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PubMedDate not supplied

Developing community-academic partnerships to enhance breast health among rural and Hispanic migrant and seasonal farmworker women.

PURPOSE/OBJECTIVES: To examine effective strategies for building community-academic partnerships for the promotion of breast cancer education and outreach among rural and Hispanic migrant and seasonal farmworker women, mostly from Mexican descent. DATA SOURCES: Published research and education articles and books, community-education models, personal experiences, and community key informant feedback. DATA SYNTHESIS: Effective community partnerships for enhanced education and outreach include a framework based on a network of partners with common goals, communication processes based on trust, and bilingual/bicultural and culturally competent staff. CONCLUSIONS: A sustainable community partnership can be achieved through systematic but flexible approaches to community planning. Involvement of community members in the development and implementation of education and screening activities helps ensure that community needs are met. Relationships based on mutual respect are key. IMPLICATIONS FOR NURSING PRACTICE: Nurses can act as catalysts through community capacity building to create community-academic partnerships to reach medically underserved populations with cancer screening, outreach, and education through the delivery of strategies that are based on common goals.

Academies and Institutes↗
PubMed2001

The role of the clinical nurse specialist in creating a healthy work environment.

The clinical nurse specialist (CNS) contributes to a healthy work environment through partnerships with the nursing staff, nurse manager, physicians, and other colleagues across the health system. Examples of these partnerships are described in this article, highlighting how the work of the CNS influences the care that patients and families receive, shapes the practice environment, and fosters collegial and respectful relationships among caregivers. The CNS is a pivotal figure in creating an environment where nurses can provide the care that is needed and feel valued for their work. Partnership with a variety of clinicians enables the CNS to influence critical care nursing practice, the intensive care unit team, and the environment in which care is provided.

Education, Nursing, Graduate↗
PubMed2006

Collaboration and control: nurses' constructions of the role of family in nursing home care.

AIM: This paper reports a study examining how nursing home staff experienced working with residents' families. BACKGROUND: Working collaboratively with the family in residential aged care to provide care is consistent with nursing philosophy. The quality of the experience, however, is frequently fraught with problems for both the family and staff involved. Little research has focused on the nature of family involvement in nursing homes from the perspective of nursing home staff. METHODS: The study adopted a naturalistic paradigm. Data were collected from 30 nursing home staff members drawn from a range of metropolitan and rural facilities in Victoria, Australia by means of conversational in-depth interviews. Issues concerned with how participants constructed the role of the family in the nursing home were explored. The data were collected in 2001-2002. RESULTS: Four key elements are presented in this paper: (1) Making the transition; (2) Forming ties; (3) Keeping them at a distance and (4) Unacceptable behaviour. Some nursing home staff have developed a substantive family orientation and had adopted practices which were inclusive of the family. Equally, many attitudes which cast the family into an adversarial and competitive role were noted, and many staff members outlined practices which were indicative of a need to control the family. CONCLUSION: A rhetoric of family partnerships is prevalent in some nursing homes. The activities of staff in these homes are still primarily geared towards provision of physical care, and families' needs become secondary to getting the work done. A new model of practice is needed that sees working collaboratively with families as a legitimate and necessary part of the staff role.

Adaptation, Psychological↗
PubMed2006

Integrating evidence-based practice in the child mental health agency: a template for clinical and organizational change.

This article describes a linked set of activities designed to address the present "science-to-service" gap in evidence-based practice from the perspective of the nonprofit child mental health agency: (a) implementing "systems-of-care" principles; (b) logic modeling; (c) strategic partnerships with external researchers; (d) selective, in-depth program evaluation; (e) critical comparison with a limited number of evidence-based practice models of national significance; and (f) internal and external dissemination activities oriented to evidence-based practice. Implications are drawn both for continuous quality improvement of existing clinical services and for the potential for agencies to contribute high quality, science-based information to child mental health services, singly and through the future development of a national network of experimenting child mental health agencies.

Child↗
PubMed1997

A partnership of care: an approach to the management of adults with cystic fibrosis.

Several factors occurring more or less simultaneously have led to a major change in the management of adults with cystic fibrosis at The Prince Charles Hospital, Brisbane. Less than 50 years ago, 80 per cent of infants born with cystic fibrosis did not survive the first two years of life. In Australia today, the median survival is around 30 years of age, with many surviving into their fourth decade (Landau & Ryan 1991, p 4). Recent developments in the management and treatment of cystic fibrosis provide an exciting and promising foundation for further development and a changing focus in cystic fibrosis management. Increased longevity has significant implications for the management of adults with cystic fibrosis. Until recently, most people with cystic fibrosis were managed within the paediatric setting, with the expectation that life expectancy would not exceed adolescence. In reality, there has been a dramatic increase in the number transferring from children's hospitals to adult facilities, and a subsequent need to provide optimal care to a group of patients coming to terms with their own perceptions of being adolescents with a life-shortening condition. From an organisational perspective, the increased demand for resources has generated the need to consider alternative methods of providing care. Such options include home intravenous therapy, day admission, alternative accommodation and education of staff in remote health centres. Home intravenous therapy has proven to be a popular alternative to hospital treatment and has significant implications for reducing lengths of stay and occupied bed-days. Within the current focus on best practice, developing strategies for providing optimal health care in the hospital setting are paramount. A multidisciplinary team focus based on a 'partnership of care' philosophy underpinned by best practice principles describes the approach adopted by the cystic fibrosis team at The Prince Charles Hospital that has led to successful outcomes in meeting challenges inherent in the care of young adults with cystic fibrosis.

