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Sample records for care program case

  1. Preparing health care organizations for successful case management programs.

    PubMed

    Bonvissuto, C A; Kastens, J M; Atwell, S R

    1997-01-01

    This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program. PMID:9335724

  2. The development of a palliative care program for managed care patients: a case example.

    PubMed

    Gazelle, G; Buxbaum, R; Daniels, E

    2001-09-01

    Palliative care is emerging as an important new field. Although programs are developing in hospital environments, little is known about development of programs in outpatient practices or those serving large managed care populations. This article provides a framework for the development of a comprehensive palliative care program in a large multispecialty group practice that serves managed care patients. The article addresses guiding principles, the need for obtaining baseline data, how the clinical consultation service was established, development of outcomes measures, and information on current program status. Five themes emerged as key to successful program development, most importantly the close collaboration between administrative and clinical staff in all aspects of program development. PMID:11559386

  3. Health programs struggling with complexity: a case study of the Dutch 'PreCare' project.

    PubMed

    Wehrens, Rik; Bal, Roland

    2012-07-01

    This article aims to understand the effects of rationalized health programs (the basic components of which are efficiency, calculability, predictability and control) on local practices. We discuss how a successful U.S. intervention in preventive youth health care (the Nurse Family Partnership) has been translated and adapted within a Dutch setting. The Dutch version of the program is called 'PreCare'. The empirical analysis highlights the effects of rationalized health programs on local practices, in terms of the amount of work required, how local practices are disciplined, how these programs (re)draw boundaries, the 'travel expenditures' involved (and developed 'coping strategies'), and how local practices (try to) reshape the program. Our empirical analysis builds on a combination of qualitative methods. We conducted 16 semi-structured interviews with 19 people involved in the PreCare program. The majority of the interviews were conducted between July and November 2008. We also conducted an analysis of relevant documents related to the PreCare intervention and protocol. Furthermore, we observed at several meetings, including case conferences and management intervision meetings. The article makes a theoretical and practical contribution to the field. Theoretically, we show how the rationalization process is linked to a broader development of quantification and how both developments are based on a particularly modern ontology and epistemology in which what is considered 'real' and 'knowledgeable' becomes closely tied to what is measurable. The article offers a different conceptualization of rationalized health programs, one that acknowledges the need to standardize some elements, but also recognizes the need to be open and flexible toward local practices. We specifically focus on the tools that are able to deal with both the need to standardize and the need to be open toward local practices. We suggest that '(re)writing devices' are a fruitful category of tools for

  4. The Business Case for Palliative Care: Translating Research Into Program Development in the U.S.

    PubMed

    Cassel, J Brian; Kerr, Kathleen M; Kalman, Noah S; Smith, Thomas J

    2015-12-01

    Specialist palliative care (PC) often embraces a "less is more" philosophy that runs counter to the revenue-centric nature of most health care financing in the U.S. A special business case is needed in which the financial benefits for organizations such as hospitals and payers are aligned with the demonstrable clinical benefits for patients. Based on published studies and our work with PC programs over the past 15 years, we identified 10 principles that together form a business model for specialist PC. These principles are relatively well established for inpatient PC but are only now emerging for community-based PC. Three developments that are key for the latter are the increasing penalties from payers for overutilization of hospital stays, the variety of alternative payment models such as accountable care organizations, which foster a population health management perspective, and payer-provider partnerships that allow for greater access to and funding of community-based PC. PMID:26297853

  5. The Business Case for Palliative Care: Translating Research Into Program Development in the U.S.

    PubMed Central

    Cassel, J. Brian; Kerr, Kathleen M.; Kalman, Noah S.; Smith, Thomas J.

    2015-01-01

    Specialist palliative care (PC) often embraces a “less is more” philosophy that runs counter to the revenue-centric nature of most health care financing in the U.S. A special business case is needed in which the financial benefits for organizations such as hospitals and payers are aligned with the demonstrable clinical benefits for patients. Based on published studies and our work with PC programs over the past 15 years, we identified 10 principles that together form a business model for specialist PC. These principles are relatively well established for inpatient PC but are only now emerging for community-based PC. Three developments that are key for the latter are the increasing penalties from payers for overutilization of hospital stays, the variety of alternative payment models such as accountable care organizations, which foster a population health management perspective, and payer-provider partnerships that allow for greater access to and funding of community-based PC. PMID:26297853

  6. A Study in Child Care (Case Study from Volume II-A): "Tacos and Tulips." Day Care Programs Reprint Series.

    ERIC Educational Resources Information Center

    O'Farrell, Brigid

    The Holland Day Care Center in Michigan serves a diverse community of Anglo children of Dutch ancestry and children of former migrant workers of Chicano, Black, Puerto Rican and Cuban origins who have settled in the area. Located in two churches which are about three blocks apart, the program divides children by ability and age into five…

  7. 24-hour care programs.

    PubMed

    Hergenrader, R

    1996-06-01

    Twenty-four-hour care programs, which combine group health programs with workers' compensation and disability benefits, hold considerable potential for cost savings and greater efficiency. This article explains these programs and uses a care history to show the savings they can achieve. PMID:10157798

  8. Change and inertia in the New York state Medicaid Personal Care Services program: an institutional case study.

    PubMed

    Adelman, Toby; Kitchener, Martin; Ng, Terence; Harrington, Charlene

    2012-01-01

    This study analyzes how competing logics (belief systems) of stakeholders have influenced patterns of change and inertia in the development of the New York Medicaid Personal Care Services (PCS) program. A case-study methodology was used to collect documents, statistics, and interview data from four key stakeholder groups: state and city officials, PCS agencies, a labor union, and consumer advocates covering the period 1999 to 2005. The New York PCS program is one of the oldest, largest, and most stable programs in the United States. Its early unionization of workers resulted in relatively generous wages and benefits and made New York number one nationally in PCS spending per capita. In spite of wide support from stakeholder groups, the overall number of participants has gradually declined since 1999. A consumer-directed model of personal care developed in 1995 challenged the status quo and has grown steadily. Resistance by public officials, agency providers, and union representatives to the consumer-directed model has resulted in a small program that is often targeted toward individuals labeled "difficult to serve." Dominant stakeholders in New York have ensured a stable personal care program that has resisted change and led to program inertia. PMID:22720889

  9. Physician-Directed Heart Failure Transitional Care Program: A Retrospective Case Review

    PubMed Central

    Ota, Ken S.; Beutler, David S.; Gerkin, Richard D.; Weiss, Jessica L.; Loli, Akil I.

    2013-01-01

    Background Despite a variety of national efforts to improve transitions of care for patients at risk for rehospitalization, 30-day rehospitalization rates for patients with heart failure have remained largely unchanged. Methods This is a retrospective review of 73 patients enrolled in our hospital-based, physican-directed Heart Failure Transitional Care Program (HFTCP). This study evaluated the 30- and 90- day readmission rates before and after enrollment in the program. The Transitionalist’s services focused on bedside consultation prior to hospital discharge, follow-up home visits within 72 hours of discharge, frequent follow-up phone calls, disease-specific education, outpatient intravenous diuretic therapy, and around-the-clock telephone access to the Transitionalist. Results The pre-enrollment 30-day readmission rates for acute decompensated heart failure (ADHF) and all-cause readmission was 26.0% and 28.8%, respectively, while the post-enrollment rates for ADHF and all-cause readmission were 4.1% (P < 0.001) and 8.2% (P = 0.002), respectively. The pre-enrollment 90-day all-cause and ADHF readmission rates were 69.8%, and 58.9% respectively, while the post-enrollment rates for all-cause and ADHF were 27.3% (P < 0.001) and 16.4% (P < 0.001) respectively. Conclusions Our physician-implemented HFTCP reduced rehospitalization risk for patients enrolled in the program. This program may serve as a model to assist other hospital systems to reduce readmission rates of patients with HF. PMID:23976905

  10. A Study in Child Care (Case Study from Volume II-A): "Children as 'Kids'." Day Care Programs Reprint Series.

    ERIC Educational Resources Information Center

    O'Farrell, Brigid

    The Georgetown Day Care Center, in Washington, D.C., is dually sponsored by a large hospital and a private non-profit organization and offers day care services to a small number of the children of parents who work at the hospital. The center also functions as a halfway house for children in a diagnostic center which identifies preschool children…

  11. Development and implementation of a geriatric care/case management program in a military community-based family medicine residency.

    PubMed

    Williams, C M; Petrelli, J; Murphy, M

    2000-11-01

    This article discusses how the development of a longitudinal geriatric assessment form facilitated a case management program in identifying high-risk frail elders within a military family practice clinic. A careful review of geriatric assessment tools was performed. From this review, a model geriatric assessment form was developed. A "SWOT" (strengths, weaknesses, opportunities, and threats) analysis of the family medicine department was completed to determine if the environment was ready for case management. Analysis of the SWOT data revealed that the environment was favorable for a population-based approach to case management. Results of this initial study are encouraging. The new longitudinal geriatric assessment form has assisted family practice residents in organizing problems and data while seeing elderly patients. As a direct result, higher-risk frail elders have been identified for closer evaluation and follow-up. Future goals are to measure outcomes-based data and to refine the geriatric assessment process. PMID:11143424

  12. Effect of the Brazilian Conditional Cash Transfer and Primary Health Care Programs on the New Case Detection Rate of Leprosy

    PubMed Central

    Nery, Joilda Silva; Pereira, Susan Martins; Rasella, Davide; Penna, Maria Lúcia Fernandes; Aquino, Rosana; Rodrigues, Laura Cunha; Barreto, Mauricio Lima; Penna, Gerson Oliveira

    2014-01-01

    Background Social determinants can affect the transmission of leprosy and its progression to disease. Not much is known about the effectiveness of welfare and primary health care policies on the reduction of leprosy occurrence. The aim of this study is to evaluate the impact of the Brazilian cash transfer (Bolsa Família Program-BFP) and primary health care (Family Health Program-FHP) programs on new case detection rate of leprosy. Methodology/Principal Findings We conducted the study with a mixed ecological design, a combination of an ecological multiple-group and time-trend design in the period 2004–2011 with the Brazilian municipalities as unit of analysis. The main independent variables were the BFP and FHP coverage at the municipal level and the outcome was new case detection rate of leprosy. Leprosy new cases, BFP and FHP coverage, population and other relevant socio-demographic covariates were obtained from national databases. We used fixed-effects negative binomial models for panel data adjusted for relevant socio-demographic covariates. A total of 1,358 municipalities were included in the analysis. In the studied period, while the municipal coverage of BFP and FHP increased, the new case detection rate of leprosy decreased. Leprosy new case detection rate was significantly reduced in municipalities with consolidated BFP coverage (Risk Ratio 0.79; 95% CI  = 0.74–0.83) and significantly increased in municipalities with FHP coverage in the medium (72–95%) (Risk Ratio 1.05; 95% CI  = 1.02–1.09) and higher coverage tertiles (>95%) (Risk Ratio 1.12; 95% CI  = 1.08–1.17). Conclusions At the same time the Family Health Program had been effective in increasing the new case detection rate of leprosy in Brazil, the Bolsa Família Program was associated with a reduction of the new case detection rate of leprosy that we propose reflects a reduction in leprosy incidence. PMID:25412418

  13. Innovation in Diabetes Care: Improving Consumption of Healthy Food Through a “Chef Coaching” Program: A Case Report

    PubMed Central

    Dill, Diana; Abrahamson, Martin J.; Pojednic, Rachele M.; Phillips, Edward M.

    2014-01-01

    Nutrition therapy as part of lifestyle care is recommended for people with type 2 diabetes. However, most people with diabetes do not follow this guideline. Changing eating habits involves obtaining knowledge and building practical skills such as shopping, meal preparation, and food storage. Just as fitness coaches use their specific knowledge base in fitness to enhance the effectiveness of their coaching, credentialed chefs trained as health coaches might combine their culinary expertise with coaching in order to improve clients' food choices and lifestyles. This report documents the case of a 55-year-old white male physician, single and living alone, who was recently diagnosed with type 2 diabetes and reported chronic stress, sedentary behavior, and unhealthy eating habits. He participated in a chef coaching program of 8 weekly one-on-one 30-minute coaching sessions via Skype delivered by a chef trained as a health coach. During the first five meetings, the patient's goals were primarily culinary; however, with his success in accomplishing these goals, the patient progressed and expanded his goals to include other lifestyle domains, specifically exercise and work-life balance. At the end of the program, the patient had improved both his nutritional and exercise habits, his confidence in further self-care improvement, and his health parameters such as HgA1c (8.8% to 6.7%; normal <6.5%). We conclude that chef coaching has the potential to help people with diabetes improve their practical culinary skills and implement them so that they eat better and, further, has the potential to help them improve their overall self-care. We intend to further develop chef coaching and assess its potential as we learn from its implementation. PMID:25568831

  14. Innovation in diabetes care: improving consumption of healthy food through a "chef coaching" program: a case report.

    PubMed

    Polak, Rani; Dill, Diana; Abrahamson, Martin J; Pojednic, Rachele M; Phillips, Edward M

    2014-11-01

    Nutrition therapy as part of lifestyle care is recommended for people with type 2 diabetes. However, most people with diabetes do not follow this guideline. Changing eating habits involves obtaining knowledge and building practical skills such as shopping, meal preparation, and food storage. Just as fitness coaches use their specific knowledge base in fitness to enhance the effectiveness of their coaching, credentialed chefs trained as health coaches might combine their culinary expertise with coaching in order to improve clients' food choices and lifestyles. This report documents the case of a 55-year-old white male physician, single and living alone, who was recently diagnosed with type 2 diabetes and reported chronic stress, sedentary behavior, and unhealthy eating habits. He participated in a chef coaching program of 8 weekly one-on-one 30-minute coaching sessions via Skype delivered by a chef trained as a health coach. During the first five meetings, the patient's goals were primarily culinary; however, with his success in accomplishing these goals, the patient progressed and expanded his goals to include other lifestyle domains, specifically exercise and work-life balance. At the end of the program, the patient had improved both his nutritional and exercise habits, his confidence in further self-care improvement, and his health parameters such as HgA1c (8.8% to 6.7%; normal <6.5%). We conclude that chef coaching has the potential to help people with diabetes improve their practical culinary skills and implement them so that they eat better and, further, has the potential to help them improve their overall self-care. We intend to further develop chef coaching and assess its potential as we learn from its implementation. PMID:25568831

  15. Illinois: Child Care Collaboration Program

    ERIC Educational Resources Information Center

    Center for Law and Social Policy, Inc. (CLASP), 2012

    2012-01-01

    The Illinois Child Care Collaboration Program promotes collaboration between child care and other early care and education providers, including Early Head Start (EHS), by creating policies to ease blending of funds to extend the day or year of existing services. While no funding is provided through the initiative, participating programs may take…

  16. Implementing a knowledge application program for anxiety and depression in community-based primary mental health care: a multiple case study research protocol

    PubMed Central

    2013-01-01

    Background Anxiety and depressive disorders are increasingly recognized as a health care policy priority. Reducing the treatment gap for common mental disorders requires strengthening the quality of primary mental health care. We developed a knowledge application program designed to improve the organization and delivery of care for anxiety and depression in community-based primary mental health care teams in Quebec, Canada. The principal objectives of the study are: to implement and evaluate this evidence-based knowledge application program; to examine the contextual factors associated with the selection of local quality improvement strategies; to explore barriers and facilitators associated with the implementation of local quality improvement plans; and to study the implementation of local quality monitoring strategies. Methods The research design is a mixed-methods prospective multiple case study. The main analysis unit (cases) is composed of the six multidisciplinary community-based primary mental health care teams, and each of the cases has identified at least one primary care medical clinic interested in collaborating with the implementation project. The training modules of the program are based on the Chronic Care Model, and the implementation strategies were developed according to the Promoting Action on Research Implementation in Health Services conceptual framework. Discussion The implementation of an evidence-based knowledge application program for anxiety and depression in primary care aims to improve the organization and delivery of mental health services. The uptake of evidence to improve the quality of care for common mental disorders in primary care is a complex process that requires careful consideration of the context in which innovations are introduced. The project will provide a close examination of the interplay between evidence, context and facilitation, and contribute to the understanding of factors associated with the process of

  17. The social costs of the International Monetary Fund's adjustment programs for poverty: the case of health care development in Ghana.

    PubMed

    Anyinam, C A

    1989-01-01

    A primary health care (PHC) strategy was adopted in Ghana in 1978, but the civilian government at the time failed to implement the program designed to achieve health for all Ghanaians. In 1982, the revolutionary military government under Rawlings indicated its commitment to the full implementation of the PHC program. In this article, the author seeks to examine the extent to which the Economic Recovery Program initiated by the Rawlings' regime, its policy of decentralization and mobilization of the masses, and its promise to institute some fundamental organizational and structural changes in the health care delivery system, are contributing to the process of achieving "health for all" Ghanaians. PMID:2753581

  18. Day Care Center Enrichment Program.

    ERIC Educational Resources Information Center

    West Virginia State Dept. of Welfare, Charleston.

    This guide to a West Virginia Department of Welfare project for upgrading the quality of day care centers throughout the state presents samples of the forms used in the program, accompanied by a brief description of the program's format, requirements and procedures. The Day Care Center Enrichment Program provides a monetary incentive for…

  19. Understanding Effects of Flexible Spending Accounts on People with Disabilities: The Case of a Consumer-Directed Care Program.

    PubMed

    Lombe, Margaret; Inoue, Megumi; Mahoney, Kevin; Chu, Yoosun; Putnam, Michelle

    2016-01-01

    This study set out to explore the saving behavior, barriers, and facilitators along with effects of participating in a consumer-directed care program among people with disabilities in the state of West Virginia (N = 29). Results suggest that respondents were able to save money through the program to enable them to purchase goods and services they needed to enhance their welfare and quality of life. Generally, items saved for fell into 3 broad categories: household equipment, individual functioning, and home modification. Facilitators and barriers to saving were also indicated and so were the benefits of program participation. Program and policy implications are presented. PMID:26623566

  20. A Study in Child Care (Case Study from Volume II-A): "A Rolls-Royce of Day Care." Day Care Programs Reprint Series.

    ERIC Educational Resources Information Center

    O'Farrell, Brigid

    The Amalgamated Day Care Center is an independent trust established through a collective bargaining agreement between the Amalgamated Clothing Workers of America, AFL-CIO, and the employers of the garment industry. The free center, open from 6:00 a.m. to 6:00 p.m., is located near the Chicago garment industries to minimize transportation problems…

  1. A Study in Child Care (Case Study from Volume II-B): "We Come with the Dust and We Go with the Wind." Day Care Programs Reprint Series.

    ERIC Educational Resources Information Center

    Elbow, Linda

    Approximately 468 children of migrant agricultural workers in the state of Washington are served in the nine Northwest Rural Opportunities (NRO) day care centers described here. A community organization program was also formed by the NRO system. Ninety percent of the families served are Chicano, and all are below the poverty level. These aspects…

  2. Problems Associated with Coordination and Role Definitions in Health Care Teams: A Hospice Program Evaluation and Intervention Case Study.

    ERIC Educational Resources Information Center

    Berteotti, Carol R.; And Others

    Using an evaluation of a hospital-based hospice as a case study, this paper analyzes problematic issues surrounding health care teams (HCTs) in light of findings revealed in the literature concerning HCT structures and processes. The factors of coordination and role definitions in HCTs and their manifestations in a particular hospice HCT in terms…

  3. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Primary care case management services. 440.168... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.168 Primary care case management services. (a) Primary care case management services means case management...

  4. Daily bowel care program

    MedlinePlus

    ... a brain or spinal cord injury. People with multiple sclerosis also have problems with their bowels. Symptoms may ... PA: Elsevier Saunders; 2010:chap 17. Read More Multiple sclerosis Recovering after stroke Patient Instructions Constipation - self-care ...

  5. A Case Exemplar for National Policy Leadership: Expanding Program of All-Inclusive Care for the Elderly (PACE).

    PubMed

    Cortes, Tara A; Sullivan-Marx, Eileen M

    2016-03-01

    In November 2015, President Obama signed the Program of All-Inclusive Care for the Elderly (PACE) Innovation Act, which expands a proven model of care to serve high-cost and high-need populations. Specifically, the law provides the Centers for Medicare & Medicaid Services with the authority to waive Medicaid requirements that could not be waived without additional statutory authority. Those requirements include the age of the beneficiary to be served and nursing home eligibility as a condition for PACE enrollment. The law also allows providers and other entities who are not current PACE providers the opportunity to become PACE providers and serve a predominately dually eligible population that has high needs and high cost through a coordinated, integrated model. The current article describes the impact of nursing on the legislation and policy that has shaped the evolution of the PACE program for more than 40 years. [Journal of Gerontological Nursing, 42(3), 9-14.]. PMID:26934968

  6. A Study in Child Care (Case Study from Volume II-A): "All Kinds of Love--in a Chinese Restaurant." Day Care Programs Reprint Series.

    ERIC Educational Resources Information Center

    Rowe, Mary

    The West 80th Street Day Care Center represents a community effort to meet the needs of the children and parents in the New York ghetto area it serves. The heart of the program and a major reason for its success is the fact that the center is community-controlled, with an unusually high degree of parent involvement. To help improve the lives of…

  7. A Lesson in Carefully Managing Resources: A Case Study from an Evaluation of a Music Education Program

    ERIC Educational Resources Information Center

    Hobson, Kristin A.; Burkhardt, Jason T.

    2012-01-01

    Background: A music education program with a goal of enhancing cognitive development of preschool-aged children enrolled in local preschools is evaluated by The Evaluation Center at Western Michigan University. The budget for the evaluation was small, and therefore presented several challenges to the evaluation team. Purpose: Through a case study…

  8. Acceptability and Feasibility of a Mobile Phone-Based Case Management Intervention to Retain Mothers and Infants from an Option B+ Program in Postpartum HIV Care.

    PubMed

    Schwartz, Sheree R; Clouse, Kate; Yende, Nompumelelo; Van Rie, Annelies; Bassett, Jean; Ratshefola, Mamothe; Pettifor, Audrey

    2015-09-01

    The objective of this study was to assess the acceptability and feasibility of a cell phone based case manager intervention targeting HIV-infected pregnant women on highly-active antiretroviral therapy (HAART). Pregnant women ≥36 weeks gestation attending antenatal care and receiving HAART through the Option B+ program at a primary care clinic in South Africa were enrolled into a prospective pilot intervention to receive text messages and telephone calls from a case manager through 6 weeks postpartum. Acceptability and feasibility of the intervention were assessed along with infant HIV testing rates and 10-week and 12-month postpartum maternal retention in care. Retention outcomes were compared to women of similar eligibility receiving care prior to the intervention. Fifty women were enrolled into the pilot from May to July 2013. Most (70%) were HAART-naive at time of conception and started HAART during antenatal care. During the intervention, the case manager sent 482 text messages and completed 202 telephone calls, for a median of 10 text messages and 4 calls/woman. Ninety-six percent completed the postpartum interview and 47/48 (98%) endorsed the utility of the intervention. Engagement in 10-week postpartum maternal HIV care was >90% in the pre-intervention (n = 50) and intervention (n = 50) periods; by 12-months retention fell to 72% and was the same across periods. More infants received HIV-testing by 10-weeks in the intervention period as compared to pre-intervention (90.0 vs. 63.3%, p < 0.01). Maternal support through a cell phone based case manager approach was highly acceptable among South African HIV infected women on HAART and feasible, warranting further assessment of effectiveness. PMID:25656728

  9. Child Care on Campus: A Review of Creative Programs.

    ERIC Educational Resources Information Center

    Mork, Bonnie-Jean; Arrowsmith, Ronald G.

    1991-01-01

    Discussion of child care for college personnel, fast becoming requisite in every benefits package, presents three composite cases illustrating the range of child care options available, looks at the kinds of flexibility parents need and program options available, and examines federal child care initiatives and program legal liabilities.…

  10. Essential program components for perinatal home care.

    PubMed

    Goodwin, L

    1994-10-01

    Home care will continue to be a rapidly expanding area of health care. This growth will be evident in the perinatal nursing specialty. There are multiple models for delivery of perinatal home services. In each case, consideration needs to be given to licensing and other standards; to operational areas such as staffing, supplies, equipment, and reimbursement; and to quality issues, such as staff development, internal and external customer service, and a continuous quality improvement program. Successful marketing of the services requires recognition that the product is nursing care. PMID:7836991

  11. Evaluation of a Research Mentorship Program in Community Care

    ERIC Educational Resources Information Center

    Ploeg, Jenny; de Witt, Lorna; Hutchison, Brian; Hayward, Lynda; Grayson, Kim

    2008-01-01

    This article describes the results of a qualitative case study evaluating a research mentorship program in community care settings in Ontario, Canada. The purpose of the program was to build evaluation and research capacity among staff of community care agencies through a mentorship program. Data were collected through in-depth, semi-structured…

  12. The Prenatal Care at School Program

    ERIC Educational Resources Information Center

    Griswold, Carol H.; Nasso, Jacqueline T.; Swider, Susan; Ellison, Brenda R.; Griswold, Daniel L.; Brooks, Marilyn

    2013-01-01

    School absenteeism and poor compliance with prenatal appointments are concerns for pregnant teens. The Prenatal Care at School (PAS) program is a new model of prenatal care involving local health care providers and school personnel to reduce the need for students to leave school for prenatal care. The program combines prenatal care and education…

  13. Case Studies in Neurocritical Care.

    PubMed

    Sakusic, Amra; Rabinstein, Alejandro A

    2016-08-01

    The practice of neurocritical care encompasses multiple acute neurologic and neurosurgical diseases and requires detailed knowledge of neurology and critical care. This article presents 5 cases that illustrate just some of the conditions encountered in the daily practice of neurocritical care and exemplify some of the common diagnostic, therapeutic, and prognostic challenges facing the neurointensivist. Life-threatening medical complications after severe acute ischemic stroke, seizures and extreme agitation from autoimmune encephalitis, refractory seizures after subdural hemorrhage, neurologic and systemic complications related to aneurysmal subarachnoid hemorrhage, and status epilepticus after cardiac arrest are discussed in this article. PMID:27445248

  14. Adolescent Child Care Program, 1992-93: OREA Report.

    ERIC Educational Resources Information Center

    Renfro, Sally

    The Program for Pregnant and Parenting Services (PPPF) assists children in the New York City public school system who also happen to be parents. In 1993 the program received a federal child care and development block grant which was used to augment the child development, child care, and case management services provided to their student clientele.…

  15. A Study in Child Care (Case Study from Volume II-B): "...While [They Took] Care of Our Children, Theirs Weren't Being Cared For." Day Care Programs Reprint Series.

    ERIC Educational Resources Information Center

    Rosenthal, Kristine

    The Mecklenburg County Department of Social Services in Charlotte, North Carolina, operates nine child development day care centers and 5 day homes which provide care for 257 Black and Anglo children, 2- to 5-years-old, primarily from low-income homes. The centers are located in churches, schools, and facilities in low income housing projects. The…

  16. The Complex and Dynamic Nature of Quality in Early Care and Educational Programs: A Case for Chaos.

    ERIC Educational Resources Information Center

    Buell, Martha J.; Cassidy, Deborah J.

    2001-01-01

    Describes how chaos theory can be used to understand the nature of quality in early care and education settings. Reviews research on quality and quality initiatives, noting challenges to such quality enhancement initiatives. Details an application of the tenets of chaos theory to early care and educational settings, and includes recommendations…

  17. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Primary care case management services. 440.168 Section 440.168 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.168 Primary care case management services. (a)...

  18. Lessons Learned From Transitioning PEPFAR Track 1.0 Care and Treatment Programs: Case Studies in Financial Management Capacity Building in Zambia and Botswana.

    PubMed

    Kuehn, Chuck; Tidwell, George; Vhugen, Jann; Sharma, Anjali

    2015-01-01

    In 2008, the United States government mandated transition of internationally managed HIV care and treatment programs to local country ownership. Three case studies illustrate the US Health Resources Services Administration's fiscal assessment and technical assistance (TA) processes to strengthen local organizations' capabilities to absorb and manage United States government funding. Review of initial, TA and follow-up reports reveal that the 1 Botswanan and 2 Zambian organizations closed 10 of 17 financial capacity gaps, with Health Resources Services Administration assisting on 2. Zambian organizations requested and absorbed targeted TA on the basis of the consultant's desk review, their finance staff revised fiscal policies and procedures, and accordingly trained other staff. In Botswana, delays in integrating recommendations necessitated on-site TA for knowledge building and role modeling. Organizational maturity may explain differences in responsiveness, ownership, and required TA approaches. Clarifying expectations of capacity building, funding agreement, and nonmonetary donor involvement can help new organizations determine and act on intervening actions. PMID:25514757

  19. A Study in Child Care (Case Study from Volume II-B): "A Sense of Belonging." Day Care Programs Reprint Series.

    ERIC Educational Resources Information Center

    Elbow, Linda

    The Berkeley Children's Centers system of seven day care centers, 3 preschool and 4 school-age, for children of working parents of low income homes (below $6,000/year) is sponsored by the Berkeley Unified School District. The 285 Black, Anglo and Chicano children enrolled are under the supervision of 83 staff members. The centers' association with…

  20. A Rural Primary Care Pediatric Residency Program.

    ERIC Educational Resources Information Center

    Kairys, Steven; Newell, Priscilla

    1985-01-01

    The primary care pediatric residency program at the Dartmouth-Hitchcock Medical Center has developed a training program in rural primary care. Residents experience the many facets of rural practice and are introduced to community-oriented approaches to child health care. (Author/MLW)

  1. Generation: A Corporate-Sponsored Retiree Health Care Program.

    ERIC Educational Resources Information Center

    Scharlach, Andrew E.; And Others

    1992-01-01

    Describes Generation, geriatric clinic program for one company's retirees and dependents. Describes program's multidisciplinary team approach to health and psychosocial assessment, medication review, retiree advisors, health promotion programs, and case management services. Notes that, in addition to traditional medical care, participants receive…

  2. Psychotropic Medication Management in a Residential Group Care Program

    ERIC Educational Resources Information Center

    Spellman, Douglas F.; Griffith, Annette K.; Huefner, Jonathan C.; Wise, Neil, III; McElderry, Ellen; Leslie, Laurel K.

    2010-01-01

    This article presents a psychotropic medication management approach that is used within a residential care program. The approach is used to assess medications at youths' times of entry and to facilitate decision making during care. Data from a typical case study have indicated that by making medication management decisions slowly, systematically,…

  3. Shared Heritage: An Intergenerational Child Care Program.

    ERIC Educational Resources Information Center

    Hawkeye Area Community Action Program, Cedar Rapids, IA.

    This report describes ways in which older persons may become involved in the field of home child care. It is intended to provide (1) detailed information on an intergenerational child care (IGCC) program; (2) general information relating to intergenerational contacts and home child care; and (3) "how-to" information for agencies planning to…

  4. The Educational Day Care Consultation Program.

    ERIC Educational Resources Information Center

    Green, Melinda; Valenstein, Thelma

    A research and training program for family day care mothers at the University of Michigan involves both group meetings and individual home consultations by educational consultants, trained community para-professionals. The program is directed toward low income and working class licensed day care mothers and is conducted by the School of Education.…

  5. Project Challenge: A Therapeutic Child Care Program.

    ERIC Educational Resources Information Center

    Adger, Susan

    Project Challenge is a unit of Project Playpen, Inc., in Pinellas County, Florida, which serves children from birth to age 5 who attend child care programs and display mild to moderate degrees of emotional challenge. This program guide describes the activities, structures, and design of Project Challenge to meet the needs of child care for working…

  6. Who Cares about Caring in Early Childhood Teacher Education Programs?

    ERIC Educational Resources Information Center

    McNamee, Abigail; Mercurio, Mia; Peloso, Jeanne M.

    2007-01-01

    The ability to care for oneself, near and distant others, animals, plants, human-made objects, and even ideas is an antidote for violence in its many forms as experienced in childhood as well as adulthood. This article makes a case for facilitating the development of the ability to care as children develop. The authors emphasize the importance of…

  7. Program Collection Honed with Care.

    ERIC Educational Resources Information Center

    Fisher, Glenn

    1982-01-01

    Reviews four programs (equivalent fractions, sentence patterns, bookself-use of Dewey system, career skills) representative of programs on a disk available from Robbinsdale Area Schools (Minneapolis, MN). Indicates programs (for Pet Commodore-16K) are interesting, well laid out, competently programed, and easy to use. (Author/JN)

  8. Patient Care Assistant. Florida Vocational Program Guide.

    ERIC Educational Resources Information Center

    Florida State Univ., Tallahassee. Center for Instructional Development and Services.

    This program guide identifies primary considerations in the organization, operation, and evaluation of a patient care assistant program. An occupational description and program content are presented. A curriculum framework specifies the exact course title, course number, levels of instruction, major course content, laboratory activities, special…

  9. Integrated Care in College Health: A Case Study

    ERIC Educational Resources Information Center

    Tucker, Cary; Sloan, Sarah K.; Vance, Mary; Brownson, Chris

    2008-01-01

    This case study describes 1 international student's treatment experience with an integrated health program on a college campus. This program uses a multidisciplinary, mind-body approach, which incorporates individual counseling, primary care, psychiatric consultation, a mindfulness-based cognitive therapy class, and a meditation group.

  10. Child Nutrition Programs: Child and Adult Care Food Program. Family Day Care Home Handbook.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Education, Oklahoma City.

    This handbook details requirements for family day care homes in Oklahoma for providing child nutrition through the Child and Adult Care Food Program. The handbook includes contact information for state consultants. The basic responsibilities for sponsors of family day care home child nutrition programs are outlined, and the sponsoring organization…

  11. Selecting, adapting, and sustaining programs in health care systems.

    PubMed

    Zullig, Leah L; Bosworth, Hayden B

    2015-01-01

    Practitioners and researchers often design behavioral programs that are effective for a specific population or problem. Despite their success in a controlled setting, relatively few programs are scaled up and implemented in health care systems. Planning for scale-up is a critical, yet often overlooked, element in the process of program design. Equally as important is understanding how to select a program that has already been developed, and adapt and implement the program to meet specific organizational goals. This adaptation and implementation requires attention to organizational goals, available resources, and program cost. We assert that translational behavioral medicine necessitates expanding successful programs beyond a stand-alone research study. This paper describes key factors to consider when selecting, adapting, and sustaining programs for scale-up in large health care systems and applies the Knowledge to Action (KTA) Framework to a case study, illustrating knowledge creation and an action cycle of implementation and evaluation activities. PMID:25931825

  12. Reviewing case management in community psychiatric care.

    PubMed

    Bush, Tony

    Case management is a process of psychiatric care provision that uses a structured and focused approach to effectively assess individual patient's needs. The aim of this article is to examine the current status of case management in NHS community mental health care in terms of therapeutic impact and relevance. PMID:16209396

  13. MIGRANT DAY CARE PROGRAM, 1961.

    ERIC Educational Resources Information Center

    NAYLOR, NAOMI L.

    WITH THE COOPERATION OF VARIOUS COMMUNITY AGENCIES AND WITH FEDERAL AID FROM THE PUBLIC WELFARE DEPARTMENT, SEVERAL MIGRANT CHILD CARE CENTERS WERE ESTABLISHED BY PENNSYLVANIA STATE UNIVERSITY IN THE CENTRAL PART OF THE STATE OF PENNSYLVANIA. STAFFS WERE COMPOSED OF DIRECTORS AND EXPERIENCED TEACHERS FROM PRESCHOOL AND ELEMENTARY EDUCATION.…

  14. Preventing Sexual Abuse in Day Care Programs: National Program Inspection.

    ERIC Educational Resources Information Center

    Zimlich, Norm; And Others

    In October 1984, a national program inspection on preventing child sexual abuse in day care programs was begun. Program inspections are short-term studies designed to provide qualitative information and quantitative data for use by the Department of Health and Human Services as an additional source of information. Participants in this study, from…

  15. Enhancing Program Quality and Care through Supervision

    ERIC Educational Resources Information Center

    Olsen, Heather; Kowalski, Christopher L.

    2010-01-01

    In this age of accountability, afterschool programs are increasingly held responsible for providing youth with quality care and education. Afterschool programs play a critical role in helping youth develop their intrapersonal and interpersonal skills, often by engaging them in activities in which they interact with their peers. Such activities…

  16. A Standardized Certification Program for Case Managers Serving Frail Elderly Texans. Module III: Implementation, Monitoring, Reassessment & Care Plan Adjustment, Closure, and Evaluation.

    ERIC Educational Resources Information Center

    Lusky, Richard A.; And Others

    This learning module is one of three training modules that were developed for members of the Texas Gerontological Consortium for Continuing Education to use in preparing case managers working in human service professions coordinating community-based programs for frail elderly Texans. Module III deals with the following topics: implementation (case…

  17. A rural primary care pediatric residency program.

    PubMed

    Kairys, S; Newell, P

    1985-10-01

    Rural primary care is often reported in the medical literature as frustrating, lonely, and nonrewarding. Many graduating residents who choose small town practice become quickly disenchanted with the life-style and leave for a more populous territory or subspecialty training. Opportunities to learn how to take advantage of rural settings and establish rewarding community practices are few. The Primary Care Pediatric Residency Program at the Dartmouth-Hitchcock Medical Center has developed a training program in rural primary care. Residents experience over a three-year period the many facets of rural practice and are introduced to community-oriented approaches to child health care. Selected rural pediatric practices within a 45-mile radius of the medical center serve as teaching laboratories in which residents develop the skills necessary to manage children's problems related to school, behavioral disorders, and chronic diseases. PMID:4045973

  18. 76 FR 61103 - Medicare Program; Comprehensive Primary Care Initiative

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ... HUMAN SERVICES Centers for Medicare & Medicaid Services Medicare Program; Comprehensive Primary Care... announces a solicitation for health care payer organizations to participate in the Comprehensive Primary Care initiative (CPC), a multipayer model designed to improve primary care. DATES: Letter of...

  19. HIV/AIDS managed care program.

    PubMed

    Bartlett, J G

    2000-01-01

    Approximately one-half of all patients with HIV infection who are under care have Medicaid as the third party payor. Unlike Medicare, Medicaid is a state-specific program that has huge variations in reimbursement strategies. Multiple studies have shown that care for persons with AIDS is about $20,000/year, but reimbursement through various state Medicaid programs varies about $100/m/m to $2800/m/m despite the fact that expectations for care are identical. Hopkins has a major commitment to persons with HIV infection with a program that now includes 30 faculty members and a support staff of 170. With the introduction of mandatory managed care for Medicaid recipients in July, 1997, we were confronted with the issue of substantial downsizing with abandonment of over half of our patients, or learning the transition to managed care. This has been a steep learning curve involving negotiations with the state Medicaid office, reorganization of our clinic, careful scrutiny of our database regarding resource utilization and cost, education of providers, and longitudinal collection of new information and integration of the rapid changes in the field. In the process of this transition, we learned that there are precious few resources to provide guidance and that there is a perceived need for assistance by HIV providers throughout the country. Consequently, we have now established the "HIV Managed Care Network" with substantial funding from diverse sources to support education, data collection, and public policy review. It is premature to evaluate performance since most of these activities have just begun, but we expect that this Network will serve as a demonstration model for methods to deal with chronic diseases under managed care. PMID:10881336

  20. Financial Management Guide: Child Care Food Program.

    ERIC Educational Resources Information Center

    Kentucky State Dept. of Education, Frankfort.

    Intended for day care providers in Kentucky, this publication contains sample forms and guidelines for filling out the forms required by the Division of School Food Services of the Kentucky Department of Education. Topics covered include allowable expenditures during the month, program income, records, auditing, reimbursement for sponsors of child…

  1. Child Day Care Program Evaluation System.

    ERIC Educational Resources Information Center

    Monroe, Marian

    In this document the Texas Department of Human Resources (DHR) presents criteria which day-care providers can use to evaluate their programs. The criteria can also be used by DHR staff to determine whether or not providers can deliver the services specified in their contracts with DHR. For each criterion, five achievement levels, clarification,…

  2. 5 CFR 792.203 - Child care subsidy programs; eligibility.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Child care subsidy programs; eligibility... of Appropriated Funds for Child Care Costs for Lower Income Employees § 792.203 Child care subsidy programs; eligibility. (a)(1) An Executive agency may establish a child care subsidy program in which...

  3. 5 CFR 792.203 - Child care subsidy programs; eligibility.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Child care subsidy programs; eligibility... of Appropriated Funds for Child Care Costs for Lower Income Employees § 792.203 Child care subsidy programs; eligibility. (a)(1) An Executive agency may establish a child care subsidy program in which...

  4. Antimicrobial Stewardship Programs in Health Care Systems

    PubMed Central

    MacDougall, Conan; Polk, Ron E.

    2005-01-01

    Antimicrobial stewardship programs in hospitals seek to optimize antimicrobial prescribing in order to improve individual patient care as well as reduce hospital costs and slow the spread of antimicrobial resistance. With antimicrobial resistance on the rise worldwide and few new agents in development, antimicrobial stewardship programs are more important than ever in ensuring the continued efficacy of available antimicrobials. The design of antimicrobial management programs should be based on the best current understanding of the relationship between antimicrobial use and resistance. Such programs should be administered by multidisciplinary teams composed of infectious diseases physicians, clinical pharmacists, clinical microbiologists, and infection control practitioners and should be actively supported by hospital administrators. Strategies for changing antimicrobial prescribing behavior include education of prescribers regarding proper antimicrobial usage, creation of an antimicrobial formulary with restricted prescribing of targeted agents, and review of antimicrobial prescribing with feedback to prescribers. Clinical computer systems can aid in the implementation of each of these strategies, especially as expert systems able to provide patient-specific data and suggestions at the point of care. Antibiotic rotation strategies control the prescribing process by scheduled changes of antimicrobial classes used for empirical therapy. When instituting an antimicrobial stewardship program, a hospital should tailor its choice of strategies to its needs and available resources. PMID:16223951

  5. [Clinical case: Complicated grief in primary care. Care plan].

    PubMed

    Ruymán Brito-Brito, Pedro; Rodríguez-Ramos, Mercedes; Pérez-García-Talavera, Carlos

    2009-01-01

    This is the case of a 61-year-old patient woman that visits her nurse in Primary Health Care to get the control of blood pressure and glycemia. In the last two years has suffered the loss of her husband and of two brothers beside having lived through other vital stressful events that have taken her to a situation of complicated grief. The care plan is realized using the M. Gordon assessment system and standardized languages NANDA, NOC and NIC. The principal aims were the improvement of the depression level and the improvement in the affliction resolution. As suggested interventions were proposed to facilitate the grief and the derivation to a mental health unit. A follow-up of the patient was realized in nursing consultation at Primary health care to weekly intervals, in the beginning, and monthly, later. The evaluation of the care plan reflects an improvement in the criteria of Prigerson's complicated grief; an increase of the recreative activities; the retreat of the mourning that still she was guarding; as well as an improvement in the control of the blood pressure numbers. The attention of nurses before a case of complicated grief turns out to be complex. Nevertheless the suitable accomplishment of certain interventions orientated to facilitating the grief, with a follow-up in consultation, shows the efficiency. The difficulty in the boarding of the psychosocial problems meets increased at the moment of are necessary the nursing diagnostics adapted for every individual case. The work in group between nurses could improves the consensus. PMID:19854088

  6. Day Care Related Federal Programs (An Addendum to Day Care Survey 1970).

    ERIC Educational Resources Information Center

    1971

    This document, an addendum to the Day Care Survey 1970, describes day care-related federal programs. Each program, is described briefly in terms of: the nature of the program, day care services provided, authorizing legislation, the administering agency, and miscellaneous information (funding, recipients, etc.). Types of programs included are: (1)…

  7. Day Care: A Program in Search of a Policy.

    ERIC Educational Resources Information Center

    Bikales, Gerda

    This report examines current issues relating to day care and challenges many of the policy assumptions that underlie a major public program of subsidized day care for children. A historical perspective of day care is presented and various types of day care are described. The costs and benefits of day care are examined and the relation of day care…

  8. 75 FR 79323 - Health Care for Homeless Veterans Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-20

    ... AFFAIRS 38 CFR Part 63 RIN 2900-AN73 Health Care for Homeless Veterans Program AGENCY: Department of... contracting with community-based treatment facilities in the Health Care for Homeless Veterans (HCHV) program... ``RIN 2900-AN73, Health Care for Homeless Veterans Program.'' Copies of comments received will...

