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PubMed1989

Department of Transportation (DOT) National Highway Traffic Safety Administration and the American Medical Association Commission on Emergency Medical Services air ambulance guidelines.

These guidelines were developed as national EMS voluntary standards to: 1) Establish standard nomenclature for levels of aeromedical crew members; 2) Define the training requirements for each level; 3) Define the medical control requirements for aeromedical crew members; 4) Describe the application of the standards; and 5) Describe the general content areas of the training of aeromedical crew members. The AMA Commission on EMS has reviewed the current draft of the proposed national EMS voluntary standards and decided to accept them for inclusion in this second edition of the Air Ambulance Guidelines with the expectation that the final version of the ASTM Committee F-30 standard will be essentially the same as the current draft standard. The guidelines are designed to acquaint practicing physicians, especially those practicing in rural and remote areas, with the following factors which affect the transportation of patients by air ambulance: 1) Risks to the patient flying at high altitudes; 2) Equipment, both general and specific, required to render anticipated care; 3) Qualifications of personnel aboard the air ambulance, and the level of care required in transit; 4) Care required for specific medical and surgical conditions during flight.

Aircraft↗
PubMed2001

An older rural widow's transition from home care to assisted living.

Designed to foster appreciation of comprehensive evaluation of home care outcomes, this case study of an older rural widow is part of a longitudinal phenomenological study of home care. Over 14 months, while her home care agency reacted to the Balanced Budget Act, nine interviews were done with a 95-year-old woman who lived alone until she moved to an assisted living facility. Data analysis yielded structures of her changing experience of home care. Although primarily supportive services may have been inconsistent with Medicare regulations, such services may have influenced the favorable outcomes of sustaining elders at home and undergirding the rural economy.

Aged↗
PubMed2003

A framework for improving the quality of cancer care: the case of breast and cervical cancer screening.

This commentary presents a conceptual framework, Quality in the Continuum of Cancer Care (QCCC), for quality improvement studies and research. Data sources include review of relevant literature (cancer care, quality improvement, organizational behavior, health services evaluation, and research). The Detecting Early Tumors Enables Cancer Therapy (DETECT) project is used to apply the QCCC model to evaluate the quality of secondary prevention. Cancer care includes risk assessment, primary prevention, screening, detection, diagnosis, treatment, recurrence surveillance, and end-of-life care. The QCCC model represents a systematic approach for assessing factors that influence types of cancer care and the transitions between them, the factors at several levels (community, plan and practice setting) that potentially impact access and quality, and the strategies groups and organizations can consider to reduce potential failures. Focusing on the steps and transitions in care where failures can occur can facilitate more organized systems and medical practices that improve care, establish meaningful measures of quality that promote improved outcomes, and enhance interdisciplinary research.

Algorithms↗