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PubMed2000

Role of victims' services in improving intimate partner violence screening by trained maternal and child health-care providers--Boston, Massachusetts, 1994-1995.

From 1992 to 1996, approximately 1 million incidents of nonfatal intimate partner violence (IPV) occurred each year in the United States; 85% of victims were women. In 1989, pediatric research found a concurrence of victimization of mothers and their children and supported a recommendation that maternal and child health-care providers (HCPs) pursue training and advocate for increased access to services to promote the safety and well-being of mothers and their children. From 1992 to 1997, the Pediatric Family Violence Awareness Project (PFVAP), a training project for maternal and child HCPs, promoted prevention of and intervention for IPV in Massachusetts. In 1994, PFVAP conducted a pilot evaluation in two urban community health centers to determine whether HCPs trained to conduct IPV assessment would increase their screening rates of women at risk for IPV if an on-site referral service for victims was available. This report summarizes the results of the pilot project, which indicate that IPV screening rates did not increase after implementing on-site victim service.

Adult↗
PubMed1987

The Monterey County Health Initiative. A post-mortem analysis of a California Medicaid demonstration project.

Twenty months after the California State Department of Health Services turned its Medicaid program in Monterey County over to a local health care authority, the Monterey County Health Initiative (MCHI), the state terminated the pilot project in favor of a return to fee-for-service reimbursement. The MCHI, plagued from its inception with shaky provider support and a flawed program design, failed to demonstrate its anticipated cost savings. The key features of this failure were overly generous fees for primary case managers, inadequate utilization control measures, a general hesitancy to assume the necessary gatekeeper function, and a management information system that was not fully operational until well into the implementation of the program. Policy implications and recommendations for future state-sponsored Medicaid demonstration projects are discussed.

California↗
PubMed2000

The UICC/WHO-CCCE Cancer Education project: a different approach.

The Union Internationale Contre le Cancer (UICC) and the WHO-Collaborating Centre for Cancer Education (WHO-CCCE) have started an international pilot project offering assistance to medical schools that want to implement in their curricula a two-week multidisciplinary cancer course aimed at cancer care in general practice. The approach will be bottom-up (based on the possibilities in individual medical schools) instead of top-down (based on general recommendations and rules established in published studies). In April 2000 one or more medical schools from each of four continents had registered. Registration is open to any medical school and to other schools that have satisfactory ongoing cancer courses. The aim is to develop a network among medical schools in order for them to learn from each other's cancer education strategies and experiences.

Americas↗
PubMed1990

[Dementia in the elderly. A 3-year project].

In order to meet the need of proper examination and treatment of memory problems in the elderly a specialized unit of psychogeriatrics has been established as a pilot project. In the period from September 1986 to April 1988, 146 persons were examined, 42% as outpatients and 58% as inpatients. The average age was 75.3 years. 54% had dementia senilis and 16% other sorts of dementia. 30% were not demented: 14% had a psychiatric illness, 8% organic damage or illness of the brain and 7% were confused. Overdose or wrong use of psychopharmacological drugs was a frequent problem, and cutting out the medication, regulating the dose, or changing to another medicine had surprising consequences. The further treatment was planned in cooperation with the patient's family and the community health service. A follow-up after nine months indicated that this was a positive procedure for the patients, and that the unit was a professional resource to the local health services in the whole district. The hospital has now been allocated funds from the Government to function as a competence centre for part of Eastern Norway.

Aged↗
PubMed2004

A new monitoring service for long term residential care.

eVital, a European funded project, aims to investigate the issues in the provision of vital signs monitoring services in the community. For the UK pilot, services to monitor the vital signs of patients in residential care homes by remote health care workers have been established. In particular, the aim was to allow the resident's own GP to observe the ECG, blood pressure, SpO2, temperature and respiration whilst still in the health centre and be able to advise on the most appropriate action should a crisis occur. As outcomes, this pilot project was designed to determine feasibility, channels of communication between key players and assess the technology. Trials have been under way for four months and preliminary results are promising. Residential home staff have commented on the extra level security they feel in being able to "summon" medical support for residents for whom they may have concern. Patient's relatives have also commented on the reassurance they experience from knowing that the resident is being monitored.

