SEARCH · PubMed Health

Results for “Interinstitutional Relations”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 631 records · Page 35Linked to original sources

PubMed1992

Risk variation and fallback insurers in universal coverage insurance plans.

This paper argues that optimal treatment of health expenditure risk variation over one's lifetime requires partial offsetting of experience-related premium fluctuations. It argues that government should provide protection against the risk of serious chronic illness by offering risk-related tax credits that offset some (though not all) of the changes in premiums due to such illnesses. The performance of a fallback insurer, present in most market-based health reform proposals, is shown to depend on whether or not it is permitted to risk rate. Forbidding any risk rating is likely to cause adverse selection problems, whereas permitting the fallback insurer to risk rate should help it to perform its proper role and avoid being subject to dumping of high risks.

Choice Behavior↗

PubMedDate not supplied

Re-entry into the registered nursing work force: we did it!

Because the enrollment in nursing programs dropped in the late 1990s and healthcare agencies and education programs were seeking ways to increase the numbers of nurses, Bethel College in Mishawaka, Indiana, and Memorial Hospital in South Bend, Indiana, designed a plan to encourage nurses who had been out of nursing to re-enter the work force. This article details the steps used in this partnership and demonstrates a process for helping registered nurses to return to nursing. In the 6-credit, 8-week course, nurses were prepared to function on a medical-surgical unit by reviewing important concepts related to nursing practice, physical assessment, nursing process, nursing skills, pharmacology, and clinical nursing update. It was anticipated that receiving college credit for the course would be a motivator for returning to study at the registered nurse to bachelor of science in nursing level. With 2 full clinical days each week, the students could experience a normal work shift and the routine of a busy clinical unit.

Attitude of Health Personnel↗

PubMed2005

The initiative for pediatric palliative care: an interdisciplinary educational approach for healthcare professionals.

There is growing empirical evidence that the U.S. healthcare system fails to meet the needs of children with life-threatening conditions and their families. The confluence of several recent developments has created a critical window of opportunity for improving clinical practice and institutional effectiveness in pediatric palliative care. This article presents an innovative, comprehensive approach to pediatric palliative care education that was developed by the Initiative for Pediatric Palliative Care, a consortium of seven academic children's hospitals, Education Development Center, the National Association of Children's Hospitals and Related Institutions, the New York Academy of Medicine, the Society of Pediatric Nursing, and the Association of Medical School Pediatric Department Chairs. The approach is based on needs assessment research with clinicians and parents and reflects a commitment to culturally respectful, family-centered care of children with life-threatening conditions. The pedagogy combines principles of adult education, includes families as teachers, and integrates affective and cognitive dimensions to enhance learning.

Child↗

PubMed2001

Pediatric Prevention Network: a multicenter collaboration to improve health care outcomes.

Nosocomial infections and antimicrobial resistance are major causes of mortality and morbidity and have become a major public health focus. To date, most national and international nosocomial infection surveillance and prevention activities have been focused on adults, despite the fact that pediatric patients are at high risk for nosocomial infections because of their immature immune systems and prevalent device usage. In 1997 the Hospital Infections Program at the Centers for Disease Control and Prevention and the National Association of Children's Hospitals and Related Institutions partnered to establish a Pediatric Prevention Network. Infection control professionals and their hospital administrators at all children's hospitals were invited to participate. The objectives of the network are to establish baseline infection rates; design, implement, and evaluate prevention interventions; establish benchmark rates and best practices; and serve as a site for multicenter studies to improve outcomes for hospitalized children. This network serves as a model for quality improvement systems in health care.

Child↗

PubMed1994

Perinatal research and its support. Corporate contributions at McGill University.

Three technologic projects with potentially patentable end results are slowly evolving in the Department of Obstetrics and Gynecology, McGill University and Royal Victoria Hospital. A tax shelter infusion of a significant amount of venture capital developed opportunities for all three projects over two years. The three projects--fetal heart rate tracing analysis related to fetal outcome, a distributed and intelligent data acquisition system and selected ultrasonic three dimensional imaging--were advanced considerably, and their results are expressed in outline. The effects of such infusions of business support into an environment of sparse research grant support have been extremely encouraging to the investigators, but the department, with its obligations of ongoing research, teaching and patient care, must develop the next steps with care, although one of the projects has been extended by an interested corporation.