Acute Disease↗
PubMed1990

Holistic medicine and mental health practice: toward a new synthesis.

Holistic medicine offers insights and techniques which can significantly enlarge and enrich mental health practice. This approach, which recognizes the uniqueness of each patient, the centrality of the therapeutic partnership, and the primacy of self-care, regards the spiritual dimension as a vital enlargement of the biopsychosocial model. After outlining the holistic approach and its congruence with psychological thinking, this paper explores the ways in which holism may shape the future of mental health practice.

Holistic Health↗
PubMedDate not supplied

Midwifery in New Zealand: responding to changing times.

This article provides a critical overview of midwifery in New Zealand. It first considers the influences in society that have assisted midwives in campaigning for change. Also outlined is the partnership of midwives and consumers that created the climate for an Act of Parliament permitting independent midwifery practice in 1990. Changes to midwifery practice since 1990 are documented, as well as some of the backlash that has occurred since then. In this article, New Zealand midwifery is set in its global context, and the major issue of partnership is also highlighted.

Female↗
PubMed2002

An implementation framework for household and community integrated management of childhood illness.

This paper describes the development and recent history of the third component of the Integrated Management of Childhood Illness (IMCI) strategy, improving household and community practices (HH/C IMCI). An implementation framework for this third component, developed through review of experiences of non-governmental organizations (NGOs) working in community-based child health and nutrition programmes, is then presented. This Framework responds to demand from NGOs and their partners for a description of the different categories of community-level activities necessary for the implementation of a comprehensive child health and nutrition programme. These categories of activities facilitate the systematic cataloguing, synthesis and coordination of organizational activities and experience. It also serves as a reference tool for improving communication of related community child health activities, and a guide for designing appropriate behaviour change strategies. The Framework was endorsed by participants in an international workshop held in Baltimore, Maryland in January 2001, and specified three linked elements that are integral to HH/C IMCI, supported by a multi-sectoral platform that addresses constraints communities face in adopting practices that promote health and nutrition. The three programmatic Elements critical to HH/C IMCI programmes are (1). improving partnerships between health facilities or services and the communities they serve; (2). increasing appropriate and accessible care and information from community-based providers; and (3). integrating promotion of key family practices critical for child health and nutrition. The Framework presented in this paper is an ideal tool for describing, sharing and coordinating efforts in the field, and is purposely descriptive rather than prescriptive.

Child↗
PubMed2002

Treating depression: the beyondblue guidelines for treating depression in primary care. "Not so much what you do but that you keep doing it".

1. Most people with depression will be treated in general practice, either by the GP alone, or (for more serious depression) in partnership with specialist mental health services. 2. Treatment plans should always be based on thorough assessment, including the type, severity and duration of the depressive episode, and any stressors that contributed to the episode. 3. For mild and moderate depression, meta-analysis shows there is little difference in relative effectiveness of treatments, and continuation of therapy is more important than initial treatment choice. 4. The best outcomes are likely when a good therapeutic alliance is formed between a healthcare professional and the patient, and adequate treatment is provided over a long enough period. For pharmacological interventions, treatment should continue for: at least one year for a first episode of depression, and at least two years for repeated episodes or where there are other risk factors for relapse.

Depressive Disorder↗
PubMed2006

Poor asthma control in children: evidence from epidemiological surveys and implications for clinical practice.

The objectives of this study is to compile current knowledge about asthma control in children in relation to goals proposed in international guidelines, to elucidate the factors associated with insufficient asthma control and to address the implications for clinical practice. Review of recent worldwide large population epidemiological surveys and clinical asthma studies of more than 20,000 children are the methods used in this study. The studies report high frequencies of sleep disturbances, emergency visits, school absence and limitations of physical activity due to asthma. Only a small percentage of children with asthma reach the goals of good asthma control set out by Global Initiative for Asthma (GINA). There is evidence of underuse of inhaled corticosteroids even in children with moderate or severe persistent asthma and over-reliance on short-acting beta(2)-agonist rescue medication. Both parents and physicians generally overestimate asthma control and have low expectations about the level of achievable control. Many children with asthma are not being managed in accordance with guideline recommendations, and asthma management practices vary widely between countries. Asthma control falls short of guideline recommendations in large proportions of children with asthma worldwide. Simple methods for assessing asthma control in clinical practice are needed. Treatment goals based on raised expectations should be established in partnership with the asthmatic child and the parents. Effective anti-inflammatory treatment should be used more frequently, and patients should be reviewed regularly.

