PubMed · 10260713
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To thrive in today's health care environment, hospitals are constantly striving to exceed their customers' expectations in delivering quality care in a cost-effective manner. Meeting the patient educational needs of the consumer is one well-recognized aspect of quality care. Delivering quality care does not happen by chance; rather, it requires intense planning. Our academic medical center formalized this process by empowering professional staff from Nursing Development to develop and implement a patient education strategic plan. This article outlines the project management for the assessment phase of this strategic planning process. The findings were instrumental in outlining the future direction for patient education initiatives that will benefit both the patient and the organization.
More Americans try to change their health behaviors through self-help than through all other forms of professionally designed programs. Mutual support groups, involving little or no cost to participants, have a powerful effect on mental and physical health, yet little is known about patterns of support group participation in health care. What kinds of illness experiences prompt patients to seek each other's company? In an effort to observe social comparison processes with real-world relevance, support group participation was measured for 20 disease categories in 4 metropolitan areas (New York, Chicago, Los Angeles, and Dallas) and on 2 on-line forums. Support seeking was highest for diseases viewed as stigmatizing (e.g., AIDS, alcoholism, breast and prostate cancer) and was lowest for less embarrassing but equally devastating disorders, such as heart disease. The authors discuss implications for social comparison theory and its applications in health care.
CONTEXT: In 1991, the Advisory Committee on Immunization Practices recommended universal vaccination of infants against hepatitis B virus (HBV), with series initiation within days of birth. OBJECTIVE: To determine HBV vaccine coverage in a low-income urban population and to examine whether HBV immunization within the first month of life affects subsequent vaccine receipt. DESIGN: Cohort study based on immunization records collected in the Pediatric Immunization Program. Setting Large public housing development in Chicago, Ill. PARTICIPANTS: All 1143 children who were born between 1991 and 1997 and enrolled between 1993 and mid-1998, with follow-up to age 35 months. MAIN OUTCOME MEASURES: On-time vaccine receipt of HBV vaccine doses, diphtheria-tetanus-pertussis vaccine (DTP) dose 1, and the 4:3:1 series (4 doses of DTP vaccine, 3 doses of poliomyelitis vaccine, and 1 dose of measles-containing vaccine), analyzed by year. RESULTS: On-time HBV vaccination increased quickly following new guidelines and reached a plateau of about 50% coverage for those born in or after 1995. Since 1994, more children (64%) received the first HBV vaccine dose on time than any other vaccine. Children who received a dose of HBV vaccine during their first month of life were more likely to receive the first DTP vaccine dose on time (60.1%) than those who did not get an HBV vaccine dose during the first month (36.4%; chi2 = 53.7; P<.001). Children who received the first HBV vaccine dose during their first month were more likely than those receiving it at age 1 to 2 months to complete 3 HBV doses by 19 months (70.6% vs 51.1%; chi2 = 11.6; P = .001) and to complete the 4:3:1 series by age 19 months (49.8% vs 37.9%; chi2 = 4.0; P = .05). CONCLUSIONS: In this inner-city population, HBV vaccine has been received at rates similar to those of other vaccines within 3 years of issuance of new recommendations. Of note, immunization with HBV vaccine at birth was associated with timely receipt of other vaccines and, therefore, may have the potential to increase vaccination among groups less likely to be up-to-date on early childhood vaccines.