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PubMedDate not supplied

Introducing accountability in an outpatient mental health clinic: an administrative process evaluation.

The administrative evaluation implemented at TRIMS makes explicit the goals and objectives of the clinic and the extent to which they were attained. Prior to the initiation of the evaluation formalized evaluation procedures and measures of accountability were nonexistent, and the monitoring of clinic activities for descriptive management purposes was noticeably absent. The Goal Attainment Scaling method in the administrative evaluation formalizes the organization's informal process of defining goals and objectives. The evaluation strategy emphasizes the explicit statement of objectives and the criteria on which performance would be evaluated. In essence the evaluation was incorportated into the management activities of the clinic, measures of accountability were established and, based on this experience, an administrative evaluation has been established in all ten clinics in the outpatient division.

Ambulatory Care↗

PubMed2002

The Danish health system through an American lens.

The organization and financing of the Danish health care system was evaluated within the framework of a SWOT analysis (analysis of strengths, weaknesses, opportunities and threats) by a panel of five members with a background in health economics. The evaluation was based on reading an extensive amount of selected documents and literature on the Danish health care system and a 1-week visit to health care authorities, providers and key persons. The present paper includes the main findings by one of the panel members. Primary care is much more accessible in Denmark than the USA. A mixed capitation-fee-for-service method of paying generalist physicians in Denmark ensures that everyone has a primary care physician and generalist physicians are responsive to providing services quickly, typically same-day appointments. An organized off-hours service ensures accessible care 24 h a day, 7 days a week. Denmark has the highest public satisfaction with health care, reflecting the value placed on accessibility of primary care. Inpatient hospital care consumes a disproportionate share of Danish health expenditures. Global hospital budgets provide little incentive for hospital or surgical productivity. Long waits for hospitalization, especially surgical procedures and cancellation of scheduled surgery, are a source of patient dissatisfaction. Women's health, patient health risk counseling and coordination of preventive and primary care are major weaknesses of the Danish health system. Patients have a choice of primary care physician within a given geographic area and may go to a hospital of their choice. However, patient surveys and feedback are underdeveloped and very little effort has been made to make services responsive to patients' preferences. While innovations in electronic prescribing are noteworthy, further development of health information technology is needed.

Delivery of Health Care↗

PubMed2005

Rehabilitation Medicine Summit: building research capacity.

The general objective of the "Rehabilitation Medicine Summit: Building Research Capacity" was to advance and promote research in medical rehabilitation by making recommendations to expand research capacity. The five elements of research capacity that guided the discussions were: 1) researchers; 2) research culture, environment, and infrastructure; 3) funding; 4) partnerships; and 5) metrics. The 100 participants included representatives of professional organizations, consumer groups, academic departments, researchers, governmental funding agencies, and the private sector. The small group discussions and plenary sessions generated an array of problems, possible solutions, and recommended actions. A post-Summit, multi-organizational initiative is called for to pursue the agendas outlined in this report.

Cooperative Behavior↗

PubMed2006

Who's making global civil society: philanthropy and US empire in world society.

Theories of US hegemony commonly ignore the role of American philanthropy in the contemporary transformations of world society and the globalization of capitalism. In this essay, I suggest that the philanthropic foundation, and with it the institution of philanthropy, is being invigorated by the expansion of its domestic role to foreign activities and to globally framed activities within the USA. I propose that US philanthropy exports American understandings of democracy and simultaneously organizes global reflexivity through citizenship education for the US populace. I offer a preliminary theoretical interpretation of the empirical patterns of international grant-making activities by US foundations, considering John W. Meyer's concept of 'instrumental culture' and some arguments made by Foucauldian 'governmentality' scholars. I emphasize the need to conceptualize the cultural-symbolic and organizational dimensions of hegemony and suggest further sociological analysis of philanthropic activities as integral to current politically and economically led transformations of societies around the globe.

Capitalism↗

PubMedDate not supplied

The Ohio Hospice Bereavement Study: meeting NHPCO standards.