  9. 76 FR 52575 - Health Care for Homeless Veterans Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... AFFAIRS 38 CFR Part 63 RIN 2900-AN73 Health Care for Homeless Veterans Program AGENCY: Department of... community-based treatment facilities in the Health Care for Homeless Veterans (HCHV) program of the... enrolled in the VA health care system. Through the HCHV program, VA identifies homeless veterans...

  10. Kids get care: integrating preventive dental and medical care using a public health case management model.

    PubMed

    Wysen, Kirsten H; Hennessy, Patricia M; Lieberman, Martin I; Garland, Tracy E; Johnson, Susan M

    2004-05-01

    Kids Get Care is a public health-based program in the Seattle area designed to ensure that low-income children, regardless of insurance status, receive early integrated preventive medical, dental, and developmental health services through attachment to medical and dental homes (the usual sources of medical or dental care). The oral health component of the program focuses on cross-training medical and dental providers, providing partner medical clinics with a case manager, and educating staff in nearby community-based organizations about how to identify incipient dental disease and possible early childhood developmental delays. The program identifies a local, well-respected dentist to champion the delivery of oral health screening within a medical clinic and to provide oral health training to medical clinic staff. The program works with community agencies to educate families on the importance of healthy baby teeth, routine dental care beginning at age one, and general prevention. In its first year, the program trained 355 community staff and 184 primary care providers on how to conduct an oral health assessment. These staff and providers screened more than 5,500 children for oral health problems. One medical clinic more than doubled the number of fluoride varnishes it provided, increasing from 80 to 167 during a nine-month pilot phase. Other outcome studies are in progress. PMID:15186069

  11. Competence of birth attendants at providing emergency obstetric care under India’s JSY conditional cash transfer program for institutional delivery: an assessment using case vignettes in Madhya Pradesh province

    PubMed Central

    2014-01-01

    Background Access to emergency obstetric care by competent staff can reduce maternal mortality. India has launched the Janani Suraksha Yojana (JSY) conditional cash transfer program to promote institutional births. During implementation of the JSY, India witnessed a steep increase in the proportion of institutional deliveries-from 40% in 2004 to 73% in 2012. However, maternal mortality reduction follows a secular trend. Competent management of complications, when women deliver in facilities under the JSY, is essential for reduction in maternal mortality and therefore to a successful program outcome. We investigate, using clinical vignettes, whether birth attendants at institutions under the program are competent at providing appropriate care for obstetric complications. Methods A facility based cross-sectional study was conducted in three districts of Madhya Pradesh (MP) province. Written case vignettes for two obstetric complications, hemorrhage and eclampsia, were administered to 233 birth attendant nurses at 73 JSY facilities. Their competence at (a) initial assessment, (b) diagnosis, and (c) making decisions on appropriate first-line care for these complications was scored. Results The mean emergency obstetric care (EmOC) competence score was 5.4 (median = 5) on a total score of 20, and 75% of participants scored below 35% of the maximum score. The overall score, although poor, was marginally higher in respondents with Skilled Birth Attendant (SBA) training, those with general nursing and midwifery qualifications, those at higher facility levels, and those conducting >30 deliveries a month. In all, 14% of respondents were competent at assessment, 58% were competent at making a correct clinical diagnosis, and 20% were competent at providing first-line care. Conclusions Birth attendants in the JSY facilities have low competence at EmOC provision. Hence, births in the JSY program cannot be considered to have access to competent EmOC. Urgent efforts are

  12. Care of the elderly program at the University of Alberta

    PubMed Central

    Charles, Lesley; Dobbs, Bonnie; Triscott, Jean; McKay, Rhianne

    2014-01-01

    Abstract Problem addressed The population is aging rapidly and there are implications for health care delivery in the face of few physicians specializing in care of the elderly (COE). Objective of program To train physicians wishing to provide COE services. Program description The COE program at the University of Alberta in Edmonton is an enhanced skills diploma program lasting 6 months to 1 year, with core program requirements including geriatric inpatient care, geriatric psychiatry, ambulatory care, continuing care, and outreach. There is a longitudinal clinic component and a research project requirement. The program is designed to cover the 85 core competencies in the CanMEDS– Family Medicine roles. Conclusion There is a need for COE physicians to provide clinical care as well as fill educational, administrative, and research roles to meet the health care needs of medically complex seniors. These physicians require alternative funding and a departmental home within a university if they are to provide an academic service. PMID:25551143

  13. State Day Care Assistance Program. First Annual Report.

    ERIC Educational Resources Information Center

    Alaska State Dept. of Community and Regional Affairs, Juneau.

    This annual report of the recently established Alaska Day Care Assistance Program describes the system of state subsidies instituted to encourage local government participation in the delivery of day care services. Established to aid low-income families in providing for adequate child care, the program is administered by the state Department of…

  14. Defining Group Care Programs: An Index of Reporting Standards

    ERIC Educational Resources Information Center

    Lee, Bethany R.; Barth, Richard P.

    2011-01-01

    Group care programs, while ubiquitous, are not clearly differentiated despite differences in the population served, size, auspices, and program activities, to name a few. Words like group care, residential care and residential treatment are often used interchangeably in policy, research and practice. This paper introduces reporting standards that…

  15. 76 FR 57637 - TRICARE; Continued Health Care Benefit Program Expansion

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-16

    ... of the Secretary 32 CFR Part 199 RIN 0720-AB30 TRICARE; Continued Health Care Benefit Program..., some MHS beneficiaries would not be eligible to purchase Continued Health Care Benefit Program (CHCBP... continued health care coverage for eligible beneficiaries who lose their MHS eligibility. It was...

  16. Comprehensive Child Care Program: Phase 1 - Evaluation Results.

    ERIC Educational Resources Information Center

    Harachi, Tracy; Anthony, Emily; Bleisner, Siri

    Seattle's Comprehensive Child Care Program (CCCP) (Washington) is made up of a child care subsidy to offset child care costs for working and student families with low incomes, and quality assurance and technical assistance for 150 child care providers, including on-site evaluations, public health consulting, continuing education for providers, and…

  17. Effectiveness of a weight loss program in community-cased primary care offices: High-intensity intervention versus low-intensity intervention

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Despite the call for primary care providers (PCPs) to offer obese patients intense behavioral therapy for weight loss, few studies have examined the effectiveness of such interventions in real-world, community-based medical practices. This study evaluated the effectiveness of a physician-guided weig...

  18. Programming, Care, and Troubleshooting of Cochlear Implants for Children.

    ERIC Educational Resources Information Center

    Hedley-Williams, Andrea J.; Sladen, Douglas P.; Tharpe, Anne Marie

    2003-01-01

    This article provides an overview of current cochlear implant technology, programming strategies, troubleshooting, and care techniques. It considers: device components, initial stimulation, speech coding strategies, use and care, troubleshooting, and the classroom environment. (Contains references.) (DB)

  19. Space Station Freedom Environmental Health Care Program

    NASA Technical Reports Server (NTRS)

    Richard, Elizabeth E.; Russo, Dane M.

    1992-01-01

    The paper discusses the environmental planning and monitoring aspects of the Space Station Freedom (SSF) Environmental Health Care Program, which encompasses all phases of the SSF assembly and operation from the first element entry at MB-6 through the Permanent Manned Capability and beyond. Environmental planning involves the definition of acceptability limits and monitoring requirements for the radiation dose barothermal parameters and potential contaminants in the SSF air and water and on internal surfaces. Inflight monitoring will be implemented through the Environmental Health System, which consists of five subsystems: Microbiology, Toxicology, Water Quality, Radiation, and Barothermal Physiology. In addition to the environmental data interpretation and analysis conducted after each mission, the new data will be compared to archived data for statistical and long-term trend analysis and determination of risk exposures. Results of these analyses will be used to modify the acceptability limits and monitoring requirements for the future.

  20. The Pediatric Home Care/Expenditure Classification Model (P/ECM): A Home Care Case-Mix Model for Children Facing Special Health Care Challenges

    PubMed Central

    Phillips, Charles D.

    2015-01-01

    Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large state in the USA. Using classification and regression tree analyses, a case-mix model for long-term pediatric home care was developed. The Pediatric Home Care/Expenditure Classification Model (P/ECM) grouped children and youth in the study sample into 24 groups, explaining 41% of the variance in annual home care expenditures. The P/ECM creates the possibility of a more equitable, and potentially more effective, allocation of home care resources among children and youth facing serious health care challenges. PMID:26740744

  1. Language, Literacy and Numeracy in National Training Packages: Case Studies in Aged Care and Hospitality.

    ERIC Educational Resources Information Center

    Haines, Christine; Brand, Jennie Bickmore

    The implementation and effectiveness of the inclusion of literacy and numeracy in industry training packages was examined in case studies of three programs in Western Australia. Two were certificate programs in cooking and food and beverage as specified in the hospitality training package, and the third was an aged care program based on the…

  2. Oregon Child Care Quality Indicators Program: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    ERIC Educational Resources Information Center

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Oregon's Child Care Quality Indicators Program prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…

  3. Implementation and evaluation of Stanford Health Care direct-care teledermatology program

    PubMed Central

    Pathipati, Akhilesh S; Ko, Justin M

    2016-01-01

    Introduction: Teledermatology has proven to be an effective means of providing dermatologic care. The existing research has primarily evaluated its usefulness in a consultative model. Few academic centers have evaluated a patient-initiated model, and direct-to-consumer services remain the subject of controversy. Stanford Health Care recently launched a direct-care, patient-initiated teledermatology pilot program. This article evaluates the viability and patient satisfaction with this service. Materials and Methods: During the pilot period, patients were able to seek remote dermatologic care using an eVisit tool in their MyHealth account. Patients initiated the consultation, answered questions regarding their complaint, and uploaded a picture if relevant. A Stanford dermatologist reviewed each eVisit and responded with an assessment and plan. The dermatologist noted whether they were able to make a diagnosis and their level of confidence in it. After the study, 10 patients participated in a focus group to provide feedback on the service. Results: In all, 38 patients sought care during the pilot period. A dermatologist was able to make a diagnosis in 36 of 38 (95%) cases, with an average confidence level of 7.9 of 10. The average time to consultation was 0.8 days. Patients indicated high levels of satisfaction with the service although they had suggestions for improvement. Discussion: Patients provided clinically useful images and information in a direct-care teledermatology model. Such services allow dermatology providers to increase access while maintaining high-quality care in an academic medical center. Further research is needed on standalone services that cannot integrate encounters with the patient’s existing medical record. PMID:27493756

  4. Development of a hospital-based care coordination program for children with special health care needs.

    PubMed

    Petitgout, Janine M; Pelzer, Daniel E; McConkey, Stacy A; Hanrahan, Kirsten

    2013-01-01

    A hospital-based Continuity of Care program for children with special health care needs is described. A family-centered team approach provides care coordination and a medical home. The program has grown during the past 10 years to include inpatients and outpatients from multiple services and outreach clinics. Improved outcomes, including decreased length of stay, decreased cost, and high family satisfaction, are demonstrated by participants in the program. Pediatric nurse practitioners play an important role in the medical home, collaborating with primary care providers, hospital-based specialists, community services, and social workers to provide services to children with special health care needs. PMID:22575784

  5. Delivery of HIV care during the 2007 post-election crisis in Kenya: a case study analyzing the response of the Academic Model Providing Access to Healthcare (AMPATH) program

    PubMed Central

    2013-01-01

    Background Widespread violence followed the 2007 presidential elections in Kenya resulting in the deaths of a reported 1,133 people and the displacement of approximately 660,000 others. At the time of the crisis the United States Agency for International Development-Academic Model Providing Access to Healthcare (USAID-AMPATH) Partnership was operating 17 primary HIV clinics in western Kenya and treating 59,437 HIV positive patients (23,437 on antiretroviral therapy (ART)). Methods This case study examines AMPATH’s provision of care and maintenance of patients on ART throughout the period of disruption. This was accomplished by implementing immediate interventions including rapid information dissemination through the media, emergency hotlines and community liaisons; organization of a Crisis Response leadership team; the prompt assembly of multidisciplinary teams to address patient care, including psychological support staff (in clinics and in camps for internally displaced persons (IDP)); and the use of the AMPATH Medical Records System to identify patients on ART who had missed clinic appointments. Results These interventions resulted in the opening of all AMPATH clinics within five days of their scheduled post-holiday opening dates, 23,949 patient visits in January 2008 (23,259 previously scheduled), uninterrupted availability of antiretrovirals at all clinics, treatment of 1,420 HIV patients in IDP camps, distribution of basic provisions, mobilization of outreach services to locate missing AMPATH patients and delivery of psychosocial support to 300 staff members and 632 patients in IDP camps. Conclusion Key lessons learned in maintaining the delivery of HIV care in a crisis situation include the importance of advance planning to develop programs that can function during a crisis, an emphasis on a rapid programmatic response, the ability of clinics to function autonomously, patient knowledge of their disease, the use of community and patient networks, addressing

  6. Basis And Application Of The CARES/LIFE Computer Program

    NASA Technical Reports Server (NTRS)

    Nemeth, Noel N.; Janosik, Lesley A.; Gyekenyesi, John P.; Powers, Lynn M.

    1996-01-01

    Report discusses physical and mathematical basis of Ceramics Analysis and Reliability Evaluation of Structures LIFE prediction (CARES/LIFE) computer program, described in "Program for Evaluation of Reliability of Ceramic Parts" (LEW-16018).

  7. Case vignette: the vicissitudes of managed care.

    PubMed

    Austad, Carol Shaw; Cummings, Nicholas A; Macklin, Ruth; Newman, Russ

    1992-01-01

    Lee Wilson, age 26, was referred to Dr. Jackson for psychotherapy 5 weeks ago by a friend. Lee has been feeling increasingly depressed about longstanding family issues and the recent breakup of a 2-year relationship with a live-in companion. Over the course of the once-per-week sessions, Dr. Jackson notes persistent suicidal ideation, with vague plans to act if, as Lee puts it, "things get any worse." Just before the sixth session, Dr. Jackson is contacted by a reviewer for the managed care health insurance program covering Lee's therapy. The reviewer informs Dr. Jackson that the company will not authorize payment for further psychotherapeutic care. Dr. Jackson knows that Lee is in need of continued treatment and fears that terminating therapy at this time could result in increased suicide risk. Lee's income could cover only a small portion of Dr. Jackson's usual fee. Dr. Jackson does not wish to abandon Lee, but he already provides a significant amount of reduced-fee service to other clients. Is the health insurance carrier's stance ethical? Should Dr. Jackson be expected to treat Lee for the foreseeable future at a greatly reduced fee? How should Dr. Jackson handle this situation? PMID:11651366

  8. 78 FR 29441 - Child Care and Development Fund (CCDF) Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-20

    ... 20, 2013 Part II Department of Health and Human Services 45 CFR Part 98 Child Care and Development... Development Fund (CCDF) Program AGENCY: Office of Child Care (OCC), Administration for Children and Families...: The Administration for Children and Families (ACF) proposes to amend the Child Care and...

  9. Crediting Foods in the Child Care Food Program. [Revised].

    ERIC Educational Resources Information Center

    Food and Nutrition Service (USDA), Robbinsville, NJ. Mid-Atlantic Regional Office.

    This modified version of a previously published title provides additional information on foods for which reimbursement may be obtained from the United States Department of Agriculture (USDA) by child care centers and family day care homes participating in the Child Care Food Program. Such foods, called creditable foods, are those that may be…

  10. 78 FR 36449 - State Long-Term Care Ombudsman Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-18

    ... HUMAN SERVICES Administration on Aging 45 CFR Parts 1321 and 1327 RIN 0985-AA08 State Long-Term Care... request for comments, to implement provisions of the Older Americans Act, the State Long-Term Care... determining State compliance in carrying out the Long-Term Care Ombudsman program functions. This...

  11. Overcoming barriers in care for the dying: Theoretical analysis of an innovative program model.

    PubMed

    Wallace, Cara L

    2016-08-01

    This article explores barriers to end-of-life (EOL) care (including development of a death denying culture, ongoing perceptions about EOL care, poor communication, delayed access, and benefit restrictions) through the theoretical lens of symbolic interactionism (SI), and applies general systems theory (GST) to a promising practice model appropriate for addressing these barriers. The Compassionate Care program is a practice model designed to bridge gaps in care for the dying and is one example of a program offering concurrent care, a recent focus of evaluation though the Affordable Care Act. Concurrent care involves offering curative care alongside palliative or hospice care. Additionally, the program offers comprehensive case management and online resources to enrollees in a national health plan (Spettell et al., 2009).SI and GST are compatible and interrelated theories that provide a relevant picture of barriers to end-of-life care and a practice model that might evoke change among multiple levels of systems. These theories promote insight into current challenges in EOL care, as well as point to areas of needed research and interventions to address them. The article concludes with implications for policy and practice, and discusses the important role of social work in impacting change within EOL care. PMID:27332743

  12. Impact of an education program on perinatal care practices.

    PubMed

    Harlan, W R; Hess, G E; Borer, R C; Hiss, R G

    1980-12-01

    Education of health professionals has an important role in improving health care. A media-based, self-instructional, perinatal education program was developed and field tested in rural and urban regions of Michigan. Cognitive tests, chart audits, and consultation/referral times were used to measure the impact on education and patient care. The program effectively increased knowledge and improved patient care practices by physicians and nurses. This study presents evidence that a targeted educational program in a media-based format can significantly improve perinatal care. PMID:6161337

  13. Child Care Programs: Fiscal Year 1996 Annual Report.

    ERIC Educational Resources Information Center

    Alaska State Dept. of Community and Regional Affairs, Juneau.

    Assistance with paying for the cost of child care often makes the critical difference in whether or not a parent can work to support the family. This annual report provides information on child care assistance programs in Alaska. The 1996 Fiscal Year (FY) funding is presented for four programs providing a portion of low to moderate income parents'…

  14. Taylor Proposes Five-Year Child-Care Program.

    ERIC Educational Resources Information Center

    Taylor, Glen

    Senator Glen Taylor of Minnesota proposed a five-year child-care program for the purposes of encouraging employer-sponsored child care and increasing by 53,000 the number of children in low-income families who were covered. This report lists central features of the program, which include: (1) tax incentives which employers can use when they build…

  15. A University Program to Improve Nursing Care to the Aged

    ERIC Educational Resources Information Center

    Marten, Marie Lucille

    1978-01-01

    Proposes a series of university nursing education programs developed to increase knowledge and skills relevant to nursing care of elderly and chronically ill persons who reside in nursing homes. Briefly describes five programs intended for persons engaged in long-term care or in preparation for such roles. (EM)

  16. Hospital's transition program coordinates care throughout the continuum.

    PubMed

    2015-02-01

    UnityPoint-St. Luke's Hospital's Transitions Home program has slashed all-cause readmissions to an average of 10% by focusing on making sure patients' needs are met while they are in the hospital and after discharge. An Advanced Medical Team of RN care navigators and social workers works in the outpatient clinic and coordinates care for patients with multiple comorbidities who take multiple medications and are being treated by multiple physicians. The Consistent Care program, overseen by a social worker, links patients who use the emergency department for primary care with a primary care physician. Dedicated care coordinators on each unit have cubicles in the nurses' stations and meet daily with the charge nurse, social worker, and bedside nurse caring for the patient to discuss the goals of care and goals for discharge of each patient on the unit. PMID:25632707

  17. School-Age Child Care: Innovative Public School Programs.

    ERIC Educational Resources Information Center

    ERS Spectrum, 1992

    1992-01-01

    Innovative school-age day care programs include Tennessee's Extended School Program; Hawaii's After-School Plus program; San Antonio's Kid's Involvement Network (offering middle school supervision); Aurora, Colorado's state-licensed Year-Round School Recreation Plan; and Pomona, California's Child Development Program. These public school programs…

  18. Case Management Takes Hold in Long-Term Care.

    ERIC Educational Resources Information Center

    Rose, Stephen M.; And Others

    1992-01-01

    Includes "Empowering Case Management Clients" (Rose); "Case Management in Rural Japan" (Maeda, Takahashi); "Coordinated-Care Teams" (Brodsky, Sobol); "Comparing Practice in the United States and the United Kingdom" (Sturges); "Business of Case Management Flourishing in the U.S." (Cress); and "Community Options Bring Change to Long-Term Care in…

  19. Family Child Care Programs within the Military System of Care

    ERIC Educational Resources Information Center

    Stevens, Carolyn S.

    2011-01-01

    Military families face challenges not found in other work environments. Shifting work schedules that are often longer than the typical 8-hour day, as well as the ever-present possibility of being deployed anywhere in the world on a moment's notice, require a child care system that is flexible but maintains high-quality standards. The U.S.…

  20. The Quality of Care under a Managed-Care Program for Dual Eligibles

    ERIC Educational Resources Information Center

    Kane, Robert L.; Homyak, Patricia; Bershadsky, Boris; Lum, Terry; Flood, Shannon; Zhang, Hui

    2005-01-01

    Purpose: Our objective in this study was to compare the quality of care provided under the Minnesota Senior Health Options (MSHO), a special program designed to serve dually eligible older persons, to care provided to controls who received fee-for-service Medicare and Medicaid managed care. Design and Methods: Two control groups were used; one was…

  1. Child Care and Other Support Programs

    ERIC Educational Resources Information Center

    Floyd, Latosha; Phillips, Deborah A.

    2013-01-01

    The U.S. military has come to realize that providing reliable, high-quality child care for service members' children is a key component of combat readiness. As a result, the Department of Defense (DoD) has invested heavily in child care. The DoD now runs what is by far the nation's largest employer-sponsored child-care system, a…

  2. Child care and other support programs.

    PubMed

    Floyd, Latosha; Phillips, Deborah A

    2013-01-01

    The U.S. military has come to realize that providing reliable, high-quality child care for service members' children is a key component of combat readiness. As a result, the Department of Defense (DoD) has invested heavily in child care. The DoD now runs what is by far the nation's largest employer-sponsored child-care system, a sprawling network with nearly 23,000 workers that directly serves or subsidizes care for 200,000 children every day. Child-care options available to civilians typically pale in comparison, and the military's system, embedded in a broader web of family support services, is widely considered to be a model for the nation. The military's child-care success rests on four pillars, write Major Latosha Floyd and Deborah A. Phillips. The first is certification by the military itself, including unannounced inspections to check on safety, sanitation, and general compliance with DoD rules. The second is accreditation by nationally recognized agencies, such as the National Association for the Education of Young Children. The third is a hiring policy that sets educational and other requirements for child-care workers, and the fourth is a pay scale that not only sets wages high enough to discourage the rapid turnover common in civilian child care but also rewards workers for completing additional training. Floyd and Phillips sound a few cautionary notes. For one, demand for military child care continues to outstrip the supply In particular, as National Guard and Reserve members have been activated during the wars in Iraq and Afghanistan, the DoD has sometimes struggled to provide child care for their children. And force reductions and budget cuts are likely to force the military to make difficult choices as it seeks to streamline its child-care services in the years ahead. PMID:25518693

  3. Program management and health care informatics: defining relationships.

    PubMed

    Harber, B W; Miller, S A

    1994-01-01

    The program management (PM) structure is a relatively well-known organizational model for hospitals. A variation of the matrix structure, it allows for an interdisciplinary team of health care providers to facilitate patient care delivery. However, providing such focused care results in a complex, highly information-dependent operational environment. To meet the information needs of such an environment, careful planning in selecting and implementing technology is required. Along with supporting patient care, the technology will also help in managing costs, human resources, quality and utilization, as well as in monitoring performance and outcomes measurement. Focusing specifically on the information technology environment, this article addresses health care informatics (the diverse categories of information and systems) needed to support clinical program managers, executives and others in a PM organization. Examples from both a university-affiliated and a community-based program managed hospital illustrate their approach to PM and information technology. PMID:10140165

  4. 75 FR 67751 - Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-03

    ... HUMAN SERVICES Centers for Medicare & Medicaid Services Medicare Program: Community-Based Care... about the upcoming Community-based Care Transitions Program. The meeting is open to the public, but... will be posted on the CMS Care Transitions Web site at...

  5. The brave new world of health care compliance programs.

    PubMed

    Bartrum, T E; Bryant, L E

    1997-01-01

    The need for corporate compliance programs in health care delivery systems is ever increasing. This article identifies the key items a good program should contain, and addresses issues raised by the existence of a program as well as its implementation. PMID:10173280

  6. Get Well Care: Guidelines for Programs Serving Mildly Ill Children.

    ERIC Educational Resources Information Center

    Montanari, Ellen Orton, Ed.

    Although child care programs for mildly ill children are proliferating around the country, very few states have developed regulations for these types of programs, and no states have developed standards or guidelines. Based upon this concern, a group of medical and early childhood professionals, parents, and directors of programs for mildly ill…

  7. Evaluation of a mentorship program to support chronic kidney disease care

    PubMed Central

    Pang, Jocelyn; Grill, Allan; Bhatt, Monisha; Woodward, Graham L.; Brimble, Scott

    2016-01-01

    Abstract Problem addressed Primary care providers (PCPs) are ideally situated to detect and manage patients with chronic kidney disease (CKD), but they could use more support from nephrologists to accomplish this. Objective of program To improve early detection and management of CKD in primary care, and improve referrals to nephrologists through education and greater partnership between nephrologists and PCPs. Program description Nephrologists provided mentorship to PCPs in Ontario through a collaborative relationship. Nephrologists provided PCPs with educational orientation sessions and need-based advice on patient cases. Conclusion Primary care providers with more than 5 years of experience were more likely to use the program. Primary care providers expressed high satisfaction with the program and reported that it was effective in supporting routine CKD screening efforts, management of early CKD, appropriate referrals, and building a collaborative relationship with nephrologists. PMID:27521409

  8. Case Studies of the Migrant Education Program.

    ERIC Educational Resources Information Center

    Marks, Ellen L.

    Intended for federal policymakers, this study examined four aspects of the Chapter 1 migrant education program: program administration, program services, students served, and program expenditures. Case studies were conducted in California, Florida, Illinois, Massachusetts, Oregon, and Texas between November 1986 and March 1987. State agencies and…

  9. Externalization of the Health Care System's Educational Programs.

    ERIC Educational Resources Information Center

    Seisser, Mary A.; Epstein, Alice L.

    1999-01-01

    Health care organizations with successful internal education programs can expand their offerings through a formal externalization process. The process involves needs assessment, environmental scanning, identification of internal successes, and selection of appropriate topics. (SK)

  10. 45 CFR 1306.35 - Family child care program option.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... cognitive, socio-emotional, and physical development, including both gross and fine motor. Family child care... 45 Public Welfare 4 2011-10-01 2011-10-01 false Family child care program option. 1306.35 Section 1306.35 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN...

  11. 45 CFR 1306.35 - Family child care program option.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... cognitive, socio-emotional, and physical development, including both gross and fine motor. Family child care... 45 Public Welfare 4 2013-10-01 2013-10-01 false Family child care program option. 1306.35 Section 1306.35 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN...

  12. 45 CFR 1306.35 - Family child care program option.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... cognitive, socio-emotional, and physical development, including both gross and fine motor. Family child care... 45 Public Welfare 4 2012-10-01 2012-10-01 false Family child care program option. 1306.35 Section 1306.35 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN...

  13. 45 CFR 1306.35 - Family child care program option.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... cognitive, socio-emotional, and physical development, including both gross and fine motor. Family child care... 45 Public Welfare 4 2014-10-01 2014-10-01 false Family child care program option. 1306.35 Section 1306.35 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN...

  14. 45 CFR 1306.35 - Family child care program option.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... cognitive, socio-emotional, and physical development, including both gross and fine motor. Family child care... 45 Public Welfare 4 2010-10-01 2010-10-01 false Family child care program option. 1306.35 Section 1306.35 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN...

  15. PENNSYLVANIA MIGRANT DAY CARE PROGRAM AND PARTICIPATING AGENCIES.

    ERIC Educational Resources Information Center

    NAYLOR, NAOMI L.

    A DESCRIPTION OF A MIGRANT DAY CARE PROGRAM WAS GIVEN. A TOTAL OF 180 PRESCHOOL AND SCHOOL AGE CHILDREN WERE ENROLLED IN SIX DAY CARE CENTERS. SOME FINANCIAL AID, EQUIPMENT, MATERIALS, AND ADVISORY HELP WERE GIVEN TO TWO OTHER CENTERS ENROLLING 40 MORE CHILDREN. FUNDS FOR THE OPERATION OF THE CENTERS WERE FEDERAL FUNDS, ALLOCATED TO PROVIDE…

  16. Evaluating a Hygiene Education Program for Child Care Workers.

    ERIC Educational Resources Information Center

    Petri, Cynthia J.; Winnail, Scott D.; Geiger, Brian F.; Artz, Lynn M.; Mason, J. W.

    Children, parents, and child caregivers are vulnerable to several infectious diseases as a result of contact with child care centers. This pilot program, implemented in a rural county in a southeastern state, was designed to enhance knowledge and skills related to improved hygiene practices in a child care setting. The target audience for the…

  17. Collaboration and Subsidized Early Care and Education Programs in Illinois

    ERIC Educational Resources Information Center

    Spielberger, Julie; Zanoni, Wladimir; Barisik, Elizabeth

    2013-01-01

    As a result of policy changes following welfare reform in 1996 and the costs associated with providing high-quality early care and education for children of low-income working families, agency collaboration in the state of Illinois has become an increasingly salient feature of subsidized early care and education programs (SECE). The authors…

  18. Day Care Programs: A Part of the Educational Continuum.

    ERIC Educational Resources Information Center

    Blackwell, Jacqueline; Leeper, Sarah H.

    In order to determine the effect of day care center sponsorship on children's development, the authors examined the ways in which programs, objects and materials, and teacher/child interactions affected the preoperational behavior of 4-year-old black children in publicly and privately supported day care centers. A total of 120 4-year-olds (30 from…

  19. Development of an interactive computer program for advance care planning

    PubMed Central

    Green, Michael J.; Levi, Benjamin H.

    2013-01-01

    Objective To describe the development of an innovative, multimedia decision aid for advance care planning. Background Advance care planning is an important way for people to articulate their wishes for medical care when they are not able to speak for themselves. Living wills and other types of advance directives are the most commonly used tools for advance care planning, but have been criticized for being vague, difficult to interpret, and inconsistent with individuals’ core beliefs and values. Results We developed a multimedia, computer-based decision aid for advance care planning (‘Making Your Wishes Known: Planning Your Medical Future’) to overcome many of the limitations of standard advance directive forms. This computer program guides individuals through the process of advance care planning, and unlike standard advance directives, provides tailored education, values clarification exercises, and a decision-making tool that translates an individual’s values and preferences into a specific medical plan that can be implemented by a health-care team. Pilot testing with 50 adult volunteers recruited from an outpatient primary care clinic showed high levels of satisfaction with the program. Further pilot testing with 34 cancer patients indicated that the program was perceived to be highly accurate at representing patients’ wishes. Conclusions This paper describes the development of an innovative decision aid for advance care planning that was designed to overcome common problems with standard advance directives. Preliminary testing suggests that it is acceptable to users and is accurate. PMID:18823445

  20. The Charged Aerosol Release Experiment (CARE) Program

    NASA Astrophysics Data System (ADS)

    Bernhardt, Paul; Scales, Wayne; Sternovsky, Zoltan; Kelley, Michael; Hysell, David; Holzworth, Robert

    A new experiment called the Charged Aerosol Release Experiment (CARE) employs the release of dust in the upper atmosphere to form a dusty plasma in space. Two solid rocket motors strapped side-by-side in opposition will provide a pin-wheel high speed dust dispenser for the CARE experiment. A spherical dust cloud will form as a radial expansion around the CARE dust release module. The release will occur between 200 and 250 km altitude in the F-region where the 10 to 1000 nm diameter particles will become charged by electron attachment. As the charged dust particle stream through the ionosphere, plasma irregularities will be produced by streaming and fluid plasma instabilities. The plasma turbulence will driven by large electric fields at the surface of the cloud resulting from the separation of unmagnetized negatively charge dust from the background positive ions which are tied to magnetic field lines. In addition, two stream instabilities from the charge particles moving through the plasma will cause plasma wave structures. The effects of the CARE dust release will be diagnosed with in situ electric field booms, dust detectors, and Langmuir probes. Remote sensing of the CARE release will involve ground backscatter radars in the HF, VHF, and UHF frequency ranges. At late times, the dust cloud will settle into the mesosphere where an artificial mesospheric cloud will be formed. Satellite imagery using the AIM satellite will measure the long-term dispersal of the artificial dust cloud. The results of the CARE experiment will be compared with radar, optical and rocket measurements of natural polar mesospheric clouds.

  1. Mathematical Caring Relations: A Challenging Case

    ERIC Educational Resources Information Center

    Hackenberg, Amy

    2010-01-01

    Developed from Noddings's (2002) care theory, von Glasersfeld's (1995) constructivism, and Ryan and Frederick's (1997) notion of subjective vitality, a mathematical caring relation (MCR) is a quality of interaction between a student and a mathematics teacher that conjoins affective and cognitive realms in the process of aiming for mathematical…

  2. Caring for Children: Case Studies of Local Government Child Care Initiatives.

    ERIC Educational Resources Information Center

    Marx, Fern

    This book of case studies highlights 26 municipalities involved in activities related to child care. Cities selected were of different sizes; were located in different parts of the country; and used diverse approaches for developing ways to improve access to affordable, high-quality child care. Each case study was developed through a telephone…

  3. Regional palliative care program in Extremadura: an effective public health care model in a sparsely populated region.

    PubMed

    Herrera, Emilio; Rocafort, Javier; De Lima, Liliana; Bruera, Eduardo; García-Peña, Francisco; Fernández-Vara, Guillermo

    2007-05-01

    The Regional Palliative Care Program in Extremadura (RPCPEx) was created and fully integrated into the Public Health Care System in 2002. The local health care authorities of Extremadura (a large sparsely populated region in the west of Spain with 1,083,897 inhabitants) decided to guarantee palliative care as a basic right, offering maximum coverage, availability, and equity, functioning at all levels of assistance and based on the complexity of the case. The program provides full coverage of the region through a network of eight Palliative Care Teams under the direction of a regional coordinator. The mobile teams work in acute hospitals and in the community. This paper describes the program, using qualitative and quantitative indicators of structure, process, and outcome. Qualitative indicators assess, among others, the performance of the regional network, including the outcomes of the quality, training, registry, treatment, and research groups. Quantitative indicators applied consisted of the number of professionals (1/26,436 inhabitants), number of patients (1,635/million inhabitants/year), number of activities/million inhabitants/year (6,183 hospital and 3,869 home visits; 1,863 consultations; 14,748 advising services; 11,539 coordination meetings; and 483 educational meetings), cost of care (2,242,000 Euros per year), and opioid consumption (494,654 daily defined doses/year). Four years after the planning process and three years after becoming operational, the RPCPEx offers an effective and efficient model integrated into the public health care system and is able to offer comprehensive coverage, availability, equity and networking among all the structures and levels of the program. Several structural and organizational tools were developed, which may be adopted by other programs within the scope of public health. The provision of palliative care should not be conditioned by the patient's geographical location, his or her condition or disease or on the ability

  4. Day Care Legal Handbook: Legal Aspects of Organizing and Operating Day Care Programs.

    ERIC Educational Resources Information Center

    Aikman, William F.

    This guide for providers of day care services presents information on business regulations and other legal considerations affecting for-profit and not-for-profit day care programs. Three basic topics covered are: (1) choosing the type of organization (sole proprietorship, partnership or corporation), (2) forming the organization, and (3) operating…

  5. A Measure of the Child Care Ecology: Day Care Program Compliance with State Regulations.

    ERIC Educational Resources Information Center

    Fiene, Richard

    Between July 1978 and June 1980 a program evaluation was undertaken in Pennsylvania in order to measure compliance with state day care licensing regulations. The evaluation involved approximately 1000 licensed/approved child care centers and 50,000 children. Statistical data indicate that by the period April to June 1980 the statewide compliance…

  6. The Design of Health Care Management Program for Chinese Health Care Professionals

    ERIC Educational Resources Information Center

    Qiu, Xiao Ling

    2008-01-01

    Business education has been booming in China due to the increasing demand of business graduates since China's economic reform. Chinese health care professionals are eager for business education to improve their competencies. The purpose of the study was to investigate the determinants of a successful health care management program for Chinese…

  7. Anaphylaxis cases presenting to primary care paramedics in Quebec.

    PubMed

    Kimchi, Nofar; Clarke, Ann; Moisan, Jocelyn; Lachaine, Colette; La Vieille, Sebastien; Asai, Yuka; Joseph, Lawrence; Mill, Chris; Ben-Shoshan, Moshe

    2015-12-01

    Data on anaphylaxis cases in pre-hospital settings is limited. As part of the Cross Canada Anaphylaxis Registry (C-CARE), we assessed anaphylaxis cases managed by paramedics in Outaouais, Quebec. A software program was developed to prospectively record demographic and clinical characteristics as well as management of cases meeting the definition of the anaphylaxis. Univariate and multivariate logistic regressions were compared to assess factors associated with severity of reactions and epinephrine use. Among 33,788 ambulance calls of which 23,486 required transport, 104 anaphylaxis cases were identified (anaphylaxis rate of 0.31% [95%CI, 0.25%, 0.37%] among all ambulance calls and 0.44% [95%CI, 0.36%, 0.54%] among those requiring transport). The median age was 46.8 years and 41.3% were males. The common triggers included food (32.7% [95%CI, 24.0%, 42.7%]), drugs (24.0% [16.4%, 33.6%]), and venom (17.3% [10.8%, 26.2%]). Among all reactions, 37.5% (95%CI, 28.4%, 47.6%) were severe. Epinephrine was not administered in 35.6% (95%CI, 26.6%, 45.6%) of all cases. Males were more likely to have severe reactions (Odds ratio [OR]: 2.50 [95%CI, 1.03, 6.01]). Venom-induced reactions and severe anaphylaxis were more likely to be managed with epinephrine (OR: 6.9 [95%CI, 1.3, 35.3] and 4.2 [95%CI, 1.5, 12.0], respectively). This is the first prospective study evaluating anaphylaxis managed by paramedics. Anaphylaxis accounts for a substantial proportion of the cases managed by paramedics in Outaouais, Quebec and exceeds prior reports of the proportion of Quebec emergency room visits attributed to anaphylaxis. Although guidelines recommend prompt use of epinephrine for all cases of anaphylaxis, more than a third of cases did not receive epinephrine. It is crucial to develop educational programs targeting paramedics to promote the use of epinephrine in all cases of anaphylaxis regardless of the specific trigger. PMID:26734462

  8. Dogs in the Hall: A Case Study of Affective Skill Development in an Urban Veterinary Program

    ERIC Educational Resources Information Center

    Martin, Michael; Tummons, John; Ball, Anna; Bird, William

    2014-01-01

    The purpose of this bounded single case study was to explore how an urban high school veterinary program impacted students' affective skill development. The program was unique because students were required to participate in internships with local animal care businesses and care for animals within the school veterinary laboratory. The…

  9. [A general practitioners' program for primary care in Chile].

    PubMed

    Bass del Campo, Germán Camilo

    2015-01-01

    The public health system in Chile does not have a comprehensive development policy for physician resources in primary care, so there is currently a significant deficit of hours for medical care. The article contains a proposal for a "General Program for Primary Care Physicians", which aims to reduce the gap of general practitioners and specialists in primary care. The program proposes to integrate newly graduated physicians to work in the public medical offices with the subsequent possibility of applying for a scholarship specialty, and consecutively a return period as a specialist in the public health network. The immediate implementation of this program is perfectly feasible given the current availability of doctors, over 1400 medical graduates from universities. PMID:25826371

  10. Few Hospital Palliative Care Programs Meet National Staffing Recommendations.

    PubMed

    Spetz, Joanne; Dudley, Nancy; Trupin, Laura; Rogers, Maggie; Meier, Diane E; Dumanovsky, Tamara

    2016-09-01

    The predominant model for palliative care delivery, outside of hospice care, is the hospital-based consultative team. Although a majority of US hospitals offer palliative care services, there has been little research on the staffing of their program teams and whether those teams meet national guidelines, such as the Joint Commission's standard of including at least one physician, an advanced practice or other registered nurse, a social worker, and a chaplain. Data from the 2012-13 annual surveys of the National Palliative Care Registry indicate that only 25 percent of participating programs met that standard based on funded positions, and even when unfunded positions were included, only 39 percent of programs met the standard. Larger palliative care programs were more likely than smaller ones to include a funded physician position, while smaller programs were more reliant upon advanced practice and registered nurses. To meet current and future palliative care needs, expanded and enhanced education, as well as supportive financing mechanisms for consultations, are needed. PMID:27605652

  11. Orthopaedic Trauma Care Specialist Program for Developing Countries.

    PubMed

    Slobogean, Gerard; Sprague, Sheila; Furey, Andrew; Pollak, Andrew

    2015-10-01

    The dire challenges faced in Haiti, both preearthquake and postearthquake, highlight the need for developing surgical infrastructure to care for traumatic musculoskeletal injuries. The proposed Orthopaedic Trauma Care Specialist (OTCS) residency program aims to close the critical human resource gap that limits the appropriate care of musculoskeletal trauma in Haiti. The OTCS program is a proposal for a 2-year residency program that will focus primarily on the management of orthopaedic trauma. The proposed program will be a comprehensive approach for implementing affordable and sustainable strategies to improve orthopaedic trauma care. Its curriculum will be tailored to the injuries seen in Haiti, and the treatments that can be delivered within their health care system. Its long-term sustainability will be based on a "train-the-trainers" approach for developing local faculty to continue the program. This proposal outlines the OTCS framework specifically for Haiti; however, this concept is likely applicable to other low- and middle-income environments in a similar need for improved trauma and fracture care. PMID:26356211

  12. Self-Employment Training Programs: Case Studies.

    ERIC Educational Resources Information Center

    Lamb, Melissa, Ed.; And Others

    This self-employment training program case study booklet has been developed for general use in exploring the feasibility of this kind of development tool. The case studies describe a number of comprehensive, self-employment training and assistance programs, from the local to the national level. Chapter II includes information on the training plan,…

  13. Developing Healthy Adolescents--A Progressive Health Care Partnership Program.

    ERIC Educational Resources Information Center

    Griesemer, Bernard A.; Hough, David L.

