PubMed · 10136232
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C Smith. 1994. Developing an HIM department employee training program for our future.. https://pubmed.ncbi.nlm.nih.gov/10136232/
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In spite of national health care legislative and model program initiatives, cancer rehabilitation has not kept pace with rehabilitation for patients with other medical problems. This article discusses, from a historical perspective, unsuccessful health care legislation related to cancer and problems in establishing and expanding cancer rehabilitation programs. The attempts to establish a cancer rehabilitation program at the Texas Medical Center and the University of Texas M. D. Anderson Cancer Center are reviewed. Lessons learned over past 40 years and strategies for maintaining the success of a cancer rehabilitation program are discussed.
BACKGROUND: Why waiting lists arise and how to address them remains unclear, and an improved understanding of these waiting list "dynamics" could lead to better management. The purpose of this study is to understand how the current shortage in radiation therapy in Ontario developed; the implications of prolonged waits; who is held accountable for managing such delays; and short, intermediate, and long-term solutions. METHODS: A case study of the radiation therapy shortage in 1998-99 at Princess Margaret Hospital, Toronto, Ontario, Canada. Relevant documents were collected; semi-structured, face-to-face interviews with ten administrators, health care workers, and patients were conducted, audio-taped and transcribed; and relevant meetings were observed. RESULTS: The radiation therapy shortage arose from a complex interplay of factors including: rising cancer incidence rates; broadening indications for radiation therapy; human resources management issues; government funding decisions; and responsiveness to previous planning recommendations. Implications of delays include poorer cancer control rates; patient suffering; and strained doctor-patient relationships. An incompatible relationship exists between moral responsibility, borne by government, and legal liability, borne by physicians. Short-term solutions include re-referral to centers with available resources; long-term solutions include training and recruiting health care workers, improving workload standards, increasing compensation, and making changes to the funding formula. CONCLUSION: Human resource planning plays a critical role in the causes and solutions of waiting lists. Waiting lists have harsh implications for patients. Accountability relationships require realignment.