Capital Financing↗

PubMed2002

Hearing the voice of the community above the din of the city: New York City Turning Point.

The New York City Public Health Partnership came together to guide the Turning Point Initiative and to involve communities in activities related to improving the health of the city's residents. Early decisions of the Partnership led to the convening of community forums, development of borough planning committees, and creation and implementation of a public health agenda--all of which have fostered community input and participation. Four years later, the Partnership continues to build upon lessons learned and explore ways of ensuring that community voice is incorporated into New York City's public health improvement efforts.

Community Health Planning↗

PubMedDate not supplied

A pilot project to detect and forecast harmful algal blooms in the northern Gulf of Mexico.

More timely access to data and information on the initiation, evolution and effects of harmful algal blooms can reduce adverse impacts on valued natural resources and human health. To achieve this in the northern Gulf of Mexico, a pilot project was initiated to develop a user-driven, end-to-end (measurements to applications) observing system. A key strategy of the project is to coordinate existing state, federal and academic programs at an unprecedented level of collaboration and partnership. Resource managers charged with protection of public health and aquatic resources require immediate notice of algal events and a forecast of when, where and what adverse effects will likely occur. Further, managers require integrated analyses and interpretations, rather than raw data, to make effective decisions. Consequently, a functional observing system must collect and transform diverse measurements into usable forecasts. Data needed to support development of forecasts will include such properties as sea surface temperature, winds, currents and waves; precipitation and freshwater flows with related discharges of sediment and nutrients; salinity, dissolved oxygen, and chlorophyll concentrations (in vivo fluorescence); and remotely-sensed spatial images of sea surface chlorophyll concentrations. These data will be provided via a mixture of discrete and autonomous in situ sensing with near real-time data telemetry, and remote sensing from space (SeaWiFS), aircraft (hyperspectral imagery) or land (high-frequency radar). With calibration across these platforms, the project will ultimately provide a 4-dimensional visualization of harmful algae events in a time frame suitable to resource managers.

Aircraft↗

PubMed2001

Can David and Goliath get along? Federal land in local places.

It is often unclear what the role of a local jurisdiction is with regard to land use management on nearby federal properties. Yet federal lands clearly impact nearby local communities. The US Department of Energy (DOE), with over 100 sites across the United States with varying degrees of environmental contamination, may be in a very difficult position with regard to relationships with local government about land use. Yet few, if any, studies have examined DOE land use issues. This study asks: (1) In general, how do local planners feel about federal government relationships with them? (2) Do local planners feel differently about the DOE than they do about other federal agencies? (3) What reasons explain any differences observed in answer to the second question? To answer these questions, local planners were interviewed from communities adjacent to non-DOE federal properties, and their responses compared to those of planners located near DOE facilities in the same regions. Findings showed that compared to other federal agencies that own land in the same regions, the DOE is relatively poorer at actively involving local officials in land use decisions at its sites. Primary reasons are the historic legacy of a culture of secrecy, focus on mission, and especially the lack of experience, training, or mandates in local planning cooperation. Findings also suggest that this attitude is markedly stronger in areas west of the Rocky Mountains. Recommendations for improved federal-local communications include the development of a vision for local government involvement that is supported by top levels of management and filtered effectively to the site level.

Communication↗

PubMedDate not supplied

New federal guidelines for physician-pharmaceutical industry relations: the politics of policy formation.

In October 2002 the federal government issued a draft "Compliance Program Guidance for Pharmaceutical Manufacturers." The draft Guidance questioned the legality of many arrangements heretofore left to the discretion of physicians and drug companies, including industry-funded educational and research grants, consultantcies, and gifts. Medical organizations and drug manufacturers proposed major revisions to the draft, arguing that current practices were in everyone's best interest. To evaluate the impact of their responses, we compare the draft, the changes requested by industry and organized medicine, and the final Guidance document (issued in April 2003). We also explore the implications--some intended, others unanticipated--of the final document.

Drug Industry↗

PubMed1996

Challenges and opportunities in establishing a Latino health research center in a majority academic institution.

This article provides a practical perspective of the issues, challenges and the opportunities involved in establishing a Latino Health Research Center in an academic institution. This article will use as an illustration the experiences related to the establishment of a Center on Latino Medical Treatment Effectiveness Program at a large public academic institution in Chicago. Some of the sociopolitical processes of establishing the Center's structure, and the recruitment and training of a multi-disciplinary core research staff are summarized, while simultaneously pursuing an ambitious research and training agenda. The article ends by suggesting a series of strategies in meeting the multiple and, at times, conflicting demands of the academic institution, the funding sources and the community, as well as the lessons learned.