    1993-01-01

    A 1991 partnership coupling Southwest Missouri State University with Saint John's Regional Health Center spawned the Midwest Sports Medicine Center, originally designed to treat orthopedic injuries. Soon the center developed major educational initiatives, including SportsPACE, a program integrating health care programs into the secondary core…

  14. A Predoctoral Program in Dental Care for the Developmentally Disabled.

    ERIC Educational Resources Information Center

    Ferguson, Fred S.; And Others

    1990-01-01

    In 1980, the State University of New York at Stony Brook began a program, integrated into the program of children's dentistry, to train students in care for the developmentally disabled. Management of developmentally disabled patients is provided over three years, and represents an extension of pediatric behavior management. (MSE)

  15. Nurturing the Future: Implementing Internships in Child Care Programs

    ERIC Educational Resources Information Center

    Peterangelo, Lisa

    2005-01-01

    One way that child care programs can help prepare future professionals in the field is to offer opportunities for the student to gain real life experience in a program. This is where internships are indispensable. An internship will help a novice develop their skills under the watchful eye of a more seasoned mentor. With internships, not only is…

  16. The Family Characteristics of Youth Entering a Residential Care Program

    ERIC Educational Resources Information Center

    Griffith, Annette K.; Ingram, Stephanie D.; Barth, Richard P.; Trout, Alexandra L.; Hurley, Kristin Duppong; Thompson, Ronald W.; Epstein, Michael H.

    2009-01-01

    Although much is known about the mental health and behavioral functioning of youth who enter residential care programs, very little research has focused on examining the family characteristics of this population. Knowledge about family characteristics is important, however, as it can aid in tailoring programs to meet the needs of families who are…

  17. A Care Coordination Program for Substance-Exposed Newborns

    ERIC Educational Resources Information Center

    Twomey, Jean E.; Caldwell, Donna; Soave, Rosemary; Fontaine, Lynne Andreozzi; Lester, Barry M.

    2011-01-01

    The Vulnerable Infants Program of Rhode Island (VIP-RI) was established as a care coordination program to promote permanency for substance-exposed newborns in the child welfare system. Goals of VIP-RI were to optimize parents' opportunities for reunification and increase the efficacy of social service systems involved with families affected by…

  18. Implementation of adolescent family-based substance use prevention programs in health care settings: Comparisons across conditions and programs.

    PubMed

    Aalborg, Annette E; Miller, Brenda A; Husson, Gail; Byrnes, Hilary F; Bauman, Karl E; Spoth, Richard L

    2012-01-01

    BACKGROUND: The majority of knowledge related to implementation of family-based substance use prevention programs is based on programs delivered in school and community settings. The aim of this study is to examine procedures related to implementation effectiveness and quality of two family-based universal substance use prevention programs delivered in health care settings, the Strengthening Families Program: For Parents and Youth 10-14 (SFP) and Family Matters (FM). These evidence-based programs were delivered as part of a larger random control intervention study designed to assess the influence of program choice vs. assignment on study participation and adolescent substance use outcomes. We also assess the effects of program choice (vs. assignment to program) on program delivery. METHODS: A mixed method case study was conducted to assess procedures used to maximize implementation quality and fidelity of family-based prevention programs delivered in health care settings. Families with an 11 year old child were randomly selected for study participation from health plan membership databases of 4 large urban medical centers in the San Francisco Bay Area. Eligible families were initially randomized to a Choice study condition (families choose SFP or FM) or Assigned study condition (assigned to FM, SFP or control group); 494 ethnically diverse families were selected for participation in study programs. RESULTS: Successful implementation of family prevention programs in health care settings required knowledge of the health care environment and familiarity with established procedures for developing ongoing support and collaboration. Ongoing training of program deliverers utilizing data from fidelity assessment appeared to contribute to improved program fidelity over the course of the study. Families who chose FM completed the program in a shorter period (p<.0001) and spent more time implementing program activities (p=0.02) compared to families assigned to FM. SFP "choice

  19. Implementation of adolescent family-based substance use prevention programs in health care settings: Comparisons across conditions and programs

    PubMed Central

    Aalborg, Annette E.; Miller, Brenda A.; Husson, Gail; Byrnes, Hilary F.; Bauman, Karl E.; Spoth, Richard L.

    2011-01-01

    Background The majority of knowledge related to implementation of family-based substance use prevention programs is based on programs delivered in school and community settings. The aim of this study is to examine procedures related to implementation effectiveness and quality of two family-based universal substance use prevention programs delivered in health care settings, the Strengthening Families Program: For Parents and Youth 10–14 (SFP) and Family Matters (FM). These evidence-based programs were delivered as part of a larger random control intervention study designed to assess the influence of program choice vs. assignment on study participation and adolescent substance use outcomes. We also assess the effects of program choice (vs. assignment to program) on program delivery. Methods A mixed method case study was conducted to assess procedures used to maximize implementation quality and fidelity of family-based prevention programs delivered in health care settings. Families with an 11 year old child were randomly selected for study participation from health plan membership databases of 4 large urban medical centers in the San Francisco Bay Area. Eligible families were initially randomized to a Choice study condition (families choose SFP or FM) or Assigned study condition (assigned to FM, SFP or control group); 494 ethnically diverse families were selected for participation in study programs. Results Successful implementation of family prevention programs in health care settings required knowledge of the health care environment and familiarity with established procedures for developing ongoing support and collaboration. Ongoing training of program deliverers utilizing data from fidelity assessment appeared to contribute to improved program fidelity over the course of the study. Families who chose FM completed the program in a shorter period (p<.0001) and spent more time implementing program activities (p=0.02) compared to families assigned to FM. SFP

  20. Teaching Interdisciplinary Geriatrics Ambulatory Care: A Case Study

    ERIC Educational Resources Information Center

    Williams, Brent C.; Remington, Tami L.; Foulk, Mariko A.; Whall, Ann L.

    2006-01-01

    Interdisciplinary health care training is advocated by numerous government and philanthropic organizations. Educators in the health professions are increasingly offering training in interdisciplinary health care in a variety of contexts, including ambulatory settings. This paper describes a three-year program to teach skills in interdisciplinary…

  1. An interactive case study assessment. Nursing care of the cancer patient with compromised immunity: practicum cases.

    PubMed

    O'Neill, P N; Adsit, K I; Volker, D

    1991-01-01

    This demonstration will present an interactive videodisc (IVD) case study assessment of nursing care of the immunocompromised cancer patient. This module is the third part of a series of instructional IVD programs entitled Nursing Care of the Cancer Patient with Compromised Immunity. The series has been developed to provide education for fourth year nursing students, experienced nurses new to the field of oncology nursing, and for continuing education. The series has been developed to run on an InfoWindow platform and can also run on an M-Motion system. The demonstration will cover the rationale, treatment, content, and instructional strategies used in the module. The technology including the development platform and authoring environment will also be presented. PMID:1807768

  2. Zero discharge programs require careful planning

    SciTech Connect

    Buecker, B.

    1997-05-01

    Environmental regulations, increasing scarcity of fresh water supplies and rising costs of clean water production have contributed to greater water conservation throughout the country. Reduced or zero discharge programs have become much more commonplace at electric utilities, chemical process industries and manufacturing facilities. Water conservation can be a very complicated issue, with methods varying considerably from site to site. The issues that influence water reduction programs include: quality, quantity and cost of fresh water available to the plant; quality of water needed for various plant processes; ability to recycle wastewater streams to other plant processes; techniques for water treatment; capital, operations, maintenance and labor costs, and floor space and construction requirements for water treatment equipment, pilot testing of proposed treatment methods and environmental restrictions on the quantity and quality of any wastewater that may be discharged. This article describes several water discharge programs available to address the complex needs of each unique plant site.

  3. 75 FR 41793 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-19

    ..., 2009, at 74 FR 34295. Child and Adult Care Food Program (CACFP) Lunch and Centers Breakfast supper \\1... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2010 Through June 30, 2011 AGENCY: Food and Nutrition...

  4. 76 FR 43254 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-20

    ..., 2010, at 75 FR 41793. Child and Adult Care Food Program (CACFP) [Per meal rates in whole or fractions... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2011 Through June 30, 2012 AGENCY: Food and Nutrition...

  5. The Care-Integrated Concentration Meditation Program for Patients With Weaning Difficulty: A Pilot Study.

    PubMed

    Thinhuatoey, Benjamard; Songwathana, Praneed; Petpichetchian, Wongchan

    2016-01-01

    Because of the multifaceted process of weaning patients with prolonged mechanical ventilation, enhancing weaning success remains a challenge. The Care-Integrated Concentration Meditation Program was developed on the basis of Buddhist philosophy and implemented to determine its procedural feasibility. A qualitative case study with 3 participants was conducted, and the process and initial outcomes were evaluated. PMID:27309409

  6. Better care and better teaching. New model of postpartum care for early discharge programs.

    PubMed Central

    Yaffe, M. J.; Russillo, B.; Hyland, C.; Kovacs, L.; McAlister, E.

    2001-01-01

    PROBLEM BEING ADDRESSED: Rapid postpartum discharge has reduced opportunities to detect early newborn or parenting problems and to teach neonatal assessment and maternal postpartum care to medical trainees. OBJECTIVE OF PROGRAM: Development of a program to not only ensure adequate care of mothers and newborns after early hospital discharge, but also to teach outpatient assessment skills to family medicine residents. MAIN COMPONENTS OF PROGRAM: In an urban, secondary care, university-affiliated teaching hospital predominantly training family medicine residents, an interdisciplinary committee created and supervised a neonatal and maternal postpartum assessment program. Newborn infants and their mothers are seen by a family physician, a family medicine resident, and a nurse within 48 hours of discharge, after which care is assumed in the community by the child's primary care physician. An assessment protocol developed by the interdisciplinary group promotes standardized mother and child care and a structured learning experience for trainees. CONCLUSION: Rapid follow up of early discharged infants and their mothers can be facilitated by a program of standardized assessment by a roster of pooled, interacting family physicians and nurses. When this assessment occurs in a teaching milieu, a comprehensive learning experience can be combined with defined objectives that emphasize and encourage newborn and maternal assessment for ambulatory patients. PMID:11723597

  7. The evolution of an innovation: variations in medicaid managed care program extensiveness.

    PubMed

    Kim, Ae-Sook; Jennings, Edward

    2012-10-01

    This article utilizes a theoretical framework of policy innovation, diffusion, and reinvention to investigate the evolving nature of Medicaid managed care programs over time. By estimating two separate models, one for primary care case management (PCCM) and a second for risk-based program enrollment, this study seeks to disentangle two different paths of learning (internal and external), investigate the potential effects of vertical diffusion of policy, and examine the impact of internal state characteristics on the extent of Medicaid managed care. With respect to diffusion and learning, the data reveal that earlier adopters implement more extensive programs. The data fail to reveal much internal learning, although there is evidence of some. External impacts are clear: managed care enrollments in neighboring states and changes in the federal waiver process affect states' decisions. Other policy choices are important: states with more generous Medicaid eligibility rules implement more extensive managed care programs. Complementing other studies of Medicaid, we find that politics and economics make a difference for the extent of managed care programs; unlike other Medicaid studies, we find no effect of race and ethnicity. PMID:22700945

  8. Choosing the Standard of Care in Private Individual Defamation Cases.

    ERIC Educational Resources Information Center

    Caudill, Susan

    1989-01-01

    Examines private individual defamation cases that include discussion of whether the reasonably prudent publisher/editor or the reasonably prudent person should set the standard of care when negligence is at issue. Considers the implication of judicial reasoning in adopting one standard of care rather than the other. (RS)

  9. Eugene's Story: A Case for Caring.

    ERIC Educational Resources Information Center

    Urban, Vicki Dodds

    1999-01-01

    As this story about a mischievous, underachieving 10th grader shows, meeting standards and showing caring, compassion, and respect are not mutually exclusive. Unless students experience a positive, supportive climate, some may never achieve minimal standards or realize their full potential. The author later discovered she had inspired Eugene to…

  10. Building the business case for patient-centered care.

    PubMed

    Charmel, Patrick A; Frampton, Susan B

    2008-03-01

    Hospitals that provide patient-centered care reap a number of financial benefits, including: Reduced length of stay. Lower cost per case. Decreased adverse events. Higher employee retention rates. Reduced operating costs. Decreased malpractice claims. Increased market share. PMID:19097611

  11. Teaching interdisciplinary geriatrics ambulatory care: a case study.

    PubMed

    Williams, Brent C; Remington, Tami L; Foulk, Mariko A; Whall, Ann L

    2006-01-01

    Interdisciplinary health care training is advocated by numerous government and philanthropic organizations. Educators in the health professions are increasingly offering training in interdisciplinary health care in a variety of contexts, including ambulatory settings. This paper describes a three-year program to teach skills in interdisciplinary care to learners from internal medicine, social work, pharmacy, and nursing in a geriatrics clinic at a major academic institution in the United States. Framed in a critical review of existing evidence for the effectiveness of interdisciplinary training and health care and expert recommendations, specific recommendations are made to educators interested in interdisciplinary training in ambulatory settings. PMID:16446270

  12. 78 FR 45176 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-26

    ... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2013 Through June 30, 2014 AGENCY: Food and Nutrition Service...-risk afterschool care centers, and adult day care centers; the food service payment rates for meals...

  13. "Anchors Away!" Implementing Program-Wide Positive Behavior Supports at the Visiting Nurses Association Child Care and Family Resource Center

    ERIC Educational Resources Information Center

    Muscott, Howard Steven; Pomerleau, Tina; Dupuis, Sherry

    2009-01-01

    Early childhood programs are growing increasingly concerned about the number of preschoolers exhibiting challenging behavior. This case study describes how educators at the Visiting Nurses Association Child Care and Family Resource Center program addressed this concern by implementing the systems, data, and practices of Program-Wide Positive…

  14. Patient Protection and Affordable Care Act; program integrity: Exchange, SHOP, and eligibility appeals. Final rule.

    PubMed

    2013-08-30

    This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, this final rule outlines Exchange standards with respect to eligibility appeals, agents and brokers, privacy and security, issuer direct enrollment, and the handling of consumer cases. It also sets forth standards with respect to a State's operation of the Exchange and Small Business Health Options Program (SHOP). It generally is finalizing previously proposed policies without change. PMID:23991479

  15. Quality of Care Provided by a Comprehensive Dementia Care Comanagement Program.

    PubMed

    Jennings, Lee A; Tan, Zaldy; Wenger, Neil S; Cook, Erin A; Han, Weijuan; McCreath, Heather E; Serrano, Katherine S; Roth, Carol P; Reuben, David B

    2016-08-01

    Multiple studies have shown that quality of care for dementia in primary care is poor, with physician adherence to dementia quality indicators (QIs) ranging from 18% to 42%. In response, the University of California at Los Angeles (UCLA) Health System created the UCLA Alzheimer's and Dementia Care (ADC) Program, a quality improvement program that uses a comanagement model with nurse practitioner dementia care managers (DCM) working with primary care physicians and community-based organizations to provide comprehensive dementia care. The objective was to measure the quality of dementia care that nurse practitioner DCMs provide using the Assessing Care of Vulnerable Elders (ACOVE-3) and Physician Consortium for Performance Improvement QIs. Participants included 797 community-dwelling adults with dementia referred to the UCLA ADC program over a 2-year period. UCLA is an urban academic medical center with primarily fee-for-service reimbursement. The percentage of recommended care received for 17 dementia QIs was measured. The primary outcome was aggregate quality of care for the UCLA ADC cohort, calculated as the total number of recommended care processes received divided by the total number of eligible quality indicators. Secondary outcomes included aggregate quality of care in three domains of dementia care: assessment and screening (7 QIs), treatment (6 QIs), and counseling (4 QIs). QIs were abstracted from DCM notes over a 3-month period from date of initial assessment. Individuals were eligible for 9,895 QIs, of which 92% were passed. Overall pass rates of DCMs were similar (90-96%). All counseling and assessment QIs had pass rates greater than 80%, with most exceeding 90%. Wider variation in adherence was found among QIs addressing treatments for dementia, which patient-specific criteria triggered, ranging from 27% for discontinuation of medications associated with mental status changes to 86% for discussion about acetylcholinesterase inhibitors. Comprehensive

  16. How to establish a perinatal home care program.

    PubMed

    Miller, T H

    1990-09-01

    Current clinical data indicates that despite advances in the obstetric and neonatal arenas, preterm birth and subsequent low birth weight infants continue to be born. Technology-based perinatal home care programs are the fastest growing segment of services available to high-risk pregnant women, recuperating post-partum women, and newborns. It is anticipated that these services will alter forever the traditional measures of care for high-risk pregnant women and newborns. PMID:10107048

  17. Patient Perspectives of an Integrated Program of Medical Care and Substance Use Treatment

    PubMed Central

    Farrell, Caitlin; Sorensen-Alawad, Amy; Palmisano, Joseph N.; Chaisson, Christine; Walley, Alexander Y.

    2014-01-01

    Abstract The benefits of integrating primary care and substance use disorder treatment are well known, yet true integration is difficult. We developed and evaluated a team-based model of integrated care within the primary care setting for HIV-infected substance users and substance users at risk for contracting HIV. Qualitative data were gathered via focus groups and satisfaction surveys to assess patients' views of the program, evaluate key elements for success, and provide recommendations for other programs. Key themes related to preferences for the convenience and efficiency of integrated care; support for a team-based model of care; a feeling that the program requirements offered needed structure; the importance of counseling and education; and how provision of concrete services improved overall well-being and quality of life. For patients who received buprenorphine/naloxone for opioid dependence, this was viewed as a major benefit. Our results support other studies that theorize integrated care could be of significant value for hard-to-reach populations and indicate that having a clinical team dedicated to providing substance use disorder treatment, HIV risk reduction, and case management services integrated into primary care clinics has the potential to greatly enhance the ability to serve a challenging population with unmet treatment needs. PMID:24428768

  18. Patient perspectives of an integrated program of medical care and substance use treatment.

    PubMed

    Drainoni, Mari-Lynn; Farrell, Caitlin; Sorensen-Alawad, Amy; Palmisano, Joseph N; Chaisson, Christine; Walley, Alexander Y

    2014-02-01

    The benefits of integrating primary care and substance use disorder treatment are well known, yet true integration is difficult. We developed and evaluated a team-based model of integrated care within the primary care setting for HIV-infected substance users and substance users at risk for contracting HIV. Qualitative data were gathered via focus groups and satisfaction surveys to assess patients' views of the program, evaluate key elements for success, and provide recommendations for other programs. Key themes related to preferences for the convenience and efficiency of integrated care; support for a team-based model of care; a feeling that the program requirements offered needed structure; the importance of counseling and education; and how provision of concrete services improved overall well-being and quality of life. For patients who received buprenorphine/naloxone for opioid dependence, this was viewed as a major benefit. Our results support other studies that theorize integrated care could be of significant value for hard-to-reach populations and indicate that having a clinical team dedicated to providing substance use disorder treatment, HIV risk reduction, and case management services integrated into primary care clinics has the potential to greatly enhance the ability to serve a challenging population with unmet treatment needs. PMID:24428768

  19. Barriers to HIV Care and Treatment Among Participants in a Public Health HIV Care Relinkage Program.

    PubMed

    Dombrowski, Julia C; Simoni, Jane M; Katz, David A; Golden, Matthew R

    2015-05-01

    Improving patient retention in HIV care and use of antiretroviral therapy (ART) are key steps to improving the HIV care continuum in the US. However, contemporary quantitative data on barriers to care and treatment from population-based samples of persons poorly engaged in care are sparse. We analyzed the prevalence of barriers to clinic visits, ART initiation, and ART continuation reported by 247 participants in a public health HIV care relinkage program in King County, WA. We identified participants using HIV surveillance data (N=188) and referrals from HIV/STD clinics and partner services (N=59). Participants most commonly reported insurance (50%), practical (26-34%), and financial (30%) barriers to care, despite residing in a state with essentially universal access to HIV care. Perceived lack of need for medical care was uncommon (<20%), but many participants (58%) endorsed a perceived lack of need for medication as a reason for not initiating ART. Depression and substance abuse were both highly prevalent (69% and 54%, respectively), and methamphetamine was the most commonly abused substance. Barriers to HIV care and treatment may be amenable to intervention by health department outreach in coordination with existing HIV medical and support services. PMID:25826007

  20. Barriers to HIV Care and Treatment Among Participants in a Public Health HIV Care Relinkage Program

    PubMed Central

    Simoni, Jane M.; Katz, David A.; Golden, Matthew R.

    2015-01-01

    Abstract Improving patient retention in HIV care and use of antiretroviral therapy (ART) are key steps to improving the HIV care continuum in the US. However, contemporary quantitative data on barriers to care and treatment from population-based samples of persons poorly engaged in care are sparse. We analyzed the prevalence of barriers to clinic visits, ART initiation, and ART continuation reported by 247 participants in a public health HIV care relinkage program in King County, WA. We identified participants using HIV surveillance data (N=188) and referrals from HIV/STD clinics and partner services (N=59). Participants most commonly reported insurance (50%), practical (26–34%), and financial (30%) barriers to care, despite residing in a state with essentially universal access to HIV care. Perceived lack of need for medical care was uncommon (<20%), but many participants (58%) endorsed a perceived lack of need for medication as a reason for not initiating ART. Depression and substance abuse were both highly prevalent (69% and 54%, respectively), and methamphetamine was the most commonly abused substance. Barriers to HIV care and treatment may be amenable to intervention by health department outreach in coordination with existing HIV medical and support services. PMID:25826007

  1. Medicare program; Medicare Shared Savings Program: Accountable Care Organizations. Final rule.

    PubMed

    2015-06-01

    This final rule addresses changes to the Medicare Shared Savings Program including provisions relating to the payment of Accountable Care Organizations participating in the Medicare Shared Savings Program. Under the Medicare Shared Savings Program, providers of services and suppliers that participate in an Accountable Care Organizations continue to receive traditional Medicare fee-for-service payments under Parts A and B, but the Accountable Care Organizations may be eligible to receive a shared savings payment if it meets specified quality and savings requirements. PMID:26065102

  2. Embracing case management for computerization of care pathways.

    PubMed

    Mei, Jing; Li, Jing; Yu, Yiqin; Li, Xiang; Liu, Haifeng; Xie, Guotong

    2014-01-01

    The computerization of care pathways (CPs) has drawn considerable attention, for improving quality of health care and reducing costs. A well-known big challenge of implementing CPs is their flexibility and ad hoc variations in execution of clinical tasks. We observe that case management suits well to address this problem, and this paper proposes a CMMN-based CP model, where CMMN (Case Management Model and Notation) is becoming an industry standard. Via an experimental experience on modelling CHF (congestive heart failure) ambulatory CP, we illustrate that the usage of case management paves the way to popularize CPs, particularly for its quick deployment and execution in industrial products. PMID:25160134

  3. [Individualised care plan during extracorporeal membrane oxygenation. A clinical case].

    PubMed

    Call Mañosa, S; Pujol Garcia, A; Chacón Jordan, E; Martí Hereu, L; Pérez Tejero, G; Gómez Simón, V; Estruga Asbert, A; Gallardo Herrera, L; Vaquer Araujo, S; de Haro López, C

    2016-01-01

    An individualised care plan is described for a woman diagnosed with pneumonia, intubated, and on invasive mechanical ventilation, who was admitted to the Intensive Care Unit for extracorporeal membrane oxygenation (ECMO). A nursing care plan was designed based on Marjory Gordon functional patterns. The most important nursing diagnoses were prioritised, using a model of clinical reasoning model (Analysis of the current status) and NANDA taxonomy. A description is presented on, death anxiety, impaired gas exchange, decreased cardiac output, dysfunctional gastrointestinal motility, risk for disuse syndrome, infection risk, and bleeding risk. The principal objectives were: to reduce the fear of the family, achieve optimal respiratory and cardiovascular status, to maintain gastrointestinal function, to avoid immobility complications, and to reduce the risk of infection and bleeding. As regards activities performed: we gave family support; correct management of the mechanical ventilation airway, cardio-respiratory monitoring, skin and nutritional status; control of possible infections and bleeding (management of therapies, care of catheters…). A Likert's scale was used to evaluate the results, accomplishing all key performance indicators which were propose at the beginning. Individualised care plans with NNN taxonomy using the veno-venous ECMO have not been described. Other ECMO care plans have not used the same analysis model. This case can help nurses to take care of patients subjected to veno-venous ECMO treatment, although more cases are needed to standardise nursing care using NANDA taxonomy. PMID:27137415

  4. Congenital toxoplasmosis and prenatal care state programs

    PubMed Central

    2014-01-01

    Background Control programs have been executed in an attempt to reduce vertical transmission and the severity of congenital infection in regions with a high incidence of toxoplasmosis in pregnant women. We aimed to evaluate whether treatment of pregnant women with spiramycin associated with a lack of monitoring for toxoplasmosis seroconversion affects the prognosis of patients. Methods We performed a prospective cohort study with 246 newborns (NB) at risk for congenital toxoplasmosis in Goiânia (Brazil) between October 2003 and October 2011. We analyzed the efficacy of maternal treatment with spiramycin. Results A total of 40.7% (66/162) of the neonates were born seriously infected. Vertical transmission associated with reactivation during pregnancy occurred in 5.5% (9/162) of the NB, with one showing severe infection (systemic). The presence of specific immunoglobulins (fetal IgM and NB IgA) suggested the worst prognosis. Treatment of pregnant women by spiramycin resulted in reduced vertical transmission. When infected pregnant women did not undergo proper treatment, the risk of severe infection (neural-optical) in NB was significantly increased. Fetal IgM was associated with ocular impairment in 48.0% (12/25) of the fetuses and neonatal IgA-specific was related to the neuro-ophthalmologic and systemic forms of the disease. When acute toxoplasmosis was identified in the postpartum period, a lack of monitoring of seronegative pregnant women resulted in a higher risk of severe congenital infection. Conclusion Treatment of pregnant women with spiramycin reduces the possibility of transmission of infection to the fetus. However, a lack of proper treatment is associated with the onset of the neural-optical form of congenital infection. Primary preventive measures should be increased for all pregnant women during the prenatal period and secondary prophylaxis through surveillance of seroconversion in seronegative pregnant woman should be introduced to reduce the

  5. 75 FR 32480 - Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-08

    ... HUMAN SERVICES Administration on Aging Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program Funding for Title VI Native American Programs Purpose of Notice: Availability of funding opportunity announcement. Funding Opportunity Title/Program Name: Affordable Care...

  6. R. I. Caregivers. Caring: A Training Program for Family Caregivers.

    ERIC Educational Resources Information Center

    Rhode Island State Dept. of Elderly Affairs, Providence.

    This document presents a training manual to help caregivers who provide care to older family members and friends at home. The program, which offers a practical approach to caregiving and a realistic view of the aging process, is intended to clarify the problems confronting caregivers of older people, serve as a basic source manual for training…

  7. Constructing a conflict resolution program for health care.

    PubMed

    Porter-O'Grady, Tim

    2004-01-01

    Resolving conflict throughout organizations requires a programmatic infrastructure and a committed management team. Leaders must recognize the need to approach conflict by building a format for learning, creating and managing an effective conflict management program. Careful attention to the elements of design and the stages of development can make all the difference in building a sustainable and useful conflict management approach. PMID:15600105

  8. Comprehensive Health Care Program for American Indians & Alaska Natives.

    ERIC Educational Resources Information Center

    Indian Health Service (PHS/HSA), Rockville, MD.

    This booklet summarizes programs of the Indian Health Service (IHS). The IHS was created in 1954 as part of the Public Health Service when responsibility for American Indian and Alaska Native health care was transferred from the Department of the Interior's Bureau of Indian Affairs to the Department of Health, Education, and Welfare. The goal of…

  9. Managed Behavioral Health Care: An Instrument to Characterize Critical Elements of Public Sector Programs

    PubMed Central

    Ridgely, M Susan; Giard, Julienne; Shern, David; Mulkern, Virginia; Burnam, M Audrey

    2002-01-01

    Objective To develop an instrument to characterize public sector managed behavioral health care arrangements to capture key differences between managed and “unmanaged” care and among managed care arrangements. Study Design The instrument was developed by a multi-institutional group of collaborators with participation of an expert panel. Included are six domains predicted to have an impact on access, service utilization, costs, and quality. The domains are: characteristics of the managed care plan, enrolled population, benefit design, payment and risk arrangements, composition of provider networks, and accountability. Data are collected at three levels: managed care organization, subcontractor, and network of service providers. Data Collection Methods Data are collected through contract abstraction and key informant interviews. A multilevel coding scheme is used to organize the data into a matrix along key domains, which is then reviewed and verified by the key informants. Principal Findings This instrument can usefully differentiate between and among Medicaid fee-for-service programs and Medicaid managed care plans along key domains of interest. Beyond documenting basic features of the plans and providing contextual information, these data will support the refinement and testing of hypotheses about the impact of public sector managed care on access, quality, costs, and outcomes of care. Conclusions If managed behavioral health care research is to advance beyond simple case study comparisons, a well-conceptualized set of instruments is necessary. PMID:12236386

  10. Vital links. Hospital's geriatric program integrates the spectrum of care.

    PubMed

    Holt, T

    1989-06-01

    In July 1988 St. Mary Medical Center (SMMC), Long Beach, CA, established Older Adult Services (OAS) to help the elderly of the community. At the time, SMMC was already providing a number of services for the elderly, but OAS enables it to provide a continuum of care. In addition, the medical staff committee developing the geriatric program recommended establishing a geriatric assessment team headed by a fellowship-trained geriatrician, having that geriatrician serve as medical director of the inpatient skilled nursing facility (SNF), having the geriatric team develop treatment protocols in various aspects of care, and extending OAS within the community. The categories of service within the continuum are extended care, acute care, ambulatory care, home care, outreach, wellness, and housing. SMMC does not directly provide all services; rather, through integrating mechanisms, it uses community-based services or services provided by other institutions to meet some patient needs. A key element to integrating the continuum is the involvement of OAS in the SNF. The SNF medical director can bring the expertise of the geriatric assessment team to a wide sphere of the medical community. This sphere of influence quickly spreads to the hospital's entire medical community. Through direct participation in utilization review and quality assurance in the SNF, the OAS director can influence the quality of care. PMID:10293329

  11. Program To Address Sociocultural Barriers to Health Care in Hispanic Communities. National Program Report.

    ERIC Educational Resources Information Center

    Jackson, Mike; Heroux, Janet

    Many members of the Hispanic community are separated from the larger community by language barriers and different cultures and belief systems. These factors can affect Hispanic Americans' ability to seek and gain access to the health care system. The Program To Address Sociocultural Barriers to Health Care in the Hispanic Community, known as…

  12. Better Federal Program Administration Can Contribute to Improving State Foster Care Programs.

    ERIC Educational Resources Information Center

    Comptroller General of the U.S., Washington, DC.

    The Adoption Assistance and Child Welfare Act of 1980 provides for annual federal incentive payments to states if they improve foster care programs by (1) avoiding unnecessary removal of children from their homes; (2) preventing extended stays in foster care; and (3) reunifying children with their families or placing them for adoption. To be…

  13. The Role of Mobile Technologies in Health Care Processes: The Case of Cancer Supportive Care

    PubMed Central

    Cucciniello, Maria; Guerrazzi, Claudia

    2015-01-01

    Background Health care systems are gradually moving toward new models of care based on integrated care processes shared by different care givers and on an empowered role of the patient. Mobile technologies are assuming an emerging role in this scenario. This is particularly true in care processes where the patient has a particularly enhanced role, as is the case of cancer supportive care. Objective This paper aims to review existing studies on the actual role and use of mobile technology during the different stages of care processes, with particular reference to cancer supportive care. Methods We carried out a review of literature with the aim of identifying studies related to the use of mHealth in cancer care and cancer supportive care. The final sample size consists of 106 records. Results There is scant literature concerning the use of mHealth in cancer supportive care. Looking more generally at cancer care, we found that mHealth is mainly used for self-management activities carried out by patients. The main tools used are mobile devices like mobile phones and tablets, but remote monitoring devices also play an important role. Text messaging technologies (short message service, SMS) have a minor role, with the exception of middle income countries where text messaging plays a major role. Telehealth technologies are still rarely used in cancer care processes. If we look at the different stages of health care processes, we can see that mHealth is mainly used during the treatment of patients, especially for self-management activities. It is also used for prevention and diagnosis, although to a lesser extent, whereas it appears rarely used for decision-making and follow-up activities. Conclusions Since mHealth seems to be employed only for limited uses and during limited phases of the care process, it is unlikely that it can really contribute to the creation of new care models. This under-utilization may depend on many issues, including the need for it to be embedded

  14. Implementing managed care in an industrial rehabilitation program.

    PubMed

    Niemeyer, L O; Foto, M; Holmes-Enix, D

    1994-01-01

    Managed care, with all its problems and potentials, is entering the scene in workers' compensation as a way to deal with escalating costs. Though the roots of managed care lie in cost containment efforts, its future depends on a shift in emphasis to quality of care. Clinicians must become partners with insurance companies and employers to evolve a "win-win" scenario that combines efficiency with effectiveness or risk both exclusion from provider networks and loss of control over what becomes incorporated into standards of care. Steps that can be taken by clinicians include developing a sense of accountability for final functional outcome, internal utilization management, and an internal case management protocol. PMID:24440843

  15. Examples of Nonconservatism in the CARE 3 Program

    NASA Technical Reports Server (NTRS)

    Dotson, Kelly J.

    1988-01-01

    This paper presents parameter regions in the CARE 3 (Computer-Aided Reliability Estimation version 3) computer program where the program overestimates the reliability of a modeled system without warning the user. Five simple models of fault-tolerant computer systems are analyzed; and, the parameter regions where reliability is overestimated are given. The source of the error in the reliability estimates for models which incorporate transient fault occurrences was not readily apparent. However, the source of much of the error for models with permanent and intermittent faults can be attributed to the choice of values for the run-time parameters of the program.

  16. Integrated Pest Management: A Curriculum for Early Care and Education Programs

    ERIC Educational Resources Information Center

    California Childcare Health Program, 2011

    2011-01-01

    This "Integrated Pest Management Toolkit for Early Care and Education Programs" presents practical information about using integrated pest management (IPM) to prevent and manage pest problems in early care and education programs. This curriculum will help people in early care and education programs learn how to keep pests out of early care and…

  17. The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) with Kangaroo Mother Care (KMC): Comprehensive Care for Preterm Infants

    PubMed Central

    Als, Heidelise; McAnulty, Gloria B.

    2014-01-01

    State-of-the-art Newborn Intensive Care Units (NICUs), instrumental in the survival of high-risk and ever-earlier-born preterm infants, often have costly human repercussions. The developmental sequelae of newborn intensive care are largely misunderstood. Developed countries eager to export their technologies must also transfer the knowledge-base that encompasses all high-risk and preterm infants’ personhood as well as the neuro-essential importance of their parents. Without such understanding, the best medical care, while assuring survival jeopardizes infants’ long-term potential and deprives parents of their critical role. Exchanging the womb for the NICU environment at a time of rapid brain growth compromises preterm infants’ early development, which results in long-term physical and mental health problems and developmental disabilities. The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) aims to prevent the iatrogenic sequelae of intensive care and to maintain the intimate connection between parent and infant, one expression of which is Kangaroo Mother Care. NIDCAP embeds the infant in the natural parent niche, avoids over-stimulation, stress, pain, and isolation while it supports self-regulation, competence, and goal orientation. Research demonstrates that NIDCAP improves brain development, functional competence, health, and life quality. It is cost effective, humane, and ethical, and promises to become the standard for all NICU care. PMID:25473384

  18. A retrospective evaluation of the Perfecting Patient Care University training program for health care organizations.

    PubMed

    Morganti, Kristy Gonzalez; Lovejoy, Susan; Beckjord, Ellen Burke; Haviland, Amelia M; Haas, Ann C; Farley, Donna O

    2014-01-01

    This study evaluated how the Perfecting Patient Care (PPC) University, a quality improvement (QI) training program for health care leaders and clinicians, affected the ability of organizations to improve the health care they provide. This training program teaches improvement methods based on Lean concepts and principles of the Toyota Production System and is offered in several formats. A retrospective evaluation was performed that gathered data on training, other process factors, and outcomes after staff completed the PPC training. A majority of respondents reported gaining QI competencies and cultural achievements from the training. Organizations had high average scores for the success measures of "outcomes improved" and "sustainable monitoring" but lower scores for diffusion of QI efforts. Total training dosage was significantly associated with the measures of QI success. This evaluation provides evidence that organizations gained the PPC competencies and cultural achievements and that training dosage is a driver of QI success. PMID:23572230

  19. Effects of stress management program on the quality of nursing care and intensive care unit nurses

    PubMed Central

    Pahlavanzadeh, Saied; Asgari, Zohreh; Alimohammadi, Nasrollah

    2016-01-01

    Background: High level of stress in intensive care unit nurses affects the quality of their nursing care. Therefore, this study aimed to determine the effects of a stress management program on the quality of nursing care of intensive care unit nurses. Materials and Methods: This study is a randomized clinical trial that was conducted on 65 nurses. The samples were selected by stratified sampling of the nurses working in intensive care units 1, 2, 3 in Al-Zahra Hospital in Isfahan, Iran and were randomly assigned to two groups. The intervention group underwent an intervention, including 10 sessions of stress management that was held twice a week. In the control group, placebo sessions were held simultaneously. Data were gathered by demographic checklist and Quality Patient Care Scale before, immediately after, and 1 month after the intervention in both groups. Then, the data were analyzed by Student's t-test, Mann–Whitney, Chi-square, Fisher's exact test, and analysis of variance (ANOVA) through SPSS software version 18. Results: Mean scores of overall and dimensions of quality of care in the intervention group were significantly higher immediately after and 1 month after the intervention, compared to pre-intervention (P < 0.001). The results showed that the quality of care in the intervention group was significantly higher immediately after and 1 month after the intervention, compared to the control group (P < 0.001). Conclusions: As stress management is an effective method to improve the quality of care, the staffs are recommended to consider it in improvement of the quality of nursing care. PMID:27186196

  20. Day Care in Caracas: A Day Care Homes Program Evaluation Report. Volume I: Executive Summary.

    ERIC Educational Resources Information Center

    de Ruesta, Maria Carlota; de Vidal, Amalia Barrios

    This document provides a summary of a formative evaluation research project concerning the neighborhood day care homes program in Caracas, Venezuela. The evaluation included nine lines of study: (1) an assessment of sociodemographic conditions of Venezuelan preschool age children, legal and employment status of Venezuelan women, and general social…

  1. Implementation of Advanced Health Care Technology into Existing Competency-Based Health Care Program. Final Report.

    ERIC Educational Resources Information Center

    Klemovage, Shirley

    A project was undertaken to develop new curriculum materials that could be incorporated into an existing health assistant program to cover recent advances in health care technology. Area physicians' offices were toured and meetings were held with administrators of local hospitals in order to discover what kinds of advances in health care…

  2. Pharmaceutical services in a capitated geriatric care program.

    PubMed

    Sorrento, T A; Bonanza, K C; Salisbury, D W

    1996-12-01

    A hospital outpatient pharmacy's planning and implementation of pharmaceutical services for a capitated geriatric care program are described. The hospital's director of pharmacy and pharmacy ambulatory care manager proposed providing distributive and clinical services for enrollees in Independent Living for Seniors (ILS), a program designed to help elderly persons to continue living at home instead of in nursing homes. ILS receives pooled monthly payments from Medicare and Medicaid; a copayment is required of enrollees not eligible for Medicaid. Medical and social services are offered, primarily through adult daycare centers. Nurses at the centers monitor ILS enrollees regularly and help them manage their medications. After a year of negotiations with the program, the outpatient satellite of the hospital's inpatient pharmacy began providing services; one pharmacist was assigned to ILS. Problems with medication stock at the daycare centers were corrected. Conservative supplies of stock drugs (mostly nonprescription items) and medications to meet patients' needs between daily pharmacy deliveries were established. A new computerized medication administration record was developed. Once distributive services were in place, a pharmacy and therapeutics committee began establishing a formulary. The pharmacist functions as part of an interdisciplinary care team, providing education on drug use and managing costs; he reviews all patients' charts every four months and meets weekly with ILS staff to recommend changes in drug therapy. The cost of services provided by the hospital outpatient pharmacy averaged $77 per patient per month in the first year, compared with about $120 for the previous vendor. A hospital's ambulatory care pharmacy improved the pharmaceutical services provided to a capitated geriatric care program. PMID:8957345

  3. Enabling Precision Medicine With Digital Case Classification at the Point-of-Care.

    PubMed

    Obermeier, Patrick; Muehlhans, Susann; Hoppe, Christian; Karsch, Katharina; Tief, Franziska; Seeber, Lea; Chen, Xi; Conrad, Tim; Boettcher, Sindy; Diedrich, Sabine; Rath, Barbara

    2016-02-01

    Infectious and inflammatory diseases of the central nervous system are difficult to identify early. Case definitions for aseptic meningitis, encephalitis, myelitis, and acute disseminated encephalomyelitis (ADEM) are available, but rarely put to use. The VACC-Tool (Vienna Vaccine Safety Initiative Automated Case Classification-Tool) is a mobile application enabling immediate case ascertainment based on consensus criteria at the point-of-care. The VACC-Tool was validated in a quality management program in collaboration with the Robert-Koch-Institute. Results were compared to ICD-10 coding and retrospective analysis of electronic health records using the same case criteria. Of 68,921 patients attending the emergency room in 10/2010-06/2013, 11,575 were hospitalized, with 521 eligible patients (mean age: 7.6 years) entering the quality management program. Using the VACC-Tool at the point-of-care, 180/521 cases were classified successfully and 194/521 ruled out with certainty. Of the 180 confirmed cases, 116 had been missed by ICD-10 coding, 38 misclassified. By retrospective application of the same case criteria, 33 cases were missed. Encephalitis and ADEM cases were most likely missed or misclassified. The VACC-Tool enables physicians to ask the right questions at the right time, thereby classifying cases consistently and accurately, facilitating translational research. Future applications will alert physicians when additional diagnostic procedures are required. PMID:26981582

  4. Medical care delivery in the US space program

    NASA Technical Reports Server (NTRS)

    Stewart, Donald F.

    1991-01-01

    The stated goal of this meeting is to examine the use of telemedicine in disaster management, public health, and remote health care. NASA has a vested interest in providing health care to crews in remote environments. NASA has unique requirements for telemedicine support, in that our flight crews conduct their job in the most remote of all work environments. Compounding the degree of remoteness are other environmental concerns, including confinement, lack of atmosphere, spaceflight physiological deconditioning, and radiation exposure, to name a few. In-flight medical care is a key component in the overall support for missions, which also includes extensive medical screening during selection, preventive medical programs for astronauts, and in-flight medical monitoring and consultation. This latter element constitutes the telemedicine aspect of crew health care. The level of in-flight resources dedicated to medical care is determined by the perceived risk of a given mission, which in turn is related to mission duration, planned crew activities, and length of time required for return to definitive medical care facilities.

