Health and Nigeria's Third National Development Plan.
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Delivery of Health Care↗
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Results for “Development Planning”
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.
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Implementing regulatory reform: the saga of Michigan's debedding experiment.
This paper traces the implementation of Michigan's program for hospital bed reduction through four phases in the critical first 30 months following enactment: standard-setting, plan development, plan approval, and legislative oversight. Procedural complexity and goal conflict complicated implementation from the start: what began as a simple proposal to close unneeded beds soon became enmeshed in efforts to address long-standing issues of equity in access to care. A combination of administrative, political, and economic factors peculiar to Michigan, as well as the more generic problems incurred in applying a regulatory approach to containing medical care costs, contributed to the difficulties encountered in implementing bed reduction. Long-range prospects for the program depend upon whether the modest results it is likely to achieve are deemed to be worth the costs incurred in administering it.
Certificate of Need↗
Health care in transition. Consequences for young physicians. Council on Long-Range Planning and Development.
Individuals planning for a career in medicine must weigh a number of factors into their decisions. Increasingly, they must understand the nature of the socioeconomic environment of health care, including the extent of competition with other physicians and other health professionals; the degree of autonomy from health care institutions, government, and third-party payers; the impact of demographic or technological changes; and the economics of medical practice. This report analyzes the environment of medicine, emphasizing those elements that will be most important to medical students and resident physicians. It focuses on three stages of a physician's career: obtaining a medical education, beginning to practice medicine, and maintaining a viable practice.
Adolescent↗
The National Health Planning and Resources Development Act: health planning renewal legislation.
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American Medical Association↗
The future of medicine. A scenario analysis. Council on Long Range Planning and Development.
The Council on Long Range Planning and Development has undertaken an analysis of the future of medicine. The purpose in undertaking this study was to examine how the changing environment might effect the AMA and to identify measures the AMA could take to ensure its success in the future. The study involved developing three scenarios that covered a broad range of possibilities for the future. Analysis of these scenarios indicated that the AMA could face some significant environmental threats in the future. In the opinion of the Council, a variety of factors could combine to erode the AMA's membership market share and reduce cooperation among Federation organizations. Consequently, the AMA will have to develop an active response to environmental change to success and thrive in the future. The Council analyzed how the AMA might best respond to environmental change. The AMA could intensify its efforts to guide the course of environmental change. Such efforts would be worth undertaking, but they do not represent a complete solution. Therefore, the AMA must change itself to succeed in the future. The Council analyzed a number of alternative models of the AMA, each representing changes in product mix and/or organizational structure. None of these models provide a solution to environmental change. Rather, the solution lies primarily in program and activity changes. The Council identified specific suggestions for changes in the AMA's activities, organizational structure, and finances. If these suggestions are implemented, they will help the AMA succeed in the emerging environment. After completing its study of the future of medicine, the Council concluded that the need for the AMA will persist in the future. The market for the Association's products and services will remain strong. By taking steps today, the AMA can position itself to benefit from the emerging environment and, thereby, ensure that the Association has a positive future.
American Medical Association↗
The future of psychiatry. Council on Long Range Planning and Development.
The American Medical Association Council on Long Range Planning and Development has been publishing a series of reports that assess trends in the environment of medicine and their impact on physicians and health care provision. The Council believes each specialty in medicine will respond differently to changes in the health care arena. This report, developed in cooperation with the American Psychiatric Association, provides an overview and environmental analysis of the specialty of psychiatry. Socioeconomic data pertinent to psychiatry are reviewed first, followed by a review of scientific and clinical developments in the specialty. Next, the changing provision patterns of psychiatric care, the emerging patient populations served by psychiatrists, and recent developments in graduate medical education in psychiatry are reviewed. The Council also addresses changes in the financing of psychiatric care. In conclusion, the Council suggests implications of these and other environmental trends for psychiatry.
American Medical Association↗
The future of pathology. Council on Long Range Planning and Development.
