Sample records for program case management

  1. The role of the case manager in a disease management program.

    PubMed

    Huston, Carol J

    2002-01-01

    Disease management programs provide new opportunities and roles for case managers to provide population-based healthcare to the chronically ill. This article identifies common components of disease management programs and examines roles assumed by case managers in disease management programs such as baseline assessment, performing economic analyses of diseases and their respective associated resource utilization, developing and/or implementing care guidelines or algorithms, educational interventions, disease management program implementation, and outcomes assessment. Areas of expertise needed to be an effective case manager in a disease management program are also identified.

  2. The role of the case manager in a disease management program.

    PubMed

    Huston, C J

    2001-01-01

    Disease management programs provide new opportunities and roles for case managers to provide population-based healthcare to the chronically ill. This article identifies common components of disease management programs and examines roles assumed by case managers in disease management programs such as baseline assessment, performing economic analyses of diseases and their respective associated resource utilization, developing and/or implementing care guidelines or algorithms, educational interventions, disease management program implementation, and outcomes assessment. Areas of expertise needed to be an effective case manager in a disease management program are also identified.

  3. [Characteristics of case management programs and their potential for patient empowerment].

    PubMed

    Grün, Oskar; Maier, Manfred

    2008-01-01

    Different types of case management programs have been increasingly developed for health care systems. This study, therefore, aimed to identify similarities and differences of case management programs, to estimate their shaping with special emphasis on patient empowerment, and to develop an instrument for their differentiation. During an interdisciplinary seminar for students, eight different case management programs were selected and analyzed. Five characteristics of case management programs were identified: type of case, extent of functions, players involved, limits of availability and need for resources. The programs were categorized into information-, provider-, disease- or patient centred. With these characteristics the selected programs could be exactly described and their potential for patient empowerment could be assessed. This newly developed tool for describing case management programs allows for their sufficient differentiation. The potential for patient empowerment apparently is most prominent in patient centred programs.

  4. Case Managers for High-Risk, High-Cost Patients as Agents and Street-Level Bureaucrats.

    PubMed

    Swanson, Jeffrey; Weissert, William G

    2017-08-01

    Case management programs often designate a nurse or social worker to take responsibility for guiding care when patients are expected to be expensive or risk a major decline. We hypothesized that though an intuitively appealing idea, careful program design and faithful implementation are essential if case management programs are to succeed. We employed two theory perspectives, principal-agent framework and street-level bureaucratic theory to describe the relationship between program designers (principals) and case managers (agents/street-level bureaucrats) to review 65 case management studies. Most programs were successful in limited program-specific process and outcome goals. But there was much less success in cost-saving or cost-effectiveness-the original and overarching goal of case management. Cost results might be improved if additional ideas of agency and street-level theory were adopted, specifically, incentives, as well as "green tape," clear rules, guidelines, and algorithms relating to resource allocation among patients.

  5. Disease Management, Case Management, Care Management, and Care Coordination: A Framework and a Brief Manual for Care Programs and Staff.

    PubMed

    Ahmed, Osman I

    2016-01-01

    With the changing landscape of health care delivery in the United States since the passage of the Patient Protection and Affordable Care Act in 2010, health care organizations have struggled to keep pace with the evolving paradigm, particularly as it pertains to population health management. New nomenclature emerged to describe components of the new environment, and familiar words were put to use in an entirely different context. This article proposes a working framework for activities performed in case management, disease management, care management, and care coordination. The author offers standard working definitions for some of the most frequently used words in the health care industry with the goal of increasing consistency for their use, especially in the backdrop of the Centers for Medicaid & Medicare Services offering a "chronic case management fee" to primary care providers for managing the sickest, high-cost Medicare patients. Health care organizations performing case management, care management, disease management, and care coordination. Road map for consistency among users, in reporting, comparison, and for success of care management/coordination programs. This article offers a working framework for disease managers, case and care managers, and care coordinators. It suggests standard definitions to use for disease management, case management, care management, and care coordination. Moreover, the use of clear terminology will facilitate comparing, contrasting, and evaluating all care programs and increase consistency. The article can improve understanding of care program components and success factors, estimate program value and effectiveness, heighten awareness of consumer engagement tools, recognize current state and challenges for care programs, understand the role of health information technology solutions in care programs, and use information and knowledge gained to assess and improve care programs to design the "next generation" of programs.

  6. The U.S. Army Wounded Warrior Program (AW2): a case study in designing a nonmedical case management program for severely wounded, injured, and ill service members and their families.

    PubMed

    Hudak, Ronald P; Morrison, Christine; Carstensen, Mary; Rice, James S; Jurgersen, Brent R

    2009-06-01

    This case study describes the innovative and unique U.S. Army Wounded Warrior Program (AW2), which provides nonmedical case management to the most severely wounded, injured, and ill soldiers and their families. The study describes the program and identifies the features for a successful nonmedical case management program of an identified population who has complex medical needs. Although the article focuses primarily on the role of the AW2 advocate, key components of the program are discussed, including successful initiatives as well as areas that required adjustment. The lessons learned are identified as well as recommendations for future nonmedical case management initiatives.

  7. Enhancing the role of case managers with specialty populations: development and evaluation of a palliative care education program.

    PubMed

    Howell, Doris; Prestwich, Catherine; Laughlin, Emmy; Giga, Nasreen

    2004-01-01

    Palliative home care is an important component of the care system for patients at the end of life and case management is considered an essential element of the Canadian home care system. Case managers play a critical role in allocating resources, thus influencing the costs and the viability of palliative home care. Case management education programs focused on care coordination with specialty palliative care populations are nonexistent. An education program targeted at improving the knowledge and skills of case managers in allocating resources to palliative care populations was developed and pilot-tested in a metropolitan Canadian city home care program. Core curriculum was based on an initial learning needs assessment and used case-based problem solving to enhance case-management skills. An improvement in knowledge was noted on posttests and case managers described increased comfort and confidence in their role as case managers to this patient population. Home care organizations caring for palliative care populations must ensure case managers are prepared for case management roles with specialty populations if the home is to be rendered an appropriate and viable care setting for patients at the end of life.

  8. Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study

    PubMed Central

    Moise, Imelda K.; Mulhall, Peter F.

    2016-01-01

    Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking clients to adequate services rather than reporting performance. Case managers favored measurable deliverables rather than operational work products. A proposed solution to current challenges emphasizes and encourages the iterative learning process and shared decision making between program targets, funders and providers. Case managers are aware of the challenging environment in which they operate for their clients and for themselves. However, future interventions will require clearly identified performance measures and increased systems support. PMID:27149061

  9. Leadership development and succession planning in case management.

    PubMed

    Miodonski, Kathleen; Hines, Patricia

    2013-01-01

    The director of case management is one of health care's leadership positions most frequently in demand. The lack of qualified and effective case management leaders will continue to be an issue for organizations for years to come, influenced by increasing pressures on health care reimbursement and the aging case management workforce. Organizations have an opportunity to create a program to develop future case management leaders from their internal talent. The proposed strategies are designed for the acute care hospital but also have applicability in other health care settings where there are case managers and a need for case management leadership. The business community offers leadership research and leadership development models with relevance to case management. Identifying and developing internal talent for leadership roles has been proven to be effective in preparation for advanced responsibilities, has a positive effect on staff morale, and minimizes the impact of vacant leadership positions during recruitment and onboarding activities. Creating a case management leadership development program for an organization can be an alternative to the process of external recruitment for case management department leaders. Such a program can be undertaken even in today's budget conscious environment by accessing existing resources in an organization in a creative and organized manner. The authors outline an approach for case management leaders to accept responsibility for succession planning and for case managers to accept responsibility for promoting their own career development through creation of a leadership development program.

  10. Case Manager Perspectives on the Role of Treatment in Supportive Housing for People with Severe Mental Illness

    PubMed Central

    Stanhope, Victoria; Choy-Brown, Mimi; Tiderington, Emmy; Henwood, Benjamin F.; Padgett, Deborah K.

    2016-01-01

    Objective Growing recognition exists of housing as a social determinant of health, and thus, health care reform initiatives are expanding the reach of health care beyond traditional settings. One result of this expansion is increased Medicaid funds for supportive-housing programs for people with severe mental illnesses. This qualitative study explores the ways in which case managers working in a supportive housing program approach treatment and how their approach is influenced by both program requirements and their beliefs about mental illness. Method The study is part of a longitudinal qualitative study on recovery for people with severe mental illnesses living in supportive housing. Multiple interviews (n = 55) with 24 case managers from a residential-continuum supportive-housing program were conducted over 18 months. To provide an in-depth view of case manager perspectives, the study uses thematic analysis with multiple coders. Results Overall, case managers understand supportive housing as being a treatment program but predominantly characterize treatment as medication management. The following themes emerged: believing medication to be the key to success in the program, persuading residents to take medication, and questioning the utility of the program for residents who were not medication adherent. Conclusions Case managers understand supportive housing to be a treatment program; however, given the external constraints and their own beliefs about mental illness, case managers often equate treatment with taking medication. Study findings demonstrate the need to train case managers about mental health recovery and integrated health care. The findings also have implications for policies that tie housing to services. PMID:28163830

  11. 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.

  12. Reflections on Case Management in Youth Support Using a Program Example

    ERIC Educational Resources Information Center

    Kennedy, Rosemary; Kennedy, Barry

    2010-01-01

    Using Moxley's (1997) program development framework as an agenda for a dialogue that juxtaposes an academic perspective with that of a seasoned youth program manager, this paper focuses on the relatively unexplored terrain of case management programs. In doing so, it exposes the convergences and divergences between academic and program manager…

  13. 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,…

  14. Overview of Medicaid capitation and case-management initiatives

    PubMed Central

    Freund, Deborah A.; Neuschler, Edward

    1986-01-01

    Case-management programs have grown in number and in acceptance in the Medicaid program since 1981. In this article, we review their structure and incentives as well as what is known about their impact on cost and use. These programs also have been difficult to implement, posing myriad management challenges for prepaid program managers and State administrators. We highlight the problems in the following areas: eligibility, enrollment, rate setting, and management information systems. PMID:10311923

  15. Obesity weight management and bariatric surgery case management programs: a review of literature.

    PubMed

    Echols, Jennie

    2010-01-01

    The proportion of Americans with clinically severe obesity has vast implications for the nation's healthcare system since this population have twice as many chronic medical conditions as people with normal weight. Through the use of review of literature, this article (a) describes the types of weight loss programs; (b) reviews the results from studies on effectiveness of bariatric surgery; and (c) identifies recommendations for obesity and bariatric surgery case management programs. Disease management companies appear to be concentrating on general weight loss strategies associated with wellness and other condition-specific disease management products, whereas larger national healthcare companies with at-risk and insurance products offer specific bariatric surgery management products. Case management programs within healthcare systems, health management organizations, and insurance companies are frequently faced with the management of individuals with morbid obesity and, increasingly, those who are requesting or have undergone bariatric surgery. Research shows that morbid obesity is a disease that remains generally unresponsive to diet and drug therapy but appears to respond well to bariatric surgery. Research findings suggest that surgical treatment is more effective than pharmacological treatment of weight loss and the control of some comorbidities associated with obesity. The number of Americans having weight loss surgery increased by 804% between 1998 and 2004, which appears to be a driver for the recent development of obesity disease management and bariatric surgery case management programs. Although the immaturity and lack of studies citing outcomes of obesity disease and case management programs limit the identification of best practices based on outcomes, emerging practices can be identified and recommendations for case management can be formulated. In addition to primary prevention and treatment programs for obesity, this article describes program activities in detail for the following key areas: (1) identification and engagement; (2) coaching, education, and support; (3) collaboration among treating providers; (4) preparation, management, and follow-up when bariatric surgery is indicated; (5) aggressive follow-up until personal goals are achieved; and (6) outcome measurement.

  16. Effectiveness of Telebehavioral Health Program Nurse Case Managers (NCM): Data Collection Tools and the Process for NCM-Sensitive Outcome Measures.

    PubMed

    Carlson, Judy; Cohen, Roslyn; Bice-Stephens, Wynona

    2014-01-01

    As a part of our nation's pursuit of improvements in patient care outcomes, continuity of care, and cost containment, the case manager has become a vital member on interdisciplinary teams and in health care agencies. Telebehavioral health programs, as a relatively new method of delivering behavioral health care, have recently begun to incorporate case management into their multidisciplinary teams. To determine the efficacy and efficiency of healthcare programs, program managers are charged with the determination of the outcomes of the care rendered to patient populations. However, programs that use telehealth methods to deliver care have unique structures in place that impact ability to collect outcome data. A military medical center that serves the Pacific region developed surveys and processes to distribute, administer, and collect information about a telehealth environment to obtain outcome data for the nurse case manager. This report describes the survey development and the processes created to capture nurse case manager outcomes. Additionally, the surveys and processes developed in this project for measuring outcomes may be useful in other settings and disciplines.

  17. Improving publicly funded substance abuse treatment: the value of case management.

    PubMed Central

    Shwartz, M; Baker, G; Mulvey, K P; Plough, A

    1997-01-01

    OBJECTIVES: This study evaluated the impact of case management on client retention in treatment and short-term relapse for clients in the publicly funded substance abuse treatment system. METHODS: A retrospective cohort design was used to study clients discharged from the following four modalities in 1993 and 1994: short-term residential (3112 clients), long-term residential (2888 clients), outpatient (7431 clients), and residential detox (7776 clients). Logistic regression models were used to analyze the impact of case management after controlling for baseline characteristics. RESULTS: The odds that case-managed clients reached a length of stay previously identified as associated with more successful treatment were 1.6 (outpatient programs) to 3.6 (short-term residential programs) times higher than the odds for non-case-managed clients. With the exception of outpatient clients, the odds of case-managed clients' being admitted to detox within 90 days after discharge (suggesting relapse) were about two thirds those of non-case-managed clients. The odds of case-managed detox clients' transitioning to post-detox treatment (a good outcome) were 1.7 times higher than the odds for non-case-managed clients. CONCLUSIONS: Case management is a low-cost enhancement that improves short-term outcomes of substance abuse treatment programs. PMID:9357349

  18. Case management for the subacute patient in a skilled nursing facility.

    PubMed

    Carr, D D

    2000-01-01

    The goal of case management has always been to manage care, cost, and outcomes. The Balanced Budget Act of 1997 and the subsequent implementation of managed care and the prospective payment system have introduced many challenges to the postacute care delivery system. The implementation of sound clinical, fiscal, and operational strategies is critical to the continued delivery of quality services and the maximization of revenue. The implementation of case management principles provides an opportunity to balance care with cost. This article focuses on the development and implementation of a case management program at a skilled nursing facility that specifically addresses the needs of a subacute population. The program's purpose is to promote efficiency, efficacy, and effectiveness of services for short-term subacute patients who will eventually return to the community. The long-term goal of the program is to classify all patients into case management categories and assign them to RN case managers or social workers, based on acuity and need.

  19. Case management's value is finally recognized. What happens now? .

    PubMed

    2015-10-01

    In recent years, case management has been recognized as a key in improving healthcare quality and reducing costs, but while hospitals are giving case managers more responsibilities, many administrators are not approving an increase in staff to handle the extra work. Case managers can help their hospital succeed with the Centers for Medicare & Medicaid Services' Value-based Purchasing program, the readmission reduction program, and bundled payments. Case management directors should make sure the hospital's senior leadership understands the roles and responsibilities of case managers and how their interventions can affect outcomes and the bottom line. The number of caseloads depends on the case management model, the responsibilities of case managers, and whether they have assistants or case management extenders who can take over some tasks and allow the licensed staff to work at the top of their licenses. Don't let technology replace communication and patient-centered interactions.

  20. 14 CFR 91.1049 - Personnel.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Management § 91.1049 Personnel. (a) Each program manager and each fractional owner must use in program... regulations. The program manager must provide oversight of those crews. (b) Each program manager must employ...) Program manager flight, duty, and rest time considerations, and in all cases within the limits set forth...

  1. Partners in School Asthma Management: Evaluation of a Self-Management Program for Children with Asthma

    ERIC Educational Resources Information Center

    Bartholomew, L. Kay; Sockrider, Marianna M.; Abramson, Stuart L.; Swank, Paul R.; Czyzewski, Danita I.; Tortolero, Susan R.; Markham, Christine M.; Fernandez, Maria E.; Shegog, Ross; Tyrrell, Shellie

    2006-01-01

    The "Partners in School Asthma Management" program for inner-city elementary school children comprises (1) case finding; (2) linkage of school nurses, parents, and clinicians; (3) a computer-based tailored educational program; and (4) school environmental assessment and intervention. Case finding identified 1730 children in 60 elementary schools…

  2. Case mix management education in a Canadian hospital.

    PubMed

    Moffat, M; Prociw, M

    1992-01-01

    The Sunnybrook Health Science Centre's matrix organization model includes a traditional departmental structure, a strategic program-based structure and a case management-based structure--the Clinical Unit structure. The Clinical Unit structure allows the centre to give responsibility for the management of case mix and volume to decentralized Clinical Unit teams, each of which manages its own budget. To train physicians and nurses in their respective roles of Medical Unit directors and Nursing Unit directors, Sunnybrook designed unique short courses on financial management and budgeting, and case-costing and case mix management. This paper discusses how these courses were organized, details their contents and explains how they fit into Sunnybrook's program of decentralized management.

  3. 76 FR 22613 - Privacy Act; Implementation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-22

    ... system of records, DA&M 01, entitled, ``Civil Liberties Program Case Management System'' from subsections...) System identifier and name: DA&M 01, Civil Liberties Program Case Management System. (i) Exemptions...

  4. Effects of Diabetic Case Management on Knowledge, Self-Management Abilities, Health Behaviors, and Health Service Utilization for Diabetes in Korea

    PubMed Central

    Shin, Soon Ae; Lee, Kunsei; Lin, Vivian; Liu, George; Shin, Eunyoung

    2015-01-01

    Purpose This study aimed to evaluate the effects of a case management program for diabetics, using a pre-post comparison design. Materials and Methods The study population comprised 6007 diabetics who received case management intervention in 2006 and were sampled nationwide in Korea. Before and after the intervention, the study population answered questions regarding their knowledge of diabetes, self-management ability, and health behaviors. Body mass index (BMI) was also calculated. Healthcare service utilization for diabetes was extracted from health insurance claim data from 2005 to 2007. Results The case management program significantly improved the study population's knowledge of diabetes and ability to self-manage nutrition, blood glucose monitoring, foot and oral care, and medications. This program also significantly changed the study population's health behaviors regarding smoking, alcohol drinking, and exercise, and BMI was positively affected. In the over-serviced subgroup, there was a significant decrease in the number of consultations (mean=7.0; SD=19.5) after intervention. Conversely, in the under-serviced subgroup, there was a significant increase in the number of consultations (mean=3.2; SD=7.9) and the days of prescribed medication (mean=66.4; SD=120.3) after intervention. Conclusion This study showed that the case management program led the study population to improve their knowledge, self-management ability, health behaviors, and utilization of health care. It is necessary in future studies to evaluate the appropriateness of healthcare usage and clinical outcome by using a control group to determine the direct effectiveness of this case management program. PMID:25510771

  5. Effects of diabetic case management on knowledge, self-management abilities, health behaviors, and health service utilization for diabetes in Korea.

    PubMed

    Shin, Soon Ae; Kim, Hyeongsu; Lee, Kunsei; Lin, Vivian; Liu, George; Shin, Eunyoung

    2015-01-01

    This study aimed to evaluate the effects of a case management program for diabetics, using a pre-post comparison design. The study population comprised 6007 diabetics who received case management intervention in 2006 and were sampled nationwide in Korea. Before and after the intervention, the study population answered questions regarding their knowledge of diabetes, self-management ability, and health behaviors. Body mass index (BMI) was also calculated. Healthcare service utilization for diabetes was extracted from health insurance claim data from 2005 to 2007. The case management program significantly improved the study population's knowledge of diabetes and ability to self-manage nutrition, blood glucose monitoring, foot and oral care, and medications. This program also significantly changed the study population's health behaviors regarding smoking, alcohol drinking, and exercise, and BMI was positively affected. In the over-serviced subgroup, there was a significant decrease in the number of consultations (mean=7.0; SD=19.5) after intervention. Conversely, in the under-serviced subgroup, there was a significant increase in the number of consultations (mean=3.2; SD=7.9) and the days of prescribed medication (mean=66.4; SD=120.3) after intervention. This study showed that the case management program led the study population to improve their knowledge, self-management ability, health behaviors, and utilization of health care. It is necessary in future studies to evaluate the appropriateness of healthcare usage and clinical outcome by using a control group to determine the direct effectiveness of this case management program.

  6. Balanced scorecards for performance management.

    PubMed

    Park, Eun-Jun; Huber, Diane L

    2007-01-01

    Nurse administrators who manage nursing case management programs are challenged to demonstrate the improved quality of patient care and financial outcomes to their organization that result from such programs. This article introduces the balanced scorecard and discusses its benefits and practical concerns for adopting the scorecard. The balanced scorecard is a useful performance management tool used to both evaluate and direct case management performance in meeting organizational missions and strategies.

  7. Implementing case management in New York State's partnerships for publicly funded breast cancer screening.

    PubMed

    Lillquist, Patricia P

    2008-04-01

    This research aimed to explore differences in the implementation of case management among local breast cancer screening partnerships in New York State after changes in federal public policy in 1998 and to achieve a better understanding of case management in a new and distinct practice setting. Capacity and willingness to implement change were theorized to explain local differences in implementation. Local breast cancer screening programs that received federal funding through the New York State Department of Health were invited to participate in the study. A mail survey was administered to the directors of New York's 53 local breast cancer screening partnerships in 2003. The survey included questions about willingness and capacity to implement case management and a scale to assess case management program philosophy. Factor analysis and correlations were used to compare willingness and capacity with differences in implementation. Two common factors--task focus and self-identity focus--were identified as factors that differentiated case management programs. Task-focus partnerships undertook a broader range of tasks but were less likely to report autonomy in making program changes. Self-identity partnerships were less likely to report difficulties with other agencies and scored highly on innovation, involvement in work, and interest in client service. Having a nurse as the case manager, being aware of the standards of case management, and providing health education were associated with both task focus and self-identity focus. The study identified distinct styles of implementation. These styles have implications for the breadth of services provided, such as whether client-level services only are offered. Interagency coordination was facilitated in partnerships with comprehensive case management.

  8. Welfare Reform: Bibliographies of Case Management and Agency/Client Contracting.

    DTIC Science & Technology

    1988-03-11

    Case Management *4 Ss made up about one-fifth of the cases in the program but made inordi- nate demands on the time and emotional resources of their...from their families, or their families face emotional strain in caring for the elderly member. Case management with a coordinator is a way to link the...based chronically mentally ill persons of the Community Support Program (CSP) of the National Institute of Men - % tal Health. Information was obtained on

  9. Disease management: findings from leading state programs.

    PubMed

    Wheatley, Ben

    2002-12-01

    Disease management programs are designed to contain costs by improving health among the chronically ill. More than 20 states are now engaged in developing and implementing Medicaid disease management programs for their primary care case management and fee-for-service populations.

  10. Heads I’m Right, Tails It Was Chance: The Strange Case of Irrationality in Program Risk Management

    DTIC Science & Technology

    2013-04-01

    47 Defense AT&L: March-April 2013 Heads I’m Right, Tails It Was Chance The Strange Case of Irrationality in Program Risk Management Lt. Col...00-00-2013 to 00-00-2013 4. TITLE AND SUBTITLE Heads I’m Right, Tails It Was Chance: The Strange Case of Irrationality in Program Risk Management...ease into reality” instead of “ exploding into it.” In many ways, an acquisition profes- sional should be the pessimist when pushing his team to en- sure

  11. The effect of the Family Case Management Program on 1996 birth outcomes in Illinois.

    PubMed

    Keeton, Kristie; Saunders, Stephen E; Koltun, David

    2004-03-01

    The purpose of this study was to determine if birth outcomes for Medicaid recipients were improved with participation in the Illinois Family Case Management Program. Health program data files were linked with the 1996 Illinois Vital Records linked birth-death certificate file. Logistic regression was used to characterize the variation in birth outcomes as a function of Family Case Management participation while statistically controlling for measurable factors found to be confounders. Results of the logistic regression analysis show that women who participated in the Family Care Management Program were significantly less likely to give birth to very low birth weight infants (odds ratio [OR] = 0.86, 95% confidence interval [CI] = 0.75, 0.99) and low birth weight infants (OR = 0.83, CI = 0.79, 0.89). For infant mortality, however, the adjusted OR (OR = 0.98, CI = 0.82, 1.17), although under 1, was not statistically significant. These results suggest that the Family Case Management Program may be effective in reducing very low birth weight and low birth weight rates among infants born to low-income women.

  12. Using evidence-integrated e-learning to enhance case management continuing education for psychiatric nurses: a randomised controlled trial with follow-up.

    PubMed

    Liu, Wen-I; Rong, Jiin-Ru; Liu, Chieh-Yu

    2014-11-01

    E-learning is a flexible strategy to improve nurses' knowledge of case management, but there are methodological limitations in previous research into the effectiveness of such programs. To describe the development and effectiveness of an evidence-integrated e-learning program in case management continuing education for Taiwanese psychiatric nurses. Multiple methods were adopted to develop the program and a randomised controlled trial with repeated measures was employed to evaluate it. The e-learning program was developed in four stages: (1) systematic review of literature; (2) needs assessment through a national survey and focus group; (3) development of learning materials; and (4) pilot test. Following program development, psychiatric nurses were recruited and randomly allocated into an experimental or comparison group. The experimental group participated in an e-learning continuing education program. The case management knowledge index with sufficient reliability and validity and a satisfaction survey were used to determine the outcomes. A generalised estimating equation was used to assess the difference between the 2 groups before, after, and at 3 months follow-up. The learning material comprised 5 simulated learning modules, self-assessment questions, learning cases, sharing experiences, and learning resources. A total of 200 participants completed the 3 measurements. Knowledge scores in the experimental group significantly exceeded those in the comparison group after the program and at the 3-month follow-up. Participants reported positive learning perceptions. The program provides an evidence-based educational resource for nursing continuing education in case management. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. 28 CFR 541.46 - Programs and services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... may be deprived of the use of that equipment in the future. (f) Case management services. The case manager is responsible for all areas of case management. This ordinarily includes preparation of the... case manager is ordinarily a member of the control unit team. (g) Counselor services. The unit...

  14. 28 CFR 541.46 - Programs and services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... may be deprived of the use of that equipment in the future. (f) Case management services. The case manager is responsible for all areas of case management. This ordinarily includes preparation of the... case manager is ordinarily a member of the control unit team. (g) Counselor services. The unit...

  15. 28 CFR 541.46 - Programs and services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... may be deprived of the use of that equipment in the future. (f) Case management services. The case manager is responsible for all areas of case management. This ordinarily includes preparation of the... case manager is ordinarily a member of the control unit team. (g) Counselor services. The unit...

  16. 28 CFR 541.46 - Programs and services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... may be deprived of the use of that equipment in the future. (f) Case management services. The case manager is responsible for all areas of case management. This ordinarily includes preparation of the... case manager is ordinarily a member of the control unit team. (g) Counselor services. The unit...

  17. Evaluation of New York State's Children and Youth Intensive Case Management Program.

    ERIC Educational Resources Information Center

    Dollard, Norin; And Others

    The evaluation plan for New York State's Children and Youth Intensive Case Management (CYICM) Program is described, which was introduced in July 1988. The CYICM Program is a statewide intervention focusing on keeping children with serious emotional disturbances in the least restrictive environment appropriate to their needs. It is a…

  18. Developing case managers for chronically ill children: Florida's registered nurse specialist program.

    PubMed

    Urbano, M T; vonWindeguth, B; Siderits, P; Parker, J; Studenic-Lewis, C

    1991-01-01

    This article describes the Florida Health and Rehabilitative Services/Children's Medical Services Nurse Specialist Program. This program is a statewide training and service delivery system designed to prepare selected nurses to provide comprehensive, family-centered case management services to children with special health care needs, within the home and community settings.

  19. Investigating Positive Psychology Approaches in Case Management and Residential Programming with Incarcerated Youth

    ERIC Educational Resources Information Center

    Cross, Lara E.; Morrison, William; Peterson, Patricia; Domene, Jose F.

    2012-01-01

    This article examines how a rural Canadian secure custody facility for youth implemented positive psychology principles in its case management protocols and residential programming. A directed content analysis design was utilized to identify specific factors of positive psychology in the facility's policy and programming manual, as well as in…

  20. Case Management for Patients with Complex Multimorbidity: Development and Validation of a Coordinated Intervention between Primary and Hospital Care

    PubMed Central

    Giménez-Campos, María Soledad; Villar-López, Julia; Faubel-Cava, Raquel; Donat-Castelló, Lucas; Valdivieso-Martínez, Bernardo; Soriano-Melchor, Elisa; Bahamontes-Mulió, Amparo; García-Gómez, Juan M.

    2017-01-01

    In the past few years, healthcare systems have been facing a growing demand related to the high prevalence of chronic diseases. Case management programs have emerged as an integrated care approach for the management of chronic disease. Nevertheless, there is little scientific evidence on the impact of using a case management program for patients with complex multimorbidity regarding hospital resource utilisation. We evaluated an integrated case management intervention set up by community-based care at outpatient clinics with nurse case managers from a telemedicine unit. The hypothesis to be tested was whether improved continuity of care resulting from the integration of community-based and hospital services reduced the use of hospital resources amongst patients with complex multimorbidity. A retrospective cohort study was performed using a sample of 714 adult patients admitted to the program between January 2012 and January 2015. We found a significant decrease in the number of emergency room visits, unplanned hospitalizations, and length of stay, and an expected increase in the home care hospital-based episodes. These results support the hypothesis that case management interventions can reduce the use of unplanned hospital admissions when applied to patients with complex multimorbidity. PMID:28970745

  1. Pathways Triple P and the Child Welfare System: A Promising Fit.

    PubMed

    Petra, Megan; Kohl, Patricia

    2010-04-01

    Parents referred to the child welfare system following maltreatment allegations are often ill-prepared to constructively address child disruptive behaviors, despite the high prevalence of these behaviors among this population. Evidence-based parent-mediated interventions are effective in improving parenting skills; however, they are rarely offered within the child welfare system. The purpose of this pilot project was to evaluate the fit and acceptability of one parent-mediated training program (Pathways Triple P) to case managers and parents within this system of care. We implemented Pathways Triple P and subsequently interviewed referring case managers and parents who had participated in the program. Case managers felt the program would work well within the existing child welfare system and would help them to better serve parents. They felt the program had potential to improve parenting skills and prevent future maltreatment. Parents appreciated the program's use of diverse methods, and the variety of parenting techniques taught. In keeping with case manager expectations, participants reported that their enhanced parenting skills and new ability to use non-physical discipline resulted in a better home life. We conclude that Pathways Triple P fits well within the child welfare system and is acceptable to both case managers and parents within this system.

  2. Case Management: Let Us Count the Ways.

    ERIC Educational Resources Information Center

    Austin, Carol D.

    Case management as implemented in programs for the elderly, has focused on interactions between the client and case manager in the areas of assessment, care planning, service plan implementation, and follow-up. Variation in these case management tasks suggests that no single model can be implemented in all local delivery systems. This emphasis on…

  3. Process and Outcomes of School Nurse Case Management for Students with Asthma

    ERIC Educational Resources Information Center

    Engelke, Martha Keehner; Swanson, Melvin; Guttu, Martha

    2014-01-01

    There have been many studies that have examined the impact of school-based asthma programs on students with asthma. However, most studies do not provide adequate elaboration on the components of the program. Therefore, replication of these programs is difficult. This study examines the process of school nurse case management, which includes the…

  4. Pitfalls in Evaluating the Effectiveness of Case Management Programs for Homeless Persons: Lessons from the NIAAA Community Demonstration Program.

    ERIC Educational Resources Information Center

    Orwin, Robert G.; And Others

    1994-01-01

    Evaluation findings of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Community Demonstration Program show few clear indications of the effectiveness of case management approaches. This article identifies phenomena that explain the lack of positive effects and suggests that evaluation problems may explain apparent negative…

  5. Case management: a case study.

    PubMed

    Stanton, M P; Walizer, E M; Graham, J I; Keppel, L

    2000-01-01

    This article describes the implementation of a pilot case management program at Walter Reed Army Medical Center. I, it we discuss obvious pitfalls and problems implementing case management in a large multiservice center and the steps and processes implemented to expedite and move case management forward in its early stages. The insights shared may be useful for those implementing case management in a complex medical center situation. Other models used in similar situations are also reviewed.

  6. Factors that influence case managers' resource allocation decisions in pediatric home care: an ethnographic study.

    PubMed

    Fraser, Kimberly D; Estabrooks, Carole; Allen, Marion; Strang, Vicki

    2009-03-01

    Case managers make decisions that directly affect the amount and type of services home care clients receive and subsequently affect the overall available health care resources of home care programs. A recent systematic review of the literature identified significant knowledge gaps with respect to resource allocation decision-making in home care. Using Spradley's methodology, we designed an ethnographic study of a children's home care program in Western Canada. The sample included 11 case managers and program leaders. Data sources included interviews, card sorts, and participant observation over a 5-month period. Data analyses included open coding, domain, taxonomic, and componential analysis. One of the key findings was a taxonomy of factors that influence case manager resource allocation decisions. The factors were grouped into one of four main categories: system-related, home care program-related, family related, or client-related. Family related factors have not been previously reported as influencing case manager resource allocation decision-making and nor has the team's role been reported as an influencing factor. The findings of this study are examined in light of Daniels and Sabin's Accountability for Reasonableness framework, which may be useful for future knowledge development about micro-level resource allocation theory.

  7. Population-based worksite obesity management interventions: a qualitative case study.

    PubMed

    Romney, Martha C; Thomson, Erin; Kash, Kathryn

    2011-06-01

    Due to the increased prevalence of obesity and associated direct and indirect costs to employers, weight management programs have become an integral component of employer and insurer benefits plans. The programs vary in foci, scope, breadth, and implementation. The aim of this study was to explore promising employer-sponsored population-based obesity management programs. A case study that utilized a telephonic semi-structured questionnaire was conducted with small and large organizations located in different regions of the United States that had been recruited to participate. Eight employers and 1 health care advocacy coalition who met the inclusion criteria were interviewed about features of their weight management programs. The case study revealed a number of themes consistent with reports in the literature and reflecting cited best practices. Key findings include confirmation that weight management is a significant component of the wellness strategy in all participating organizations because employers are invested in population health programs and cost savings. Based upon their experience and knowledge, occupational health specialists are responsible for designing, implementing, managing, and evaluating employee health programs. Almost all employers utilize electronic media as a prominent component of wellness and disease management initiatives. Experience has shown that incentives-both financial and nonmonetary-are effective motivators for employee engagement and outcomes. However, while employers report success, favorable outcomes have been difficult to quantify.