  5. Caring for high-need, high-cost patients: what makes for a successful care management program?

    PubMed

    Hong, Clemens S; Siegel, Allison L; Ferris, Timothy G

    2014-08-01

    Provider groups taking on risk for the overall costs of care in accountable care organizations are developing care management programs to improve care and thereby control costs. Many such programs target "high-need, high-cost" patients: those with multiple or complex conditions, often combined with behavioral health problems or socioeconomic challenges. In this study we compared the operational approaches of 18 successful complex care management programs in order to offer guidance to providers, payers, and policymakers on best practices for complex care management. We found that effective programs customize their approach to their local contexts and caseloads; use a combination of qualitative and quantitative methods to identify patients; consider care coordination one of their key roles; focus on building trusting relationships with patients as well as their primary care providers; match team composition and interventions to patient needs; offer specialized training for team members; and use technology to bolster their efforts. PMID:25115035

  6. Home Visiting Programs: What the Primary Care Clinician Should Know.

    PubMed

    Finello, Karen Moran; Terteryan, Araksi; Riewerts, Robert J

    2016-04-01

    Responsibilities for primary care clinicians are rapidly expanding ascomplexities in families' lives create increased disparities in health and developmental outcomes for young children. Despite the demands on primary care clinicians to promote health in the context of complex family and community factors, most primary care clinicians are operating in an environment of limited training and a shortage of resources for supporting families. Partnerships with evidence-based home visiting programs for very young children and their families can provide a resource that will help to reduce the impact of adverse early childhood experiences and facilitate health equity. Home visiting programs in the United States are typically voluntary and designed to be preventative in nature, although families are usually offered services based on significant risk criteria since the costs associated with universal approaches have been considered prohibitive. Programs may be funded within the health (physical orbehavioral/mental health), child welfare, early education, or early intervention systems or by private foundation dollars focused primarily on oneof the above systems (e.g., health), with a wide range of outcomes targeted by the programs and funders. Services may be primarily focused on the child, the parent, or parent-child interactions. Services include the development of targeted and individualized intervention strategies, better coaching of parents, and improved modeling of interactions that may assist struggling families. This paper provides a broad overview ofthe history of home visiting, theoretical bases of home visiting programs, key components of evidence-based models, outcomes typically targeted, research on effectiveness, cost information, challenges and benefits of home visiting, and funding/sustainability concerns. Significance for primary care clinicians isdescribed specifically and information relevant for clinicians is emphasized throughout the paper. PMID:26872870

  7. Doctor of nursing practice program development: reengineering health care.

    PubMed

    Wall, Barbra M; Novak, Julie C; Wilkerson, Sharon A

    2005-09-01

    In this article, we describe the developmental process of a Doctor of Nursing Practice (DNP) program that uses interdisciplinary resources to create unique DNP curriculum opportunities. Other schools may benefit from this experience in the development of their own DNP programs. The program delivers an innovative curriculum from post-baccalaureate to doctorate, emphasizing health care engineering and interdisciplinary collaboration among faculty, hospitals, community leaders, and policymakers. This DNP program is uniquely situated to provide leadership in solving complex clinical problems through its partnership with the Regenstrief Center for Healthcare Engineering, the School of Pharmacy, the Homeland Security Institute, and the Center on Aging and the Life Course. Doctoral coursework, interdisciplinary collaboration, health care engineering/systems approaches, and new knowledge result in uniquely qualified providers. Post-baccalaureate students complete the university's Adult Nurse Practitioner program or its developing Pediatric Nurse Practitioner program during the first 2 years of the 4-year curriculum. A total of 83 post-baccalaureate credit hours include 1,526 hours of supervised clinical practice, a health policy residency, and cognate residencies in an area of specialization. The seven core competencies recommended by the American Association of Colleges of Nursing are incorporated into the curriculum. PMID:16220646

  8. 42 CFR 1001.201 - Conviction relating to program or health care fraud.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS...) With respect to any act or omission in a health care program, other than Medicare and a State health... 42 Public Health 5 2011-10-01 2011-10-01 false Conviction relating to program or health care...

  9. 42 CFR 1001.201 - Conviction relating to program or health care fraud.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS...) With respect to any act or omission in a health care program, other than Medicare and a State health... 42 Public Health 5 2012-10-01 2012-10-01 false Conviction relating to program or health care...

  10. 42 CFR 1001.201 - Conviction relating to program or health care fraud.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS...) With respect to any act or omission in a health care program, other than Medicare and a State health... 42 Public Health 5 2014-10-01 2014-10-01 false Conviction relating to program or health care...

  11. 42 CFR 1001.201 - Conviction relating to program or health care fraud.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS...) With respect to any act or omission in a health care program, other than Medicare and a State health... 42 Public Health 5 2013-10-01 2013-10-01 false Conviction relating to program or health care...

  12. 42 CFR 1001.201 - Conviction relating to program or health care fraud.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS...) With respect to any act or omission in a health care program, other than Medicare and a State health... 42 Public Health 5 2010-10-01 2010-10-01 false Conviction relating to program or health care...

  13. A Program Design To Motivate Individuals with SCI for Self-Care.

    ERIC Educational Resources Information Center

    Scotzin, Martha

    The report compares a skin care education program with a standard rehabilitation program to determine whether the program improved the self care motivations of spinal cord injury (SCI) paraplegic and quadriplegic inpatients (N=42). Study findings suggest that the skin care educational program was successful in changing patients' thinking about…

  14. Tennessee Star-Quality Child Care Program: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    ERIC Educational Resources Information Center

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Tennessee's Star-Quality Child Care Program prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…

  15. A Profile of the Federal TRIO Programs and Child Care Access Means Parents in School Program

    ERIC Educational Resources Information Center

    US Department of Education, 2008

    2008-01-01

    To help fulfill the goal of No Child Left Behind (NCLB), high-quality postsecondary education opportunities must be available to all students. In keeping with this goal, the Federal TRIO programs and Child Care Access Means Parents in School (CCAMPIS) program provide outreach and support to help low-income and first-generation college students, as…

  16. 76 FR 34541 - Child and Adult Care Food Program Improving Management and Program Integrity

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-13

    ... improve Program management and integrity in the Child and Adult Care Food Program (CACFP), at 67 FR 43447 (June 27, 2002) and at 69 FR 53501 (September 1, 2004). Section 243 of Public Law 106-224, the... rule was issued in proposed form on September 12, 2000 (65 FR 55101). In response to State and...

  17. Service-Learning at Dementia Care Programs: An Orientation and Training Program

    ERIC Educational Resources Information Center

    Lambert-Shute, Jennifer J.; Jarrott, Shannon E.; Fruhauf, Christine A.

    2004-01-01

    The present paper describes a project that addresses the unique challenge service-learners face at dementia care programs. The project was conducted in conjunction with two courses on aging that offer students a service-learning (S-L) option at a university adult day service (ADS) program that accepts service-learners from these courses. The…

  18. Stability of Subsidy Participation and Continuity of Care in the Child Care Assistance Program in Minnesota. Minnesota Child Care Choices Research Brief Series. Publication #2014-55

    ERIC Educational Resources Information Center

    Davis, Elizabeth E.; Krafft, Caroline; Tout, Kathryn

    2014-01-01

    The Minnesota Child Care Assistance Program (CCAP) provides subsidies to help low-income families pay for child care while parents are working, looking for work, or attending school. The program can help make quality child care affordable and is intended both to support employment for low-income families and to support the development and…

  19. Kansas Primary Care Weighs In: A Pilot Randomized Trial of a Chronic Care Model Program for Obesity in 3 Rural Kansas Primary Care Practices

    ERIC Educational Resources Information Center

    Ely, Andrea C.; Banitt, Angela; Befort, Christie; Hou, Qing; Rhode, Paula C.; Grund, Chrysanne; Greiner, Allen; Jeffries, Shawn; Ellerbeck, Edward

    2008-01-01

    Context: Obesity is a chronic disease of epidemic proportions in the United States. Primary care providers are critical to timely diagnosis and treatment of obesity, and need better tools to deliver effective obesity care. Purpose: To conduct a pilot randomized trial of a chronic care model (CCM) program for obesity care in rural Kansas primary…

  20. Brain-oriented care in the NICU: a case study.

    PubMed

    Bader, Lisa

    2014-01-01

    With the advances of technology and treatment in the field of neonatal care, researchers can now study how the brains of preterm infants are different from full-term infants. The differences are significant, and the outcomes are poor overall for premature infants as a whole. Caregivers at the bedside must know that every interaction with the preterm infant affects brain development-it is critical to the developmental outcome of the infant. The idea of neuroprotection is not new to the medical field but is a fairly new idea to the NICU. Neuroprotection encompasses all interventions that promote normal development of the brain. The concept of brain-oriented care is a necessary extension of developmental care in the NICU. By following the journey of 26-week preterm twin infants through a case study, one can better understand the necessity of brain-oriented care at the bedside. PMID:25161134

  1. Transforming Cultures of Care: A Case Study in Organizational Change

    ERIC Educational Resources Information Center

    Purvis, Karyn; Cross, David; Jones, Daren; Buff, Gary

    2012-01-01

    The authors report on a small organizational case study highlighting the dimensions of trauma-informed care, the processes of organizational change, and the growth of caregiver expertise. The article is framed by the notion of caregiving cultures, which refers to the beliefs, languages, and practices of caregivers and caregiving organizations.…

  2. A Proposed Research Program for Hospital-Medical Care

    PubMed Central

    Feldman, Paul

    1967-01-01

    This proposal for a federal government program of health services research, written in spring of 1966, played a key role in development of the National Center for Health Services Research and Development, announced by the President early this year. The paper points to the lack of economic incentives for development of cost-saving innovations for hospitals compared to incentives to develop innovations improving the quality of care. It indicates the analytic procedure which, if followed, would lead to an efficient program of research, and points out several aspects of the analysis that are critical requirements for its successful application. PMID:4964151

  3. Mandated Preparation Program Redesign: Kentucky Case

    ERIC Educational Resources Information Center

    Browne-Ferrigno, Tricia

    2013-01-01

    This case study presents a chronicle of events spanning a decade in Kentucky that led to state policy changes for principal preparation and details the response to those mandated changes by professors at the University of Kentucky. Professors' collaborative efforts resulted in a new teacher leadership program and redesigned principal…

  4. Model Point-of-Care Ultrasound Curriculum in an Intensive Care Unit Fellowship Program and Its Impact on Patient Management

    PubMed Central

    Killu, Keith; Coba, Victor; Mendez, Michael; Reddy, Subhash; Adrzejewski, Tanja; Huang, Yung; Ede, Jessica; Horst, Mathilda

    2014-01-01

    Objectives. This study was designed to assess the clinical applicability of a Point-of-Care (POC) ultrasound curriculum into an intensive care unit (ICU) fellowship program and its impact on patient care. Methods. A POC ultrasound curriculum for the surgical ICU (SICU) fellowship was designed and implemented in an urban, academic tertiary care center. It included 30 hours of didactics and hands-on training on models. Minimum requirement for each ICU fellow was to perform 25–50 exams on respective systems or organs for a total not less than 125 studies on ICU. The ICU fellows implemented the POC ultrasound curriculum into their daily practice in managing ICU patients, under supervision from ICU staff physicians, who were instructors in POC ultrasound. Impact on patient care including finding a new diagnosis or change in patient management was reviewed over a period of one academic year. Results. 873 POC ultrasound studies in 203 patients admitted to the surgical ICU were reviewed for analysis. All studies included were done through the POC ultrasound curriculum training. The most common exams performed were 379 lung/pleural exams, 239 focused echocardiography and hemodynamic exams, and 237 abdominal exams. New diagnosis was found in 65.52% of cases (95% CI 0.590, 0.720). Changes in patient management were found in 36.95% of cases (95% CI 0.303, 0.435). Conclusions. Implementation of POC ultrasound in the ICU with a structured fellowship curriculum was associated with an increase in new diagnosis in about 2/3 and change in management in over 1/3 of ICU patients studied. PMID:25478217

  5. Five case studies of multifamily weatherization programs

    SciTech Connect

    Kinney, L; Wilson, T.; Lewis, G.; MacDonald, M.

    1997-12-31

    The multifamily case studies that are the subject of this report were conducted to provide a better understanding of the approach taken by program operators in weatherizing large buildings. Because of significant variations in building construction and energy systems across the country, five states were selected based on their high level of multifamily weatherization. This report summarizes findings from case studies conducted by multifamily weatherization operations in five cities. The case studies were conducted between January and November 1994. Each of the case studies involved extensive interviews with the staff of weatherization subgrantees conducting multifamily weatherization, the inspection of 4 to 12 buildings weatherized between 1991 and 1993, and the analysis of savings and costs. The case studies focused on innovative techniques which appear to work well.

  6. Tying it all together: integrating a hospital-based health care system through case management education.

    PubMed

    Czerenda, A J; Best, L

    1994-01-01

    Recognizing the importance of the case manager as a system integrator, United Health Services, Inc. (UHS), a hospital-based health care system located in upstate New York, implemented several diverse case management models. Case managers were working in a variety of settings, often in isolation. It was determined that a system-wide case management education program would accomplish two goals: (a) provide all case managers within the UHS system with similar case management practice skills and language, and (b) provide an opportunity for case managers to meet, share role responsibilities and common case management issues, and use each other as resources. With input from leadership throughout the UHS system, a 4-week case management education program was developed and presented. Participants included multidisciplinary staff who had case management responsibilities within the system. Sessions were taught by UHS staff experts in a number of different disciplines. A teaching guide and manual were developed to supplement the didactic material. Feedback from the program was provided via written participant evaluation and follow-up discussions. PMID:8000326

  7. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be...

  8. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be...

  9. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be...

  10. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be...

  11. Training Programs for Family Child Care Providers: An Analysis of Ten Curricula. Second Edition.

    ERIC Educational Resources Information Center

    Modigliani, Kathy

    This report analyzes the following 10 curricula for training programs for family child care providers: (1) Child Care, a family day home care provider program developed by Texas A&M's Agricultural Extension Service; (2) the Family Day Care Education Series, a coordinated resource manual and independent study course, the Active Learning Series, and…

  12. Comparative Evaluation of AB 3059 Alternative Child Care Programs. Summary Report.

    ERIC Educational Resources Information Center

    Warner, Donna D.; And Others

    Findings from the evaluation of the AB 3059 alternative child care programs are presented in this report. (AB 3059 child care programs were mandated by the California legislature in 1976 with the goals of assessing features that might reduce child care costs, ensuring maximum parental choice among facilities, addressing unmet child care needs…

  13. Child Care in JOBS Employment and Training Program: What Difference Does Quality Make?

    ERIC Educational Resources Information Center

    Meyers, Marcia K.

    1993-01-01

    Examined data from Job Opportunities and Basic Skills program. Found that participants increased their use of substitute child care and of licensed day-care homes/centers, after beginning job readiness activities. Child care was found to be highly variable in terms of convenience and program quality. Problems with child care increased…

  14. Narrative research methods in palliative care contexts: two case studies.

    PubMed

    Thomas, Carol; Reeve, Joanne; Bingley, Amanda; Brown, Janice; Payne, Sheila; Lynch, Tom

    2009-05-01

    Narrative methods have played a minor role in research with dying patients to date, and deserve to be more widely understood. This article illustrates the utility and value of these methods through the narrative analysis of semi-structured interview data gathered in a series of interviews with two terminally ill cancer patients and their spouses. The methods and findings associated with these two case studies are outlined and discussed. The authors' contention is that an analytical focus on the naturalistic storytelling of patients and informal carers can throw new light on individuals' perceived illness states and symptoms, care-related needs, behaviors, and desires. In addition, the juxtaposition of two cases that share a number of markers of risk and need at the end of life illustrates how the narrative analysis of patients' experiential accounts can assist in uncovering important distinctions between cases that are of relevance to care management. PMID:18954961

  15. The business case for health-care quality improvement.

    PubMed

    Swensen, Stephen J; Dilling, James A; Mc Carty, Patrick M; Bolton, Jeffrey W; Harper, Charles M

    2013-03-01

    The business case for health-care quality improvement is presented. We contend that investment in process improvement is aligned with patients' interests, the organization's reputation, and the engagement of their workforce. Four groups benefit directly from quality improvement: patients, providers, insurers, and employers. There is ample opportunity, even in today's predominantly pay-for-volume (that is, evolving toward value-based purchasing) insurance system, for providers to deliver care that is in the best interest of the patient while improving their financial performance. PMID:23429226

  16. Pediatric intensive care sedation: survey of fellowship training programs.

    PubMed

    Marx, C M; Rosenberg, D I; Ambuel, B; Hamlett, K W; Blumer, J L

    1993-02-01

    Children hospitalized in a pediatric intensive care unit are frequently distressed. The purpose of this study was to identify the patterns of use of sedative agents in pediatric critical care patients. A questionnaire survey was mailed to 45 directors of Pediatric Critical Care Fellowship Training Programs listed in Critical Care Medicine, January 1989. The response rate was 75.6% (34 questionnaires). The most commonly identified goals of sedation were reduced patient discomfort or distress and fewer unplanned extubations. The agents most frequently employed for this purpose were opioids (morphine or fentanyl), chloral hydrate, or benzodiazepines. Although conventional doses are used, opioids and benzodiazepines are often given hourly or by continuous infusion. Satisfaction with the efficacy and safety of commonly used opioids was greater (most common response "very satisfied") than for the benzodiazepines ("somewhat satisfied"). The physician's or nurse's clinical impression was reported to be the "most important" criterion for deciding when a patient required a dose of sedative; objective criteria were selected as less important. The majority of patients (65.7%) in the surveyed units were ideally "sedated to the point of no distress with as-needed medication." The majority of respondents (76.4%) identified efficacy as the major problem with sedation. Drug withdrawal was considered to be the major problem with sedative use by only a minority of respondents (6.9%). Although withdrawal is seen in 61.8% of units, it is generally treated when recognized, rather than prevented by routine tapering of sedation. Optimal sedation of pediatric intensive care unit patients is considered problematic, despite the use of frequent doses of many sedatives. Systematic investigation of pharmacodynamic response to these agents in the pediatric critical care population is indicated. PMID:8424013

  17. Day Care for School-Agers: A Program for School-Agers, Parents, and Day Care Staff.

    ERIC Educational Resources Information Center

    Browne, Gayle, Comp.

    Activities for school age day care programs are presented in detail in this guide for children, parents, and day care staff. The guide consists of 14 illustrated booklets that provide activity instructions and some background information. Topics are: (1) functions of school age day care; (2) quiet and active games and materials; (3) toys and play…

  18. Planning an eLearning Dementia Care Program for Healthcare Teams in Long-Term Care Facilities: The Learners' Perspectives

    ERIC Educational Resources Information Center

    MacDonald, Colla J.; Stodel, Emma J.; Coulson, Irene

    2004-01-01

    This paper presents a needs analysis conducted to obtain information concerning online dementia care training of healthcare workers in long-term care (LTC) facilities. The resulting information was used to guide the development of an online dementia care training program designed to facilitate the acquisition of skills and knowledge necessary for…

  19. 76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1,...

  20. 32 CFR 199.20 - Continued Health Care Benefit Program (CHCBP).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 2 2013-07-01 2013-07-01 false Continued Health Care Benefit Program (CHCBP...) § 199.20 Continued Health Care Benefit Program (CHCBP). (a) Purpose. The CHCBP is a premium-based temporary health care coverage program that will be available to beneficiaries who meet the eligibility...

  1. 32 CFR 199.20 - Continued Health Care Benefit Program (CHCBP).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Continued Health Care Benefit Program (CHCBP...) § 199.20 Continued Health Care Benefit Program (CHCBP). (a) Purpose. The CHCBP is a premium based temporary health care coverage program that will be available to qualified beneficiaries (set forth...

  2. 32 CFR 199.20 - Continued Health Care Benefit Program (CHCBP).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 2 2011-07-01 2011-07-01 false Continued Health Care Benefit Program (CHCBP...) § 199.20 Continued Health Care Benefit Program (CHCBP). (a) Purpose. The CHCBP is a premium based temporary health care coverage program that will be available to qualified beneficiaries (set forth...

  3. 32 CFR 199.20 - Continued Health Care Benefit Program (CHCBP).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 2 2014-07-01 2014-07-01 false Continued Health Care Benefit Program (CHCBP...) § 199.20 Continued Health Care Benefit Program (CHCBP). (a) Purpose. The CHCBP is a premium-based temporary health care coverage program that will be available to beneficiaries who meet the eligibility...

  4. 32 CFR 199.20 - Continued Health Care Benefit Program (CHCBP).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 2 2012-07-01 2012-07-01 false Continued Health Care Benefit Program (CHCBP...) § 199.20 Continued Health Care Benefit Program (CHCBP). (a) Purpose. The CHCBP is a premium-based temporary health care coverage program that will be available to beneficiaries who meet the eligibility...

  5. Feminist health care in a hostile environment: a case study of the Womancare Health Center.

    PubMed

    Hyde, Cheryl A

    2008-01-01

    This article presents a case study of the Womancare Health Center in order to illustrate the development of and challenges to the feminist health movement in the United States. Specific attention is placed on the legislative, fiscal, and direct actions by the New Right against this organization. Analysis focuses on the means through which Womancare survived. The repercussions of constant intimidation and harassment for women's health programs and for health care policy overall are discussed. PMID:19213480

  6. Evaluation of an Assertive Continuing Care Program for Hispanic Adolescents

    PubMed Central

    Strunz, Eric; Jungerman, Joanna; Kinyua, Juliet; Frew, Paula M.

    2015-01-01

    Purpose: This study evaluated an Adolescent Community Reinforcement Approach (A-CRA) and Assertive Continuing Care (ACC) program targeting Hispanic adolescents at risk for substance abuse. Method: The Clinic for Education, Treatment, and Prevention of Addiction (CETPA, Inc.), a behavioral health provider offering culturally appropriate substance use and mental health services, carried out the intervention. We examined longitudinal substance use data in relation to time spent in the program and possible confounders. Results: We analyzed data from 72 adolescent clients collected between 2010 and 2012. Self-reported data were evaluated to determine if time spent in the program was associated with substance use reduction. The data were correlated, zero-inflated, and overdispersed; consequently, we employed a mixed-effects zero-inflated negative-binomial model. Time spent in CETPA’s program was significantly associated with reductions in the number of days of substance use (p = .039), but not with the likelihood of fully abstaining from use (p = .290). For non-abstinent participants who spend a year in the program, our models revealed an average decline of 46% in reported days of substance use. Conclusions: A culturally tailored and age-appropriate substance abuse program for Hispanic adolescents resulted in a significant reduction of the numbers of days using alcohol, drugs, or other illicit substances. The A-CRA/ACC approach can yield successful results in culturally diverse settings. PMID:26156933

  7. An early stage evaluation of the Supporting Program for Obstetric Care Underserved Areas in Korea.

    PubMed

    Na, Baeg Ju; Kim, Hyun Joo; Lee, Jin Yong

    2014-06-01

    "The Supporting Program for Obstetric Care Underserved Areas (SPOU)" provides financial aids to rural community (or district) hospitals to reopen prenatal care and delivery services for regions without obstetrics and gynecology clinics or hospitals. The purpose of this study was to evaluate the early stage effect of the SPOU program. The proportion of the number of birth through SPOU was calculated by each region. Also survey was conducted to investigate the extent of overall satisfaction, elements of dissatisfaction, and suggestions for improvement of the program; 209 subjects participated from 7 to 12 December, 2012. Overall, 20% of pregnant women in Youngdong (71 cases) and Gangjin (106 cases) used their community (or district) hospitals through the SPOU whereas Yecheon (23 cases) was 8%; their satisfaction rates were high. Short distance and easy accessibility was the main reason among women choosing community (or district) hospital whereas the reasons of not selecting the community (or district) hospital were favor of the outside hospital's facility, system, and trust in the medical staffs. The SPOU seems to be currently effective at an early stage. However, to successfully implement this program, the government should make continuous efforts to recruit highly qualified medical staffs and improve medical facility and equipment. PMID:24932075

  8. The CARE (CAse REport) guidelines and the standardization of case reports.

    PubMed

    Rison, Richard A; Kidd, Michael R; Koch, Christian A

    2013-01-01

    Case reports comprise the core of Journal of Medical Case Reports, are a time-honored tradition firmly established within the medical literature, and represent a growing importance of valuable clinical medical information in our modern information-flowing times. While there is already a body of published literature on how and when to write a case report and both Journal of Medical Case Reports and BioMed Central make known their own criteria, case report quality across all of the medical literature is still variable. Additionally, although health reporting agencies do have standardization guidelines for other aspects of health-care reporting, there has never been an organizational body responsible for international standardization of how to write a case report. With the newly-published CARE (CAse REport) guidelines, Gagnier and colleagues hope to change this. This editorial serves as a brief introduction to the CARE guidelines and briefly examines the proposed standardization of case reports. We invite feedback on the CARE guidelines from all of our readers and encourage their trial run implementation by our own case report authors. PMID:24283496

  9. A Plan of Action for Recruitment and Evaluation of the Child Care Credential Training Program for Child Care Professionals.

    ERIC Educational Resources Information Center

    Whaley, Deborah W.

    This practicum project was designed to formulate and initiate a plan of action to promote and evaluate a community college Child Care Credential (CCC) training program. A pre-implementation survey indicated that few child care professionals in the community knew of the program or its characteristics. A media campaign was designed to promote the…

  10. Expanding physician education in health care fraud and program integrity.

    PubMed

    Agrawal, Shantanu; Tarzy, Bruce; Hunt, Lauren; Taitsman, Julie; Budetti, Peter

    2013-08-01

    Program integrity (PI) spans the entire spectrum of improper payments from fraud to abuse, errors, and waste in the health care system. Few physicians will perpetrate fraud or abuse during their careers, but nearly all will contribute to the remaining spectrum of improper payments, making preventive education in this area vital. Despite the enormous impact that PI issues have on government-sponsored and private insurance programs, physicians receive little formal education in this area. Physicians' lack of awareness of PI issues not only makes them more likely to submit inappropriate claims, generate orders that other providers and suppliers will use to submit inappropriate claims, and document improperly in the medical record but also more likely to become victims of fraud schemes themselves.In this article, the authors provide an overview of the current state of PI issues in general, and fraud in particular, as well as a description of the state of formal education for practicing physicians, residents, and fellows. Building on the lessons from pilot programs conducted by the Centers for Medicare and Medicaid Services and partner organizations, the authors then propose a model PI education curriculum to be implemented nationwide for physicians at all levels. They recommend that various stakeholder organizations take part in the development and implementation process to ensure that all perspectives are included. Educating physicians is an essential step in establishing a broader culture of compliance and improved integrity in the health care system, extending beyond Medicare and Medicaid. PMID:23807100

  11. History of the Animal Care Program at Johnson Space Center

    NASA Technical Reports Server (NTRS)

    Khan-Mayberry, Noreen; Bassett, Stephanie

    2010-01-01

    NASA has a rich history of scientific research that has been conducted throughout our numerous manned spaceflight programs. This scientific research has included animal test subjects participating in various spaceflight missions, including most recently, Space Shuttle mission STS-131. The Animal Care Program at Johnson Space Center (JSC) in Houston, Texas is multi-faceted and unique in scope compared to other centers within the agency. The animal care program at JSC has evolved from strictly research to include a Longhorn facility and the Houston Zoo's Attwater Prairie Chicken refuge, which is used to help repopulate this endangered species. JSC is home to more than 300 species of animals including home of hundreds of white-tailed deer that roam freely throughout the center which pose unique issues in regards to population control and safety of NASA workers, visitors and tourists. We will give a broad overview of our day to day operations, animal research, community outreach and protection of animals at NASA Johnson Space Center.

  12. A Feminine Care Clinical Research Program Transforms Women's Lives.

    PubMed

    Tzeghai, Ghebre E; Ajayi, Funmilayo O; Miller, Kenneth W; Imbescheid, Frank; Sobel, Jack D; Farage, Miranda A

    2015-01-01

    Feminine hygiene products and menstruation education have transformed the lives of women throughout the world. The P&G Feminine Care Clinical Innovation Research Program has played a key role by expanding scientific knowledge as well as developing technical insights and tools for the development of feminine hygiene products. The aim has been to meet the needs of women throughout their life stages, advancing their urogenital health beyond just menstruation, as well as helping to understand the role of sex hormones in various important health issues that women face. This review article highlights key contributions and research findings in female hygiene products, urogenital health research, and method development. The clinical research team focused on utilizing the results of clinical safety studies to advance the acceptance of feminine hygiene products world-wide. Key findings include that perception of skin sensitivity is not limited to the facial area, but is also relevant to the body and the genital area. Also, they shed light on the role of estrogen in autoimmune diseases as well as premenstrual syndrome. Efforts in the method development area focused on innovative tools that are reliable, predictive of clinical trial results and capable of measuring wear comfort, genital skin health, and the impact of product use on the consumer's quality of life. A novel method, behind-the-knee (BTK) test, developed to model irritation under normal wear conditions, was the first to account for both chemical and mechanical sources of irritation. The method has been accepted by the FDA as a substitute in clinical trials in some cases, and by American Society for Testing and Materials as a global standard test method. Additional proprietary methods were developed to enhance visual grading of irritation using cross-polarized light, to measure the amount of lotion transferred from sanitary pads, and to evaluate the skin mildness. Finally, the Farage Quality of Life tool was created

  13. [Case management. The nursing business of care or cost].

    PubMed

    Sandhu, B K; Duquette, A; Kérouac, S; Rouillier, L

    1992-01-01

    Less money spent on health services, cost-effectiveness, better productivity and more efficiency are some of the driving forces of contemporary "neo-liberalism" and political trends. How can nursing services and the profession's human values adapt in this difficult context? The authors describe the newest modality of patient care delivery system: nursing case management. They examine the factors and assumptions that led up to its development and point out the validity of asking some serious questions before embarking on the euphoria of case management. PMID:1291932

  14. 76 FR 67801 - Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-02

    .... In the April 7, 2011 Federal Register (76 FR 19528), we published the Shared Savings Program proposed...-based purchasing initiatives, please refer to section I.A. of the proposed rule (76 FR 19530). B... within section 3022 of the Affordable Care Act is in section I.B. of the proposed rule (see 76 FR...

  15. Evaluation of forensic cases admitted to pediatric intensive care unit

    PubMed Central

    Duramaz, Burcu Bursal; Yıldırım, Hamdi Murat; Kıhtır, Hasan Serdar; Yeşilbaş, Osman; Şevketoğlu, Esra

    2015-01-01

    Aim: This study aimed to determine the epidemiological and clinical characteristics of pediatric forensic cases to contribute to the literature and to preventive health care services. Material and Methods: Pediatric forensic cases hospitalized in our pediatric intensive care unit below the age of 17 years were reviewed retrospectively (January 2009–June 2014) . The patients were evaluated in two groups as physical traumas (Group A) and poisonings (Group B). The patients’ age, gender, complaints at presentation, time of presentation and referral (season, time) and, mortality rates were determined. Cases of physical trauma (Group A) were classified as traffic accidents, falling down from height, falling of device, drowning, electric shock, burns and child abuse. Poisonings (Group B) were classified as pharmaceuticals, pesticides, other chemicals and unknown drug poisonings. Results: Two hundred twenthy cases were included. The mean age was 5.1+3.1 years. One hundred fifteen (%52.5) of the cases were male and 105 (%47.5) were female. Group A consisted of 62 patients and Group B consisted of 158 patients. The patients presented most frequently in summer months. The most common reason for presentation was falling down from height (12.7%) in Group A and accidental drug poisoning (most frequently antidepressants) in Group B. The mortality rate was 5%. Conclusion: Forensic cases in the pediatric population (physical trauma and poisoning) are preventable health problems. Especially, preventive approach to improve the environment for falling down from height must be a priority. Increasing the awareness of families and the community on this issue, in summer months during which forensic cases are observed most frequently can contribute to a reduction in the number of cases. PMID:26568689

  16. Nonprofit ownership and quality in Medicaid's longterm care program for persons with developmental disabilities.

    PubMed

    Brown, Samuel L

    2002-01-01

    To assess ownership-related differences in the Intermediate Care Facility Program for persons with Mental Retardation (ICF/MR) Industry, this article analyzes a nationally representative sample of data on Medicaid certified facilities from the Health Care Financing Administration On-line Survey and Certification Reporting System. This study found that nonprofit providers provided a higher level of quality than for-profit facilities when organizational size and facility-mix were controlled. The size and case-mix composition of these facilities were also influenced by nonprofit ownership type. Nonprofit providers offered smaller facilities, on average, and were more likely to enroll heavy case-mix residents than their for-profit counterparts. PMID:15188998

  17. Teaching Medical Students about Quality and Cost of Care at Case Western Reserve University.

    ERIC Educational Resources Information Center

    Headrick, Linda A.; And Others

    1992-01-01

    At Case Western University (Ohio), medical students critically analyze the quality and cost of asthma care in the community by studying patients in primary care practices. Each writes a case report, listing all medical charges and comparing them with guidelines for asthma care. Several recommendations for improved care have emerged. (MSE)

  18. Augmenting Predictive Modeling Tools with Clinical Insights for Care Coordination Program Design and Implementation

    PubMed Central

    Johnson, Tracy L.; Brewer, Daniel; Estacio, Raymond; Vlasimsky, Tara; Durfee, Michael J.; Thompson, Kathy R.; Everhart, Rachel M.; Rinehart, Deborath J.; Batal, Holly

    2015-01-01

    Context: The Center for Medicare and Medicaid Innovation (CMMI) awarded Denver Health’s (DH) integrated, safety net health care system $19.8 million to implement a “population health” approach into the delivery of primary care. This major practice transformation builds on the Patient Centered Medical Home (PCMH) and Wagner’s Chronic Care Model (CCM) to achieve the “Triple Aim”: improved health for populations, care to individuals, and lower per capita costs. Case description: This paper presents a case study of how DH integrated published predictive models and front-line clinical judgment to implement a clinically actionable, risk stratification of patients. This population segmentation approach was used to deploy enhanced care team staff resources and to tailor care-management services to patient need, especially for patients at high risk of avoidable hospitalization. Developing, implementing, and gaining clinical acceptance of the Health Information Technology (HIT) solution for patient risk stratification was a major grant objective. Findings: In addition to describing the Information Technology (IT) solution itself, we focus on the leadership and organizational processes that facilitated its multidisciplinary development and ongoing iterative refinement, including the following: team composition, target population definition, algorithm rule development, performance assessment, and clinical-workflow optimization. We provide examples of how dynamic business intelligence tools facilitated clinical accessibility for program design decisions by enabling real-time data views from a population perspective down to patient-specific variables. Conclusions: We conclude that population segmentation approaches that integrate clinical perspectives with predictive modeling results can better identify high opportunity patients amenable to medical home-based, enhanced care team interventions. PMID:26290884

  19. Children, Food, and Family Day Care: A Manual for Sponsorship of the Child Care Food Program in Licensed Family Day Care.

    ERIC Educational Resources Information Center

    O'Konski, Gerry, Ed.

    This manual provides detailed information on how local non-profit organizations can sponsor licensed family day care homes for participation in the federally funded Child Care Food Program. This program subsidizes the provision of nutritious meals to children who are not in school. The introductory section of the manual answers basic questions…

  20. Helping Cancer Patients Across the Care Continuum: The Navigation Program at The Queen's Medical Center

    PubMed Central

    Ishihara-Wong, Debra D M; Domingo, Jermy B; Nishioka, Jocelyn; Wilburn, Andrea; Tsark, JoAnn U; Braun, Kathryn L

    2013-01-01

    Research suggests that cancer patient navigation improves care, but few reports describe the variety of patients managed by a hospital-based navigation program. Differences in navigated patients by the intensity (low, medium, or high) of navigation services they received were examined. The 835 clients seen by the navigators in a hospital-based cancer center were first stratified by quarter and by four ethnic groups. Randomized selection from each group assured there would be equal representation for analysis of Hawaiians, Filipinos, Japanese, and Whites and even numbers over all time intervals. Five professionals extracted data from these case records on demographics, type/stage of cancer, diagnosis and treatment dates, barriers, and navigator actions. Clients had breast (30.0%), lung (15.8%), esophageal (6.7%), colon (5.8%), ovarian (4.2%), prostate (3.3%), and other cancers (34.2%). The median number of actions taken on behalf of a client was 4 (range 1–83), and the median number of days a case was open was 14 (range 1–216). High intensity cases (those receiving more assistance over longer periods of time) were more likely than low-intensity cases to need help with education and reassurance, transportation, care coordination, and covering costs. Although there were no demographic differences across intensity groups, Neighbor Island patients from Hawai‘i, Maui, Moloka‘i, Lana‘i and Kaua‘i were more likely to need help with arranging travel, care coordination, and costs associated with getting treatment (all at P=.05), and patients on public insurance were more likely to have stage 4 cancer (P=.001) and to need help with costs (P=.006). Findings suggest that this hospital-based navigation program is filling a real need of patients across the cancer care continuum. A triage protocol and an integrated data capture system could help improve the targeting and documentation of cancer patient navigation services. PMID:23795311

  1. Helping cancer patients across the care continuum: the navigation program at the Queen's Medical Center.

    PubMed

    Allison, Amanda L; Ishihara-Wong, Debra D M; Domingo, Jermy B; Nishioka, Jocelyn; Wilburn, Andrea; Tsark, JoAnn U; Braun, Kathryn L

    2013-04-01

    Research suggests that cancer patient navigation improves care, but few reports describe the variety of patients managed by a hospital-based navigation program. Differences in navigated patients by the intensity (low, medium, or high) of navigation services they received were examined. The 835 clients seen by the navigators in a hospital-based cancer center were first stratified by quarter and by four ethnic groups. Randomized selection from each group assured there would be equal representation for analysis of Hawaiians, Filipinos, Japanese, and Whites and even numbers over all time intervals. Five professionals extracted data from these case records on demographics, type/stage of cancer, diagnosis and treatment dates, barriers, and navigator actions. Clients had breast (30.0%), lung (15.8%), esophageal (6.7%), colon (5.8%), ovarian (4.2%), prostate (3.3%), and other cancers (34.2%). The median number of actions taken on behalf of a client was 4 (range 1-83), and the median number of days a case was open was 14 (range 1-216). High intensity cases (those receiving more assistance over longer periods of time) were more likely than low-intensity cases to need help with education and reassurance, transportation, care coordination, and covering costs. Although there were no demographic differences across intensity groups, Neighbor Island patients from Hawai'i, Maui, Moloka'i, Lana'i and Kaua'i were more likely to need help with arranging travel, care coordination, and costs associated with getting treatment (all at P=.05), and patients on public insurance were more likely to have stage 4 cancer (P=.001) and to need help with costs (P=.006). Findings suggest that this hospital-based navigation program is filling a real need of patients across the cancer care continuum. A triage protocol and an integrated data capture system could help improve the targeting and documentation of cancer patient navigation services. PMID:23795311

  2. Two Programs for Primary Care Practitioners: Family Medicine Training in an Affiliated University Hospital Program and Primary Care Graduate Training in an Urban Private Medical Center

    ERIC Educational Resources Information Center

    Farley, Eugene S.; Piemme, Thomas E.

    1975-01-01

    Eugene Farley describes the University of Rochester and Highland Hospital Family Medicine Program for teaching of primary care internists, primary care pediatricians, and family doctors. Thomas Piemme presents the George Washington University School of Medicine alternative, a 2-year program in an ambulatory setting leading to broad eligibility in…

  3. Palliative Care Education in Nurse Practitioner Programs: A Survey of Academic Deans.

    PubMed

    Jensen-Seaman, Kari; Hebert, Randy S

    2016-01-01

    The need for clinicians trained in palliative care will increase as more Americans live with life-limiting illness. Although multiple studies have described the nature of palliative care education in prelicensure programs, there have been no similar studies of nurse practitioner programs. We surveyed 101 nurse practitioner programs. Most programs provide little instruction in palliative care; education is often limited to a few hours of lecture. One-third of programs offer no instruction. Although palliative care is an important component of advanced practice nursing practice, programs may not be providing adequate education. PMID:26862687

  4. "I Want Child Care He's Gonna Be Happy in": A Case Study of a Father's Child Care Experiences

    ERIC Educational Resources Information Center

    Ceglowski, Deborah; Shears, Jeffrey; Furman, Richard

    2010-01-01

    Research Findings: This in-depth single case study explores the experiences of a single father with finding and maintaining child care for his son. This American middle-income, Caucasian father lives and works in Minnesota. Findings include difficulty locating and maintaining child care, dissatisfaction with child care quality, concerns about…

  5. Implementing a Palliative Care Nurse Leadership Fellowship Program in Uganda.

    PubMed

    Downing, Julia; Leng, Mhoira; Grant, Liz

    2016-05-01

    Global oncology and palliative care needs are increasing faster than the available capacity to meet these needs. This is particularly marked in sub-Saharan Africa, where healthcare capacity and systems are limited and resources are stretched. Uganda, a country of 35.6 million people in eastern Africa, faces the challenges of a high burden of communicable disease and a rising number of cases of non-communicable disease, including cancer. The vast majority of patients in Uganda are diagnosed with cancer too late for curative treatment to be an option because of factors like poor access to healthcare facilities, a lack of health education, poverty, and delays resulting from seeking local herbal or other traditional remedies. This article describes an innovative model of nurse leadership training in Uganda to improve the delivery of palliative care. The authors believe this model can be applicable to other low- and middle-income countries, where health resources are constrained and care needs are great.
. PMID:27105201

  6. What Causes Care Coordination Problems? A Case for Microanalysis

    PubMed Central

    Zachary, Wayne; Maulitz, Russell Charles; Zachary, Drew A.

    2016-01-01

    Introduction: Care coordination (CC) is an important fulcrum for pursuing a range of health care goals. Current research and policy analyses have focused on aggregated data rather than on understanding what happens within individual cases. At the case level, CC emerges as a complex network of communications among providers over time, crossing and recrossing many organizational boundaries. Micro-level analysis is needed to understand where and how CC fails, as well as to identify best practices and root causes of problems. Coordination Process Diagramming: Coordination Process Diagramming (CPD) is a new framework for representing and analyzing CC arcs at the micro level, separating an arc into its participants and roles, communication structure, organizational structures, and transitions of care, all on a common time line. Conclusion: Comparative CPD analysis across a sample of CC arcs identifies common CC problems and potential root causes, showing the potential value of the framework. The analyses also suggest intervention strategies that could be applied to attack the root causes of CC problems, including organizational changes, education and training, and additional health information technology development. PMID:27563685

  7. Environmental Technology Verification (ETV) Program Case Studies: Demonstrating Program Outcomes, Volume III

    EPA Science Inventory

    This booklet, ETV Program Case Studies: Demonstrating Program Outcomes, Volume III contains two case studies, addressing verified environmental technologies for decentalized wastewater treatment and converting animal waste to energy. Each case study contains a brief description ...

  8. 32 CFR 199.16 - Supplemental Health Care Program for active duty members.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 2 2014-07-01 2014-07-01 false Supplemental Health Care Program for active duty... (CHAMPUS) § 199.16 Supplemental Health Care Program for active duty members. (a) Purpose and applicability. (1) The purpose of this section is to implement, with respect to health care services provided...

