PubMed Health⌕ Search

Biomedical subjects

H E Hayes

Publications and source records attributed to H E Hayes.

3 recordsLinked to original sources
PubMed2000

Pentavalent treatment: preliminary effects on state hospital utilization.

The purpose of this exploratory study was to determine if a low-cost alternative to assertive community treatment (ACT) programs could achieve results comparable to those previously reported by high-fidelity ACT programs with regard to state hospital utilization by patients with long-term, treatment-refractory serious mental illness and high rates of hospital recidivism. A sample of 30 patients was exposed to a low- cost alternative to ACT for a 12-month period. A quasi-experimental research design was used to compare state hospital utilization by the treatment group and a matched comparison group. The treatment group exhibited significantly less state hospital utilization than the comparison group and had an 88% reduction in state hospital utilization in comparison to its 10-year baseline. Low cost alternatives to ACT programs may be as effective as high-fidelity programs in reducing state hospital utilization and may be more easily adaptable to the current structure, operation, and financial constraints of community mental health centers.

Journal Article↗
PubMed1997

Assessing and balancing elder risk, safety and autonomy: decision-making practices of health care professionals.

Diverse professionals assess and manage risk with frail elderly yet no standard practice guidelines are used across the care continuum. This qualitative study provides new understanding of how eldercare workers conceptualize and assess risk with frail elderly clients. Fifteen professionals were interviewed using the Long-Interview Method of McCracken (1988) and Crabtree and Miller (1991). Respondents included home care case managers, visiting nurses and hospital discharge social workers. This paper reports on two key decision-making styles identified through multidisciplinary analysis of transcripts: the "snap decision-makers" and the "agonizers." Labeling strategies are identified that may assist eldercare workers with the dissonance between professional training and the realities of practice. Variable thresholds for risk tolerance among diverse professionals were found. These findings suggest that risk assessment often reflects the values of the individual practitioner's profession and agency culture. Standardized training and ethical practice guidelines are needed to reduce extreme variability in professionals' judgments; and to better assist staff with assessing and balancing elder risk, safety and autonomy.

Aged↗