  8. Impact of a disability management program on employee productivity in a petrochemical company.

    PubMed

    Skisak, Christopher M; Bhojani, Faiyaz; Tsai, Shan P

    2006-05-01

    An inhouse disability management program was implemented to reduce nonoccupational absences in a petrochemical corporation. The program was administered by full-time certified, corporate-based case managers and nine manufacturing location nurses. Employees were required to report all absences on the first day and again on the fourth workday of absence. A medical certification form was required for absences of 4 or more working days. Extended absences were actively managed. An Internet-based case management tool, Medgate, was used as a primary management tool. Results were compared with the previous year among the target population and with company business units not participating in the program. The program resulted in a 10% reduction in total absence days per employee (6.9 to 6.2) compared with the previous year, whereas business units not using the program had an 8% increase (5.5 to 5.9). This disability management program resulted in a more than four to one return on investment based on direct expenditures and cost savings in terms of reduced absence days. The inhouse disability management program was successful by absence duration, employee satisfaction, and return on investment criteria.

  9. Evaluation of the Pilot Program of the Truancy Case Management Partnership Initiative in the District of Columbia, 2011-12

    ERIC Educational Resources Information Center

    Liberman, Akiva; Cahill, Meagan

    2012-01-01

    This evaluation of the Case Management Partnership Initiative (CPMI) found that the program successfully linked high-need families with services designed to prevent truancy. The truancy prevention program, implemented at Anacostia and Ballou High Schools in 2011-2012, links chronically truant ninth graders and their families to social services and…

  10. Disease management: a leap of faith to lower-cost, higher-quality health care.

    PubMed

    Short, Ashley; Mays, Glen; Mittler, Jessica

    2003-10-01

    With managed care's promise to reduce costs and improve quality waning, employers and health plans are exploring more targeted ways to control rapidly rising health costs. Disease management programs, which focus on patients with chronic conditions such as asthma and diabetes, are growing in popularity, according to findings from the Center for Studying Health System Change's (HSC) 2002-03 site visits to 12 nationally representative communities. In addition to condition-based disease management programs, some health plans and employers are using intensive case management services to coordinate care for high-risk patients with potentially costly and complex medical conditions. Despite high expectations, evidence of both disease management and case management programs' success in controlling costs and improving quality remains limited.

  11. Effects of a case management program on patients with oral precancerous lesions: a randomized controlled trial.

    PubMed

    Lin, Hsiu-Ying; Chen, Shu-Ching; Peng, Hsi-Ling; Chen, Mu-Kuan

    2016-01-01

    The aim of this study is to identify the effects of a case management program on knowledge about oral cancer, preventive behavior for oral cancer, and level of uncertainty for patients with oral precancerous lesions. A randomized controlled trial was conducted with two groups, using a pre- and posttest design. The experimental group received a case management program and telephone follow-up sessions; the control group received routine care. Patients were assessed at three time points: first visit to the otolaryngology clinic for biopsy examination (T0), and then at 2 weeks (T1) and 4 weeks (T2) after the biopsy examination. Patients in both groups had significantly higher levels of knowledge about oral cancer, preventive behavior for oral cancer, and lower level of uncertainty at T2 compared to T0. At T2, participants in the experimental group had significantly greater knowledge about oral cancer, more preventive behavior for oral cancer, and less uncertainty compared to those in the control group. The case management program with telephone counseling effectively improved knowledge about oral cancer, preventive behavior for oral cancer, and uncertainty levels in patients with oral precancerous lesions in the four weeks after receiving a biopsy examination. The case management program can be applied with positive results to patients receiving different types of cancer screening, including colorectal, breast, and cervical screening.

  12. The cost-effectiveness of syndromic management in pharmacies in Lima, Peru.

    PubMed

    Adams, Elisabeth J; Garcia, Patricia J; Garnett, Geoffrey P; Edmunds, W John; Holmes, King K

    2003-05-01

    Many people with sexually transmitted diseases (STDs) in Lima, Peru, seek treatment in pharmacies. The goal was to assess the cost-effectiveness of training pharmacy workers in syndromic management of STDs. Cost-effectiveness from both the program and societal perspectives was determined on the basis of study costs, societal costs (cost of medicine), and the number of cases adequately managed. The latter was calculated from estimated incidence, proportion of symptomatic patients, proportion seeking treatment in pharmacies, and proportion of cases adequately managed in both comparison and intervention districts. Univariate and multivariate sensitivity analyses were performed. Under base-case assumptions, from the societal perspective the intervention saved an estimated US$1.51 per case adequately managed; from the program perspective, it cost an estimated US$3.67 per case adequately managed. In the sensitivity analyses, the proportion of females with vaginal discharge or pelvic inflammatory disease who seek treatment in pharmacies had the greatest impact on the estimated cost-effectiveness, along with the medication costs under the societal perspective. Training pharmacists in syndromic management of STDs appears to be cost-effective when only program costs are used and cost-saving from the societal perspective. Our methods provide a template for assessing the cost-effectiveness of managing STD syndromes, on the basis of indirect estimates of effectiveness.

  13. Interim Evaluation of the Pilot Program of the Truancy Case Management Partnership Intervention in the District of Columbia

    ERIC Educational Resources Information Center

    Liberman, Akiva; Cahill, Meagan; Cramer, Lindsey

    2012-01-01

    The Case Management Partnership Initiative (CMPI) addresses chronic truancy by linking truant ninth graders and their families to social services and case management, along with regular interagency case management meetings. A pilot was conducted at Anacostia and Ballou High Schools in 2011-2012. The implementation evaluation found that the pilot…

  14. Facilitating adaptive management in a government program: A household energy efficiency case study.

    PubMed

    Curtis, Jim; Graham, Alex; Ghafoori, Eraj; Pyke, Susan; Kaufman, Stefan; Boulet, Mark

    2017-02-01

    Interim evaluations of government programs can sometimes reveal lower than expected outcomes, leading to the question of how adjustments can be made while the program is still underway. Although adaptive management frameworks can provide a practical roadmap to address this question, a lack of successful learnings and poor implementation have hampered the progress and wider application of adaptive management. Using a case study involving an energy efficiency government program targeting low-income households, this article provides supporting evidence on how adaptive management can be facilitated and applied. Factors such as proactive and responsive leadership, establishing a research-practice interface, and recognizing the skills, expertise, and contributions of multiple stakeholders guided adjustments to the program, and later paved the way for longer-term organizational learning that impacted how other programs are delivered. Implications for knowledge and practice, and a discussion of the challenges faced in the program, advance current thinking in adaptive management. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Vocational rehabilitation case manager factors associated with vocational rehabilitation service program outcomes for people with disabilities in Taiwan - an exploratory study.

    PubMed

    Wang, Yun-Tung; Lin, Yi-Jiun

    2017-02-01

    Purpose The aim of this study is to explore whether/which vocational rehabilitation case manager (VRCMer) factors were significantly associated with the vocational rehabilitation service (VRS) program outcomes in Taiwan. Method This study used the 2011 VRS Program for People with Disabilities Database in a metropolitan city in Taiwan (N = 466) to do a secondary data analysis using hierarchical logistic regression. Results This study found that the employment rate and stable employment rate created by the 2011 VRS program in a metropolitan city in Taiwan were 48.7% and 42.1%, respectively. For the predictors of employment/stable employment, "occurrences of the services provided by the VRCMer" variable was definitely dominant. In addition, "level of the disability" was the second-ranking predictor, and was significantly negatively correlated with both employment and stable employment outcomes. Conclusions Vocational rehabilitation case manager factors in this study were significantly correlated with VRS program outcomes for people with disabilities in Taiwan after controlling for the clients' socio-demographic variables. The results indicate that greater input by VRCMers for people with disabilities equates to better employment outcomes in metropolitan Taiwan. Implications for Rehabilitation This is the first study to build an inferential statistical model in attempt to explain and predict the association between vocational rehabilitation case manager factors and vocational rehabilitation service program outcomes for people with disabilities in Taiwan. In cases of severe disability, a vocational rehabilitation case manager should seek out more in-kind and in-cash resources, and choose a suitable job coach to cooperate in assisting the client to become employed. Based on the findings, government has to continue implementing opportunities for people with disabilities to attain higher and better quality educational levels, for increasing their employment rate. Vocational rehabilitation case managers should raise the referral rate and cooperation with job coaches as this directly affects the quality of services and clients' employment rate.

  16. 75 FR 9638 - Surface Transportation Project Delivery Pilot Program; Caltrans Audit Report

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-03

    ... practice on a case- by-case basis. The FHWA recommends that Caltrans develop a departmentwide, holistic corrective action management approach and system that will develop and implement an internal process review... the Pilot Program. During the on-site audit, Caltrans staff and management continued to express...

  17. The Woodworker's Website: A Project Management Case Study

    ERIC Educational Resources Information Center

    Jance, Marsha

    2014-01-01

    A case study that focuses on building a website for a woodworking business is discussed. Project management and linear programming techniques can be used to determine the time required to complete the website project discussed in the case. This case can be assigned to students in an undergraduate or graduate decision modeling or management science…

  18. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Case management services. 440.169 Section 440.169 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.169 Case management...

  19. Meeting the challenges of case management with remote patient monitoring technology.

    PubMed

    Cherry, J C; Colliflower, S J; Tsiperfal, A

    2000-01-01

    The article presents an overview of some of the current trends in health care and the challenges faced by nurse case managers who are providing disease management services. It discusses some of the emerging technologies available today for innovative case management. In particular, this article describes a program run by a healthcare system in Sacramento, California that uses an Internet-based technology to enhance their nurse case management model. The article demonstrates how the Health Hero platform enables interactive communication between nurse case managers and their patients, thereby meeting some of the challenges the nurse case managers are faced with in the modern disease-management world.

  20. An evidence-based approach to case management model selection for an acute care facility: is there really a preferred model?

    PubMed

    Terra, Sandra M

    2007-01-01

    This research seeks to determine whether there is adequate evidence-based justification for selection of one acute care case management model over another. Acute Inpatient Hospital. This article presents a systematic review of published case management literature, resulting in classification specific to terms of level of evidence. This review examines the best available evidence in an effort to select an acute care case management model. Although no single case management model can be identified as preferred, it is clear that adequate evidence-based literature exists to acknowledge key factors driving the acute care model and to form a foundation for the efficacy of hospital case management practice. Although no single case management model can be identified as preferred, this systematic review demonstrates that adequate evidence-based literature exists to acknowledge key factors driving the acute care model and forming a foundation for the efficacy of hospital case management practice. Distinctive aspects of case management frameworks can be used to guide the development of an acute care case management model. The study illustrates: * The effectiveness of case management when there is direct patient contact by the case manager regardless of disease condition: not only does the quality of care increase but also length of stay (LOS) decreases, care is defragmented, and both patient and physician satisfaction can increase. * The preferred case management models result in measurable outcomes that can directly relate to, and demonstrate alignment with, organizational strategy. * Acute care management programs reduce cost and LOS, and improve outcomes. * An integrated case management program that includes social workers, as well as nursing, is the most effective acute care management model. * The successful case management model will recognize physicians, as well as patients, as valued customers with whom partnership can positively affect financial outcomes in terms of reduction in LOS, improvement in quality, and delivery of care.

  1. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In working...

  2. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In working...

  3. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In working...

  4. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In working...

  5. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In working...

  6. Data Overload Impact on Project Management: How Knowledge Management Systems Can Improve Federal Agencies Effectiveness

    ERIC Educational Resources Information Center

    Rodriguez, Jacinto

    2013-01-01

    This mixed method exploratory case study was used to explore the effect data overload has on project management, how data overload affects project management effectiveness, how prepared program office staff is to manage multiple projects effectively, and how the program office's organizational structure and data management systems affect project…

  7. A combined disease management and process modeling approach for assessing and improving care processes: a fall management case-study.

    PubMed

    Askari, Marjan; Westerhof, Richard; Eslami, Saied; Medlock, Stephanie; de Rooij, Sophia E; Abu-Hanna, Ameen

    2013-10-01

    To propose a combined disease management and process modeling approach for evaluating and improving care processes, and demonstrate its usability and usefulness in a real-world fall management case study. We identified essential disease management related concepts and mapped them into explicit questions meant to expose areas for improvement in the respective care processes. We applied the disease management oriented questions to a process model of a comprehensive real world fall prevention and treatment program covering primary and secondary care. We relied on interviews and observations to complete the process models, which were captured in UML activity diagrams. A preliminary evaluation of the usability of our approach by gauging the experience of the modeler and an external validator was conducted, and the usefulness of the method was evaluated by gathering feedback from stakeholders at an invitational conference of 75 attendees. The process model of the fall management program was organized around the clinical tasks of case finding, risk profiling, decision making, coordination and interventions. Applying the disease management questions to the process models exposed weaknesses in the process including: absence of program ownership, under-detection of falls in primary care, and lack of efficient communication among stakeholders due to missing awareness about other stakeholders' workflow. The modelers experienced the approach as usable and the attendees of the invitational conference found the analysis results to be valid. The proposed disease management view of process modeling was usable and useful for systematically identifying areas of improvement in a fall management program. Although specifically applied to fall management, we believe our case study is characteristic of various disease management settings, suggesting the wider applicability of the approach. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. ["Back pain coach". A project for patients with back pain].

    PubMed

    Lindena, G; Marnitz, U; Hartmann, P; Müller, G

    2012-12-01

    Back pain is a challenge for case management but is a health insurance fund (HIF) that identifies high risk patients and includes them in a back pain assessment and a multimodal program cost-effective? Case managers of a HIF contacted selected patients and requested information on pain and current perspectives. Patients in the intervention group were offered a multimodal assessment and, if applicable, a multimodal treatment program. Control group patients received verbal or written (back book) information. Cost data were evaluated with respect to the interview data 1 year prior and 1 year afterwards. Of the 800 insured persons contacted 621 were nationwide, 88 were regional controls and 91 were intervention patients. Inability to work was still rising in all groups but less in the intervention group versus both control groups. Drugs, hospital as well as cure/adjuvant costs were less for intervention patients than in both control groups. The investment for the program was thus more than refinanced. Case management was well accepted but the intervention was in need of training for case managers and the specific diagnostic and treatment option regionally. The HIF was responsible for the study investment and project partners shared the training of the HIF regional case managers.

  9. Management philosophies as applied to major NASA programs

    NASA Technical Reports Server (NTRS)

    Dannenberg, K. K.

    1974-01-01

    A definition of 'management philosophies' is discussed explaining the position of NASA in the planning and control of space programs and technology. The impact of these philosophies on the Apollo and Saturn 1 programs are described along with the need for the Saturn 5 spacecraft and launch site development. Case studies are included and describe unscheduled events where management decisions were necessary to keep programs on track.

  10. The Asthma Management Program as a Predictor of Emergency Room Visits and Hospitalizations at David Grant USAF Medical Center

    DTIC Science & Technology

    1998-08-01

    tracked continuously, Asthma Management 2 thereby adding new opportunities for patient education other than at the hospital or physician’s office...avoided with more consistent patient education and follow-up (Collins, Goodman & McQueston, 1995). Asthma Management Program at DGMC The Asthma...management, 2) objective measures of lung function, 3) environmental control, and 4) patient education . Proactive case management programs that

  11. COMMUNITY-BASED WATERSHED MANAGEMENT: CREATING A TOOL FOR PROGRAM EVALUATION AND DESIGN

    EPA Science Inventory

    The criteria will be assembled into a manual to be used by community organizers, academics, managers, or policy makers in evaluating community-based watershed management initiatives and in designing new watershed management programs. The case study will also be added to the b...

  12. Assessment and Management of Professionalism Issues in Pathology Residency Training: Results From Surveys and a Workshop by the Graduate Medical Education Committee of the College of American Pathologists.

    PubMed

    Domen, Ronald E; Talbert, Michael L; Johnson, Kristen; Post, Miriam D; Brissette, Mark D; Conran, Richard Michael; Hoffman, Robert D; McCloskey, Cindy B; Raciti, Patricia M; Roberts, Cory Anthony; Rojiani, Amyn M; Tucker, J Allan; Powell, Suzanne Zein-Eldin

    2015-01-01

    Professionalism issues are common in residency training and can be very difficult to recognize and manage. Almost one-third of the milestones for pathology recently instituted by the Accreditation Council for Graduate Medical Education encompass aspects of professionalism. Program directors are often unsure of how and when to remediate residents for unprofessional behavior. We used a case-based educational approach in a workshop setting to assist program directors in the management of unprofessional behavior in residents. Eight case scenarios highlighting various aspects of unprofessional behavior by pathology residents were developed and presented in an open workshop forum at the annual pathology program director's meeting. Prior to the workshop, 2 surveys were conducted: (1) to collect data on program directors' experience with identifying, assessing, and managing unprofessional behavior in their residents and (2) to get feedback from workshop registrants on how they would manage each of the 8 case scenarios. A wide range of unprofessional behaviors have been observed by pathology program directors. Although there is occasionally general agreement on how to manage specific behaviors, there remains wide variation in how to manage many of the presented unprofessional behaviors. Remediation for unprofessional behavior in pathology residents remains a difficult and challenging process. Additional education and research in this area are warranted.

  13. Parents' Perspectives: An Evaluation of Case Management Interventions in Home Visiting Programs for Young Children

    ERIC Educational Resources Information Center

    Allen, Susan F.

    2007-01-01

    In home visiting programs for children younger than age three, home visitors work with parents to enhance the child's environment. This study examined how the home visitor-parent relationship, amount of contact, and level of need affected the intensity of case management interventions received. Researchers interviewed 90 mothers to measure the…

  14. Arbitration Intervention Worker (AIW) Services: Case Management Overlay in a Juvenile Diversion Program

    ERIC Educational Resources Information Center

    Poythress, Norman G.; Dembo, Richard; DuDell, Gary; Wareham, Jennifer

    2006-01-01

    In this issue we describe a clinical trials study of the impact of adding specific case manager overlay services to "treatment as usual" services for youths in a Juvenile Arbitration Program. In this first article we describe the experimental intervention, the Arbitration Intervention Worker (AIW) service, which was provided to a randomly selected…

  15. Leadership Strategies for Department Chairs and Program Directors: A Case Study Approach.

    ERIC Educational Resources Information Center

    Comer, Robert W.; Haden, N. Karl; Taylor, Robert L.; Thomas, D. Denee

    2002-01-01

    Reviews leadership challenges and management concepts in academic dentistry as they were applied in a case-based faculty development workshop, in order to provide a foundation for three cases that follow in subsequent articles. The workshop was structured to address leadership challenges relating to managing people, mission management, conflict…

  16. Defining, Delivering, and Documenting the Outcomes of Case Management by School Nurses

    ERIC Educational Resources Information Center

    Engelke, Martha Keehner; Guttu, Martha; Warren, Michelle B.

    2009-01-01

    Case management is a component of school nurse practice that provides an opportunity to demonstrate the contribution that school nurses make to the health and academic success of children, particularly children with chronic health conditions. However, case management programs vary in their mission and scope, leading to confusion about what it…

  17. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...; (ii) The qualifications of case management providers; or (iii) The methodology under which case... legal papers. (5) Home investigations. (6) Providing transportation. (7) Administering foster care... by another federally-funded program, the State must use cost allocation methodologies, consistent...

  18. Evaluating the Facilities Planning, Design, and Construction Department: The Capital Programs Management Audit.

    ERIC Educational Resources Information Center

    Kaiser, Harvey H.; Kirkwood, Dennis M.

    2000-01-01

    Presents a diagnostic model for assessing the state of an institution's capital programs management (CPM) by delineating "work processes" which comprise that function. What capital programs management is, its resources, and its phases and work processes are described, followed by case studies of the CPM Process Model as an assessment tool. (GR)

  19. 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,…

  20. Strategic Human Resources Management of Employer Cooperative Education Programs.

    ERIC Educational Resources Information Center

    Nielsen, Richard P.; Porter, Ralph C.

    1982-01-01

    This article discusses effective strategic planning and management of employer cooperative education programs. It examines types of planning, the need for such programs, and implementation strategies. Several case studies are considered: Dayton-Hudson, IBM, AT&T, Delta Airlines, and Rockwell International. (CT)

  1. The Partners in Prevention Program: The Evaluation and Evolution of the Task-Centered Case Management Model

    ERIC Educational Resources Information Center

    Colvin, Julanne; Lee, Mingun; Magnano, Julienne; Smith, Valerie

    2008-01-01

    This article reports on the further development of the task-centered model for difficulties in school performance. We used Bailey-Dempsey and Reid's (1996) application of Rothman and Thomas's (1994) design and development framework and annual evaluations of the Partners in Prevention (PIP) Program to refine the task-centered case management model.…

  2. Executive Programs for Brazilian Mid-Career Public Managers: Pitfalls and Challenges

    ERIC Educational Resources Information Center

    Pacheco, Regina Silvia; Franzese, Cibele

    2017-01-01

    This paper discusses the challenges of professional education for mid-career public managers at graduate level, pointing out pitfalls to avoid and obstacles to face. Analyzing the Brazilian case, the goal is to raise issues that may also be present in other cases. The main argument developed here is that the puzzle faced by graduate programs on…

  3. A Standardized Certification Program for Case Managers Serving Frail Elderly Texans. Module II: Assessment and Care Plan Development.

    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 II deals with the following topics: assessment (role of…

  4. Internet Telehealth for Pediatric Asthma Case Management: Integrating Computerized and Case Manager Features for Tailoring a Web-Based Asthma Education Program

    PubMed Central

    Wise, Meg; Gustafson, David H.; Sorkness, Christine A.; Molfenter, Todd; Staresinic, Anthony; Meis, Tracy; Hawkins, Robert P.; Shanovich, Kathleen Kelly; Walker, Nola P.

    2008-01-01

    This article reports on the development of a personalized, Web-based asthma-education program for parents whose 4- to 12-year-old children have moderate to severe asthma. Personalization includes computer-based tailored messages and a human coach to build asthma self-management skills. Computerized features include the Asthma Manager, My Calendar/Reminder, My Goals, and a tailored home page. These are integrated with monthly asthma-education phone calls from an asthmanurse case manager. The authors discuss the development process and issues and describe the current randomized evaluation study to test whether the yearlong integrated intervention can improve adherence to a daily asthma controller medication, asthma control, and parent quality of life to reduce asthma-related healthcare utilization. Implications for health education for chronic disease management are raised. PMID:16928987

  5. 40 CFR 123.63 - Criteria for withdrawal of State programs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... withdrawal of State programs. (a) In the case of a sewage sludge management program, references in this... under this part, including failure to issue permits; (ii) Repeated issuance of permits which do not... sludge management program, § 501.14 of this chapter). (5) Where the State fails to develop an adequate...

  6. Interactive training for the management of breast cancer in general practice in Europe.

    PubMed

    Möller, Torgil; Amadori, Dino; Bellos, George; Cancian, Maurizio; Gravgaard, Anne-Marie; Ioannidou-Mouzaka, Lydia; Marotta-Kelly, Mercedes; Van Dongen, Johannes; Wanrooij, Bernadina; Lindholm, Lars H

    2002-01-01

    General practitioners need to play a more active role in the management of patients with breast cancer, specifically in screening programs, counseling, follow-up, palliative care, and psychosocial support. Special training is needed to meet these demands. An interactive training program resident on CD-ROM was developed. It includes nine cases designed according to the case method and three cases created for group discussions. The program also contains a self-test and an encyclopedia with facts and figures about breast cancer. The program was tested by 20 trainers/trainees in each of four participating countries. The formata, content, and usefulness of the program were ranked highly: generally between 4 and 5 on a scale from 1 (low) to 5 (high), based on 78 evaluation forms. The program seems to be an adequate tool for GP training.

  7. Adaptation of intensive mental health intensive case management to rural communities in the Veterans Health Administration.

    PubMed

    Mohamed, Somaia

    2013-03-01

    There has been increasing concern in recent years about the availability of mental health services for people with serious mental illness in rural areas. To meet these needs the Department of Veterans Affairs (VA) implemented the Rural Access Networks for Growth Enhancement (RANGE) program, in 2007, modeled on the Assertive Community Treatment (ACT) model. This study uses VA administrative data from the RANGE program (N = 343) to compare client characteristics at program entry, patterns of service delivery, and outcomes with those of Veterans who received services from the general VA ACT-like program (Mental Health Intensive Case Management (MHICM) (N = 3,077). Veterans in the rural program entered treatment with similar symptom severity, less likelihood of being diagnosed with schizophrenia and having had long-term hospitalization, but significantly higher suicidality index scores and greater likelihood of being dually diagnosed compared with those in the general program. RANGE Veterans live further away from their treatment teams but did not differ significantly in measures of face-to-face treatment intensity. Similar proportions of RANGE and MHICM Veterans were reported to have received rehabilitation services, crisis intervention and substance abuse treatment. The rural programs had higher scores on overall satisfaction with VA mental health care than general programs, slightly poorer outcomes on quality of life and on the suicidality index but no significant difference on other outcomes. These data demonstrate the clinical need, practical feasibility and potential effectiveness of providing intensive case management through small specialized case management teams in rural areas.

  8. Fifteen-month follow up of an assertive community treatment program for chronic patients with mental illness.

    PubMed

    Kim, Tae-Won; Jeong, Jong-Hyun; Kim, Young-Hee; Kim, Yura; Seo, Ho-Jun; Hong, Seung-Chul

    2015-09-16

    The aim of this study was to evaluate the effect of an Assertive Community Treatment (ACT) program on psychiatric symptoms, global functioning, life satisfaction, and recovery-promoting relationships among individuals with mental illness. Participants were patients at the Suwon Mental Health Center. Thirty-two patients were part of the ACT program and 32 patients matched for age, sex, and mental illness were in a standard case-management program and served as a control group. Follow-up with patients occurred every 3 months during the 15 months after a baseline interview. Participants completed the Brief Psychiatric Rating Scale (BPRS), Global Assessment of Functioning (GAF) Scale, Life Satisfaction Scale, and Recovery-Promoting Relationship Scale (RPRS). No significant differences were noted in the sociodemographic characteristics of the ACT and the case-management group. According to the BPRS, the ACT group showed a significant reduction in symptom severity, but the ACT program was not significantly more effective at reducing psychiatric symptoms from baseline to the 15-month follow-up compared to the case-management approach. The ACT group showed more significant improvement than the control group in terms of the GAF Scale. Both groups showed no significant differences in the change of life satisfaction and in the change of recovery-promoting relationships. We observed a significant increase in recovery-promoting relationships in the control group, but the degree of change of recovery-promoting relationships through time flow between groups was not significantly different. In this study, we observed that ACT was significantly better at improving the GAF than case management and that participation in ACT was associated with a significant decrease in BPRS scores. However, ACT did not demonstrate an absolute superiority over the standard case-management approach in terms of the BPRS and the measures of life satisfaction and recovery-promoting relationships. ACT may have some advantages over a standard case management approach.

  9. Case Study of American Healthways' Diabetes Disease Management Program

    PubMed Central

    Pope, James E.; Hudson, Laurel R.; Orr, Patty M.

    2005-01-01

    Disease management has been defined as a system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant (Disease Management Association of America, 2005). The purpose of this article is to provide an overview of the diabetes disease management program offered by American Healthways (AMHC) and highlight recently reported results of this program (Villagra, 2004a; Espinet et al., 2005). PMID:17288077

  10. [Implementation and evaluation of case management in Catalonia: the ISP-SMD program].

    PubMed

    Balsera Gómez, J; Rodríguez Medina, C; Caba Calvet, R; Vega Prada, R; Ruiz Ureña, H; Berruezo Ortiz, L; Clusa Gironella, D; Rodríguez Montes, M J; Haro Abad, J M

    2002-01-01

    The pilot study of the Individualized Service Program for people with Severe Mental Disorders (ISP-SMD) consists of the implementation of case management services in Catalonia. The ISP-SMD has been implemented in two health care sectors and will be expanded to the rest of Catalonia in the next years. The program serves people with persistent mental disorders who have serious social or family problems and/or who have inadequate mental health service use (high use of inpatient services, no use of community services). The ISP-SMD is a community intervention program that focuses its activities on direct care and coordination between services. Thirty patients have been included in the evaluation. The results of the pilot study have shown that, compared to the year before entering the program, the patients show better clinical status, they decrease their unmet need level, they have more appropriate use of health services and have lower treatment costs. Satisfaction of the patients, family members and professionals with the program is very high. It is possible to adapt and implement case management services in Catalonia. When implemented, they improve patient quality of life.

  11. Case management: key to access, quality, and financial success.

    PubMed

    Smith, Alison P

    2003-01-01

    Several strategic, organizational, and operational variables drive successful case management programs. Organizational goals and accountability for support by administrative and medical staff leaders set the stage for a comprehensive program. The integration of utilization review, discharge planning, and other functions into the role of the case manager improves productivity and continuity. Choosing a model for assigning patients, a variable unique to the institution, should be carefully considered. Regardless of the power of strategic goals or the creative selection of a model, daily practices that promote daily review and communication will reveal all of the opportunities for improved performance. Complications are avoided one patient at a time and patients deserve vigilance. Length of stay is shortened 1 day at a time and we can no longer afford to miss these opportunities. In the period of high census, an unnecessary day for one patient at the end of his/her stay may mean another patient being diverted to another hospital away from his/her physician and past medical records. Creating constructive physician partnerships and cooperative relationships with postacute care providers can bring a case management program to higher level of performance. While many organizations have employees called "case managers," fewer have a comprehensive approach that has the potential to drive so many important indicators of performance.

  12. Cost-effectiveness of diabetes case management for low-income populations.

    PubMed

    Gilmer, Todd P; Roze, Stéphane; Valentine, William J; Emy-Albrecht, Katrina; Ray, Joshua A; Cobden, David; Nicklasson, Lars; Philis-Tsimikas, Athena; Palmer, Andrew J

    2007-10-01

    To evaluate the cost-effectiveness of Project Dulce, a culturally specific diabetes case management and self-management training program, in four cohorts defined by insurance status. Clinical and cost data on 3,893 persons with diabetes participating in Project Dulce were used as inputs into a diabetes simulation model. The Center for Outcomes Research Diabetes Model, a published, peer-reviewed and validated simulation model of diabetes, was used to evaluate life expectancy, quality-adjusted life expectancy (QALY), cumulative incidence of complications and direct medical costs over patient lifetimes (40-year time horizon) from a third-party payer perspective. Cohort characteristics, treatment effects, and case management costs were derived using a difference in difference design comparing data from the Project Dulce program to a cohort of historical controls. Long-term costs were derived from published U.S. sources. Costs and clinical benefits were discounted at 3.0 percent per annum. Sensitivity analyses were performed. Incremental cost-effectiveness ratios of $10,141, $24,584, $44,941, and $69,587 per QALY gained were estimated for Project Dulce participants versus control in the uninsured, County Medical Services, Medi-Cal, and commercial insurance cohorts, respectively. The Project Dulce diabetes case management program was associated with cost-effective improvements in quality-adjusted life expectancy and decreased incidence of diabetes-related complications over patient lifetimes. Diabetes case management may be particularly cost effective for low-income populations.

  13. Perceptions of ESL Program Management in Canadian Higher Education: A Qualitative Case Study

    ERIC Educational Resources Information Center

    Eaton, Sarah Elaine

    2017-01-01

    ESL programs at post-secondary institutions must often generate revenue in addition to teaching students English. Institutions often impose explicit expectations on these programs to generate profit, creating unique challenges for those who administer them. This qualitative case study investigated challenges faced by ESL program directors at one…

  14. Reengineering outcomes management: an integrated approach to managing data, systems, and processes.

    PubMed

    Neuman, K; Malloch, K; Ruetten, V

    1999-01-01

    The integration of outcomes management into organizational reengineering projects is often overlooked or marginalized in proportion to the entire project. Incorporation of an integrated outcomes management program strengthens the overall quality of reengineering projects and enhances their sustainability. This article presents a case study in which data, systems, and processes were reengineered to form an effective Outcomes Management program as a component of the organization's overall project. The authors describe eight steps to develop and monitor an integrated outcomes management program. An example of an integrated report format is included.

  15. How State-Funded Home Care Programs Respond to Changes in Medicare Home Health Care: Resource Allocation Decisions on the Front Line

    PubMed Central

    Corazzini, Kirsten

    2003-01-01

    Objective To examine how case managers in a state-funded home care program allocate home care services in response to information about a client's Medicare home health care status, with particular attention to the influence of work environment. Data Sources/Study Setting Primary data collected on 355 case managers and 26 agency directors employed in June 1999 by 26 of the 27 regional agencies administering the Massachusetts Home Care Program for low-income elders. Study Design Data were collected in a cross-sectional survey study design. A case manager survey included measures of work environment, demographics, and factorial survey vignette clients (N=2,054), for which case managers assessed service eligibility levels. An agency director survey included measures of management practices. Data Collection/Extraction Methods Hierarchical linear models estimated the effects of work environment on the relationship between client receipt of Medicare home health care and care plan levels while controlling for case-mix differences in agencies' clients. Principal Findings Case managers did not supplement extant Medicare home health services, but did allocate more generous service plans to clients who have had Medicare home health care services recently terminated. This finding persisted when controlling for case mix and did not vary by work environment. Work environment affected overall care plan levels. Conclusions Study findings indicate systematic patterns of frontline resource allocation shaping the relationships among community-based long-term care payment sources. Further, results illustrate how nonuniform implementation of upper-level initiatives may be partially attributed to work environment characteristics. PMID:14596390

  16. One University's Experience Partnering with an Online Program Management (OPM) Provider: A Case Study

    ERIC Educational Resources Information Center

    Springer, Scott

    2018-01-01

    University and college administrators frequently choose to develop and implement online programs with the help of for-profit companies known as online program management (OPM) providers that specialize in the development and implementation of online programs. This paper reports on the partnership of a private university in the Western United…

  17. Prototyping with Application Generators: Lessons Learned from the Naval Aviation Logistics Command Management Information System Case

    DTIC Science & Technology

    1992-10-01

    Prototyping with Application Generators: Lessons Learned from the Naval Aviation Logistics Command Management Information System Case. This study... management information system to automate manual Naval aviation maintenance tasks-NALCOMIS. With the use of a fourth-generation programming language

  18. Case Study of the U.S. Army’s Should-Cost Management Implementation

    DTIC Science & Technology

    2013-12-03

    and Pelvic Protection Systems (PPS). After graduating from the Naval Postgraduate School, Major Choi will be assigned to the U.S. Army...Systems PMO Product/Project/Program Management Office PMT Program Management Training POA&M Plan of Action and Milestones POE Program Office...Intelligence, Electronic Warfare and Sensors  PEO Simulation, Training , and Instrumentation  JPEO Chemical and Biological Defense The researcher

  19. The Agway Management Development Program: Design and Implementation

    ERIC Educational Resources Information Center

    Barth, Anthony L.; Engfer, Robert T.