Aged↗
PubMed1991

Liaison services for a remotely located biotechnology research center.

In April 1989, the Houston Academy of Medicine-Texas Medical Center (HAM-TMC) Library initiated a prototype liaison program with the Baylor College of Medicine (BCM), Center for Biotechnology (CBT). The library was interested in examining the benefits and costs of the outreach concept and in supporting Houston's efforts to develop into a center for biotechnology research. Located thirty-five miles from the HAM-TMC Library, CBT was receptive to an outreach project that would improve its access to the library's collection and services. This article describes the objectives and development of the pilot project, the services provided, feedback from the biotechnologists, and program costs. Although limited in scope, the project has provided the HAM-TMC Library with useful data about the information needs of a particular group of biotechnologists and strengthened relationships with these scientists. In addition, the knowledge and experience gained from this effort are being used to plan outreach efforts for other client groups.

Biotechnology↗
PubMed2006

Application of the clinical nurse leader role in an acute care delivery model.

The authors describe a 6-month pilot project incorporating a modified version of the American Association of Colleges of Nursing's (AACN) clinical nurse leader (CNL) role as a prelude to implementation of the AACN-defined CNL role. The purpose of the project was to evaluate a new nursing care delivery model on a designated nursing unit, incorporating the modified CNL role. The pilot was evaluated using nurse-sensitive indicators. Results showed positive trends for all indicators.

Humans↗
PubMedDate not supplied

RN students: unobtrusive cost-effective change agents.

A teaching learning project that empowers registered nurse (RN) to bachelor of science in nursing (BSN) senior nursing students to undertake cost containment and quality improvement pilot projects in the institutions where they work enables nursing education and nursing service to collaborate in promoting cost containment and quality improvement. Understanding how this process was implemented in one institution, as well as the outcomes, can help guide the application of this creative teaching strategy.

Cost Control↗
PubMed2004

Exploring the portability of informatics capabilities from a clinical application to a bioscience application.

This report describes XDesc (eXperiment Description), a pilot project that serves as a case study exploring the degree to which an informatics capability developed in a clinical application can be ported for use in the biosciences. In particular, XDesc uses the Entity-Attribute-Value database implementation (including a great deal of metadata-based functionality) developed in TrialDB, a clinical research database, for use in describing the samples used in microarray experiments stored in the Yale Microarray Database (YMD). XDesc was linked successfully to both TrialDB and YMD, and was used to describe the data in three different microarray research projects involving Drosophila. In the process, a number of new desirable capabilities were identified in the bioscience domain. These were implemented on a pilot basis in XDesc, and subsequently "folded back" into TrialDB itself, enhancing its capabilities for dealing with clinical data. This case study provides a concrete example of how informatics research and development in clinical and bioscience domains has the potential for synergy and for cross-fertilization.

Clinical Medicine↗
PubMed1993

The Maintenance of Competence (MOCOMP) Program: motivating specialists to appraise the quality of their continuing medical education activities.

The goal of the Maintenance of Competence (MOCOMP) Pilot Project is to develop a comprehensive CME strategy that will motivate specialists to continuously update their clinical practice. In its 1st year the pilot program has taken several significant steps. A credit system has been implemented to facilitate recognition of CME of the highest educational quality and to encourage specialists to compare their CME efforts with those of their colleagues. The self-directed CME curriculum currently followed by the typical MOCOMP Program member has been described. A diary has been implemented for specialists to record CME activities and their potential impact on practice. The MOCOMP Program is the first attempt to motivate self-directed continuing medical education (CME) through the use of a diary and the first attempt to use this instrument to encourage critical appraisal of personal CME habits.

