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Results for “Models, Organizational”

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PubMedDate not supplied

Demystifying the cardiopulmonary code team response.

OBJECTIVE: To familiarize the reader with the sequence of events in a hospital-based cardiopulmonary resuscitation. DATA SOURCES: The American Heart Association's Textbook of Advanced Cardiac Life Support and the Standards and Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care. DATA EXTRACTION: The roles and responsibilities of members of the cardiopulmonary code team are discussed. DATA SYNTHESIS: A typical code sequence is described, with emphasis on drug therapy. CONCLUSIONS: This information will provide a better understanding of the cardiopulmonary resuscitation team response and, in particular, the role of the pharmacist as an integral team member.

Cardiopulmonary Resuscitation↗
PubMed2006

Local epidemiosurveillance in swine diseases in Northern Vietnam: description and preliminary results.

The REMAPORC is an epidemiosurveillance network in swine diseases and an organizational model for local veterinary services in one district of Northern Vietnam. A strong concern was done on quality of the sanitary information chain from field and feedback to local agents. Based on 4,000 declarations provided by veterinarians and animal health workers involved, preliminary results highlighted the major incidence of porcine respiratory disease complex; digestive affections in piglets, and reproductive disorders in newly raised exotic sows have been also noticed.

Animals↗
PubMed1995

Organization versus activation: the role of endocrine-disrupting contaminants (EDCs) during embryonic development in wildlife.

Many environmental contaminants disrupt the vertebrate endocrine system. Although they may be no more sensitive to endocrine-disrupting contaminants (EDCs) than other vertebrates, reptiles are good sentinels of exposure to EDCs due to the lability in their sex determination. This is exemplified by a study of alligators at Lake Apopka, Florida, showing that EDCs have altered the balance of reproductive hormones resulting in reproductive dysfunction. Such alterations may be activationally or organizationally induced. Much research emphasizes the former, but a complete understanding of the influence of EDCs in nature can be generated only after consideration of both activational and organizational alterations. The organizational model suggests that a small quantity of an EDC, administered during a specific period of embryonic development, can permanently modify the organization of the reproductive, immune, and nervous systems. Additionally, this model helps explain evolutionary adaptations to naturally occurring estrogenic compounds, such as phytoestrogens.

Animals↗
PubMedDate not supplied

Planning and resource allocation in NHS colleges of health studies: 1.

The rapidly changing environment in which NHS colleges of health studies are now operating presents tremendous challenges to leaders in nurse education. Financial constraints brought about by the internal market and rapidly changing technology have resulted in complex funding arrangements and incompatible planning cycles. In the first of two articles, the funding of nurse education is explained and the recent changes in funding for NHS colleges are explained.

Decision Making, Organizational↗
PubMed2006

Palliative care as a framework for older people's long-term care.

This article draws on the findings from several years of research on the health problems, quality of life and care of older people, especially during the later years of life, and argues that there is a need to develop and provide care according to the principles of palliative care. The findings indicate that palliative care, including a focus on symptom management, psychosocial and existential issues, may be appropriate for the long-term care of older or very old people - not just those at the very end of life. However, the way that palliative care is provided to older people at the very end of life needs to be adjusted. It should be adapted to the situation that accompanies advanced age and having lived a long life. It should recognize that symptom management ought to address clusters of health complaints rather than isolated symptoms, bodily changes and how they are perceived. Palliative care for older people should also take into consideration the importance of the social network as well as common fears of dying and the very essence of death, and fear of being separated from one's loved ones and the activities valued in life.

Activities of Daily Living↗
PubMed1995

Principles of social systems structure and social interaction: an application to the health planning process.

The purpose of this article was to explore how applications of principles of social structure and social interaction may enhance health program planning. Theoretical aspects of social structure and social interaction and their relationships to planning were discussed. Potential problems in health planning as a result of not considering social system structure and interaction within a system were discussed. It was concluded that the health educator could benefit by applying principles of social structure and social interaction in health planning. Practical applications to the health planning process were postulated.

Health Planning Organizations↗
PubMed1994

The pharmaceutical industry and health reform: lessons from Europe.

Many countries in Europe, which have significant pharmaceutical industries, recently have embarked on reforms in the organization of their health care systems and methods of regulating the pharmaceutical market. This paper describes the different systems in major European countries and the changes taking place. Although it is too early to make final judgment on the impact of these changes, it is possible to predict some of the more likely outcomes. The organizational models and regulatory approaches in Europe offer a useful store of experience for those assessing the potential impact of reform proposals in the United States.

Cost Control↗
PubMed2006

[Primary care in European Union countries: configurations and organizational reforms in the 1990s].