    1977-01-01

    Focus is on the Agway (a farm supply and food marketing cooperative) retail store system in this informational case history and how-to approach for designing, developing, and implementing a formal corporate management program. (Editor/TA)

  20. A Case Study of Obsolescence Management Constraints During Development of Sustainment-Dominated Systems

    NASA Astrophysics Data System (ADS)

    Welch, Jonathan

    This case study focused on obsolescence management constraints that occur during development of sustainment-dominated systems. Obsolescence management constraints were explored in systems expected to last 20 years or more and that tend to use commercial off-the-shelf products. The field of obsolescence has received little study, but obsolescence has a large cost for military systems. Because developing complex systems takes an average of 3 to 8 years, and commercial off-the-shelf components are typically obsolete within 3 to 5 years, military systems are often deployed with obsolescence issues that are transferred to the sustainment community to determine solutions. The main problem addressed in the study was to identify the constraints that have caused 70% of military systems under development to be obsolete when they are delivered. The purpose of the study was to use a qualitative case study to identify constraints that interfered with obsolescence management occurring during the development stages of a program. The participants of this case study were managers, subordinates, and end-users who were logistics and obsolescence experts. Researchers largely agree that proactive obsolescence management is a lower cost solution for sustainment-dominated systems. Program managers must understand the constraints and understand the impact of not implementing proactive solutions early in the development program lifecycle. The conclusion of the study found several constraints that prevented the development program from early adoption of obsolescence management theories, specifically pro-active theories. There were three major themes identified: (a) management commitment, (b) lack of details in the statement of work, and (c) vendor management. Each major theme includes several subthemes. The recommendation is future researchers should explore two areas: (a) comparing the cost of managing obsolescence early in the development process versus the costs of managing later, (b) exploring the costs and value to start a centralized obsolescence group at each major defense contractor location.

  1. Using intensive case management to reduce violence by mentally ill persons in the community.

    PubMed

    Dvoskin, J A; Steadman, H J

    1994-07-01

    Aggressive and intensive case management and a comprehensive array of community support services are the keys to reducing the risk of violence by people with serious mental illness in the community. The authors describe the elements of intensive case management for potentially violent clients, including use of individual case managers responsible for small caseloads, 24-hour availability of case managers, and strong linkages to agencies providing mental health services, substance abuse treatment, and social services as well as to the criminal justice system. They summarize the results of three recent studies of intensive case management programs suggesting that this intervention is effective in reducing clients' dangerousness in the community. They discuss cultural and human resource issues that affect planning of intensive case management services. Intensive case managers need to be "boundary spanners" with the training, experience, and personality to bridge the often-broad gap between human service and criminal justice systems.

  2. 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…

  3. The Collaborative Educational Programs of the National Association of Bank Women: Mechanisms for Career Change.

    ERIC Educational Resources Information Center

    Thomas, Kirk R.; Parker, L. Allen

    This case description portrays the educational programs of the National Association of Bank Women designed to meet the special needs of women seeking advancement or career changes in the banking industry. After sketching several shorter programs, the case elaborates upon the collaborative Baccalaureate Degree Program in Management for Women, which…

  4. Impact of a COPD comprehensive case management program on hospital length of stay and readmission rates.

    PubMed

    Alshabanat, Abdulmajeed; Otterstatter, Michael C; Sin, Don D; Road, Jeremy; Rempel, Carmen; Burns, Jane; van Eeden, Stephan F; FitzGerald, J M

    2017-01-01

    COPD accounts for the highest rate of hospital admissions among major chronic diseases. COPD hospitalizations are associated with impaired quality of life, high health care utilization, and poor prognosis and result in an economic and a social burden that is both substantial and increasing. The aim of this study is to determine the efficacy of a comprehensive case management program (CCMP) in reducing length of stay (LOS) and risk of hospital admissions and readmissions in patients with COPD. We retrospectively compared outcomes across five large hospitals in Vancouver, BC, Canada, following the implementation of a systems approach to the management of COPD patients who were identified in the hospital and followed up in the community for 90 days. We compared numbers, rates, and intervals of readmission and LOS during 2 years of active program delivery compared to 1 year prior to program implementation. A total of 1,564 patients with a clinical diagnosis of COPD were identified from 2,719 hospital admissions during the 3 years of study. The disease management program reduced COPD-related hospitalizations by 30% and hospitalizations for all causes by 13.6%. Similarly, the rate of readmission for all causes showed a significant decline, with hazard ratios (HRs) of 0.55 (year 1) and 0.51 (year 2) of intervention ( P <0.001). In addition, patients' mean LOS (days) for COPD-related admissions declined significantly from 10.8 to 6.8 ( P <0.05). A comprehensive disease management program for COPD patients, including education, case management, and follow-up, was associated with significant reduction in hospital admissions and LOS.

  5. A brief overview of channel monitoring in land management: Five case studies. Case study #1

    Treesearch

    Leslie Reid

    1999-01-01

    Yesterday we heard about some successful monitoring programs,but today I would like to share some findings from a study I did, which was basically a post-mortem of failed monitoring programs.There were about 30 projects,and I wanted to know why did they fail,and were there patterns of why they failed.The projects ranged from university studies,land management,and...

  6. Resource Management Resource Guide. A Resource for Teaching the Resource Management Core Course Area of Ohio's Work and Family Life Program.

    ERIC Educational Resources Information Center

    Kister, Joanna; And Others

    This Resource Management Resource Guide is intended to help teachers implement Ohio's Work and Family Life Program. Course content focuses on the practical problems related to managing human and material resources, making consumer decisions, and feeding, clothing, and housing the family. These practical problems are posed through case studies and…

  7. World Perspective Case Descriptions on Educational Programs for Adults: Ireland.

    ERIC Educational Resources Information Center

    Hassett, Michael; And Others

    Fifteen adult education programs being conducted in Ireland are described in the case studies in this packet. The courses range from adult basic education to university degree courses in management and industrial relations, from marriage preparation to inservice teacher education. The following programs are profiled: (1) certificate in farming…

  8. Clinical Characteristics of the Suicide Attempters Who Refused to Participate in a Suicide Prevention Case Management Program.

    PubMed

    Park, Soyoung; Choi, Kyoung Ho; Oh, Youngmin; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai; Lee, Kyoung-Uk

    2015-10-01

    Case management interventions for suicide attempters aimed at helping adjust their social life to prevent reattempts have high nonparticipation and dropout rates. We analyzed the clinical characteristics of the group who refused to participate in the suicide prevention program in Korea. A total of 489 patients with a suicide attempt who visited Uijeongbu St. Mary's Hospital, the Catholic University of Korea, from December 2009 to December 2013 were analyzed. All patients were divided into the participation group (n = 262) and the refusal group (n = 227) according to their participation in the case management program. Demographic and clinical characteristics of each group were examined. Results showed that the refusal group had low risks for suicide in terms of risk factors related with psychopathologies and presenting suicide behavior. That is, the refusal group had less patients with co-morbid medical illnesses and more patients with mild severity of depression compared to the participation group. However, the refusal group had more interpersonal conflict, more isolation of social integrity, and more impaired insight about suicide attempt. The results suggest that nonparticipation in the case management program may depend upon the patient's impaired insight about the riskiness of suicide and lack of social support.

  9. 77 FR 57096 - Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-17

    ... psychiatric and mental health therapy, nurse medical case management focused on treatment adherence, and... therapy, nurse medical case management focused on treatment adherence, and referrals to specialty medical...

  10. Making the case for OWTS management: lessons from case studies and research

    NASA Astrophysics Data System (ADS)

    Rahm, B.; Woods, F.; Hwang, S.; Walter, M. T.; Grantham, D. G.; Riha, S. J.

    2016-12-01

    On-site wastewater treatment systems (OWTS) are used in 20-25% of homes in the United States and can be an efficient and cost-effective alternative to conventional centralized systems. However, OWTS also represent a source of non-point nutrient, pathogen, and micro-contaminant pollution to surface and groundwater if they are poorly designed, sited and/or maintained. Despite their ubiquity and potential to negatively impact water resources, the contribution of OWTS to local and regional water contamination issues is poorly understood. There are no federal regulations or uniform standards for the operation, maintenance, and management of these systems. The effectiveness of educational programs and best management practices developed by the US Environmental Protection Agency, along with local and regional governments, remains uncertain. Here we describe attempts to increase our knowledge of the state of OWTS in relation to water resources and their management. Specifically, we summarize 1) efforts to modernize a NY State-wide inventory of residential OWTS using GIS-based tools; 2) research aimed at better understanding the impact of OWTS on surface and ground water in 5 upstate NY counties across a gradient of land uses; 3) lessons learned from 13 case studies of municipal OWTS management programs across the US; and 4) observations on the roles of data, education and policy in creating and evaluating successful municipal OWTS management programs. Initial results show that total numbers of OWTS in NY State continue to grow, particularly in areas associated with ex-urban migration. Research into the relationship between OWTS and nutrient and pathogen contamination in ground and surface waters, respectively, suggests location-specific variation. This has implications for management approaches: preventing failure of any individual OWTS may be just as effective as programs attempting to bring all OWTS up to a high level of performance. Case studies of management programs, which we assess using a set of policy-related criteria, suggest that approaches differ according to local regulations, stakeholder values, and other environmental, economic, and social factors.

  11. 44 CFR 66.3 - Establishment of community case file and flood elevation study docket.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... case file and flood elevation study docket. 66.3 Section 66.3 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program CONSULTATION WITH LOCAL OFFICIALS § 66.3 Establishment of community case...

  12. 44 CFR 66.3 - Establishment of community case file and flood elevation study docket.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... case file and flood elevation study docket. 66.3 Section 66.3 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program CONSULTATION WITH LOCAL OFFICIALS § 66.3 Establishment of community case...

  13. 44 CFR 66.3 - Establishment of community case file and flood elevation study docket.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... case file and flood elevation study docket. 66.3 Section 66.3 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program CONSULTATION WITH LOCAL OFFICIALS § 66.3 Establishment of community case...

  14. Do employee health management programs work?

    PubMed

    Serxner, Seth; Gold, Daniel; Meraz, Angela; Gray, Ann

    2009-01-01

    Current peer review literature clearly documents the economic return and Return-on-Investment (ROI) for employee health management (EHM) programs. These EHM programs are defined as: health promotion, self-care, disease management, and case management programs. The evaluation literature for the sub-set of health promotion and disease management programs is examined in this article for specific evidence of the level of economic return in medical benefit cost reduction or avoidance. The article identifies the methodological challenges associated with determination of economic return for EHM programs and summarizes the findings from 23 articles that included 120 peer review study results. The article identifies the average ROI and percent health plan cost impact to be expected for both types of EHM programs, the expected time period for its occurrence, and caveats related to its measurement.

  15. Harm reduction for drug abusing ex-offenders: outcome of the California prevention and education project MORE project.

    PubMed

    Bowser, Benjamin P; Jenkins-Barnes, Tazima; Dillard-Smith, Carla; Lockett, Gloria

    2010-01-01

    MORE was a mobile outreach drug abuse prevention and HIV harm reduction program primarily for ex-offenders who are active drug users. Through case management, clients were provided substance abuse education, counseling, and referral. Long term goals of these services were to reduce their drug use and re-incarceration for drug related crimes. From January 2002 to May 2006, 487 unduplicated clients were recruited in year long cohorts and offered services. The program evaluation tool was the Federal Office of Budget and Management Government Performance and Results Act questionnaire. Government Performance and Results Act interviews were conducted at in-take into the program, approximately six months later and again approximately 12 months after their initial in-take. By the six and 12 month follow-up interviews, active drug using clients reported significant reductions in their use of alcohol, cocaine/crack, heroin, and fewer sex partners and crimes. Program completers reported significantly reduced cocaine/crack and heroin use as well as fewer days in jail and crimes than non-completers (p < .01 to .001). Six program components account for these reductions: case management, day-treatment, outpatient services, outreach, HIV/AIDS, and substance abuse education. The differences in program service intensity, income, and employment for program completers and non-completers were analyzed using logistic regression. The intensity of case management and all services received along with having higher income by month six were the most significant predictors of program completion.

  16. Cooperative Education in the Andean Countries: A Case Study of International Education Efforts

    ERIC Educational Resources Information Center

    Cushman, Charles B., Jr.

    2010-01-01

    Since 2001, the Graduate School of Political Management (GSPM) at The George Washington University (GW) has managed a cooperative education program with a network of nine respected universities in South America. This "governance and political management" program serves working professionals in the civil service, political party offices,…

  17. 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,…

  18. Patient and Nurse Experiences in a Rural Chronic Disease Management Program: A Qualitative Evaluation.

    PubMed

    Davisson, Erica A; Swanson, Elizabeth A

    Rural status confounds chronic disease self-management. The purpose of this qualitative, descriptive study was to evaluate the nurse-led "Living Well" chronic disease management program reporting patient recruitment and retention issues since program initiation in 2013. The Chronic Care Model (CCM) was the guiding framework used to reinforce that interdisciplinary teams must have productive patient interactions for their program(s) to be sustainable. A rural, Midwest county clinic's chronic disease management program. Observations, interviews, and within- and across-case coding were used. Patients' responses were analyzed to identify (1) reasons for recruitment and retention problems and (2) program elements that were viewed as successful or needing improvement. A convenience sample of 6 rural, English-speaking adults (65 years or older, with no severe cognitive impairment) with at least one chronic condition was recruited and interviewed. Themes emerged related to nurse knowledge, availability, and value; peer support; overcoming barriers; adherence enhancement; and family/friends' involvement. Patients reported engagement in self-management activities because of program elements such as support groups and productive nurse-patient interactions. Interdisciplinary communication, commitment, and patient referral processes were identified as reasons for recruitment and retention issues. Findings substantiated that certain elements must be present and improved upon for future rural programs to be successful. Interdisciplinary communication may need to be improved to address recruitment and retention problems. It was clear from patient interviews that the nurse coordinators played a major role in patients' self-management adherence and overall satisfaction with the program. This is important to case management because results revealed the need for programs of this nature that incorporate the vital role of nurse coordinators and align with the CCM value of providing a supportive community health care resource for patients with chronic disease.

  19. Multidisciplinary teams of case managers in the implementation of an innovative integrated services delivery for the elderly in France.

    PubMed

    de Stampa, Matthieu; Vedel, Isabelle; Trouvé, Hélène; Ankri, Joël; Saint Jean, Olivier; Somme, Dominique

    2014-04-07

    The case management process is now well defined, and teams of case managers have been implemented in integrated services delivery. However, little is known about the role played by the team of case managers and the value in having multidisciplinary case management teams. The objectives were to develop a fuller understanding of the role played by the case manager team and identify the value of inter-professional collaboration in multidisciplinary teams during the implementation of an innovative integrated service in France. We conducted a qualitative study with focus groups comprising 14 multidisciplinary teams for a total of 59 case managers, six months after their recruitment to the MAIA program (Maison Autonomie Integration Alzheimer). Most of the case managers saw themselves as being part of a team of case managers (91.5%). Case management teams help case managers develop a comprehensive understanding of the integration concept, meet the complex needs of elderly people and change their professional practices. Multidisciplinary case management teams add value by helping case managers move from theory to practice, by encouraging them develop a comprehensive clinical vision, and by initiating the interdisciplinary approach. The multidisciplinary team of case managers is central to the implementation of case management and helps case managers develop their new role and a core inter-professional competency.

  20. Assessment of utility side financial benefits of demand side management considering environmental impacts

    NASA Astrophysics Data System (ADS)

    Abeygunawardane, Saranga Kumudu

    2018-02-01

    Any electrical utility prefers to implement demand side management and change the shape of the demand curve in a beneficial manner. This paper aims to assess the financial gains (or losses) to the generating sector through the implementation of demand side management programs. An optimization algorithm is developed to find the optimal generation mix that minimizes the daily total generating cost. This daily total generating cost includes the daily generating cost as well as the environmental damage cost. The proposed optimization algorithm is used to find the daily total generating cost for the base case and for several demand side management programs using the data obtained from the Sri Lankan power system. Results obtained for DSM programs are compared with the results obtained for the base case to assess the financial benefits of demand side management to the generating sector.

  1. BestPractices Corporate Energy Management Case Study: Alcoa Teams with DOE to Reduce Energy Consumption

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    2004-05-01

    This is the first in a series of DOE Industrial Technologies Program case studies on corporate energy management. The case study highlights Alcoa Aluminum's successful results and activities through its corporate energy management approach and collaboration with DOE. Case studies in this series will be used to encourage other energy-intensive industrial plants to adopt a corporate strategy, and to promote the concept of replicating results with a company or industry.

  2. On-the-job training won't cut it any more, experts say.

    PubMed

    2013-07-01

    Today's case managers need far more than on-the-job training to understand the complexities of the job and all of the tasks they must do on a daily basis. The length and content of the training must be geared to individual case managers and take into account their knowledge, skill set and experience. New case managers should be able to pass competencies and should meet with the case manager director and the person doing the training at the end of the week to discuss how the training is going. Hospital case managers must develop their own case management training programs that are based on hospital procedures and policies, specific job descriptions, and goals of the department, some experts say. In many cases, rather than hiring an experienced case manager who may not fit well into your department, it's better to hire someone with the characteristics you are looking for and teach him or her case management.

  3. A case study in R and D productivity: Helping the program manager cope with job stress and improve communication effectiveness

    NASA Technical Reports Server (NTRS)

    Bodensteiner, W. D.; Gerloff, E. A.

    1985-01-01

    Certain structural changes in the Naval Material Command which resulted from a comparison of its operations to those of selected large-scale private sector companies are described. Central to the change was a reduction in the number of formal reports from systems commands to headquarters, and the provision of Program Management Assistance Teams (at the request of the program manager) to help resolve project problems. It is believed that these changes improved communication and information-processing, reduced program manager stress, and resulted in improved productivity.

  4. Case management for the elderly with complex needs: cross-linking the views of their role held by elderly people, their informal caregivers and the case managers.

    PubMed

    Balard, Frédéric; Gely-Nargeot, Marie-Christine; Corvol, Aline; Saint-Jean, Olivier; Somme, Dominique

    2016-11-08

    In 2009, case management interventions were a new social service in France implemented within the framework of the PRISMA-France program (2006-2010). People who had benefitted from case management intervention were individuals, over 60 years old living at home in situations deemed complex by professionals. Their informal caregivers were also considered as users of the service. This research accompanied the interventions during the implementation of PRISMA-France attempting to explore the users' (old people and their informal caregivers) and case managers' first experiences of case management. Its aim is to provide a thorough knowledge of the dispositive in order to reveal any initial failings and to ensure optimum conditions for the onset of full implementation. The study had a qualitative explorative design. Cross-linked representations of case-management were obtained through opened-ended and guided interviews with three types of informants: old people (19), their informal caregivers (11) and the case managers (5) who participated in the program during the first 6 months. Thematic analysis of the data was carried out. The analysis revealed that each group of people generated its own representations of the case manager's role, even though the three groups of informants shared the idea that the case manager is first and foremost a helper. The case managers insisted on their proximity to the old people and their role as coordinators. The informal caregivers saw the professional as a partner and potential provider of assistance in accompanying old people. The old people focused on the personal connections established with the case manager. The innovative and experimental dimension of case management in France and the flexible nature of the role generated a broad spectrum of representations by those involved. These different representations are, in part, the fruit of each individual's projected expectations of this social service. Analyzing the first representations of the case manager's role during the implementation phase of the CM service appears as a necessary step before considering the effects of the services. The implementation and the success of a case management model have to be evaluated regarding the previous healthcare context and the expectations of the people involved.

  5. Does gender discrimination exist in a gynecology training program in a private hospital?

    PubMed

    Geisler, J P; Mernitz, C S; Geisler, M J; Harsha, C G; Eskew, P N

    1999-01-01

    Does gender discrimination by attending physicians exists in a residency in regard to residents' opportunities to perform complete/operative management of hysterectomies versus just being surgical assistants? The program studied is a 4-year program in obstetrics and gynecology residency with 3 residents per year. All cases involving a resident were recorded in a computer program designed by one of the authors (C.S.M.) to collect data for Residency Review Committee reports. Data were able to be sorted in a variety of methods including level of management, date of procedure, Physicians' Current Procedural Terminology codes, and attending physician name or resident name. Only intrafascial and extrafascial hysterectomies for benign disease were included in the study. Data were collected from July 1, 1996 to March 31, 1997. Five hundred and forty-nine hysterectomies with residents participating as primary surgeon (complete/operative management) or surgical assistant were performed during the study period. Complete/operative management was performed by the resident in 82.5% of cases while the resident was surgical assistant in 17.5%. Male residents were responsible for complete/operative management in 81.6% of cases and female residents in 83.2% of cases (P = 0.33). Male attending physicians were more likely to allow residents (male or female) to participate as the primary surgeon in abdominal hysterectomies (95.3%) and vaginal hysterectomies (68.5%) than female attending physicians (abdominal, 87.0% and vaginal, 57.3%) (P < 0.001 and P = 0.006, respectively). Although male attending physicians were more likely than female attending physicians to allow residents to perform complete/operative management, there was no discrimination as to whether the resident in question was male or female. When determining the level of management private gynecologists will allow residents to perform they do not practice gender discrimination.

  6. Access Management Awareness Program. Phase II Report

    DOT National Transportation Integrated Search

    1997-01-01

    This report presents the results of a number of detailed Iowa access management case studies. Case studies were selected to provide a cross-section of locations and community sizes in Iowa as well as a variety of project types. Projects were analyzed...

  7. The development of an acute care case manager orientation.

    PubMed

    Strzelecki, S; Brobst, R

    1997-01-01

    The authors describe the development of an inpatient acute care case manager orientation in a community hospital. Benner's application of the Dreyfus model of skill acquisition provides the basis for the orientation program. The candidates for the case manager position were expert clinicians. Because of the role change it was projected that they would function as advanced beginners. It was also predicted that, as the case managers progressed within the role, the educational process would need to be adapted to facilitate progression of skills to the proficient level. Feedback from participants reinforced that the model supported the case manager in the role transition. In addition, the model provided a predictive framework for ongoing educational activities.

  8. 76 FR 5341 - Notice of Federal Advisory Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-31

    ... Medical Case Management 1:00 Break 1:15 Army Services for TBI and PTSD 2:15 Break 2:30 Army Programs for... Management 11:45 Break 1:00 Air Force Medical Services for TBI and PTSD 1:15 Air Force Programs for...

  9. Marketing of Revenue-Generating ESL Programs at the University of Calgary: A Qualitative Study

    ERIC Educational Resources Information Center

    Eaton, Sarah Elaine

    2009-01-01

    This qualitative case study endeavored to understand how program managers at one post-secondary Canadian university define, understand and undertake the marketing of their revenue-generating English as a Second Language (ESL) programs. Data were collected through interviews with three managers of distinct English as a Second Language (ESL)…

  10. Understanding service disengagement from the perspective of case managers.

    PubMed

    Stanhope, Victoria; Henwood, Benjamin F; Padgett, Deborah K

    2009-04-01

    Disengagement from services by persons experiencing homelessness and co-occurring disorders challenges the mental health system and the frontline providers who build clinical relationships that end prematurely. This qualitative study explored how case managers understand and respond to disengagement. This study was conducted at four programs serving persons with co-occurring disorders experiencing homelessness. The qualitative design used a case study approach based on in-depth interviews with 18 case managers about 29 cases of disengagement. The study compared their accounts with predisengagement interviews when available and the postdeparture residential status of consumers. Themes were derived by independent coding and consensus. Case managers attributed disengagement primarily to substance relapse and a preference for alternative living arrangements. The following themes emerged: seeing disengagement as part of their work, believing disengagement to be poor decision making on the part of the consumer, and coping with the revolving-door syndrome. The majority of consumers experienced homelessness after disengagement. The study illustrated the challenge of building hope-instilling relationships with consumers when faced with the reality of frequent disengagement. In an era of recovery-oriented services and consumer choice, case managers need support when faced with consumer decisions to leave treatment settings. Greater program flexibility may also help to reduce disengagement.

  11. Office ergonomics programs. A case study of North American corporations.

    PubMed

    Moore, J S

    1997-12-01

    Subject matter experts from 13 North American corporations provided detailed descriptions of the historical development and the current components and operations of their office ergonomics programs. Results were summarized across corporations and presented for the following programmatic topics: backgrounds of key people, initial awareness and preliminary needs assessment, program development, program implementation, program monitoring and evaluation, program components, education and training, workstation and job analysis, early identification of cases, case management, and alternate office environments. The subject matter experts also provided comments about the strengths of their programs, their advice to others, and lessons they learned. These observations suggested the need for an office ergonomics program, and possibly other occupational health programs, to fit into a corporation's culture and capitalize on its infrastructure. Most corporations used multidisciplinary task forces or teams to develop their programs. Communication, which included training, awareness, advertising, and feedback, was also an important issue. Flexibility and simplicity were important attributes of these programs. It is hoped that this descriptive information will be helpful to some occupational health managers interested in or concerned about managerial perspectives and skills related to the development and implementation of programs within their own corporations.

  12. Classroom Management for Kids Who Won't Sit Still and Other "Bad Apples"

    ERIC Educational Resources Information Center

    Cahill, Susan M.

    2006-01-01

    This article presents a case description of collaboration between an occupational therapist and a general education teacher to develop an effective classroom management system. The classroom management system described here was based on the Alert Program for Self-regulation: How Does Your Engine Run? In addition, the case description provides a…

  13. 78 FR 20324 - Proposed Information Collection Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-04

    ..., document the experiences of program participants, examine differences in service receipt and educational experiences between program and control group members, describe the intervention as it was implemented in each... leadership/ managers, instructional staff, case managers/advisors, partners and employers; (d) a brief survey...

  14. Applying the 15 Public Health Emergency Preparedness Capabilities to Support Large-Scale Tuberculosis Investigations in Complex Congregate Settings

    PubMed Central

    Toren, Katelynne Gardner; Elsenboss, Carina; Narita, Masahiro

    2017-01-01

    Public Health—Seattle and King County, a metropolitan health department in western Washington, experiences rates of tuberculosis (TB) that are 1.6 times higher than are state and national averages. The department’s TB Control Program uses public health emergency management tools and capabilities sustained with Centers for Disease Control and Prevention grant funding to manage large-scale complex case investigations. We have described 3 contact investigations in large congregate settings that the TB Control Program conducted in 2015 and 2016. The program managed the investigations using public health emergency management tools, with support from the Preparedness Program. The 3 investigations encompassed medical evaluation of more than 1600 people, used more than 100 workers, identified nearly 30 individuals with latent TB infection, and prevented an estimated 3 cases of active disease. These incidents exemplify how investments in public health emergency preparedness can enhance health outcomes in traditional areas of public health. PMID:28892445

  15. Florida's Medicaid AIDS Waiver: An Assessment of Dimensions of Quality

    PubMed Central

    Cowart, Marie E.; Mitchell, Jean M.

    1995-01-01

    Some State Medicaid agencies have implemented home and community-based waiver programs targeting acquired immunodeficiency syndrome (AIDS) patients. Under these initiatives, State Medicaid agencies can provide home and community-based services to persons with AIDS (PWA) as an alternative to more costly Medicaid-covered institutional care. This article evaluates quality of care under the Florida Medicaid waiver for PWA along two dimensions: program effectiveness and client satisfaction. Clients are generally satisfied with their case managers and the range and availability of services. Case managers appear to be well trained. Moreover, the probability of turnover is quite low, despite heavy caseloads and high mortality. The major difficulty faced by clients and case managers relates to the process of becoming Medicaid eligible. PMID:10151885

  16. A taxonomy for disease management: a scientific statement from the American Heart Association Disease Management Taxonomy Writing Group.

    PubMed

    Krumholz, Harlan M; Currie, Peter M; Riegel, Barbara; Phillips, Christopher O; Peterson, Eric D; Smith, Renee; Yancy, Clyde W; Faxon, David P

    2006-09-26

    Disease management has shown great promise as a means of reorganizing chronic care and optimizing patient outcomes. Nevertheless, disease management programs are widely heterogeneous and lack a shared definition of disease management, which limits our ability to compare and evaluate different programs. To address this problem, the American Heart Association's Disease Management Taxonomy Writing Group developed a system of classification that can be used both to categorize and compare disease management programs and to inform efforts to identify specific factors associated with effectiveness. The AHA Writing Group began with a conceptual model of disease management and its components and subsequently validated this model over a wide range of disease management programs. A systematic MEDLINE search was performed on the terms heart failure, diabetes, and depression, together with disease management, case management, and care management. The search encompassed articles published in English between 1987 and 2005. We then selected studies that incorporated (1) interventions designed to improve outcomes and/or reduce medical resource utilization in patients with heart failure, diabetes, or depression and (2) clearly defined protocols with at least 2 prespecified components traditionally associated with disease management. We analyzed the study protocols and used qualitative research methods to develop a disease management taxonomy with our conceptual model as the organizing framework. The final taxonomy includes the following 8 domains: (1) Patient population is characterized by risk status, demographic profile, and level of comorbidity. (2) Intervention recipient describes the primary targets of disease management intervention and includes patients and caregivers, physicians and allied healthcare providers, and healthcare delivery systems. (3) Intervention content delineates individual components, such as patient education, medication management, peer support, or some form of postacute care, that are included in disease management. (4) Delivery personnel describes the network of healthcare providers involved in the delivery of disease management interventions, including nurses, case managers, physicians, pharmacists, case workers, dietitians, physical therapists, psychologists, and information systems specialists. (5) Method of communication identifies a broad range of disease management delivery systems that may include in-person visitation, audiovisual information packets, and some form of electronic or telecommunication technology. (6) Intensity and complexity distinguish between the frequency and duration of exposure, as well as the mix of program components, with respect to the target for disease management. (7) Environment defines the context in which disease management interventions are typically delivered and includes inpatient or hospital-affiliated outpatient programs, community or home-based programs, or some combination of these factors. (8) Clinical outcomes include traditional, frequently assessed primary and secondary outcomes, as well as patient-centered measures, such as adherence to medication, self-management, and caregiver burden. This statement presents a taxonomy for disease management that describes critical program attributes and allows for comparisons across interventions. Routine application of the taxonomy may facilitate better comparisons of structure, process, and outcome measures across a range of disease management programs and should promote uniformity in the design and conduct of studies that seek to validate disease management strategies.

  17. Cultural Influences on the Design and Management of Transnational Higher Education Programs in China: A Case Study of Three Programs

    ERIC Educational Resources Information Center

    He, Lan; Liu, Ersi

    2018-01-01

    Purpose: The purpose of this paper is to identify the influence of cultural differences on the design and management of two franchise programs and one joint degree program run by a Chinese university in partnership with a British university and a French university. The cross-cultural challenges and the differences in the strategies taken by the…

  18. Educating resident physicians using virtual case-based simulation improves diabetes management: a randomized controlled trial.

    PubMed

    Sperl-Hillen, JoAnn; O'Connor, Patrick J; Ekstrom, Heidi L; Rush, William A; Asche, Stephen E; Fernandes, Omar D; Appana, Deepika; Amundson, Gerald H; Johnson, Paul E; Curran, Debra M

    2014-12-01

    To test a virtual case-based Simulated Diabetes Education intervention (SimDE) developed to teach primary care residents how to manage diabetes. Nineteen primary care residency programs, with 341 volunteer residents in all postgraduate years (PGY), were randomly assigned to a SimDE intervention group or control group (CG). The Web-based interactive educational intervention used computerized virtual patients who responded to provider actions through programmed simulation models. Eighteen distinct learning cases (L-cases) were assigned to SimDE residents over six months from 2010 to 2011. Impact was assessed using performance on four virtual assessment cases (A-cases), an objective knowledge test, and pre-post changes in self-assessed diabetes knowledge and confidence. Group comparisons were analyzed using generalized linear mixed models, controlling for clustering of residents within residency programs and differences in baseline knowledge. The percentages of residents appropriately achieving A-case composite clinical goals for glucose, blood pressure, and lipids were as follows: A-case 1: SimDE = 21.2%, CG = 1.8%, P = .002; A-case 2: SimDE = 15.7%, CG = 4.7%, P = .02; A-case 3: SimDE = 48.0%, CG = 10.4%, P < .001; and A-case 4: SimDE = 42.1%, CG = 18.7%, P = .004. The mean knowledge score and pre-post changes in self-assessed knowledge and confidence were significantly better for SimDE group than CG participants. A virtual case-based simulated diabetes education intervention improved diabetes management skills, knowledge, and confidence for primary care residents.

  19. 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…

  20. The Management of Student Affairs Programs in Community Colleges: Revamping Processes and Structures. Horizons Issues Monograph Series.

    ERIC Educational Resources Information Center

    Deegan, William L.

    Based on a review of the management literature in the fields of business and education and on case studies, interviews, and discussions, this monograph identifies the prerequisites for the successful management of student affairs programs. Chapter 1 presents perspectives on the student affairs profession, summarizes the problems facing the field,…

  1. 31 CFR 5.10 - How will Treasury entities use administrative offset (offset of non-tax Federal payments) to...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Offset Program. (1) In most cases, the Financial Management Service uses the Treasury Offset Program to... transferred to the Financial Management Service under § 5.9 of this part, Treasury entities will refer any... Management Service, in writing, that the debt is valid, delinquent, legally enforceable, and that there are...

