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Results for “Transitional Care”

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PubMedDate not supplied

Transitioning yourself into the new health care business.

This article discusses the impact of the evolving health care industry on the individual staff nurse. It identifies future trends that affect nursing's role within the acute care setting, as well as the skills and characteristics of the successful nurse of the future. Ideas and suggestions for success in this new environment are presented in a nonintimidating way. Methods to obtain information on future nursing roles are discussed, and implications for current nursing roles are presented in an informal and easily understood way. Ideas on ways for staff nurses to assess their career options, as well as plan for any potential downsizing in their existing facilities, are also discussed. The idea that each nurse must take an active role in their own career development and not wait for someone else to do it or assume they will be taken care of runs throughout the article.

Career Mobility↗
PubMedDate not supplied

Creating Healthy Futures: an innovative nurse-managed transition clinic for adolescents and young adults with special health care needs.

The Creating Healthy Futures (CHF) clinic is an innovative, nurse-managed service model that provides comprehensive transition services to youth and young adults with special health care needs. Unlike other transition service models reported in the literature that are medically based, comprehensive transition services were coordinated by a family nurse practitioner who worked in close collaboration with an interagency team of pediatric and adult service providers. The Creating Healthy Futures (CHF) service model was originally developed for use in educational settings but was adapted for use in health care settings. The components of the service model are described in detail as a model for replication in other health care settings.

Adolescent↗
PubMed1997

A model to structure student learning in ambulatory care settings.

Providing students with an explicit framework for conducting patients' follow-up visits can ease students' transition into ambulatory care settings and enhance their learning. The authors describe a model that structures and defines students' tasks for a follow-up office visit. The model gives priority to the organization of patient care issues, the efficient use of patient and preceptor time, and the student's identification of a learning agenda for each patient encounter. In a rapidly expanding managed care world where physician and practice productivity are paramount, this model has the potential to enhance standardization of learning across diverse clinical sites and to increase the cost-effectiveness of teaching medical students in ambulatory settings. The authors have introduced this model in a half-day orientation for a primary care clerkship. Initial feedback suggests that the model is useful in preparing students to function more effectively in an ambulatory care setting.

Ambulatory Care↗
PubMed1996

[The problems in optimizing the delivery of general therapeutic care at the regional level during the transition to compulsory medical insurance].

The authors hold that perfection of local therapeutic service in present-day situation when insurance principles are introduced in medical care may be achieved through design of medico-economic standards of guaranteed minimum of medical aid for each citizen of Russian Federation. This approach allows accurate estimation of required personnel and equipment. The standards should not replace the principle of individual approach to each case.

Delivery of Health Care↗
PubMed1997

EMS for children: recommendations for coordinating care for children with special health care needs. Emergency Medical Services for Children, National Task Force on Children With Special Health Care Needs.

STUDY OBJECTIVE: To address the need for coordinated care for children and their families during the acute care phase of their hospitalization. METHODS: A multidiscipline task force developed this concept paper through a consensus process. The process was coordinated by the Emergency Medical Services for Children Program (a program of the Health Resources and Services Administration and the National Highway Traffic Safety Administration). The task force included representatives from prehospital care, acute care, rehabilitation, primary care, and education, as well as consumers. This representation provided a broad perspective on the needs of children and their families in the transition from hospital care to home. CONCLUSION: One designated individual is essential during the acute care phase who can assist the family with gaining information and resources to ensure a successful transition to community services and resources. This article provides a framework for acute care facilities and providers to use in planning services and working with acutely ill and injured children. Several recommendations highlight the need for care coordination to be initiated early in the child's hospitalization. An overview of services and resources (both health and educational) that a child and family may need is also provided. Such services and resources include identifying a care coordinator, working with the family to identify a primary care provider before hospital discharge, and building bridges with community-based health and education services.

Child↗
PubMed2001

Patients' views on the professional behaviour of family physicians.