Little attention has been paid to documenting the quality and impact of hospice bereavement programs. While quality of life, quality of dying, and quality of end-of-life measures are common indicators of effective clinical service, they are not adequate gauges of quality from a bereavement perspective. The National Hospice and Palliative Care Organization (NHPCO) published standards for hospice and palliative care programs that included a section on bereavement care. Little evaluative work has been done to discover whether hospice programs nationwide are compliant with these standards. The purpose of this study was to evaluate whether hospice programs (n = 32) in the state of Ohio were meeting the NHPCO bereavement standards. Findings indicated that the participating hospice programs were 83 percent compliant at least some of the time.

Bereavement↗

PubMed1995

The main challenges.

The last few decades have witnessed dramatic changes, not only in health, but also in all aspects of human life. From the social point of view, the individual and family are again becoming the focus of attention, and there is an increasing concern about socio-economic conditions and human rights. From the health point of view, morbidity and mortality patterns are changing and many people live longer and fewer people die. The reasons behind these changes are mainly the expansion in knowledge and technology and the concern about our lifestyles. These changes impact heavily on both medical education, the delivery of health services, and the cost of health care. Medical schools should respond by introducing changes in the medical education process and ensure the proper training of a new generation of doctors who are community- and socially oriented, capable of relating to the community and its needs. The health care system should also respond to these changes by restructuring its organization and finance to ensure quality in health care and that health services are not rationed according to an individual's ability to pay. There are apparent advantages in establishing close links between medical education and health care. Both systems and the community stand to gain from these links. Full integration of the two systems could be the final objective but should be preceded by careful study and experimentation.

Costs and Cost Analysis↗

PubMed1991

The evaluation of the Henry J. Kaiser Family Foundation's Community Health Promotion Grant Program: design.

The Kaiser Family Foundation's Community Health Promotion Grant Program (CHPGP) provides funding and technical assistance in support of community-based efforts to prevent major health problems. The first phase of the program was implemented in 11 communities in the western United States. This paper describes the evaluation design of the CHPGP in the West, the methods of data collection, and the baseline comparability of intervention and control communities. Major features of the evaluation design include: (1) the randomization of qualified communities making application into funded and unfunded comparison groups; (2) a second set of matched control communities for some intervention sites; (3) data gathering through repeated surveys of community residents (probability samples of adults and adolescents) and institutions (health-related organizations and randomly sampled grocery stores and restaurants); and (4) the use of secondary data to monitor health events. Selected baseline data show that intervention and control communities differ in racial/ethnic composition, but relevant health behaviors and ratings of community activation for health promotion appear comparable.

Adolescent↗

PubMed2001

Talbot Hospice Foundation. A successful community endeavor.

Since it opened its doors 20 years ago, the Talbot Hospice Foundation, located in Talbot County, Maryland, has grown to be one of the most highly respected service organizations in the county. A professional, non-medical staff of about five full-time employees manages some 800 volunteers who offer free hospice services to anyone in the community. It is dedicated to the concept that dying is not just a medical event, and that trained community lay people can play a significant role in providing practical and emotional support to their neighbors. The Foundation is supported completely by donations and receives no reimbursement from Medicare or other insurers.

Bereavement↗

PubMedDate not supplied

[People of African descent in the region of the Americas and health equity].

The Region of the Americas and the Caribbean has a complex demographic profile from an ethnic and racial perspective. One of the largest groups is composed of persons of African descent, who in some countries, such as Brazil and the Dominican Republic, comprise 46 and 84% of the total population, respectively. Recent analyses of the statistics available in some countries of the Region show wide gaps in terms of living conditions and health in these communities, as well as gaps in access to health services. PAHO, through its Public Policy and Health Program, under the Division of Health and Human Development, supports sectorial efforts and those of civil organizations that aim to improve health conditions in this segment of the population, while taking into account their sociodemographic and cultural characteristics. This article briefly summarizes health conditions and access to health services in selected countries, as well as some aspects of the recent changes to the legislation in those countries. Finally, collaborative activities on the part of United Nations agencies and international financial institutions for the benefit of people of African descent and other ethnic minorities are described.