  2. Chronic case management: Clinical governance with cost reductions.

    PubMed

    Costa, Élide Sbardellotto Mariano da; Hyeda, Adriano

    2016-01-01

    With increasing global impact of chronic degenerative non-communicable diseases (CDNCD), multidisciplinary chronic disease management care programs (CDMCP) come as a solution to improve the quality of patients care. We conducted a cross-sectional epidemiologic prospective cohort study with data comparing a group of patients monitored by a CDMCP with subjects without CDMCP care, from 2010 to 2012. The patients monitored in this program were selected because they presented CDNCD with frequent hospitalization and/or emergency care in the year prior to study selection. Also, the patients could be referred to the program by their physicians and/or other programs such as HomeCare or family medicine. All costs related to the program were included and compared with the costs of users with the same epidemiological profile who opted for not participating in the CDMCP. We analyzed data from 1,256 cases, including 639 (51%) men and 617 (49%) women. The mean age was 56.99 years and 73% were older than 50 years. There was a prevalence of 34% (428) cases with ischemic heart disease (myocardial infarction and stroke) and 17% (210) with neoplasms. The cases studied showed a reduction of 79% in the number of days of hospitalization compared with the cases without CDMCP monitoring. The average reduction of total costs (hospitalizations, emergency room visits and/or disease complications) was 31.94%, with average reduction of 8.36% in monthly costs. Multidisciplinary monitoring carried out by CDNCD patient management programs can reduce hospitalizations, emergency room visits and complications, positively impacting the costs with health care.

  3. Case Management and Rehabilitation Counseling: Procedures and Techniques. Fourth Edition

    ERIC Educational Resources Information Center

    Roessler, Richard T.; Rubin, Stanford E.

    2006-01-01

    "Case Management and Rehabilitation Counseling" discusses procedures that are useful to rehabilitation professionals working in many settings. Specifically, this book reviews the finer points relating to diagnosing, arranging services, monitoring program outcomes, arranging for placement, planning for accommodations, ethical decision making,…

  4. Managed Migration: The Caribbean Approach to Addressing Nursing Services Capacity

    PubMed Central

    Salmon, Marla E; Yan, Jean; Hewitt, Hermi; Guisinger, Victoria

    2007-01-01

    Objective To (1) provide a contextual analysis of the Caribbean region with respect to forces shaping the current and emerging nursing workforce picture in the region; (2) discuss country-specific case(s) within the Caribbean; and (3) describe the Managed Migration Program as a potential framework for addressing regional and global nurse migration issues. Principal Findings The Caribbean is in the midst of a crisis of shortages of nurses with an average vacancy rate of 42 percent. Low pay, poor career prospects, and lack of education opportunities are among the reasons nurses resign. Many of these nurses look outside the region for job opportunities in the United Kingdom, Canada, the United States, and other countries. Compounding the situation is the lack of resources to train nurses to fill the vacancies. The Managed Migration Program of the Caribbean is a multilateral, cross-sector, multi-interventional, long-term strategy for developing and maintaining an adequate supply of nurses for the region. Conclusions The Managed Migration Program of the Caribbean has made progress in establishing regional support for addressing the nursing shortage crisis and developing a number of interesting initiatives such as training for export and temporary migration. Recommendations to move the Managed Migration Program of the Caribbean forward focus on advocacy, integration of the program into regional policy decisions, and integration of the program with regional health programming. PMID:17489919

  5. 44 CFR 16.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: Existing facilities. 16.150 Section 16.150 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the... facilities accessible to and usable by individuals with handicaps; (2) In the case of historic preservation...

  6. Evaluation of a case-based urology learning program.

    PubMed

    Mishra, Kirtishri; Snow-Lisy, Devon C; Ross, Jonathan; Goldfarb, David A; Goldman, Howard; Campbell, Steven C

    2013-12-01

    To address the challenges that today's trainees encounter, such as information overload and reduced immersion in the field, and recognizing their preference for novel educational resources, an electronic case-based urology learning program was developed. Each case was designed to illustrate the basic principles of the disease process and the fundamentals of evaluation and management using the Socratic method, recapitulating a prototypical patient encounter. A 21-question survey was developed after review of published reports of classroom and clinical learning environment surveys. The target group was 2 pilot urology training programs (the Cleveland Clinic and University Hospitals-Case Medical Center). The responses were entirely anonymous. A total of 32 trainees participated (8 fellows and 24 residents), representing a 53% response rate. Most trainees (79%) were able to process cases within an average of ≤ 10 minutes. Of the trainees, 91% reported referring back to particular cases for patient care, to review for examinations, or for studying. Most trainees believed a case-based urology learning program would be a potentially important resource for clinical practice (69%) and for preparing for the in-service (63%) or board (69%) examinations. Most trainees believed the program met its goals of illustrating the basics principles of the disease process (88%), outlining the fundamentals of evaluation and management (94%), and improving the trainees' knowledge base (91%). An electronic case-based urology learning program is feasible and useful and stimulates learning at all trainee levels. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Traumatic anterior shoulder dislocation: a case study of nonoperative management in a mixed martial arts athlete.

    PubMed

    Sims, Kevin; Spina, Andreo

    2009-12-01

    To present an evidence-informed approach to the nonoperative management of a first-time, traumatic anterior shoulder dislocation. A 30-year-old mixed martial arts athlete, with no prior shoulder injuries, presented one day following a first-time, traumatic anterior shoulder dislocation. An eight-week, individualized, intensive, nonoperative rehabilitation program was immediately begun upon presentation. Management consisted of immobilization of the shoulder in external rotation and a progressive rehabilitation program aimed at restoring range of motion, strength of the dynamic stabilizers, and proprioception of the shoulder. Eight weeks post-dislocation the patient had regained full range of motion and strength compared to the unaffected limb and apprehension and relocation tests for instability were negative. This case illustrates successful management of a first-time, traumatic, anterior shoulder dislocation using immobilization in external rotation combined with an intensive rehabilitation program.

  8. Traumatic anterior shoulder dislocation: a case study of nonoperative management in a mixed martial arts athlete

    PubMed Central

    Sims, Kevin; Spina, Andreo

    2009-01-01

    Objective: To present an evidence-informed approach to the nonoperative management of a first-time, traumatic anterior shoulder dislocation. Clinical Features: A 30-year-old mixed martial arts athlete, with no prior shoulder injuries, presented one day following a first-time, traumatic anterior shoulder dislocation. An eight-week, individualized, intensive, nonoperative rehabilitation program was immediately begun upon presentation. Intervention and Outcome: Management consisted of immobilization of the shoulder in external rotation and a progressive rehabilitation program aimed at restoring range of motion, strength of the dynamic stabilizers, and proprioception of the shoulder. Eight weeks post-dislocation the patient had regained full range of motion and strength compared to the unaffected limb and apprehension and relocation tests for instability were negative. Conclusion: This case illustrates successful management of a first-time, traumatic, anterior shoulder dislocation using immobilization in external rotation combined with an intensive rehabilitation program. PMID:20037691

  9. Case histories in pharmaceutical risk management.

    PubMed

    McCormick, Cynthia G; Henningfield, Jack E; Haddox, J David; Varughese, Sajan; Lindholm, Anders; Rosen, Susan; Wissel, Janne; Waxman, Deborah; Carter, Lawrence P; Seeger, Vickie; Johnson, Rolley E

    2009-12-01

    The development and implementation of programs in the U.S. to minimize risks and assess unintended consequences of new medications has been increasingly required by the Food and Drug Administration (FDA) since the mid 1990s. This paper provides four case histories of risk management and post-marketing surveillance programs utilized recently to address problems associated with possible abuse, dependence and diversion. The pharmaceutical sponsors of each of these drugs were invited to present their programs and followed a similar template for their summaries that are included in this article. The drugs and presenting companies were OxyContin, an analgesic marketed by Purdue Pharma L.P., Daytrana and Vyvanse, ADHD medications marketed by Shire Pharmaceuticals, Xyrem for narcolepsy marketed by Jazz Pharmaceuticals, and Subutex and Suboxone for opioid dependence marketed by Reckitt Benckiser Pharmaceuticals Inc. These case histories and subsequent discussions provide invaluable real-world examples and illustrate both the promise of risk management programs in providing a path to market and/or for keeping on the market drugs with serious potential risks. They also illustrate the limitations of such programs in actually controlling unintended consequences, as well as the challenge of finding the right balance of reducing risks without posing undue barriers to patient access. These experiences are highly relevant as the FDA increasingly requires pharmaceutical sponsors to develop and implement the more formalized and enforceable versions of the risk management term Risk Evaluation and Mitigation Strategies (REMS).

  10. Strategies in disability management. Corporate disability management programs implemented at the work site.

    PubMed

    Kalina, C M

    1999-10-30

    Managers are challenged to demonstrate all programs as economically essential to the business, generating an appreciable return on investment. Further challenge exists to blend and integrate clinical and business objectives in program development. Disability management programs must be viewed as economically essential to the financial success of the business to assure management support for clinical interventions and return-to-work strategies essential for a successful program. This paper discusses a disability management program integrating clinical and business goals and objectives in return-to-work strategies to effect positive clinical, social-cultural, and business results. Clinical, educational, social, and economic challenges in the development, implementation, and continued management of a disability program at a large corporation with multiple global work sites are defined. Continued discussion addresses the effective clinical interventions and educational strategies utilized successfully within the workplace environment in response to each defined challenge. A multiple disciplinary team approach, clinical and business outcome measures, and quality assurance indicators are discussed as major program components. This article discusses a successful program approach focusing on business process and methodology. These parameters are used to link resources to strategy, developing a product for implementing and managing a program demonstrating economic value added through effective clinical medical case management.

  11. Ergonomics: CTD management evaluation tool.

    PubMed

    Ostendorf, J S; Rogers, B; Bertsche, P K

    2000-01-01

    Cumulative trauma disorder (CTD) occurrences peaked in number in 1994 and although decreasing in 1995, still accounted for 62% of all illness cases reported. A CTD Management Evaluation Tool was developed to assist Occupational Safety and Health Compliance Officers (CSHOs) in program evaluation and documentation of the occupational health management component and the need for an ergonomics program. Occupational and environmental health nurses may use the tool not only to reduce and prevent CTD occurrences, but also as a benchmark for program evaluation.

  12. The case and opportunity for public-supported financial incentives to implement integrated pest management.

    PubMed

    Brewer, Michael J; Hoard, Robert J; Landis, Joy N; Elworth, Lawrence E

    2004-12-01

    Food, water, and worker protection regulations have driven availability, and loss, of pesticides for use in pest management programs. In response, public-supported research and extension projects have targeted investigation and demonstration of reduced-risk integrated pest management (IPM) techniques. But these new techniques often result in higher financial burden to the grower, which is counter to the IPM principle that economic competitiveness is critical to have IPM adopted. As authorized by the 2002 Farm Bill and administered by the U.S. Department of Agriculture (USDA) Natural Resources Conservation Service (NRCS), conservation programs exist for delivering public-supported financial incentives to growers to increase environmental stewardship on lands in production. NRCS conservation programs are described, and the case for providing financial incentives to growers for implementing IPM is presented. We also explored the opportunity and challenge to use one key program, the Environmental Quality Incentives Program (EQIP), to aid grower adoption of IPM. The EQIP fund distribution to growers from 1997 to 2002 during the last Farm Bill cycle totaled approximately 1.05 billion dollars with a portion of funds supporting an NRCS-designed pest management practice. The average percentage of allocation of EQIP funds to this pest management practice among states was 0.77 +/- 0.009% (mean +/- SD). Using Michigan as an example, vegetable and fruit grower recognition of the program's use to implement IPM was modest (25% of growers surveyed), and their recognition of its use in aiding implementation of IPM was improved after educational efforts (74%). Proposals designed to enhance program usefulness in implementing IPM were delivered through the NRCS advisory process in Michigan. Modifications for using the NRCS pest management practice to address resource concerns were adopted, incentive rates for pest management were adjusted, and an expanded incentive structure for IPM technique adoption was tabled for future consideration. The case is strong for using public-supported financial incentives offered by the EQIP to aid grower adoption of IPM as a means to address resource concerns, but current use of the EQIP for this purpose is modest to meager. With appropriate program adjustments and increased grower awareness, USDA NRCS conservation programs, and the EQIP in particular, may provide an important opportunity for growers to increase their use of IPM as a resource conservation and farm management tool.

  13. Critical Success Factors for an Effective Security Risk Management Program in an Organization: An Exploratory Case Study

    ERIC Educational Resources Information Center

    Zafar, Humayun

    2010-01-01

    This study investigates differences in perception between layers of management (executive, middle, and lower) and staff with regard to the influence of critical success factors (CSFs) on security risk management (SRM) effectiveness. This is an in-depth case study conducted at a Fortune 500 company. Rockart's (1979) CSF method is modified through…

  14. The development and preliminary effectiveness of a nursing case management e-learning program.

    PubMed

    Liu, Wen-I; Chu, Kuo-Chung; Chen, Shing-Chia

    2014-07-01

    The purpose of this article was to describe the development and preliminary effectiveness of a digital case management education program. The e-learning program was built through the collaboration of a nurse educator and an informatics professor. The program was then developed according to the following steps: (1) building a visual interface, (2) scripting each unit, (3) preparing the course material and assessment tests, (4) using teaching software to record audio and video courses, (5) editing the audio recordings, (6) using instructional media or hyperlinks to finalize the interactions, (7) creating the assessment and obtaining feedback, and (8) testing the overall operation. The digital program consisted of five learning modules, self-assessment questions, learning cases, sharing experiences, and learning resources. Forty nurses participated in this study and fully completed the questionnaires both before and after the program. The knowledge and confidence levels in the experimental group were significantly higher over time than those of the comparison group. The results supported the use of educational technology to provide a more flexible and effective presentation method for continuing education programs.

  15. 25 CFR 20.515 - What is required for case management?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....515 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.515 What is required for case management? Social services workers must document regular contact with children and families in accordance...

  16. 78 FR 53770 - Proposed Information Collection Activity; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ... eligibility period. 8. The U.S. Repatriation Program Individual Case Management Report and Financial Claim... more...... 1 or more......... 0.20 200 or more. Individual Case Management Report. Estimated Total.... because of destitution, illness, war, threat of war, or a similar crisis, and are without available...

  17. Evaluation of a Stress Management Program in a Child Protection Agency.

    ERIC Educational Resources Information Center

    Cahill, Janet; Feldman, Lenard H.

    High stress levels experienced by child protection workers have been well documented. This study examined the effectiveness of a stress management program in a child protection agency. Subjects were case workers, immediate supervisors, and clerical staff; 320 subjects participated in pretesting and 279 subjects participated in posttesting.…

  18. Mental health court and assisted outpatient treatment: perceived coercion, procedural justice, and program impact.

    PubMed

    Munetz, Mark R; Ritter, Christian; Teller, Jennifer L S; Bonfine, Natalie

    2014-03-01

    Mandated community treatment has been proposed as a mechanism to engage people with severe and persistent mental disorders in treatment. Recently, two approaches to mandate treatment through the courts have been highlighted: assisted outpatient treatment (AOT) and mental health court programs. This study examined levels of perceived coercion, procedural justice, and the impact of the program (mental health court or AOT) among participants in a community treatment system. Data were analyzed from interviews with former AOT participants who were no longer under court supervision (N=17) and with graduates of a mental health court program (N=35). The MacArthur Admission Experience Survey, created to measure perceived coercion, procedural justice, and program impact on hospital admission, was modified to include judges and case managers. Mental health court graduates perceived significantly less coercion and more procedural justice in their interactions with the judge than did AOT participants. No significant difference was found between mental health court and AOT participants in perceptions of procedural justice in interactions with their case managers. Mental health court participants felt more respected and had more positive feelings about the program than did AOT participants. Both mental health courts and AOT programs have potentially coercive aspects. Findings suggest that judges and case managers can affect participants' perceptions of these programs by the degree to which they demonstrate procedural justice, a process that may affect the long-term effects of the programs on individuals.

  19. [Study protocol of a prevention of recurrent suicidal behaviour program based on case management (PSyMAC)].

    PubMed

    Sáiz, Pilar A; Rodríguez-Revuelta, Julia; González-Blanco, Leticia; Burón, Patricia; Al-Halabí, Susana; Garrido, Marlen; García-Alvarez, Leticia; García-Portilla, Paz; Bobes, Julio

    2014-01-01

    Prevention of suicidal behaviour is a public health priority in the European Union. A previous suicide attempt is the best risk predictor for future attempts, as well as completed suicides. The primary aim of this article is to describe a controlled study protocol designed for prevention of recurrent suicidal behaviour that proposes case management, and includes a psychoeducation program, as compared with the standard intervention (PSyMAC). Patients admitted from January 2011 to June 2013 to the emergency room of the Hospital Universitario Central de Asturias were evaluated using a protocol including sociodemographic, psychiatric, and psychosocial assessment. Patients were randomly assigned to either a group receiving continuous case management including participation in a psychoeducation program (experimental group), or a control group receiving standard care. The primary objective is to examine whether or not the period of time until recurrent suicidal behaviour in the experimental group is significantly different from that of the control group. PSyMAC proposes low cost and easily adaptable interventions to the usual clinical setting that can help to compensate the shortcoming of specific action protocols and suicidal behaviour prevention programs in our country. The evaluation of PSyMAC results will determine their real effectivity as a case-magament program to reduce suicidal risk. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

  20. How a Fully Automated eHealth Program Simulates Three Therapeutic Processes: A Case Study.

    PubMed

    Holter, Marianne T S; Johansen, Ayna; Brendryen, Håvar

    2016-06-28

    eHealth programs may be better understood by breaking down the components of one particular program and discussing its potential for interactivity and tailoring in regard to concepts from face-to-face counseling. In the search for the efficacious elements within eHealth programs, it is important to understand how a program using lapse management may simultaneously support working alliance, internalization of motivation, and behavior maintenance. These processes have been applied to fully automated eHealth programs individually. However, given their significance in face-to-face counseling, it may be important to simulate the processes simultaneously in interactive, tailored programs. We propose a theoretical model for how fully automated behavior change eHealth programs may be more effective by simulating a therapist's support of a working alliance, internalization of motivation, and managing lapses. We show how the model is derived from theory and its application to Endre, a fully automated smoking cessation program that engages the user in several "counseling sessions" about quitting. A descriptive case study based on tools from the intervention mapping protocol shows how each therapeutic process is simulated. The program supports the user's working alliance through alliance factors, the nonembodied relational agent Endre and computerized motivational interviewing. Computerized motivational interviewing also supports internalized motivation to quit, whereas a lapse management component responds to lapses. The description operationalizes working alliance, internalization of motivation, and managing lapses, in terms of eHealth support of smoking cessation. A program may simulate working alliance, internalization of motivation, and lapse management through interactivity and individual tailoring, potentially making fully automated eHealth behavior change programs more effective.

  1. How a Fully Automated eHealth Program Simulates Three Therapeutic Processes: A Case Study

    PubMed Central

    Johansen, Ayna; Brendryen, Håvar

    2016-01-01

    Background eHealth programs may be better understood by breaking down the components of one particular program and discussing its potential for interactivity and tailoring in regard to concepts from face-to-face counseling. In the search for the efficacious elements within eHealth programs, it is important to understand how a program using lapse management may simultaneously support working alliance, internalization of motivation, and behavior maintenance. These processes have been applied to fully automated eHealth programs individually. However, given their significance in face-to-face counseling, it may be important to simulate the processes simultaneously in interactive, tailored programs. Objective We propose a theoretical model for how fully automated behavior change eHealth programs may be more effective by simulating a therapist’s support of a working alliance, internalization of motivation, and managing lapses. Methods We show how the model is derived from theory and its application to Endre, a fully automated smoking cessation program that engages the user in several “counseling sessions” about quitting. A descriptive case study based on tools from the intervention mapping protocol shows how each therapeutic process is simulated. Results The program supports the user’s working alliance through alliance factors, the nonembodied relational agent Endre and computerized motivational interviewing. Computerized motivational interviewing also supports internalized motivation to quit, whereas a lapse management component responds to lapses. The description operationalizes working alliance, internalization of motivation, and managing lapses, in terms of eHealth support of smoking cessation. Conclusions A program may simulate working alliance, internalization of motivation, and lapse management through interactivity and individual tailoring, potentially making fully automated eHealth behavior change programs more effective. PMID:27354373

  2. Case Managers' Perspectives On What They Need To Do Their Job

    PubMed Central

    Eack, Shaun M.; Greeno, Catherine G.; Christian-Michaels, Stephen; Dennis, Amy; Anderson, Carol M.

    2013-01-01

    Objective To identify the perceived training needs of case managers working on community support teams in a community mental health center serving a semi-rural/suburban area. Methods Semi-structured interviews were conducted with 18 case managers and 3 supervisors to inquire about areas of training need in case management. Interviews were coded and analyzed for common themes regarding training needs and methods of training improvement. Results Identified training needs called for a hands-on, back to basics approach that included education on the symptoms of severe mental illness, co-morbid substance use problems, and methods of engaging consumers. A mentoring model was proposed as a potential vehicle for disseminating knowledge in these domains. Conclusions Case managers identify significant training needs that would address their basic understanding of severe mental illness. Programs targeting these needs may result in improved outcomes for case managers and the individuals with psychiatric disabilities. PMID:19346211

  3. Patient population management: taking the leap from variance analysis to outcomes measurement.

    PubMed

    Allen, K M

    1998-01-01

    Case managers today at BCHS have a somewhat different role than at the onset of the Collaborative Practice Model. They are seen throughout the organization as: Leaders/participants on cross-functional teams. Systems change agents. Integrating/merging with quality services and utilization management. Outcomes managers. One of the major cross-functional teams is in the process of designing a Care Coordinator role. These individuals will, as one of their functions, assume responsibility for daily patient care management activities. A variance tracking program has come into the Utilization Management (UM) department as part of a software package purchased to automate UM work activities. This variance program could potentially be used by the new care coordinators as the role develops. The case managers are beginning to use a Decision Support software, (Transition Systems Inc.) in the collection of data that is based on a cost accounting system and linked to clinical events. Other clinical outcomes data bases are now being used by the case manager to help with the collection and measurement of outcomes information. Hoshin planning will continue to be a framework for defining and setting the targets for clinical and financial improvements throughout the organization. Case managers will continue to be involved in many of these system-wide initiatives. In the words of Galileo, 1579, "You need to count what's countable, measure what's measurable, and what's not measurable, make measurable."

  4. [Case study: school meals' management in Santiago de Cali and Bogota].

    PubMed

    Díaz, Mónica del Pilar; Montoya, Iván A; Montoya, Luz A

    2011-10-01

    This research was aimed at ascertaining the state's role regarding hunger and how it manages to combat this matter; a food security program in two Colombian cities was thus assessed (i.e. school meals' provision in Cali and Bogota). A qualitative approach was adopted; documentary analysis, participant observation and in-depth interviews with various actors for both selected cases were used as data collection techniques. It was found that several measures taken in this area were not covered by regulatory principles aimed at covering all the dimensions of food security. Serious weaknesses in school meals' management in Cali were associated with a weak environment regarding the fight against hunger. School meals' management in Bogotá was aimed at recognizing the right to food as being supported by an institutional process where the issue of reducing hunger has become a firm purpose. School meals' program management was associated with the characteristics of its product, thereby affecting the program and the population's food and nutritional status; state management thus becomes another dimension of food security.

  5. Learning through Participatory Resource Management Programs: Case Studies from Costa Rica

    ERIC Educational Resources Information Center

    Sims, Laura; Sinclair, A. John

    2008-01-01

    Based on an ongoing qualitative case study in Costa Rica, this article presents the participatory work that the Instituto Costarricense de Electricidad (ICE) is doing with farmers to protect watersheds from erosion and contamination. Specifically, it includes a description of ICE's Watershed Management Agricultural Programme and how farmers…

  6. Involving Volunteers in Your Advancement Programs. The Best of "CASE Currents."

    ERIC Educational Resources Information Center

    Smith, Virginia Carter, Ed.; Alberger, Patricia LaSalle, Ed.

    A compilation of the best articles from "CASE Currents" on involving volunteers in institutional advancement programs is presented. Overall topics include: management of volunteers, working with trustees (volunteers at the top), benefits of participation for volunteers, and involving volunteers in fund raising, public relations, student…

  7. Case Management Models in Permanent Supported Housing Programs for People With Complex Behavioral Issues Who Are Homeless.

    PubMed

    Clark, Colleen; Guenther, Christina C; Mitchell, Jessica N

    2016-01-01

    The purpose of this article is to examine two evidence-based models of case management for people with co-occurring disorders and histories of chronic homelessness and to better understand their roles in permanent supported housing. Critical Time Intervention and Assertive Community Treatment are examined in terms of key elements, how they assist in ending homelessness, as well as the role they play in an individual's recovery from co-occurring disorders. Participants in two supported housing programs were interviewed at baseline and 6 months. One program used Critical Time Intervention (n = 144) and the other used Assertive Community Treatment (n = 90). Staff in both programs were interviewed about their experiences and fidelity assessments were conducted for each program. Both programs operated at high levels of fidelity. Despite similar criteria for participation, there were significant differences between groups. Critical Time Intervention participants were older, were more likely to be male, were more likely to be homeless, and reported greater psychiatric symptoms and higher levels of substance use (all p's < .001). Separate outcome analyses suggested that each program was successful in supporting people to transition from homelessness to stable housing; 88.6% of Assertive Community Treatment participants were homeless at baseline, while at 6 months 30% were homeless (p < .001), and 91.3% of those in the Critical Time Intervention were homeless at baseline, while 44.3% were homeless at 6 months (p < .001). Participants in the Critical Time Intervention program also showed significant decreases in alcohol use, drug use, and psychiatric symptoms (all p's < .01). The preliminary results suggest that each case management model is helpful in assisting people with complex behavioral health needs and chronic homelessness to move to stable housing. Permanent supported housing seems to be an effective way to end homelessness among people with co-occurring disorders. Further research is needed to determine which case management models work most effectively with supported housing to help policy makers and program directors make informed decisions in developing these programs.

  8. Student Outcomes Assessment of a Logistics and Supply Chair Management Major

    ERIC Educational Resources Information Center

    Walter, Clyde Kenneth

    2012-01-01

    Assessment of specialized programs, such as logistics and supply chain management program described here, may pose challenges because previous experience are less widely shared than in the more mainline subjects. This case study provides one model that may guide other faculties facing a similar assignment. The report detailed the steps followed to…

  9. Scandal and Tragedy Or Acquisition Lessons Relearned by the F-35 Program

    DTIC Science & Technology

    2017-01-01

    Ribbon Commission on Defense Management , referred to as the Packard Commission Report, determined that MDAPs take too long to develop, cost too much...understanding program management discipline. Yin (1994) and Patton (2002) believed a deep-rooted and multilevel case study analysis could help formulate... management ), good recommendations come from open questions, often applying the researcher’s and SME’s own expe- riences, instead of from scientific

  10. Optimal management program for asbestos containing building materials to be available in the event of a disaster.

    PubMed

    Kim, Young-Chan; Hong, Won-Hwa

    2017-06-01

    The safe management and disposal of asbestos is a matter of considerable importance. A large number of studies have been undertaken to quantify the issue of waste management following a disaster. Nevertheless, there have been few (if any) studies concerning asbestos waste, covering the amount generated, the cost of disposal, and the degree of hazard incurred. Thus, the current study focuses on developing a program for the management of Asbestos Containing Building Materials (ACBMs), which form the source of asbestos waste in the event of a disaster. The study will also discuss a case study undertaken in a specific region in Korea in terms of: (1) the location of ACBM-containing buildings; (2) types and quantities of ACBMs; (3) the cost of ACBM disposal; (4) the amount of asbestos fiber present during normal times and during post-disaster periods; (5) the required order in which ACBM-containing buildings should be dismantled; and (6) additional greenhouse gases generated during ACBM removal. The case study will focus on a specific building, with an area of 35.34m 2 , and will analyze information concerning the abovementioned points. In addition, the case study will focus on a selected area (108 buildings) and the administrative district (21,063 buildings). The significance of the program can be established by the fact that it visibly transmits information concerning ACBM management. It is a highly promising program, with a widespread application for the safe management and optimal disposal of asbestos in terms of technology, policy, and methodology. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Shaping Learning through Space: The Case of Outdoor Management Training.

    ERIC Educational Resources Information Center

    Hall, Roger; Rowland, Caroline

    This paper explores the relationship between experiential learning theory and outdoor management training, and describes a British outdoor management program grounded in adult learning theory. An introduction explores competing paradigms in management education: the managerialist perspective, which focuses on development of skills and…

  12. A case study of polypharmacy management in nine European countries: Implications for change management and implementation.

    PubMed

    McIntosh, Jennifer; Alonso, Albert; MacLure, Katie; Stewart, Derek; Kempen, Thomas; Mair, Alpana; Castel-Branco, Margarida; Codina, Carles; Fernandez-Llimos, Fernando; Fleming, Glenda; Gennimata, Dimitra; Gillespie, Ulrika; Harrison, Cathy; Illario, Maddalena; Junius-Walker, Ulrike; Kampolis, Christos F; Kardas, Przemyslaw; Lewek, Pawel; Malva, João; Menditto, Enrica; Scullin, Claire; Wiese, Birgitt

    2018-01-01

    Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained. Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases. Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation. Within the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change management and theory-based implementation strategies, and provide examples of polypharmacy management initiatives that can assist managers and policymakers in developing new programs or scaling up existing ones, particularly in places currently lacking such initiatives.

  13. An assessment of patient education and self-management in diabetes disease management--two case studies.

    PubMed

    Fitzner, Karen; Greenwood, Deborah; Payne, Hildegarde; Thomson, John; Vukovljak, Lana; McCulloch, Amber; Specker, James E

    2008-12-01

    Diabetes affects 7.8% of Americans, nearly 24 million people, and costs $174 billion yearly. People with diabetes benefit from self-management; disease management (DM) programs are effective in managing populations with diabetes. Little has been published on the intersection of diabetes education and DM. Our hypothesis was that diabetes educators and their interventions integrate well with DM and effectively support providers' care delivery. A literature review was conducted for papers published within the past 3 years and identified using the search terms "diabetes educator" and "disease management." Those that primarily addressed community health workers or the primary care/community setting were excluded. Two case studies were conducted to augment the literature. Ten of 30 manuscripts identified in the literature review were applicable and indicate that techniques and interventions based on cognitive theories and behavioral change can be effective when coupled with diabetes DM. Better diabetes self-management through diabetes education encourages participation in DM programs and adherence to recommended care in programs offered by DM organizations or those that are provider based. Improved health outcomes and reduced cost can be achieved by blending diabetes education and DM. Diabetes educators are a critical part of the management team and, with their arsenal of goal setting and behavior change techniques, are an essential component for the success of diabetes DM programs. Additional research needs to be undertaken to identify effective ways to integrate diabetes educators and education into DM and to assess clinical, behavioral, and economic outcomes arising from such programs.

  14. The value of daily money management: an analysis of outcomes and costs.

    PubMed

    Sacks, Debra; Das, Dhiman; Romanick, Raquel; Caron, Matt; Morano, Carmen; Fahs, Marianne C

    2012-01-01

    For vulnerable and frail older adults, management of daily financial obligations can become an overwhelming burden spiraling into at-risk situations. Social service agencies have developed community-based Daily Money Management programs to assist these adults in protecting their financial security. Through this study the authors present the first economic estimates of the costs of Daily Money Management programs which, along with case management programs, save $60,000 per individual when compared with the cost of nursing home placement, making them highly cost effective. Most importantly, individuals are able to remain in their homes. The authors address the current gap between cost-effective community-based practice and public policy support.

  15. Evaluating the social and economic impact of community-based prenatal care.

    PubMed

    Cramer, Mary E; Chen, Li-Wu; Roberts, Sara; Clute, Dorothea

    2007-01-01

    This article describes the evaluation and findings of a community-based prenatal care program, Omaha Healthy Start (OHS), designed to reduce local racial disparities in birth outcomes. This evaluative study used a comparative descriptive design, and Targeting Outcomes of Programs was the conceptual framework for evaluation. The evaluation followed 3 groups for 2 years: OHS birth mothers (N=79; N=157); non-OHS participant birth mothers (N=746; N=774); and Douglas County birth mothers (N=7,962; N=7,987). OHS provided case management, home visits, screening, referral, transportation, and health education to participants. Program outcome measures included low birth weight, infant mortality, adequacy of care, trimester of care, and costs of care. OHS birth outcomes improved during year 2, and there was a 31% cost saving in the average hospital expenditure compared with the nonparticipant groups. Preliminary evaluative analysis indicates that prenatal case management and community outreach can improve birth outcomes for minority women, while producing cost savings. Further prospective study is needed to document trends over a longer period of time regarding the relationship between community-based case management programs for minority populations, birth outcomes, and costs of care.

  16. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Peterson, Mark J; Efroymson, Rebecca Ann; Adams, Marshall

    The long-term ecological recovery of an impaired stream in response to an industrial facility's pollution abatement actions and the implications of the biological monitoring effort to environmental management is the subject of this special issue of Environmental Management. This final article focuses on the synthesis of the biological monitoring program's components and methods, the efficacy of various biological monitoring techniques to environmental management, and the lessons learned from the program that might be applicable to the design and application of other programs. The focus of the 25-year program has been on East Fork Poplar Creek, an ecologically impaired stream inmore » Oak Ridge, Tennessee with varied and complex stressors from a Department of Energy facility in its headwaters. Major components of the long-term program included testing and monitoring of invertebrate and fish toxicity, bioindicators of fish health, fish contaminant accumulation, and instream communities (including periphyton, benthic macroinvertebrate, and fish). Key parallel components of the program include water chemistry sampling and data management. Multiple lines of evidence suggested positive ecological responses during three major pollution abatement periods. Based on this case study and the related literature, effective environmental management of impaired streams starts with program design that is consistent across space and time, but also adaptable to changing conditions. The biological monitoring approaches used for the program provided a strong basis for assessments of recovery from remedial actions, and the likely causes of impairment. This case study provides a unique application of multidisciplinary and quantitative techniques to address multiple and complex regulatory and programmatic goals, environmental stressors, and remedial actions.« less

  17. Case study and lessons learned for the Great Lakes ITS Program, Airport ITS Integration and the Road Infrastructure Management System projects, final report, Wayne County, Michigan

    DOT National Transportation Integrated Search

    2007-03-02

    This report presents the case study and lessons learned for the national evaluation of the Great Lakes Intelligent Transportation Systems (GLITS) Airport ITS Integration and Road Infrastructure Management System (RIMS) projects. The Airport ITS Integ...

  18. Leaders on the Front Line--Managing Emotion for Ethical Decision Making

    ERIC Educational Resources Information Center

    Tenuto, Penny L.; Gardiner, Mary E.; Yamamoto, Julie K.