Canada↗
PubMed2004

Burden in adolescent children of parents with schizophrenia. The Edmonton High Risk Project.

OBJECTIVE: Adolescent children of parents with schizophrenia are generally overlooked in studies of family burden. Few published data exist about this younger cohort compared to adult family members such as parents, spouses, and siblings. This pilot study aims to examine the types of burden described by adolescent children of parents with a diagnosis of schizophrenia. METHODS: Thirteen adolescents (9F: 4M) between the ages of 13 and 18 who had at least one parent diagnosed with schizophrenia were administered a semi-structured interview as part of a pilot project to examine burden in this group. Questions asked during the interview were directed at the subject's knowledge of the disorder, relationship with the parent, impact of the disorder on personal life, coping strategies used, and future concerns. RESULTS: Responses showed that the adolescents were uninformed about their parent's illness, had difficulties dealing with symptoms (positive and negative), were required to assume additional household responsibilities, and were concerned about their parent's future welfare. CONCLUSION: This pilot study illustrates that children of individuals with schizophrenia feel their lives are impacted by their parent's illness. More research is needed in this area to quantify and describe the types of burden experienced by this vulnerable group to ensure availability of adequate support.

Adaptation, Psychological↗
PubMedDate not supplied

Development of an outcome/variance tracking tool for sedation and non-surgical procedures.

A large academic cancer center devised a performance improvement plan for special procedures and sedation. A group of interdisciplinary professionals convened to address data collection, complications, and outcomes for non-surgical procedures and sedation. Administrative, medical, and nursing representatives from all areas in which these procedures are performed gathered to assess existing data and data collection methods and to develop an improvement plan. Gastroenterology, pulmonary, diagnostic imaging, intensive care, gynecology, genitourinary, hematology, and anesthesiology specialties were represented. The group was facilitated by staff from the institution's Office of Performance Improvement and co-chaired by an anesthesiologist and a pulmonary specialist. A representative from the Practice Outcomes Department was also an active participant. This article describes group process, design efforts, pilot testing, and analyses for this project. Pilot data are presented as well as a discussion of staff involvement.

Procedural Sedation↗
PubMed2002

Campaigning for change.

Most organizations must change if they're to stay alive. Change is tough to accomplish, but it's not impossible and can be systematized. The author, who has been involved in change initiatives at scores of companies, believes that the success of such programs has more to do with execution than with conceptualization. The successful change programs he observed had one thing in common: They employed three distinct but linked campaigns--political, marketing, and military. The author cites examples from such companies as Hewlett-Packard, Bristol-Myers Squibb, and Saturn to illustrate how effective such campaigns can be. A political campaign creates a coalition strong enough to support and guide the initiative. Sometimes, coalitions arise from changes to a company's formal structure. But they may come out of the informal structure, or they could stem from a temporary counterstructure. A marketing campaign must go beyond simply publicizing the initiative's benefits. It focuses on listening to ideas that bubble up from the field as well as on working with lead customers to design the initiative. A clearly articulated theme for the transformation program must also be developed. A military campaign deploys executives' scarce resources of attention and time. Successful executives secure their supply lines by, for instance, piggybacking onto initiatives that have already captured people's interests or already exist as bootleg projects. These managers also set up pilot projects that turn into beachheads because the projects expose them to the difficult dynamics they will ultimately face. Successful executives launch all three campaigns simultaneously. The three always feed on one another, and if any one campaign is not properly implemented, the change initiative is bound to fail.

Commerce↗
PubMed2003

[Laying hens in alternative housing systems--practical experiences].

Alternative keeping systems of laying hens in Germany at present are run as deep litter-, aviary- and free-range systems. After a short description of these housing types special requirements on management are considered. First solutions for the reduction of parasite and environmental burden in front of the hen-house are presented as well as opportunities to improve the utilization of that part of the outside run, which lay far from the pen. Although the management has improved a lot, the average mortality in alternative keeping systems of laying hens is still very high, probable reasons were discussed. Beside that the further development of furnished cages for groups of laying hens up to 40 and 60 individuals per unit is described; the first experiences from scientifically attended pilot projects are reported.