  9. 32 CFR 199.16 - Supplemental Health Care Program for active duty members.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Supplemental Health Care Program for active duty... (CHAMPUS) § 199.16 Supplemental Health Care Program for active duty members. (a) Purpose and applicability. (1) The purpose of this section is to implement, with respect to health care services provided...

  10. 32 CFR 199.16 - Supplemental Health Care Program for active duty members.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 2 2012-07-01 2012-07-01 false Supplemental Health Care Program for active duty... (CHAMPUS) § 199.16 Supplemental Health Care Program for active duty members. (a) Purpose and applicability. (1) The purpose of this section is to implement, with respect to health care services provided...

  11. 32 CFR 199.16 - Supplemental Health Care Program for active duty members.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 2 2013-07-01 2013-07-01 false Supplemental Health Care Program for active duty... (CHAMPUS) § 199.16 Supplemental Health Care Program for active duty members. (a) Purpose and applicability. (1) The purpose of this section is to implement, with respect to health care services provided...

  12. 32 CFR 199.16 - Supplemental Health Care Program for active duty members.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 2 2011-07-01 2011-07-01 false Supplemental Health Care Program for active duty... (CHAMPUS) § 199.16 Supplemental Health Care Program for active duty members. (a) Purpose and applicability. (1) The purpose of this section is to implement, with respect to health care services provided...

  13. 77 FR 17143 - Medicaid Program; Eligiblity Changes Under the Affordable Care Act of 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-23

    ... Medicaid eligibility changes under the Affordable Care Act (listed in more detail in 76 FR 51155) and... Services 42 CFR Parts 431, 435 and 457 Medicaid Program; Eligibility Changes Under the Affordable Care Act... Parts 431, 435, and 457 RIN 0938-AQ62 Medicaid Program; Eligiblity Changes Under the Affordable Care...

  14. Risk Factors Associated with Children Lost to Care in a State Early Childhood Intervention Program

    ERIC Educational Resources Information Center

    Giannoni, Peggy P.; Kass, Philip H.

    2010-01-01

    A retrospective cohort study was conducted to identify risk factors associated with children lost to care, and their families, compared to those not lost to care within the California Early Start Program. The cohort included data on 8987 children enrolled in the Early Start Program in 1998. This cohort consisted of 2443 children lost to care, 6363…

  15. 45 CFR 60.15 - Reporting exclusions from participation in Federal or state health care programs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... or state health care programs. 60.15 Section 60.15 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... exclusions from participation in Federal or state health care programs. (a) Who must report. Federal Government agencies and state law and fraud enforcement agencies must report health care...

  16. Goals and Characteristics of Long-Term Care Programs: An Analytic Model.

    ERIC Educational Resources Information Center

    Braun, Kathryn L.; Rose, Charles L.

    1989-01-01

    Used medico-social analytic model to compare five long-term care programs: Skilled Nursing Facility-Intermediate Care Facility (SNF-ICF) homes, ICF homes, foster homes, day hospitals, and home care. Identified similarities and differences among programs. Preliminary findings suggest that model is useful in the evaluation and design of long-term…

  17. 76 FR 5222 - Notice of Federal Long Term Care Insurance Program Open Season

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-28

    ... MANAGEMENT Notice of Federal Long Term Care Insurance Program Open Season AGENCY: Office of Personnel Management. ACTION: Notice of Federal Long Term Care Insurance Open Season. SUMMARY: The Office of Personnel Management (OPM) is announcing an Open Season for the Federal Long Term Care Insurance Program (FLTCIP)....

  18. 78 FR 58291 - TRICARE; Fiscal Year 2014 Continued Health Care Benefit Program Premium Update

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-23

    ... of the Secretary TRICARE; Fiscal Year 2014 Continued Health Care Benefit Program Premium Update AGENCY: Office of the Secretary, DoD. ACTION: Notice of Updated Continued Health Care Benefit Program Premiums for Fiscal Year 2014. SUMMARY: This notice provides the updated Continued Health Care...

  19. Genital infections and syndromic diagnosis among HIV-infected women in HIV care programs in Kenya

    PubMed Central

    Djomand, Gaston; Gao, Hongjiang; Singa, Benson; Hornston, Sureyya; Bennett, Eddas; Odek, James; McClelland, R. Scott; John-Stewart, Grace; Bock, Naomi

    2015-01-01

    Background Control of genital infections remains challenging in most regions. Despite advocacy by the World Health Organization (WHO) for syndromic case management, there are limited data on the syndromic approach, especially in HIV care settings. This study compared the syndromic approach against laboratory diagnosis among women in HIV care in Kenya. Methods A mobile team visited 39 large HIV care programs in Kenya and enrolled participants using population-proportionate sampling. Participants provided behavioral and clinical data with genital and blood specimens for lab testing. Results Among 1,063 women, 68.4% had been on antiretroviral therapy >1 year; 58.9% were using cotrimoxazole prophylaxis; 51 % had CD4+T-lymphocytes < 350 cells/mL. Most women (63.1%) reported at least one genital symptom. Clinical signs were found in 63% of women; and 30.8% had an etiological diagnosis. Bacterial vaginosis (17.4%), vaginal candidiasis (10.6%) and trichomoniasis (10.5%) were the most common diagnoses. Using laboratory diagnoses as gold standard, sensitivity and positive predictive value of the syndromic diagnosis for vaginal discharge were 47.6% and 52.7%, respectively, indicating a substantial amount of overtreatment. A systematic physical examination increased by 9.3% the positive predictive value for genital ulcer disease. Conclusions Women attending HIV care programs in Kenya have high rates of vaginal infections. Syndromic diagnosis was a poor predictor of those infections. PMID:25614522

  20. Orientation of Medical Residents to the Psychosocial Aspects of Primary Care: Influence of Training Program.

    ERIC Educational Resources Information Center

    Eisenthal, Sherman; And Others

    1994-01-01

    A survey of 63 general medical residents found most accepted the psychosocial role of the primary care physician, found it most appropriate in ambulatory care settings, felt ambivalent about their ability to perform it, and assigned it secondary priority in patient care. More attention by training programs to ambulatory care and psychosocial…

  1. [Nursing care in patients undergoing radiological surgery. A case report].

    PubMed

    Armero-Barranco, David; Ruiz-Mateos, María; Alcaraz-Baños, Miguel; Bernal-Páez, Fernando Luis

    2007-01-01

    We report the case of a 73-year-old man with medical diagnoses of long-standing diabetes mellitus, chronic ischemia of the lower limbs and intermittent claudication, for which the patient had been treated with minimally invasive radiological surgery. On arrival at the radiology unit, the patient had nursing diagnoses of anxiety and fear. Intraoperatively, the client had nursing diagnoses of pain, urine retention and infection risk. At discharge, a collaboration problem was detected and hemorrhagic risk. The patient received individualized nursing care. Interventions were planned following the nursing intervention classification (NIC) and the expected results for these interventions followed the Nursing Outcomes Classification (NOC) taxonomy. The application of an appropriate nursing care plan contributes to making the patient's hospital stay easier, more comfortable and less traumatic. PMID:17915125

  2. Multimedia medical case authorship and simulator program.

    PubMed

    Berger, R G; Boxwala, A

    1995-01-01

    For the last several years, third and fourth year medical students rotating on the rheumatology/immunology service at the University of North Carolina School of Medicine have been using a laptop computer as a teaching adjunct to their formal training in rheumatology. The laptop contains diagnostic programs, reference management and clinical note generation facilities, remote medline access, and most recently, multimedia case simulations. These simulations have been created by the use of a case authoring and simulation system which is presented in this demonstration. The program is divided into simulator and designer modules and uses graphics and sound to portray such data as physical examination findings, blood smears, radiographs, heart sounds, etc. The simulator module includes diagnostic sections with feedback to the student as well as robust patient management trees with an occasional circuitous route for patient outcome. The student receives a numerical score based on deviations from the correct path and optimal cost as designated by the case designer. The system simulates complete management of a patient from the first encounter until treatment is complete. During each encounter, a student obtains the patient's history, physical examination findings, orders tests and reviews their results, makes a differential diagnosis, and treats the patient. The patient's progress and further treatment options at any time are dependent on the treatment option selected by the student at an earlier stage. Students are given the costs of ancillary tests and hospitalization before they order them. Words or phrases can be marked as hypertext and the student can get more information about the marked words by a mouse click. The designer interface of the program creates the clinical case by prompts and requests for information from the designer who needs no programming skills. The designer is almost always an expert faculty member who bases the simulated case on a real patient

  3. Study protocol: translating and implementing psychosocial interventions in aged home care the lifestyle engagement activity program (LEAP) for life

    PubMed Central

    2013-01-01

    Background Tailored psychosocial activity-based interventions have been shown to improve mood, behaviour and quality of life for nursing home residents. Occupational therapist delivered activity programs have shown benefits when delivered in home care settings for people with dementia. The primary aim of this study is to evaluate the effect of LEAP (Lifestyle Engagement Activity Program) for Life, a training and practice change program on the engagement of home care clients by care workers. Secondary aims are to evaluate the impact of the program on changes in client mood and behaviour. Methods/design The 12 month LEAP program has three components: 1) engaging site management and care staff in the program; 2) employing a LEAP champion one day a week to support program activities; 3) delivering an evidence-based training program to care staff. Specifically, case managers will be trained and supported to set meaningful social or recreational goals with clients and incorporate these into care plans. Care workers will be trained in and encouraged to practise good communication, promote client independence and choice, and tailor meaningful activities using Montessori principles, reminiscence, music, physical activity and play. LEAP Champions will be given information about theories of organisational change and trained in interpersonal skills required for their role. LEAP will be evaluated in five home care sites including two that service ethnic minority groups. A quasi experimental design will be used with evaluation data collected four times: 6-months prior to program commencement; at the start of the program; and then after 6 and 12 months. Mixed effect models will enable comparison of change in outcomes for the periods before and during the program. The primary outcome measure is client engagement. Secondary outcomes for clients are satisfaction with care, dysphoria/depression, loneliness, apathy and agitation; and work satisfaction for care workers. A process

  4. A disease management program for heart failure: collaboration between a home care agency and a care management organization.

    PubMed

    Gorski, Lisa A; Johnson, Kathy

    2003-01-01

    This article describes a collaborative approach to manage patients with heart failure between a home care agency and a care management agency. The resulting disease management program used a combination of home visits and phone contact. Care management plans emphasized patient education on increasing adherence to medical and diet regimens, and recognizing early symptoms of exacerbation that could lead to rehospitalization. Clinician activities and patient outcomes are described. PMID:14646784

  5. Local Long-Term Care Ombudsman Program effectiveness and the measurement of program resources.

    PubMed

    Hollister, Brooke A; Estes, Carroll L

    2013-09-01

    Local Long-Term Care Ombudsman Programs (LLTCOPs) protect the health, safety, welfare, and rights of residents in long-term care (LTC) facilities. This study examines the (a) existing resources available to LLTCOPs in Georgia, California, and New York, (b) relationship of resources to LLTCOP's reported effectiveness in meeting its federal mandates, and (c) state-specific mediating factors influencing LLTCOPs' resources and reported effectiveness. Quantitative and qualitative data from the National Ombudsman Reporting System (NORS) and a telephone survey of LLTCOPs in Georgia, California, and New York were collected and analyzed. Resource adequacy, as measured by beds per full-time equivalent staff (beds/FTE), is inconsistently associated with effectiveness in meeting federal mandates across and within the states studied. Analysis of alternate resource measures suggests a threshold of LLTCOP size, under which program effectiveness may be lower. LLTCOPs report the changing LTC environment and additional state mandates as factors influencing resource adequacy. PMID:25474795

  6. Creating and Maintaining a Wellness Environment in Child Care Centers Participating in the Child and Adult Care Food Program

    ERIC Educational Resources Information Center

    Lofton, Kristi L.; Carr, Deborah H.

    2010-01-01

    Purpose/Objectives: This study identifies issues associated with creating and maintaining a wellness environment in child care centers (CCCs) participating in the Child and Adult Care Food Program (CACFP). Methods: Structured interviews and focus groups were conducted with CCC professionals and state agency personnel to develop a survey to assess…

  7. 75 FR 21301 - Office of Clinical and Preventive Services; Elder Care Initiative Long-Term Care Grant Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-23

    ... HUMAN SERVICES Indian Health Service Office of Clinical and Preventive Services; Elder Care Initiative Long-Term Care Grant Program Announcement Type: New. Funding Announcement Number: HHS-2010-IHS-EHC-0001... Service (IHS) announces the availability of up to $600,000 for competitive grants through the Elder...

  8. Caring for Our Children. National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs.

    ERIC Educational Resources Information Center

    American Public Health Association, Washington, DC.

    This document presents a set of standards to be used in planning and establishing a high quality child care program. The standards are based on the recommendations of technical panels that studied particular facets in child care and are intended to serve as goals for practice and guidelines for implementation. The nine chapters of the text address…

  9. Effects of Early Day Care Experience on Subsequent Observed Program Behaviors.

    ERIC Educational Resources Information Center

    Lay, Margaret Z.; Meyer, William J.

    To determine if there are discernable effects on children of a group child-care program, the performance of 20 children, 3 to 4 years 10 months of age, who had been cared for in a day-care center from the age of 6 months is compared with that of 20 matched children with no prior day-care program experience. The 40 children participated in…

  10. Caring for the Kids During Family-Centered Programs: A Practical Workbook.

    ERIC Educational Resources Information Center

    Lyman, Alexi; Crane, Jessie

    This handbook for the nonprofessional provides basic information, organizational suggestions,and program ideas for operating child care programs which do not require advance registration or regular attendance. The focus is on child care provided in conjunction with "family-centered programs" (such as parent discussion groups) where parents remain…

  11. Evaluation of the Child Care Program 1978-1979. Report No. 8034.

    ERIC Educational Resources Information Center

    Figgures, Cleo

    The Child Care Program was evaluated in terms of developmental activities, parent involvement, staff development, and supportive services. Results from the Developmental Behavior Checklist (DBC) indicated that the Child Care Program's performance was better than the average of the other programs in language, for all age groups. Also indicated was…

  12. Sliding Fee Scales That Work: A Model for State Child Care Programs.

    ERIC Educational Resources Information Center

    Lookner, Sherrie

    Guiding principles for using sliding fee scales are presented in this paper in an effort to help states plan new child care initiatives, coordinate or strengthen existing programs, and improve sliding fee scales for current programs. Introductory comments urge states to adopt a single sliding fee scale for all their child care programs. The report…

  13. Integrating Collaborative Interprofessional Simulation into Pre-Licensure Health Care Programs.

    PubMed

    New, Sandra N; Huff, Deborah Cooley; Hutchison, Lisa C; Bilbruck, Timothy J; Ragsdale, Patricia Sue; Jennings, Joy E; Greenfield, M

    2015-01-01

    This interprofessional education activity incorporated National League of Nursing unfolding case studies and patient simulation with nursing, pharmacy, and medical students. Faculty developed a full-day simulation experience; the most unique element was a team meeting where nursing students presented home health findings to an interprofessional team, and students worked together to design a comprehensive plan of care. All students were in their geriatric specialty program rotations. The interprofessional simulation introduced students across disciplines for the purpose of enhancing communication, developing mutual respect, and identifying role clarity through team learning. PMID:26753301

  14. Case-volume, quality of care, and care efficiency in coronary artery bypass surgery

    PubMed Central

    Auerbach, Andrew D.; Hilton, Joan F.; Maselli, Judith; Pekow, Penelope S.; Rothberg, Michael B.; Lindenauer, Peter K.

    2016-01-01

    Background How case volume and quality of care relate to hospital costs or length of stay are important questions as we seek to improve the value of healthcare. Methods Observational study of patients 18 or older who underwent coronary artery bypass grafting surgery in a network of US hospitals. Case volumes were estimated using our dataset. Quality was assessed by whether recommended medications and services were not received in ideal patients, as well as the overall number of measures missed. We used multivariable hierarchical models to estimate the effects of case volume and quality on hospital cost and length of stay. Results The majority of hospitals (51%) and physicians (78%) were lowest volume providers and only 18% of patients received all quality of care measures. Median length of stay was 7 days (interquartile range [IQR] 6 to 11 days), and median costs were $25140 (IQR $19677, $33121). In analyses adjusted for patient and site characteristics, lowest volume hospitals had 19.8% higher costs (95% CI 3.9% to 38% higher); adjusting for care quality did not eliminate differences in costs. Low surgeon volume was also associated with higher costs, though less strongly (3.1% higher costs, 95% CI 0.6% to 5.6% higher). Individual quality measures had inconsistent associations with costs or length of stay, but patients who had no quality measures missed had much lower length of stay and costs than those who missed even one. Conclusions Avoiding lowest volume hospitals and maximizing quality are separate approaches to improving healthcare efficiency through reducing costs of coronary bypass surgery. PMID:20660837

  15. A realistic evaluation: the case of protocol-based care

    PubMed Central

    2010-01-01

    Background 'Protocol based care' was envisioned by policy makers as a mechanism for delivering on the service improvement agenda in England. Realistic evaluation is an increasingly popular approach, but few published examples exist, particularly in implementation research. To fill this gap, within this paper we describe the application of a realistic evaluation approach to the study of protocol-based care, whilst sharing findings of relevance about standardising care through the use of protocols, guidelines, and pathways. Methods Situated between positivism and relativism, realistic evaluation is concerned with the identification of underlying causal mechanisms, how they work, and under what conditions. Fundamentally it focuses attention on finding out what works, for whom, how, and in what circumstances. Results In this research, we were interested in understanding the relationships between the type and nature of particular approaches to protocol-based care (mechanisms), within different clinical settings (context), and what impacts this resulted in (outcomes). An evidence review using the principles of realist synthesis resulted in a number of propositions, i.e., context, mechanism, and outcome threads (CMOs). These propositions were then 'tested' through multiple case studies, using multiple methods including non-participant observation, interviews, and document analysis through an iterative analysis process. The initial propositions (conjectured CMOs) only partially corresponded to the findings that emerged during analysis. From the iterative analysis process of scrutinising mechanisms, context, and outcomes we were able to draw out some theoretically generalisable features about what works, for whom, how, and what circumstances in relation to the use of standardised care approaches (refined CMOs). Conclusions As one of the first studies to apply realistic evaluation in implementation research, it was a good fit, particularly given the growing emphasis on

  16. Equity in health care financing: The case of Malaysia

    PubMed Central

    Yu, Chai Ping; Whynes, David K; Sach, Tracey H

    2008-01-01

    Background Equitable financing is a key objective of health care systems. Its importance is evidenced in policy documents, policy statements, the work of health economists and policy analysts. The conventional categorisations of finance sources for health care are taxation, social health insurance, private health insurance and out-of-pocket payments. There are nonetheless increasing variations in the finance sources used to fund health care. An understanding of the equity implications would help policy makers in achieving equitable financing. Objective The primary purpose of this paper was to comprehensively assess the equity of health care financing in Malaysia, which represents a new country context for the quantitative techniques used. The paper evaluated each of the five financing sources (direct taxes, indirect taxes, contributions to Employee Provident Fund and Social Security Organization, private insurance and out-of-pocket payments) independently, and subsequently by combined the financing sources to evaluate the whole financing system. Methods Cross-sectional analyses were performed on the Household Expenditure Survey Malaysia 1998/99, using Stata statistical software package. In order to assess inequality, progressivity of each finance sources and the whole financing system was measured by Kakwani's progressivity index. Results Results showed that Malaysia's predominantly tax-financed system was slightly progressive with a Kakwani's progressivity index of 0.186. The net progressive effect was produced by four progressive finance sources (in the decreasing order of direct taxes, private insurance premiums, out-of-pocket payments, contributions to EPF and SOCSO) and a regressive finance source (indirect taxes). Conclusion Malaysia's two tier health system, of a heavily subsidised public sector and a user charged private sector, has produced a progressive health financing system. The case of Malaysia exemplifies that policy makers can gain an in depth

  17. 76 FR 21372 - Medicare Program; Solicitation for Proposals for the Medicare Community-Based Care Transitions...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-15

    ...) hospitals and whose governing bodies include sufficient representation of multiple health care stakeholders... cognitive impairments. In selecting CBOs to participate in the program, preference will be given to...

  18. Challenges to Providing End-of-Life Care to Low-Income Elders with Advanced Chronic Disease: Lessons Learned from a Model Program

    ERIC Educational Resources Information Center

    Kramer, Betty J.; Auer, Casey

    2005-01-01

    Purpose: This study explored the challenges in providing end-of-life care to low-income elders with multiple comorbid chronic conditions in a fully "integrated" managed care program, and it highlighted essential recommendations. Design and Methods: A case-study design was used that involved an extensive analysis of qualitative data from five focus…

  19. Medicaid and Children's Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in Managed Care, and Revisions Related to Third Party Liability. Final rule.

    PubMed

    2016-05-01

    This final rule modernizes the Medicaid managed care regulations to reflect changes in the usage of managed care delivery systems. The final rule aligns, where feasible, many of the rules governing Medicaid managed care with those of other major sources of coverage, including coverage through Qualified Health Plans and Medicare Advantage plans; implements statutory provisions; strengthens actuarial soundness payment provisions to promote the accountability of Medicaid managed care program rates; and promotes the quality of care and strengthens efforts to reform delivery systems that serve Medicaid and CHIP beneficiaries. It also ensures appropriate beneficiary protections and enhances policies related to program integrity. This final rule also implements provisions of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) and addresses third party liability for trauma codes. PMID:27192729

  20. The excess health care costs of KardioPro, an integrated care program for coronary heart disease prevention.

    PubMed

    Becker, Christian; Holle, Rolf; Stollenwerk, Björn

    2015-06-01

    Coronary heart disease (CHD) is a major cause of death and important driver of health care costs. Recent German health care reforms have promoted integrated care contracts allowing statutory health insurance providers more room to organize health care provision. One provider offers KardioPro, an integrated primary care-based CHD prevention program. As insurance providers should be aware of the financial consequences when developing optional programs, this study aims to analyze the costs associated with KardioPro participation. 13,264 KardioPro participants were compared with a propensity score-matched control group. Post-enrollment health care costs were calculated based on routine data over a follow-up period of up to 4 years. For those people who incurred costs, KardioPro participation was significantly associated with increased physician costs (by 33%), reduced hospital costs (by 19%), and reduced pharmaceutical costs (by 16%). Overall costs were increased by 4%, but this was not significant. Total excess costs per observation year were €131 per person (95% confidence interval: [€-36.5; €296]). Overall, KardioPro likely affected treatment as the program increased costs of physician services and reduced costs of hospital services. Further effects of substituting potential inpatient care with increased outpatient care might become fully apparent only over a longer time horizon. PMID:25656962

  1. A national long-term care program for the United States. A caring vision. The Working Group on Long-term Care Program Design, Physicians for a National Health Program.

    PubMed

    Harrington, C; Cassel, C; Estes, C L; Woolhandler, S; Himmelstein, D U

    1991-12-01

    The financing and delivery of long-term care (LTC) need substantial reform. Many cannot afford essential services; age restrictions often arbitrarily limit access for the nonelderly, although more than a third of those needing care are under 65 years old; Medicaid, the principal third-party payer for LTC, is biased toward nursing home care and discourages independent living; informal care provided by relatives and friends, the only assistance used by 70% of those needing LTC, is neither supported nor encouraged; and insurance coverage often excludes critically important services that fall outside narrow definitions of medically necessary care. We describe an LTC program designed as an integral component of the national health program advanced by Physicians for a National Health Program. Everyone would be covered for all medically and socially necessary services under a single public plan, federally mandated and funded but administered locally. An LTC payment board in each state would contract directly with providers through a network of local public agencies responsible for eligibility determination and care coordination. Nursing homes, home care agencies, and other institutional providers would be paid a global budget to cover all operating costs and would not bill on a per-patient basis. Alternatively, integrated provider organizations could receive a capitation fee to cover a broad range of LTC and acute care services. Individual practitioners could continue to be paid on a fee-for-service basis or could receive salaries from institutional providers. Support for innovation, training of LTC personnel, and monitoring of the quality of care would be greatly augmented. For-profit providers would be compensated for past investments and phased out. Our program would add between $18 billion and $23.5 billion annually to current spending on LTC. Polls indicate that a majority of Americans want such a program and are willing to pay earmarked taxes to support it. PMID

  2. Leadership models in health care - a case for servant leadership.

    PubMed

    Trastek, Victor F; Hamilton, Neil W; Niles, Emily E

    2014-03-01

    Our current health care system is broken and unsustainable. Patients desire the highest quality care, and it needs to cost less. To regain public trust, the health care system must change and adapt to the current needs of patients. The diverse group of stakeholders in the health care system creates challenges for improving the value of care. Health care providers are in the best position to determine effective ways of improving the value of care. To create change, health care providers must learn how to effectively lead patients, those within health care organizations, and other stakeholders. This article presents servant leadership as the best model for health care organizations because it focuses on the strength of the team, developing trust and serving the needs of patients. As servant leaders, health care providers may be best equipped to make changes in the organization and in the provider-patient relationship to improve the value of care for patients. PMID:24486078

  3. A new analytical framework of 'continuum of prevention and care' to maximize HIV case detection and retention in care in Vietnam

    PubMed Central

    2012-01-01

    no systematic monitoring of referral services. Conclusions Our COPC analytical framework was instrumental in identifying system-related strengths and constraints that contribute to HIV case detection and retention in care. The national HIV program plans to strengthen provincial programming by re-defining various service linkages and accelerate the transition from project-based approach to integrated service delivery in line with the ‘Treatment 2.0’ initiative. PMID:23272730

  4. 75 FR 70165 - Medicare Program; Request for Information Regarding Accountable Care Organizations and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-17

    ... HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Chapter IV Medicare Program; Request for Information Regarding Accountable Care Organizations and the Medicare Shared Saving Program AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Request for information. SUMMARY: This...

  5. Pneumothoraces in a Neonatal Tertiary Care Unit: Case Series

    PubMed Central

    Ali, Rehan; Ahmed, Shakeel; Qadir, Maqbool; Maheshwari, Prem; Khan, Rehan

    2013-01-01

    Objective Neonatal pneumothoraces are associated with high mortality. Prompt recognition to minimize its complications is paramount for ultimate outcome of these babies. Methods A retrospective case series study was carried out at Aga khan University Hospital, from January 2010 to December 2010 to determine the etiology and outcome of neonates with pneumothorax in a neonatal tertiary care unit. Results Ten neonates diagnosed radiologically with pneumothoraces were included. M: F ratio was 1:2.3. Birth weight ranged from 1750-3600 grams with a mean of 2100 grams. The occurrence of pneumothoraces was 50% on the left side, 20% on right, and 30% were bilateral. Primary etiology included pneumonia and sepsis (30%), hyaline membrane disease (20%), meconium aspiration syndrome (20%) and congenital diaphragmatic hernia (10%). Spontaneous pneumothoraces were present in 20% of cases. In our study, the incidence of neonatal pneumothoraces was 2.5/1000 births compared to 10-15/1000 in Denmark, 10-20/1000 in Turkey and 6.3/1000 from Vermont Oxford Group. Despite the small number of cases, one incidental finding was the occurrence of pneumothorax, which declined in elective cesarean section after 37 weeks gestation i.e., 1.3 of 1000 births. Mortality was 60% determined mainly by the primary etiology and other co-morbid conditions. Conclusion The study showed a higher number of mortality cases (60%). Although, it was difficult to draw a conclusion from the limited number of cases, there may be a benefit on neonatal respiratory outcome to be obtained by better selection of mothers and by waiting until 37 weeks before performing elective cesarean section. Adequate clinician training in soft ventilation strategies will reduce the occurrence of pneumothoraces. PMID:23386951

  6. Quality Assurance for Social Service Programs: Lessons from Health Care.

    ERIC Educational Resources Information Center

    Coulton, Claudia J.

    1982-01-01

    Suggests that many aspects of quality assurance in health care can be applied to social service agencies. Reviews what has been learned about quality assurance in health care and suggests guidelines for its implementation in social services. (Author/JAC)

  7. The INTERACT Quality Improvement Program: An Overview for Medical Directors and Primary Care Clinicians in Long-Term Care

    PubMed Central

    Ouslander, Joseph G.; Bonner, Alice; Herndon, Laurie; Shutes, Jill

    2014-01-01

    INTERACT is a publicly available quality improvement program that focuses on improving the identification, evaluation, and management of acute changes in condition of nursing home residents. Effective implementation has been associated with substantial reductions in hospitalization of nursing home residents. Familiarity with and support of program implementation by medical directors and primary care clinicians in the nursing home setting are essential to effectiveness and sustainability of the program over time. In addition to helping nursing homes prevent unnecessary hospitalizations and their related complications and costs, and thereby continuing to be or becoming attractive partners for hospitals, health care systems, managed care plans, and ACOs, effective INTERACT implementation will assist nursing homes in meeting the new requirement for a robust QAPI program which is being rolled out by the federal government over the next year. PMID:24513226

  8. Primary health care and donor dependency: a case study of nongovernment assistance in Burkina Faso.

    PubMed

    Maclure, R

    1995-01-01

    Primary health care assistance has become prominent in the rural development programs of many nongovernment organizations throughout sub-Saharan Africa. By emphasizing education and the promotion of new participatory health systems, most such programs aim to enhance the conditions of women as principal community care givers. Yet village-level health assistance in Africa is not without shortcomings. This is exemplified in a case study of two nongovernment programs in Burkina Faso's Namentenga Province. Although both programs have contributed to maternal health and infant survival, they have also induced new ties of donor dependency. This appears to present a conundrum for the sponsoring agencies which espouse self-reliance as a development assistance goal. In fact, however, where the intervention of nongovernment organizations helps to improve rural health, new dimensions of dependency may prove to be a positive first stage in the mobilization of women and the development of locally managed health systems. For this to be so, much is contingent on the capacity of these organizations to integrate local participation in their own planning and management processes, and to augment the professional status of indigenous health workers. PMID:7591380

  9. Reframing tobacco dependency management in acute care: A case study.

    PubMed

    Schultz, Annette S H; Guzman, Randolph; Sawatzky, Jo-Ann V; Thurmeier, Rick; Fedorowicz, Anna; Fulmore, Kaitlin

    2016-08-01

    Effective tobacco dependence treatment within acute care tends to be inadequate. The purpose of the Utilizing best practices to Manage Acute care patients Tobacco Dependency (UMAT) was to implement and evaluate an evidence-based intervention to support healthcare staff to effectively manage nicotine withdrawal symptoms of acute surgical patients. Data collection for this one-year longitudinal case study included: relevant patient experiences and staff reported practice, medication usage, and chart review. Over the year each data source suggested changes in tobacco dependence treatment. Key changes in patient survey responses (N=55) included a decrease in daily smoking and cigarette cravings. Of patients who used nicotine replacement therapy, they reported an increase in symptom relief. Staff (N=45) were surveyed at baseline, mid-point and end of study. Reported rates of assessing smoking status did not change over the year, but assessment of withdrawal symptoms emerged as daily practice and questions about cessation diminished. Also delivery of nicotine replacement therapy products increased over the year. Chart reviews showed a shift in content from documenting smoking behavior to withdrawal symptoms and administration of nicotine replacements; also frequency of comments increased. In summary, the evidence-based intervention influenced unit norms and reframed the culture related to tobacco dependence treatment. PMID:27392584

  10. CASE--A PROGRAM FOR SIMULATION OF CONCEPT LEARNING.

    ERIC Educational Resources Information Center

    BAKER, FRANK B.

    THE "CASE" PROGRAM WAS DEVELOPED TO PROVIDE A VEHICLE FOR UNDERSTANDING THE PSYCHOLOGICAL PROCESSES INVOLVED IN CONCEPT LEARNING BY MEANS OF COMPUTER SIMULATION TECHNIQUES. BECAUSE THE MAJORITY OF PUBLISHED "SIMULATION OF CONCEPT LEARNING" PROGRAMS PROVIDED FEW INSIGHTS INTO THE LEARNING PROCESS, THE "CASE" PROGRAM WAS DESIGNED TO PROVIDE A BETTER…

  11. Learning by doing. Training health care professionals to become facilitator of moral case deliberation.

    PubMed

    Stolper, Margreet; Molewijk, Bert; Widdershoven, Guy

    2015-03-01

    Moral case deliberation (MCD) is a dialogue among health care professionals about moral issues in practice. A trained facilitator moderates the dialogue, using a conversation method. Often, the facilitator is an ethicist. However, because of the growing interest in MCD and the need to connect MCD to practice, healthcare professionals should also become facilitators themselves. In order to transfer the facilitating expertise to health care professionals, a training program has been developed. This program enables professionals in health care institutions to acquire expertise in dealing with moral questions independent of the expertise of an (external) ethicist. Over the past 10 years, we developed a training program with a specific mix of theory and practice, aiming to foster the right attitude, skills and knowledge of the trainee. The content and the didactics of the training developed in line with the philosophy of MCD: pragmatic hermeneutics, dialogical ethics and Socratic epistemology. Central principles are: 'learning by doing', 'reflection instead of ready made knowledge', and 'dialogue on dialogue'. This paper describes the theoretical background and the didactic content of the current training. Furthermore, we present didactic tools which we developed for stimulating active learning. We also go into lessons we learned in developing the training. Next, we provide some preliminary data from evaluation research of the training program by participants. The discussion highlights crucial aspects of educating professionals to become facilitators of MCD. The paper ends with concluding remarks and a plea for more evaluative evidence of the effectiveness and meaning of this training program for doing MCD in institutions. PMID:25218568

  12. Theme Issue: Marketing Child Care Programs: Why and How.

    ERIC Educational Resources Information Center

    Frank, Mary, Ed.; Caldwell, Bettye M., Ed.

    1984-01-01

    Contains seven papers divided into three sections addressing: (1) the application of marketing principles to child care organizations and ways of remedying the negative public image of child care; (2) training child care professionals to develop marketing skills; and (3) successful uses of five basic marketing skills illustrated through four case…

  13. Unexplained neuropsychiatric symptoms in intensive care: A Fahr Syndrome case.

    PubMed

    Calili, Duygu Kayar; Mutlu, Nevzat Mehmet; Mutlu Titiz, Ayse Pinar; Akcaboy, Zeynep Nur; Aydin, Eda Macit; Turan, Isil Ozkocak

    2016-08-01

    Fahr Syndrome is a rare disease where calcium and other minerals are stored bilaterally and symmetrically in the basal ganglia, cerebellar dentate nucleus and white matter. Fahr Syndrome is associated with various metabolic disorders, mainly parathyroid disorders. The presented case discusses a 64-year old male patient admitted to the intensive care unit of our hospital diagnosed with aspiration pneumonia and urosepsis. The cranial tomography examination to explain his nonspecific neurological symptoms showed bilateral calcifications in the temporal, parietal, frontal, occipital lobes, basal ganglia, cerebellar hemisphere and medulla oblongata posteriorly. His biochemical test results also indicated parathormone-calcium metabolic abnormalities. Fahr Syndrome must be considered for a definitive diagnosis in patients with nonspecific neuropsychiatric symptoms and accompanying calcium metabolism disorders in order to control serious morbidity and complications because of neurological damage. PMID:27524543

  14. Evaluation of the Restorative Care Education and Training Program for Nursing Homes

    ERIC Educational Resources Information Center

    Johnson, C. Shanthi Jacob; Myers, Anita M.; Jones, Gareth R.; Fitzgerald, Clara; Lazowski, Darien-Alexis; Stolee, Paul; Orange, J. B.; Segall, Nicole; Ecclestone, Nancy A.

    2005-01-01

    Restorative care attempts to break the cycle of dependency and functional decline in nursing homes by addressing individual resident needs. The Restorative Care Education and Training (RCET) Program consists of a five-week workshop and resource manual for both supervisory and direct care staff. This paper describes the RCET approach and presents…

  15. A Child at the Door: A Guidebook for Starting a Child Care Program in Your Church.

    ERIC Educational Resources Information Center

    North Carolina Rural Economic Development Center, Raleigh.

    This guidebook presents information for use by religious leaders to plan and implement financially sound, high quality child care programs. A foreword describes child care provision as a ministry within the mainstream of congregational activity. Chapter 1, "Assessing the Need," provides a statewide overview of the need for child care services in…

  16. The Impact of a Caregiver Health Education Program on Health Care Costs

    ERIC Educational Resources Information Center

    Toseland, Ronald W.; Smith, Tamara L.

    2006-01-01

    Objectives: This study examined health care cost outcomes resulting from a health education program (HEP), a social work intervention for spouse caregivers of frail older adults. Method: One-hundred five spouses were recruited and randomly assigned to HEP or usual care (UC). Health care utilization and cost data were collected from the HMO's…

  17. 78 FR 48688 - Medicare Program; Comprehensive ESRD Care Initiative; Extension of the Submission Deadlines for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-09

    ... Medicare program. We anticipate that the Comprehensive ESRD Care Model would result in improved health... seamless and integrated care for beneficiaries with ESRD, we are developing a comprehensive care delivery... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH...

  18. The Effect of Home Caregiving Program for Family Members Providing Care for Chronically Ill Relative Client

    ERIC Educational Resources Information Center

    Mohammed, Hussein Jassim; Kamel, Andaleeb Abu

    2015-01-01

    Health care systems in many countries are moving towards outpatient care in which family members are central in providing care for patients with life-threatening illness. Family members and friends haven't knowledge and skills to become caregivers as many studies found that, the need to involve in such program to enhance their ability to be…

  19. 76 FR 29249 - Medicare Program; Pioneer Accountable Care Organization Model: Request for Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-20

    ... HUMAN SERVICES Centers for Medicare & Medicaid Services Medicare Program; Pioneer Accountable Care... participate in the Pioneer Accountable Care Organization Model for a period beginning in 2011 and ending...://innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care-models/pioneer-aco . Application...

  20. 75 FR 18138 - Health Care Eligibility Under the Secretarial Designee Program and Related Special Authorities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-09

    ... of the Secretary 32 CFR Part 108 Health Care Eligibility Under the Secretarial Designee Program and... proposed action would establish policies and assign responsibilities for health care eligibility under the... reimbursement for inpatient health care provided in the United States to foreign military or...

  1. Smallfry Smiles: A Guide for Teaching Dental Health in Community Care Programs.

    ERIC Educational Resources Information Center

    Johnson, Alice; And Others

    This publication has been designed to help nurses, teachers, volunteers, health administrators, social workers, and other individuals in the community in improving dental care instruction for the children in a community dental care program. The publication is based on the premise that availability of dental care services does not necessarily…

  2. Nutrition and Meal Planning in Child-Care Programs: A Practical Guide.

    ERIC Educational Resources Information Center

    Edelstein, Sari

    Designed to assist child care center managers in planning nutritious meals for children in centers or licensed home day care programs, this guide presents information on the nutritional requirements of infants and children, sample menus for child care centers, and resources for further information. The first part of the guide details the…

  3. The 2014 United States National Residency Match Program data for primary care programs: a review.

    PubMed

    Flannery, Michael T

    2015-01-01

    The paper focuses on the past five years of National Residency Match Program (NRMP) information in the Unites States with a comparison point of twenty years ago utilized because of a referenced article. It is well known to our students going through the match that it is more competitive than in prior years. To rank enough programs for your field, take Step 2 early to maximize your score, to get quality letters and to practice mock interviews. The 99% match rate has remained steady over the past five years despite an increase in all primary care disciplines particularly Internal Medicine. Family Medicine and Internal Medicine work with, on average, about half U.S. seniors and half from other groups including Osteopathic and IMG (U.S. citizen and non-U.S. citizen). This can create a holistic experience for residents with a sharing of ideas from students from varied backgrounds. While the Supplemental Offer and Acceptance Program appear as an initial success, the student's goal should be to avoid such a step altogether. The key twenty years ago and today is the existence of appropriate numbers of resident and faculty role models. This is a stressful goal considering the demands on faculty for billing and patient care due to the shiftwork nature of the new work hours. PMID:25579787

  4. World Perspective Case Descriptions on Educational Programs for Adults: Chile.

    ERIC Educational Resources Information Center

    Donoso, Patricio; Gajardo, Marcela

    This document contains two case studies of adult education programs in Chile. Both case studies begin with a "face sheet" on which is recorded basic information about the program and the description. The first case study, prepared by Patricio Donoso, reports on Centro El Canelo de Nos, an inservice center for educators who work with Chile's most…

  5. Reliability of an interactive computer program for advance care planning.

    PubMed

    Schubart, Jane R; Levi, Benjamin H; Camacho, Fabian; Whitehead, Megan; Farace, Elana; Green, Michael J

    2012-06-01

    Despite widespread efforts to promote advance directives (ADs), completion rates remain low. Making Your Wishes Known: Planning Your Medical Future (MYWK) is an interactive computer program that guides individuals through the process of advance care planning, explaining health conditions and interventions that commonly involve life or death decisions, helps them articulate their values/goals, and translates users' preferences into a detailed AD document. The purpose of this study was to demonstrate that (in the absence of major life changes) the AD generated by MYWK reliably reflects an individual's values/preferences. English speakers ≥30 years old completed MYWK twice, 4 to 6 weeks apart. Reliability indices were assessed for three AD components: General Wishes; Specific Wishes for treatment; and Quality-of-Life values (QoL). Twenty-four participants completed the study. Both the Specific Wishes and QoL scales had high internal consistency in both time periods (Knuder Richardson formula 20 [KR-20]=0.83-0.95, and 0.86-0.89). Test-retest reliability was perfect for General Wishes (κ=1), high for QoL (Pearson's correlation coefficient=0.83), but lower for Specific Wishes (Pearson's correlation coefficient=0.57). MYWK generates an AD where General Wishes and QoL (but not Specific Wishes) statements remain consistent over time. PMID:22512830

  6. Reliability of an Interactive Computer Program for Advance Care Planning

    PubMed Central

    Levi, Benjamin H.; Camacho, Fabian; Whitehead, Megan; Farace, Elana; Green, Michael J

    2012-01-01

    Abstract Despite widespread efforts to promote advance directives (ADs), completion rates remain low. Making Your Wishes Known: Planning Your Medical Future (MYWK) is an interactive computer program that guides individuals through the process of advance care planning, explaining health conditions and interventions that commonly involve life or death decisions, helps them articulate their values/goals, and translates users' preferences into a detailed AD document. The purpose of this study was to demonstrate that (in the absence of major life changes) the AD generated by MYWK reliably reflects an individual's values/preferences. English speakers ≥30 years old completed MYWK twice, 4 to 6 weeks apart. Reliability indices were assessed for three AD components: General Wishes; Specific Wishes for treatment; and Quality-of-Life values (QoL). Twenty-four participants completed the study. Both the Specific Wishes and QoL scales had high internal consistency in both time periods (Knuder Richardson formula 20 [KR-20]=0.83–0.95, and 0.86–0.89). Test-retest reliability was perfect for General Wishes (κ=1), high for QoL (Pearson's correlation coefficient=0.83), but lower for Specific Wishes (Pearson's correlation coefficient=0.57). MYWK generates an AD where General Wishes and QoL (but not Specific Wishes) statements remain consistent over time. PMID:22512830

  7. Case managers discuss ethics: dilemmas of an emerging occupation in long-term care in the United States.

    PubMed

    Kane, R A; Penrod, J D; Kivnick, H Q

    1994-01-01

    As case management programs mature, ethical questions undoubtedly arise. Yet there are few, if any, standards by which case managers can guide their actions and decisions. In this article, the authors present the results of a survey of 251 frontline case managers in 10 states who were asked to describe the ethical challenges they face. The respondents were conscious of struggling with difficult, even life-and-death decisions involving important choices in their clients' lives. Generally, the case managers were committed to the ideology of respect for client autonomy but found themselves making uneasy compromises with the concept at every turn. Ethical issues arose not only with the client but also with the client's family, colleagues, and providers. Case managers, long-term care providers, and governmental policymakers could all benefit from both theoretical and practical explorations of desirable approaches to individual and societal long-term care decisions. PMID:8000320

  8. Evaluation of the Person-Centered Care Essentials Program: Importance of Trainers in Achieving Targeted Outcomes

    ERIC Educational Resources Information Center

    King, Scott P.; O'Brien, Catherine J.; Edelman, Perry; Fazio, Sam

    2011-01-01

    A person-centered care (PCC) training program was developed and disseminated to 84 institutes for retired religious persons across the United States. The program was delivered via a train-the-trainer model wherein institute trainers attended a 2-day training conference, then taught the material to direct care workers (DCWs) at their respective…

  9. Evaluation of the Get Set Day Care Program, 1978-1979.

    ERIC Educational Resources Information Center

    Figgures, Cleo

    This study reports results of an evaluation of the developmental, parent involvement, staff development, and supportive services components of the Get Set Day Care Program in Philadelphia. During 1978-1979, the program provided day care and educational services to approximately 4,100 children in 70 sites. Developmental Behavior Checklist (DBC)…

  10. Leadership Program in the Care of Infants and Toddlers: A Training Model. Final Report.

    ERIC Educational Resources Information Center

    Shigaki, Irene S.; Zorn, Vera

    New York University's Leadership Program in the Care of Infants and Toddlers, an interdisciplinary training model, is described in this final report covering the program's three-year grant period from the National Institute of Mental Health. Focusing primarily on training individuals for leadership positions in the area of infant and toddler care,…

  11. Nutrition Standards for Child Care Programs: Meeting Children's Nutrition and Education Needs. Nutrition, Health and Safety.