    2016-01-01

    To build capacity for students in educational leadership programs, we developed a teaching case study focused on managing emotion for ethical decision making in supervision of personnel. The case offers troubling encounters between a secondary assistant principal and a novice teacher, a veteran teacher, and a veteran administrator. Scenarios…

  19. Localized Quality Assurance and Certification for Cross-Border Education: A Shanghai Case Study

    ERIC Educational Resources Information Center

    Yadong, Li; Yanqiao, Jiang

    2009-01-01

    The authors present a case study of Sino-foreign cooperation in education to illustrate how developments in the management of licensing and the approval of programs can contribute to better quality assurance. The study demonstrates how the Shanghai municipal education authority has jettisoned traditional dependence on administrative management and…

  20. Expanding the Role of Institutional Research at Small Private Universities: A Case Study in Enrollment Management Using Data Mining

    ERIC Educational Resources Information Center

    Antons, Christopher M.; Maltz, Elliot N.

    2006-01-01

    This case study documents a successful application of data-mining techniques in enrollment management through a partnership between the admissions office, a business administration master's-degree program, and the institutional research office at Willamette University (Salem, Oregon). (Contains 1 table and 3 figures.)

  1. Knowledge Management Model: Practical Application for Competency Development

    ERIC Educational Resources Information Center

    Lustri, Denise; Miura, Irene; Takahashi, Sergio

    2007-01-01

    Purpose: This paper seeks to present a knowledge management (KM) conceptual model for competency development and a case study in a law service firm, which implemented the KM model in a competencies development program. Design/methodology/approach: The case study method was applied according to Yin (2003) concepts, focusing a six-professional group…

  2. 32 CFR 105.13 - Case management for Unrestricted Reports of sexual assault.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 1 2014-07-01 2014-07-01 false Case management for Unrestricted Reports of sexual assault. 105.13 Section 105.13 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN SEXUAL ASSAULT PREVENTION AND RESPONSE PROGRAM PROCEDURES § 105...

  3. 32 CFR 105.13 - Case management for Unrestricted Reports of sexual assault.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 1 2013-07-01 2013-07-01 false Case management for Unrestricted Reports of sexual assault. 105.13 Section 105.13 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN SEXUAL ASSAULT PREVENTION AND RESPONSE PROGRAM PROCEDURES § 105...

  4. 76 FR 81521 - Information Collection for Native Employment Training Grant (NET Grant) Program; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-28

    ... communities by providing: Job and skills training combined with intensive case management and supportive... obtained jobs, and the direct assistance and case management services which have facilitated employment... skills in order to obtain employment or find more sustainable work. Grants may encompass terms of up to...

  5. Analysis of a managed psychiatric disability program.

    PubMed

    McCulloch, J; Ozminkowski, R J; Cuffel, B; Dunn, R L; Goldman, W; Kelleher, D; Comporato, A

    2001-02-01

    The cost of mental illness to employers has been well documented; however, efforts to effectively reduce the costs of psychiatric disability are adversely affected by the fragmentation of health care services. This report is a case study of a program in which a managed behavioral health care organization managed the psychiatric disability of a telecommunications company. Compared with a non-random cohort of claimants not managed under the pilot, the duration of disability was reduced by 23% (17.1 days). Patient and provider satisfaction with the program was high. This study illustrates the potential for effectively reducing the cost of psychiatric disability and the challenges in coordinating health care.

  6. Comprehensive transportation asset management : making a business case and prioritizing assets for inclusion in formal asset management programs.

    DOT National Transportation Integrated Search

    2011-12-01

    Several agencies are applying asset management principles as a business tool and paradigm to help them define goals and prioritize agency resources in decision making. Previously, transportation asset management (TAM) has focused more on big ticke...

  7. Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea.

    PubMed

    Oh, Jinjoo; Oh, Seieun

    2017-12-01

    The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea. Copyright © 2017. Published by Elsevier B.V.

  8. Linking data to decision-making: applying qualitative data analysis methods and software to identify mechanisms for using outcomes data.

    PubMed

    Patel, Vaishali N; Riley, Anne W

    2007-10-01

    A multiple case study was conducted to examine how staff in child out-of-home care programs used data from an Outcomes Management System (OMS) and other sources to inform decision-making. Data collection consisted of thirty-seven semi-structured interviews with clinicians, managers, and directors from two treatment foster care programs and two residential treatment centers, and individuals involved with developing the OMS; and observations of clinical and quality management meetings. Case study and grounded theory methodology guided analyses. The application of qualitative data analysis software is described. Results show that although staff rarely used data from the OMS, they did rely on other sources of systematically collected information to inform clinical, quality management, and program decisions. Analyses of how staff used these data suggest that improving the utility of OMS will involve encouraging staff to participate in data-based decision-making, and designing and implementing OMS in a manner that reflects how decision-making processes operate.

  9. Developing a database management system to support birth defects surveillance in Florida.

    PubMed

    Salemi, Jason L; Hauser, Kimberlea W; Tanner, Jean Paul; Sampat, Diana; Correia, Jane A; Watkins, Sharon M; Kirby, Russell S

    2010-01-01

    The value of any public health surveillance program is derived from the ways in which data are managed and used to improve the public's health. Although birth defects surveillance programs vary in their case volume, budgets, staff, and objectives, the capacity to operate efficiently and maximize resources remains critical to long-term survival. The development of a fully-integrated relational database management system (DBMS) can enrich a surveillance program's data and improve efficiency. To build upon the Florida Birth Defects Registry--a statewide registry relying solely on linkage of administrative datasets and unconfirmed diagnosis codes-the Florida Department of Health provided funding to the University of South Florida to develop and pilot an enhanced surveillance system in targeted areas with a more comprehensive approach to case identification and diagnosis confirmation. To manage operational and administrative complexities, a DBMS was developed, capable of managing transmission of project data from multiple sources, tracking abstractor time during record reviews, offering tools for defect coding and case classification, and providing reports to DBMS users. Since its inception, the DBMS has been used as part of our surveillance projects to guide the receipt of over 200 case lists and review of 12,924 fetuses and infants (with associated maternal records) suspected of having selected birth defects in over 90 birthing and transfer facilities in Florida. The DBMS has provided both anticipated and unexpected benefits. Automation of the processes for managing incoming case lists has reduced clerical workload considerably, while improving accuracy of working lists for field abstraction. Data quality has improved through more effective use of internal edits and comparisons with values for other data elements, while simultaneously increasing abstractor efficiency in completion of case abstraction. We anticipate continual enhancement to the DBMS in the future. While we have focused on enhancing the capacity of our DBMS for birth defects surveillance, many of the tools and approaches we have developed translate directly to other public health and clinical registries.

  10. Structure and management of tuberculosis control programs in fragile states--Afghanistan, DR Congo, Haiti, Somalia.

    PubMed

    Mauch, Verena; Weil, Diana; Munim, Aayid; Boillot, Francois; Coninx, Rudi; Huseynova, Sevil; Powell, Clydette; Seita, Akihiro; Wembanyama, Henriette; van den Hof, Susan

    2010-07-01

    Health care delivery is particularly problematic in fragile states often connected with increased incidence of communicable diseases, among them tuberculosis. This article draws upon experiences in tuberculosis control in four fragile states from which four lessons learned were derived. A structured inventory to extract common themes specific for TB control in fragile states was conducted among twelve providers of technical assistance who have worked in fragile states. The themes were applied to the TB control programs of Afghanistan, DR Congo, Haiti and Somalia during the years 2000-2006. Case notifications and treatment outcomes have increased in all four countries since 2003 (treatment success rates 81-90%). Access to care and case detection however have remained insufficient (case detection rates 39-62%); There are four lessons learned: 1. TB control programs can function in fragile states. 2. National program leadership and stewardship are essential for quality and sustained TB control. 3. Partnerships with non-governmental providers are vital for continuous service delivery; 4. TB control programs in fragile states require consistent donor support. Despite challenges in management, coordination, security, logistics and funding, TB control programs can function in fragile states, but face considerable problems in access to diagnosis and treatment and therefore case detection. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  11. Alcoa Teams with DOE to Reduce Energy Consumption

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    None

    2004-05-01

    This is the first in a series of DOE Industrial Technologies Program case studies on corporate energy management. The case study highlights Alcoa Aluminum's successful results and activities through its corporate energy management approach and collaboration with DOE. Case studies in this series will be used to encourage other energy-intensive industrial plants to adopt a corporate strategy, and to promote the concept of replicating results with a company or industry.

  12. Knowledge and Skill Competency Values of an Undergraduate University Managed Cooperative Internship Program: A Case Study in Design Education

    ERIC Educational Resources Information Center

    Barbarash, David

    2016-01-01

    Students from the Purdue University landscape architecture program undergo a year-long managed cooperative internship between their junior and senior years of enrollment. During this paid internship students experience the realities of a professional design office outside of the protection of the academic classroom. Through surveys of faculty…

  13. A joint labor-management hazard communication training program: a case study in worker health and safety training.

    PubMed

    Robins, T G; Hugentobler, M K; Kaminski, M; Klitzman, S

    1994-01-01

    The 1983 OSHA Hazard Communication Standard requires training of employees exposed to hazardous chemicals. The authors provide a detailed look at the successes and failures of a joint labor-management training program that was designed to bring a firm with more than 50 manufacturing facilities into compliance with the standard.

  14. Case Management to Reduce Cardiovascular Disease Risk in American Indians and Alaska Natives With Diabetes: Results From the Special Diabetes Program for Indians Healthy Heart Demonstration Project

    PubMed Central

    Jiang, Luohua; Manson, Spero M.; Beals, Janette; Henderson, William; Pratte, Katherine; Acton, Kelly J.; Roubideaux, Yvette

    2014-01-01

    Objectives. We evaluated cardiovascular disease (CVD) risk factors in American Indians/Alaska Natives (AI/ANs) with diabetes in the Special Diabetes Program for Indians Healthy Heart (SDPI-HH) Demonstration Project. Methods. Multidisciplinary teams implemented an intensive case management intervention among 30 health care programs serving 138 tribes. The project recruited 3373 participants, with and without current CVD, between 2006 and 2009. We examined data collected at baseline and 1 year later to determine whether improvements occurred in CVD risk factors and in Framingham coronary heart disease (CHD) risk scores, aspirin use, and smoking status. Results. A1c levels decreased an average of 0.2% (P < .001). Systolic and diastolic blood pressure, low-density lipoprotein (LDL) cholesterol, and triglyceride levels decreased, with the largest significant reduction in LDL cholesterol (∆ = −5.29 mg/dL; P < .001). Average Framingham CHD risk scores also decreased significantly. Aspirin therapy increased significantly, and smoking decreased. Participants with more case management visits had significantly greater reductions in LDL cholesterol and A1c values. Conclusions. SDPI-HH successfully translated an intensive case management intervention. Creative retention strategies and an improved understanding of organizational challenges are needed for future Indian health translational efforts. PMID:25211728

  15. The impact of disease management on outcomes and cost of care: a study of low-income asthma patients.

    PubMed

    Rossiter, L F; Whitehurst-Cook, M Y; Small, R E; Shasky, C; Bovbjerg, V E; Penberthy, L; Okasha, A; Green, J; Ibrahim, I A; Yang, S; Lee, K

    2000-01-01

    An asthma disease management program designed specifically for low-income patients experiencing significant adverse events can improve health outcomes substantially, while lowering costs. The Virginia Health Outcomes Partnership aimed to help physicians in a fee-for-service primary care case management program manage asthma in Medicaid recipients. Approximately one-third of physicians treating asthma in an area designated as the intervention community volunteered to participate in training on disease management and communication skills. This large-scale study discovered that the rate of emergency visit claims for patients of participating physicians who received feedback reports dropped an average of 41% from the same quarter a year earlier, compared to only 18% for comparison community physicians. Although only a third of the intervention community physicians participated in the training, emergency visit rates for all intervention community physicians nonetheless declined by 6% relative to the comparison community among moderate-to-severe asthma patients when data for participating and nonparticipating physicians were combined. At the same time, the dispensing of some reliever drugs recommended for asthma increased 25% relative to the comparison community. A cost-effectiveness analysis projected direct savings to Medicaid of $3 to $4 for every incremental dollar spent providing disease management support to physicians. The results of this study demonstrate the potential this program offers, especially for Medicaid programs in other states that want to improve the care of their primary care case management networks and, at the same time, manage costs.

  16. Intermediate Outcomes, Strategies, and Challenges of Eight Healthy Start Projects

    PubMed Central

    Walker, Deborah Klein; Hargreaves, Margaret; Rosenbach, Margo

    2008-01-01

    Site visits were conducted for the evaluation of the national Healthy Start program to gain an understanding of how projects design and implement five service components (outreach, case management, health education, depression screening and interconceptional care) and four system components (consortium, coordination/collaboration, local health system action plan and sustainability) as well as program staff’s perceptions of these components’ influence on intermediate outcomes. Interviews with project directors, case managers, local evaluators, clinicians, consortium members, outreach/lay workers and other stakeholders were conducted during 3-day in-depth site visits with eight Healthy Start grantees. Grantees reported that both services and systems components were related to self-reported service achievements (e.g. earlier entry into prenatal care) and systems achievements (e.g. consumer involvement). Outreach, case management, and health education were perceived as the service components that contributed most to their achievements while consortia was perceived as the most influential systems component in reaching their goals. Furthermore, cultural competence and community voice were overarching project components that addressed racial/ethnic disparities. Finally, there was great variability across sites regarding the challenges they faced, with poor service availability and limited funding the two most frequently reported. Service provision and systems development are both critical for successful Healthy Start projects to achieve intermediate program outcomes. Unique contextual and community issues influence Healthy Start project design, implementation and reported accomplishments. All eight projects implement the required program components yet outreach, case management, and health education are cited most frequently for contributing to their perceived achievements. PMID:19011959

  17. The Diabetes Management Education Program in South Texas: An Economic and Clinical Impact Analysis.

    PubMed

    Kash, Bita A; Lin, Szu-Hsuan; Baek, Juha; Ohsfeldt, Robert L

    2017-01-01

    Diabetes is a major chronic disease that can lead to serious health problems and high healthcare costs without appropriate disease management and treatment. In the United States, the number of people diagnosed with diabetes and the cost for diabetes treatment has dramatically increased over time. To improve patients' self-management skills and clinical outcomes, diabetes management education (DME) programs have been developed and operated in various regions. This community case study explores and calculates the economic and clinical impacts of expanding a model DME program into 26 counties located in South Texas. The study sample includes 355 patients with type 2 diabetes and a follow-up hemoglobin A1c level measurement among 1,275 individuals who participated in the DME program between September 2012 and August 2013. We used the Gilmer's cost differentials model and the United Kingdom Prospective Diabetes Study (UKPDS) Risk Engine methodology to predict 3-year healthcare cost savings and 10-year clinical benefits of implementing a DME program in the selected 26 Texas counties. Changes in estimated 3-year cost and the estimated treatment effect were based on baseline hemoglobin A1c level. An average 3-year reduction in medical treatment costs per program participant was $2,033 (in 2016 dollars). The total healthcare cost savings for the 26 targeted counties increases as the program participation rate increases. The total projected cost saving ranges from $12 million with 5% participation rate to $185 million with 75% participation rate. A 10-year outlook on additional clinical benefits associated with the implementation and expansion of the DME program at 60% participation is estimated to result in approximately 4,838 avoided coronary heart disease cases and another 392 cases of avoided strokes. The implementation of this model DME program in the selected 26 counties would contribute to substantial healthcare cost savings and clinical benefits. Organizations that provide DME services may benefit from reduction in medical treatment costs and improvement in clinical outcomes for populations with diabetes.

  18. Personnel Management. Universities.

    ERIC Educational Resources Information Center

    Ohio Board of Regents, Columbus. Management Improvement Program.

    This manual is one of 10 completed in the Ohio Management Improvement Program (MIP) during the 1971-73 biennium. In this project, Ohio's 34 public universities and colleges, in an effort directed and staffed by the Ohio Board of Regents, have developed manuals of management practices, in this case, concerning personnel management. Emphasis in this…

  19. An epidemiologic perspective on a case management program.

    PubMed

    Kahler, Deborah; Salber, Patricia; Wilson, Thomas

    2010-01-01

    to improve a case management (CM) program using the principles and tools of epidemiology. Specifically, to use epidemiology to describe the population being managed, to analyze factors influencing outcomes, to assess the degree to which the CM process (or intervention) is related to those outcomes, to utilize the findings in order to make recommendations (to take action) for both better evaluation and improved and more efficient CM process, to provide an estimate of the impact of the CM program based on the comparison of pre-CM and post-CM interventions, and finally to discuss the caveat that pre-CM period probably does not provide a prediction of patterns to be expected in the post-CM period had CM not been present (an ideal, but difficult-to-find referent population for this kind of effectiveness analysis). a Medicare Advantage health plan. there were a total of 12,185 individuals who met the continuous enrollment requirement of 6 months (28 days) prior to initial contact with the CM department and 6 months after the contact date: 53% were female; the average age was 73.9 (standard deviation = ± 9.5). There was a linear relationship between the average "dose" of CM-as measured by the number of times a case manager had contact with a case-and the risk profile of the case-as measured by a standard risk assessment tool provided by the Centers for Medicare & Medicaid Services. The month-to-month costs for the study population prior to CM showed a sharp rise in the month prior to the initial contact with CM and a sharp decline beginning before the contact. This pattern was consistent across different risk profiles and our operational definition of CM "dose."The average costs 6 months prior to CM were higher than the average costs 6 months after the CM. The difference in cost varied by "dose" category. When coupled with the number of cases per dosage category, the greatest value for the CM program was in the management of moderate risk cases called two to four times.However, some of the overall decline that begins prior to the initial CM contact is likely attributed to "regression to the mean" (i.e., costs may have shown a decline in spite of CM) but not all. Subsequent studies will be designed to assess the degree to which this is the case by including an equivalent referent; ideally, one that has not experienced CM or, in the absence of that, one that experienced a different kind of CM so that a valid "comparative effectiveness" study can be conducted. the "dose" of CM to its cases was in synch with an independent assessment of risk of the cases. This implies that case managers were directing their resources to those in need. However, case managers and CM processes are a limited resource and it is of interest for management to allocate those CM resources in the most efficient way possible. Methods of assessment based on individual experiences of case managers can be improved with structured, population-based assessment. These population-based tools, according to the principles of epidemiology, will be used to better allocate CM resources for optimized impact on patient populations in the future.

  20. Development of hydronephrosis secondary to poorly managed neurogenic bowel requiring surgical disimpaction in a patient with spinal cord injury: A case report

    PubMed Central

    Downs, Jairon; Wolfe, Tracy; Walker, Heather

    2014-01-01

    Context Case of an adult patient with paraplegia managing neurogenic bladder with intermittent catheterization who was not performing a standard bowel program for management of neurogenic bowel. Findings Patient presented with increasing spasticity, fecal incontinence, and abdominal pain and ultimately was hospitalized for management. Imaging revealed massive fecal impaction, resulting in ureteral obstruction and hydronephrosis. Despite repeated aggressive bowel regimens, serial abdominal X-rays showed continued large stool burden. Ultimately surgical intervention was required to evacuate the colon and subsequently the hydronephrosis resolved. Conclusion/Clinical relevance This case illustrates the importance of proper management of neurogenic bowel, as significant medical complications, such as hydronephrosis can occur with poorly managed neurogenic bowel. PMID:24617444

  1. Tuberculosis genotyping information management system: enhancing tuberculosis surveillance in the United States.

    PubMed

    Ghosh, Smita; Moonan, Patrick K; Cowan, Lauren; Grant, Juliana; Kammerer, Steve; Navin, Thomas R

    2012-06-01

    Molecular characterization of Mycobacterium tuberculosis complex isolates (genotyping) can be used by public health programs to more readily identify tuberculosis (TB) transmission. The Centers for Disease Control and Prevention's National Tuberculosis Genotyping Service has offered M. tuberculosis genotyping for every culture-confirmed case in the United States since 2004. The TB Genotyping Information Management System (TB GIMS), launched in March 2010, is a secure online database containing genotype results linked with case characteristics from the national TB registry for state and local TB programs to access, manage and analyze these data. As of September 2011, TB GIMS contains genotype results for 89% of all culture-positive TB cases for 2010. Over 400 users can generate local and national reports and maps using TB GIMS. Automated alerts on geospatially concentrated cases with matching genotypes that may represent outbreaks are also generated by TB GIMS. TB genotyping results are available to enhance national TB surveillance and apply genotyping results to conduct TB control activities in the United States. Published by Elsevier B.V.

  2. The Business of Internationalisation: Emerging Issues for the Entrepreneurial University. AIR 1999 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Poole, David; Pratt, Graham

    This paper analyzes various strategic management models for international programs from an Australian perspective. It presents the results of a qualitative case study of one Australian university faculty of business in the context of the relevance of chaos and complexity theories to strategic management. The case study is organized around the…

  3. Integrated Project Management: A Case Study in Integrating Cost, Schedule, Technical, and Risk Areas

    NASA Technical Reports Server (NTRS)

    Smith, Greg

    2004-01-01

    This viewgraph presentation describes a case study as a model for integrated project management. The ISS Program Office (ISSPO) developed replacement fluid filtration cartridges in house for the International Space Station (ISS). The presentation includes a step-by-step procedure and organizational charts for how the fluid filtration problem was approached.

  4. The Diploma in Rehabilitation Studies--The Birth of a New Form of Industry-Driven Learning.

    ERIC Educational Resources Information Center

    Leberman, Sarah I.

    The Accident Rehabilitation and Compensation Insurance Corporation (ARCIC) provides no-fault rehabilitation and compensation to all New Zealanders. In order to meet the training needs created by ARCIC's recent shift to a case management approach, the Victoria University of Wellington instituted a program to train case managers. The 27-week program…

  5. The Impact of Arbitration Intervention Services on Psychosocial Functioning: A Follow-Up Study

    ERIC Educational Resources Information Center

    Dembo, Richard; Wareham, Jennifer; Poythress, Norman G.; Cook, Brittany; Schmeidler, James

    2006-01-01

    We report the impact of case management services on drug use and self-reported delinquency for youths involved in a clinical trial of the Juvenile Arbitration program. The project evaluated an innovative intervention service providing 16 weeks of intensive case management services to youths and their families. The present study examines interview…

  6. 77 FR 5865 - Privacy Act; System of Records: State-59, Refugee Case Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-06

    ..., pursuant to the provisions of the Privacy Act of 1974, as amended (5 U.S.C. 552a) and Office of Management... with the Office of Management and Budget. The amended system description, ``Refugee Case Records, State... Presidential Documents, Pg. 2880 (Refugee Resettlement Grants Program); Refugee Crisis in Iraq Act of 2007...

  7. Involving Employers in Training: Case Studies. Research and Evaluation Report Series 97-J.

    ERIC Educational Resources Information Center

    Isbell, Kellie; Trutko, John W.; Barnow, Burt S.; Nightengale, Demetra; Pindus, Nancy

    This document contains in-depth descriptions and assessments of 17 exemplary employer-based training (EBT) programs that were studied as part of an examination of EBT programs. The case studies are based on site visits to each firm, during which interviews were conducted with company management, supervisors of workers in training, individuals…

  8. A review of recent literature - nurse case managers in diabetes care: equivalent or better outcomes compared to primary care providers.

    PubMed

    Watts, Sharon A; Lucatorto, Michelle

    2014-07-01

    Primary care has changed remarkably with chronic disease burden growth. Nurse case managers assist with this chronic disease by providing if not significantly better care, than equivalent care to that provided by usual primary care providers. Chronic disease management requires patient-centered skills and tools, such as registries, panel management, review of home data, communicating with patients outside of face-to-face care, and coordinating multiple services. Evidence reviewed in this article demonstrates that registered nurse care managers (RNCM) perform many actions required for diabetes chronic disease management including initiation and titration of medications with similar or improved physiologic and patient satisfaction outcomes over usual care providers. Selection and training of the nurse case managers is of utmost importance for implementation of a successful chronic disease management program. Evidence based guidelines, algorithms, protocols, and adequate ongoing education and mentoring are generally cited as necessary support tools for the nurse case managers.

  9. Case Management Directors

    PubMed Central

    Bankston White, Cheri; Birmingham, Jackie

    2015-01-01

    Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care of patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. This is Part 2 of a two-part article written for case management directors, particularly new ones. Part 1 covered the first 4 of 7 tracks: (1) Staffing and Human Resources, (2) Compliance and Accreditation, (3) Discharge Planning and (4) Utilization Review and Revenue Cycle. Part 2 addresses (5) Internal Departmental Relationships (Organizational), (6) External Relationships (Community Agency), and (7) Quality and Program Outcomes. This article attempts to answer the following questions: Are case management directors prepared for an expanded role that affects departments and organizations outside of their own?How does a case management director manage the transition of care of patients while managing required relationships outside the department?How does the director manage program outcomes in such a complex department? Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems and have frontline case managers (CMs) reporting to them. Findings/Conclusions: Part 1 found that case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. The same conclusion applies to Part 2, which addresses the director's responsibilities outside her immediate department. Leadership and management skills apply as well to building strong, productive relationships across a broad spectrum of external organizations that include payer, provider, and regulatory agencies. At the same time, they must also develop the skills to positively influence the revenue cycle and financial health of both the organization for which they work and those to whom they transition patients. Implications for Case Management: A director of case management with responsibility for transitions of care has more power and influence over patient safety than is commonly known. Few of the directors who are drawn from clinical case management or other leadership positions and thrust into this role are prepared to navigate within the organization, much less across the whole spectrum of payer, provider, and monitoring organizations. Yet the external focus of the director's role continues to grow in importance as the health care industry evolves and more focus is placed on population management and relationships with payers and community providers. PMID:25700135

  10. Plant invasions in mountains: Global lessons for better management

    USGS Publications Warehouse

    McDougall, K.L.; Khuroo, A.A.; Loope, L.L.; Parks, C.G.; Pauchard, A.; Reshi, Z.A.; Rushworth, I.; Kueffer, C.

    2011-01-01

    Mountains are one of few ecosystems little affected by plant invasions. However, the threat of invasion is likely to increase because of climate change, greater anthropogenic land use, and continuing novel introductions. Preventive management, therefore, will be crucial but can be difficult to promote when more pressing problems are unresolved and predictions are uncertain. In this essay, we use management case studies from 7 mountain regions to identify common lessons for effective preventive action. The degree of plant invasion in mountains was variable in the 7 regions as was the response to invasion, which ranged from lack of awareness by land managers of the potential impact in Chile and Kashmir to well-organized programs of prevention and containment in the United States (Hawaii and the Pacific Northwest), including prevention at low altitude. In Australia, awareness of the threat grew only after disruptive invasions. In South Africa, the economic benefits of removing alien plants are well recognized and funded in the form of employment programs. In the European Alps, there is little need for active management because no invasive species pose an immediate threat. From these case studies, we identify lessons for management of plant invasions in mountain ecosystems: (i) prevention is especially important in mountains because of their rugged terrain, where invasions can quickly become unmanageable; (ii) networks at local to global levels can assist with awareness raising and better prioritization of management actions; (iii) the economic importance of management should be identified and articulated; (iv) public acceptance of management programs will make them more effective; and (v) climate change needs to be considered. We suggest that comparisons of local case studies, such as those we have presented, have a pivotal place in the proactive solution of global change issues. ?? International Mountain Society.

  11. U.S. Army Medical Department Journal, July-September 2005

    DTIC Science & Technology

    2005-09-01

    problems exposed by the press in Oct 03, Fort Lewis formalized Remote Care the Remote Care Program with protocols agreed by senior level commanders...workload of MAMC, like most of the formal work of the case management practice to identify key AMEDD, has not decreased with combat deployments and, in...and return to SRCMP within 72 hours, receive a formal case couches with sitting and standing Soldiers drinking coffee and number, Case Manager, and

  12. Violent reinjury risk assessment instrument (VRRAI) for hospital-based violence intervention programs.

    PubMed

    Kramer, Erik J; Dodington, James; Hunt, Ava; Henderson, Terrell; Nwabuo, Adaobi; Dicker, Rochelle; Juillard, Catherine

    2017-09-01

    Violent injury is the second most common cause of death among 15- to 24-year olds in the US. Up to 58% of violently injured youth return to the hospital with a second violent injury. Hospital-based violence intervention programs (HVIPs) have been shown to reduce injury recidivism through intensive case management. However, no validated guidelines for risk assessment strategies in the HVIP setting have been reported. We aimed to use qualitative methods to investigate the key components of risk assessments employed by HVIP case managers and to propose a risk assessment model based on this qualitative analysis. An established academic hospital-affiliated HVIP served as the nexus for this research. Thematic saturation was reached with 11 semi-structured interviews and two focus groups conducted with HVIP case managers and key informants identified through snowball sampling. Interactions were analyzed by a four-member team using Nvivo 10, employing the constant comparison method. Risk factors identified were used to create a set of models presented in two follow-up HVIP case managers and leadership focus groups. Eighteen key themes within seven domains (environment, identity, mental health, behavior, conflict, indicators of lower risk, and case management) and 141 potential risk factors for use in the risk assessment framework were identified. The most salient factors were incorporated into eight models that were presented to the HVIP case managers. A 29-item algorithmic structured professional judgment model was chosen. We identified four tiers of risk factors for violent reinjury that were incorporated into a proposed risk assessment instrument, VRRAI. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Problems and Issues in Using Emerging Computer Technologies To Manage and Evaluate Instructional Programs 1, 2, 3.

    ERIC Educational Resources Information Center

    Atwood, Nancy K.

    School districts have begun examining the feasibility of, and in some cases are developing and implementing automated systems for, managing and evaluating instructional programs. This paper describes and analyzes the issues and problems that emerged over the course of three projects--a large suburban school in the West, a consortium of five small…

  14. Tour NASA’s Kennedy Space Center LIVE with Director Bob Cabana and GSDO Associate Program Manager Shawn Quinn

    NASA Image and Video Library

    2017-05-23

    We experienced some technical issues during our live stream of Behind The Scenes at NASA’s Kennedy Space Center. In case you missed it, please enjoy the show with Director Bob Cabana, and an exclusive tour inside the Vehicle Assembly Building (VAB) with Ground Systems Development Office (GSDO) Associate Program Manager Shawn Quinn

  15. How Schools and Students Respond to School Improvement Programs: The Case of Brazil's PDE

    ERIC Educational Resources Information Center

    Carnoy, Martin; Gove, Amber K.; Loeb, Susanna; Marshall, Jeffrey H.; Socias, Miguel

    2008-01-01

    This study uses rich empirical data from Brazil to assess how a government program (PDE) that decentralizes school management decisions changes what goes on in schools and how these changes affect student outcomes. It appears that the PDE resulted in some improvements in management and learning materials, but little change in other areas including…

  16. Economic assessment of home-based COPD management programs.

    PubMed

    Liu, Sheena Xin; Lee, Michael C; Atakhorrami, Maryam; Tatousek, Jan; McCormack, Meredith; Yung, Rex; Hart, Nicholas; White, David P

    2013-12-01

    Home-based exacerbation management programs have been proposed as an approach to reducing the clinical and financial burden of COPD. We demonstrate a framework to evaluate such programs in order to guide program design and performance decisions towards optimizing cost and clinical outcomes. This study models the impact of hypothetical exacerbation management programs through probabilistic Markov simulations. Patients were stratified by risk using exacerbation rates from the ECLIPSE study and expert opinion. Three scenarios were modeled, using base, worst and best case parameters to suggest potential telehealth program performance. In these scenarios, acute exacerbations could be detected early, with sensitivity and specificity ranging from 60-90%. Detected acute exacerbations could be diverted to either a sub-acute pathway (12.5-50% probability), thus entirely avoiding hospitalization, or a lower cost pathway through length-of-stay reduction (14-28% reduction). For a cohort of patients without prior hospitalization, the base case telehealth scenario results in a cumulative per-patient lifetime savings of $2.9 K over ≈ 12 years. For a higher risk cohort of patients with a prior admission and 1 to 2 acute exacerbations per year, a cumulative $16K per patient was saved during the remaining ≈ 3 life-years. Acceptable prices for home-based exacerbation detection testing were highly dependent on patient risk and scenario, but ranged from $290-$1263 per month for the highest risk groups. These results suggest the economic viability of exacerbation management programs and highlight the importance of risk stratification in such programs. The presented model can further be adapted to model specific programs as trial data becomes available.

  17. Health economic evaluation of an infection prevention and control program: are quality and patient safety programs worth the investment?

    PubMed

    Raschka, Stefanie; Dempster, Linda; Bryce, Elizabeth

    2013-09-01

    The effect of regional consolidation of an infection prevention and control (IPC) program on reduction of selected health care-acquired infections (HAIs), the economic burden of these illnesses, and where the potential for greatest financial benefit in reducing infection rates lies was assessed. Cost-benefit analysis (in Canadian $) was used to evaluate the effectiveness of a regional IPC program in preventing incident cases of HAIs. The costs of managing these infections, as well as the operational costs of the IPC program were compared against reductions in HAI rates over a 4-year period. Benefits were calculated as cost avoided by reducing HAI cases year over year. The Health Authority spent more than $66.3 million managing 24,937 HAI cases over the 4-year evaluation period. Urinary tract infections, methicillin-resistant Staphylococcus aureus, and bacteremias incurred the greatest costs. A reduction of 4,739 HAI cases led to avoided costs of $9.1 million in 4 years; the IPC program budget was $6.7 million during this period. Regionalization of the IPC program with standardized policies, procedures, and initiatives led to a 19% reduction in selected HAIs over 4 years and a cost avoidance of at least $9 million. This was particularly evident in years 3 and 4 of the program when $7.2 million (79% of the total) savings were realized. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  18. RMP*Comp

    EPA Pesticide Factsheets

    You can use this free software program to complete the Off-site Consequence Analyses (both worst case scenarios and alternative scenarios) required under the Risk Management Program rule, so that you don't have to do calculations by hand.

  19. 26 CFR 1.162-1 - Business expenses.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... included in business expenses are management expenses, commissions (but see section 263 and the regulations... from such business. In the case of any sports program to which section 114 (relating to sports programs...

  20. 26 CFR 1.162-1 - Business expenses.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... included in business expenses are management expenses, commissions (but see section 263 and the regulations... from such business. In the case of any sports program to which section 114 (relating to sports programs...

  1. 26 CFR 1.162-1 - Business expenses.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... included in business expenses are management expenses, commissions (but see section 263 and the regulations... from such business. In the case of any sports program to which section 114 (relating to sports programs...

  2. 26 CFR 1.162-1 - Business expenses.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... included in business expenses are management expenses, commissions (but see section 263 and the regulations... from such business. In the case of any sports program to which section 114 (relating to sports programs...

