and practice communities. The consensus-conference model has significant potential to establish a bridge between the worlds of research and practice in a variety of settings.
Accidental Falls↗
Postmodern pedagogy and the nursing curriculum: collaborating for excellence.
Nursing in developed and developing countries alike has made, or is making, the move from apprenticeship and service-driven models of nurse education to those situated in and determined by the higher education sector. In Australia this move was made some twenty years ago. In this paper I present the epistemological and operational contours of a highly successful collaboration between the Tasmanian School of Nursing & Midwifery and St Vincent's Private Hospital, Sydney. In educational terms this collaborative curriculum is forged from a postmodern pedagogy. This means both student and teacher become reciprocal agents in the making of (new) knowledge arising out of a praxis-oriented curriculum whereby theory informs practice and practice mutually informs theory. Both the university and the hospital are significant beneficiaries of this professional/business partnership and as a result, the oft discussed 'theory/practice divide' is thwarted in its conceptualisation and articulation through the ways the university (theory) and the hospital (practice) amalgamate through their combined responsibility for the students' success.
Australia↗
CAN-Care: an innovative model of practice-based learning.
The "Collaborative Approach to Nursing Care" (CAN-Care) Model of practice-based education is designed to meet the unique learning needs of the accelerated nursing program student. The model is based on a synergistic partnership between the academic and service settings, the vision of which is to create an innovative practice-based learning model, resulting in a positive experience for both the student and unit-based nurse. Thus, the objectives of quality outcomes for both the college and Health Care Organization are fulfilled. Specifically, the goal is the education of nurses ready to meet the challenges of caring for persons in the complex health care environment of the 21st century.
Competency-Based Education↗
Reshaping clinical nursing education: an academic-service partnership.
This article describes the conceptualization and implementation of an academic-service partnership for a baccalaureate nursing program. The partnership began its fifth year in the fall of 2002; 107 students have entered the partnership since its inception. The partnership goals were to develop and implement clinical training experiences that teach students key skills for community-based practice settings, and to develop and evaluate an innovative and collaborative model for community-based clinical education. Students in the partnership have a unique opportunity for learning the art and science of nursing in a complex, integrated health care system with a strong emphasis on quality of environment, providers, and care delivery. A longitudinal program evaluation is underway, based on an American Association of Colleges of Nursing publication, the vision and goals of the School of Nursing, and the construct of organizational socialization.
Clinical Competence↗