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PubMed1997

Accident scenes.

Many hospital errors--including some of the most serious--never come to the attention of executives. A behind-the-scenes study shows how mixed incentives and communication snafus mask patterns of errors.

Clinical Competence↗
PubMedDate not supplied

Face to face.

Explore the source record for details and available documents.

Adult↗
PubMed1997

Multidisciplinary approach to management of a hereditary neurodegenerative disorder: Huntington disease.

Huntington Disease is a well known autosomal dominant inherited disease resulting in emotional problems, abnormalities of movement, and eventually dementia. It stands out as one of the most devastating illnesses, not only for its neurodegenerative progression but also for its impact on families. Care often becomes fragmented due to the person's response to symptoms and/or family breakdown. The successful interaction of health care disciplines working with Huntington Disease in our centers, namely, the family physicians, nursing, Genetics, Neurology, Psychiatry, Social Work, and Long Term Care has resulted in a comprehensive program of care for our patients and their families. This article will describe the history, structure and interaction of the multidisciplinary group. It will describe the difficulties we have overcome and offer suggestions for the implementation of similar programs for the care of people with other disorders.

Humans↗
PubMed1997

[The creation of partnerships: perspectives and possibilities].

This article re-examines access to treatment and care in the current context of fiscal restriction and change in locus of care. Taking the position that the development of partnerships with all parties who work in the mental health area is an important process, this article argues that such processes are infrequently discussed. Further, creating a partnered relationship with the person with mental disorder is also neglected. The authors examine mechanisms of relationship change as care moved from large, total-care institutions to general hospitals and finally, to the community. How professionals, individuals with mental disorder and their families have been affected by this change in terms of how alliances are constituted and maintained is discussed. The authors conclude with two case examples which illustrate the reconciliation and non-reconciliation of differing points of view between all partners which likely affected clinical outcomes.

Health Care Reform↗
PubMed1997

[Effects of the improvement in the quality of care in a university hospital].

In charge with the development of quality assurance in a university hospital, the authors have recorded actions realised in medical departments to improve quality. A first questionnaire was sent to every physician (340) and every chief nurse (170). The 126 answers allowed to pick 467 actions out and to identify 72 professionals who were involved in quality actions. These last ones have been asked during semi-directive interviews in view to describe those actions, their results and difficulties encountered. The main actions consisted in writing procedures (197), animating working groups (84) or department reunions (54), realising studies (54) or measuring indicators (33). This study shows the professionals' dynamism who spontaneously develop actions to improve the quality of care. It also shows the limits of these actions because of a lack of specific resources and methods.

Communication↗
PubMed1998

Position paper: dentistry and the dental industry summit on managed care.

A taskforce of dental professionals and industry leaders looked at the impact of dental benefit programs on America's oral health. When properly done, such benefits programs are positive; but precautions must be taken to ensure that underfunded programs and those which restrict choice are not allowed to erode dental health. Six possible courses of action are developed, centered around education, communication, and collaboration.

Communication↗
PubMed1998

Ethics summit I: assembling the ethical community.

Ethics Summit I was a unique gathering of organizations representing all of oral health care, convened by the American College of Dentists, for the purpose of seeking a common ethical ground. The background of the conference and its logistics are described here. Four themes were discussed: the role of ethics codes, conflicting values, responding to unethical behavior, and organizations as ethical agents. The conference was grounded in the unusual assumptions that the participants did not have to have a common profile of values to engage in ethical discussion and that individual behavior is not the only level at which ethical discussion must take place. Finally, we did not begin with an assumption that one group could define an ethical code that all others might subscribe to. One strong consensus that emerged was the desirability of creating an alliance of all concerned with oral health care to continue such conversations.

Dentistry↗