  3. Get Connected: an HIV prevention case management program for men and women leaving California prisons.

    PubMed

    Myers, Janet; Zack, Barry; Kramer, Katie; Gardner, Mick; Rucobo, Gonzalo; Costa-Taylor, Stacy

    2005-10-01

    Individuals leaving prison face challenges to establishing healthy lives in the community, including opportunities to engage in behavior that puts them at risk for HIV transmission. HIV prevention case management (PCM) can facilitate linkages to services, which in turn can help remove barriers to healthy behavior. As part of a federally funded demonstration project, the community-based organization Centerforce provided 5 months of PCM to individuals leaving 3 state prisons in California. Program effects were measured by assessing changes in risk behavior, access to services, reincarnation, and program completion. Although response rates preclude definitive conclusions, HIV risk behavior did decrease. Regardless of race, age, or gender, those receiving comprehensive health services were significantly more likely to complete the program. PCM appears to facilitate healthy behavior for individuals leaving prison.

  4. Identifying Variability in Permanent Supportive Housing: A comparative effectiveness approach to measuring health outcomes

    PubMed Central

    Dickson-Gomez, Julia; Quinn, Katherine; Bendixen, Arturo; Johnson, Amy; Nowicki, Kelly; Ko, Thant Ko; Galletly, Carol

    2017-01-01

    Supportive housing has become the dominant model in the United States to provide housing to chronically homeless and to improve their housing stability and health. Most supportive housing programs follow a “housing first” paradigm modeled after the Pathways to Housing program in New York City. However, components of housing first supportive housing models were poorly defined and supportive models have varied considerably in their dissemination and implementation to other parts of the country. Recently, research has been conducted to determine the fidelity by which specific housing programs adhere to the Pathways Housing First model. However, evidence regarding which combination of components leads to better health outcomes for particular subpopulations is lacking. This paper presents results from qualitative interviews with supportive housing providers in the Chicago Metropolitan area. Supportive housing varied according to housing configuration (scattered-site versus project-based) and service provision model (low-intensity case management, intensive case management and behavioral health) resulting in six basic types. Supportive housing programs also differed in services they provided in addition to case management and the extent to which they followed harm reduction versus abstinence policies. Results showed advantages and disadvantages to each of the six basic types. Comparative effectiveness research may help identify which program components lead to better health outcomes among different subpopulations of homeless. Future longitudinal research will use the identified typology and other factors to compare the housing stability and health outcomes of supportive housing residents in programs that differ along these dimensions. PMID:28301175

  5. Four Generations of Maintenance Resource Management Programs in the United States: An Analysis of the Past, Present, and Future

    NASA Technical Reports Server (NTRS)

    Taylor, James C.; Patankar, Manoj S.

    2001-01-01

    This paper analyzes four generations of Maintenance Resource Management (MRM) programs implemented by aviation maintenance organizations in the United States. Data collected from over ten years of survey research and field observations are used for this analysis; they are presented in a case-study format. The first three generations of MRM programs were episodic efforts to increase safety through teamwork, focus group discussions, and awareness courses, respectively. Now, the fourth generation programs, characterized by a commitment to long-term communication and behavioral changes in maintenance, are set to build on those earlier generations, toward a culture of mutual trust between mechanics, their managers, and regulators.

  6. Computer aided system engineering and analysis (CASE/A) modeling package for ECLS systems - An overview

    NASA Technical Reports Server (NTRS)

    Dalee, Robert C.; Bacskay, Allen S.; Knox, James C.

    1990-01-01

    An overview of the CASE/A-ECLSS series modeling package is presented. CASE/A is an analytical tool that has supplied engineering productivity accomplishments during ECLSS design activities. A components verification program was performed to assure component modeling validity based on test data from the Phase II comparative test program completed at the Marshall Space Flight Center. An integrated plotting feature has been added to the program which allows the operator to analyze on-screen data trends or get hard copy plots from within the CASE/A operating environment. New command features in the areas of schematic, output, and model management, and component data editing have been incorporated to enhance the engineer's productivity during a modeling program.

  7. Inequitable provision of optimal services for patients with chronic heart failure: a national geo-mapping study.

    PubMed

    Clark, Robyn A; Driscoll, Andrea; Nottage, Justin; McLennan, Skye; Coombe, David M; Bamford, Errol J; Wilkinson, David; Stewart, Simon

    2007-02-19

    To compare the location and accessibility of current Australian chronic heart failure (CHF) management programs and general practice services with the probable distribution of the population with CHF. Data on the prevalence and distribution of the CHF population throughout Australia, and the locations of CHF management programs and general practice services from 1 January 2004 to 31 December 2005 were analysed using geographic information systems (GIS) technology. Distance of populations with CHF to CHF management programs and general practice services. The highest prevalence of CHF (20.3-79.8 per 1000 population) occurred in areas with high concentrations of people over 65 years of age and in areas with higher proportions of Indigenous people. Five thousand CHF patients (8%) discharged from hospital in 2004-2005 were managed in one of the 62 identified CHF management programs. There were no CHF management programs in the Northern Territory or Tasmania. Only four CHF management programs were located outside major cities, with a total case load of 80 patients (0.7%). The mean distance from any Australian population centre to the nearest CHF management program was 332 km (median, 163 km; range, 0.15-3246 km). In rural areas, where the burden of CHF management falls upon general practitioners, the mean distance to general practice services was 37 km (median, 20 km; range, 0-656 km). There is an inequity in the provision of CHF management programs to rural Australians.

  8. A Symbiosis between Instructional Systems Design and Project Management

    ERIC Educational Resources Information Center

    Pan, Cheng-Chang

    2012-01-01

    This study is intended to explore a complementary relationship between instructional systems design (ISD) and project management in an attempt to build a plausible case for integrating project management as a distinct course in the core of the graduate instructional systems design programs. It is argued that ISD and project management should form…

  9. An Evaluation of Management Training and Coaching

    ERIC Educational Resources Information Center

    Berg, Morten Emil; Karlsen, Jan Terje

    2012-01-01

    Purpose: The focus of this paper is on management training and development. The purpose has been to address how coaching can be applied to learn about leadership tools and what effect this has on management behaviour and development. Design/methodology/approach: This is a qualitative case study of a management development program. The empirical…

  10. Program budgeting and marginal analysis: a case study in chronic airflow limitation.

    PubMed

    Crockett, A; Cranston, J; Moss, J; Scown, P; Mooney, G; Alpers, J

    1999-01-01

    Program budgeting and marginal analysis is a method of priority-setting in health care. This article describes how this method was applied to the management of a disease-specific group, chronic airflow limitation. A sub-program flow chart clarified the major cost drivers. After assessment of the technical efficiency of the sub-programs and careful and detailed analysis, incremental and decremental wish lists of activities were established. Program budgeting and marginal analysis provides a framework for rational resource allocation. The nurturing of a vigorous program management group, with members representing all participants in the process (including patients/consumers), is the key to a successful outcome.

  11. The Development of MUMPS-Based Rehabilitation Psychology Computer Applications.

    ERIC Educational Resources Information Center

    Dutro, Kenneth R.

    The use of computer assisted programs in career exploration and occupational information is well documented. Various phases of the vocational counseling process, i.e., diagnostic evaluation, program planning, career exploration, case management, and program evaluation, offer similarly promising opportunities for computerization. Using the…

  12. Effects of pay-for-performance system on tuberculosis default cases control and treatment in Taiwan.

    PubMed

    Tsai, Wen-Chen; Kung, Pei-Tseng; Khan, Mahmud; Campbell, Claudia; Yang, Wen-Ta; Lee, Tsuey-Fong; Li, Ya-Hsin

    2010-09-01

    In order to make tuberculosis (TB) treatment more effective and to lower the default rate of the disease, the Bureau of National Health Insurance (BNHI) in Taiwan implemented the "pay-for-performance on Tuberculosis" program (P4P on TB) in 2004. The purpose of this study is to investigate the effectiveness of the P4P system in terms of default rate. This is a retrospective study. National Health Insurance Research Datasets in Taiwan from 2002 to 2005 has been used for the study. The study compared the differences of TB default rate before and after the implementation of P4P program, between participating and non-participating hospitals, and between P4P hospitals with and without case managers. Furthermore, logistic regression analysis was conducted to explore the related factors influencing TB patients default treatment after TB detected. The treatment default rate after "P4P on TB" was 11.37% compared with the 15.56% before "P4P on TB" implementation. The treatment default rate in P4P hospitals was 10.67% compared to 12.7% in non-P4P hospitals. In addition, the default rate was 10.4% in hospitals with case managers compared with 12.68% in hospitals without case managers. The results of the study showed that "P4P on TB" program improved the treatment default rate for TB patients. In addition, case managers improved the treatment outcome in controlling patients' default rate. Copyright 2010 The British Infection Society. Published by Elsevier Ltd. All rights reserved.

  13. 15 CFR 923.44 - State review on a case-by-case basis of actions affecting land and water uses subject to the...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS Authorities and Organization § 923.44 State review on... specified in subsection 306(d)(11) of the Act for control of land and water uses within the coastal zone...

  14. Exploring Enrollment Management for an Independent, Faith-Based, Secondary School: A Case Study

    ERIC Educational Resources Information Center

    McMaster, Jason Andrew

    2017-01-01

    This single site case study looked specifically at the foundation and the structure of an independent school in California with respect to how it managed its enrollment and retention rates. For context, the institution being studied utilized a high-tuition strategy combined with a strong financial aid program. In 2012, the school peaked in its…

  15. "Another Link in the Chain" Update: State Policies and Practices for Case Management and Environmental Investigation for Lead-Poisoned Children.

    ERIC Educational Resources Information Center

    McLaine, Pat; Gaitens, Joanna

    This report details a national survey, conducted in 2000, to document changes since 1998 in policies and practices for case management and environmental investigation for lead poisoned children; the study also investigated the impact of the previous national survey in precipitating change. Participating in the survey were program directors or…

  16. A Statewide Case Management, Surveillance, and Outcome Evaluation System for Children with Special Health Care Needs

    PubMed Central

    Monsen, Karen A.; Elsbernd, Scott A.; Barnhart, Linda; Stock, Jacquie; Prock, Carla E.; Looman, Wendy S.; Nardella, Maria

    2013-01-01

    Objectives. To evaluate the feasibility of implementing a statewide children with special health care needs (CSHCN) program evaluation, case management, and surveillance system using a standardized instrument and protocol that operationalized the United States Health and Human Services CSHCN National Performance Measures. Methods. Public health nurses in local public health agencies in Washington State jointly developed and implemented the standardized system. The instrument was the Omaha System. Descriptive statistics were used for the analysis of standardized data. Results. From the sample of CSHCN visit reports (n = 127), 314 problems and 853 interventions were documented. The most common problem identified was growth and development followed by health care supervision, communication with community resources, caretaking/parenting, income, neglect, and abuse. The most common intervention category was surveillance (60%), followed by case management (24%) and teaching, guidance, and counseling (16%). On average, there were 2.7 interventions per problem and 6.7 interventions per visit. Conclusions. This study demonstrates the feasibility of an approach for statewide CSHCN program evaluation, case management, and surveillance system. Knowledge, behavior, and status ratings suggest that there are critical unmet needs in the Washington State CSHCN population for six major problems. PMID:23533804

  17. 14 CFR 91.1017 - Amending program manager's management specifications.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... applicant for the amendment to become effective, unless a shorter time is approved, in cases such as mergers, acquisitions of operational assets that require an additional showing of safety (for example, proving tests or...

  18. Six-month Outcomes of Mobile Phone Application-based Self-management in a Patient with Type 2 Diabetes.

    PubMed

    Hong, Mi Kyeong; Cho, Young Yun; Rha, Mi Yong; Kim, Jae Hyeon; Lee, Moon-Kyu

    2015-07-01

    We report the case in order to examine the effect of a mobile application program ("Diabetes & Nutrition") developed in 2011-2012 for self-management in patients with type 2 diabetes and to recommend important considerations when the mobile application program is developed. A 46-year-old man was newly diagnosed with type 2 diabetes in 2013 and had no complications. The height of the patient was 168 cm and the body weight was 75.6 kg. Nutrition education was conducted according to a medical prescription, and follow-up nutrition education was conducted after 3 and 6 months. After nutrition education, the patient was engaged in self-management using "Diabetes & Nutrition" program during 3 months. At 3 months, the body weight had decreased by 4.4 kg (from 75.6 to 71.2 kg), waist circumference by 5 cm (from 88 to 83 cm) and HbA1c level from 7.9% to 6.1%. Also at 3 months, the medication was reduced from from the dose of 850 mg to the dose of 500 mg metformin per twice a day. Since then, the patient did not continue to use the "Diabetes & Nutrition" because the level of blood glucose had stabilized, and the patient felt inconvenient and annoying to use the program. At 6 months, no significant change in the body weight and body composition was observed in comparison with those at 3 months. The present case demonstrates that the early use of "Diabetes & Nutrition" could be helpful for self-management of glycemic control in patients with type 2 diabetes. Developing self-management mobile application programs in the future will require strategies of how to promote continuous use of application program and self-management of type 2 diabetes.

  19. NASA Schedule Management Handbook

    NASA Technical Reports Server (NTRS)

    2011-01-01

    The purpose of schedule management is to provide the framework for time-phasing, resource planning, coordination, and communicating the necessary tasks within a work effort. The intent is to improve schedule management by providing recommended concepts, processes, and techniques used within the Agency and private industry. The intended function of this handbook is two-fold: first, to provide guidance for meeting the scheduling requirements contained in NPR 7120.5, NASA Space Flight Program and Project Management Requirements, NPR 7120.7, NASA Information Technology and Institutional Infrastructure Program and Project Requirements, NPR 7120.8, NASA Research and Technology Program and Project Management Requirements, and NPD 1000.5, Policy for NASA Acquisition. The second function is to describe the schedule management approach and the recommended best practices for carrying out this project control function. With regards to the above project management requirements documents, it should be noted that those space flight projects previously established and approved under the guidance of prior versions of NPR 7120.5 will continue to comply with those requirements until project completion has been achieved. This handbook will be updated as needed, to enhance efficient and effective schedule management across the Agency. It is acknowledged that most, if not all, external organizations participating in NASA programs/projects will have their own internal schedule management documents. Issues that arise from conflicting schedule guidance will be resolved on a case by case basis as contracts and partnering relationships are established. It is also acknowledged and understood that all projects are not the same and may require different levels of schedule visibility, scrutiny and control. Project type, value, and complexity are factors that typically dictate which schedule management practices should be employed.

  20. Two-year outcome of team-based intensive case management for patients with schizophrenia.

    PubMed

    Aberg-Wistedt, A; Cressell, T; Lidberg, Y; Liljenberg, B; Osby, U

    1995-12-01

    Two-year outcomes of patients with schizophrenic disorders who were assigned to an intensive, team-based case management program and patients who received standard psychiatric services were assessed. The case management model featured increased staff contact time with patients, rehabilitation plans based on patients' expressed needs, and patients' attendance at team meetings where their rehabilitation plan was discussed. Forty patients were randomly assigned to either the case management group or the control group that received standard services. Patients' use of emergency and inpatient services, their quality of life, the size of their social networks, and their relatives' burden of care were assessed at assignment to the study groups and at two-year follow-up. Patients in the case management group had significantly fewer emergency visits compared with the two years before the study, and their relatives reported significantly reduced burden of care associated with relationships with psychiatric services over the two-year period. The size of patients' social networks increased for the case management group and decreased for the control group. A team-based intensive case management model is an effective intervention in the rehabilitation of patients with chronic schizophrenia.

  1. 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…

  2. Case management needs of older and elderly cancer survivors.

    PubMed

    Stanton, Marietta; Franco, Gina; Scoggins, Reggie

    2012-01-01

    The purpose of this study was to examine the case management needs of older and elderly adults. The specific aim was to describe the results of a survey distributed to cancer survivors, asking them to respond to questions about their specific needs. The survey targeted the physical, psychosocial, social, and spiritual needs. Outpatient setting, outreach program. Fatigue, fear of reoccurrence, and sleep disturbances were of the greatest concern to the older and elderly cancer survivor. Case managers dealing with elderly cancer survivors can target these needs in terms of transitions from inpatient to outpatient care and beyond into the survivorship period.

  3. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nancy Carlisle: NREL

    This publication is one of a series of case studies of energy-efficient modern laboratories; it was prepared for "Laboratories for the 21st Century," a joint program of the Environmental Protection Agency and the U.S. DOE Federal Energy Management Program

  4. Depicting individual responses to physical therapist led chronic pain self-management support with pain science education and exercise in primary health care: multiple case studies.

    PubMed

    Miller, Jordan; MacDermid, Joy C; Richardson, Julie; Walton, David M; Gross, Anita

    2017-01-01

    Previous evidence suggests self-management programs for people with chronic pain improve knowledge and self-efficacy, but result in small to negligible changes in function. The purpose of this multiple case studies design was to describe the unique responses of six participants to a new self-management program aimed at improving function, to detail each component of the program, and to explore potential explanations for the varied trajectories of each of the participants. Six participants who had been experiencing chronic pain for at least 5 years were included. All participants were enrolled 6 weeks of ChrOnic pain self-ManageMent support with pain science EducatioN and exercise (COMMENCE). Participants completed an assessment at baseline, 7 weeks (1-week follow-up), and 18 weeks (12-week follow-up). Each participant had a unique initial presentation and goals. Assessments included: function as measured by the Short Musculoskeletal Function Assessment - Dysfunction Index, how much participants are bothered by functional difficulties, pain intensity, fatigue, pain interference, cognitive and psychological factors associated with pain and disability, pain neurophysiology, self-efficacy, satisfaction, and perceived change. The self-management program was 6-weeks in length, consisting of one individual visit and one group visit per week. The program incorporated three novel elements not commonly included in self-management programs: pain neurophysiology education, individualized exercises determined by the participants' goals, and additional cognitive behavioural approaches. Participants were all satisfied with self-management support received. Change in function was variable ranging from 59% improvement to 17% decline. Two potential explanations for variances in response, attendance and social context, are discussed. Several challenges were identified by participants as barriers to attendance. A primary care self-management intervention including pain education and individualized exercise has potential to improve function for some people with chronic pain, although strategies to improve adherence and reduce barriers to participation may be needed to optimize the impact.

  5. Managing the Social Determinants of Health: Part I: Fundamental Knowledge for Professional Case Management.

    PubMed

    Fink-Samnick, Ellen

    PRIMARY PRACTICE SETTING(S):: Applicable to health and behavioral health settings, wherever case management is practiced. The SDH pose major challenges to the health care workforce in terms of effective resource provision, health and behavioral health treatment planning plus adherence, and overall coordination of care. Obstacles and variances to needed interventions easily lead to less than optimal outcomes for case managers and their health care organizations. Possessing sound knowledge and clear understanding of each SDH, the historical perspectives, main theories, and integral dynamics, as well as creative resource solutions, all support a higher level of intentional and effective professional case management practice. Those persons and communities impacted most by the SDH comprise every case management practice setting. These clients can be among the most vulnerable and disenfranchised members of society, which can easily engender biases on the part of the interprofessional workforce. They are also among the costliest to care for with 50% of costs for only 5% of the population. Critical attention to knowledge about managing the SDH leverages and informs case management practice, evolves more effective programming, and enhances operational outcomes across practice settings.

  6. Operating a sustainable disease management program for chronic obstructive pulmonary disease.

    PubMed

    Endicott, Linda; Corsello, Phillip; Prinzi, Michele; Tinkelman, David G; Schwartz, Abby

    2003-01-01

    Chronic obstructive pulmonary disease (COPD) is one of our nation's most rapidly growing chronic health conditions. It is estimated that over 16 million individuals are diagnosed with COPD (Friedman & Hilleman, 2001). In addition, another 16 million are misdiagnosed as asthma or not diagnosed at all. COPD is a condition that affects the working-age as well as the elderly. Despite the high mortality rate, COPD is a treatable and modifiable condition. Disease management programs (DMPs) for asthma are a common initiative within many health insurance plans and integrated delivery networks. Similar initiatives are not as common for COPD. This article will highlight the National Jewish Medical and Research Center's COPD DMP interventions and outcomes. To outline interventions and operational strategies critical in developing and operating a sustainable and effective disease management program for COPD. Disease Management is an effective model for managing individuals with COPD. Applying a case management model that includes (1) risk-identification and stratification; (2) education and empowerment regarding self-monitoring and management; (3) lifestyle modification; (4) communication and collaboration amongst patients, healthcare providers, and case managers to enhance the treatment plan; (5) providing after-hours support; and (6) monitoring care outcomes is crucial. Applying these interventions in a credible manner will improve the quality of life and quality of care delivered to individuals with mild, moderate, severe, and very severe COPD. Additionally, these interventions can significantly reduce utilization events.

  7. Cyanotic Premature Babies: A Videodisc-Based Program

    PubMed Central

    Tinsley, L.R.; Ashton, G.C.; Boychuk, R.B.; Easa, D.J.

    1989-01-01

    This program for the IBM InfoWindow system is designed to assist medical students and pediatric residents with diagnosis and management of premature infants exhibiting cyanosis. The program consists of six diverse case simulations, with additional information available on diagnosis, procedures, and relevant drugs. Respiratory difficulties accompanied by cyanosis are a common problem in premature infants at or just after birth, but the full diversity of causes is rarely seen in a short training period. The purpose of the program is to assist the student or resident with diagnosis and management of a variety of conditions which they may or may not see during their training. The opening menu permits selection from six cases, covering (1) respiratory distress syndrome proceeding through patent ductus arteriosus to pneumothorax, (2) a congenital heart disorder, (3) sepsis/pneumonia, (4) persistent fetal circulation, (5) diaphragmatic hernia, and (6) tracheo-esophageal fistula. In each case the student is provided with relevant introductory information and must then proceed with diagnosis and management. At each decision point the student may view information about relevant procedures, obtain assistance with diagnosis, or see information about useful drugs. Segments between decision points may be repeated if required. Provision is made for backtracking and review of instructional segments. The program is written in IBM's InfoWindow Presentation System authoring language and the video segments are contained on one side of a standard 12″ laserdisc. The program runs on IBM's InfoWindow System, with the touch screen used to initiate all student actions. The extensive graphics in the program were developed with Storyboard Plus, using the 640×350 resolution mode. This program is one of a number being developed for the Health Sciences Interactive Videodisc Consortium, and was funded in part by IBM Corporation.

  8. Cardiac catheterization laboratory management: the fundamentals.

    PubMed

    Newell, Amy

    2012-01-01

    Increasingly, imaging administrators are gaining oversight for the cardiac cath lab as part of imaging services. Significant daily challenges include physician and staff demands, as well as patients who in many cases require higher acuity care. Along with strategic program driven responsibilities, the management role is complex. Critical elements that are the major impacts on cath lab management, as well as the overall success of a cardiac and vascular program, include program quality, patient safety, operational efficiency including inventory management, and customer service. It is critically important to have a well-qualified cath lab manager who acts as a leader by example, a mentor and motivator of the team, and an expert in the organization's processes and procedures. Such qualities will result in a streamlined cath lab with outstanding results.

  9. Case study evaluation of the Virginia Department Of Transportation's I-81 ITS program

    DOT National Transportation Integrated Search

    2002-03-15

    The primary goal of this report is to provide information to the Sponsors, Policy Committee, and Management of the I-81 Intelligent Transportation Systems (ITS) Program that may improve the Program. In order to do this, the report focuses on the deve...

  10. Enforcing Academic Rules in Higher Education--A Total Quality Management Approach. AIR 1993 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Burgar, Paul

    A case study was done of how Total Quality Management (TQM) was used in a Masters in Business Administration program to prevent rule infractions rather than to punish students. The program allowed students to take up to 20 hours of classes under an unclassified status before they took an admissions test. In order to continue, however, students…

  11. The role of predictive uncertainty in the operational management of reservoirs

    NASA Astrophysics Data System (ADS)

    Todini, E.

    2014-09-01

    The present work deals with the operational management of multi-purpose reservoirs, whose optimisation-based rules are derived, in the planning phase, via deterministic (linear and nonlinear programming, dynamic programming, etc.) or via stochastic (generally stochastic dynamic programming) approaches. In operation, the resulting deterministic or stochastic optimised operating rules are then triggered based on inflow predictions. In order to fully benefit from predictions, one must avoid using them as direct inputs to the reservoirs, but rather assess the "predictive knowledge" in terms of a predictive probability density to be operationally used in the decision making process for the estimation of expected benefits and/or expected losses. Using a theoretical and extremely simplified case, it will be shown why directly using model forecasts instead of the full predictive density leads to less robust reservoir management decisions. Moreover, the effectiveness and the tangible benefits for using the entire predictive probability density instead of the model predicted values will be demonstrated on the basis of the Lake Como management system, operational since 1997, as well as on the basis of a case study on the lake of Aswan.

  12. A case study of polypharmacy management in nine European countries: Implications for change management and implementation

    PubMed Central

    MacLure, Katie; Stewart, Derek; Kempen, Thomas; Mair, Alpana; Castel-Branco, Margarida; Codina, Carles; Fernandez-Llimos, Fernando; Fleming, Glenda; Gennimata, Dimitra; Gillespie, Ulrika; Harrison, Cathy; Illario, Maddalena; Junius-Walker, Ulrike; Kampolis, Christos F.; Kardas, Przemyslaw; Lewek, Pawel; Malva, João; Menditto, Enrica; Scullin, Claire; Wiese, Birgitt

    2018-01-01

    Background Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained. Methods Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases. Results Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation. Conclusion Within the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change management and theory-based implementation strategies, and provide examples of polypharmacy management initiatives that can assist managers and policymakers in developing new programs or scaling up existing ones, particularly in places currently lacking such initiatives. PMID:29668763

  13. [Case management process identified from experience of nurse case managers].

    PubMed

    Park, Eun-Jun; Kim, Chunmi

    2008-12-01

    The purpose of this study was to develop a substantive theory of case management (CM) practice by investigating the experience of nurse case managers caring for Medical Aid enrollees in Korea. A total of 12 nurses were interviewed regarding their own experience in CM practice. Data were recorded and analyzed using grounded theory. Empowerment was the core category of CM for Medical Aid enrollees. The case managers engaged in five phases as follows, phase of inquiring in advance, building a relationship with the client, giving the client critical mind, facilitating positive changes in the client's use of healthcare services, and maintaining relationship bonds. These phases moved gradually and were circular if necessary. Also, they were accelerated or slowed depending on factors including clients' characteristics, case managers' competency level, families' support level, and availability of community resources. This study helps understand what CM practice is and how nurses are performing this innovative CM role. It is recommended that nurse leaders and policy makers integrate empowerment as a core category and the five critical CM phases into future CM programs.

  14. Global Hawk Systems Engineering. Case Study

    DTIC Science & Technology

    2010-01-01

    Management Core System ( TBMCS ) (complex software development) • F-111 Fighter (joint program with significant involvement by the Office of the...Software Requirements Specification TACC Tailored Airworthiness Certification Criteria TBMCS Theater Battle Management Core System TEMP Test and

  15. Impact of 2 employer-sponsored population health management programs on medical care cost and utilization.

    PubMed

    Mattke, Soeren; Serxner, Seth A; Zakowski, Sarah L; Jain, Arvind K; Gold, Daniel B

    2009-02-01

    Integrated health management programs combining disease prevention and disease management services, although popular with employers, have been insufficiently researched with respect to their effect on costs. To estimate the overall impact of a population health management program and its components on cost and utilization. STUDY DESIGN, SETTING, AND PARTICIPANTS: Observational study of 2 employer-sponsored health management programs involving more than 200,000 health plan members. We used claims data for the first program year and the 2 preceding years to calculate cost and utilization metrics, and program activity data to determine program uptake. Using an intent-to-treat approach and regression-based risk adjustment, we estimated whether the program was associated with changes in cost and utilization. Data on program fees were unavailable. Overall, the program was associated with a nonsignificant cost increase of $13.75 per member per month (PMPM). The wellness component alone was associated with a significant increase of $20.14 PMPM. Case and disease management were associated with a significant decrease in hospital admissions of 4 and 1 per 1000 patient-years, respectively. Our results suggest that the programs did not reduce medical cost in their first year, despite a beneficial effect on hospital admissions. If we had been able to include program fees, it is likely that the overall cost would have increased significantly. Although this study had important limitations, the results suggest that a belief that these programs will save money may be too optimistic and better evaluation is needed.

  16. Information Management Strategies for Program Tracking and Formative Evaluation

    NASA Astrophysics Data System (ADS)

    Siegfried, D.; Detrick, L.; Valaitis, S.; Johnson, A.; Thomas, S. H.; Fauver, A.

    2013-05-01

    The Institute for Broadening Participation (IBP) has developed information management systems to facilitate programmatic formative evaluation, tracking and outreach activities. Nearly a decade of design solutions and technical implementations in support of IBP's professional development and mentoring programs for students (including the "Pathways to Ocean Science," "Minorities Striving and Pursuing Higher Degrees of Success" in Earth System Science, and "Pathways to Engineering") has provided IBP with a toolbox of proven strategies for addressing program engagement and participant tracking, outreach, and a variety of other information management needs. In this session, IBP will use case-specific examples to share general design strategies for program participant and activities data collection in REUs and other program types. The cases will illustrate an approach that begins with a review of program logic, objectives, expected outcomes, constraints and requirements, which then informs a comprehensive system design. When implemented, such information systems improve administrative efficiency through streamlined data collection processes and easy-to-use data capture forms, and a corresponding set of reporting tools provides access to data that is crucial for ongoing program improvement. IBP presents this information in response to collaborations with administrators of Research Experience for Undergraduates (REU) programs as well as longer duration programs, who have expressed the need for more comprehensive and easy to use information systems. Recently IBP has also worked with the directors of NSF and NASA funded programs seeking assistance in addressing their formative evaluation needs including system design, information collection, and reporting efforts.

  17. Estuary ecosystem restoration: implementing and institutionalizing adaptive management: Institutionalizing adaptive management

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ebberts, Blaine D.; Zelinsky, Ben D.; Karnezis, Jason P.

    We successfully implemented and institutionalized an adaptive management (AM) process for the Columbia Estuary Ecosystem Restoration Program, which is a large-scale restoration program focused on improving ecosystem conditions in the 234-km lower Columbia River and estuary. For our purpose, “institutionalized” means the AM process and restoration program are embedded in the work flow of the implementing agencies and affected parties. While plans outlining frameworks, processes, or approaches to AM of ecosystem restoration programs are commonplace, establishment for the long term is not. This paper presents the basic AM framework and explains how AM was implemented and institutionalized. Starting with amore » common goal, we pursued included a well-understood governance and decision-making structure, routine coordination and communication activities, data and information sharing, commitment from partners and upper agency management to the AM process, and meaningful cooperation among program managers and partners. The overall approach and steps to implement and institutionalize AM for ecosystem restoration explained here are applicable to situations where it has been less than successful or, as in our case, the restoration program is just getting started.« less

  18. In-home behavioral health case management: an integrated model for high-risk populations.

    PubMed

    Theis, Gerald A; Kozlowski, Deirdre; Behrens, Jenna

    2006-01-01

    The escalating health care costs attributed to high-risk populations have fueled a need for a proactive approach to deal with people affected by complex mental health issues that often coexist with chronic medical conditions. Through an in-home behavioral health case management (CM) program, patients with mental illnesses (some with coexisting medical conditions) receive integrated medical and mental health services through a disease-management approach that has proven effective in treating high-risk patients.

  19. Users guide for information retrieval using APL

    NASA Technical Reports Server (NTRS)

    Shapiro, A.

    1974-01-01

    A Programming Language (APL) is a precise, concise, and powerful computer programming language. Several features make APL useful to managers and other potential computer users. APL is interactive; therefore, the user can communicate with his program or data base in near real-time. This, coupled with the fact that APL has excellent debugging features, reduces program checkout time to minutes or hours rather than days or months. Of particular importance is the fact that APL can be utilized as a management science tool using such techniques as operations research, statistical analysis, and forecasting. The gap between the scientist and the manager could be narrowed by showing how APL can be used to do what the scientists and the manager each need to do, retrieve information. Sometimes, the information needs to be retrieved rapidly. In this case APL is ideally suited for this challenge.

  20. Capacity Building in Using NASA Remote Sensing for Water Resources and Disasters Management

    NASA Astrophysics Data System (ADS)

    Mehta, A. V.; Podest, E.; Prados, A. I.

    2017-12-01

    The NASA Applied Remote Sensing Training Program (ARSET), a part of NASA's Applied Sciences Capacity Building program, empowers the global community through online and in-person training. The program focuses on helping policy makers, environmental managers, and other professionals, both domestic and international, use remote sensing in decision making. Since 2011, ARSET has provided more than 20 trainings in water resource and disaster management, including floods and droughts. This presentation will include an overview of the ARSET program, best practices for approaching trainings, feedback from participants, and examples of case studies from the trainings showing the application of GPM, SMAP, Landsat, Terra and Aqua (MODIS), and Sentinel (SAR) data. This presentation will also outline how ARSET can serve as a liaison between remote sensing applications developers and users in the areas of water resource and disaster management.

  1. Management Education: An Experimental Course.

    ERIC Educational Resources Information Center

    Gutelius, Paul Payne

    The thesis describes the design, implementation, and evaluation of a course in the theory and practice of management. It gives an appraisal of programmed learning techniques and compares three methods of teaching management--by readings, by cases, and by computer gaming. Additionally, it relates student reactions to the opportunity to select one…

  2. Improving Performance of the System Safety Function at Marshall Space Flight Center

    NASA Technical Reports Server (NTRS)

    Kiessling, Ed; Tippett, Donald D.; Shivers, Herb

    2004-01-01

    The Columbia Accident Investigation Board (CAIB) determined that organizational and management issues were significant contributors to the loss of Space Shuttle Columbia. In addition, the CAIB observed similarities between the organizational and management climate that preceded the Challenger accident and the climate that preceded the Columbia accident. To prevent recurrence of adverse organizational and management climates, effective implementation of the system safety function is suggested. Attributes of an effective system safety program are presented. The Marshall Space Flight Center (MSFC) system safety program is analyzed using the attributes. Conclusions and recommendations for improving the MSFC system safety program are offered in this case study.