    ERIC Educational Resources Information Center

    Briley, Margaret E.; Grey, Cynthia R.

    2000-01-01

    Presents information on standards for American child care and early education programs participating in the Child and Adult Care Food Program. Topics discussed include meal plans, nutritional requirements, food preparation and food service, cultural diversity, food safety and sanitation, nutrition education, and emotional climate at mealtimes. (KB)

  12. Military Child Care Programs: Progress Made, More Needed. Report to the Secretary of Defense.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC.

    In response to the House and Senate Armed Services and Appropriations Committees' need for information on the condition of child care facilities, construction requirements, program operation, and methods for controlling costs, the General Accounting Office (GAO) has reviewed child care programs provided for military personnel. Although the…

  13. Physical Activity and Beverages in Home- and Center-Based Child Care Programs

    ERIC Educational Resources Information Center

    Tandon, Pooja S.; Garrison, Michelle M.; Christakis, Dimitri A.

    2012-01-01

    Objective: To describe and compare obesity prevention practices related to physical activity and beverages in home- and center-based child care programs. Methods: A telephone survey of licensed home- and center-based child care programs in Florida, Massachusetts, Michigan, and Washington between October and December 2008. Results: Most programs…

  14. Developing Memory Clinics in Primary Care: An Evidence-Based Interprofessional Program of Continuing Professional Development

    ERIC Educational Resources Information Center

    Lee, Linda; Weston, W. Wayne; Hillier, Loretta M.

    2013-01-01

    Introduction: Primary care is challenged to meet the needs of patients with dementia. A training program was developed to increase capacity for dementia care through the development of Family Health Team (FHT)-based interprofessional memory clinics. The interprofessional training program consisted of a 2-day workshop, 1-day observership, and 2-day…

  15. Evaluation of Access, a Primary Care Program for Indigent Patients: Inpatient and Emergency Room Utilization.

    ERIC Educational Resources Information Center

    Davidson, Richard A.; Giancola, Angela; Gast, Andrea; Ho, Janice; Waddell, Rhondda

    2003-01-01

    Evaluated the impact of Accessing Community Care through Eastside Social Services (ACCESS), a program that provided indigent patients with free primary care, on inpatient admissions, emergency room (ER) visits, and subsequent charges. Data on 19 people before and after program enrollment showed significant decreases in ER visits following…

  16. Pediatric Language Laboratory--A Day Care Center Program During 1977-78.

    ERIC Educational Resources Information Center

    Dodson, Susan; And Others

    The document describes the Pediatric Language Laboratory, a day care center which provides day care and therapeutic services to 20 mild to moderate communicatively delayed children, 1 to 4 years old. Initial sections address program philosophy; program components (diagnostics, remedial services, typical services, parent education, and community…

  17. Respecting Children's Agency for Learning and Rights to Participation in Child Care Programs

    ERIC Educational Resources Information Center

    Berthelsen, Donna; Brownlee, Joanne

    2005-01-01

    The rights of participation for children in child care programs have not received strong attention. This is because the primary purpose of such programs is not to serve the needs of children. Government in many western countries support and promote child care primarily to serve economic imperatives related to parental participation in employment.…

  18. An Exploratory Study of the Impacts of an Employer-Supported Child Care Program

    ERIC Educational Resources Information Center

    Morrissey, Taryn W.; Warner, Mildred E.

    2011-01-01

    Although employer-sponsored child care programs have become more common, there is little empirical research on whether these programs affect employees' satisfaction with child care or their work-life balance, and if effects vary across employee characteristics. In this exploratory study, we administered a survey to employees with children at one…

  19. Promoting Inclusion by Improving Child Care Quality in Inner-City Programs

    ERIC Educational Resources Information Center

    Campbell, Philippa; Milbourne, Suzanne; Silverman, Christine; Feller, Natalie

    2005-01-01

    An innovative training program to improve the quality of child care for all children including those with disabilities was developed, implemented, and evaluated over a 5-year time span with child caregivers working primarily in inner city child care programs. A total of 283 directors and child caregivers participated in 1 of 15 courses that used…

  20. Geriatric Foot Care: A Model Educational Program for Mid-Level Practitioners.

    ERIC Educational Resources Information Center

    Suggs, Patricia K.; Krissak, Ruth; Caruso, Frank; Teasdall, Robert

    2002-01-01

    An educational program on geriatric foot care was completed by 59 nurse practitioners, 12 physicians' assistants, and 1 physician. The 3 1/2 day program included interactive sessions, observation, and hands-on patient care. Posttest results and 6-month follow-up showed significant knowledge increases and incorporation of learning into practice.…

  1. The Long-Term Care Ombudsman Program: What Does the Complaint Reporting System Tell Us?

    ERIC Educational Resources Information Center

    Netting, F. Ellen; And Others

    1992-01-01

    Long-term care ombudsman programs are charged with resolving complaints and solving problems of elderly persons in long-term care settings. Conducted content analysis of annual ombudsman program reports sent to Administration on Aging from 49 states in 1990. Found substantial variation in documented information at both state and local levels and…

  2. Primary care program improves reimbursement. The Federally Qualified Health Center program helps hospitals improve services to the medically indigent.

    PubMed

    Fahey, T M; Gallitano, D G

    1993-03-01

    Under a program created by Congress in 1989, certain primary care treatment centers serving the medically and economically indigent can become Federally Qualified Health Centers (FQHCs). Recently enacted rules and regulations allow participants in the FQHC program to receive 100 percent reasonable cost reimbursement for Medicaid services and 80 percent for Medicare services. An all-inclusive annual cost report is the basis for determining reimbursement rates. The report factors in such expenses as physician and other healthcare and professional salaries and benefits, medical supplies, certain equipment depreciation, and overhead for facility and administrative costs. Both Medicaid and Medicare reimbursement is based on an encounter rate, and states employ various methodologies to determine the reimbursement level. In Illinois, for example, typical reimbursement for a qualified encounter ranges from $70 to $88. To obtain FQHC status, an organization must demonstrate community need, deliver the appropriate range of healthcare services, satisfy management and finance requirements, and function under a community-based governing board. In addition, an FQHC must provide primary healthcare by physicians and (where appropriate) midlevel practitioners; it must also offer its community diagnostic laboratory and x-ray services, preventive healthcare and dental care, case management, pharmacy services, and arrangements for emergency services. Because FQHCs must be freestanding facilities, establishing them can trigger a number of ancillary legal issues, such as those involved in forming a new corporation, complying with not-for-profit corporation regulations, applying for tax-exempt status, and applying for various property and sales tax exemptions. Hospitals that establish FQHCs must also be prepared to relinquish direct control over the delivery of primary care services. PMID:10124301

  3. Let’s Talk Critical. Development and Evaluation of a Communication Skills Training Program for Critical Care Fellows

    PubMed Central

    Hsieh, S. Jean; Howes, Jennifer M.; Keene, Adam B.; Fausto, James A.; Pinto, Priya A.; Gong, Michelle Ng

    2015-01-01

    Rationale: Although expert communication between intensive care unit clinicians with patients or surrogates improves patient- and family-centered outcomes, fellows in critical care medicine do not feel adequately trained to conduct family meetings. Objectives: We aimed to develop, implement, and evaluate a communication skills program that could be easily integrated into a U.S. critical care fellowship. Methods: We developed four simulation cases that provided communication challenges that critical care fellows commonly face. For each case, we developed a list of directly observable tasks that could be used by faculty to evaluate fellows during each simulation. We developed a didactic curriculum of lectures/case discussions on topics related to palliative care, end-of-life care, communication skills, and bioethics; this month-long curriculum began and ended with the fellows leading family meetings in up to two simulated cases with direct observation by faculty who were not blinded to the timing of the simulation. Our primary measures of effectiveness were the fellows’ self-reported change in comfort with leading family meetings after the program was completed and the quality of the communication as measured by the faculty evaluators during the family meeting simulations at the end of the month. Measurements and Main Results: Over 3 years, 31 critical care fellows participated in the program, 28 of whom participated in 101 family meeting simulations with direct feedback by faculty facilitators. Our trainees showed high rates of information disclosure during the simulated family meetings. During the simulations done at the end of the month compared with those done at the beginning, our fellows showed significantly improved rates in: (1) verbalizing an agenda for the meeting (64 vs. 41%; Chi-square, 5.27; P = 0.02), (2) summarizing what will be done for the patient (64 vs. 39%; Chi-square, 6.21; P = 0.01), and (3) providing a follow-up plan (60 vs. 37%; Chi

  4. The performance of integrated health care networks in continuity of care: a qualitative multiple case study of COPD patients

    PubMed Central

    Waibel, Sina; Vargas, Ingrid; Aller, Marta-Beatriz; Gusmão, Renata; Henao, Diana; Vázquez, M. Luisa

    2015-01-01

    Background Integrated health care networks (IHN) are promoted in numerous countries as a response to fragmented care delivery by providing a coordinated continuum of services to a defined population. However, evidence on their effectiveness and outcome is scarce, particularly considering continuity across levels of care; that is the patient's experience of connected and coherent care received from professionals of the different care levels over time. The objective was to analyse the chronic obstructive pulmonary disease (COPD) patients’ perceptions of continuity of clinical management and information across care levels and continuity of relation in IHN of the public health care system of Catalonia. Methods A qualitative multiple case study was conducted, where the cases are COPD patients. A theoretical sample was selected in two stages: (1) study contexts: IHN and (2) study cases consisting of COPD patients. Data were collected by means of individual, semi-structured interviews to the patients, their general practitioners and pulmonologists and review of records. A thematic content analysis segmented by IHN and cases with a triangulation of sources and analysists was carried out. Results COPD patients of all networks perceived that continuity of clinical management was existent due to clear distribution of roles for COPD care across levels, rapid access to care during exacerbations and referrals to secondary care when needed; nevertheless, patients of some networks highlighted too long waiting times to non-urgent secondary care. Physicians generally agreed with patients, however, also indicated unclear distribution of roles, some inadequate referrals and long waiting times to primary care in some networks. Concerning continuity of information, patients across networks considered that their clinical information was transferred across levels via computer and that physicians also used informal communication mechanisms (e-mail, telephone); whereas physicians

  5. Quality Details: A Close-Up Look at Child Care Program Strengths and Weaknesses.

    ERIC Educational Resources Information Center

    Cryer, Debby; Phillipsen, Leslie

    1997-01-01

    Examined quality of infant/toddler and preschool child care centers. Found that although overall program quality was mediocre at best, accredited programs scored better than nonaccredited programs. Preschool classrooms needed improvements in cultural awareness, child privacy, and furnishings for relaxation. For infant/toddler programs,…

  6. Healthcare organization-education partnerships and career ladder programs for health care workers.

    PubMed

    Dill, Janette S; Chuang, Emmeline; Morgan, Jennifer C

    2014-12-01

    Increasing concerns about quality of care and workforce shortages have motivated health care organizations and educational institutions to partner to create career ladders for frontline health care workers. Career ladders reward workers for gains in skills and knowledge and may reduce the costs associated with turnover, improve patient care, and/or address projected shortages of certain nursing and allied health professions. This study examines partnerships between health care and educational organizations in the United States during the design and implementation of career ladder training programs for low-skill workers in health care settings, referred to as frontline health care workers. Mixed methods data from 291 frontline health care workers and 347 key informants (e.g., administrators, instructors, managers) collected between 2007 and 2010 were analyzed using both regression and fuzzy-set qualitative comparative analysis (QCA). Results suggest that different combinations of partner characteristics, including having an education leader, employer leader, frontline management support, partnership history, community need, and educational policies, were necessary for high worker career self-efficacy and program satisfaction. Whether a worker received a wage increase, however, was primarily dependent on leadership within the health care organization, including having an employer leader and employer implementation policies. Findings suggest that strong partnerships between health care and educational organizations can contribute to the successful implementation of career ladder programs, but workers' ability to earn monetary rewards for program participation depends on the strength of leadership support within the health care organization. PMID:25441318

  7. Creditable Foods Guide for Child Care Centers on the Child Care Food Program.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Health, Denver.

    This manual provides information on creditable and noncreditable foods in child care centers, before-and-after-school centers, family day care homes, and adult day care centers. Creditable foods are foods that may be counted toward meeting the requirements for a reimbursable meal. Foods are determined to be creditable according to guidelines…

  8. The team approach to home-based primary care: restructuring care to meet individual, program, and system needs.

    PubMed

    Reckrey, Jennifer M; Soriano, Theresa A; Hernandez, Cameron R; DeCherrie, Linda V; Chavez, Silvia; Zhang, Meng; Ornstein, Katherine

    2015-02-01

    Team-based models of care are an important way to meet the complex medical and psychosocial needs of the homebound. As part of a quality improvement project to address individual, program, and system needs, a portion of a large, physician-led academic home-based primary care practice was restructured into a team-based model. With support from an office-based nurse practitioner, a dedicated social worker, and a dedicated administrative assistant, physicians were able to care for a larger number of patients. Hospitalizations, readmissions, and patient satisfaction remained the same while physician panel size increased and physician satisfaction improved. The Team Approach is an innovative way to improve interdisciplinary, team-based care through practice restructuring and serves as an example of how other practices can approach the complex task of caring for the homebound. PMID:25645568

  9. The Team Approach to Home-Based Primary Care: Restructuring Care to Meet Patient, Program, and System Needs

    PubMed Central

    Reckrey, Jennifer M.; Soriano, Theresa A.; Hernandez, Cameron R.; DeCherrie, Linda V.; Chavez, Silvia; Zhang, Meng; Ornstein, Katherine

    2016-01-01

    Team-based models of care are an important way to meet the complex medical and psychosocial needs of the homebound. As part of a quality improvement project to address patient, program, and system needs, we restructured a portion of our large, physician-led academic home-based primary care practice into a team-based model. With support from an office-based nurse practitioner, a dedicated social worker, and a dedicated administrative assistant, physicians were able to care for a larger number of patients. Hospitalizations, readmissions, and patient satisfaction remained the same while physician panel size increased and physician satisfaction improved. Our Team Approach is an innovative way to improve interdisciplinary, team-based care though practice restructuring and serves as an example of how other practices can approach the complex task of caring for the homebound. PMID:25645568

  10. The Boston Health Care for the Homeless Program: A Public Health Framework

    PubMed Central

    Oppenheimer, Sarah C.; Judge, Christine M.; Taube, Robert L.; Blanchfield, Bonnie B.; Swain, Stacy E.; Koh, Howard K.

    2010-01-01

    During the past 25 years, the Boston Health Care for the Homeless Program has evolved into a service model embodying the core functions and essential services of public health. Each year the program provides integrated medical, behavioral, and oral health care, as well as preventive services, to more than 11 000 homeless people. Services are delivered in clinics located in 2 teaching hospitals, 80 shelters and soup kitchens, and an innovative 104-bed medical respite unit. We explain the program's principles of care, describe the public health framework that undergirds the program, and offer lessons for the elimination of health disparities suffered by this vulnerable population. PMID:20558804

  11. An Evaluation of the AirCare Program Based on Cost-Benefit and Cost-Effectiveness Analyses

    ERIC Educational Resources Information Center

    Bi, Hsiaotao T.; Wang, Dianle

    2006-01-01

    A cost-benefit analysis of the AirCare program in the province of British Columbia on the basis of emissions cost factors from the literature showed a benefit outweighing the cost. Furthermore, a cost-effectiveness analysis comparing the AirCare program with a hybrid-car rebate program revealed that the AirCare program is more effective in…

  12. Respite Care and Crisis Nursery 1992 Annual Program Survey: For Services Provided during 1991. Data Collection, Analysis and Report.

    ERIC Educational Resources Information Center

    Huntington, Gail S.; Langmeyer, David B.

    This annual survey of respite care and crisis nursery programs funded by the Children's Bureau of the Administration for Children, Youth, and Families of the U.S. Department of Health and Human Services contains program information for 43 crisis nursery programs and 65 respite care programs. Data on crisis nurseries and on respite care programs…

  13. Funding a Health Disparities Research Agenda: The Case of Medicare Home Health Care

    ERIC Educational Resources Information Center

    Davitt, Joan K.

    2014-01-01

    Medicare home health care provides critical skilled nursing and therapy services to patients in their homes, generally after a period in an inpatient facility or nursing home. Disparities in access to, or outcomes of, home health care can result in patient deterioration and increased cost to the Medicare program if patient care needs intensify.…

  14. Availability of antidotes and key emergency drugs in tertiary care hospitals of Punjab and assessment of the knowledge of health care professionals in the management of poisoning cases.

    PubMed

    Arslan, Naheed; Khiljee, Sonia; Bakhsh, Allah; Ashraf, Muhammad; Maqsood, Iram

    2016-03-01

    This study was conducted to evaluate the availability of antidotes/key emergency drugs in tertiary care hospitals of the Punjab province, and to assess the knowledge of health care professionals in the stocking and administration of antidotes in the proper management of poisoning cases. Seventeen (n=17) tertiary care hospitals of Punjab Pakistan were selected. Two performas (A and B) were designed for 26 antidotes/key emergency drugs and given to the hospital pharmacists and physicians respectively. It was observed that Activated Charcoal, being the universal antidote was found only in 6 hospitals (41%). Digoxin Immune Fab, Edentate Calcium disodium and Glucagon were not available in emergency department of any hospital and even not included in the formulary of any hospital. About 80% pharmacists were aware of the method of preparation of Activated Charcoal and 85% physicians were familiar with its route of administration. Data showed that tertiary care hospitals of Punjab do not stock antidotes according to national drug policy. Moreover the study strongly suggests the development of health care centers and professional by organizing antidote awareness programs, continuous education and record keeping of poisonous cases and availability of emergency drugs around the clock. PMID:27087082

  15. Effects of a Safe Patient Handling and Mobility Program on Patient Self-Care Outcomes

    PubMed Central

    Shiyko, Mariya; Margulis, Heather; Campo, Marc

    2014-01-01

    OBJECTIVE. The aim of this study was to determine the effect of a safe patient handling and mobility (SPHM) program on patient self-care outcomes. METHOD. We used a retrospective cohort design. Data were obtained from the electronic medical records of 1,292 patients receiving inpatient rehabilitation services. Self-care scores from the FIM™ for patients who participated in rehabilitation before implementation of an SPHM program were compared with the scores of patients who participated after implementation of the program. RESULTS. Patients who received inpatient rehabilitation services with an SPHM program were as likely to achieve at least modified independence in self-care as those who received inpatient rehabilitation services without an SPHM program. CONCLUSION. SPHM programs may not affect self-care performance in adults receiving inpatient rehabilitation services. However, more work must be done to define specific and effective methods for integrating patient handling technologies into occupational therapy practice. PMID:25184472

  16. Effects of a safe patient handling and mobility program on patient self-care outcomes.

    PubMed

    Darragh, Amy R; Shiyko, Mariya; Margulis, Heather; Campo, Marc

    2014-01-01

    OBJECTIVE. The aim of this study was to determine the effect of a safe patient handling and mobility (SPHM) program on patient self-care outcomes. METHOD. We used a retrospective cohort design. Data were obtained from the electronic medical records of 1,292 patients receiving inpatient rehabilitation services. Self-care scores from the FIM™ for patients who participated in rehabilitation before implementation of an SPHM program were compared with the scores of patients who participated after implementation of the program. RESULTS. Patients who received inpatient rehabilitation services with an SPHM program were as likely to achieve at least modified independence in self-care as those who received inpatient rehabilitation services without an SPHM program. CONCLUSION. SPHM programs may not affect self-care performance in adults receiving inpatient rehabilitation services. However, more work must be done to define specific and effective methods for integrating patient handling technologies into occupational therapy practice. PMID:25184472

  17. Socio-political constraints on primary health care: a case study from Java.

    PubMed

    Williams, G; Satoto

    1980-01-01

    The Alma-Ata 1978 conference emphasized the importance of the concept of primary health care in the health system and overall socioeconomic development of the community. However, theories of development generally do not allow for the complexity of human conditions, and the relevance of contact with the village people. This paper presents the experience of a PHC (primary health care) project on the northern coast of central Java. The case illustrates some of the institutional and sociopolitical constraints which the Indonesian government may face in implementing a PHC program in the next few years, such as village politics; the reluctance of men to allow women to participate in the decision-making process of the program, and; the reluctance of land-owning farmers to allow landless villagers in the decision-making process. The following conditions would create a most favorable sociopolitical climate for starting a PHC program in Indonesia: 1) at the village level, non-pamong desa (village elders), women and landless villagers are encouraged to participate in decision-making processes which affect their interests and to take on positions of responsibility in village affairs; 2) there is a process of frank, 2-way communication marked by mutual respect between government agencies at regency and subdistrict levels village-level organization, and 3) supra-village authorities allow village institution to develop at their own pace, intervening only when interests of poor and underprivileged groups are endangered. PMID:12261889

  18. Modelling catchment areas for secondary care providers: a case study.

    PubMed

    Jones, Simon; Wardlaw, Jessica; Crouch, Susan; Carolan, Michelle

    2011-09-01

    Hospitals need to understand patient flows in an increasingly competitive health economy. New initiatives like Patient Choice and the Darzi Review further increase this demand. Essential to understanding patient flows are demographic and geographic profiles of health care service providers, known as 'catchment areas' and 'catchment populations'. This information helps Primary Care Trusts (PCTs) to review how their populations are accessing services, measure inequalities and commission services; likewise it assists Secondary Care Providers (SCPs) to measure and assess potential gains in market share, redesign services, evaluate admission thresholds and plan financial budgets. Unlike PCTs, SCPs do not operate within fixed geographic boundaries. Traditionally, SCPs have used administrative boundaries or arbitrary drive times to model catchment areas. Neither approach satisfactorily represents current patient flows. Furthermore, these techniques are time-consuming and can be challenging for healthcare managers to exploit. This paper presents three different approaches to define catchment areas, each more detailed than the previous method. The first approach 'First Past the Post' defines catchment areas by allocating a dominant SCP to each Census Output Area (OA). The SCP with the highest proportion of activity within each OA is considered the dominant SCP. The second approach 'Proportional Flow' allocates activity proportionally to each OA. This approach allows for cross-boundary flows to be captured in a catchment area. The third and final approach uses a gravity model to define a catchment area, which incorporates drive or travel time into the analysis. Comparing approaches helps healthcare providers to understand whether using more traditional and simplistic approaches to define catchment areas and populations achieves the same or similar results as complex mathematical modelling. This paper has demonstrated, using a case study of Manchester, that when estimating

  19. Aging in poverty: making the case for comprehensive care management.

    PubMed

    Judd, Rebecca G; Moore, Brenda A

    2011-10-01

    A model for holistic care management that would enhance outcomes for economically vulnerable older adults who receive an array of disjointed services administered through the older Americans Act (OAA) and local Area Agencies on Aging (AAA) is proposed. Fragmented service delivery is typically wasteful and ineffectual, but comprehensive care management that includes an autonomous care manager, a single interagency plan of care and ongoing monitoring that is client-centered may protect those aging in poverty from negative health outcomes. PMID:21967136

  20. Health Partners of Western Ohio: Integrated Care Case Study.

    PubMed

    Taflinger, Kimberly; West, Elizabeth; Sunderhaus, Janis; Hilton, Irene V

    2016-03-01

    Health centers are unique health care delivery organizations in which multiple disciplines, such as primary care, dental, behavioral health, pharmacy, podiatry, optometry and alternative medicine, are often located at the same site. Because of this characteristic, many health centers have developed systems of integrated care. This paper describes the characteristics of health centers and highlights the integrated health care delivery system of one early adopter health center, Health Partners of Western Ohio. PMID:27044240

  1. Intervening at the Setting Level to Prevent Behavioral Incidents in Residential Child Care: Efficacy of the CARE Program Model.

    PubMed

    Izzo, Charles V; Smith, Elliott G; Holden, Martha J; Norton, Catherine I; Nunno, Michael A; Sellers, Deborah E

    2016-07-01

    The current study examined the impact of a setting-level intervention on the prevention of aggressive or dangerous behavioral incidents involving youth living in group care environments. Eleven group care agencies implemented Children and Residential Experiences (CARE), a principle-based program that helps agencies use a set of evidence-informed principles to guide programming and enrich the relational dynamics throughout the agency. All agencies served mostly youth referred from child welfare. The 3-year implementation of CARE involved intensive agency-wide training and on-site consultation to agency leaders and managers around supporting and facilitating day-to-day application of the principles in both childcare and staff management arenas. Agencies provided data over 48 months on the monthly frequency of behavioral incidents most related to program objectives. Using multiple baseline interrupted time series analysis to assess program effects, we tested whether trends during the program implementation period declined significantly compared to the 12 months before implementation. Results showed significant program effects on incidents involving youth aggression toward adult staff, property destruction, and running away. Effects on aggression toward peers and self-harm were also found but were less consistent. Staff ratings of positive organizational social context (OSC) predicted fewer incidents, but there was no clear relationship between OSC and observed program effects. Findings support the potential efficacy of the CARE model and illustrate that intervening "upstream" at the setting level may help to prevent coercive caregiving patterns and increase opportunities for healthy social interactions. PMID:27138932

  2. Orientation to Multicultural Health Care in Migrant Health Programs.

    ERIC Educational Resources Information Center

    Trotter, Robert T., II

    This guide furnishes health care providers serving migrant and seasonal farmworkers with information to cope with the complexities of health care delivery in a multiethnic, multicultural environment. Section I provides an introduction to basic cultural concepts that influence the outcome of interactions between providers and their migrant…

  3. Health Care of Incarcerated Youth: State Programs & Initiatives.

    ERIC Educational Resources Information Center

    Thompson, Linda S.; Sheahan, Paula M.

    This report presents the analysis and results of a survey of states' progress in meeting the goals and objectives of their state action plans on the health care of incarcerated youth. The survey questioned 48 juvenile justice professionals, health care professionals, and university faculty from across the nation concerning state progress toward…

  4. A review of advance care planning programs in long-term care homes: are they dementia friendly?

    PubMed

    Wickson-Griffiths, Abigail; Kaasalainen, Sharon; Ploeg, Jenny; McAiney, Carrie

    2014-01-01

    Background. Persons living with dementia in the long-term care home (LTCH) setting have a number of unique needs, including those related to planning for their futures. It is therefore important to understand the advance care planning (ACP) programs that have been developed and their impact in order for LTCH settings to select a program that best suits residents' needs. Methods. Four electronic databases were searched from 1990 to 2013, for studies that evaluated the impact of advance care planning programs implemented in the LTCH setting. Studies were critically reviewed according to rigour, impact, and the consideration of the values of residents with dementia and their family members according to the Dementia Policy Lens Toolkit. Results and Conclusion. Six ACP programs were included in the review, five of which could be considered more "dementia friendly." The programs indicated a variety of positive impacts in the planning and provision of end-of-life care for residents and their family members, most notably, increased ACP discussion and documentation. In moving forward, it will be important to evaluate the incorporation of residents with dementia's values when designing or implementing ACP interventions in the LTCH settings. PMID:24757563

  5. A Review of Advance Care Planning Programs in Long-Term Care Homes: Are They Dementia Friendly?

    PubMed Central

    Wickson-Griffiths, Abigail; Kaasalainen, Sharon; McAiney, Carrie

    2014-01-01

    Background. Persons living with dementia in the long-term care home (LTCH) setting have a number of unique needs, including those related to planning for their futures. It is therefore important to understand the advance care planning (ACP) programs that have been developed and their impact in order for LTCH settings to select a program that best suits residents' needs. Methods. Four electronic databases were searched from 1990 to 2013, for studies that evaluated the impact of advance care planning programs implemented in the LTCH setting. Studies were critically reviewed according to rigour, impact, and the consideration of the values of residents with dementia and their family members according to the Dementia Policy Lens Toolkit. Results and Conclusion. Six ACP programs were included in the review, five of which could be considered more “dementia friendly.” The programs indicated a variety of positive impacts in the planning and provision of end-of-life care for residents and their family members, most notably, increased ACP discussion and documentation. In moving forward, it will be important to evaluate the incorporation of residents with dementia's values when designing or implementing ACP interventions in the LTCH settings. PMID:24757563

  6. Implementing a care coordination program for children with special healthcare needs: partnering with families and providers.

    PubMed

    Taylor, April; Lizzi, Michele; Marx, Alison; Chilkatowsky, Maryann; Trachtenberg, Symme W; Ogle, Sue

    2013-01-01

    Care coordination has been a key theme in national forums on healthcare quality, design, and improvement. This article describes the characteristics of a care coordination program aimed at supporting families in building care coordination competencies and providers in the coordination of care across multiple specialties. The program included implementation of a Care Coordination Counselor (CC Counselor) and several supporting tools-Care Binders, Complex Scheduling, Community Resources for Families Database, and a Care Coordination Network. Patients were referred by a healthcare provider to receive services from the CC Counselor or to receive a Care Binder organizational tool. To assess the impact of the counselor role, we compared patient experience survey results from patients receiving CC Counselor services to those receiving only the Care Binder. Our analysis found that patients supported by the CC Counselor reported greater agreement with accessing care coordination resources and identifying a key point person for coordination. Seventy-five percent of CC Counselor patients have graduated from the program. Our findings suggest that implementation of a CC Counselor role and supporting tools offers an integrative way to connect patients, families, and providers with services and resources to support coordinated, continuous care. PMID:22913270

  7. The ephemeral accountable care organization-an unintended consequence of the Medicare shared savings program.

    PubMed

    Harvey, H Benjamin; Gowda, Vrushab; Gazelle, G Scott; Pandharipande, Pari V

    2014-02-01

    A fundamental element of health care payment reform under the Affordable Care Act is the development of Accountable Care Organizations (ACOs). The ACO model employs shared-risk contracts to better align the interests of health care providers and payers with the intent of driving efficiency and quality in care. The Medicare Shared Savings Program is the most popular of the Medicare ACO programs, with over 200 health systems across the nation participating at this time. However, a pitfall in the way that the Medicare Shared Savings Program is structured, specifically the benchmarking and rebasing method, could make it difficult for even top-performing ACOs to achieve sustained success, thereby threatening the long-term viability of the program. In this paper, we present this pitfall to the radiology community as well as potential solutions that can be considered by CMS moving forward. PMID:24360903

  8. The case for diversity in the health care workforce.

    PubMed

    Cohen, Jordan J; Gabriel, Barbara A; Terrell, Charles

    2002-01-01

    Increasing the racial and ethnic diversity of the health care workforce is essential for the adequate provision of culturally competent care to our nation's burgeoning minority communities. A diverse health care workforce will help to expand health care access for the underserved, foster research in neglected areas of societal need, and enrich the pool of managers and policymakers to meet the needs of a diverse populace. The long-term solution to achieving adequate diversity in the health professions depends upon fundamental reforms of our country's precollege education system. Until these reforms occur, affirmative action tools in health professions schools are critical to achieving a diverse health care workforce. PMID:12224912

  9. Neo-Conservatism and Child Care Services in Alberta: A Case Study. Occasional Paper No. 9.

    ERIC Educational Resources Information Center

    Hayden, Jacqueline

    The development and delivery of child care services in Canada has never been without controversy. This case study examines the development of the child care system in Alberta, Canada, showing how the role of the government proceeded through four distinct phases, each determining a different outcome for child care stakeholders. Power mechanisms and…

  10. Intensive Care in India: The Indian Intensive Care Case Mix and Practice Patterns Study

    PubMed Central

    Divatia, Jigeeshu V.; Amin, Pravin R.; Ramakrishnan, Nagarajan; Kapadia, Farhad N.; Todi, Subhash; Sahu, Samir; Govil, Deepak; Chawla, Rajesh; Kulkarni, Atul P.; Samavedam, Srinivas; Jani, Charu K.; Rungta, Narendra; Samaddar, Devi Prasad; Mehta, Sujata; Venkataraman, Ramesh; Hegde, Ashit; Bande, BD; Dhanuka, Sanjay; Singh, Virendra; Tewari, Reshma; Zirpe, Kapil; Sathe, Prachee

    2016-01-01

    Aims: To obtain information on organizational aspects, case mix and practices in Indian Intensive Care Units (ICUs). Patients and Methods: An observational, 4-day point prevalence study was performed between 2010 and 2011 in 4209 patients from 124 ICUs. ICU and patient characteristics, and interventions were recorded for 24 h of the study day, and outcomes till 30 days after the study day. Data were analyzed for 4038 adult patients from 120 ICUs. Results: On the study day, mean age, Acute Physiology and Chronic Health Evaluation (APACHE II) and sequential organ failure assessment (SOFA) scores were 54.1 ± 17.1 years, 17.4 ± 9.2 and 3.8 ± 3.6, respectively. About 46.4% patients had ≥1 organ failure. Nearly, 37% and 22.2% patients received mechanical ventilation (MV) and vasopressors or inotropes, respectively. Nearly, 12.2% patients developed an infection in the ICU. About 28.3% patients had severe sepsis or septic shock (SvSpSS) during their ICU stay. About 60.7% patients without infection received antibiotics. There were 546 deaths and 183 terminal discharges (TDs) from ICU (including left against medical advice or discharged on request), with ICU mortality 729/4038 (18.1%). In 1627 patients admitted within 24 h of the study day, the standardized mortality ratio was 0.67. The APACHE II and SOFA scores, public hospital ICUs, medical ICUs, inadequately equipped ICUs, medical admission, self-paying patient, presence of SvSpSS, acute respiratory failure or cancer, need for a fluid bolus, and MV were independent predictors of mortality. Conclusions: The high proportion of TDs and the association of public hospitals, self-paying patients, and inadequately equipped hospitals with mortality has important implications for critical care in India. PMID:27186054

  11. Evaluation of a Case-Based Primary Care Pediatric Conference Curriculum

    PubMed Central

    Talwalkar, Jaideep S.; Fenick, Ada M.

    2011-01-01

    Background Our goal was to assess the impact of a standardized residency curriculum in ambulatory pediatrics on residents' participation, satisfaction, and confidence. Methods A case-based curriculum for weekly primary care conference was developed to replace the existing free-form review of topics at the Yale Pediatrics Residency Program. Before the curricular switch, faculty preceptors and members of the academic year 2005–2006 intern class completed surveys designed to measure conference occurrence and resident attendance, participation, satisfaction, and confidence in clinical skills. One year after the curricular switch, identical surveys were completed by faculty preceptors and members of the academic year 2006–2007 intern class. Results Faculty surveys indicated that conferences took place significantly more often after the curricular switch. The number of residents at conference each day (3.18 vs 4.50; P < .01) and the percentage who actually spoke during conference (45% vs 82%, P < .01) significantly increased. There were 18 demographically similar interns in each of the 2 classes. Members of the academic year 2006–2007 intern class, having trained exclusively with the standardized curriculum, were significantly more likely to respond favorably to survey items about participation, satisfaction, and confidence. In addition, they were more likely to endorse survey items that reflected explicit goals of the standardized curriculum and the Accreditation Council for Graduate Medical Education core competencies. Conclusion Implementation of a structured curriculum for ambulatory care improved interns' self-reported participation, satisfaction, and confidence. The primary care conference occurred more dependably after the curricular change, and improvements in attendance and participation were documented. Pediatric residency programs may make better use of conference time in the ambulatory setting through the use of structured, case

  12. Implementing what works: a case study of integrated primary health care revitalisation in Timor-Leste

    PubMed Central

    2014-01-01

    Background Revitalising primary health care (PHC) and the need to reach MDG targets requires developing countries to adapt current evidence about effective health systems to their local context. Timor-Leste in one of the world’s newest developing nations, with high maternal and child mortality rates, malaria, TB and malnutrition. Mountainous terrain and lack of transport pose serious challenges for accessing health services and implementing preventive health strategies. Methods We conducted a non-systematic review of the literature and identified six components of an effective PHC system. These were mapped onto three countries’ PHC systems and present a case study from Timor-Leste’s Servisu Integrado du Saude Comunidade (SISCa) focussing on MDGs. Some of the challenges of implementing these into practice are shown through locally collected health system data. Results An effective PHC system comprises 1) Strong leadership and government in human rights for health; 2) Prioritisation of cost-effective interventions; 3) Establishing an interactive and integrated culture of community engagement; 4) Providing an integrated continuum of care at the community level; 5) Supporting skilled and equipped health workers at all levels of the health system; 6) Creating a systems cycle of feedback using data to inform health care. The implementation case study from Timor-Leste (population 1 million) shows that in its third year, limited country-wide data had been collected and the SISCa program provided over half a million health interactions at the village level. However, only half of SISCa clinics were functional across the country. Attendances included not only pregnant women and children, but also adults and older community members. Development partners have played a key role in supporting this implementation process. Conclusion The SISCa program is a PHC model implementing current best practice to reach remote communities in a new developing country. Despite limited

  13. Hospice care for patients living alone: results of a demonstration program.

    PubMed

    Bly, J L; Kissick, P

    1994-01-01

    The Wissahickon Hospice initiated a demonstration program in 1988 to provide home hospice care to individuals living at home without primary care persons. This paper describes the planning process and admission requirements for the Live Alone Program and the evaluation results for 34 Live Alone patients compared to 105 regular hospice patients. Principal findings were that the hospice was able to maintain patients at home, to provide care safely to patients, and to enable home deaths for patients living alone. Patients living alone tended to require more supportive services than regular patients and to incur higher patient care costs. PMID:7829035

  14. Who Cares? How Teachers Can Scaffold Children's Ability to Care: A Case for Picture Books

    ERIC Educational Resources Information Center

    McNamee, Abigail; Mercurio, Mia Lynn

    2007-01-01

    Academic inquiry has focused recently on how to create caring classrooms and school communities--that is, classrooms and school communities that encourage children to continue to develop caring feelings, thoughts, and behaviors, or to feel, think, and practice them anew. After reviewing research on caring and attachment, this article discusses how…

  15. Translational research in cancer complementary and alternative medicine: the National Cancer Institute's Best Case Series Program.

    PubMed

    Lee, Colleen O

    2004-04-01

    Public interest in CAM for cancer care likely will influence the need for continued scientific evaluation. The NCI BCS program evaluates case studies involving novel alternative therapies for cancer treatment. Through the NCI BCS program, meaningful data are generated that may lead to NCI-supported research projects, including prospective studies, clinical trials, and advances in scientific knowledge. Individuals interested in obtaining a submission packet for the NCI BCS program may access the official OCCAM Web site at http://www3.cancer.gov/occam/ or call 301-435-7980. PMID:15108425

  16. Modifying the Electronic Health Record to Facilitate the Implementation and Evaluation of a Bundled Care Program for Intensive Care Unit Delirium

    PubMed Central

    Collinsworth, Ashley W.; Masica, Andrew L.; Priest, Elisa L.; Berryman, Candice D.; Kouznetsova, Maria; Glorioso, Oscar; Montgomery, Donna

    2014-01-01

    Context: Electronic health records (EHRs) have been promoted as a key driver of improved patient care and outcomes and as an essential component of learning health systems. However, to date, many EHRs are not optimized to support delivery of quality and safety initiatives, particularly in Intensive Care Units (ICUs). Delirium is a common and severe problem for ICU patients that may be prevented or mitigated through the use of evidence-based care processes (daily awakening and breathing trials, formal delirium screening, and early mobility—collectively known as the “ABCDE bundle”). This case study describes how an integrated health care delivery system modified its inpatient EHR to accelerate the implementation and evaluation of ABCDE bundle deployment as a safety and quality initiative. Case Description: In order to facilitate uptake of the ABCDE bundle and measure delivery of the care processes within the bundle, we worked with clinical and technical experts to create structured data fields for documentation of bundle elements and to identify where these fields should be placed within the EHR to streamline staff workflow. We created an “ABCDE” tab in the existing patient viewer that allowed providers to easily identify which components of the bundle the patient had and had not received. We examined the percentage of ABCDE bundle elements captured in these structured data fields over time to track compliance with data entry procedures and to improve documentation of care processes. Major Themes: Modifying the EHR to support ABCDE bundle deployment was a complex and time-consuming process. We found that it was critical to gain buy-in from senior leadership on the importance of the ABCDE bundle to secure information technology (IT) resources, understand the different workflows of members of multidisciplinary care teams, and obtain continuous feedback from staff on the EHR revisions during the development cycle. We also observed that it was essential to

  17. ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) PROGRAM CASE STUDIES: DEMONSTRATING PROGRAM OUTCOMES

    EPA Science Inventory

    The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) Program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This bookle...

  18. Environmental Technology Verification Program - ETV - Case Studies: Demonstrating Program Outcomes

    EPA Science Inventory

    The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) Program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This cd con...