Adolescent↗
PubMed2000

The Del Rio project: a case for community-campus partnership.

CONTEXT: Interdisciplinary teams of graduate health professions students and faculty were provided with experiential learning opportunities while assisting a small rural community address critical health-related issues. PROJECT OBJECTIVES: To establish an effective partnership with community leaders and area residents to assist in determining the feasibility of a new primary care clinic and to remediate a water borne disease threat. To create interdisciplinary clinical learning experiences and to develop future longitudinal learning opportunities, emphasizing primary prevention. To create a community-campus partnership with control originating in and sustained by the community. PARTNERSHIP DEVELOPMENT: An interdisciplinary team of health professions students and faculty worked with community leaders and residents to develop leadership skills, enhance infrastructure and coordinate efforts to address health concerns. A health marketing analysis and a series of year-long environmental assessments of surface and ground water were completed. The community was assisted with reaching consensus for future actions, emphasizing local control, enhanced county-based ownership, and sustainability of intervention efforts. OUTCOMES AND IMPLICATIONS: The Del Rio and East Tennessee State University partnership was instrumental in accomplishing its short-term objectives with the remediation of two major health issues. The more important long-term objectives of enhancing citizen leadership skills and developing a more action-oriented community infrastructure were also met. Using an experiential learning model, students practiced community organization skills, conflict resolution and problem-solving strategies. The campus-community partnership illustrated the advantages of experiential, multidisciplinary education and accentuated the positive aspects of collaborative planning and action. The partnership continues to provide expanded learning opportunities for students and contributes to the empowerment and self-sufficiency of the community. The ripple effects of the model have become evident, with dramatic increases in university-wide efforts to increase partnership opportunities and enhanced support for service learning throughout the region.

Journal Article↗
PubMed1990

Innovations in clinical practice through hospital-funded grants.

Improving patient outcomes while controlling the costs of care requires a partnership between clinical researchers and hospital management. To this end, Strong Memorial Hospital in Rochester, New York, dedicated hospital operating funds to a program of small grants designed to align the patient care and academic interests of clinicians with the goals of efficient hospital management. The grants gave clinicians an opportunity to test the efficacy of specific patient care maneuvers. These studies resulted in improved guidelines for the use of diagnostic and therapeutic modalities, new technology, and length of hospitalization. Annual marginal cost savings from implementing the first-year study results are projected to be $587,255, an 8 to 1 return on the first year's expenses. The authors conclude that a hospital-funded applied research program encourages those delivering patient care to identify inefficiencies and introduce change while ensuring quality patient care. This joint faculty-management effort can augment the hospital's quality-assurance, utilization management, and technology assessment programs while advancing the scholarship of faculty members.

Cost-Benefit Analysis↗
PubMed2004

Creating a successful RN first assistant practice.

Many RN first assistants (RNFAs) aspire to having their own practice. This article provides helpful exercises to help RNFAs determine if they have what it takes to be business owners and their own bosses. The pros and cons of different business structures-sole proprietorships, partnerships, and corporations-also are discussed to help RNFAs determine the best structure for their independent practice.

Entrepreneurship↗
PubMed2006

Developing an innovative undergraduate curriculum--responding to the 2002 National Review of Nursing Education in Australia.

The Australian government responded to the recent global critical shortage of registered nurses by initiating a national review into nursing education. The 36 recommendatons of the review report published in 2002 supported one or more of three strategies: building a sustainable workforce throuh partnership; maximising health outcomes through quaality education; and capacity building. The review drew extensively on the international research literature, invited submissions, previous reviews and commissioned research. This paper articulates the key features of a new innovative undergraduate nursing curriculum that incorporates several of the recommendations of the national review, specifically a new approach in delivery of the clinical component of the curriculum. The curriculum model emerged from a strategically planned partnership between a university and heath care providers committed to improving graduate outcomes and transition into professional practice. The curriculum was implemented in 2004 in a Faculty of Health Sciences that had not previously offered nursing programs. It is anticipated that the newly implemented undergraduate nursing program, modelled on a clinical schools partnership approach, will graduate registered nurses able to face the challenges of a rapidly changing health sector. The objective of this paper is to describe the key features of the program and share new insights that might challenge traditional curriculum approaches in undergraduate nursing.

Australia↗
PubMed1995

Effective hospital leadership for quality: theory and practice.