During the 1990s, proposals to contain health expenditures and demands raised by changes in the epidemiological profile led to organizational reforms in primary healthcare services in European Union countries, aimed at promoting the coordination of services provided by the various levels of care. Based on a literature review, document analysis, and interviews with key informants, the current study analyzes the institutional configurations for first-level healthcare and discusses the pre-coordination organizational reforms in the European Union countries. First-level outpatient care is provided in these countries through a wide variety of institutional configurations, observing the different financing mechanisms, range of healthcare professionals, range of clinical services provided, and the position occupied by physicians in primary care within the healthcare system. Reforms in the last decade were accompanied by a diversification in the outpatient care organizational models, with an expansion in the clinical, healthcare coordination management, and financing functions of primary care professionals, indicating a process in transition, with a redefinition of the roles played by general practitioners as the leaders of patient care.

European Union↗
PubMed2006

[European integration and health policies: repercussions of the internal European Market on access to health services].

This article explores the health policy repercussions of countries' regional integration into the European Union. The aim is to review the regulation of access in other countries, with the conclusion of the single European market and the free circulation of persons, services, goods, and capital. The article begins by reviewing the various forms of integration and describes the expansion and institutionalization of Community agencies. The repercussions of European integration on health policies and regulation of access are analyzed. Market impacts on health result from Treaty directives and internal policy adjustments to free circulation. Health services access is gradually regulated and granted by rulings. Projects along borders illustrate the dynamics where differences are used to achieve comprehensive care. In the oldest integration experience, the market regulation has generated intentional and non-intentional impacts on the health policies of member states, regardless of the organizational model. Knowledge and analysis of this experience signals challenges for the Southern Cone Common Market (Mercosur) and adds to future debates and decisions.

Delivery of Health Care↗
PubMed1999

The organization and delivery of craniofacial health services: the state of the art.

The dominant organizational structure providing care for cleft palate and other craniofacial conditions is the health care team. Various types of health care team organization are profiled, including intradisciplinary, multidisciplinary, and interdisciplinary teams. Effective team-based care delivery has the ability to address the fragmentation and dehumanization that can result when a variety of specialists and disciplines are required to provide assessment and technical care. A team's leadership and its hierarchy of professional authority can be expected to affect its ability to function effectively. Health reform and managed care are considered for their impact on the team and on the doctor-patient relationship. Trends in team regionalization, quality assurance, outcomes research, and consumer advocacy are reviewed. The cleft palate and craniofacial team is profiled as an organizational model that is being affected by the forces of health system change.

Cleft Lip↗
PubMed1989

Origins of authority: the organization of medical care in Sweden.

Earlier research by Gardell and Gustafsson indicates a general discrepancy between perceived needs and organizational structure in Swedish somatic hospitals; the work organization directs the work process as if cure and medical treatment were the only appropriate goals in almost all kinds of health care settings. The standard organizational model for general hospitals, here named "the acute care model"--which is a merger of medical and administrative hierarchies--forces great segments of the staff into a work content that is neither appropriate for patients' needs nor satisfying for the personnel. The present study is a historical-sociological discourse in which the structural antecedents of the acute care model are traced. It gives an exposé of the main stages in the formation of the Swedish health care system from the middle ages to the present. In 1864 a regulation of the hospital boards was issued. This meant the definite consolidation of the acute care model and was in line with earlier developments, which were characterized by an incremental interorganizational activity demarcation that divided the core of institutional care into three branches: somatic hospitals, mental hospitals, and homes for the elderly. The driving forces in the formation of the total health care system are shown to be closely related to premedical and extramedical factors, such as military needs, mercantilism, and the emergence of the middle class.

Acute Disease↗
PubMed1990

The insulin receptor. A multifunctional protein.

The insulin receptor is a multifunctional protein encoded by a modular gene. Certain discrete domains within the insulin-receptor structure subserve specific functional properties. In some instances, these discrete domains are encoded by individual exons. This organizational model of the insulin receptor predicts the existence of divergent signaling pathways facilitating specific bioeffects. Some of these signaling pathways are shared with the closely related insulinlike growth factor I receptor (convergent pathways), whereas others are different (divergent). The concept of discrete functional domains also provides several mechanisms whereby inactive insulin receptors (no kinase activity) can inhibit the function of normal receptors. The ability of kinase-inactive insulin receptors to inhibit the signaling function of normal insulin receptors may be an operative mechanism in certain insulin-resistant states.

Adenosine Triphosphate↗
PubMed2004

Managed care organization and the quality of diabetes care: the Translating Research Into Action for Diabetes (TRIAD) study.

