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PubMed1986

Canadian cancer care: organizational models.

Canadian cancer care has evolved under systems of provincial and federal fiscal control and aims to optimize the management of patients within each province. In Manitoba, patients are initially assessed at one centre but can subsequently receive chemotherapy at an outreach centre closer to home. In British Columbia, two outreach mechanisms exist: consultative clinics provide consultative and follow-up care by radiotherapists and medical oncologists who travel to outreach centres, and community-based regional oncologists provide diagnostic and treatment services in small communities. In Ontario, peripheral clinics are staffed by oncologists from the two provincial cancer institutions, but efforts have been made to find newer outreach models that will better serve certain communities in that province. Two basic models of cancer care organization in the community presently exist in Canada: one stresses the extension of resources outward to the community from major cancer centres, and the other stresses the support of already established resources in the community. Efforts to coordinate these activities are being initiated.

British Columbia↗
PubMed1983

An organizational model of a psychiatric hospital program for the elderly.

This article is a summary describing the program planning and initial experience of a new unit for geriatric psychiatry in a private psychiatric hospital. Elderly psychiatric patients, predominantly with diagnoses of depression, alcohol dependency, and dementia, but also other psychiatric illnesses, demonstrate more self-centeredness and less group awareness than do younger patients. Staff members often experience frustration, sadness, and anger in response to working with them. Major problems unique to a geriatric psychiatric unit include the paucity of adequate resources for post-discharge care and the necessity to plan an excellent medical support system.

Aged↗
PubMedDate not supplied

An organizational model of community health agencies for health education internships.

An essential element in the preparation of aspiring health care professionals is the internship experience. It is usually identified, by student and professionals alike, as the single most important aspect of training. The selection of any agency which provides such a vital function, however, can be confusing. There are thousands of different community health agencies which are specifically concerned with a particular aspect of human health for some designated subset of the general population. These agencies range from the well known giants like the World Health Organization, the American Cancer Society, and the National Institutes of Health, to the less well know but equally important agencies like Compassionate Friends and the National Atoxia Foundation. The purpose of this article is to identify a classification system that will organize the seemingly disparate health care industry. It is hoped that this system will enable users, such as aspiring young professionals seeking field placement or employment, or local consumers seeking assistance for a health problem, to distinguish among the plethora of agencies, institutions, and organizations concerned with health/medical care and make intelligent choices concerning their selection and utilization.

Foundations↗
PubMed2002

[Ad-hoc coronary angioplasty: organizational model, clinical results and costs].

BACKGROUND: Our center routinely employs the strategy of ad hoc percutaneous coronary intervention (PCI) after diagnostic catheterization in previously informed and prepared patients with anatomical and clinical indications for some years. The aim of this study was to evaluate clinical results and resource consumption of the ad hoc PCI strategy in our center. METHODS: We evaluated the results and resource consumption of 783 PCIs performed between January 1, 1999 and June 30, 2001, divided into 642 (82%) ad hoc and 141 (18%) deferred PCIs. We analyzed the patients' in-hospital clinical and procedural characteristics, the 1 and 6-month outcomes and resource consumption (costs of materials, quantity of contrast medium, fluoroscopic time and duration of procedures) in the two groups. RESULTS: Patients in the ad hoc group had more frequently previous PCI, hypertension, diabetes, acute coronary syndrome, single vessel disease, single lesion and single vessel PCI, stent use and direct stenting, use of glycoprotein IIb/IIIa inhibitors and hemostatic devices; those in the deferred PCI group had more frequently previous myocardial infarction, stable angina, elective programmed hospital admission for PCI and multilesion single vessel PCI. The clinical results were good: clinical success in 97% of cases, in-hospital major adverse clinical events occurred in 2%, non-Q wave myocardial infarction in 3.4% (creatine-kinase-MB > 3 times higher than the upper normal limit in serial routine controls), major vascular complications in 0.4%, 1-month and 6-month major adverse clinical events in 4 and 9% respectively, without any difference between the two groups. Ad hoc PCI resulted in less contrast medium use, a shorter procedure duration, lower costs and shorter fluoroscopy times with respect to deferred PCI plus diagnostic catheterization, although not statistically significant. CONCLUSIONS: In our experience, ad hoc PCI was safe and effective. Costs were lower and less resources were required. Patients were satisfactorily assisted and the logistics and organization of the procedure were optimal.

Aged↗
PubMed2003

[Quality system in cardiology: practical example to develop an organizational model for management certification without bureaucracy].

It is a difficult task to define practical guidelines and a pragmatic achievement for the new document of the Italian Ministry of Health for structures of the national health system obtaining a quality system according to the ISO 9000 standard. The present article illustrates the different steps to accomplish the quality management in our cardiology department, recently internationally certified, and it gives several practical examples of the path followed in the different sections of the department to obtain the best management of all the Operative Units, identifying customer requests and measuring customer satisfaction.

Cardiology↗