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Results for “Pilot Projects”

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PubMed2003

A rapid-cycle collaborative model to promote guidelines for acute myocardial infarction.

BACKGROUND: This American College of Cardiology (ACC) Acute Myocardial Infarction (AMI) Guidelines Applied in Practice (GAP) collaborative in Michigan represented ACC's third initiative, in partnership with local health care coalitions and the Michigan Peer Review Organization. The GAP Pilot Project formed the basis for this project, which supported caregivers' efforts to improve their processes and consistently apply the evidence-based guidelines for AMI care. THE SOUTHEAST MICHIGAN EXPANSION PROJECT: The Institute for Healthcare Improvement (IHI) Breakthrough Series model of improvement was modified to merge the GAP Pilot Project's design with a rapid-cycle quality improvement model. The collaborative included learning sessions that focused on five phases--planning, tool implementation, monitoring tool use, remeasurement, and results--and on increasing tool use rates in each phase. CONCLUSIONS: Building on the work of two previous efforts, the ACC AMI GAP projects yielded substantial collective knowledge. Developing and fostering a collaborative culture allowed hospital teams to avoid barriers or overcome them successfully based on others' experiences and collectively solve problems, and it shortened the learning curve and accelerated QI.

Acute Disease↗

PubMedDate not supplied

Analysis of OBQI outcomes in participating Michigan home health agencies.

As part of the Centers for Medicare & Medicaid Services' plan to implement Outcome-Based Quality Improvement (OBQI) in home health settings nationwide, a pilot project was initiated in 5 states. This article analyzes the results of the Michigan Peer Review Organization's (MPRO's) pilot project in terms of changes in patient outcomes that occurred in participating home health agencies between 2000 and 2001. Participating agencies had statistically significant improvements when comparing their performance in 2001 versus their performance in 2000. They did not achieve significant improvement though in comparison to the national reference group. Agencies should implement the OBQI process in its entirety annually until the desired outcome is achieved.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed2005

Stimulating cancer research in Asian communities and training the next generation of scientists.

The landmark Institute of Medicine Report on the "Unequal Burden of Cancer" urgently called for efforts to reduce cancer disparities by conducting research that could rapidly translate laboratory and clinical findings to benefit large segments of society. It also called for intensifying efforts to produce well-trained minority researchers as a way to increase the quantity, quality and community relevance of cancer control research. This manuscript summarized our strategies and successes in these two areas. Over a five year period, the Los Angeles site of the NCI-funded Asian American Network for Cancer Awareness, Research, and Training (AANCART-LA) conducted intensive community based cancer awareness activities through a coalition of over 20 Asian serving community organizations. In addition, a major focus of AANCART-LA was on increasing community-relevant research and on training scientists to conduct research among Asians. Strategies to reach these goals included a focus on pilot studies as a way of introducing the community to research, selection of promising junior scientists to submit applications for pilot funding, and close mentoring of these individuals by seasoned investigators. We describe four pilot project proposals that were selected for funding by the NCI peer review process. In addition, AANCART-LA was able to obtain peer reviewed funding for several other research projects targeting a variety of Asian sub-groups. These projects were the direct outcome of extensive cancer awareness activities in the community, the publicity associated with receiving peer-reviewed pilot project funding, and the collaborations established with multiple community based organizations.

Adult↗

PubMedDate not supplied

Quick response teams: a new approach in utilization management.

In a 12-month pilot project, a "quick response team" was able to prevent 206 admissions out of the 237 referrals it received. In December 1990, an Ontario hospital implemented the project to avoid unnecessary hospital admissions of frail, elderly and disabled adults. Based on actual home care and hospital staffing costs, the pilot project illustrated that a quick response team is a cost-effective alternative to hospitalization for this patient population.

Adult↗

PubMed1999

The sustainability of telemedicine projects.

Although there are instances where the provision of health care is successfully driven by the profit motive, in most countries it is considered a public service. The provision of telemedicine services assuredly meets an important social need to extend health care to remote and rural areas in developing countries. While there are potential advantages and benefits from telemedicine, the evidence of its cost-effectiveness and sustainability is meagre. Telemedicine undoubtedly yields cost savings in certain circumstances, but few service providers have found a way to recover their costs (and make a profit) from those to whom they provide their service. With their low expenditures per person, developing countries face a daunting challenge in making such public services sustainable. Pilot projects should be a first step in demonstrating the cost-effectiveness and benefits of telemedicine, but such projects should also be sustainable. Sponsors of such pilot projects must have a clear plan from the start about how the project can continue after the sponsorship comes to an end. This paper examines ways in which telemedicine services can be made sustainable.

Capital Financing↗

PubMedDate not supplied

Pilot assessment of the subtelomeric regions of children with autism: detection of a 2q deletion.

