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At least 613 records · Page 34Linked to original sources

PubMed1998

The Bridge to Health Project: a collaborative model for assessing the health of a community.

The Bridge to Health Project, a collaborative effort of 70 health related organizations, was designed to collect population-based health status data about approximately a half million residents in a primarily rural region in northeast Minnesota and northwest Wisconsin. Funding and staff support were provided by a regional medical center. The importance of sound survey methodology, role clarification, adequate staff support, and a well organized process to foster collaboration have applicability to other regions considering a collaborative process of health status assessment.

Academic Medical Centers↗

PubMed1996

Organizational structure and communication strategies of the bypass angioplasty revascularization investigation: a multicenter clinical trial.

Efficient communication is a challenge for the many operating components of a multicenter randomized clinical trial. Traditional management theory states that communications generally flow along a path established by a hierarchical organizational structure. A multicenter clinical trial does not fit traditional organizational models well and requires modification of traditional communication techniques. While the scientific community typically views a clinical trial as one large and cohesive enterprise, at each site the trial may actually be conducted as a small project related to the medical specialty of the investigator. Therefore overall trial management must be accomplished through collaboration rather than through direct management. In the Bypass Angioplasty Revascularization Investigation (BARI), the BARI clinical coordinating center has designed and utilized several mechanisms that facilitate effective communication and administrative control of a multicenter clinical trial. These mechanisms provide a framework of communication techniques that accommodate the specific needs of a complex organization.

Angioplasty, Balloon, Coronary↗

PubMed2006

TuBaFrost 3: regulatory and ethical issues on the exchange of residual tissue for research across Europe.

The regulatory regimes for research with residual tissue and accompanying data differ widely between countries in the European Union (EU): from specific consent to opt-out or even no consent at all. This could greatly hamper research where the exchange of tissue and accompanying data has become the gold standard, like in TubaFrost. Instead of adhering to international guidelines, which have a democratic deficit, or an attempt for a new set of possible harmonising rules, TubaFrost chose to create a coordinating rule: if tissue may legitimately be used for a certain kind of research in the country where it was taken and under whose jurisdiction the patient falls, it may also be used for such research in the country where it is sent to in the context of a scientific program even if in that other country other regulations would apply for research with residual tissue taken from patients under their jurisdiction. This coordinating rule has a sound basis in EU law in general and will solve the problems related to diverging national regulatory regimes in the case of cross national research with residual tissue.

Ethics, Research↗

PubMed1990

Health maintenance organizations and medical education: breaking the barriers.

Academic medical centers (AMCs) are under pressure to increase ambulatory medical education, but their capacity for such teaching is limited. Health maintenance organizations (HMOs) are a large and growing institutional setting that could participate in clinical education. Until now, relatively few HMOs and AMCs have reached agreements about teaching, because traditional suspicions have blocked collaboration. Responding to a case prepared as the basis of discussion, about 450 academics and HMO medical directors explored the barriers to and incentives for cooperation between AMCs and HMOs in clinical education. The two groups identified different issues as barriers to collaboration, leaving considerable room to negotiate agreements. AMCs, especially, need to be prepared to offer meaningful academic and financial inducements to attract HMOs to participate in teaching.

Academic Medical Centers↗

PubMed2003

Using theories of action to guide national program evaluation and local strategy in the community care network demonstration.

Evaluations of multisite community-based projects are notoriously difficult to conceptualize and conduct. Projects may share an overarching vision but operate in varying contexts and pursue different initiatives. One tool that can assist evaluators facing these challenges is to develop a "theory of action" (TOA) that identifies critical assumptions regarding how a program expects to achieve its goals. Community Care Network (CCN) evaluators used the TOA to refine research questions, define key variables, relate questions to each other, and identify when we might realistically expect to observe answers. In this article, the authors present their national-level CCN TOA. They also worked with sites to help them "surface" their local TOA; the article analyzes the results to determine the content, clarity, extent of evidence base, and strategic orientation of theories articulated by different sites.

Community Networks↗

PubMed2006

Health industry practices that create conflicts of interest: a policy proposal for academic medical centers.

Conflicts of interest between physicians' commitment to patient care and the desire of pharmaceutical companies and their representatives to sell their products pose challenges to the principles of medical professionalism. These conflicts occur when physicians have motives or are in situations for which reasonable observers could conclude that the moral requirements of the physician's roles are or will be compromised. Although physician groups, the manufacturers, and the federal government have instituted self-regulation of marketing, research in the psychology and social science of gift receipt and giving indicates that current controls will not satisfactorily protect the interests of patients. More stringent regulation is necessary, including the elimination or modification of common practices related to small gifts, pharmaceutical samples, continuing medical education, funds for physician travel, speakers bureaus, ghostwriting, and consulting and research contracts. We propose a policy under which academic medical centers would take the lead in eliminating the conflicts of interest that still characterize the relationship between physicians and the health care industry.

Academic Medical Centers↗

PubMed2003

Outcomes research at the National Cancer Institute: measuring, understanding, and improving the outcomes of cancer care.