Hospitals need excellent leadership to be efficient in the use of scarce stakeholder resources and to be effective in the competitive provision of services to multiple customers. This study was conducted with the cooperation of the executive team at a large government-funded hospital in Brisbane. It focused on understanding the conceptual models of leadership held by members of the executive and comparing this model with an externally derived model of leadership. Performance on the local model was estimated by cross-linking performance assessment on the external model. Members of the executive espoused, and were also rated by others in the hospital as practising, to a moderate degree, a transformational style of leadership. An overall evaluation of quality practice in the hospital revealed the use of data, the understanding of processes and the formation of supplier partnerships as the areas of hospital activity most limiting the ability to improve. The implications of the conceptual model and performance levels are discussed in relation to the introduction of quality management practice in the hospital, and in terms of management development. A complementary paper focusing on quality implementation as perceived at different staff levels in the hospital is in preparation.

Australia↗
PubMed2000

Interview with Dr. Andre Davy, Honorary President, International Union of Phlebology; Honorary President, French Society of Phlebology; Honorary President, European Society of Phlebectomy. Interview by Jose Antonio Olivencia.

Dr. Davy is the Honorary President International Union of Phlebology, Honorary President French Society of Phlebology, Honorary President European Society of Phlebectomy. Dr. Andre Davy was born in 1924 in Basse, Normandy. I met Dr. Davy in 1967 in a World Congress of Phlebology in Amsterdam. I was so impressed with his skills and knowledge that when he later on proposed to be associated in the practice of phlebology, I accepted immediately. That lead to a very long medical and surgical partnership. He was an expert in the Muller phlebectomy and was also interested in chronic venous insufficiency, chronic stasis ulcer and lymphedema. He promoted sclerotherapy as part of the overall treatment of venous disease. In the early seventies, he started a training program that included not only theoretical but also practical knowledge of phlebology. In 1974 he published a book entitled, "Les Varices." He organized the first Franco-British Symposium of Phlebology that was held in Touquet in May 1981. That symposium was a complete success. It was immediately followed by a second Franco-British symposium and later on by the creation of the Venous Forum of the Royal Society of Medicine, the birth of the English journal "Phlebology," the North American Society of Phlebology, and the American Venous Forum. Later, he became Editor in Chief of Phlebologie, the journal of the French Society of Phlebology. He was named President of the French Society of Phlebology in 1986 and in 1989 President of the International Union of Phlebology. This very well educated and calm gentleman with a very outward tranquil appearance and great strength of character has always held strong opinions. He is now retired at his family home in Pont L'Eveque, France and spends his time reading, listening to the music of his favorite composers Verdi and Mahler, continuously visiting old friends such as Jean Van der Stricht, Robert Muller, Claude Gillot, and still remaining very close to his family. PAUL OUVRY, MD France

France↗
PubMed2003

Toward a communicative perspective of collaborating in research: the case of the researcher-decision-maker partnership.

In the shift to a post-industrial order, the production and use of knowledge is gaining greater importance in a world beyond science. Particularly in the health sciences, research foundations are emphasising the importance of translating research results into practice and are experimenting with various strategies to achieve this outcome, including requiring practitioners to become part of funded research teams. In this paper, we present a case of a partnership between researchers and decision-makers in Canada who collaborated on an investigation of implementing change in health care organisations. Grounded in this case and recent empirical work, we propose that such research collaborations can be best understood from a communicative perspective and as involving four key elements: relational stance that researchers and decision-makers assume toward each other; purpose at hand that situates occasions for developing and using knowledge; knowledge-sharing practices for translating knowledge; and forums in which researchers and practitioners access knowledge. Our analyses suggest that partnerships are most effective when researchers see the value of contextualising their work and decision-makers see how this work can help them accomplish their purpose at hand.

Canada↗
PubMedDate not supplied

Reducing legal fees in medical group practices. The role of health care alternative dispute resolution.

Conflict is a growth industry, particularly in an increasingly complex health care system. Litigation is the most common, and most costly, method of settling health care disputes. Highly adversarial, the process of litigation often generates as much, if not more, hostility than the original dispute. In addition, satisfaction with the outcome is very low. The challenge that has arisen is to manage the conflicts so that the underlying needs and interests of all the parties can best be met. Often the techniques and processes of alternative dispute resolution (ADR) can be successfully used in resolving these sorts of conflicts quickly, cheaply and with greater satisfaction for all parties. Various applications of ADR are currently being used or tested in a variety of health care disputes in the United States and Canada. Tremendous success has been achieved in mediating medical malpractice claims, medical staff disputes, economic credentialing conflicts, insurer relations issues and denial of coverage disputes. Professional relations and departmental staff disputes, partnership and employee conflicts, and organizational disputes within clinics, HMOs and large group practices have all been found particularly amenable to ADR. These are all situations in which everyone benefits from quick, non-hostile resolutions and on-going relationships can continue.

Canada↗