The American Medical Association Council on Long Range Planning and Development has identified trends in the environment of medicine and has assessed their likely implications for the pathology specialty. Competition and economic pressures focused on the hospital setting are likely to continue to affect the choice of delivery site for pathology practice. During the past decade, the pathology specialty has been subject to extensive regulation, placing a new focus on the role of the laboratory within the hospital and generating new ventures for the provision of pathology services. A continuing challenge to the specialty is management innovation and adaptation in the face of regulatory restrictions and cost-containment experiments. The significant forces for change affecting the demand for services and the shape of future provision of pathology services include rapid advances in technology and scientific knowledge, funding for biomedical research, training for research pathologists, demographic trends in the population, and medical liability trends. Finally, with renewed emphasis on quality of care in the health professions, the pathology specialty has the potential to make substantial contributions to the quality and art of medical practice and is likely to remain at the center of efforts to refine methods of quality assessment and implementation.
American Medical Association↗
General practitioners' plans for developments in the inner city: a review by a primary care project.
This paper describes part of the work of a development project, working in Tower Hamlets in east London in 1983-87, with the wider remit for facilitating primary care development in the inner city. Thirty-nine of the 43 practices in the district were visited and general practitioners discussed their plans for development and the problems they encountered. The paper presents the results of the discussions and the follow-up work, which explored how further developments could be brought about. It concludes that many general practitioners are considering and introducing a wide range of new developments in their inner city practices. Planning for development of primary care in the inner city should focus more closely at local levels on what practices are already planning and provide more encouragement and practical help than at present.
Adult↗
A universal precautions monitoring system adaptable to any health care department.
The Occupational Safety and Health Administration has proposed monitoring employee compliance with universal precautions, as recommended by the Centers for Disease Control. Our respiratory care department, following a four-step system development plan, has developed and implemented a universal precautions monitoring system that is easy to adapt to any health care department. The results from monitoring can be used for educational planning, quality assurance purposes, and employee performance reviews.
Cooperative Behavior↗
[The 5-year plan of development of public health for 1966-1970 and tasks of planning].
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Health Facilities↗
A case-mix method for developing health planning criteria for hospital services.
The principal concern of this article is the inadequacy of the planning criteria currently being used by existing federally funded health planning agencies. A case-mix method was created for developing appropriate criteria. Chart-abstract data from New Jersey were used to create a list of those diagnoses eligible for treatment in the cardiac care unit (CCU), select a sample of hospitals for study and analyze the relationship between CCU bed need and CCU clinical practice. It was shown that existing bed-need criteria for CCU planning represent current CCU clinical practice patterns, which are probably not cost effective. The method was also used to develop empirical values of these criteria, which do represent cost-effective practice. It is recommended that the method be used to strengthen and update continuously all hospital-service need criteria used in current planning activities, including Plan Development and Certificate of Need Review.
Bed Occupancy↗
The future of general surgery. AMA council on long range planning and development.
During the past several years, the American Medical Association's Council on Long Range Planning and Development has identified trends in the environment of medicine that are likely to affect physicians, their practices, and the provision of medical care in the future. In the course of its environmental analysis studies, the Council has recognized that each medical specialty is uniquely subject to anticipated changes in the environment of medicine. As part of an ongoing series of analyses prepared by the Council, this report focuses on environmental trends that are likely to influence the practice of general surgery. The report outlines the current state of general surgery, the forces for change in the environment, and the implications regarding these changes. The Council concludes that there are certain challenges and many positive indicators for the future of general surgery.
American Medical Association↗
The future of general surgery. Council on Long Range Planning and Development.
During the past several years, the American Medical Association's Council on Long Range Planning and Development has identified trends in the environment of medicine that are likely to affect physicians, their practices, and the provision of medical care in the future. In the course of its environmental analysis studies, the Council has recognized that each medical specialty is uniquely subject to anticipated changes in the environment of medicine. As part of an ongoing series of analyses prepared by the Council, this report focuses on environmental trends that are likely to influence the practice of general surgery. The report outlines the current state of general surgery, the forces for change in the environment, and the implications regarding these changes. The Council concludes that there are certain challenges and many positive indicators for the future of general surgery.
Adult↗
The future of family practice. Implications of the changing environment of medicine. Council on Long Range Planning and Development in cooperation with the American Academy of Family Physicians.
