Biomedical subjects
Publications and source records attributed to S Meads.
Balancing the multiple uses of ICD-9-CM with its central purpose as a statistical classification system is the function of the Coordination and Maintenance Committee. This article describes the process to modify diagnosis and procedure codes and how AHIMA members can contribute to improving ICD-9-CM.
The Reason for Encounter Classification (RFEC) was designed by a WHO Working Party to classify the reasons why patients seek care at the primary care level. It is designed along two axes: Chapters and Components. Each chapter carries an alpha-code which is the first character of the basic 3-character alphanumeric code. Each chapter is subdivided into seven "components" carrying 2-digit numeric codes. The field trial was undertaken by family physicians and nurses in: Australia, Barbados, Brazil, Hungary, Malaysia, the Netherlands, Norway and the US. 90497 RFE's were analysed. Their distribution over the chapters and components characterize the content of international primary care. Listings with the most common RFE's in the participating countries reflect the cultural differences. It is concluded that the RFEC is not only feasible to classify reasons why patients seek care but also to classify the diagnosis and the process of primary care. As a result of this, the International Classification of Primary Care (ICPC) succeeds the RFEC.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Sarah Meads is General Manager of Serco Health Services. In an earlier article "Transforming Support Services Through Competition", published in the September/October 1992 issue, she described the use of external competition to create incentives to transform support service functions. In this article she describes how competing single service contracts or simply combining services that appear functionally related, for example, cleaning and orderly services, is no longer enough if health service providers are serious about maximising the benefits of competition. This is because a superior result may be achieved through combining several support services under one single contract, or facilities management contracting, selected on the basis of delivering client outcomes. The ability to maximise the benefits relies on providers adopting a change in attitude and a relentless focus on client needs which is not constrained by existing organisational structure.
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Facilities Management Contracting is a catalyst for developing high performance individuals and teams to deliver value for money in today's demanding funding environment. It is a key to unlocking individuals' creativity, and learning, through effective change management strategies, and to developing organisational processes and structures to promote this. Sarah Meads, General Manager of Serco Health Services, explores how health providers could make more effective use of Facilities Management Contracting to release the potential that already exists within their organisations by thinking of Facilities Management as a change management tool. Serco Health Services is the division of Serco Group NZ Limited responsible for assisting healthcare providers to review and manage a wide range of non-core support services.
Despite the worldwide trend to Facilities Management Contracting and the documented improvements in organisational efficiency, the NZ health sector has yet to grasp the benefits of awarding a single contract to manage a comprehensive range of services. This appears contradictory for an industry which has considerable assets tied up in supporting its core business and is under huge pressure to reduce costs and improve service. NZ is therefore faced with two options: an "evolutionary" route which could take us over a decade to achieve the same benefits as they are currently enjoying in the UK NHS, or "revolutionary" route, taking a quantum leap forward, both in the way contracts are specified and the way services are structured and managed. In this article Sarah Meads, General Manager of Serco Health Services, takes a look at how New Zealand health providers could learn from the NHS experience of contracting out since the introduction of Compulsory Competitive Tendering in 1983. Serco Health Services is the division of Serco Group NZ Limited responsible for assisting healthcare providers to review and manage a wide range of non-core support services. It shares resource and expertise with similar divisions working with the NHS and health-care organisations in Hong Kong.
In 1978, the World Health Organization formed a group to begin work on the Reason for Encounter Classification (RFEC), which is designed to classify the reasons why patients seek care at the primary level. The relatively simple classification is based on two axes--chapters and components--and uses a three-character alpha-numeric code. Chapters, which are named by body systems or more general terms, are the reasons that health care was sought. Five of the seven components, or subdivisions of chapters, contain rubrics identified by the same two-digit numerical code. A pilot study with a training exercise was carried out in The Netherlands by nine family physicians to confirm the feasibility of using the new classification system in primary care settings. Training consisted of viewing videotapes of encounters and an exercise of coding 76 vignettes by the RFEC. Within 2 months, the physicians in the subsequent pilot study had collected and coded 7,503 reasons for encounters. Results of the pilot study confirm that the RFEC is feasible, easy to use in practice, and different from disease-oriented classifications in its system of classifying the reasons for encounter. The pilot study results have been used to modify the RFEC in preparation for a field trial in ambulatory care settings worldwide.