PubMed · 5275680
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B J McCarthy. 1970. Missing links in achieving effective services.. https://pubmed.ncbi.nlm.nih.gov/5275680/
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Care of persons with non-insulin-dependent diabetes mellitus (NIDDM) in the United Kingdom resembles that in the United States. However, health care practice in Europe is being influenced by the Saint Vincent Declaration, the joint European World Health Organization-International Diabetes Federation initiative, which emphasizes prevention of diabetic complications. In recent years, the responsibility for care for NIDDM has shifted in the United Kingdom to general practice teams. The effect of this shift on the quality of care and the coordinating and educational role of local diabetes specialist teams is discussed, as is the importance of an individualized "menu" of care for each patient. This menu aims for optimum blood glucose level control as well as detection and correction of risk factors for diabetic complications. The pervasive and dangerous notion of NIDDM as a "mild" disease must be corrected. The importance of systematic auditing of process and outcomes in diabetes care is emphasized, as is the need for regular data acquisition, aggregation, and analysis to achieve continuous improvement in the quality of care. Although patient-health professional encounters are the core of good diabetes care, the need for larger-scale appraisal on a local, regional, and national basis is now apparent.
A three-hour "think tank" session and continual revision have led to a creative reorganization of admissions procedures that successfully addressed a growing problem of "boarders." This has resulted in providing more comprehensive patient care, increased satisfaction for both family and caregivers and significant cost reductions.
The Hospital Committee of the European Union has redefined the role of the hospital within a changing society. In future the hospital will be dedicated to a clear vision of public health and will constitute part of a network of integrated care. From a bed-focused enterprise it will become a health centre providing all services requisite for the care of acute, psychiatric and chronically ill patients, whether stationary, as outpatients or in daycare. This center will be distinguished from other care services by its operative technical resources and by its highly motivated and well-trained staff.