  19. Where Are They Now? An Update on Defendants. Part 3--High Profile Sexual Abuse in Child Care Cases.

    ERIC Educational Resources Information Center

    Strickland, Jim

    1999-01-01

    Following up on "Child Abuse Storm Scale--Part 1" ("Child Care Information Exchange," Jan-Feb 1999) and Part 2 (Mar-Apr 1999), this article shares the current status of prominent sexual abuse in child care cases. Cases include McMartin Preschool, Fells Acres Day Care, Wee Care Nursery School (the Kelly Michaels case), Little Rascals, and Breezy…

  20. Medicare and Medicaid Programs; Fire Safety Requirements for Certain Health Care Facilities. Final rule.

    PubMed

    2016-05-01

    This final rule will amend the fire safety standards for Medicare and Medicaid participating hospitals, critical access hospitals (CAHs), long-term care facilities, intermediate care facilities for individuals with intellectual disabilities (ICF-IID), ambulatory surgery centers (ASCs), hospices which provide inpatient services, religious non-medical health care institutions (RNHCIs), and programs of all-inclusive care for the elderly (PACE) facilities. Further, this final rule will adopt the 2012 edition of the Life Safety Code (LSC) and eliminate references in our regulations to all earlier editions of the Life Safety Code. It will also adopt the 2012 edition of the Health Care Facilities Code, with some exceptions. PMID:27192728

  1. Translating the Diabetes Prevention Program to Primary Care: A Pilot Study

    PubMed Central

    Whittemore, Robin; Melkus, Gail; Wagner, Julie; Northrup, Veronika; Dziura, James; Grey, Margaret

    2009-01-01

    Background: Research on the translation of efficacious lifestyle change programs to prevent type 2 diabetes into community or clinical settings is needed. Objectives: To examine the reach, implementation, and efficacy of a 6-month lifestyle program implemented in primary care by nurse practitioners (NP) for adults at risk for type 2 diabetes. Method: The NP sites (n = 4) were randomized to an enhanced standard care program (1 NP and 1 nutrition session) or a lifestyle program (enhanced standard care and 6 NP sessions). These NPs recruited adults at-risk for diabetes from their practice (n = 58) with an acceptance rate of 70%. Results: The program reached a diverse, obese, moderately low-income sample. The NPs were able to successfully implement the protocols. The average length of the program was 9.3 months. Attendance was high (98%) and attrition low (12%). The NPs were able to adopt the educational, behavioral, and psychosocial strategies of the intervention easily. Motivational interviewing was more difficult for NPs. Mixed-model repeated measures analysis indicated significant trends or improvement in both groups for nutrition and exercise behavior. Participants of the lifestyle program demonstrated trends for better high density lipoprotein (HDL) as well as exercise behavior compared to enhanced standard care participants. Twenty-five percent of lifestyle participants met treatment goals of 5% weight loss compared to 11% of standard care participants. Discussion: A lifestyle program can be implemented in primary care by NPs, reach the targeted population, and be modestly successful. Further research is indicated. PMID:19092550

  2. Parenting the Poorly Attached Teenager. Fostering Families. A Specialized Training Program Designed for Foster Care Workers & Foster Care Parents.

    ERIC Educational Resources Information Center

    Schatz, Mona Struhsaker; Faust, Timothy Philip

    This module is part of a training program for foster parents and foster care workers offered at Colorado State University. The module explores the attachment process and the long-term effects of attachment difficulties in the first years of a child's life. The module's learning objectives address: (1) ways of identifying the basic concepts…

  3. Drinking, Drugs & Youth: Use and Abuse. Fostering Families. A Specialized Training Program Designed for Foster Care Workers & Foster Care Parents.

    ERIC Educational Resources Information Center

    Schatz, Mona Struhsaker; And Others

    This module is part of a training program for foster parents and foster care workers offered at Colorado State University. The module examines substance abuse by children aged 10 years and above. The module's learning objectives address: (1) family rules and coping mechanisms relevant to substance-abusing youth; (2) characteristics of adolescent…

  4. Kaiser Permanente Medical Care Programs (KP-MCP)

    Cancer.gov

    The Division of Research within KP-MCP conducts, publishes, and disseminates high-quality epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the society at large.

  5. The Caring Equation: An Intervention Program for Teenage Mothers and Their Male Partners

    ERIC Educational Resources Information Center

    Robbers, Monica L. P.

    2008-01-01

    This article presents findings from the evaluation of the Caring Equation, a Department of Health and Human Services-funded project established in 2003 in Arlington County, Virginia, public schools. The program is a multifaceted intervention program and is one of about 20 programs currently operating in school districts around the United States.…

  6. Child Care Food Program Financial Management Guide. PTM No. 300.83.

    ERIC Educational Resources Information Center

    Haszu, Louis A.; McAtee, Sharon A.

    While costs are no longer reported to the Child Care Food Program on the monthly reimbursement voucher, Federal regulations for the program require that each participating sponsor operate a nonprofit food service and that any income accrued from the program be used solely for the conduct of improvement of the food service operation. Therefore, it…

  7. Pathfinders: A Self-Care and Health Education Program for Older Widows and Widowers.

    ERIC Educational Resources Information Center

    Caserta, Michael S.; Lund, Dale A.; Rice, Sarah Jane

    1999-01-01

    Describes a research-based self-care health education program for recently widowed people. Program aims to provide a foundation of knowledge, motivation, and encouragement to initiate positive behavioral changes, and to establish a support network. Preliminary analysis suggests the program is achieving many of the intended outcomes. (Author/JDM)

  8. Parental Decision Making about Technology and Quality in Child Care Programs

    ERIC Educational Resources Information Center

    Rose, Katherine K.; Vittrup, Brigitte; Leveridge, Tinney

    2013-01-01

    Background: This study investigated parental decision making about non-parental child care programs based on the technological and quality components of the program, both child-focused and parent-focused. Child-focused variables related to children's access to technology such as computers, educational television programming, and the internet.…

  9. The Potential Contribution of Mentor Programs to Relational Permanency for Youth Aging out of Foster Care

    ERIC Educational Resources Information Center

    Avery, Rosemary J.

    2011-01-01

    This article summarizes published research regarding the effectiveness of mentor programs in general, and for youth in foster care specifically, as a basis for evidence-based practice in child welfare. It examines the pros and cons of mentor programs and characteristics of programs that are more or less effective for achieving specific social…

  10. AB 3059: A Report to the Governor on the Alternative Child Care Programs, 1976-80.

    ERIC Educational Resources Information Center

    Hailey, Jack

    This publication of the California Governor's Committee on Child Development Programs focuses on the Alternative Child Care Program in California (AB 3059). The report looks back over four years of the AB 3059, reviews the goals of that legislation, and measures the program's accomplishments against those goals. In early 1976, the Governor's…

  11. English Language and Skills Training for Entry-Level Health Care Jobs. Program Guide.

    ERIC Educational Resources Information Center

    Vaidya, Elma

    The guide describes a vocational English-as-a-Second-Language program for pre-employment training of Southeast Asians seeking work in entry-level health care jobs. The program was conducted in cooperation with a hospital in Massachusetts. The guide describes the program and its four instructional units in detail, and includes lesson plans,…

  12. Security, Dignity, Caring Relationships, and Meaningful Work: Needs Motivating Participation in a Job-Training Program

    ERIC Educational Resources Information Center

    Ayers, David F.; Miller-Dyce, Cherrel; Carlone, David

    2008-01-01

    Researchers asked 17 participants in a job-training program to describe their personal struggles following an economic restructuring. Examined through a critical theoretical lens, findings indicate that the learners enrolled in the program to reclaim security, dignity, meaningful work, and caring relationships. Program planners at community…

  13. Enhancing the Safety of Children in Foster Care and Family Support Programs: Automated Critical Incident Reporting

    ERIC Educational Resources Information Center

    Brenner, Eliot; Freundlich, Madelyn

    2006-01-01

    The Adoption and Safe Families Act of 1997 has made child safety an explicit focus in child welfare. The authors describe an automated critical incident reporting program designed for use in foster care and family-support programs. The program, which is based in Lotus Notes and uses e-mail to route incident reports from direct service staff to…

  14. 5 CFR 792.200 - What are the benefits of the child care subsidy program law?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... subsidy program law? 792.200 Section 792.200 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... Subsidy Program Legislation and to Whom Does It Apply? § 792.200 What are the benefits of the child care subsidy program law? Sec. 630 of Public Law 107-67 permits executive agencies to use appropriated funds...

  15. 5 CFR 792.200 - What are the benefits of the child care subsidy program law?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... subsidy program law? 792.200 Section 792.200 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... Subsidy Program Legislation and to Whom Does It Apply? § 792.200 What are the benefits of the child care subsidy program law? Sec. 630 of Public Law 107-67 permits executive agencies to use appropriated funds...

  16. 5 CFR 792.200 - What are the benefits of the child care subsidy program law?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... subsidy program law? 792.200 Section 792.200 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... Subsidy Program Legislation and to Whom Does It Apply? § 792.200 What are the benefits of the child care subsidy program law? Sec. 630 of Public Law 107-67 permits executive agencies to use appropriated funds...

  17. Treatment Foster Care Programs: A Review of Evaluation Research and Suggested Directions.

    ERIC Educational Resources Information Center

    Hudson, Joe; And Others

    1994-01-01

    Reviews findings from 11 evaluation studies of treatment (also known as therapeutic or specialized) foster care (TFC) programs in Canada, United Kingdom, and United States. Notes that studies found TFC programs successfully served youths with serious problems in living and that youths experienced positive in-program changes. Notes that TFC…

  18. Development and Applications of an Outcomes Assessment Framework for Care Management Programs in Learning Health Systems

    PubMed Central

    Wang, Lin; Kuntz-Melcavage, Kara; Forrest, Christopher B.; Lu, Yanyan; Piet, Leslie; Evans, Kathy; Uriyo, Maria; Sherry, Melissa; Richardson, Regina; Hawkins, Michelle; Neale, Donna

    2015-01-01

    Purpose: To develop and apply an outcomes assessment framework (OAF) for care management programs in health care delivery settings. Background: Care management (CM) refers to a regimen of organized activities that are designed to promote health in a population with particular chronic conditions or risk profiles, with focus on the triple aim for populations: improving the quality of care, advancing health outcomes, and lowering health care costs. CM has become an integral part of a care continuum for population-based health care management. To sustain a CM program, it is essential to assure and improve CM effectiveness through rigorous outcomes assessment. To this end, we constructed the OAF as the foundation of a systematic approach to CM outcomes assessment. Innovations: To construct the OAF, we first systematically analyzed the operation process of a CM program; then, based on the operation analysis, we identified causal relationships between interventions and outcomes at various implementation stages of the program. This set of causal relationships established a roadmap for the rest of the outcomes assessment. Built upon knowledge from multiple disciplines, we (1) formalized a systematic approach to CM outcomes assessment, and (2) integrated proven analytics methodologies and industrial best practices into operation-oriented CM outcomes assessment. Conclusion: This systematic approach to OAF for assessing the outcomes of CM programs offers an opportunity to advance evidence-based care management. In addition, formalized CM outcomes assessment methodologies will enable us to compare CM effectiveness across health delivery settings. PMID:25992387

  19. Effective ABE Programming: Nine Case Studies.

    ERIC Educational Resources Information Center

    Sjogren, Douglas; Jacobson, Larry

    The document presents an indepth study of nine selected exemplary adult basic education (ABE) programs in Region 8: Volunteers Clearing House, Fort Collins, Colorado; Utah Navajo Development Council, Blanding, Utah; Adult Education Tutorial Program, Denver, Colorado; Project SAVE, Lemmon, South Dakota; Gates Rubber Company, Denver, Colorado;…

  20. The impact of case mix on timely access to appointments in a primary care group practice.

    PubMed

    Ozen, Asli; Balasubramanian, Hari

    2013-06-01

    At the heart of the practice of primary care is the concept of a physician panel. A panel refers to the set of patients for whose long term, holistic care the physician is responsible. A physician's appointment burden is determined by the size and composition of the panel. Size refers to the number of patients in the panel while composition refers to the case-mix, or the type of patients (older versus younger, healthy versus chronic patients), in the panel. In this paper, we quantify the impact of the size and case-mix on the ability of a multi-provider practice to provide adequate access to its empanelled patients. We use overflow frequency, or the probability that the demand exceeds the capacity, as a measure of access. We formulate problem of minimizing the maximum overflow for a multi-physician practice as a non-linear integer programming problem and establish structural insights that enable us to create simple yet near optimal heuristic strategies to change panels. This optimization framework helps a practice: (1) quantify the imbalances across physicians due to the variation in case mix and panel size, and the resulting effect on access; and (2) determine how panels can be altered in the least disruptive way to improve access. We illustrate our methodology using four test practices created using patient level data from the primary care practice at Mayo Clinic, Rochester, Minnesota. An important advantage of our approach is that it can be implemented in an Excel Spreadsheet and used for aggregate level planning and panel management decisions. PMID:23076360

  1. Development of casing design program for directional and horizontal wells

    SciTech Connect

    Maruyama, Kazushi; Tsukano, Yasushi; Ueno, Masakatsu; Inowaki, Ryuichi

    1995-12-31

    This paper describes the development of a horizontal well casing design program. The main features of the program are an application of new casing performances under simulated horizontal well conditions and integration of essential functions for horizontal well design such as well path design, casing shoe depth determination, utilization of wear information, material selection in sour service, casing safety evaluation in pick-up and set-down operations, and calculation of the least expensive casing design. The target of this design program is to facilitate and cut short the complicated design analysis involved in horizontal wells, and to provide designers with detailed analytical results for the obtained design. A menu-oriented input and color graphic output using Windows enhances its usability as well. As an example, an application of this casing design program for Japan National Oil Corporation`s test well in Niigata Prefecture is introduced.

  2. World Perspective Case Descriptions on Educational Programs for Adults: Portugal.

    ERIC Educational Resources Information Center

    Soares de Melo, Alvaro; Cristovao, Artur F. A. C.

    The case descriptions of two adult education programs in Portual contained in this document are part of a set that reflects a cooperative effort by adult educators to increase international understanding of various educational programs for adults in their societal context. A face sheet for each program provides this information: name,…

  3. World Perspective Case Descriptions on Educational Programs for Adults: India.

    ERIC Educational Resources Information Center

    Jayagopal, R.; Burns, E. P.

    Four adult education programs being conducted in India are described in the case studies in this packet. Two of the projects involve literacy; the third promotes literacy as one part of its community development program, and the fourth trains workers in hotel management and catering technology. The literacy programs are (1) development of a…

  4. World Perspective Case Descriptions on Educational Programs for Adults: Yugoslavia.

    ERIC Educational Resources Information Center

    Rebesko, Branco; And Others

    These eight case descriptions of adult education programs in Yugoslavia are part of a set that reflects a cooperative effort by adult educators to increase international understanding of various educational programs for adults in their societal context. A face sheet for each program provides this information: name, organization, and address of the…

  5. Alternatives for the Care of Mildly Ill Children: United States Air Force Child Care Program.

    ERIC Educational Resources Information Center

    Brant, Linda J.

    Information related to day care center policies for dealing with mildly ill children is provided in this document. Data cited in the report indicate wide inconsistencies at the present time in policies and procedures for screening ill children in Air Force child care centers and in the policies followed for admitting and readmitting children who…

  6. Mississippi Curriculum Framework for Respiratory Care Technology Programs (CIP: 51.0908--Respiratory Therapy Technology). Postsecondary Programs.

    ERIC Educational Resources Information Center

    Mississippi Research and Curriculum Unit for Vocational and Technical Education, State College.

    This document, which is intended for use by community and junior colleges throughout Mississippi, contains curriculum frameworks for the course sequences in the respiratory care technology program. Presented in the introductory section are a description of the program and suggested course sequence. Section I lists baseline competencies, and…

  7. The Association of Shelter Veterinarians' 2016 Veterinary Medical Care Guidelines for Spay-Neuter Programs.

    PubMed

    Griffin, Brenda; Bushby, Philip A; McCobb, Emily; White, Sara C; Rigdon-Brestle, Y Karla; Appel, Leslie D; Makolinski, Kathleen V; Wilford, Christine L; Bohling, Mark W; Eddlestone, Susan M; Farrell, Kelly A; Ferguson, Nancy; Harrison, Kelly; Howe, Lisa M; Isaza, Natalie M; Levy, Julie K; Looney, Andrea; Moyer, Michael R; Robertson, Sheilah Ann; Tyson, Kathy

    2016-07-15

    As community efforts to reduce the overpopulation and euthanasia of unwanted and unowned cats and dogs have increased, many veterinarians have increasingly focused their clinical efforts on the provision of spay-neuter services. Because of the wide range of geographic and demographic needs, a wide variety of spay-neuter programs have been developed to increase delivery of services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, community cat programs, and services provided through private practitioners. In an effort to promote consistent, high-quality care across the broad range of these programs, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. These guidelines consist of recommendations for general patient care and clinical procedures, preoperative care, anesthetic management, surgical procedures, postoperative care, and operations management. They were based on current principles of anesthesiology, critical care medicine, infection control, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs regardless of location, facility, or type of program. The Association of Shelter Veterinarians envisions that these guidelines will be used by the profession to maintain consistent veterinary medical care in all settings where spay-neuter services are provided and to promote these services as a means of reducing sheltering and euthanasia of cats and dogs. PMID:27379593

  8. Nurse Practitioner Mental Health Care in the Primary Context: A Californian Case Study

    PubMed Central

    Theophilos, Theane; Green, Roger; Cashin, Andrew

    2015-01-01

    In America, mental health needs surpass the availability of specialized providers. This vulnerable population also has other obstacles for comprehensive care including gaps in medical coverage, stigma, economic barriers, and a geographical mal-distribution of qualified mental health professionals. A wide availability of primary care providers, including primary care and family nurse practitioners, are well-positioned to deliver integrated mental and physical health care. A case study from a Southern California Coachella Valley primary care clinic with integrated services is used to demonstrate the much-needed approach of care to address health disparities that face low-income immigrants, migrant workers, and others without access to specialized care centers and providers. It is argued that mental health care should be part of all holistic treatment provided by primary care and family nurse practitioners. This has implications for curricula and practice development. PMID:27417754

  9. Sustainable practice improvements: impact of the Comprehensive Advanced Palliative Care Education (CAPCE) program.

    PubMed

    Harris, Diane; Hillier, Loretta M; Keat, Nancy

    2007-01-01

    This paper describes an education program designed to improve palliative care practice through the development of workplace hospice palliative care resources (PCRs), and its impact on knowledge transfer and longer-term changes to clinical practice. Evaluation methods included pre- and post-program questionnaires, and a survey of learners' (n=301) perceptions of program learning strategies. Interviews (n=21) were conducted with a purposeful sample of PCRs and representatives from their work sites. Ratings of the sessions indicated that they were relevant to learners' clinical practice. At follow up, the majority of learners (83%) continued to serve as PCRs. Many positive effects were identified, including enhanced pain and symptom management, staff education, and development of care policies and guidelines. Management support, particularly the prioritization of palliative care and staff development, were factors facilitating sustained implementation. These findings highlight the importance of multimodal learning strategies and supportive work environments in the development of PCRs to enhance palliative care practice. PMID:18251444

  10. Preparing Tomorrow’s Nursing Home Nurses: The Wisconsin-Long Term Care Clinical Scholars Program

    PubMed Central

    Nolet, Kim; Roberts, Tonya; Gilmore-Bykovskyi, Andrea; Roiland, Rachel; Gullickson, Colleen; Ryther, Brenda; Bowers, Barbara J.

    2014-01-01

    Preparing future nurses to care for the growing population of older adults has become a national priority. The demand for long term care services is expected to double between 2000 and 2040, yet the field remains stigmatized as an undesirable place for highly-skilled nurses to work. Recent efforts to increase student preparation in geriatrics have been shown to improve student attitudes toward working with older adults and increase knowledge, but long term care settings remain unattractive to students. This paper reports on development, implementation and evaluation of The Wisconsin Long Term Care Clinical Scholars Program, a nursing home internship for baccalaureate nursing students. The program couples a paid nursing home work experience with an evidence-based long term care nursing curriculum. The program increased student preparation and interest in working with older adults and in nursing homes, while concurrently increasing the capacity of nursing homes to provide a positive student experience. PMID:25162659

  11. 42 CFR 1003.105 - Exclusion from participation in Medicare, Medicaid and all Federal health care programs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... application from a State agency for a waiver if the physician's exclusion from the State health care program...) If a waiver is granted, it is applicable only to the State health care program for which the State... waiver will cease and the person will be excluded from the State health care program for the remainder...

  12. 42 CFR 1003.105 - Exclusion from participation in Medicare, Medicaid and all Federal health care programs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... application from a State agency for a waiver if the physician's exclusion from the State health care program...) If a waiver is granted, it is applicable only to the State health care program for which the State... waiver will cease and the person will be excluded from the State health care program for the remainder...

  13. 42 CFR 1003.105 - Exclusion from participation in Medicare, Medicaid and all Federal health care programs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... application from a State agency for a waiver if the physician's exclusion from the State health care program...) If a waiver is granted, it is applicable only to the State health care program for which the State... waiver will cease and the person will be excluded from the State health care program for the remainder...

  14. 42 CFR 1003.105 - Exclusion from participation in Medicare, Medicaid and all Federal health care programs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... application from a State agency for a waiver if the physician's exclusion from the State health care program...) If a waiver is granted, it is applicable only to the State health care program for which the State... waiver will cease and the person will be excluded from the State health care program for the remainder...

  15. 42 CFR 1003.105 - Exclusion from participation in Medicare, Medicaid and all Federal health care programs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... application from a State agency for a waiver if the physician's exclusion from the State health care program...) If a waiver is granted, it is applicable only to the State health care program for which the State... waiver will cease and the person will be excluded from the State health care program for the remainder...

  16. 77 FR 69550 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-19

    ... AFFAIRS Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program... provided by or through the Michael E. DeBakey Home Care Program. DATES: Written comments and... information technology. Title: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form...

  17. A risk-adjusted approach to comparing the return on investment in health care programs.

    PubMed

    Sendi, Pedram; Al, Maiwenn J; Zimmermann, Heinz

    2004-09-01

    The league table approach to rank ordering health care programs according to the incremental cost-effectiveness ratio is a common method to guide policy makers in setting priorities for resource allocation. In the presence of uncertainty, however, ranking programs is complicated by the degree of variability associated with each program. Confidence intervals for cost-effectiveness ratios may be overlapping. Moreover, confidence intervals may include negative ratios and the interpretation of negative cost-effectiveness ratios is ambiguous. We suggest to rank mutually exclusive health care programs according to their rate of return which is defined as the net monetary benefit over the costs of the program. However, how does a program with a higher expected return but higher uncertainty compare to a program with a lower expected return but lower risk? In the present paper we propose a risk-adjusted measure to compare the return on investment in health care programs. Financing a health care program is treated as an investment in a risky asset. The risky asset is combined with a risk-free asset in order to construct a combined portfolio. The weights attributed to the risk-free and risky assets are chosen in such a manner that all programs under consideration exhibit the same degree of uncertainty. We can then compare the performance of the individual programs by constructing a risk-adjusted league table of expected returns. PMID:15277778

  18. Understanding Models of Palliative Care Delivery in Sub-Saharan Africa: Learning From Programs in Kenya and Malawi.

    PubMed

    Downing, Julia; Grant, Liz; Leng, Mhoira; Namukwaya, Elizabeth

    2015-09-01

    The need for palliative care has never been greater. From being significantly present in only five African countries in 2004, palliative care is now delivered in nearly 50% of African countries; however, less than 5% of people in need receive it. To scale-up palliative care, we need greater knowledge about how different models of palliative care work within different health systems. A case study evaluation was undertaken in Kenya and Malawi to define the models used, contextualize them, and identify challenges, best practices, and transferable lessons for scale-up. Visits were made to seven sites and, using an audit tool, data were collected from program staff, hospital staff, and local stakeholders, and care observed as appropriate. Three models of palliative care service delivery were identified, which supports the existing literature, that is, specialist, district hospital level, and community level. However, in looking further, findings show that the major determinants for each model were a set of philosophical questions and assumptions underpinning each and influencing staff and patient decision-making, planning, and allocation of resources. The health system structure and the beliefs about palliative care determined, and were determined most by, referrals, the patient journey, the centeredness of the model, and role definition and training. The models are also closely associated with the physical setting of services. Understanding how the services have developed because of, and indeed despite the geographical setting and the system level, provides us with a different set of indicators of program structure incorporated into the three models. The analysis of models provides pointers to future planning for palliative care. PMID:25936938

  19. Social Workers in Home Care: The Israeli Case

    ERIC Educational Resources Information Center

    Ayalon, Liat; Baum, Nehami

    2010-01-01

    In Israel, the government partially supports personal home care services (grooming, feeding, assistance with transfers) as a means to maintain frail individuals in their home environment for as long as possible. Social workers capture a prominent position in these arrangements as initiators and supervisors of personal home care services. This…

  20. Female Leadership and the Ethic of Care: Three Case Studies.

    ERIC Educational Resources Information Center

    Kropiewnicki, Mary I.; Shapiro, Joan P.

    A study explored the ethical framework of care as a leadership attribute in three female principals at an elementary school, a junior high school, and a high school in northeast Pennsylvania. Recent studies of educational administrators reveal that new leadership models and attributes, identified as the ethic of care, are emerging among both male…

  1. Care management: quelling the confusion. Case managers help clients access resources appropriate to their needs.

    PubMed

    Westhoff, L J

    1992-06-01

    The vast number of available healthcare services can be confusing to those seeking care. Care managers can resolve these issues by helping the vulnerable and their families find and receive appropriate services. Care management is not limited to the elderly: Others with special needs also benefit from care management. Care managers integrate and coordinate services, providing a continuum between the client and the providers of acute, long-term, home-based, and community-based care. The care management model that most organizations adopt at first is the brokering model. In this model care managers identify the appropriate service package from resources in the community. In the service management model, the care manager authorizes the services provided within specified financial limits. The funding source influences what services he or she can recommend. Another model is managed care. The carrier of a high-risk group of clients or a group of enrollees in a certain healthcare program prospectively pays the organization providing care management. In the acute care setting, providers find the transition to care management challenging because they have been oriented to short, episodic care. These providers must adopt new protocols to be able to work with providers and programs within their own organization or at other organizations. In community-based care, care managers' goal is to help the client and family access appropriate services so the client can function independently within his or her home. Community-based referrals are from family members or agencies and infrequently follow an acute care hospitalization. PMID:10118342

  2. Interdisciplinary Programs Focused Populations: The Case of Health Management Program

    ERIC Educational Resources Information Center

    Davidovitch, Nitza; Yavich, Roman

    2015-01-01

    The Ariel University has a unique interdisciplinary program in healthcare management that targets experienced healthcare professionals who wish to earn an academic degree. Only one academic study has been held so far on the integration of graduates of an academic university-level school in healthcare management in the field. In the current study,…

  3. Joint Task Force on Undergraduate Physics Programs: Implications for physics programs and why you should care

    NASA Astrophysics Data System (ADS)

    Hodapp, Theodore

    2016-03-01

    The content of undergraduate physics programs has not changed appreciably in 50 years, however, the jobs our students take have changed dramatically. Preparing students for careers they are likely to encounter requires physics programs to rethink and in some cases retool to provide an education that will not only educate an individual in the habits of mind and keen sense of how to solve complex technical problems, but also what related skills they will need to be effective in those careers. Do you teach your student how to read or create a budget? How about dealing with a low-performing member of an R&D team? This talk will explore driving forces behind this report, potential implications for physics departments, and practical steps faculty members can take to continue to consider improvements in experiences for our students. This work is supported in part by the National Science Foundation (NSF-1540570).

  4. Ceramic material life prediction: A program to translate ANSYS results to CARES/LIFE reliability analysis

    NASA Technical Reports Server (NTRS)

    Vonhermann, Pieter; Pintz, Adam

    1994-01-01

    This manual describes the use of the ANSCARES program to prepare a neutral file of FEM stress results taken from ANSYS Release 5.0, in the format needed by CARES/LIFE ceramics reliability program. It is intended for use by experienced users of ANSYS and CARES. Knowledge of compiling and linking FORTRAN programs is also required. Maximum use is made of existing routines (from other CARES interface programs and ANSYS routines) to extract the finite element results and prepare the neutral file for input to the reliability analysis. FORTRAN and machine language routines as described are used to read the ANSYS results file. Sub-element stresses are computed and written to a neutral file using FORTRAN subroutines which are nearly identical to those used in the NASCARES (MSC/NASTRAN to CARES) interface.

  5. [Apprenticeship of caring in student baccalaureate nurses in a program of formation of competence].

    PubMed

    Krol, Pawel

    2010-09-01

    The nursing profession and university nursing programs both took great strides after universities first introduced nursing programs in and around the 1950s. The purpose of this phenomenological qualitative study was to describe the meaning of the apprenticeship of caring through in the Bachelor of Science in Nursing program. Watson's human caring philosophy (2008) suggested that researchers explore the meaning persons ascribe to phenomena. Based on semi-structured interviews this phenomenological study described the essence of the phenomenon and revealed that the apprenticeship of caring meant the harmonisation of the "self-perceived" and the "self-lived" that allows the embodiment of caring. The results of this research are available to teachers who may wish to consider its recommendations when planning and developing assessment and training programs for various kinds of nursing clienteles. PMID:20957804

  6. Patient navigator programs, cancer disparities, and the patient protection and affordable care act.

    PubMed

    Moy, Beverly; Chabner, Bruce A

    2011-01-01

    Patients in vulnerable population groups suffer disproportionately from cancer. The elimination of cancer disparities is critically important for lessening the burden of cancer. Patient navigator programs have been shown to improve clinical outcomes. Among its provisions relevant to disparities in cancer care, The Patient Protection and Affordability Care Act authorizes continued funding of patient navigator programs. However, given the current economic and political environment, this funding is in jeopardy. This article describes patient navigator programs and summarizes the elements of the health care law that are relevant to these programs. It is vital that the entire oncology community remain committed to leading efforts toward the improvement of cancer care among our most vulnerable patients. PMID:21804070

  7. How to Choose the Best Day-Care Program for Your Child.

    ERIC Educational Resources Information Center

    Patten, Peggy

    1984-01-01

    When selecting a day-care program, parents should observe the center personally and talk with other parents for references. Suggestions for evaluating curriculum, staff, physical space, and family-school relations are offered. (DF)

  8. Teacher/Child Behaviors in an Open Environment Day Care Program. Final Report.

    ERIC Educational Resources Information Center

    Lay, Margaret Z.; Meyer, William J.

    A limited set of behaviors of three-, four-, and five-year-old children were observed in a day-care program designed to permit the children a maximum of freedom for environmental encounters. The sample consists of 20 children with day-care experience dating back to infancy and a group of 20 children (a contrast group) without prior day-care…

  9. A Program to Improve Access to Health Care Among Mexican Immigrants in Rural Colorado

    ERIC Educational Resources Information Center

    Diaz-Perez, Maria de Jesus; Farley, Tillman; Cabanis, Clara Martin

    2004-01-01

    Migration to the United States from Mexico is increasing every year. Mexican immigrants tend to be poor, uninsured, monolingual Spanish speakers without adequate access to appropriate medical care. As a further barrier, many are also undocumented. This article describes a program developed to improve access to health care among Mexican immigrants…

  10. Respite Care: An Overview of Federal, Selected State, and Private Programs. Report to Congressional Requesters.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. Div. of Human Resources.

    This report examines respite care services that provide temporary relief to family members and other caretakers of children at risk of abuse or neglect including children who are mentally retarded, behaviorally disturbed, physically disabled, or chronically or terminally ill. In 1988 the 25 states surveyed funded 111 respite care programs as did…

  11. Understanding a School-Based Mental Health Program: Creating a Caring Environment.

    ERIC Educational Resources Information Center

    Kist-Kline, Gail E.; Quantz, Richard A.

    1998-01-01

    Demonstrates how a school-based mental health program helps create a caring alternative high school, based on data gathered by shadowing students; interviewing students, teachers, staff, and counselors; reviewing documents; and observing group-counseling sessions. Findings indicate that counseling allows students to experience caring, when…

  12. 78 FR 50495 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-19

    ... line FQHC Federally qualified health center FR Federal Register FTE Full-time equivalent FUH Follow-up... 42 CFR Parts 412, 413, 414, et al. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care; Hospital Prospective Payment System and Fiscal...

  13. 75 FR 50041 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-16

    ..., phone 1-800-743-3951. Electronic Access This Federal Register document is also available from the... CFR Parts 412, 413, 415, et al. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System Changes and FY2011...

  14. 77 FR 53257 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-31

    ... Printing Office Web page at: http://www.gpo.gov/fdsys/browse/collection.action?collectionCode=FR . Free... 42 CFR Parts 412, 413, 424, et al. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal...

  15. Cooperation, Coordination and Collaboration: A Guide for Child Care and Head Start Programs.

    ERIC Educational Resources Information Center

    Oregon State Dept. of Education, Salem.

    Intended for those interested in building a collaborative system of services for young children and their families, this guide describes models used in developing Oregon's coordinated Head Start and early child care programs. Chapter 1, "Introduction and Overview," sets out the goals of the Oregon Child Care/Head Start Collaboration Work Group.…

  16. The Early Patient-Oriented Care Program as an Educational Tool and Service.

    ERIC Educational Resources Information Center

    Grabe, Darren W.; Bailie, George R.; Manley, Harold J.; Yeaw, Barbara F.

    1998-01-01

    The Early Patient-Oriented Care Program provides early clinical education for pharmacy students and clinical services for patients. Six students were assigned to visit 12-15 hemodialysis patients monthly under preceptor supervision. Topics covered include approach to patient, medical information retrieval, pharmaceutical care philosophy,…

  17. Increasing the Efficiency of Program Status Reporting by Residential Direct Care Staff

    ERIC Educational Resources Information Center

    Bastien, James S.; Burns, William J.; Kelly, Francis D.; Schumm, Patricia A.; Allen, Theresa P.

    2005-01-01

    In large residential treatment centers for adolescent youth, program administrators and clinical staff rely on the information imparted to them by direct care staff to make appropriate decisions regarding administrative and clinical support functions so that the residents in care can receive the best treatment possible. This study was designed to…

  18. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false General requirements for adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult...

  19. Implementation of a Program of Outcomes Research in Residential Care Settings: Outcomes for Children and Youth

    ERIC Educational Resources Information Center

    Portwood, Sharon G.; Boyd, A. Suzanne; Murdock, Tamera B.

    2016-01-01

    Background: There is a need to examine behavioral and mental health outcomes for children in out-of-home care across settings. Objective: Using a participatory research approach, researchers and agency personnel aimed to implement a program of scientific outcomes research in residential care settings. Data were used to examine children's…

  20. Iterations of the SafeCare Model: An Evidence-Based Child Maltreatment Prevention Program

    ERIC Educational Resources Information Center

    Edwards, Anna; Lutzker, John R.

    2008-01-01

    SafeCare is an evidenced-based parenting program for at-risk and maltreating parents that addresses the social and family ecology in which child maltreatment occurs. SafeCare home visitors focus on behavioral skills that are trained to predetermined performance criteria. Recent research has stressed the importance of successful dissemination and…

  1. Creating a Child Care Center in a Nursing Home and Implementing an Intergenerational Program.

    ERIC Educational Resources Information Center

    Foster, Karen B.

    The success of the Champaign County Nursing Home Child Care Center (CCNHCCC) in Illinois provides a model for the establishment of child care centers in nursing homes. Needs assessment, financial support, licensing, staff hiring and training are all important factors that need to addressed in the start up and running of such a program. The…

  2. The Child and Adult Care Food Program and the Nutrition of Preschoolers

    ERIC Educational Resources Information Center

    Korenman, Sanders; Abner, Kristin S.; Kaestner, Robert; Gordon, Rachel A.

    2013-01-01

    Children spend a considerable amount of time in preschools and child care centers. As a result, these settings may have an influence on their diet, weight, and food security, and are potentially important contexts for interventions to address nutritional health. The Child and Adult Care Food Program (CACFP) is one such intervention. No national…

  3. Minding the Children: Ford Foundation Assistance to Child-Care Programs.

    ERIC Educational Resources Information Center

    Ford Foundation, New York, NY.

    This report describes child care related programs which have received major grants from the Ford Foundation since 1969. Specific information and referral services such as the Children's Council of San Francisco Childcare Switchboard, the Cambridge/Somerville Child Care Resource Center in Massachusetts, the Pre-School Association of the West Side…

  4. Effects of the Program of All-Inclusive Care for the Elderly on Hospital Use

    ERIC Educational Resources Information Center

    Meret-Hanke, Louise A.

    2011-01-01

    Purpose of the Study: This study evaluates the effects of the Program of All-Inclusive Care for the Elderly (PACE) on hospital use. PACE's capitated financing creates incentives to reduce the use of costly services. Furthermore, its emphasis on preventative care and regular monitoring by provides a mechanism for reducing unnecessary hospital use…

  5. 76 FR 9283 - Medicaid Program; Payment Adjustment for Provider-Preventable Conditions Including Health Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-17

    ... Medicaid Program; Payment Adjustment for Provider-Preventable Conditions Including Health Care-Acquired... amounts expended for providing medical assistance for health care-acquired conditions. It would also... Federal financial participation FY Fiscal year HAC Hospital-acquired condition HCAC Health...

  6. Evaluation of Multidisciplinary Tobacco Cessation Training Program in a Large Health Care System

    ERIC Educational Resources Information Center

    Chen, Timothy C.; Hamlett-Berry, Kim W.; Watanabe, Jonathan H.; Bounthavong, Mark; Zillich, Alan J.; Christofferson, Dana E.; Myers, Mark G.; Himstreet, Julianne E.; Belperio, Pamela S.; Hudmon, Karen Suchanek

    2015-01-01

    Background: Health care professionals can have a dramatic impact by assisting patients with tobacco cessation but most have limited training. Purpose: To evaluate the effectiveness of a 4-hour tobacco cessation training program. Methods: A team of multidisciplinary health care professionals created a veteran-specific tailored version of the Rx for…

  7. Characteristics Predicting Nursing Home Admission in the Program of All-Inclusive Care for Elderly People

    ERIC Educational Resources Information Center

    Friedman, Susan M.; Steinwachs, Donald M.; Rathouz, Paul J.; Burton, Lynda C.; Mukamel, Dana B.

    2005-01-01

    Long term care in a nursing home prior to enrollment in PACE remain at high risk of readmission, despite the availability of comprehensive services. This study determined overall risk and predictors of long-term nursing home admission within the Program of All-Inclusive Care for the Elderly (PACE). Design and Methods: Data PACE records for 4,646…

  8. School Readiness: The Contribution of Formal Early Education and Care Programs. Draft.

    ERIC Educational Resources Information Center

    Kisker, Ellen Eliason

    Preparing America's children to start school ready to learn will depend in large part on the availability, quality, and affordability of early education and care. Research conducted since the 1970s indicates that, despite increases, the supply of formal early education and care programs is not adequate to meet the needs of all families. Many…

  9. Palliative care communication curriculum: what can students learn from an unfolding case?

    PubMed

    Goldsmith, Joy; Wittenberg-Lyles, Elaine; Shaunfield, Sara; Sanchez-Reilly, Sandra

    2011-06-01

    Limited attention to palliative care communication training is offered to medical students. In this work, we pursued unfolding case responses and what they indicated about student tendencies to use palliative care communication as well as what medical students can learn from their own reflective practice about palliative care. Findings showed an overwhelming trend for students to avoid palliative care communication or inclusion of topics including advance directives, place of care, family support, and dying. Instead, students relied heavily on the SPIKES protocol, communication that was strategically vague and ambiguous, and discussions that centered on specialty care and referral. In reflecting on their own case study responses, students noted an absence of direct communication about prognosis, no coordination of care, late hospice entry, and patient pain resulting from communication inefficacies. Future research should focus on the development of formal and adaptive curriculum structures to address these communication needs. PMID:21071434

  10. The Industry Coupled Case Study Program final report

    SciTech Connect

    Stringfellow, J.

    1982-10-01

    The Industry Coupled Case Study Program was conceived as a short-term cooperative program between the Federal government and private industry. Federal funds were committed to stimulate geothermal exploration and development between 1977 and 1979, although some work under the program continues into 1982. Federal funding has been phased out and the remaining information developed during the program is being disseminated and reported. This report presents an overview of the program and documents the technical results and open-file data base resulting from the program.

  11. Managed care under siege: how an effective compliance program can protect your company.

    PubMed

    Stratton, K M; Nahra, M H

    1996-01-01

    This article discusses the current enforcement emphasis on managed care fraud and examines how managed care organizations can utilize compliance programs, including legal audits, to protect against unwarranted investigations and liability. The article reviews the elements of an effective compliance program, how to conduct an internal audit, and the risks and benefits of a voluntary disclosure in the event fraudulent activity is discovered. PMID:10154069

  12. Effect of an oral health training program on knowledge and behavior of state agency long-term-care surveyors.

    PubMed

    Kaiser, C M; Williams, K B; Mayberry, W; Braun, J; Pozek, K D

    2000-01-01

    This study examines the effect of a training program on long-term-care (LTC) surveyors' knowledge of factors affecting oral health and their behavior in citing oral health deficiencies of LTC residents. Twenty surveyors were recruited for the experimental group, along with a non-equivalent comparison group of 31 surveyors. The experimental group participated in a three-hour interactive, case-based training program. The experimental group had a significant increase in total knowledge (p < 0.002) post-test scores with a moderate effect size, eta 2 = 0.115. The training program resulted in a statistically significant increase (p < 0.0001) in oral health citation behavior for the experimental group for six months following training. This study provides evidence that an interactive case-based training program can affect participants' knowledge regarding oral health of LTC residents and participants' oral health citation behavior. As the elderly population experiences an increased life expectancy with increased need for assistance with Activities of Daily Living (ADL), similar training programs will become an important factor in assessing the quality of care provided to LTC residents. PMID:11203881

  13. CARES/LIFE Ceramics Analysis and Reliability Evaluation of Structures Life Prediction Program

    NASA Technical Reports Server (NTRS)

    Nemeth, Noel N.; Powers, Lynn M.; Janosik, Lesley A.; Gyekenyesi, John P.

    2003-01-01

    This manual describes the Ceramics Analysis and Reliability Evaluation of Structures Life Prediction (CARES/LIFE) computer program. The program calculates the time-dependent reliability of monolithic ceramic components subjected to thermomechanical and/or proof test loading. CARES/LIFE is an extension of the CARES (Ceramic Analysis and Reliability Evaluation of Structures) computer program. The program uses results from MSC/NASTRAN, ABAQUS, and ANSYS finite element analysis programs to evaluate component reliability due to inherent surface and/or volume type flaws. CARES/LIFE accounts for the phenomenon of subcritical crack growth (SCG) by utilizing the power law, Paris law, or Walker law. The two-parameter Weibull cumulative distribution function is used to characterize the variation in component strength. The effects of multiaxial stresses are modeled by using either the principle of independent action (PIA), the Weibull normal stress averaging method (NSA), or the Batdorf theory. Inert strength and fatigue parameters are estimated from rupture strength data of naturally flawed specimens loaded in static, dynamic, or cyclic fatigue. The probabilistic time-dependent theories used in CARES/LIFE, along with the input and output for CARES/LIFE, are described. Example problems to demonstrate various features of the program are also included.

  14. Developing a Quality School-Age Child Care Program: An Information and Training Manual for Directors of School-Age Child Care Programs.

    ERIC Educational Resources Information Center

    Childcare Resources, Birmingham, AL.