PURPOSE: Autism is a chronic neurodevelopmental disorder characterized by deficits in reciprocal social interaction, language and communication, and by the presence of stereotypical behaviors. The disorder is a complex genetic trait with no known predisposing genes. We report the results of a pilot project to screen for aberrations in the gene-rich subtelomeric chromosomal regions of a cohort of children with autism. METHODS: For our pilot project, we used a multiprobe system that includes probes for the subtelomeric regions of all human chromosomes. We assessed the subtelomeric regions of chromosomes from 10 children with a diagnosis of autism. RESULTS: The screen identified one child with an apparent deletion of the subtelomeric region of chromosome 2q; nine children and pooled control samples yielded normal results. The deletion in our patient was confirmed with two other subtelomeric probes and a targeted cytogenetic study revealed a subtle difference in appearance for one chromosome 2 homologue. CONCLUSION: There have been several reports of children with dysmorphic features, autistic behaviors, and 2q deletions detectable with standard cytogenetic techniques. It may be that the distal region of chromosome 2q harbors a gene or genes that may predispose to autism.

Autistic Disorder↗

PubMedDate not supplied

Institute for Nursing Excellence: a retention model.

In 1989, the General Assembly funded initiatives for the recruitment and retention of nurses, including two pilot "Institutes for Nursing Excellence" designed to develop, recognize, and reward excellent staff nurses. The Wake Area Health Education Center (AHEC) implemented the pilot projects. In 1991, additional funding was obtained to replicate the pilot projects. The grant was awarded to the Wake AHEC from the General Assembly, through the newly established Center for Nursing. This cooperative effort between the legislature and nursing is considered a model of its kind in this state and possibly the nation. The purpose of the Institute was to develop mentoring, role-modeling, change, and lifelong learning skills in an atmosphere of renewal, rejuvenation, and trust.

Academies and Institutes↗

PubMed1994

Telemedicine on the move: health care heads down the information superhighway.

Telemedicine has drawn increasing attention as one of the emerging new service delivery vehicles that will run on the information superhighway. In reality, remote diagnosis and consultation through the application of telecommunications technology have been practiced for many years. But advances in technology and reform imperatives to extend access beyond traditional boundaries are pushing telemedicine into new applications. This is evidenced by the explosion in the number of pilot projects begun within the last 12 months. While demonstrating telemedicine's growing capabilities--for education and administration, as well as medical practice--these projects also raise a number of legal, clinical, and technical questions that must be answered before government and other payers will routinely reimburse for remote services. Academic and industry consortia are springing up to deal with the most compelling issues, including documenting telemedicine's safety and efficacy, developing uniform data and transmission standards, and determining the minimum resolution needed to maintain the integrity of clinical transmissions. Almost every type of medical specialty has proved amenable to performing evaluations via telemedicine links; however, specialties with less direct patient contact, like radiology and pathology, are generally identified as better candidates for telemedicine interactions. The telemedicine equipment required for these consults ranges from the simple to the ultra-sophisticated, depending on the type of system used and its clinical application. The most common system configuration involves a base station in the main facility where specialists and other consultants are housed and a number of remote referral sites. Consults are performed by interactively sharing voice, video, or image data. Increasingly, systems are being introduced that use easy-to-learn, intuitive displays and controls. Systems also require the use of any number of different communication media including land-based wire networks, high-speed fiberoptics, microwave links, or satellite transponders. Quantum leaps in telemedicine performance are being made constantly, many being swept along as a result of intensified interest in developing similar consumer and business services that are destined for the new information highway. In addition to information infrastructure projects, telemedicine has also recently benefitted from the effects of defense reinvestment, political interest in cost-reducing technologies, increased availability of funding for pilot projects, and the emergence of multifacility, multitiered, integrated delivery systems. Technical, financial, and logistical factors, which had once worked against telemedicine feasibility, are suddenly shifting to rapidly propel telemedicine technologies out of investigational settings and into mainstream clinical practice.

Computer Communication Networks↗

PubMed2003

Overview of the ISCE ECG "genome project".

The International Society for Computerized Electrocardiography (ISCE) "genome" project was begun at the end of 2000 to explore mechanisms for development of a cross-platform electrocardiogram (ECG) database. Ultimate feasibility of this project is based on established interactive cooperation of clinical investigators, engineers, and industry within the ISCE framework. The US Food and Drug Administration (FDA) mandate for centralized access to digitized ECG waveforms used in clinical trials provides a complementary stimulus to technologies that facilitate ECG database development. The constituency of ISCE is interested in acquisition and analysis of data from both standard 12-lead (resting) ECG and ambulatory (monitoring) ECG. Support for project goals from industry, at the Trustee as well as at the engineering level, has led to initial focus on the resting ECG. A one-year pilot project has been proposed to establish and implement software methodology for transmission, storage, and integrated reanalysis of digitized ECG waveforms provided by several major manufacturers. Beyond data acquisition, storage, and analysis, a number of critical issues are associated with database development. These include definition of clinically relevant "gold" standards, acquisition and validation of non-ECG data, protection of patient privacy, control and ownership of data, and accessibility and use of the database. However, implementation of the pilot project is a necessary first step, since all issues become moot without technical cooperation for shared formatting and analysis.