  3. The Organizational Decision Making Climate of Issues Management Programs: A Case Study.

    ERIC Educational Resources Information Center

    Wills, Sandra

    A study examined the decision making climate of organizations that are using issues management and what type of model of issues management is followed--theorists have been attempting to define issues management since it began appearing 20 year ago. Subjects, 112 males and 30 females who were professionals working in the area of issues management…

  4. Effects of a nurse-managed program on hepatitis A and B vaccine completion among homeless adults.

    PubMed

    Nyamathi, Adeline; Liu, Yihang; Marfisee, Mary; Shoptaw, Steven; Gregerson, Paul; Saab, Sammy; Leake, Barbara; Tyler, Darlene; Gelberg, Lillian

    2009-01-01

    Hepatitis B virus (HBV) infection constitutes a major health problem for homeless persons. Ability to complete an HBV vaccination series is complicated by the need to prioritize competing needs, such as addiction issues, safe places to sleep, and food, over health concerns. The objectives of this study were to evaluate the effectiveness of a nurse-case-managed intervention compared with that of two standard programs on completion of the combined hepatitis A virus (HAV) and HBV vaccine series among homeless adults and to assess sociodemographic factors and risk behaviors related to the vaccine completion. A randomized, three-group, prospective, quasi-experimental design was conducted with 865 homeless adults residing in homeless shelters, drug rehabilitation sites, and outdoor areas in the Skid Row area of Los Angeles. The programs included (a) nurse-case-managed sessions plus targeted hepatitis education, incentives, and tracking (NCMIT); (b) standard targeted hepatitis education plus incentives and tracking (SIT); and (c) standard targeted hepatitis education and incentives only (SI). Sixty-eight percent of the NCMIT participants completed the three-series vaccine at 6 months, compared with 61% of SIT participants and 54% of SI participants. NCMIT participants had almost 2 times greater odds of completing vaccination than those of participants in the SI program. Completers were more likely to be older, to be female, to report fair or poor health, and not to have participated in a self-help drug treatment program. Newly homeless White adults were significantly less likely than were African Americans to complete the vaccine series. The use of vaccination programs incorporating nurse case management and tracking is critical in supporting adherence to completion of a 6-month HAV/HBV vaccine. The finding that White homeless persons were the least likely to complete the vaccine series suggests that programs tailored to address their unique cultural issues are needed.

  5. Reimbursement for pediatric diabetes intensive case management: a model for chronic diseases?

    PubMed

    Beck, Joni K; Logan, Kathy J; Hamm, Robert M; Sproat, Scott M; Musser, Kathleen M; Everhart, Patricia D; McDermott, Harrold M; Copeland, Kenneth C

    2004-01-01

    Current reimbursement policies serve as potent disincentives for physicians who provide evaluation and management services exclusively. Such policies threaten nationwide availability of care for personnel-intensive services such as pediatric diabetes. This report describes an approach to improving reimbursement for highly specialized, comprehensive pediatric diabetes management through prospective contracting for services. The objective of this study was to determine whether pediatric diabetes intensive case management services are cost-effective to the payer, the patient, and a pediatric diabetes program. A contract with a third-party payer was created to reimburse for 3 key pediatric diabetes intensive case management components: specialty education, 24/7 telephone access to an educator (and board-certified pediatric endocrinologist as needed), and quarterly educator assessments of self-management skills. Data were collected and analyzed for 15 months after signing the contract. Within the first 15 months after the contract was signed, 22 hospital admissions for diabetic ketoacidosis (DKA) occurred in 16 different patients. After hospitalizations for DKA, all 16 patients were offered participation in the program. All were followed during the subsequent 1 to 15 months of observation. Ten patients elected to participate, and 6 refused participation. Frequency of rehospitalization, emergency department visits, and costs were compared between the 2 groups. Among the 10 participating patients, there was only 1 subsequent DKA admission, whereas among the 6 who refused participation, 5 were rehospitalized for DKA on at least 1 occasion. The 10 patients who participated in the program had greater telephone contact with the team compared with those who did not (16 crisis-management calls vs 0). Costs (education, hospitalization, and emergency department visits) per participating patient were approximately 1350 dollars less than those for nonparticipating patients. Differences between participating and nonparticipating groups included age (participants were of younger age), double-parent households (participants were more likely to be from double parent households), and number of medical visits kept (participants kept more follow-up visits). No differences in duration of diabetes, months followed in the program, sex, or ethnicity were observed. Contracting with third-party payers for pediatric diabetes intensive case management services reduces costs by reducing emergency department and inpatient hospital utilizations, likely a result of intensive education and immediate access to the diabetes health care team for crisis management. Such strategies may prove to be cost saving not only for diabetes management but also for managing other costly and personnel-intensive chronic diseases.

  6. ACHP | News | Mrs. Laura Bush Presents "Preserve America History Teacher

    Science.gov Websites

    cases. However, regulatory and statutory changes since then have significantly altered case management practices. The Section 106 review process has evolved to focus ACHP participation on high-profile cases . Involvement in these cases can also lead the ACHP to pursue broad changes to Federal agency programs or

  7. Student Assistance Programs: New Approaches for Reducing Adolescent Substance Abuse.

    ERIC Educational Resources Information Center

    Moore, David D.; Forster, Jerald R.

    1993-01-01

    Describes school-based Student Assistance Programs (SAPs), which are designed to reduce adolescents' substance abuse. Notes that SAPs, modeled after Employee Assistance Programs in workplace, are identifying, assessing, referring, and managing cases of substance-abusing students. Sees adoption of SAP model as accelerating in response to growing…

  8. Negotiating the COAPRT Learning Outcomes Transition Using Quality Management Tools: A Case Study of the COAPRT Beta Test Site

    ERIC Educational Resources Information Center

    Ellis, Gary D.

    2014-01-01

    This paper is a case study. It tells the story of the process that the Council on Accreditation for Parks, Recreation, Tourism and Related Professions beta test site created its learning outcomes assessment program. A planning process was used that has evolved from quality management philosophy and practice: DMADV. Use of DMADV required precise…

  9. Using Getting To Outcomes to facilitate the use of an evidence-based practice in VA homeless programs: a cluster-randomized trial of an implementation support strategy.

    PubMed

    Chinman, Matthew; McCarthy, Sharon; Hannah, Gordon; Byrne, Thomas Hugh; Smelson, David A

    2017-03-09

    Incorporating evidence-based integrated treatment for dual disorders into typical care settings has been challenging, especially among those serving Veterans who are homeless. This paper presents an evaluation of an effort to incorporate an evidence-based, dual disorder treatment called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking-Veterans Edition (MISSION-Vet) into case management teams serving Veterans who are homeless, using an implementation strategy called Getting To Outcomes (GTO). This Hybrid Type III, cluster-randomized controlled trial assessed the impact of GTO over and above MISSION-Vet Implementation as Usual (IU). Both conditions received standard MISSION-Vet training and manuals. The GTO group received an implementation manual, training, technical assistance, and data feedback. The study occurred in teams at three large VA Medical Centers over 2 years. Within each team, existing sub-teams (case managers and Veterans they serve) were the clusters randomly assigned. The trial assessed MISSION-Vet services delivered and collected via administrative data and implementation barriers and facilitators, via semi-structured interview. No case managers in the IU group initiated MISSION-Vet while 68% in the GTO group did. Seven percent of Veterans with case managers in the GTO group received at least one MISSION-Vet session. Most case managers appreciated the MISSION-Vet materials and felt the GTO planning meetings supported using MISSION-Vet. Case manager interviews also showed that MISSION-Vet could be confusing; there was little involvement from leadership after their initial agreement to participate; the data feedback system had a number of difficulties; and case managers did not have the resources to implement all aspects of MISSION-Vet. This project shows that GTO-like support can help launch new practices but that multiple implementation facilitators are needed for successful execution of a complex evidence-based program like MISSION-Vet. ClinicalTrials.gov NCT01430741.

  10. Addressing hospital-acquired pressure ulcers: patient care managers enhancing outcomes at the point of service.

    PubMed

    Frumenti, Jeanine M; Kurtz, Abby

    2014-01-01

    An innovative leadership training program for patient care managers (PCMs) aimed at improving the management of operational failures was conducted at a large metropolitan hospital center. The program focused on developing and enhancing the transformational leadership skills of PCMs by improving their ability to manage operational failures in general and, in this case, hospital-acquired pressure ulcers. The PCMs received 8 weeks of intense training using the Toyota Production System process improvement approach, along with executive coaching. Compared with the control group, the gains made by the intervention group were statistically significant.

  11. Effectiveness of a Comprehensive Stress Management Program to Reduce Work-Related Stress in a Medium-Sized Enterprise

    PubMed Central

    2014-01-01

    Objectives To assess the effectiveness of a comprehensive workplace stress management program consisting of participatory action-oriented training (PAOT) and individual management. Methods A comprehensive workplace stress management program was conducted in a medium-sized enterprise. The baseline survey was conducted in September 2011, using the Korean Occupational Stress Scale (KOSS) and Worker’s Stress Response Inventory (WSRI). After implementing both organizational and individual level interventions, the follow up evaluation was conducted in November 2011. Results Most of the workers participated in the organizational level PAOT and made Team-based improvement plans. Based on the stress survey, 24 workers were interviewed by a researcher. After the organizational and individual level interventions, there was a reduction of several adverse psychosocial factors and stress responses. In the case of blue-collar workers, psychosocial factors such as the physical environment, job demands, organizational system, lack of rewards, and occupational climate were significantly improved; in the case of white-collar workers, the occupational climate was improved. Conclusions In light of these results, we concluded that the comprehensive stress management program was effective in reducing work-related stress in a short-term period. A persistent long-term follow up is necessary to determine whether the observed effects are maintained over time. Both team-based improvement activities and individual interviews have to be sustainable and complementary to each other under the long-term plan. PMID:24524591

  12. Evaluation of Text Messaging Effects on Health Goal Adherence in the Management of Participants With Chronic Diseases.

    PubMed

    Stagg, Sharon J; Speroni, Karen Gabel; Daniel, Marlon G; Eigenbrode, Melissa; Geisler, Lori

    The study purpose was to determine whether text messaging health-related messages, questions, and reminders to community case management participants with chronic diseases increased health goal adherence. This study was conducted by a rural community case management, hospital-affiliated program. This pilot, quasiexperimental study measured health goal adherence, the degree to which an individual continues work toward self-identified health goals under limited supervision, before and after a text messaging intervention. All participants were receiving community case management services for chronic disease. Participants completed baseline and follow-up surveys regarding a text messaging intervention. Most participants were African Americans, had diabetes, with equal numbers by gender, an average age of 57.8 years, and had been in the community case management program for 3-5 years. Participants were sent a total of 1,654 messages/questions and 571 reminders. At follow-up, respondents who reported "Did you work on your health goals?" increased significantly (p = .0430). However, no differences were found for "Did you go to your health care appointments?" and "Did you take your medicines as you should?" No differences were noted in reported visits/hospitalizations overall or specifically at the research site. Lastly, study member visit/hospitalization numbers did not change significantly at follow-up. Although text messaging is not meant to take the place of face-to-face interactions, it does provide community case managers with an additional modality of communication with patients to offer support and important care reminders, and to facilitate patient participation in his or her care.

  13. Developing a rural transitional care community case management program using clinical nurse specialists.

    PubMed

    Baldwin, Kathleen M; Black, Denice; Hammond, Sheri

    2014-01-01

    This quality improvement project developed a community nursing case management program to decrease preventable readmissions to the hospital and emergency department by providing telephonic case management and, if needed, onsite assessment and treatment by a clinical nurse specialist (CNS) with prescriptive authority. As more people reach Medicare age, the number of individuals with worsening chronic diseases with dramatically increases unless appropriate disease management programs are developed. Care transitions can result in breakdown in continuity of care, resulting in increased preventable readmissions, particularly for indigent patients. The CNS is uniquely educated to managing care transitions and coordination of community resources to prevent readmissions. After a thorough SWOT (strengths, weaknesses, opportunities, and threats) analysis, we developed and implemented a cost-avoidance model to prevent readmissions in our uninsured and underinsured patients. The project CNS used a wide array of interventions to decrease readmissions. In the last 2 years, there have been a total of 22 less than 30-day readmissions to the emergency department or hospital in 13 patients, a significant decrease from readmissions in these patients prior to the program. Three of them required transfer to a larger hospital for a higher level of care. Using advanced practice nurses in transitional care can prevent readmissions, resulting in cost avoidance. The coordination of community resources during transition from hospital to home is a job best suited to CNSs, because they are educated to work within organizations/systems. The money we saved with this project more than justified the cost of hiring a CNS to lead it. More research is needed into this technology. Guidelines for this intervention need to be developed. Replicating our cost-avoidance transitional care model can help other facilities limit that loss.

  14. Social Capital Development within a Novice District-Grown Principal Preparation Program: A Case Study of the DCPS Patterson Fellowship

    ERIC Educational Resources Information Center

    Hansen, Allison

    2016-01-01

    In the last decade district-managed principal preparation programs have become common as a means for school leadership preparation (Leithwood, Seashore-Lewis, Anderson, & Wahlstrom, 2004; Turnbull, Riley, & MacFarlane, 2015), but evaluations of these programs are relatively rare. This dissertation evaluates one such program, the Mary Jane…

  15. Special Plans and Operations: Assessment of DOD Wounded Warrior Matters - Fort Sam Houston

    DTIC Science & Technology

    2011-03-17

    nurse case managers, and squad leaders • Assess WTB unit order and discipline • Develop comprehensive training programs for nurse case managers...consist of, but are not limited to, military cadre, physicians, nurses , TBI and behavioral health specialists such as psychologists and social workers...and access to care standards. Triad of Care At the nucleus of the WTU is the “Triad of Care,” which is comprised of a squad leader, a nurse case

  16. Depression Case Finding Strategies in a Care Management Program for Chronically Ill Medicare Recipients

    PubMed Central

    Jennifer, Taylor; Michael, Schoenbaum; Katon Wayne, J; Pincus Harold, A; Diane, Hogan; Jürgen, Unützer

    2013-01-01

    Objective To examine case-finding strategies for depression in the context of a disease management program for chronically ill Medicare recipients. Study Design Observational analysis of telephone/mail surveys and claims data collected for the Medicare Health Support (MHS) program. Methods This study examines data from 14,902 participants with diabetes and/or congestive heart failure in the MHS program administered by Green Ribbon Health.. Depression screening was performed by administering a 2-item screener (PHQ-2) by telephone or mail. Additional information about depression was drawn from ICD-9 depression diagnoses from claims and self-reported use of antidepressant medications. We compared screener positive rates for depression on the PHQ-2 administered by telephone or mail, examined variations in screener positives by care manager, and compared rates of positive screens to antidepressant use and claims diagnoses of depression. Results Nearly 14 % of participants received an ICD-9 diagnosis of depression in the year prior to program enrollment; 7% reported taking antidepressants, and 5 % screened positive on the PHQ-2. Substantial variation in positive depression screens by care manager was found that could not be explained by case mix, prior depression diagnoses or current depression treatment. After adjusting for demographic and clinical differences, the PHQ2 positive rate was 6.5% by phone and 14.1% by mail screen (p<0.001). Conclusion A combined depression screening approach with mail screening (using the PHQ-2) augmented by information about antidepressant use and claims diagnoses of depression may be the most cost-effective method to identify depression in a large sample of medically ill Medicare recipients. PMID:18690765

  17. The business case for quality.

    PubMed

    Boehler, Richard; Hardesty, Daniel; Gonzales, Eva; Kasnetz, Karen

    2009-10-01

    Among the lessons St. Joseph Medical Center learned in implementing a diabetes care management program were that: There is a sound business case for quality with such a program. A sound business plan based on a track record of accomplishments by other organizations is key to gaining clinician buy-in. Deploying dwindling resources to simultaneously improve care and the organization's bottom line requires collaboration between clinicians and finance.

  18. New program for identification of child maltreatment in emergency department: preliminary data.

    PubMed

    Milani, Gregorio P; Vianello, Federica A; Cantoni, Barbara; Agostoni, Carlo; Fossali, Emilio F

    2016-07-13

    Early detection of child maltreatment in pediatric emergency department is one of the most important challenges for the Italian and European medical care system. Several interventions have been proposed, but results are often unquantifiable or inadequate to face this problem. We promoted an educational program and built up an interdisciplinary team to improve the identification and management of maltreated children. Aim of this study is to report preliminary results of these interventions. Meetings structured with lecture-based teaching and case-based lessons were focused on identification and management of maltreatment cases. An interdisciplinary team with forensic physicians, dermatologists, orthopedics, radiologists, gynecologists, oculists, psychologists and psychiatrics, was created to manage children with suspected diagnosis of maltreatment. We analysed the characteristics of subjects diagnosed after these interventions and their number was compared with the one in the two previous years. An increased rate of diagnoses of 16.9 % was found. Results of the reported program are encouraging, but many efforts are still mandatory to improve the child maltreatment identification in emergency departments.

  19. Topical Backgrounder: Evaluating Chemical Hazards in the Community: Using RMP's Offsite Consequence Analysis

    EPA Pesticide Factsheets

    Part of a May 1999 series on the Risk Management Program Rule and issues related to chemical emergency management. Explains hazard versus risk, worst-case and alternative release scenarios, flammable endpoints and toxic endpoints.

  20. Implementing a pilot work injury management program in Hong Kong.

    PubMed

    Lai, Hon-Sun; Chan, Chetwyn C H

    2007-12-01

    This paper reports the results of implementing a pilot case management system for work injuries in Hong Kong. The case management approach was characterized by use of a case manager who worked closely with each of the reported injury cases. The case manager undertook the roles of assessor, referral agent, counselor, work-site liaison, and return-to-work (RTW) expert. A quasi-experimental study design was used. The study compared the RTW and workers' compensation outcomes in injured workers in a cleaning company in a case management group (n = 296) and a conventional rehabilitation group (n = 137). Outcomes of the intervention were followed up at 6 months. The results indicated that the RTW rate was 97.0% and 94.2% for the case management and conventional rehabilitation groups respectively, with no significant differences between them. Participants in the case management group had significantly fewer days of sick leave (mean = 27.5 and 41.6 days, respectively) and lower compensation costs (mean = HK$7,212.2 and $20,617.3, respectively) than those in the comparison group. Age of the participants was found to influence the outcomes with those who were between 41 and 50 years old and received case management intervention had shorter sick leave and lower cost of compensation than their conventional rehabilitation counterpart. The majority of the participants who had returned to work in both the case management (95.8%) and the conventional rehabilitation (96.2%) groups were found to maintain their work status 6 months after the intervention. The findings suggested that applying the case management approach to the Hong Kong workers' compensation system was more effective overall. Nevertheless, the inherent problems associated with implementing such an approach within the existing system, which focuses on compensation and medical interventions, remained unresolved.

  1. State-local policy management project. Final report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1981-08-01

    The report describes case studies to explore new approaches for increasing state and local coordination in planning and managing programs in areas with significant scientific and technical components such as energy and environment. Specifically, the case studies reveal efforts of various states in the areas of energy conservation, weatherization, emergency preparedness, and air quality. Successes and failures of Maryland's decentralized approach to energy conservation are documented; success of the thermal and lighting efficiency standards program in Texas is discussed; state aid for local energy conservation programs in Clinton County, Michigan, is reviewed; and the success of the weatherization program inmore » Oregon is examined. Pilot programs in weatherization in Pennsylvania are shown to have led a statewide effort. Two Minnesota projects in emergency preparedness are documented and factors for success are listed. In addition, long-range planning for fuel shortages in New York is examined and the benefits of regional planning in Fairfax County, Virgina, are noted. Efforts are examined to improve air quality in Ohio, California, and New Jersey.« less

  2. A Data Management System for Multi-Phase Case-Control Studies

    PubMed Central

    Gibeau, Joanne M.; Steinfeldt, Lois C.; Stine, Mark J.; Tullis, Katherine V.; Lynch, H. Keith

    1983-01-01

    The design of a computerized system for the management of data in multi-phase epidemiologic case-control studies is described. Typical study phases include case-control selection, abstracting of data from medical records, and interview of study subjects or next of kin. In consultation with project personnel, requirements for the system were established: integration of data from all study phases into one data base, accurate follow-up of subjects through the study, sophisticated data editing capabilities, ready accessibility of specified programs to project personnel, and generation of current status and exception reports for project managment. SIR (Scientific Information Retrieval), a commercially available data base management system, was selected as the foundation of this system. The system forms a comprehensive data management system applicable to many types of public health research studies.

  3. The Lifestyle Engagement Activity Program (LEAP): Implementing Social and Recreational Activity into Case-Managed Home Care.

    PubMed

    Low, Lee-Fay; Baker, Jessica Rose; Harrison, Fleur; Jeon, Yun-Hee; Haertsch, Maggie; Camp, Cameron; Skropeta, Margaret

    2015-12-01

    The Lifestyle Engagement Activity Program (LEAP) incorporates social support and recreational activities into case-managed home care. This study's aim was to evaluate the effect of LEAP on engagement, mood, and behavior of home care clients, and on case managers and care workers. Quasi-experimental. Five Australian aged home care providers, including 2 specializing in care for ethnic minorities. Clients (n = 189) from 5 home care providers participated. The 12-month program had 3 components: (1) engaging support of management and staff; (2) a champion to drive practice change; (3) staff training. Case managers were trained to set meaningful social and/or recreational goals during care planning. Care workers were trained in good communication, to promote client independence and choice, and in techniques such as Montessori activities, reminiscence, music, physical activity, and humor. Data were collected 6 months before program commencement, at baseline, and 6 and 12 months. The Homecare Measure of Engagement Staff report and Client-Family interview were primary outcomes. Secondary outcomes were the Cohen-Mansfield Agitation Inventory; apathy, dysphoria, and agitation subscales of the Neuropsychiatric Inventory-Clinician Rating; the geriatric depression scale; UCLA loneliness scale; and home care satisfaction scale. Staff provided information on confidence in engaging clients and the Utrecht Work Engagement Scale. Twelve months after program commencement, clients showed a significant increase in self- or family-reported client engagement (b = 5.39, t[113.09] = 3.93, P < .000); and a significant decrease in apathy (b = -0.23, t(117.00) = -2.03, P = .045), dysphoria (b = -0.25, t(124.36) = -2.25, P = .026), and agitation (b = -0.97, t(98.15) = -3.32, P = .001) on the Neuropsychiatric Inventory-Clinician. Case managers and care workers both reported significant increases in their confidence to socially and recreationally engage clients (b = 0.52, t(21.33) = 2.80, P = .011, b = 0.29, t(198.69) = 2.58, P = .011, respectively). There were no significant changes in care worker-rated client engagement or client or family self-complete measures of depression or loneliness (P > .05). Client and family self-rated apathy increased over 12 months (b = 0.04, t(43.36) = 3.06, P = .004; b = 3.63, t(34.70) = 2.20, P = .035) CONCLUSIONS: LEAP demonstrated that home care providers can incorporate social and recreational care into usual practice for older clients, and that this benefits clients' engagement, dysphoria, and agitation. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  4. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Deeb, Rula A.; Hawley, Elisabeth L.

    The goal of United States (U.S.) Department of Energy's (DOE)'s environmental remediation programs is to restore groundwater to beneficial use, similar to many other Federal and state environmental cleanup programs. Based on past experience, groundwater remediation to pre-contamination conditions (i.e., drinking water standards or non-detectable concentrations) can be successfully achieved at many sites. At a subset of the most complex sites, however, complete restoration is not likely achievable within the next 50 to 100 years using today's technology. This presentation describes several approaches used at complex sites in the face of these technical challenges. Many complex sites adopted a long-termmore » management approach, whereby contamination was contained within a specified area using active or passive remediation techniques. Consistent with the requirements of their respective environmental cleanup programs, several complex sites selected land use restrictions and used risk management approaches to accordingly adopt alternative cleanup goals (alternative endpoints). Several sites used long-term management designations and approaches in conjunction with the alternative endpoints. Examples include various state designations for groundwater management zones, technical impracticability (TI) waivers or greater risk waivers at Superfund sites, and the use of Monitored Natural Attenuation (MNA) or other passive long-term management approaches over long time frames. This presentation will focus on findings, statistics, and case studies from a recently-completed report for the Department of Defense's Environmental Security Technology Certification Program (ESTCP) (Project ER-0832) on alternative endpoints and approaches for groundwater remediation at complex sites under a variety of Federal and state cleanup programs. The primary objective of the project was to provide environmental managers and regulators with tools, metrics, and information needed to evaluate alternative endpoints for groundwater remediation at complex sites. A statistical analysis of Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) sites receiving TI waivers will be presented as well as case studies of other types of alternative endpoints and alternative remedial strategies that illustrate the variety of approaches used at complex sites and the technical analyses used to predict and document cost, time frame, and potential remedial effectiveness. This presentation is intended to inform DOE program managers, state regulators, practitioners and other stakeholders who are evaluating technical cleanup challenges within their own programs, and establishing programmatic approaches to evaluating and implementing long-term management approaches. Case studies provide examples of long-term management designations and strategies to manage and remediate groundwater at complex sites. At least 13 states consider some designation for groundwater containment in their corrective action policies, such as groundwater management zones, containment zones, and groundwater classification exemption areas. Long-term management designations are not a way to 'do nothing' or walk away from a site. Instead, soil and groundwater within the zone is managed to be protective of human health and the environment. Understanding when and how to adopt a long-term management approach can lead to cost savings and the more efficient use of resources across DOE and at numerous other industrial and military sites across the U.S. This presentation provides context for assessing the use and appropriate role of alternative endpoints and supporting long-term management designations in final remedies. (authors)« less

  5. Integrating team resource management program into staff training improves staff's perception and patient safety in organ procurement and transplantation: the experience in a university-affiliated medical center in Taiwan.

    PubMed

    Hsu, Ya-Chi; Jerng, Jih-Shuin; Chang, Ching-Wen; Chen, Li-Chin; Hsieh, Ming-Yuan; Huang, Szu-Fen; Liu, Yueh-Ping; Hung, Kuan-Yu

    2014-08-11

    The process involved in organ procurement and transplantation is very complex that requires multidisciplinary coordination and teamwork. To prevent error during the processes, teamwork education and training might play an important role. We wished to evaluate the efficacy of implementing a Team Resource Management (TRM) program on patient safety and the behaviors of the team members involving in the process. We implemented a TRM training program for the organ procurement and transplantation team members of the National Taiwan University Hospital (NTUH), a teaching medical center in Taiwan. This 15-month intervention included TRM education and training courses for the healthcare workers, focused group skill training for the procurement and transplantation team members, video demonstration and training, and case reviews with feedbacks. Teamwork culture was evaluated and all procurement and transplantation cases were reviewed to evaluate the application of TRM skills during the actual processes. During the intervention period, a total of 34 staff members participated the program, and 67 cases of transplantations were performed. Teamwork framework concept was the most prominent dimension that showed improvement from the participants for training. The team members showed a variety of teamwork behaviors during the process of procurement and transplantation during the intervention period. Of note, there were two potential donors with a positive HIV result, for which the procurement processed was timely and successfully terminated by the team. None of the recipients was transplanted with an infected organ. No error in communication or patient identification was noted during review of the case records. Implementation of a Team Resource Management program improves the teamwork culture as well as patient safety in organ procurement and transplantation.

  6. Integrating team resource management program into staff training improves staff’s perception and patient safety in organ procurement and transplantation: the experience in a university-affiliated medical center in Taiwan

    PubMed Central

    2014-01-01

    Background The process involved in organ procurement and transplantation is very complex that requires multidisciplinary coordination and teamwork. To prevent error during the processes, teamwork education and training might play an important role. We wished to evaluate the efficacy of implementing a Team Resource Management (TRM) program on patient safety and the behaviors of the team members involving in the process. Methods We implemented a TRM training program for the organ procurement and transplantation team members of the National Taiwan University Hospital (NTUH), a teaching medical center in Taiwan. This 15-month intervention included TRM education and training courses for the healthcare workers, focused group skill training for the procurement and transplantation team members, video demonstration and training, and case reviews with feedbacks. Teamwork culture was evaluated and all procurement and transplantation cases were reviewed to evaluate the application of TRM skills during the actual processes. Results During the intervention period, a total of 34 staff members participated the program, and 67 cases of transplantations were performed. Teamwork framework concept was the most prominent dimension that showed improvement from the participants for training. The team members showed a variety of teamwork behaviors during the process of procurement and transplantation during the intervention period. Of note, there were two potential donors with a positive HIV result, for which the procurement processed was timely and successfully terminated by the team. None of the recipients was transplanted with an infected organ. No error in communication or patient identification was noted during review of the case records. Conclusion Implementation of a Team Resource Management program improves the teamwork culture as well as patient safety in organ procurement and transplantation. PMID:25115403

  7. Lessons Learned from a Decade of Sudden Oak Death in California: Evaluating Local Management

    NASA Astrophysics Data System (ADS)

    Alexander, Janice; Lee, Christopher A.

    2010-09-01

    Sudden Oak Death has been impacting California’s coastal forests for more than a decade. In that time, and in the absence of a centrally organized and coordinated set of mandatory management actions for this disease in California’s wildlands and open spaces, many local communities have initiated their own management programs. We present five case studies to explore how local-level management has attempted to control this disease. From these case studies, we glean three lessons: connections count, scale matters, and building capacity is crucial. These lessons may help management, research, and education planning for future pest and disease outbreaks.

  8. Lessons Learned from a Decade of Sudden Oak Death in California: Evaluating Local Management

    PubMed Central

    Alexander, Janice

    2010-01-01

    Sudden Oak Death has been impacting California’s coastal forests for more than a decade. In that time, and in the absence of a centrally organized and coordinated set of mandatory management actions for this disease in California’s wildlands and open spaces, many local communities have initiated their own management programs. We present five case studies to explore how local-level management has attempted to control this disease. From these case studies, we glean three lessons: connections count, scale matters, and building capacity is crucial. These lessons may help management, research, and education planning for future pest and disease outbreaks. PMID:20559634

  9. An effectiveness and cost-benefit analysis of a hospital-based discharge transition program for elderly Medicare recipients.

    PubMed

    Saleh, Shadi S; Freire, Chris; Morris-Dickinson, Gwendolyn; Shannon, Trip

    2012-06-01

    To investigate the business case of postdischarge care transition (PDCT) among Medicare beneficiaries by conducting a cost-benefit analysis. Randomized controlled trial. A general hospital in upstate New York State. Elderly Medicare beneficiaries being treated from October 2008 through December 2009 were randomly selected to receive services as part of a comprehensive PDCT program (intervention--173 patients) or regular discharge process (control--160 patients) and followed for 12 months. The intervention comprised five activities: development of a patient-centered health record, a structured discharge preparation checklist of critical activities, delivery of patient self-activation and management sessions, follow-up appointments, and coordination of data flow. Cost-benefit ratio of the PDCT program; self-management skills and abilities. The 1-year readmission analysis revealed that control participants were more likely to be readmitted than intervention participants (58.2% vs 48.2%; P = .08); with most of that difference observed in the 91 to 365 days after discharge. Findings from the cost-benefit analysis revealed a cost-benefit ratio of 1.09, which indicates that, for every $1 spent on the program, a saving of $1.09 was realized. In addition, participating in a care transition program significantly enhanced self-management skills and abilities. Postdischarge care transition programs have a dual benefit of enhancing elderly adults' self-management skills and abilities and producing cost savings. This study builds a case for the inclusion of PDCT programs as a reimbursable service in benefit packages. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  10. The role of digital data entry in participatory environmental monitoring.

    PubMed

    Brammer, Jeremy R; Brunet, Nicolas D; Burton, A Cole; Cuerrier, Alain; Danielsen, Finn; Dewan, Kanwaljeet; Herrmann, Thora Martina; Jackson, Micha V; Kennett, Rod; Larocque, Guillaume; Mulrennan, Monica; Pratihast, Arun Kumar; Saint-Arnaud, Marie; Scott, Colin; Humphries, Murray M

    2016-12-01

    Many argue that monitoring conducted exclusively by scientists is insufficient to address ongoing environmental challenges. One solution entails the use of mobile digital devices in participatory monitoring (PM) programs. But how digital data entry affects programs with varying levels of stakeholder participation, from nonscientists collecting field data to nonscientists administering every step of a monitoring program, remains unclear. We reviewed the successes, in terms of management interventions and sustainability, of 107 monitoring programs described in the literature (hereafter programs) and compared these with case studies from our PM experiences in Australia, Canada, Ethiopia, Ghana, Greenland, and Vietnam (hereafter cases). Our literature review showed that participatory programs were less likely to use digital devices, and 2 of our 3 more participatory cases were also slow to adopt digital data entry. Programs that were participatory and used digital devices were more likely to report management actions, which was consistent with cases in Ethiopia, Greenland, and Australia. Programs engaging volunteers were more frequently reported as ongoing, but those involving digital data entry were less often sustained when data collectors were volunteers. For the Vietnamese and Canadian cases, sustainability was undermined by a mismatch in stakeholder objectives. In the Ghanaian case, complex field protocols diminished monitoring sustainability. Innovative technologies attract interest, but the foundation of effective participatory adaptive monitoring depends more on collaboratively defined questions, objectives, conceptual models, and monitoring approaches. When this foundation is built through effective partnerships, digital data entry can enable the collection of more data of higher quality. Without this foundation, or when implemented ineffectively or unnecessarily, digital data entry can be an additional expense that distracts from core monitoring objectives and undermines project sustainability. The appropriate role of digital data entry in PM likely depends more on the context in which it is used and less on the technology itself. © 2016 Society for Conservation Biology.

  11. What Case Managers Should Know About Their Roles and Functions: A National Study From the Commission for Case Manager Certification: Part 1.

    PubMed

    Tahan, Hussein M; Watson, Annette C; Sminkey, Patrice V

    2015-01-01

    The purpose of this national role and function study was to identify the essential activities and necessary knowledge areas for effective case manager practice from the perspective of those currently functioning in various care settings and across diverse professional disciplines. The national study covered all case management practices and/or work settings across the full continuum of health care. This cross-sectional descriptive study used the practice analysis method and online survey research design. It employed a purposive sample of case managers, in which 52,370 individuals received an invitation to participate. Data collection completed over a 4-week period, resulting in 7,668 useable survey responses (nearly a 15% response rate). The study identified the common activities and knowledge areas necessary for competent and effective performance of case managers, as is highlighted in this article, which is the first of a 2-part series on the role and function study. The results informed the needed update of the test specifications for the Certified Case Manager (CCM) certification examination, as will be delineated in Part 2 of the article series, to ensure that it continues to be substantiated in current practice. Of special note are the emergence of specific activity and knowledge domains in the area of case management ethical, legal, and practice standards, and an increase in the number of employers requiring certified case managers to fill vacant positions and compensating them financially for such qualifications. This study helps keep the CCM credentialing examination evidence-based and maintain its validity for evaluating competency of case managers. Specifically, the study identified essential activities and knowledge domains that define competent case management practice. Findings can be used for developing programs and curricula for the training and development of case managers. The study instrument also can be used for further research of case management practice.