Academic Medical Centers↗

PubMed1999

Partnerships for comprehensive school health: collaboration among colleges/universities, state-level organizations, and local school districts.

A qualitative survey on the collaborative experiences of colleges and universities, state-level organizations, and school districts related to comprehensive school health programs in 12 states found four primary collaborative outcomes: training, consultation, research, and networking. Five common dimensions of collaboration also were identified: interpersonal and organizational interactions, level of awareness and understanding of comprehensive school health programs, organizational priorities and reward systems, political forces, and availability and sharing of resources. The potential for such linkages to advance comprehensive school health programs remains largely untapped. Recommendations for developing such collaborations are presented.

Data Collection↗

PubMedDate not supplied

Public health and business: a partnership that makes cents.

Historically, public health agencies have had relatively few formal partnerships with private business. However, both groups share an interest in ensuring a healthy population. Businesses have a financial interest in supporting organized public health efforts; in turn, business partnerships can increase the reach and effectiveness of public health. This paper makes the case for the business sector's participation in the broad public health system and its support of governmental public health agencies. Examples of past and current partnerships exemplify how public health efforts benefit business and suggest opportunities for future collaboration to improve the public's health.

Commerce↗

PubMed2003

Leadership development: prerequisite for successful public-private partnership. New challenge for medical schools: graduates' outcome competences in health leadership.

Medical education stands at the doorstep of profound change, forced to step into an uncertain and potentially hostile new environment. These changes have nothing to do with scholar self-reflection, but rather are a direct consequence of the process of globalization visible also in medical education and the revolution in health care financing for which we use the general term "managed care". On one hand, globalization has penetrated different areas of our life, among others including science, public health and medicine which is a global profession. Medical knowledge, research and education have traditionally crossed national boundaries. Many aptitudes of physicians are universal, as well as the core competencies required by physicians throughout the world. The question is "what kind of core or essential competences are required for "global physicians". Besides medical knowledge and basic clinical skills, professionalism, interpersonal communication skills, context of care, information management, understanding a health system, etc. also need to be addressed. On the other hand, there is a growing concern that the corporate transformation of medical care, especially related to the impact of the changing and more business-oriented health care system, may lead to the decline and death of traditional professional values, such as fidelity, altruism, confidentiality, and integrity. No doubt, there is an inherent clash of values between business and medicine. However, as business interests have already gained an important place in medicine, we can hope that physicians progressively adopt a business mentality without losing professional virtue. While occurring changes inevitably bring some sense of loss, it also brings an opportunity to help reshape medical education to better meet the health needs of society.

Cooperative Behavior↗

PubMed1982

Contractual relationships between colleges of pharmacy and university hospitals.

The relationships that exist between colleges of pharmacy and university hospitals located in academic medical centers were investigated, and the types of pharmaceutical services that are being offered by these institutions were profiled. Questionnaires were mailed to 35 directors of pharmaceutical services located in academic medical centers. Of the 30 institutions represented by respondents, 27 had a college of pharmacy on the same campus, and 13 had a formal agreement between the hospital and the college. Ninety-seven percent of the hospitals surveyed had unit-dose or partial unit-dose programs, and all of the hospitals had i.v. admixture services. Nine of the 13 hospitals with formal agreements and 13 of the 17 hospitals without formal agreements had decentralized pharmaceutical services. The staffing patterns in these institutions showed that only 10.3% of the pharmacist FTE positions were funded by the college of pharmacy. There was no difference in trends as related to faculty appointment, title, or tenure between directors in hospitals with and without affiliation agreements. Seven of the directors of pharmacy were in tenure-track positions, and the director's reporting mechanism in the college was either to the dean or the chairman of pharmacy practice. No differences were found between the pharmaceutical services offered, staffing patterns, or status of the director of pharmacy in hospitals with or without formal agreements with colleges of pharmacy. These authors believe that a firm relationship between the college and hospital might prove advantageous to both parties.

Contract Services↗

PubMed2005

Public health care under pressure in sub-Saharan Africa.