Databases as Topic↗

PubMed2005

Ethics committee reviews and mutual acceptance: a pilot study.

AIMS: To develop a human research ethics committee (HREC) mutual acceptance (MA) model, based on the National Health and Medical Research Council's guidelines. The MA model aims to facilitate aspects of multicentre research and decrease the time taken to finalise the HREC review process. METHODS: Four HREC (The Alfred Hospital, Austin Health, Peter MacCallum Cancer Centre and Melbourne Health) agreed to participate in a 13-month pilot project to evaluate the MA model. Evaluation included times from submission to approval and stakeholder surveys. RESULTS: Seventeen consecutive studies were submitted to the MA pilot project. Stakeholders agreed that the MA model was efficient and effective and that submission and review processes had improved, with a demonstrable reduction in the levels of duplication. There was a 27% improvement in approval times for multicentre studies. CONCLUSIONS: Our (MA) model resulted in clear improvements in HREC processes and timelines. Stakeholder acceptance was high. This model provides a framework for a broader program of MA.

Australia↗

PubMed2004

Cognitive behavioral treatment for older adults with generalized anxiety disorder. A therapist manual for primary care settings.

At least four academic clinical trials have demonstrated the utility of cognitive behavior therapy (CBT) for older adults with generalized anxiety disorder (GAD). These data may not generalize, however, to more heterogeneous and functionally impaired patients and the medical settings in which they typically receive care. A recent pilot project suggested the potential benefits of a new version of CBT for GAD among older patients in primary care. The manual developed and tested in this pilot project is presented here. Treatment components include motivation and education, relaxation skills, cognitive therapy, problem-solving-skills training, exposure exercises, and sleep-management-skills training. Procedures are designed to be administered flexibly to maximize attention to individual patient needs. Examples of session summaries, patient handouts, and homework forms are provided.

Aged↗

PubMed1998

A multistakeholder-driven model for developing an outcome management system.

Increasing demands for accountability in the delivery of public mental health services are engendering organized systems of treatment outcome monitoring. As such systems are designed and implemented, it is critical that key stakeholders be involved to the greatest extent possible in developing assessment instruments and methodologies so as to ensure relevance and acceptability of the outcome management system. A multistakeholder-based initiative for developing standardized outcome assessment for public mental health services in Virginia is described. Key components of the initiative include the process by which stakeholders were enlisted, the identification of recommended assessment instruments, and a pilot project that began the evaluation of the feasibility, utility, and cost-benefit of using the instruments. To illustrate features of this initiative, the child/adolescent mental health pilot project is described in detail. Implications for behavioral health administrators and next steps for Virginia's outcome management system are discussed, highlighting the role of key stakeholders.

Adolescent↗

PubMed2005

The Citizenship Safety Project: a pilot study.

The Government White Paper Saving Lives: Our Healthier Nation (1999) provides a clear indication that accidents are a serious public health problem and have been targeted by the Department of Health as a key area for prevention over the next 10 years. School-based injury prevention programmes have been identified as one of the key settings for the implementation of the White Paper's heath promotion strategies. The Citizen Safety Project (CSP) is a peer-delivered injury prevention programme for Year 10 students (14-15 years) and Year 2 pupils (6-7 years). This paper summarizes the findings of a pilot study that assessed the feasibility of implementing the CSP in schools and of conducting a larger study. Working as part of their Personal Social Health Education lessons, 11 pairs (n = 22) of Year 10 students developed a project to take one accident prevention theme of their choice into a primary school to teach small groups of five or six Year 2 pupils (n = 55). A formative evaluation was conducted, based on interviews with Year 2 and Year 10 teachers (n = 2), and the diaries of Year 10 students. Knowledge of accident prevention and risk awareness was measured in Year 2 pupils using the Draw and Write technique, and impact on Year 10 students was measured using self-esteem and locus of control inventories. Using both statistical and thematic analysis the study concludes that the CSP is well accepted, improves knowledge in Year 2 pupils and boosts confidence in Year 10 students, while concurrently achieving key stage attainment targets. Implications of the study are discussed in terms of future research, as are recommendations with regard to modifications to the project.

Accident Prevention↗

PubMed1996

Building nursing's minimum data set: the results of a pilot study.