BACKGROUND: Patient satisfaction is an important part and a measure of the quality of health care. Patient satisfaction with family physicians was studied within the project 'Analysis of Transition of Health Care System in Croatia'. OBJECTIVES: The aim of this study was to explore patient satisfaction with family physicians through evaluation of some characteristics of physician behaviour. The specific goals of this study were to determine whether there were differences in the evaluation of patient satisfaction with physician behaviour with regard to some sociodemographic characteristics of the respondents. METHODS: The study group consisted of 1217 respondents: 479 (39.4%) men and 738 (60.6%) women. Medical students interviewed the respondents 'face-to-face' immediately after their consultation with the physician. An anonymous questionnaire was created providing answers to 10 questions on patient satisfaction. Data on sociodemographic characteristics and the reason for encounter of the respondents were also collected. RESULTS: The average positive rating over 10 questions on patient satisfaction was 85.3%. There was a statistically significant difference in age distribution between geographic areas (P < 0.001). Differences in answers were found regarding sex, age, educational level (P < 0.001) and reason for encounter (P < 0.01). Two factors were obtained by factor analysis: the first could be called physician's competence/expertise estimated by respondents, and the other physician's empathy evaluated by respondents. The respondents were divided into two groups based on the reason for encounter as a criterion for discriminant analysis: acute (symptoms and complaints, injuries; n = 553) and other reasons (n = 664). The discriminant function obtained was statistically significant (P < 0.01). Younger respondents, regardless of sex, whose reason for encounter was an acute condition, were less satisfied with the physician's expertise, agreeableness during the consultation, physician's interest in what they were saying and physician's friendliness. CONCLUSION: Considering the difficulties present in the health systems of countries in transition, the results of our study were surprisingly encouraging, showing that the respondents were satisfied with the physician's behaviour and that the physicians fulfilled the basic elements of professional behaviour.

Adult↗
PubMed2001

The effectiveness of CAHPS among women enrolling in Medicaid managed care.

The large-scale transition of public health insurance programs to managed care has shifted much of the responsibility for selecting appropriate coverage to beneficiaries--a role for which many have had little preparation. This study evaluates the impact of a CAHPS (Consumer Assessment of Health Plans Study) health care report card in assisting newly enrolled Medicaid case heads in selecting a managed care plan. The major finding is that the CAHPS report card helped consumers make more informed decisions. Those who received the report cards found judging quality between plans easier, felt that they had significantly more information on which to make decisions, and recognized the importance of their decision more often than those receiving only standard enrollment packets.

Adult↗
PubMed1996

Prevention and the reforming U.S. health care system: changing roles and responsibilities for public health.

This review presents historical and cost-effectiveness perspectives of prevention in health care; discusses the nature, extent, and determinants of health system change, particularly the transition to managed care with large integrated health care corporations; and identifies implications for public health agencies and opportunities for prevention within the reforming health system.

Cause of Death↗
PubMedDate not supplied

Perspectives on confidential care for adolescent girls.

PURPOSE: We wanted to obtain perspectives of mothers and daughters on facilitators of and barriers to with adolescent girls' timely access to risk-appropriate reproductive care. METHODS: We conducted 5 separate focus groups with Latina and black mothers and their adolescent daughters. All participants resided in impoverished neighborhoods of New York City. Participants addressed mothers' roles in helping girls initiate gynecologic care, perceived role of physicians in daughters' sexual health, including the provision of confidential care, and perceived need for girls' gynecologic care. Data were analyzed using qualitative data analysis methods. RESULTS: Mothers see themselves as their daughters' primary protectors against daughters' poor reproductive outcomes. Many believe that confidential care promotes risky behavior and undermines mothers' efforts to protect girls. Mothers endorse facilitating gynecologic care and entering alliances with physicians but see the need for care as arising only after girls' sexual debut. Unfortunately, maternal awareness of sexual activity is low. Adolescent girls express considerable discomfort around reproductive health care and negotiating maternal involvement, and they fear breaches in confidentiality. CONCLUSIONS: A lack of trust in health care clinicians and the mother's gatekeeper role are key barriers to girls' transition to reproductive care. Consistently including a confidential component to health care visits in early adolescence, with preparation for both mothers and daughters, may reduce the distrust and discomfort.

Adolescent↗