How to do it. Raise funds.
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A comprehensive short-term fund-raising campaign, was launched in 1987 by a health charity organization in cooperation with the only Norwegian TV-channel covering the whole country. The campaign which was extensively announced on TV and other media and which involved large proportions of the population, finished up with a six hour TV-show on the fund-raising day. Because a considerable amount of information on prevention of heart disease was presented in connection with the campaign, it is presently evaluated as a nationwide health education campaign. Twenty-two per cent of the population reported changes in one or more habits in connection with the campaign (one third of them took more exercise, while one quarter reduced/quit their smoking). Health behaviour change among family/friends, reported new knowledge of health and worry created by the campaign, were the factors most clearly associated with self-reported behaviour change. The paper discusses the magnitude of the effects of the campaign in relation to the study design, and the importance of social environment and fear arousal on health behaviour.
As hospital-based hospice programs proliferate across the country, most are under the leadership of a nurse administrator. Nurse administrators must be prepared to manage the many components that constitute the broad scope of this role. Cost-effective management is the greatest challenge. The author explores this management role, including a discussion of hospice-program reimbursement, hospital-based program advantages, options to increase staff productivity, management of drugs and durable medical equipment, inpatient admissions, volunteer services, and fund-raising. Cost-effective measures are explored throughout the discussion, along with a history and explanation of the hospice concept of care.
Pediatric training programs are faced with rapid, fundamental changes in hospital practice and an increasingly rigorous regulatory and fiscal environment. Traditional models for providing care and teaching students and house officers may not be sufficiently responsive to these challenges. In 1986, the Department of Medicine at Children's Hospital, Boston, reorganized the general inpatient program and implemented a "service chief" system adapted from British hospital "firms." Three age-based inpatient services (Thomas Morgan Rotch infant/toddler service, Kenneth Daniel Blackfan school-age service, and Charles Alderson Janeway adolescent/young adult service) were created, each headed by an experienced clinician and teacher (service chief). The service chiefs developed age-appropriate curricula, recruited a balanced faculty of generalists and specialists to serve as attending physicians and provide teaching in their areas of expertise, and established strong collaborative relationships with nurse managers on their respective wards. Implementation of the service chief system has been associated with development of faculty esprit de corps, standardized tracking of faculty performance, enhanced supervision and counseling of housestaff, and improved continuity of patient care. Relationships with referring physicians have improved dramatically, as measured by formal satisfaction surveys. Accountability and documentation have been emphasized, and departmental billings have increased sharply. Ongoing quality indicators have been developed, and collaborative patient care, teaching, and quality-improvement projects have been initiated with the nursing staff. Naming the services for distinguished past physicians-in-chief has provided a focus for fund-raising.(ABSTRACT TRUNCATED AT 250 WORDS)
Although tax-based and social insurance-based forms of single-source financing differ in how they raise funds, they share a common set of structural characteristics. In particular, they both enable publicly accountable authorities to control aggregate expenditure levels by creating a countervailing power to pressures for increased expenditures from providers. While major reform initiatives are under way in European single-source financing systems, these initiatives have so far sought to improve the efficiency, effectiveness, and/or responsiveness to patterns of service delivery without reducing their commitment to universal access to necessary care. The article concludes with a review of the advantages and disadvantages that could accompany the introduction of a single-source financing system in the United States.
Although still used in fund raising campaigns, the serious aspects of hanseniasis are less common now, thanks to early diagnosis and treatment. This new image of hanseniasis should be propagated by health education, especially directed to patients and contacts. Integration should refer not only to hanseniasis but also to leprologists, who became also "segregated", due to the pejorative "leprosy". The good relationship with the patient depends on the psychological capacity of the physician, revealed as soon as the diagnosis of the disease is made.
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