Africa↗

PubMed2002

Examining e-health.

As part of its continuing mission to serve trustees and staff of health foundations and corporate giving programs, Grantmakers In Health (GIH) convened a small group of representatives from foundations, healthcare organizations, and the technology field to share their experiences and expertise on electronic health (e-health). This roundtable, held April 28, 2002, in Chicago, Illinois, highlighted emerging opportunities and challenges for foundations that wish to fund e-health initiatives. This report summarizes some of the key points from the day's discussion, providing both an introduction for grantmakers new to this area and offering the perspectives of some funders already experienced in funding e-health activities.

Computer Security↗

PubMed1997

NARSAD: a decade of support for psychiatric research. Interview by John A Talbott.

The National Alliance for Research on Schizophrenia and Depression (NARSAD) celebrated its tenth anniversary this year. The organization raises and distributes funds for scientific research on brain disorders. As a member of NARSAD's scientific council since the organization was founded, I have been greatly impressed by the energy and commitment of NARSAD's leaders and staff and the many individuals who volunteer as members of the board of directors and the scientific council. I asked Constance E. Lieber, president of the board of directors, and Herbert Pardes, M.D., president of the scientific council, both of whom have been deeply involved with NARSAD since its inception, to agree to an interview with Psychiatric Services. The following is an edited transcript of the interview.

Depressive Disorder↗

PubMed2005

Promoting translational research in academic health centers: navigating the "roadmap".

The translation of hypothesis-driven research laboratory findings about basic disease mechanisms into clinically useful tests or therapies, particularly in pediatric diseases, is time-consuming, expensive, and not well supported by traditional research grant mechanisms. Accordingly, the development of new drugs and clinical assays has typically been largely the domain of the pharmaceutical industry. Aside from partnering with for-profit companies, academic health centers are challenged to find ways to actively engage in biomedical research to bridge the gap between basic and clinical research. The Translational Research Initiative (TRI) at Cincinnati Children's Hospital Medical Center was launched in 2001 with the mission to build an institutional infrastructure for promoting and facilitating the clinical implementation of investigator-initiated basic research. The TRI's goals are to provide grant support for proposals that are translational in nature and that address serious diagnostic or therapeutic deficiencies in pediatric illnesses; to create and support specialized research cores and a specialized office that provides support for research protocol development and regulatory affairs; and to organize educational opportunities focused on bridging communication between basic and clinical scientists and encouraging multidisciplinary interactions. The authors describe the program structure and provide an interim outcome report as measured by extramural funding obtained, Investigational New Drug applications filed, manuscripts published, clinical trials launched, and educational initiatives created. The broad success of this program suggests that it might serve as a model for other academic health centers in promoting and conducting translational research.

Academic Medical Centers↗

PubMed1998

Interorganizational collaboration: a cautionary note for tribal health nurses.

As the Indian Health Service restructures and more Indian tribes assume control for their health care services, more collaborative initiatives between Indian tribal health and other organizations may be anticipated. This paper addresses the topic of interorganizational collaboration and tribal health care. There are unique issues related to Indian tribal healthcare, and this paper provides a cautionary note to public health nurses who work with and for Indian tribes. Interorganizational collaboration and tribal health care will of be interest not only to the public health nurses working for a tribe, but also to the county and state public health nurses who may be entering into a collaborative effort with a tribal health care agency.

Community Health Nursing↗

PubMed2006

Association for medical education and research in substance abuse.