Taking as point of departure the need for a strong public health care sector in developing countries the article firstly outlines how in sub-Saharan Africa enhanced scarcity has characterized the content and quality of health care in the public sector. This has eroded the trust among the public in the government as provider of health care and guardian of public health. Secondly, it describes how workers in the public health domain have dealt with the implications of scarcity by etching out a "puvate" zone in health care provision and how these informal activities need to be interpreted as "muddling through". It also points out what are reactions of clients to a decline in public health care provision. Thirdly, it discusses the changing relation between the state as provider of health care and private sector health care provision at a time of emerging public-private partnerships. The article emphasizes the need for strong health services at basic health centre level. It is at that level that the state has to address problems of scarcity and regain public trust. It also is at that level where major long-term health policies like the imminent large-scale delivery of antiretrovirals (3by5) have to be accomplished.

Africa South of the Sahara↗

PubMedDate not supplied

Creating a mentoring partnership model: a university-department of health experience.

The purpose of this project was to increase the number of students participating in public health nursing experiences at Vermont Department of Health through creation of a mentoring partnership model. The model targeted preceptor needs, including roles and responsibilities when working with students; educational needs of faculty, particularly related to evolving roles of public health nurses; and creation of additional clinical opportunities for students. Outcomes included improved working relationships among students, faculty, and public health mentors as measured by narrative evaluative comments of project participants; a 150% increase in the number of students participating in public health nursing clinical experiences; expanded involvement of Vermont Department of Health district offices and central office, with the addition of two new clinical sites and increased numbers of students in sites used prior to this project. Guidelines for preceptors working with students were also developed.

Education, Nursing, Baccalaureate↗

PubMed1996

What information do general practitioners want about accident and emergency patients?

OBJECTIVES: To establish what information general practitioners (GPs) want about their patients who attend accident and emergency (A&E) departments and the GPs' preferences for the type of communication and method of delivery. METHODS: Analysis of questionnaire sent to all 350 GPs in the catchment area of one A&E department. RESULTS: 219 completed questionnaires (63%) were returned. GPs requested information about most new attendances at A&E, but only 50% of GPs wanted details of every new A&E patient. Most GPs preferred a small computer generated letter or sticky label which included details of investigation results, diagnosis, treatment, and follow up arrangements. 47% of GPs requested delivery of letters by the pathology specimen service, but 25% preferred hand delivery by the patient or a relative. Individual GPs often had widely different preferences, especially about the type of communication and method of delivery. Most GPs would value a monthly list of all their patients who have attended A&E. CONCLUSIONS: GPs need prompt and appropriate information about their patients who attend A&E. A computerised records system should be arranged so that relevant information can be produced easily and quickly in a format suitable for filing in GP records. Good communications with GPs would improve the continuity of care for A&E patients.

Communication↗

PubMed1996

How good is intercenter agreement in the identification of embolic signals in carotid artery disease?

BACKGROUND AND PURPOSE: There has been concern regarding the reproducibility of the detection of embolic signals, particularly in patients with carotid artery stenosis in whom the signals are of low intensity. No published studies have examined inter-center agreement in reporting specific embolic signals or the factors responsible for any lack of agreement. We examined reproducibility between two centers in which widely differing proportions of embolic signals have previously been reported in patients with carotid artery stenosis. METHODS: Recordings from the middle cerebral artery of eight patients with ipsilateral carotid artery stenosis in whom embolic signals had been detected during a previously study were independently examined by three experienced observers in one center and by one experienced observer in another center. We calculated agreement within and between centers by estimating the probability that one observer would identify a specific embolic signal if other observers had identified it (a probability of 1 indicates complete agreement). The influence of different characteristics of the embolic signal on the probability of its detection as an embolic signal was determined. RESULTS: A high level of agreement in the identification of specific embolic signals was found. This was similar between all observers (.90), between the three observers in one center (.89), and between observers in the two different centers (.94). The probability of detection was independently related to the relative intensity of the embolic signal (P<.0001). It was less (although significantly) independently related to the position of the embolic signal in the cardiac cycle (P=.02), with signals in systole being more reliably detected. There was no independent relationship between the probability of detection and either the duration of the embolic signal or the velocity at the maximum intensity increase. The use of threshold intensity as a criterion for embolic signal detection increased interobserver agreement but reduced the sensitivity in detecting signals. CONCLUSIONS: The high level of interobserver agreement suggests that the technique is sufficiently reproducible for clinical use.

Blood Flow Velocity↗