Nursing's viability in health care data bases is nonexistent. If nursing is to receive acknowledgment and reimbursement for the services provided to patients, nursing data elements must be visible in national health care databases. To identify nursing data elements, this pilot project tested three instruments that could be used to identify nursing diagnoses commonly used in the peri-operative and peri-procedural care of patients. The results of the pilot project survey, the instrument of choice, and nursing diagnoses used during the pre, intra, and postoperative/procedural experience are described.

Data Collection↗

PubMedDate not supplied

Options for Recovery: California's perinatal projects.

In response to the increasing magnitude of problems related to perinatal exposure to alcohol and other drugs, a novel interagency collaboration was formed that involved the California Departments of Alcohol and Drug Programs, Developmental Services. Health Services, and Social Services. This collaboration was named Options for Recovery (OFR). Its mission was to promote the recovery of pregnant, postpartum, and parenting chemically dependent women and the enhancement of the health of their children by providing comprehensive and coordinated alcohol and other drug treatment, case management, and recruitment and training of foster parents and relative caregivers. Seven OFR pilot projects were selected. Findings from the three-year evaluation of the pilot projects showed that the initiative was successful in connecting women with essential services, promoting perinatal recovery and child health, and increasing family reunification of children in foster care. Women who were most likely to complete alcohol and other drug treatment were younger, high school graduates, mandated to treatment, or those who participated in treatment 150 days or more. Participants reported high levels of satisfaction with OFR. The findings indicate that OFR served the unique needs of high-risk perinatal populations. Future efforts should try to reach women early in their pregnancies and should provide a wide array of alcohol and other drug treatment approaches that are responsive to the myriad needs of women and their children.

Adult↗

PubMed2002

Using Internet GIS technology for sharing health and health related data for the West Midlands Region.

Recent government legislation highlights the need for co-operative working by government agencies to improve the overall health of people and to help reduce the existing health inequalities in England. To effectively tackle health inequalities, access to a range of timely and relevant data sets about a region is vital. The Multi-Agency Internet Geographic Information Service (MAIGIS) project is a 3-yr pilot project funded by the Public Health Development Fund to establish an interactive map-based web site for sharing health and health related data for the West Midlands Region (http://maigis.wmpho.org.uk). Data sets within the MAIGIS project follow three broad themes of health, socio-economic and environmental information. Data are made available by different organisations and shared using geography as the linking theme. This paper discusses the use of Internet GIS technology for sharing health and health related data based on the issues that arose during the formative period of the MAIGIS project. Issues such as data confidentiality, amalgamation and copyright are discussed and the technical development of the project is outlined. The links that MAIGIS has formed with other regional and national initiatives for the sharing of health and health related information are also presented. Finally, the future work programme for the MAIGIS project is summarised.

Data Collection↗

PubMed1996

[Operating room assistance: an innovative practice].

Professional practice changes in the operating room have led to the development of a new role for nurses--as surgical assistants. Essentially, the surgical assistant nurse helps ensure the patient's safety while providing technical and clinical assistance to the surgeon in such areas as exposing and manipulating tissues, suturing fascia and using various specialized instruments. The surgical assistant nurse function is being implemented through a pilot project at the Institut de cardiologie de Montréal. Developed by representatives of the nursing and surgical departments there, the project was approved by the Collège des médecins du Québec in April 1995 and subsequently by the institute's council of physicians, dentists and pharmacists. It has also gained recognition from the Ordre des infirmières et infirmiers du Québec (OIIQ). The pilot project incorporated a 186-hour training program, which was delivered from May to September 1995 according to three distinct learning modules: maintenance of a safe environment for the patient, clinical assistance and technical assistance. A tutorial approach to learning included individual and team work, simulation exercises, technical courses, lab work and practical training in the operating room. At the end of the training program, two surgical assistant nurses began practising in their new role. An evaluation of the project will be performed in September 1996.

Curriculum↗

PubMed1991

Daycare tonsillectomy and/or adenoidectomy at the British Columbia Children's Hospital.

The fact that tonsillectomy (T), or tonsillectomy with adenoidectomy (T & A) or adenoidectomy (A) can be performed safely in selected children on a daycare or outpatient basis is well proven. This article illustrates the approach that the British Columbia Children's Hospital (B.C.C.H.) took to confirm that the procedures were safe locally. A pilot project was started in June of 1984 to perform daycare adenoidectomies only, using two full-time pediatric otolaryngologists. When this proved successful, other otolaryngologists were encouraged to use the program. In June of 1988, a second pilot project was started for daycare tonsillectomies (or tonsillectomy and adenoidectomy). Criteria were established for patient selection, preparation, anesthesia, post-anesthetic recovery (PAR), Daycare Unit (DCU) nursing, and discharge. Follow-up information was obtained. Daycare tonsillectomy with or without adenoidectomy and daycare adenoidectomy are now routine procedures at B.C.C.H.

Adenoidectomy↗