Animal Husbandry↗
PubMed2004

"Peer" educator initiatives for adolescent reproductive health projects in Indonesia.

Since the ICPD in 1994, the Government of Indonesia has struggled with the challenge of providing sexual and reproductive health education to adolescents. Following an attempt at a family-centred approach, a pilot project was carried out in Central and East Java to train peer educators, coordinated by the National Family Planning Coordinating Board (BKKBN). A total of 80 peer educators (male/female teams) carried out small-group information sessions in ten different districts. Over 1,300 adolescents attended in all. Forty peer counsellors in 20 teams then carried out five outreach sessions each in their communities, attended by nearly 4,000 adults and adolescents. Educators chosen were older in age, knowledge level, authority and communication skills than adolescents, but were well accepted as mentors. Adolescents wanted to know how to deal with sexual relationships and feelings, unwanted pregnancy and STDs. With 42 million Indonesian adolescents needing information, the government cannot produce enough manuals to satisfy demand. New strategies are required to put information in the public domain, e.g. via the media. The approach described in this paper would probably be beyond the staffing and resource capacity of most districts in Indonesia. Nonetheless, it shows that there was great enthusiasm across a variety of communities for efforts to educate young people on protecting their reproductive health.

Adolescent↗
PubMed2006

Use of telemedicine in chronic pain consultation: a pilot study.

OBJECTIVES: Telemedicine has been used extensively in various settings, including monitoring patient treatment response and counseling. However, there are few data on the application of telemedicine to chronic pain patients. The present study was the first pilot project to determine whether telemedicine technology for chronic pain consultation was feasible, cost-saving, and satisfactory to patients and pain physicians. METHODS: A prospective pilot study was conducted on chronic pain patients requiring follow-up consultations using telemedicine technology. Patients were interviewed by phone following the consultation. RESULTS: Eleven telemedicine anesthesia consultations involving eight patients (age 42+/-9 years; six men, two women) were performed. All were follow-up consultations. The average distance from patients' home to the clinic was 314+/-170 km. The reasons for consultation were for update of patient progress (10/11), medication change (6/11), and counseling (3/11). The time to complete the consultation was 24.5+/-9.5 minutes. The data for the time and the cost that the patient spent on the consultation are presented as median and 25% to 75% interquartile range. Patients having telemedicine consultations spent 0.9 hours (0.83-1) and Canadian dollar 3 (dollar 2-4) versus an estimate of 8 hours (6-8) and Canadian dollar 80 (dollar 46-260) for a conventional consultation (both P<0.005). Telemedicine consultation was found to be highly satisfactory to the patient and the consulting and attending anesthesiologists. CONCLUSIONS: This pilot study indicates that telemedicine follow-up consultations for chronic pain patients are feasible and cost-saving. Patients and anesthesiologists were highly satisfied with telemedicine consultation. Patients reported a significant saving in time and cost compared with a conventional consultation.

Adult↗
PubMed2002

The use of videoconferencing to enhance tertiary mental health service provision to the island of Jersey.

A six-month trial of videoconferencing was undertaken between the States of Jersey Health and Social Services in the Channel Islands and the South London and Maudsley NHS Trust in England. The purpose of the project was to evaluate the effectiveness and benefits of obtaining specialist tertiary mental health services not normally available on the island of Jersey. During the six-month pilot project in 2001, five teleconsultations were conducted: two acute psychiatric assessments and three case reviews. In addition, six presentations using videoconferencing were held on forensic psychiatry (24 participants), affective disorders (12), psychosis (8), eating disorders (3), crisis disorders (12) and community specialist teams (12). Results using the Guy s Communication Questionnaire indicated high satisfaction levels from all participants. The project successfully raised the awareness of telemedicine and its potential in the delivery of mental health services in Jersey.

Attitude of Health Personnel↗