What is the National Cancer Institute (NCI) doing to enhance the state of the science for measuring and understanding patient-centered outcomes of cancer care and to make this information useful for improved decision making? The NCI has a new focus on research that describes, interprets, and predicts the impact of various influences, especially interventions, on end points that matter to decision makers. The research includes end points such as survival, health-related quality of life, satisfaction and patient experience, and economic burden. To further this work, NCI supports and conducts research to (1) identify valid, reliable, responsive, and feasible end-point measures; (2) collect high-quality evidence about the impact of interventions on the end points of interest; (3) improve our understanding of the effects of other factors that shape this interaction; and (4) expand our capacity to translate research findings into information that is useful to patients, clinical policy makers, payers, regulators, standard setters, and providers of cancer care.

Humans↗

PubMed1998

The Northern New England Cardiovascular Disease Study Group: a regional collaborative effort for continuous quality improvement in cardiovascular disease.

BACKGROUND: The Northern New England Cardiovascular Disease Study Group, a voluntary regional consortium, includes all cardiothoracic surgeons and interventional cardiologists, as well as nurses, anesthesiologists, perfusionists, administrators, and scientists associated with the six medical centers in Maine, New Hampshire, and Vermont and one Massachusetts-based medical center that support coronary artery bypass graft (CABG) surgery and percutaneous coronary interventions (PCI). Since 1987 the group has met at least three times a year to foster improvements in patient care. PROGRESS IN THE STUDY OF CABG SURGERY: The group's activities have included continued monitoring of outcomes, training in continuous quality improvement, and a benchmarking effort that allowed institutions to learn from one another. In the postintervention period (mid-1991 through early 1992) there were 293 fewer deaths (n = 575) than the 868 expected. In 1995 a new cycle of quality improvement work aimed at identifying the causes and correlates of postoperative mortality began. Study groups for each institution were organized to examine issues related to death from low-output states. PROGRESS IN THE STUDY OF PCIS: Major improvement in hospital outcomes have occurred in relation to the improving technology (primarily coronary stenting). Near-twofold variability in the use of stents has led to vigorous discussions about the role of new devices. LESSONS LEARNED: Randomized clinical trials are very important to assessing the effects of specific treatments, but most of what is known about actual clinical care will come from observational studies. Demonstrating the variability in practice patterns can be a potent stimulus to try to answer the important questions.

Academic Medical Centers↗

PubMedDate not supplied

Northern New Jersey Nursing Education Consortium: a partnership for graduate nursing education.

The purpose of this article is to describe the evolution and implementation of the Northern New Jersey Nursing Education consortium--a consortium of seven member institutions established in 1992. Details regarding the specific functions of the consortium relative to cross-registration of students in graduate courses, financial disbursement of revenue, faculty development activities, student services, library privileges, and institutional research review board mechanisms are described. The authors also review the administrative organizational structure through which the work conducted by the consortium occurs. Both the advantages and disadvantages of such a graduate consortium are explored, and specific examples of recent potential and real conflicts are fully discussed. The authors detail governance and structure of the consortium as a potential model for replication in other environments.

Education, Nursing, Graduate↗

PubMed2005

[Characteristics of work stimulation of the medical personnel in the treatment-and-prophylactic institutions].

Social and economic relations of the last years that were formed in our country have lead to the changes in approaches to administrative activity. Under conditions of administrative-and-command guidance the patriotism and requirements of production discipline ensured the highly effective work. Today the economic relations between employer and personnel are of the first priority. These principles can be attributed to the military medical collective activity. The algorithm developed during the investigation for stimulating the employees working in the in-patient military medical institutions suggests the following performance of measure complex directed to the improvement of professional training of managerial staff working in the military medical institutions work with subordinates, fulfilment of motivation activity, summing up the medical staff work.

Attitude of Health Personnel↗

PubMed2005

Standards for education and training for interagency working in child protection in the UK: implications for nurses, midwives and health visitors.

This article presents a discussion of key issues for the education of nurses, midwives and health visitors following the completion of a Department of Health funded project, managed by the General Social Care Council and conducted jointly by two research centres; Salford Centre for Social Work Research and Salford Centre for Nursing, Midwifery and Collaborative Research. The work was initiated in response to Lord Laming's report on the circumstances leading to the death of Victoria Climbié. The project was conducted in relation to specified professions and occupational groups: doctors; health visitors; midwives; nurses; police; teachers, and social workers. It was undertaken in two stages. The first stage mapped existing material about standards in relation to education and training for interagency working. The second stage engaged in an extensive consultation exercise through which a model and a set of proposed standards for interagency education and training for interagency work were developed. The former is detailed fully in this report, while nine examples of standards are presented. The project final report was presented seven months after commencement.

Child↗

PubMed1990

Contracts between hospitals and health maintenance organizations.

This article describes the contractual relations that are emerging between health maintenance organizations (HMOs) and hospitals. Six HMOs in four large metropolitan areas provided information on 102 hospital contracts. The authors found that the HMOs are becoming more aggressive in placing hospitals in competition with each other for HMO patients. Staff and network HMOs are able to obtain a higher concentration of patients and substantially larger discounts for inpatient services than are individual practice association (IPA) plans in this study.