The Council on Long Range Planning and Development of the American Medical Association has identified trends in the environment of medicine and the implications of these trends for specific medical specialties. This report considers the evolution of family practice as a specialty and its role in the future of health care delivery. As a specialty established less than 20 years ago, family practice has successfully surmounted several obstacles to achieve recognition within the medical community and among the public. However, the Council has identified new challenges and opportunities facing this specialty. In particular, the areas of graduate medical education, reimbursement, professional liability, and several health-related societal and ethical issues will pose challenges for and place constraints on family physicians. Family practice will encounter a number of opportunities in the evolving environment of medicine, due in part to demographic trends in the population and the growth in managed care. The Council concludes that, despite the challenges, the increasing demand for the services of family physicians has positive implications for the future of this specialty.
Education, Medical, Graduate↗
The future of obstetrics and gynecology. Council on Long Range Planning and Development with the cooperation of the American College of Obstetricians and Gynecologists.
The American Medical Association Council on Long Range Planning and Development has identified trends in the environment of medicine that are likely to affect the future of obstetrics and gynecology practice. The professional liability crisis is among the most potent factors affecting the types and numbers of services that obstetricians and gynecologists will provide in the future. The setting for obstetrics and gynecology practice is likely to be affected by advances in technology and trends in delivery and reimbursement systems. Two factors with potential to affect the organization of practice are the high numbers of women entering the specialty and increasing practice expenses, largely associated with liability costs. Other factors affecting future patterns of delivery include the anticipated aging of the female population and the changing social and economic roles of women. In particular, the feminist movement has focused more attention on women's health care and is expected to have a continuing impact on the delivery of obstetric and gynecologic care. The Council concludes that the most salient issues for the specialty in the future will be the following: (1) the direction of the professional liability crisis, (2) medical practice competition, (3) the feminization of poverty, (4) ethical issues arising from technological and social imperatives, (5) the changing gender profile of the specialty, and (6) the impact of the feminist movement on women's health care.
Ethics, Medical↗
Developing care plans for psychosocial nursing diagnoses.
In 1992, the Nursing Department Documentation Committee at Spaulding Rehabilitation Hospital decided to revise the process of and forms for documenting nursing diagnoses. A sub-committee developed a format for standardized nursing care plans and piloted its use on two patient care units. The unit nursing staffs selected a number of common nursing diagnoses and, using the new format, developed standardized nursing care plans for them. After refining the process based on this pilot, the development of care plans was extended to all patient care units. A collaborative partnership was then formed between interested Primary Nurses, the Psychiatric Clinical Nurse Specialist and the Nursing Practice Coordinator to focus on developing psychosocially-oriented care plans as well as physically-oriented plans. Although psychosocial diagnoses are less frequently identified in the assessment process and included in nursing care planning, they are still very important for providing comprehensive care. This article describes the process of developing and implementing psychosocial care plans. This article also describes the components of the standardized nursing care plans developed for four psychosocial nursing diagnoses.
Humans↗
Developing family planning nurse practitioner protocols.
This article focuses on the process of development of protocols for family planning nurse practitioners. A rationale for the use of protocols, a definition of the types and examples, and the pros and cons of practice with protocols are presented. A how-to description for the development process follows, including methods and a suggested tool for critique and evaluation. The aim of the article is to assist nurse practitioners in developing protocols for their practice.
Evaluation Studies as Topic↗
Planning and developing a prehospital mobile intensive care system in an urban setting.
A suggested model for the development of an urban based prehospital emergency care system is described. Factors considered in the planning and development include: 1) demand for services, projected and actual; 2) analysis of costs; 3) design and maintenance of the delivery system; and 4) establishment of the evaluation mechanisms. Over one year's experience and 1,144 mobile intensive care unit (MICU) calls in a densely populated urban setting with over 500,000 persons are reported. During the peak 8-hour period, predetermined dispatch categories were employed to activate one MICU operating in conjunction with three conventional ambulances. This partial conversion imparted MICU capability to the entire system at an 11 per cent increase in the ambulance budget. MICU calls averaged 4.5 per 8-hour peak shift and took 45 minutes each.
Ambulances↗