    This manual for directors of school-age child care (SACC) programs contains six sections. Section I provides a rationale for SACC. Section II describes characteristics of school-age children. The extensive Section III discusses characteristics of high quality SACC. After an initial discussion of the importance of out-of-school time, the section…

  15. Leasing Commercial Space for Your Child Care Program.

    ERIC Educational Resources Information Center

    Stephens, Keith

    1987-01-01

    Covers leasing of commercial space for child care centers, either as an enhancement to a developer's project or on a commercial basis in competition with other types of commercial development. Discusses different negotiating psychologies and key negotiating points to be used in each leasing situation. (NH)

  16. Assessing the Quality of Portuguese Child Care Programs for Toddlers

    ERIC Educational Resources Information Center

    Barros, Silvia; Aguiar, Cecilia

    2010-01-01

    The purpose of this study was to describe the quality of toddler child care classrooms in the district of Porto, in the north of Portugal. One hundred and sixty classrooms for children between 1 and 3 years of age participated in this study. Results suggested the existence of poor average quality and absence of good-quality classrooms. Child-adult…

  17. Impact of a Patient Incentive Program on Receipt of Preventive Care

    PubMed Central

    Mehrotra, Ateev; An, Ruopeng; Patel, Deepak N.; Sturm, Roland

    2014-01-01

    Objectives Patient financial incentives are being promoted as a mechanism to increase receipt of preventive care, encourage healthy behavior, and improve chronic disease management. However, few empirical evaluations have assessed such incentive programs. Study Design In South Africa, a private health plan has introduced a voluntary incentive program which costs enrollees approximately $20 per month. In the program, enrollees earn points when they receive preventive care. These points translate into discounts on retail goods such as airline tickets, movie tickets, or cell phones. Methods We compared the change in 8 preventive care services over the years 2005–11 between those who entered the incentive program and those that did not. We used multivariate regression models with individual random effects to try to address selection bias. Results Of the 4,186,047 unique individuals enrolled in the health plan, 65.5% (2,742,268) voluntarily enrolled in the incentive program. Joining the incentive program was associated with a statistically higher odds of receiving all 8 preventive care services. The odds ratio and estimated percentage point increase for receipt of cholesterol testing was 2.70 (8.9%), glucose testing 1.51 (4.7%), glaucoma screening 1.34 (3.9%), dental exam 1.64 (6.3%), HIV test 3.47 (2.6%), prostate specific antigen testing 1.39 (5.6%), Papanicolaou screening 2.17 (7.0%), and mammogram 1.90 (3.1%) (p<0.001 for all eight services). However, preventive care rates among those in the incentive program was still low. Conclusions Voluntary participation in a patient incentive program was associated with a significantly higher likelihood of receiving preventive care, though receipt of preventive care among those in the program was still lower than ideal. PMID:25180436

  18. Coordinating Mental Health Care across Primary Care and Schools: ADHD as a Case Example

    ERIC Educational Resources Information Center

    Power, Thomas J.; Blum, Nathan J.; Guevara, James P.; Jones, Heather A.; Leslie, Laurel K.

    2013-01-01

    Although primary care practices and schools are major venues for the delivery of mental health services to children, these systems are disconnected, contributing to fragmentation in service delivery. This paper describes barriers to collaboration across the primary care and school systems, including administrative and fiscal pressures, conceptual…

  19. Outpatient Palliative Care for Chronic Obstructive Pulmonary Disease: A Case Series

    PubMed Central

    Yount, Susan; Szmuilowicz, Eytan; Rosenberg, Sharon R.; Kalhan, Ravi

    2014-01-01

    Abstract Background: Patients with chronic obstructive pulmonary disease (COPD) have well-documented symptoms that affect quality of life. Professional societies recommend palliative care for such patients, but the optimal way of delivering this care is unknown. Objective: To describe an outpatient palliative medicine program for patients with COPD. Design: Retrospective case series. Setting/Subjects: Thirty-six patients with COPD followed in a United States academic outpatient palliative medicine clinic. Measurements: Descriptive analysis of sociodemographic data, disease severity and comorbidities, treatments, hospitalizations, mortality, topic discussion, and symptom assessment. Results: Thirty-six patients (representing 5% of the total number of patients with COPD seen in a specialty pulmonary clinic) were seen over 11 months and followed for 2 years. Seventy-seven percent of patients were Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 3–4 and 72% were on oxygen at home. No patients had documented advanced directives at the initial visit but documentation increased to 61% for those who had follow-up appointments. The most commonly documented topics included symptoms (100%), social issues (94%), psychological issues (78%), and advance care planning (75%). Of symptoms assessed, pain was the least prevalent (51.6%), and breathlessness and fatigue were the most prevalent (100%). Symptoms were often undertreated prior to the palliative care appointment. During the 3-year study period, there were 120 hospital admissions (median, 2) and 12 deaths (33%). Conclusions: The patients with COPD seen in the outpatient palliative medicine clinic had many comorbid conditions, severe illness, and significant symptom burden. Many physical and psychological symptoms were untreated prior to the palliative medicine appointment. Whether addressing these symptoms through a palliative medicine intervention affects outcomes in COPD is unknown but represents an

  20. Using Case Study Analysis and Case Writing to Structure Clinical Experiences in a Teacher Education Program

    ERIC Educational Resources Information Center

    Floyd, Deborah M.; Bodur, Yasar

    2005-01-01

    This study reports on the design and results of a two-semester study on the use of case study analysis and case writing in clinical experiences in an undergraduate teacher education program. Findings indicated that structured experiences with case studies and case writing increase preservice teachers' informed decision making on educational…

  1. Evaluation of Quality in Social Care: Aplus Program

    ERIC Educational Resources Information Center

    Dutrenit, Jean-Marc

    2005-01-01

    France is not advanced regarding evaluation in social work, despite a law established in January 2002 making evaluation a legal obligation every 5 years. This article presents a software program to help social services evaluate on both individual and group levels. Automatic dashboard results of the program with special emphasis on the main…

  2. Knowing and Caring Toward an Effective Social Studies Reading Program.

    ERIC Educational Resources Information Center

    Hubbard, Russ

    Hundreds of suitable books are available to include in a reading program to supplement the prescribed social studies curriculum. Gordon Parks's book "The Learning Tree" reflects three criteria teachers should consider when selecting books for use in a supplementary reading program. First, the story has what one reader called "cool writing," that…

  3. Translating an Evidence-based Lifestyle Intervention Program into Primary Care: Lessons Learned

    PubMed Central

    Blonstein, Andrea C.; Yank, Veronica; Stafford, Randall S.; Wilson, Sandra R.; Rosas, Lisa Goldman; Ma, Jun

    2014-01-01

    Obesity is one of the top health priorities in the United States. Primary care physicians are the designated “gatekeepers” for obesity prevention, detection, and treatment. However, they and the current U.S. health care structure and reimbursement systems are often ill-equipped to implement evidence-based obesity care. The Group Lifestyle Balance™ (GLB) program is a group-delivery adaptation of the predominantly one-on-one lifestyle intervention proven efficacious in the Diabetes Prevention Program (DPP) trial. Participant intervention goals are 7% weight loss and sustained moderate physical activity of 150 minutes or more each week. Sequential instruction and coaching encompasses nutrition, behavior modification, and physical activity principles. The E-LITE (Evaluation of Lifestyle Interventions to Treat Elevated Cardiometabolic Risk in Primary Care) trial evaluates the feasibility and potential effectiveness of delivering the GLB program, supplemented with food tasting and supervised physical activity during each of 12 group sessions, and electronic communication for long-term follow up, in a primary care setting. Benefits and potential areas for improvement in three areas of implementation emerged during the 15-month E-LITE trial: (1) delivery of an established lifestyle intervention program by specialized professionals, (2) integration of a lifestyle intervention program into a primary care clinic, and (3) information technology use in a primary care-based lifestyle intervention program. Our experience shows the feasibility of implementing an evidence-based lifestyle intervention program combining group-delivered nutrition and behavioral counseling, physical activity training, and technology-mediated follow-up in a primary care clinic setting, but challenges remain, and we offer possible solutions to overcome them. PMID:23539264

  4. Depression case finding in primary care: a method for the mandates.

    PubMed

    Nease, Donald E; Klinkman, Michael S; Aikens, James E

    2006-01-01

    The current mandates for depression screening in primary care create a dilemma for clinicians. How should screening be implemented in the face of limited evidence for sustainable strategies for effective depression monitoring and management in primary care. In this article we review the issues surrounding primary care depression screening, and develop the argument for a case-finding strategy that includes careful choice of a single instrument, focused identification of high-risk patients, and systematic monitoring of outcomes. We believe this is a sustainable method that primary care clinicians can implement to address the spirit of current depression screening mandates. PMID:17154144

  5. Economic grand rounds: A pay-for-performance program for behavioral health care practitioners.

    PubMed

    Pelonero, Anthony L; Johnson, Richard L

    2007-04-01

    This column describes a pay-for-performance program for behavioral health care practitioners. Implemented in 1996 by a large national health insurer, the program's goals are to improve the quality of care, recognize the practitioners who provide higher-quality care, demonstrate the value of behavioral health services to purchasers, and help providers align their practices with national standards. A future goal is to provide patients with data on provider quality to improve their treatment decisions. Important considerations in measure development include application of the measure to all disciplines, feasible data collection processes for providers, creation of clinically meaningful and fair measures, and selection of measures with large baseline variability. PMID:17412840

  6. Managed care and medical education: hard cases and hard choices.

    PubMed

    Friedman, E

    1997-05-01

    As managed care becomes more and more dominant in U.S. health care, it is coming into conflict with medical education. There are historical reasons for this: medical education traditionally excluded physicians who chose to work in health plans, and for profit managed care has tended to avoid subsidizing medical education. In order to improve the climate, three changes are necessary: medical education must understand the tense history of discord between the two; distinctions must be made between responsible and irresponsible managed care plans; and medical educators should not assume they own the moral high ground. Arrogance, a gross oversupply of physicians and especially specialists, scandals and fraud, an often callous attitude toward the poor, and other sins can be laid at medical education's door. The worse threat for both sides is that the public and payers could simply abandon both, leading to underfunding for health professions education, a society that does not trust its health care system, and the loss of superb teaching organizations. To prevent this, managed care and medical education should work together to solve several difficult problems: how to shrink the medical education infrastructure; how to report honestly the uses to which medical education funds are put; and how to identify and end irresponsible behavior on the part of health plans and medical education entities alike. If the two sides can exercise leadership in these areas, they will be able to protect and enhance the singular place of honor that medical education holds in this society. PMID:9159575

  7. Reengineering and infection control programs: commentary and a case study.

    PubMed

    Jackson, M; Massanari, R M

    2000-02-01

    Transformation of the health care system has been an ongoing process for generations, but many changes in the past 2 decades have focused on reducing costs in concert with rapidly changing technologies and demands for high quality care. Many cost-containment efforts in the 1990s are characterized by attempts to apply the business model for "reengineering the corporation" to health care systems. This commentary reviews principles of reengineering and how strategies to reduce costs through market forces, competition, and downsizing can result in substantial problems for bureaucratic organizations unaccustomed to rapid change and innovation. A case study drawn from experiences of a large metropolitan academic health care system is presented, with specific focus on lessons that will be helpful to infection control professionals (ICPs) confronted with similar situations. PMID:10679136

  8. Exercise in clinical cancer care: a call to action and program development description

    PubMed Central

    Santa Mina, D.; Alibhai, S.M.H.; Matthew, A.G.; Guglietti, C.L.; Steele, J.; Trachtenberg, J.; Ritvo, P.G.

    2012-01-01

    A large and convincing body of evidence demonstrates the benefits of exercise for cancer survivors during and after treatment. Based on that literature, more cancer survivors should be offered exercise support and programming. Unfortunately, exercise programs remain an exception rather than the norm in cancer care. Not surprisingly, common barriers to the implementation of exercise programs in oncology include limited resources, expertise, and awareness of benefits on the part of patients and clinicians. To improve the accessibility and cost-effectiveness of cancer exercise programs, one proposed strategy is to combine the resources of hospital and community-based programs with home-based exercise instruction. The present paper highlights current literature regarding exercise programming for cancer survivors, describes the development of an exercise program for cancer patients in Toronto, Canada, and offers experiential insights into the integration of exercise into oncologic care. PMID:22670103

  9. The Mood Disorders Association of British Columbia Psychiatric Urgent Care Program: A Preliminary Evaluation of a Suggested Alternative Model of Outpatient Psychiatric Care

    PubMed Central

    Remick, Ronald A; Araki, Yuriko; Bruce, Robin; Gorman, Chris; Allen, Judy; Remick, Abigail K; Lear, Scott A

    2014-01-01

    Objective: To describe an alternative model of psychiatric outpatient care for patients with mood and anxiety disorders (the Mood Disorders Association of British Columbia Psychiatric Urgent Care Program or the MDA Program) using group medical visits (GMV) and (or) email communications in lieu of individual follow-up appointments. Method: Annual costs of the MDA Program were compared with average costs of private psychiatrists offering outpatient care and patients being treated in a mental health centre. In addition, questionnaires as to patient satisfaction with the MDA Program intake, GMV experience, and family physician satisfaction with the MDA Program were administered. Results: The MDA Program model of care is significantly more cost effective than individual psychiatric outpatient care or health authority mental health centre care for patients with moderate or severe illness. Patients and family physicians were very satisfied with the model of care and GMVs offered. Conclusions: The MDA Program model of care appears to be efficient and cost-effective, and patients and referring physicians appear satisfied with the care offered in this program. PMID:25007115

  10. Case Report Writing in a Doctor of Physical Therapy Education Program: A Case Study

    ERIC Educational Resources Information Center

    Fillyaw, Michael J.

    2011-01-01

    Case reports are an established form of scholarship used for teaching and learning in medicine and health care, but there are few examples of the teaching and learning activities used to prepare students to write a case report. This report describes the implementation of two courses that prepare physical therapy students to write and disseminate a…

  11. Palau assessment for a continuing health care professional development program.

    PubMed

    Chen, Tai-Ho; Dever, Gregory; Kuartei, Stevenson; Maskarinec, Gregory G

    2007-03-01

    In 2003, the University of Hawai'i Department of Family Medicine and Community Health entered a 4-year cooperative agreement with the U.S. Health Resources and Services Administration to establish the "Pacific Association for Clinical Training" (PACT). PACT's goal is to develop effective distance education methods to improve the education and skills of health care professionals in the U.S.-Affiliated Pacific Island nations. To determine the situation existing in 2004, one of PACT's first projects was to perform site visits to each jurisdiction, conducting needs assessments through interviews with key health care professionals, hospital administrators and government officials. This article highlights findings of PACT's Palau assessment. Meant to establish a baseline for future reference, all data were collected in 2004-2005 and have not been updated. PMID:19772140

  12. Coordinating Mental Health Care Across Primary Care and Schools: ADHD as a Case Example

    PubMed Central

    Power, Thomas J.; Blum, Nathan J.; Guevara, James P.; Jones, Heather A.; Leslie, Laurel K.

    2012-01-01

    Although primary care practices and schools are major venues for the delivery of mental health services to children, these systems are disconnected, contributing to fragmentation in service delivery. This paper describes barriers to collaboration across the primary care and school systems, including administrative and fiscal pressures, conceptual and linguistic differences between healthcare and educational professionals, role restrictions among professionals, and privacy laws. Strategies for overcoming these barriers that can be applied in both primary care and school settings are described. The paper has a primary focus on children with ADHD, but the principles and strategies described are applicable to children with a range of mental health and health conditions. PMID:23459527

  13. Navigating the Needs of Rural Women with Breast Cancer: A Breast Care Program

    PubMed Central

    Depke, Jill L.; Boreen, Amanda; Onitilo, Adedayo A.

    2015-01-01

    We describe the development and establishment of a breast care program (BCP) with service for rural breast cancer patients. Our program is a comprehensive program serving rural communities in Wisconsin. Our BCP is committed to breast health throughout the continuum from breast cancer risk assessment and prevention, advanced diagnostics, and screening tools to genetic testing and state-of-the-art surgical techniques. To provide the highest level of care, we coordinate a breast care team involving collaboration of multidisciplinary healthcare professionals. Experts from various departments, including radiologists, pathologists, breast surgeons, medical and radiation oncologists, genetic counselors, clinical trial specialists, and our breast care navigator, all work together to provide cutting edge cancer treatment and management. Our distinctive BCP allows patients to see multiple providers without having to make multiple appointments and promotes discussion of treatment recommendations and creation of a personalized treatment plan for each patient by a team of specialists. PMID:26056376

  14. The History of the Animal Care Program at NASA Johnson Space Center

    NASA Technical Reports Server (NTRS)

    Khan-Mayberry, Noreen; Bassett, Stephanie

    2010-01-01

    This slide presentation reviews the work of the Animal Care Program (ACP). Animals have been used early in space exploration to ascertain if it were possible to launch a manned spacecraft. The program is currently involved in many studies that assist in enhancing the scientific knowledge of the effect of space travel. The responsibilities of the ACP are: (1) Organize and supervise animal care operations & activities (research, testing & demonstration). (2) Maintain full accreditation by the International Association for the Assessment and Accreditation of Laboratory Animal Care (AAALAC) (3) Ensure protocol compliance with IACUC recommendations (4) Training astronauts for in-flight animal experiments (5) Maintain accurate & timely records for all animal research testing approved by JSC IACUC (6) Organize IACUC meetings and assist IACUC members (7) Coordinate IACUC review of the Institutional Program for Humane Care and Use of Animals (every 6 mos)

  15. Developing the DESCARTE Model: The Design of Case Study Research in Health Care.

    PubMed

    Carolan, Clare M; Forbat, Liz; Smith, Annetta

    2016-04-01

    Case study is a long-established research tradition which predates the recent surge in mixed-methods research. Although a myriad of nuanced definitions of case study exist, seminal case study authors agree that the use of multiple data sources typify this research approach. The expansive case study literature demonstrates a lack of clarity and guidance in designing and reporting this approach to research. Informed by two reviews of the current health care literature, we posit that methodological description in case studies principally focuses on description of case study typology, which impedes the construction of methodologically clear and rigorous case studies. We draw from the case study and mixed-methods literature to develop the DESCARTE model as an innovative approach to the design, conduct, and reporting of case studies in health care. We examine how case study fits within the overall enterprise of qualitatively driven mixed-methods research, and the potential strengths of the model are considered. PMID:26336896

  16. The Association of Shelter Veterinarians veterinary medical care guidelines for spay-neuter programs.

    PubMed

    Looney, Andrea L; Bohling, Mark W; Bushby, Philip A; Howe, Lisa M; Griffin, Brenda; Levy, Julie K; Eddlestone, Susan M; Weedon, James R; Appel, Leslie D; Rigdon-Brestle, Y Karla; Ferguson, Nancy J; Sweeney, David J; Tyson, Kathy A; Voors, Adriana H; White, Sara C; Wilford, Christine L; Farrell, Kelly A; Jefferson, Ellen P; Moyer, Michael R; Newbury, Sandra P; Saxton, Melissa A; Scarlett, Janet M

    2008-07-01

    As efforts to reduce the overpopulation and euthanasia of unwanted and unowned dogs and cats have increased, greater attention has been focused on spay-neuter programs throughout the United States. Because of the wide range of geographic and demographic needs, a wide variety of programs have been developed to increase delivery of spay-neuter services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, feral cat programs, and services provided through private practitioners. In an effort to ensure a consistent level of care, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. The guidelines consist of recommendations for preoperative care (eg, patient transport and housing, patient selection, client communication, record keeping, and medical considerations), anesthetic management (eg, equipment, monitoring, perioperative considerations, anesthetic protocols, and emergency preparedness), surgical care (eg, operating-area environment; surgical-pack preparation; patient preparation; surgeon preparation; surgical procedures for pediatric, juvenile, and adult patients; and identification of neutered animals), and postoperative care (eg, analgesia, recovery, and release). These guidelines are based on current principles of anesthesiology, critical care medicine, microbiology, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs. PMID:18593314

  17. A Model for Community-Based Pediatric Oral Heath: Implementation of an Infant Oral Care Program

    PubMed Central

    Ramos-Gomez, Francisco J.

    2014-01-01

    The Affordable Care Act (ACA) mandates risk assessments, preventive care, and evaluations based on outcomes. ACA compliance will require easily accessible, cost-effective care models that are flexible and simple to establish. UCLA has developed an Infant Oral Care Program (IOCP) in partnership with community-based organizations that is an intervention model providing culturally competent perinatal and infant oral care for underserved, low-income, and/or minority children aged 0–5 and their caregivers. In collaboration with the Venice Family Clinic's Simms/Mann Health and Wellness Center, UCLA Pediatrics, Women, Infants, and Children (WIC), and Early Head Start and Head Start programs, the IOCP increases family-centered care access and promotes early utilization of dental services in nontraditional, primary care settings. Emphasizing disease prevention, management, and care that is sensitive to cultural, language, and oral health literacy challenges, IOCP patients achieve better oral health maintenance “in health” not in “disease modality”. IOCP uses interprofessional education to promote pediatric oral health across multiple disciplines and highlights the necessity for the “age-one visit”. This innovative clinical model facilitates early intervention and disease management. It sets a new standard of minimally invasive dental care that is widely available and prevention focused, with high retention rates due to strong collaborations with the community-based organizations serving these vulnerable, high-risk children. PMID:24587803

  18. SCI Hospital in Home Program: Bringing Hospital Care Home for Veterans With Spinal Cord Injury.

    PubMed

    Madaris, Linda L; Onyebueke, Mirian; Liebman, Janet; Martin, Allyson

    2016-01-01

    The complex nature of spinal cord injury (SCI) and the level of care required for health maintenance frequently result in repeated hospital admissions for recurrent medical complications. Prolonged hospitalizations of persons with SCI have been linked to the increased risk of hospital-acquired infections and development or worsening pressure ulcers. An evidence-based alternative for providing hospital-level care to patients with specific diagnoses who are willing to receive that level of care in the comfort of their home is being implemented in a Department of Veterans Affairs SCI Home Care Program. The SCI Hospital in Home (HiH) model is similar to a patient-centered interdisciplinary care model that was first introduced in Europe and later tested as part of a National Demonstration and Evaluation Study through Johns Hopkins School of Medicine and School of Public Health. This was funded by the John A. Hartford Foundation and the Department of Veterans Affairs. The objectives of the program are to support veterans' choice and access to patient-centered care, reduce the reliance on inpatient medical care, allow for early discharge, and decrease medical costs. Veterans with SCI who are admitted to the HiH program receive daily oversight by a physician, daily visits by a registered nurse, access to laboratory services, oxygen, intravenous medications, and nursing care in the home setting. In this model, patients may typically access HiH services either as an "early discharge" from the hospital or as a direct admit to the program from the emergency department or SCI clinic. Similar programs providing acute hospital-equivalent care in the home have been previously implemented and are successfully demonstrating decreased length of stay, improved patient access, and increased patient satisfaction. PMID:26938182

  19. Personnel for Health Care: Case Studies of Educational Programmes. Public Health Papers No. 70.

    ERIC Educational Resources Information Center

    Katz, F. M., Ed.; Fulop, T., Ed.

    Innovations in the training of community health personnel that emphasize the importance of the development of health personnel able and willing to serve the community by providing health care, promoting health, preventing disease, and caring for those in need are examined. The need for effective and efficient training programs relevant to present…

  20. A new "loyalty rewards" program in health care customer relationships.

    PubMed

    Macstravic, Scott

    2006-01-01

    "Loyalty rewards" in sponsored DM and HRM programs can apply to both providers and consumers. Physicians and hospitals can be paid to "loyally" adhere to payers' guidelines for managing diseases and risks. Many payer and their outsourced vendor programs include significant efforts to create collaborations between payer and provider, rather than relying on unilateral efforts. And growing numbers are rewarding providers for their efforts and results achieved. PMID:17590970

  1. Alternative Learning Programs Evaluation: Part 3 Report. Case Studies of Alternative Schools and Programs.

    ERIC Educational Resources Information Center

    Cobb, Caronly; Brewer, Delores; Bauman, Amy; Groves, Paula; Rayle, Joesph; Noblit, George

    In 1996, North Carolina began a 5-year evaluation of alternative learning programs (ALPs). This report contains in-depth case studies of four ALPs during the 1996-97 school year. The ALPs were selected to represent different types of programs in the state, and include one middle school, two high school, and one elementary school programs. The case…

  2. Paper and Process: How Youth Programs Manage Program Intake, Individual Service Strategy Development, and Case Files.

    ERIC Educational Resources Information Center

    Callahan, Jim; McLaughlin, Brenda

    This guide presents information and materials to help youth programs manage program intake, design an individual service strategy (ISS) as mandated in the Workforce Investment Act, and manage case files. The materials are based on information obtained from staff working in seven successful youth workforce investment programs in Maryland,…

  3. Towards a Culturally Competent System of Care. Volume II: Programs Which Utilize Culturally Competent Principles.

    ERIC Educational Resources Information Center

    Isaacs, Mareasa R.; Benjamin, Marva P.

    This monograph was developed to assist states and communities in planning, designing, and implementing culturally competent systems of care for children with serious emotional disturbances. It highlights the culturally competent aspects of 11 programs serving people of color. Each program targets at least one of the four major ethnic minority…

  4. State Long Term Care Ombudsman Programs: Factors Associated with Perceived Effectiveness

    ERIC Educational Resources Information Center

    Estes, Carroll L.; Zulman, Donna M.; Goldberg, Sheryl C.; Ogawa, Dawn D.

    2004-01-01

    Purpose: This article reports findings from a nationwide study on factors associated with the perceived effectiveness of state Long Term Care Ombudsman Programs (LTCOPs). Design and Methods: Researchers conducted telephone interviews with ombudsmen from the 50 state programs as well as from Washington, DC, and Puerto Rico. Data from the National…

  5. An Assessment of Social Diffusion in the Respecting Choices Advance Care Planning Program

    ERIC Educational Resources Information Center

    Moorman, Sara M.; Carr, Deborah; Kirchhoff, Karin T.; Hammes, Bernard J.

    2012-01-01

    This study examines the potential social diffusion effects of the Respecting Choices advance care planning program administered in La Crosse, Wisconsin, since 1991. The program produces educational materials for patients, trains facilitators to help patients prepare for end of life, and ensures that advance directives are connected to patients'…

  6. Educators' Curriculum Guide. Quality Assurance and Animal Care: Youth Education Program.

    ERIC Educational Resources Information Center

    Busboom, Jan R.; Newman, Jerry A.; Shulaw, William P.; Jeffreys, J. Bradford

    This curriculum guide contains a six-unit, two-level program combining animal science and veterinary care for youth club leaders and members in grades three through twelve. The Facilitator and Educator/Leader Introductions describe the program, the goals, and the students who will participate. The six lesson plans contain what the lesson is about,…

  7. Early Careerist Interest and Participation in Health Care Leadership Development Programs.

    PubMed

    Thompson, Jon M; Temple, April

    2015-01-01

    Health care organizations are increasingly embracing leadership development programs. These programs include a variety of specific activities, such as formally structured leadership development, as well as mentoring, personal development and coaching, 360-degree feedback, and job enlargement, in order to increase the leadership skills of managers and high-potential staff. However, there is a lack of information on how early careerists in health care management view these programs and the degree to which they participate. This article reports on a study undertaken to determine how early careerists working in health care organizations view leadership development programs and their participation in such programs offered by their employers. Study findings are based on a survey of 126 early careerists who are graduates of an undergraduate health services administration program. We found varying levels of interest and participation in specific leadership development activities. In addition, we found that respondents with graduate degrees and those with higher compensation were more likely to participate in selected leadership development program activities. Implications of study findings for health care organizations and early careerists in the offering of, and participation in, leadership development programs are discussed. PMID:26506297

  8. 7 CFR 250.61 - Child and Adult Care Food Program (CACFP).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... donated foods. In accordance with the Richard B. Russell National School Lunch Act, and with 7 CFR part... National School Lunch Program (NSLP) and Other Child Nutrition Programs § 250.61 Child and Adult Care Food... lunches and suppers are those meeting the nutritional standards established in 7 CFR part 226. The...

  9. 7 CFR 250.61 - Child and Adult Care Food Program (CACFP).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... donated foods. In accordance with the Richard B. Russell National School Lunch Act, and with 7 CFR part... National School Lunch Program (NSLP) and Other Child Nutrition Programs § 250.61 Child and Adult Care Food... lunches and suppers are those meeting the nutritional standards established in 7 CFR part 226. The...

  10. 7 CFR 250.61 - Child and Adult Care Food Program (CACFP).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... donated foods. In accordance with the Richard B. Russell National School Lunch Act, and with 7 CFR part... National School Lunch Program (NSLP) and Other Child Nutrition Programs § 250.61 Child and Adult Care Food... lunches and suppers are those meeting the nutritional standards established in 7 CFR part 226. The...

  11. 7 CFR 250.61 - Child and Adult Care Food Program (CACFP).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... donated foods. In accordance with the Richard B. Russell National School Lunch Act, and with 7 CFR part... National School Lunch Program (NSLP) and Other Child Nutrition Programs § 250.61 Child and Adult Care Food... lunches and suppers are those meeting the nutritional standards established in 7 CFR part 226. The...

  12. 7 CFR 250.61 - Child and Adult Care Food Program (CACFP).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... donated foods. In accordance with the Richard B. Russell National School Lunch Act, and with 7 CFR part... National School Lunch Program (NSLP) and Other Child Nutrition Programs § 250.61 Child and Adult Care Food... lunches and suppers are those meeting the nutritional standards established in 7 CFR part 226. The...

  13. 42 CFR 1001.601 - Exclusion or suspension under a Federal or State health care program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Exclusion or suspension under a Federal or State..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.601 Exclusion or suspension under a Federal or State health...

  14. 42 CFR 1001.601 - Exclusion or suspension under a Federal or State health care program.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Exclusion or suspension under a Federal or State..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.601 Exclusion or suspension under a Federal or State health...

  15. 42 CFR 1001.601 - Exclusion or suspension under a Federal or State health care program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Exclusion or suspension under a Federal or State..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.601 Exclusion or suspension under a Federal or State health...

  16. 42 CFR 1001.601 - Exclusion or suspension under a Federal or State health care program.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Exclusion or suspension under a Federal or State..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.601 Exclusion or suspension under a Federal or State health...

  17. 42 CFR 1001.601 - Exclusion or suspension under a Federal or State health care program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Exclusion or suspension under a Federal or State..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.601 Exclusion or suspension under a Federal or State health...

  18. Teaching the Spiritual Dimension of Nursing Care: A Survey of U.S. Baccalaureate Nursing Programs.

    ERIC Educational Resources Information Center

    Lemmer, Corinne

    2002-01-01

    Responses from 132 baccalaureate nursing programs indicated that the majority include spiritual dimensions in program philosophy and curriculum, but few had definitions of spirituality and nursing care. Content typically addressed patients' spiritual needs, dying, and holism. Respondents were uncertain about faculty preparation to teach about…

  19. In-Home Continuing Care Services for Substance-Affected Families: The Bridges Program.

    ERIC Educational Resources Information Center

    Gruber, Kenneth J.; Fleetwood, Thomas W.; Herring, Michael W.

    2001-01-01

    Presents a preliminary view of a continuing care substance abuse recovery services program designed to assist the substance-affected family. The program focuses on helping substance abusers and their families achieve relapse prevention by addressing functioning in four domains: individual actions and cognitions; individual recovery actions; family…

  20. In-Home Respite Care Program Development. Background. Coordinator's Manual. Training Manual.

    ERIC Educational Resources Information Center

    Parham, J. D.; And Others

    This volume consists of a background discussion, coordinator's manual, and training manual dealing with developing programs for the in-home respite care (IHRC) of the developmentally disabled. Addressed in the background information unit are the nature of developmental disabilities; program variables, planning, and funding; and practical…

  1. An Evaluation of the Pilot Child Care Sliding Fee Program in Ramsey County.

    ERIC Educational Resources Information Center

    Ramsey County Child Care Council, Inc., St. Paul, Minn.

    This study was designed to assess the monetary and human costs and benefits of the Pilot Child Care Sliding Fee Program in Ramsey County, Minnesota. A 21-item questionnaire was used to survey 53 of the 161 families who had participated in the program. The vast majority of the sample consisted of single, female, working-parent families with from…

  2. Status of School Age Child Care or Extended Day Programs in Minnesota Schools.

    ERIC Educational Resources Information Center

    Minnesota State Dept. of Education, St. Paul.

    This report is based upon survey responses from 139 school districts and 59 nonpublic schools in Minnesota that offer School Age Child Care (SACC), or extended day programs. The report presents data on public and private SACC programs related to: (1) administration and growth; (2) number of children served; (3) types of services offered; (4)…

  3. A Comparison of Three Levels of Structure of Educational Programs in Family Day Care.

    ERIC Educational Resources Information Center

    Goodman, Norman; And Others

    This research project evaluated and compared three educational programs of high, medium, and low structure in family day care settings for a period of 10 months, to determine their impact on cognitive and social development in 60 children aged 2 1/2 to 4 years. The high-structure program followed the Bereiter-Engelmann approach, the…

  4. Child Care Recipes: Food for Health and Fun. From USDA's Child and Adult Care Food Program.

    ERIC Educational Resources Information Center

    Food and Nutrition Service (USDA), Washington, DC.

    Intended to help child care providers show young children how to make healthy food choices, this collection contains standardized recipes and kitchen tips to help providers put together great tasting, nutritious meals that will appeal to young children. The recipe instructions are geared for groups of 25 and 50, and have been tested for product…

  5. Essential Skills for the Care Team. A Program for New Employees in Residential and Home Care.

    ERIC Educational Resources Information Center

    State Univ. of New York, Albany. Rockefeller Coll.

    This document contains modules for two types of training. It provides 20 hours of training to newly hired Nursing Assistant Trainees (NATs) in residential care settings preparing to become state Certified Nursing Assistants (CNAs), using eight stand-alone modules supported by training process guides. It also includes 7 hours of training for newly…

  6. Developing a performance-based incentive program for hospitals: a case study from Maine.

    PubMed

    Nalli, Gino A; Scanlon, Dennis Patrick; Libby, Douglas

    2007-01-01

    A health care coalition in Maine has piloted a performance-based incentive payment program that creates a single statewide program, based on common standards. Incentive payments were funded by a hospital's financial guarantee that was matched by employers. A two-step incentive allocation methodology differentiates adequate and superior performance. The incentive model is sufficiently flexible to accommodate different settings and evolving performance standards. This case study provides useful insights to payers and hospitals that are considering similar regional initiatives, emphasizing the collaborative context that underscored this venture. PMID:17485761

  7. World Perspective Case Descriptions on Educational Programs for Adults: Italy.

    ERIC Educational Resources Information Center

    Federighi, Paolo; And Others

    Nine adult education programs being conducted in Italy are described in the case studies in this packet. The courses range from adult basic education to continuing education courses in languages and management. Most are described in connection with the area of the country in which they are offered. The following programs are profiled: (1) public…

  8. Sustainability of Social Programs: A Comparative Case Study Analysis

    ERIC Educational Resources Information Center

    Savaya, Riki; Spiro, Shimon; Elran-Barak, Roni

    2008-01-01

    The article reports on the findings of a comparative case study of six projects that operated in Israel between 1980 and 2000. The study findings identify characteristics of the programs, the host organizations, and the social and political environment, which differentiated programs that are sustained from those that are not. The findings reaffirm…

  9. Case Studies of Selected Cooperative Adult Education Programs.

    ERIC Educational Resources Information Center

    Moore, Allen B., Ed.; And Others

    Third in a series of five, the document presents case study reports of site visits to cooperative adult education programs. The five locations visited included programs between: (1) Wharton County Junior College and Johnson Testers, Inc. (Texas); (2) Louisiana State Department of Education and B. F. Trappey and Sons (Louisiana); (3) Grand Rapids…

  10. World Perspective Case Descriptions on Educational Programs for Adults: Finland.

    ERIC Educational Resources Information Center

    Virtala, Mirja; And Others

    This document contains eight case studies of the following adult education programs in Finland: (1) an experiment combining classroom teaching and distance education and one that studied the effects of offering art courses at different levels in 1982-1985 (Virtala); (2) cooperative programs since 1981 between municipal and city levels in Mikkeli…

  11. Evaluation of Publications in Program Development--A Case Study

    ERIC Educational Resources Information Center

    Groves, David L.; And Others

    1978-01-01

    A difficult aspect of continuing education is evaluation, especially of publications used for program development. This case study was undertaken to determine the usability of four publications in a 4-H forestry seedling planting program as rated by professionals and 4-Hers. The intent was to develop instrumentation that can be used in any program…

  12. Inservice Teacher Education: A Case Study of One District's Program.

    ERIC Educational Resources Information Center

    Hatfield, Robert C.

    This case study was initiated to test and refine a procedural model for structuring inservice programs and to produce a comprehensive description of a district inservice teacher education plan. The study involved an analysis of the inservice education program in a single school district. The procedural model used in the study was formulated using…

  13. Collaborative case conferences in rectal cancer: case series in a tertiary care centre

    PubMed Central

    Eskicioglu, C.; Forbes, S.; Tsai, S.; Francescutti, V.; Coates, A.; Grubac, V.; Sonnadara, R.; Simunovic, M.

    2016-01-01

    Background In many hospitals, resource barriers preclude the use of preoperative multidisciplinary cancer conferences (mccs) for consecutive patients with cancer. Collaborative cancer conferences (cccs) are modified mccs that might overcome such barriers. Methods We established a ccc at an academic tertiary care centre to review preoperative plans for patients with rectal cancer. Attendees included only surgeons who perform colorectal cancer procedures and a radiologist with expertise in cross-sectional imaging. Individual reviews began with the primary surgeon presenting the case information and initial treatment recommendations. Cross-sectional images were then reviewed, the case was discussed, and consensus on ccc-treatment recommendations was achieved. Outcomes for the present study were changes in treatment recommendations defined as “major” (that is, redirection of patient to preoperative radiation from straight-to-surgery or uncertain plan, or redirection of the patient to straight-to-surgery from preoperative radiation or plan uncertain) or as “minor” (that is, referral to a multidisciplinary cancer clinic, request additional tests, change type of neoadjuvant therapy, change type of surgery). Chart reviews provided relevant patient, tumour, and treatment information. Results Between September 2011 and September 2012, 101 rectal cancer patients were discussed at a ccc. Of the 35 management plans (34.7%) that were changed as a result, 8 had major changes, and 27 had minor changes. Available patient and tumour factors did not predict for a change in treatment recommendation. Conclusions Preoperative cccs at a tertiary-care centre changed treatment recommendations for one third of patients with rectal cancer. Given that no specific factor predicted for a treatment plan change, it is likely prudent that all rectal cancer patients undergo some form of collaborative review. PMID:27122982

  14. Examining Quality Improvement Programs: The Case of Minnesota Hospitals

    PubMed Central

    Olson, John R; Belohlav, James A; Cook, Lori S; Hays, Julie M

    2008-01-01

    Objective To determine if there is a hierarchy of improvement program adoption by hospitals and outline that hierarchy. Data Sources Primary data were collected in the spring of 2007 via e-survey from 210 individuals representing 109 Minnesota hospitals. Secondary data from 2006 were assembled from the Leapfrog database. Study Design As part of a larger survey, respondents were given a list of improvement programs and asked to identify those programs that are used in their hospital. Data Collection/Data Extraction Rasch Model Analysis was used to assess whether a unidimensional construct exists that defines a hospital's ability to implement performance improvement programs. Linear regression analysis was used to assess the relationship of the Rasch ability scores with Leapfrog Safe Practices Scores to validate the research findings. Principal Findings The results of the study show that hospitals have widely varying abilities in implementing improvement programs. In addition, improvement programs present differing levels of difficulty for hospitals trying to implement them. Our findings also indicate that the ability to adopt improvement programs is important to the overall performance of hospitals. Conclusions There is a hierarchy of improvement programs in the health care context. A hospital's ability to successfully adopt improvement programs is a function of its existing capabilities. As a hospital's capability increases, the ability to successfully implement higher level programs also increases. PMID:18761677

  15. Practicing End-of-Life Conversations: Physician Communication Training Program in Palliative Care.

    PubMed

    Rucker, Bronwyn; Browning, David M

    2015-01-01

    A Physician Communication Training Program (PCTP) utilizing scripts based on actual family conferences with patients, families, and the health care team was developed at one medical center in the Northeast. The program was designed, adapted, and directed by a palliative care social worker. The primary goal of the program is to help residents and attending physicians build better communication skills in establishing goals of care and in end-of-life planning. The scripts focus on improving physicians' basic skills in conducting family meetings, discussing advance directives, prognosis, brain death, and withdrawal of life support. Excerpts from the scripts utilized in the program are included. Feedback from participants has been positive, with all respondents indicating improvement in their capacity to take part in these challenging conversations. PMID:26380923

  16. Perceived value of stroke outcome measures across the post-acute care continuum: a qualitative case study.

    PubMed

    Danzl, Megan M; Hunter, Elizabeth G

    2013-04-01

    Connecting the continuum of post-acute care stroke services may be important for easing patients' transition between settings and facilitating recovery and community reintegration. The use of outcome measures is suggested as one means of connecting the continuum. The purpose of this qualitative case study is to describe administrators' and physiotherapists' perceived value of an outcomes program across the post-acute care stroke continuum at a rehabilitation hospital. Data were collected through individual interviews and focus groups with 18 participants. Three themes emerged on the value of the outcomes program: 1) enhanced communication; 2) supports clinical decision-making; and 3) value of objective data. These findings lend support for the use of standardized outcome measures by physiotherapists in stroke rehabilitation. Findings from this study may be useful for organizations and physiotherapists who wish to integrate outcome measures into practice. PMID:23039017

  17. 45 CFR 302.52 - Distribution of support collected in Title IV-E foster care maintenance cases.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... foster care maintenance cases. 302.52 Section 302.52 Public Welfare Regulations Relating to Public... Distribution of support collected in Title IV-E foster care maintenance cases. Effective October 1, 1984, the... collected in foster care maintenance cases shall be treated in accordance with the provisions of §...

  18. 76 FR 624 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-05

    ... AFFAIRS Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program.... 2900-New (VA Form 10-0476).'' SUPPLEMENTARY INFORMATION: Title: Patient Satisfaction Survey Michael E... their satisfaction with the quality of services/care provided by home care program staff. An agency...

  19. Team Performance and Risk-Adjusted Health Outcomes in the Program of All-Inclusive Care for the Elderly (PACE)

    ERIC Educational Resources Information Center

    Mukamel, Dana B.; Temkin-Greener, Helena; Delavan, Rachel; Peterson, Derick R.; Gross, Diane; Kunitz, Stephen; Williams, T. Franklin

    2006-01-01

    Purpose: The Program of All-Inclusive Care for the Elderly (PACE) is a community-based program providing primary, acute, and long-term care to frail elderly individuals. A central component of the PACE model is the interdisciplinary care team, which includes both professionals and non-professionals. The purpose of this study was to examine the…

  20. Pursuing an Ethic of Care: A Case Study of One Female Superintendent

    ERIC Educational Resources Information Center

    Rico, Rachelle G.

    2009-01-01

    This instrumental case study explores how the Ethic of Care is experienced within one Midwestern school system as an alternative approach to traditional school system hierarchical infrastructures. Through the qualitative tradition of portraiture (Lawrence-Lightfoot & Davis, 1997), this study documents the caring leadership actions, behaviors and…