Competitive Bidding↗

PubMedDate not supplied

The Integrated Care in Shropshire project: lessons from experience.

Support for the idea of teamwork as an abstract ideal is not matched by practice. The Integrated Care in Shropshire project formed a partnership between Shropshire Social Services Department, Shropshire District Health Authority and Shropshire Family Health Services Authority together with the Helen Hamlyn Foundation. The first strand of the project was the development of procedures for assessment; it had a relatively clear goal and a firm deadline. The second strand was the development of better-integrated primary health care teams, but insufficient time and resources limited what could be achieved. Collaboration between the agencies has been extended for a further period and local units will be invited to put forward their own schemes. The ICIS project illustrates the need for 'pilot projects' to be conceived and managed by their sponsor agencies as sites for organisational learning if they are to be effective.

Aged↗

PubMed1996

[The Protomedicato Tribunal in the Central Administration of the Spanish Crown].

The Protomedicato was born, developed, and declined in the central administration of the Castilian Kingdom during the historic period known as the Modern Age (15th-19th centuries). The main objective of this study was to produce a conceptual analysis of this royal institution, a high collegiate court of technical character whose aim was to control all health-related professions in Castile; it had an independent jurisdiction and was not subordinate to the Royal Council (Consejo Real), although it was sometimes influenced by this council. We studied the legislative and everyday life and evolution of this court through different stages in its long life span. The Protomedicato, considered not as an isolated institution but within the bureaucracy of modern administration, is analyzed in the context of its sometimes strained relationship with other national, regional and local institutions of the Kingdom, the University, the Church and the Professional Association.

Government Agencies↗

PubMed2003

Preparing to respond: Joint Trauma Training Center and USAF Nursing Warskills Simulation Laboratory.

Injuries related to the events of September 11, 2001, and continuing military actions associated with Operation Enduring Freedom underscore the accurate focus of the Joint Trauma Training Center and the Warskills Simulation Laboratory. These two programs ensure that nurses are prepared to respond to diverse medical situations worldwide. Outcome measures from both initiatives attest to the effectiveness of an integrated program that facilitates critical thinking skills and clinical judgment to increase the nurses' ability to provide trauma care to severely injured military personnel.

Clinical Competence↗

PubMedDate not supplied

The National Institute of Environmental Health Sciences' research program on children's environmental health.

This article highlights the wide array of research programs supported by the National Institute of Environmental Health Sciences (NIEHS) that address issues related to children's environmental health. Special attention is given to the interagency, collaborative Centers for Children's Environmental Health and Disease Prevention Research program. A brief description of each of the eight centers highlights scientific foci and research efforts to date. In addition to discussing NIEHS-supported research programs, the article emphasizes the NIEHS' commitment to the promotion of translating basic research findings into public health knowledge so that culturally sensitive and applicable interventions may be developed.

Child↗

PubMed2005

Chasing the sun: a virtual reference service between SAHSLC (SA) and SWICE (UK).

AIM: In 2002, a discussion in the United Kingdom (UK) between South-west Information for Clinical Effectiveness (SWICE) librarians and a member of the South Australian Department of Human Services Libraries' Consortium (SAHSLC) raised the possibility of developing an after-hours virtual reference service between the two consortium groups. The aim of the service is to put medical practitioners in contact with a librarian when urgent help is required in finding clinical medical information after hours. METHODS: A trial project has begun and has been given the name 'Chasing the Sun'. The service will make use of time-zone differences between the UK and Australia, so that librarians at work in another country will be able to answer urgent patient-related queries that cannot wait until normal office hours. RESULTS: This paper looks at the development of 'Chasing the Sun' from initial concept, funding proposal and trial project stage to implementation. It includes details of the groundwork, software evaluation, trials, outcomes, cost and benefits, future directions and potential problems yet to be experienced or overcome. CONCLUSION: This service is the first of its kind between health libraries in the world and offers potential for future worldwide expansion.

After-Hours Care↗

PubMed2003

Toward a communicative perspective of collaborating in research: the case of the researcher-decision-maker partnership.

In the shift to a post-industrial order, the production and use of knowledge is gaining greater importance in a world beyond science. Particularly in the health sciences, research foundations are emphasising the importance of translating research results into practice and are experimenting with various strategies to achieve this outcome, including requiring practitioners to become part of funded research teams. In this paper, we present a case of a partnership between researchers and decision-makers in Canada who collaborated on an investigation of implementing change in health care organisations. Grounded in this case and recent empirical work, we propose that such research collaborations can be best understood from a communicative perspective and as involving four key elements: relational stance that researchers and decision-makers assume toward each other; purpose at hand that situates occasions for developing and using knowledge; knowledge-sharing practices for translating knowledge; and forums in which researchers and practitioners access knowledge. Our analyses suggest that partnerships are most effective when researchers see the value of contextualising their work and decision-makers see how this work can help them accomplish their purpose at hand.

Canada↗