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Biomedical subjects

M Splaine

Publications and source records attributed to M Splaine.

11 recordsLinked to original sources
PubMed1998

Looking at care from the inside out: a conceptual approach to geriatric care.

Today, managing care from the "outside in" is the predominant model for changing health care. The risk of this outside-in approach is that the health care system may lose sight of the people and communities for which it serves and cares. In this article, an "inside-out" model for viewing health care in a geriatric population is presented from the perspective of patients and providers, placing the provider in a proactive rather than reactive role. By focusing attention on the outcomes or value a patient is experiencing, providers are challenged to consider new ways of managing care.

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PubMed1998

The population of people age 80 and older: a sentinel group for understanding the future of health care in the United States.

Those age 80 years or older (80+) constitute a relatively small percentage of a health care system's population. However, because of the associated risks, costs, and variation of their medical care, 80+ patients are sentinel for elder care quality. This article describes the survey components of the 80+ Project. This project was designed to help clinicians gain a complete picture of the special needs of the 80+ population. The information about these patients' health and functional status, how they utilize health care resources, how they obtain access to care, and their satisfaction with the care is useful for clinicians who wish to improve health care delivery.

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PubMed1998

Assessing access as a first step toward improving the quality of care for very old adults.

Understanding the barriers to obtaining care that the population of people age 80 and older (80+) experiences is one of the first steps toward developing organizational and clinical strategies aimed at improving care. This article reviews the data from the 80+ Project's survey to assess the prevalence of barriers to care and identify the characteristics that place the 80+ population at risk. Barriers to access for older adults occur on many levels. Ultimately, the ability to improve health outcomes through reducing barriers to care is dependent on the effectiveness and quality of care received. By recognizing the barriers to care that limit access, health care professionals can begin to develop strategies to eliminate these barriers and improve the health care of older adult patients.

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PubMed1998

Geriatric education: a system approach.

This article describes an institutionwide geriatric educational initiative (called Geriatrics Awareness Month) that provided didactic and formal experiential learning designed for health professionals. From an educational perspective, to learn geriatrics requires systems thinking, and, to learn systems thinking, geriatrics provides an excellent clinical context. The authors evaluated the didactic and experiential aspects of Geriatric Awareness Month. For attendees of didactic sessions, the availability of pocket-sized educational materials was deemed most valuable. Despite busy schedules, house staff were able to make a change in their practice and study the effect of this change.

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PubMed1998

Implementing a strategy for improving care: lessons from studying those age 80 and older in a health system.

This article describes some potential solutions to the many practical barriers that arise when trying to improve clinical care in everyday practice. A useful mnemonic for incorporating measurement into daily work is called GAPS--setting Goals, Assessing the current processes, Planning a new approach, and Starting it. The 80+ Project represents a foundation of information and offers promise to create durable, productive interactions for elderly individuals and their health care providers.

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PubMed1974

On the use of contour maps in the analysis of spread of communicable disease.

The co-ordinates of the dwellings where cases of variola minor (alastrim) occurred during a small epidemic were used in a worked example of contour mapping of disease spread. The contoured variable was the date of onset, relative to an arbitrary base date, of the case introducing the disease into each of twenty-two households. Three contour maps prepared with slightly different computer programmes or dates exhibited similar concentric loops whose centres were close to the first infected household. The average rate of spread of the disease was estimated by regression of the number of days to onset of the first case in the household on the average distance from an arbitrary origin to the relevant contour line. The calculated average rate of spread was 1.22 metres per day. An additional map was contoured using the cumulative number of cases as the contoured variable, relative to the onset of the example epidemic.

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