The Association for Medical Education and Research in Substance Abuse (AMERSA) is a multi-disciplinary organization committed to health professional faculty development in substance abuse. In 1976, members of the Career Teachers Training Program in Alcohol and Drug Abuse, a US federally funded multi-disciplinary faculty development program, formed AMERSA. The organization grew from 59 founding members, who were primarily medical school faculty, to over 300 health professionals from a spectrum of disciplines including physicians, nurses, social workers, dentists, allied health professionals, psychologists and other clinical educators who are responsible for advancing substance abuse education. AMERSA members promote substance abuse education among health professionals by developing curricula, promulgating relevant policy and training health professional faculty to become excellent teachers in this field. AMERSA influences public policy by offering standards for improving substance abuse education. The organization publishes a peer-reviewed, quarterly journal, Substance Abuse, which emphasizes research on the education and training of health professions and also includes original clinical and prevention research. Each year, the AMERSA National Conference brings together researchers and health professional educators to learn about scientific advances and exemplary teaching approaches. In the future, AMERSA will continue to pursue this mission of advancing and supporting health professional faculty who educate students and trainees to address substance abuse in patients and clients.

Awards and Prizes↗

PubMed1992

Ownership and performance of outpatient substance abuse treatment centers.

BACKGROUND: Little is known about the organization and performance of outpatient substance abuse treatment (OSAT) centers. We examine several performance measures of OSAT units, including clients treated, services provided, revenue sources, financial performance, and access to care, in relation to ownership of the center. METHODS: Data were drawn from a national random sample of 575 OSAT centers (85.8% response rate) participating in a telephone survey conducted in 1988. Analysis of variance by ownership was conducted on each performance measure, with differences subjected to tests of statistical significance. RESULTS: Descriptive results show that major funding sources differ by ownership. Private for-profit centers generate higher profits, charge higher prices, and achieve higher levels of financial performance than public and not-for-profit centers. Public centers provide better access to care for persons who are unable to pay. CONCLUSIONS: There appear to be substantial and interrelated differences by ownership type in the financing and operation of OSAT units.

Financing, Organized↗

PubMedDate not supplied

Turning Point's National Excellence Collaboratives: assessing a new model for policy and system capacity development.

This article reviews the factors leading to successful collaborations and observations about the functioning of groups of states in collaborative coalitions by examining one specific collaboration--the Turning Point initiative. Turning Point is an initiative funded by The Robert Wood Johnson Foundation (RWJF) to transform and strengthen the US public health system so that it is more effective, more community based, and more collaborative in protecting and improving the public's health and well-being. A unique aspect of the Turning Point initiative is the creation of 5 National Excellence Collaboratives, with participating members from multiple Turning Point state partnerships, national public health associations, federal agencies, and diverse other organizations appropriate to each Collaborative's focus. Over 5 years, Turning Point Collaboratives developed educational materials, practice tools, and policy recommendations aimed at improving the public health system at the state and local levels and, ultimately, improving the health of the US population. The literature on collaborative partnerships and coalitions describes key elements and factors among successful partnerships. Areas of importance to success in Turning Point Collaboratives that have implications for future efforts include: continuity of leadership and membership, adequate technical assistance, diversity of Collaborative membership, regular feedback, and incentives.

Community Health Planning↗

PubMed1985

How nonprofit organizations can develop comprehensive in-home support services by utilizing various funding streams.

Home-chore service delivery can provide nonprofit organizations with opportunities for service, employment, training, and economic development. This article describes the ways that such organizations can fund and develop home-chore programs. It examines the five major funding sources and the opportunities for combining program funds to promote comprehensive care. It then discusses issues to consider in competing for contract bids with proprietary providers. Marketing strategies are outlined for each funding source, including which services to offer and how to project a favorable agency image. This section places special emphasis on ways to tap the often overlooked but largest potential client population, the private pay sector. Finally, there are guidelines and projections for preparing budgets.

Aged↗

PubMed2001

The 'value case' for investment in occupational health.

This paper introduces the problems facing occupational health departments in the current environment created by new legislation and changes in social attitudes. The problems of establishing the true costs and benefits of service provision are discussed. The paper also explains the employment of the 'value principle' in organizations and postulates its use in order to establish the appropriate position of occupational health in corporate thinking. A practical system is suggested, based on a four-step process of strategic planning, issues development, option establishment and plan implementation, which can be used to evaluate and justify investment in services. The problems of future risk are addressed. The paper concludes with the priority of establishing the strategic importance of occupational health services alongside other personnel issues and expresses the possibility of using the same principles outside the business world.

Attitude to Health↗