OBJECTIVE: To examine the association between the organizational model and diabetes processes of care. RESEARCH DESIGN AND METHODS: We used data from the Translating Research into Action for Diabetes (TRIAD), a multicenter study of diabetes care in managed care, including 8354 patients with diabetes. We identified five model types: for-profit group/network, for-profit independent practice association (IPA), nonprofit group/network, nonprofit IPA, and nonprofit group/staff. Process measures included retinal, renal, foot, lipid, and HbA(1c) testing; aspirin recommendations; influenza vaccination; and a sum of these seven processes of care over 1 year. Hierarchical regression models were constructed for each process measure and accounted for clustering at the health plan and provider group levels and adjusted for participant age, sex, race, ethnicity, diabetes treatment and duration, education, income, health status, and survey language. RESULTS: Participant membership in the model types ranged from 9% in nonprofit IPA models to 38% in nonprofit group/staff models. Over 75% of participants received most of the processes of care, regardless of model type. However, among for-profit plans, group/network models provided on average more processes of care than IPA models (5.5 vs. 4.7, P < 0.0001), and group/network models generally increased the probability of receiving a process by >or=10 percentage points. Among nonprofit plans, no effect of model type was found. CONCLUSIONS: Among for-profit plans, group/network models provided better diabetes processes of care than IPA models. Although reasons are speculative, this may be due to the clinical infrastructure available in group models that is not available in IPA models.

Diabetes Mellitus↗
PubMed2004

Chicago project uses ecological approach to obesity prevention.

CLOCC may be useful as a model for local, cooperative, overweight-prevention efforts that involve researchers, clinicians, and public health advocates in complementary and shared work. It employs an ecological approach and is guided by an understanding of critical periods in the development of overweight in childhood.

Chicago↗
PubMed1995

Faculty workload and collegial support related to proportion of part-time faculty composition.

Part-time faculty use has become more prevalent in higher education in response to enrollment shifts and budgetary constraints. This descriptive, exploratory study used a mailed survey to investigate whether full-time nursing faculty perceptions of workload and collegial support differ with changes in the proportion of part-time faculty in Comprehensive I baccalaureate nursing programs. Workload was measured by Dick's Workload Instrument. Collegial support was measured by the Survey of Collegial Communication, adapted by Beyer, which was based on Likert's organizational model. Schools were partitioned into three strata based on the proportion of part-time faculty employed (low, medium, and high). A 30% sample of schools were randomly selected from each stratum (10 schools from each). Within each selected school, six full-time undergraduate faculty were chosen by their respective deans to participate. The total response rate was 89.4%. The results of this study did not support assertions about part-time faculty use in the literature and existing accreditation standards. Findings indicated that there were significant differences in reported total faculty workload when varying proportions of part-time faculty are employed. Faculty in nursing programs with medium proportions of part-time faculty reported higher average total workloads per week than faculty in programs with low and high proportions of part-timers. Another finding demonstrated that full-time faculty in nursing programs with high proportions of part-time faculty spend fewer hours in direct clinical supervision of their students when compared with faculty in the other two strata. There were, however, no differences in perceived collegial support among full-time faculty participants. It was recommended that further research be conducted to investigate specific workload differences found in this study using more precise quantitative measures. Communication and collegiality between part-time and full-time faculty should be further developed and researched under more controlled conditions. Case studies of arrangements that make part-time faculty use beneficial are needed. Other variables such as leadership style, scholarly productivity, and morale and their relationship to the proportion of part-time faculty employed in the nursing program should be investigated.

Adult↗
PubMed1992

National Study of Internal Medicine Manpower: XIX. Trends in internal medicine residency training programs.

The National Study of Internal Medicine Manpower (NaSIMM) reports on the results of its 1989-1990 census of residency programs. The results are integrated into an organizational model identifying inputs, process, outputs, and environment of medical training programs. The number of residents entering internal medicine continues to grow at a relatively rapid pace. This growth is largely accounted for by foreign citizens who are graduates of foreign medical schools (AFMGs). Residents are spending an increasing proportion of their time in ambulatory care settings, but, thus far, this ambulatory care training has occurred primarily in hospital clinics and emergency rooms. The proportion of a program's residents entering general internal medicine was found in a multiple regression analysis to be negatively associated with the number of subspecialty programs located in the training hospital, the percent of AFMG residents in the program, and the presence of a preliminary track in the program.

Career Choice↗
PubMed1990

Hospitals, physicians need to be allies, not adversaries.

The only way to bring hospital costs under control without sacrificing quality is to end the adversarial relationship between administration and physician staff, says Philip Hoggard. It's time to integrate the two camps into a shared organizational model that allocates risks and rewards fairly.

Economic Competition↗