  12. Inventory and perspectives of chronic disease management programs in Switzerland: an exploratory survey.

    PubMed

    Peytremann-Bridevaux, Isabelle; Burnand, Bernard

    2009-10-07

    To describe chronic disease management programs active in Switzerland in 2007, using an exploratory survey. We searched the internet (Swiss official websites and Swiss web-pages, using Google), a medical electronic database (Medline), reference lists of pertinent articles, and contacted key informants. Programs met our operational definition of chronic disease management if their interventions targeted a chronic disease, included a multidisciplinary team (>/=2 healthcare professionals), lasted at least six months, and had already been implemented and were active in December 2007. We developed an extraction grid and collected data pertaining to eight domains (patient population, intervention recipient, intervention content, delivery personnel, method of communication, intensity and complexity, environment, clinical outcomes). We identified seven programs fulfilling our operational definition of chronic disease management. Programs targeted patients with diabetes, hypertension, heart failure, obesity, psychosis and breast cancer. Interventions were multifaceted; all included education and half considered planned follow-ups. The recipients of the interventions were patients, and healthcare professionals involved were physicians, nurses, social workers, psychologists and case managers of various backgrounds. In Switzerland, a country with universal healthcare insurance coverage and little incentive to develop new healthcare strategies, chronic disease management programs are scarce. For future developments, appropriate evaluations of existing programs, involvement of all healthcare stakeholders, strong leadership and political will are, at least, desirable.

  13. Crusted scabies in remote Australia, a new way forward: lessons and outcomes from the East Arnhem Scabies Control Program.

    PubMed

    Lokuge, Buddhi; Kopczynski, Alex; Woltmann, Angela; Alvoen, Faye; Connors, Christine; Guyula, Terrence; Mulholland, Eddie; Cran, Samantha; Foster, Tim; Lokuge, Kamalini; Burke, Tanya; Prince, Sam

    2014-06-16

    Crusted scabies is a highly infectious, debilitating and disfiguring disease, and remote Aboriginal communities of northern Australia have the highest reported rates of the condition in the world. We draw on monitoring data of the East Arnhem Scabies Control Program to discuss outcomes and lessons learnt through managing the condition in remote communities. Using active case finding, we identified seven patients with crusted scabies in three communities and found most had not presented to health services despite active disease. We compared presentations and hospitalisations for a cumulative total of 99 months during a novel preventive program with 99 months immediately before the program for the seven cases and seven sentinel household contacts. Our preventive long-term case management approach was associated with a significant 44% reduction in episodes of recurrent crusted scabies (from 36 to 20; P = 0.025) in the seven cases, and a non-significant 80% reduction in days spent in hospital (from 173 to 35; P = 0.09). It was also associated with a significant 75% reduction in scabies-related presentations (from 28 to 7; P = 0.017) for the seven sentinel household contacts. We recommend active surveillance and wider adoption of this preventive case management approach, with ongoing evaluation to refine protocols and improve efficiency. Contacts of children presenting with recurrent scabies should be examined to exclude crusted scabies. In households where crusted scabies is present, a diagnosis of parental neglect due to recurrent scabies and weight loss in children should be made with extreme caution. Improved coordination of care by health services, and research and development of new therapies including immunotherapies for crusted scabies, must be a priority.

  14. A Patient-Centered Transitional Care Case Management Program: Taking Case Management to the Streets and Beyond.

    PubMed

    Lovelace, Derenda; Hancock, Diane; Hughes, Sabrina S; Wyche, Phyllis R; Jenkins, Claire; Logan, Cindy

    In 2011, the Hunter Holmes McGuire Veterans Administration Medical Center (VAMC) in Richmond, VA, had a cumulative readmission rate and emergency department (ED) revisits for discharged Veterans of 1 in 5. In 2012, a transitional care program (TCP) was implemented to improve care coordination and outcomes among Veterans, with an emphasis on geriatric patients with chronic disease. This TCP was created with an interdisciplinary approach using intensive case management interventions, with a goal of reducing Veteran ED and hospital revisits by 30%. To examine the impact of the McGuire VAMC TCP on Veteran ED and hospital utilization and costs. Veterans being discharged to home following an inpatient admission, ED visit, and/or short rehab stay. The primary means of identifying patients for the program is through daily screening of the previous 24-hour admission and ED report, which the inpatient nurse practitioner performs. She completes an extensive review of each Veteran's electronic medical record to determine the number of ED visits and inpatient admissions at the VAMC and in the community. Initial criteria for consideration in the program included the following: more than two hospital admissions and/or ED visits in the past 90 days or at high risk for readmission based on a Care Assessment Need score of greater than 95. Two hundred Veterans participated in the program in fiscal year (FY) 2013, with 146 participating in FY 2014. A retrospective chart review of Veterans participating in the TCP in FYs 2013 and 2014 was conducted, with a focus on number of admissions and ED visits 90 days prior to admission to the TCP and 90 days following TCP admission. Average admission and ED costs for this VA were calculated to determine cost savings from pre- to post-90 days of admission and ED visits. Veterans who obtained TCP services in FYs 2013 and 2014 experienced a 67% decrease in hospital admissions and a 61% decrease in ED visits in the 90 days following participation in this program compared with the 90 days prior to participation. This produced an estimated net savings of $3,823,673 in medical center costs. In addition, registered nurse case managers (RN CMs) noted improved patient compliance and satisfaction with care and the licensed clinical social worker noted reduced caregiver burden. The results of this program demonstrate how using an interdisciplinary approach to develop patient-centered transition plans of care through intensive case management interventions improves resource utilization with substantial financial savings. This program represents a feasible option for other VAMCs as well as civilian hospitals seeking to provide cost-effective transitional care to patients upon discharge and prevent untimely readmissions. With an RN CM at the hub of patient care, this program successfully demonstrates the value of smooth care transitions.

  15. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bolan, N.A.; Hansen-Murray, C.S.; Haynes, R.W.

    Implications of the interim comprehensive strategy for improved Pacific salmon and steelhead habitat management (PACFISH) were estimated for those Bureau of Land Management (BLM) districts and National Forest System (NFS) lands west of the Rocky Mountains that have anadromous fish. The physical impacts and associated mitigation costs from implementing the PACFISH strategy over the next decade in Pacific Northwest, Intermountain, Northern, Pacific Southwest, and Alaska Region National Forest and BLM district recreation, range, and timber programs were analyzed with the actual current output as the base. Economic considerations were added to evaluate any change in the perceived ranking of severitymore » among the impacts. Two cases were considered in the analyses: a derived worst case, where a total reduction of the actual current output of the programs in anadromous fishbearing drainages occurs (giving a minimum value for the programs in those drainages), and a mitigated case where all or part of the loss is mitigated and the cost of doing so is evaluated with two phases, one without economics and the other with it.« less

  16. Evaluation of an interactive case simulation system in dermatology and venereology for medical students

    PubMed Central

    Wahlgren, Carl-Fredrik; Edelbring, Samuel; Fors, Uno; Hindbeck, Hans; Ståhle, Mona

    2006-01-01

    Background Most of the many computer resources used in clinical teaching of dermatology and venereology for medical undergraduates are information-oriented and focus mostly on finding a "correct" multiple-choice alternative or free-text answer. We wanted to create an interactive computer program, which facilitates not only factual recall but also clinical reasoning. Methods Through continuous interaction with students, a new computerised interactive case simulation system, NUDOV, was developed. It is based on authentic cases and contains images of real patients, actors and healthcare providers. The student selects a patient and proposes questions for medical history, examines the skin, and suggests investigations, diagnosis, differential diagnoses and further management. Feedback is given by comparing the user's own suggestions with those of a specialist. In addition, a log file of the student's actions is recorded. The program includes a large number of images, video clips and Internet links. It was evaluated with a student questionnaire and by randomising medical students to conventional teaching (n = 85) or conventional teaching plus NUDOV (n = 31) and comparing the results of the two groups in a final written examination. Results The questionnaire showed that 90% of the NUDOV students stated that the program facilitated their learning to a large/very large extent, and 71% reported that extensive working with authentic computerised cases made it easier to understand and learn about diseases and their management. The layout, user-friendliness and feedback concept were judged as good/very good by 87%, 97%, and 100%, respectively. Log files revealed that the students, in general, worked with each case for 60–90 min. However, the intervention group did not score significantly better than the control group in the written examination. Conclusion We created a computerised case simulation program allowing students to manage patients in a non-linear format supporting the clinical reasoning process. The student gets feedback through comparison with a specialist, eliminating the need for external scoring or correction. The model also permits discussion of case processing, since all transactions are stored in a log file. The program was highly appreciated by the students, but did not significantly improve their performance in the written final examination. PMID:16907972

  17. Corporate Energy Conservation Program for Alcoa North American Extrusions: Office of Industrial Technologies (OIT) Aluminum BestPractices Management Case Study

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    U.S. Department of Energy

    2001-08-06

    This case study is the latest in a series on industrial firms who are implementing energy efficient technologies and system improvements into their manufacturing processes. The case studies document the activities, savings, and lessons learned on these projects.

  18. On-boarding the Middle Manager.

    PubMed

    OʼConnor, Mary

    The trend of promoting clinical experts into management roles continues. New middle managers need a transitional plan that includes support, mentoring, and direction from senior leaders, including the chief nursing officer (CNO). This case study demonstrates how the CNO of one organization collaborated with a faculty member colleague to develop and implement a yearlong personalized on-boarding program for a group of new nurse middle managers.

  19. Reducing environmental noise impacts: A USAREUR noise management program handbook

    NASA Astrophysics Data System (ADS)

    Feather, Timothy D.; Shekell, Ted K.

    1991-06-01

    Noise pollution is a major environmental problem faced by the U.S. Army in Europe. Noise-related complaints from German citizens can escalate into intense political issues in German communities. This in turn hampers efficient operation of military training and often times threatens the Army's mission. In order to remedy these problems, USAREUR has developed a noise management program. A successful noise management program will limit the impact of unavoidable noise on the populace. This report, a component of the noise management program, is a reference document for noise management planning. It contains guidelines and rules-of-thumb for noise management. This document contains procedures which operation and training level personnel can understand and apply in their day to day noise management planning. Noise mitigation tips are given. Basic technical information that will aid in understanding noise mitigation is provided along with noise management through land use planning. Noise management for specific components of the military community, (airfields, base operations, training areas, and housing and recreation areas) are addressed. The nature of noise generated, means of noise abatement at the source, path, and receiver (both physical and organizational/public relations methods), and a case study example are described.

  20. Analysis of Risk Management in Adapted Physical Education Textbooks

    ERIC Educational Resources Information Center

    Murphy, Kelle L.; Donovan, Jacqueline B.; Berg, Dominck A.

    2016-01-01

    Physical education teacher education (PETE) programs vary on how the topics of safe teaching and risk management are addressed. Common practices to cover such issues include requiring textbooks, lesson planning, peer teaching, videotaping, reflecting, and reading case law analyses. We used a mixed methods design to examine how risk management is…

  1. A Health Systems Approach to Integrated Community Case Management of Childhood Illness: Methods and Tools

    PubMed Central

    McGorman, Laura; Marsh, David R.; Guenther, Tanya; Gilroy, Kate; Barat, Lawrence M.; Hammamy, Diaa; Wansi, Emmanuel; Peterson, Stefan; Hamer, Davidson H.; George, Asha

    2012-01-01

    Integrated community case management (iCCM) of childhood illness is an increasingly popular strategy to expand life-saving health services to underserved communities. However, community health approaches vary widely across countries and do not always distribute resources evenly across local health systems. We present a harmonized framework, developed through interagency consultation and review, which supports the design of CCM by using a systems approach. To verify that the framework produces results, we also suggest a list of complementary indicators, including nine global metrics, and a menu of 39 country-specific measures. When used by program managers and evaluators, we propose that the framework and indicators can facilitate the design, implementation, and evaluation of community case management. PMID:23136280

  2. Medicare and You

    MedlinePlus

    ... 800-829-4833 va. gov Office of Personnel Management Get information about the Federal Employee Health Benefits (FEHB) Program ... in health plans, including Medicare ■ Medical and case management records (except ... Any other records that contain information that doctors or health plans use to make ...

  3. Livestock grazing and wildlife: developing compatabilities.

    Treesearch

    Martin Vavra

    2005-01-01

    Livestock grazing has been considered detrimental to wildlife habitat. Managed gazing programs, however, have the potential to maintain habitat diversity and quality. In cases in which single-species management predominates (sage-grouse [Centrocercus urophasianus] or elk [Cervus elaphus nelsoni] winter range), grazing systems...

  4. Simulation Based Training Improves Airway Management for Helicopter EMS Teams

    NASA Technical Reports Server (NTRS)

    Dhindsa, Harinder S.; Reid, Renee; Murray, David; Lovelady, James; Powell, Katie; Sayles, Jeff; Stevenson, Christopher; Baker, Kathy; Solada, Brian; Carroll, Scott; hide

    2011-01-01

    The use of paralytic medications in the performance of RSI intubation is a high risk intervention used by many HEMS crews. There is no margin for error in RSI intubation as the results can be fatal. Operating room access for airway management training has become more difficult, and is not representative of the environment in which HEMS crews typically function. LifeEvac of Virginia designed and implemented an SST airway management program to provide a realistic, consistent training platform. The dynamic program incorporates standardized scenarios, and real life challenging cases that this and other programs have encountered. SST is done in a variety of settings including the helicopter, back of ambulances, staged car crashes and simulation centers. The result has been the indoctrination of a well defined, consistent approach to every airway management intervention. The SST program facillitates enhancement of technical skills. as well as team dynamics and communication.

  5. SLFP: a stochastic linear fractional programming approach for sustainable waste management.

    PubMed

    Zhu, H; Huang, G H

    2011-12-01

    A stochastic linear fractional programming (SLFP) approach is developed for supporting sustainable municipal solid waste management under uncertainty. The SLFP method can solve ratio optimization problems associated with random information, where chance-constrained programming is integrated into a linear fractional programming framework. It has advantages in: (1) comparing objectives of two aspects, (2) reflecting system efficiency, (3) dealing with uncertainty expressed as probability distributions, and (4) providing optimal-ratio solutions under different system-reliability conditions. The method is applied to a case study of waste flow allocation within a municipal solid waste (MSW) management system. The obtained solutions are useful for identifying sustainable MSW management schemes with maximized system efficiency under various constraint-violation risks. The results indicate that SLFP can support in-depth analysis of the interrelationships among system efficiency, system cost and system-failure risk. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Long-Term Monitoring of Cased Pipelines Using Longrange Guided-Wave Technique

    DOT National Transportation Integrated Search

    2009-05-19

    Integrity management programs for gas transmission pipelines are required by The Office of Pipeline Safety (OPS)/DOT. Direct Assessment (DA) and 'Other Technologies' have become the focus of assessment options for pipeline integrity on cased crossing...

  7. Child Protection and Case Management Team Performance Evaluation Tool (CPCMT P.E.T.).

    DTIC Science & Technology

    1982-05-01

    audit): ( 1 ) Structural measures - the environment, physical facilities, personnel capability, and organizational characteristics of the program (e.g...Need objective criteria for the measurement - define terms . Examples: Under organization, what is ( 1 ) "complete interdisciplinary composition" and (5...VATALOG NUMBER Health Care Studies Div Rpt #82-00 1 4. TITLE (and SubtUo) S. TYPE OF REPORT & PERIOD COVERED Child Protection and Case Management Team

  8. CONSERVATIVE MANAGEMENT OF AN ISOLATED GRADE III LATERAL COLLATERAL LIGAMENT INJURY IN AN ADOLESCENT MULTI-SPORT ATHLETE: A CASE REPORT

    PubMed Central

    Haddad, M. Alex; Budich, Justin M.; Eckenrode, Brian J.

    2016-01-01

    ABSTRACT Study design Case report Background Isolated, grade III lateral collateral ligament knee injuries are an uncommon traumatic injury with little guidance available in the literature for conservative management and prognosis for return to sport. The purpose of this case report is to describe the clinical decision-making in both differential diagnosis and physical therapy management of an isolated grade III lateral collateral ligament sprain in an adolescent multi-sport high school athlete. Case Description A 16 year-old male, high school, multi-sport athlete (cross country, wrestling, track and field) sustained a traumatic knee injury during a wrestling match when his involved lower extremity was forcefully externally rotated by his opponent. Initial clinical presentation revealed pain and increased laxity with varus stress testing of the left knee, which was subsequently identified via MRI as a complete lateral collateral ligament rupture (grade III). A conservative physical therapy program was developed targeting the active and neuromuscular subsystems, theorized to compensate for the lack of an intact lateral collateral ligament. Outcomes The subject attended 18 visits of physical therapy over a period of 12 weeks. His rehabilitation program focused on functional strengthening of the posterolateral corner, enhancement of neuromuscular control, and graded progression to sports specific drills. Return to play decisions were based on a combination of lower extremity functional performance measures, condition specific outcome measures and subjective performance on sports specific tasks. At discharge from physical therapy, he reported 0/10 pain, scored a 76/80 on the Lower Extremity Functional Scale, and was able to return to competitive track and field events. Discussion Few descriptions in the literature exist for the conservative management of isolated, grade III lateral collateral ligament injuries. A program of selective functional strengthening, proprioceptive training, and graded sport specific activities may allow these individuals to return to sport with conservative management. Levels of Evidence 4 (Single Case Report) PMID:27525183

  9. Performance analysis of Virginia's safety service patrol programs : a case study approach.

    DOT National Transportation Integrated Search

    2006-01-01

    Many state departments of transportation (DOTs) operate safety service patrols (SSPs) as part of their incident management programs. The primary objectives of SSPs are to minimize the duration of freeway incidents, restore full capacity of the freewa...

  10. Beneficial Uses of Dredged Material Case Study: San Francisco Bay Region

    EPA Pesticide Factsheets

    A major interagency, regional planning effort led to the development of the Long-Term Management Strategy and other planning programs in the San Francisco Bay area. These programs incorporate beneficial uses of dredged material into local projects.

  11. Truancy Assessment and Service Centers (TASC): Engaging Elementary School Children and Their Families

    ERIC Educational Resources Information Center

    Rhodes, Judith L. F.; Thomas, Johanna M.; Lemieux, Catherine M.; Cain, Daphne S.; Guin, Cecile C.

    2010-01-01

    This article reviews literature describing truancy and its correlates, and it analyzes the current research on truancy prevention programs. Few truancy prevention programs exist in elementary school settings. This article describes Truancy Assessment and Service Centers, a theory-driven program providing case management services to children in 85…

  12. Entrepreneurial Learning through Action: A Case Study of the Six-Squared Program

    ERIC Educational Resources Information Center

    Pittaway, Luke; Missing, Caroline; Hudson, Nigel; Maragh, Dean

    2009-01-01

    This paper explores the role of "action" in entrepreneurial learning and illustrates how programs designed to support action learning can enhance management development in entrepreneurial businesses. The paper begins by exploring action learning and the way "action" is conceived in different types of program. In the second part, the paper details…

  13. FSILP: fuzzy-stochastic-interval linear programming for supporting municipal solid waste management.

    PubMed

    Li, Pu; Chen, Bing

    2011-04-01

    Although many studies on municipal solid waste management (MSW management) were conducted under uncertain conditions of fuzzy, stochastic, and interval coexistence, the solution to the conventional linear programming problems of integrating fuzzy method with the other two was inefficient. In this study, a fuzzy-stochastic-interval linear programming (FSILP) method is developed by integrating Nguyen's method with conventional linear programming for supporting municipal solid waste management. The Nguyen's method was used to convert the fuzzy and fuzzy-stochastic linear programming problems into the conventional linear programs, by measuring the attainment values of fuzzy numbers and/or fuzzy random variables, as well as superiority and inferiority between triangular fuzzy numbers/triangular fuzzy-stochastic variables. The developed method can effectively tackle uncertainties described in terms of probability density functions, fuzzy membership functions, and discrete intervals. Moreover, the method can also improve upon the conventional interval fuzzy programming and two-stage stochastic programming approaches, with advantageous capabilities that are easily achieved with fewer constraints and significantly reduces consumption time. The developed model was applied to a case study of municipal solid waste management system in a city. The results indicated that reasonable solutions had been generated. The solution can help quantify the relationship between the change of system cost and the uncertainties, which could support further analysis of tradeoffs between the waste management cost and the system failure risk. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. Improving environmental and social targeting through adaptive management in Mexico's payments for hydrological services program.

    PubMed

    Sims, Katharine R E; Alix-Garcia, Jennifer M; Shapiro-Garza, Elizabeth; Fine, Leah R; Radeloff, Volker C; Aronson, Glen; Castillo, Selene; Ramirez-Reyes, Carlos; Yañez-Pagans, Patricia

    2014-10-01

    Natural resource managers are often expected to achieve both environmental protection and economic development even when there are fundamental trade-offs between these goals. Adaptive management provides a theoretical structure for program administrators to balance social priorities in the presence of trade-offs and to improve conservation targeting. We used the case of Mexico's federal Payments for Hydrological Services program (PSAH) to illustrate the importance of adaptive management for improving program targeting. We documented adaptive elements of PSAH and corresponding changes in program eligibility and selection criteria. To evaluate whether these changes resulted in enrollment of lands of high environmental and social priority, we compared the environmental and social characteristics of the areas enrolled in the program with the characteristics of all forested areas in Mexico, all areas eligible for the program, and all areas submitted for application to the program. The program successfully enrolled areas of both high ecological and social priority, and over time, adaptive changes in the program's criteria for eligibility and selection led to increased enrollment of land scoring high on both dimensions. Three factors facilitated adaptive management in Mexico and are likely to be generally important for conservation managers: a supportive political environment, including financial backing and encouragement to experiment from the federal government; availability of relatively good social and environmental data; and active participation in the review process by stakeholders and outside evaluators. © 2014 Society for Conservation Biology.

  15. Report to Congress on the U.S. Department of Energy`s Environmental Management Science Program: Research funded and its linkages to environmental cleanup problems, and Environmental Management Science Program research award abstracts. Volume 2 of 3 -- Appendix B

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    The Department of Energy`s Environmental Management Science Program (EMSP) serves as a catalyst for the application of scientific discoveries to the development and deployment of technologies that will lead to reduction of the costs and risks associated with cleaning up the nation`s nuclear complex. Appendix B provides details about each of the 202 research awards funded by the EMSP. This information may prove useful to researchers who are attempting to address the Department`s environmental management challenges in their work, program managers who are planning, integrating, and prioritizing Environmental Management projects, and stakeholders and regulators who are interested in the Department`smore » environmental challenges. The research award information is organized by the state and institution in which the lead principal investigator is located. In many cases, the lead principal investigator is one of several investigators at a number of different institutions. In these cases, the lead investigator (major collaborator) at each of the additional institutions is listed. Each research award abstract is followed by a list of high cost projects that can potentially be impacted by the research results. High cost projects are Environmental Management projects that have total costs greater than $50 million from the year 2007 and beyond, based on the March 1998 Accelerating Cleanup: Paths to Closure Draft data, and have costs or quantities of material associated with an Environmental Management problem area. High cost projects which must remain active in the year 2007 and beyond to manage high risk are also identified. Descriptions of these potentially related high cost Environmental Management projects can be found in Appendix C. Additional projects in the same problem area as a research award can be located using the Index of High Cost Environmental Management Projects by Problem Area, at the end of Appendices B and C.« less

  16. The community case management program: for 12 years, caring at its best.

    PubMed

    Luzinski, Cyndy Hunt; Stockbridge, Eleanor; Craighead, Janet; Bayliss, Deborah; Schmidt, Marie; Seideman, Janice

    2008-01-01

    One of the most complex issues currently under debate in this country is how best to provide health care for our society. Since 1995, Poudre Valley Hospital in Fort Collins, Colorado, has been effectively addressing one facet of this national crisis by providing services to a population of primarily elderly, chronically ill individuals perpetually caught in the gaps between acute and end-of-life services. Community case managers link program participants with appropriate health care services and providers that enhance physiological and functional status, identify resources that enrich quality of life, and encourage relationships and skills which foster self-efficacy. By emphasizing timely access to health-maximizing services, this program documented an impressive 81% reduction in financial losses to the organization during 2006 for emergency and inpatient services provided to a specific sample from this population.

  17. Using Constructive Alignment to Improve Student Research and Writing Skills: A Case Study of a Master's Program in Real Estate Management

    ERIC Educational Resources Information Center

    Azasu, Samuel; Berggren, Björn

    2015-01-01

    The purpose of the paper is to describe and analyse efforts to integrate research into teaching in a postgraduate degree program in real estate management. The long term goals of the changes were to increase graduation rates as well as the quality of dissertations. In order to validate our findings, the data for this paper emanate from a three…

  18. [New professional field in France: Analysis of the training needs of case managers].

    PubMed

    Somme, Dominique; Corvol, Aline; Couturier, Yves; Pimouguet, Clément; Moreau, Olivier; Perivier, Samuel; Balard, Frédéric; de Stampa, Matthieu

    2015-01-01

    Case management is a relatively new career field in France. It was first introduced on an experimental basis in 2007-2008, and was then developedfollowing the National Alzheimer Plan and finally enshrined in legislation in 2012. This careerfield is based on a set of tasks widely described internationally: identifying the right level of intervention, standardized multidimensional assessment, planning all aid (care and social services), implementation of the plan, monitoring and reassessment and periodic reassessment of all needs in a continuous and long-term process. The specific, systematic and dedicated nature of these tasks to these tasks makes training essential. Regulations also stipulate that the professional must acquire additional training by a dedicated inter-university degree. This requirement is a French specificity The authors present the history of case management and training in France and analyze the various international training frameworks identified by an Internet search. Moreover, based on the opinions expressed by case managers at different times of the scientific assessment and a review ofseveral studies conducted by inter-university case management program students, this article highlights the specific training needs of case managers and how the proposed training can meet these needs.

  19. Is Case Management Effective for Long-Lasting Suicide Prevention?

    PubMed

    Wang, Liang-Jen; Wu, Ya-Wen; Chen, Chih-Ken

    2015-01-01

    Case management services have been implemented in suicide prevention programs. To investigate whether case management is an effective strategy for reducing the risks of repeated suicide attempts and completed suicides in a city with high suicide rates in northern Taiwan. The Suicide Prevention Center of Keelung City (KSPC) was established in April 2005. Subjects included a consecutive sample of individuals (N = 2,496) registered in KSPC databases between January 1, 2006, and December 31, 2011, with at least one episode of nonfatal self-harm. Subjects were tracked for the duration of the study. Of all the subjects, 1,013 (40.6%) received case management services; 416 (16.7%) had at least one other deliberate self-harm episode and 52 (2.1%) eventually died by suicide. No significant differences were found in the risks of repeated self-harm and completed suicides between suicide survivors who received case management and those who refused the services. However, a significant reduction in suicide rates was found after KSPC was established. Findings suggest that case management services might not reduce the risks of suicide repetition among suicide survivors during long-term follow-up. Future investigation is warranted to determine factors impacting the downward trend of suicide rates.

  20. Healthcare cost savings estimator tool for chronic disease self-management program: a new tool for program administrators and decision makers.

    PubMed

    Ahn, SangNam; Smith, Matthew Lee; Altpeter, Mary; Post, Lindsey; Ory, Marcia G

    2015-01-01

    Chronic disease self-management education (CDSME) programs have been delivered to more than 100,000 older Americans with chronic conditions. As one of the Stanford suite of evidence-based CDSME programs, the chronic disease self-management program (CDSMP) has been disseminated in diverse populations and settings. The objective of this paper is to introduce a practical, universally applicable tool to assist program administrators and decision makers plan implementation efforts and make the case for continued program delivery. This tool was developed utilizing data from a recent National Study of CDSMP to estimate national savings associated with program participation. Potential annual healthcare savings per CDSMP participant were calculated based on averted emergency room visits and hospitalizations. While national data can be utilized to estimate cost savings, the tool has built-in features allowing users to tailor calculations based on their site-specific data. Building upon the National Study of CDSMP's documented potential savings of $3.3 billion in healthcare costs by reaching 5% of adults with one or more chronic conditions, two heuristic case examples were also explored based on different population projections. The case examples show how a small county and large metropolitan city were not only able to estimate healthcare savings ($38,803 for the small county; $732,290 for the large metropolitan city) for their existing participant populations but also to project significant healthcare savings if they plan to reach higher proportions of middle-aged and older adults. Having a tool to demonstrate the monetary value of CDSMP can contribute to the ongoing dissemination and sustainability of such community-based interventions. Next steps will be creating a user-friendly, internet-based version of Healthcare Cost Savings Estimator Tool: CDSMP, followed by broadening the tool to consider cost savings for other evidence-based programs.

  1. Revolutionizing Child Welfare with Outcomes Management

    PubMed Central

    Toche-Manley, Linda L.; Dietzen, Laura; Nankin, Jesse; Beigel, Astrid

    2013-01-01

    Outcomes management technology holds great promise for improving the quality of services provided to youth in the child welfare system. Advantages include better detection of behavioral health and trauma-related issues, early indicators of case progress or risk of failure and program- and system-level learning. Yet organizational barriers to implementation persist. Attention is spent in this paper on addressing these barriers so the use of outcomes management technology becomes a common practice. A model for predicting resiliency is presented, along with case examples demonstrating its potential use for treatment planning and monitoring progress. PMID:23460130

  2. Using archived data to measure operational benefits of ITS investments, volume 1 : ramp meters.

    DOT National Transportation Integrated Search

    2004-06-01

    develop two case study evaluations for Oregon, including an evaluation of the COMET incident management program and the : Portland ramp metering system. The COMET evaluation will include a thorough literature review of other incident management : pro...

  3. Optimization Strategies for Long-Term Ground Water Remedies (with Particular Emphasis on Pump and Treat Systems)

    EPA Pesticide Factsheets

    This fact sheet has been prepared to assist environmental case managers from Federal and State agencies, environmental program managers from private organizations, and environmental contractors with optimization of operating long-term ground water remedies

  4. The Columbia University Management Program.

    ERIC Educational Resources Information Center

    Yavarkovsky, Jerome; Haas, Warren J.

    In 1971, a management consulting firm undertook a case study of the Columbia University libraries to improve library performance by reviewing and strengthening the organization and recasting staff composition and deployment patterns. To implement the study's recommendations, an administrative structure was proposed which would emphasize functional…

  5. Making the business case for health and productivity management.

    PubMed

    Sullivan, Sean

    2004-06-01

    Health and productivity management (HPM) is an important innovation for businesses concerned with rising health care costs. Like any innovation, however, it will not be adopted rapidly unless it is tailored to the needs of employers. For the last 6 years the Institute for Health and Productivity Management has studied the needs of American employers and sponsored employer driven case studies of health care and productivity. From these studies and the work of academic experts we have fashioned a set of programs to effectively communicate the advantages of health and productivity measurement and management. To make the business case for health and productivity management, researchers need to (1) demonstrate the relative advantage of HPM, (2) keep the evidence simple, (3) show that HPM is compatible with employer practices, and (4) communicate the results within and across corporate departments.

  6. Employee Participation: Some Australian Cases.

    ERIC Educational Resources Information Center

    Lansbury, Russell D.; Davis, Edward M.

    1992-01-01

    The Australian Workplace Industrial Relations Survey of 2,353 companies showed sporadic employee participation in decision making. Although case studies of Ford Motor, Australia Post, Lend Lease, Telecom Australia, and Woodlawn Mining illustrate successful programs, most managers appear cautious about industrial democracy. (SK)

  7. Heart failure disease management programs: a cost-effectiveness analysis.

    PubMed

    Chan, David C; Heidenreich, Paul A; Weinstein, Milton C; Fonarow, Gregg C

    2008-02-01

    Heart failure (HF) disease management programs have shown impressive reductions in hospitalizations and mortality, but in studies limited to short time frames and high-risk patient populations. Current guidelines thus only recommend disease management targeted to high-risk patients with HF. This study applied a new technique to infer the degree to which clinical trials have targeted patients by risk based on observed rates of hospitalization and death. A Markov model was used to assess the incremental life expectancy and cost of providing disease management for high-risk to low-risk patients. Sensitivity analyses of various long-term scenarios and of reduced effectiveness in low-risk patients were also considered. The incremental cost-effectiveness ratio of extending coverage to all patients was $9700 per life-year gained in the base case. In aggregate, universal coverage almost quadrupled life-years saved as compared to coverage of only the highest quintile of risk. A worst case analysis with simultaneous conservative assumptions yielded an incremental cost-effectiveness ratio of $110,000 per life-year gained. In a probabilistic sensitivity analysis, 99.74% of possible incremental cost-effectiveness ratios were <$50,000 per life-year gained. Heart failure disease management programs are likely cost-effective in the long-term along the whole spectrum of patient risk. Health gains could be extended by enrolling a broader group of patients with HF in disease management.

  8. [Constraints and opportunities for inter-sector health promotion initiatives: a case study].

    PubMed

    Magalhães, Rosana

    2015-07-01

    This article analyzes the implementation of inter-sector initiatives linked to the Family Grant, Family Health, and School Health Programs in the Manguinhos neighborhood in the North Zone of Rio de Janeiro, Brazil. The study was conducted in 2010 and 2011 and included document review, local observation, and 25 interviews with program managers, professionals, and staff. This was an exploratory case study using a qualitative approach that identified constraints and opportunities for inter-sector health experiences, contributing to the debate on the effectiveness of health promotion and poverty relief programs.

  9. The potential of disease management for neuromuscular hereditary disorders.

    PubMed

    Chouinard, Maud-Christine; Gagnon, Cynthia; Laberge, Luc; Tremblay, Carmen; Côté, Charlotte; Leclerc, Nadine; Mathieu, Jean

    2009-01-01

    Neuromuscular hereditary disorders require long-term multidisciplinary rehabilitation management. Although the need for coordinated healthcare management has long been recognized, most neuromuscular disorders are still lacking clinical guidelines about their long-term management and structured evaluation plan with associated services. One of the most prevalent adult-onset neuromuscular disorders, myotonic dystrophy type 1, generally presents several comorbidities and a variable clinical picture, making management a constant challenge. This article presents a healthcare follow-up plan and proposes a nursing case management within a disease management program as an innovative and promising approach. This disease management program and model consists of eight components including population identification processes, evidence-based practice guidelines, collaborative practice, patient self-management education, and process outcomes evaluation (Disease Management Association of America, 2004). It is believed to have the potential to significantly improve healthcare management for neuromuscular hereditary disorders and will prove useful to nurses delivering and organizing services for this population.

  10. Regional monitoring programs in the United States: Synthesis of four case studies from Pacific, Atlantic, and Gulf Coasts

    USGS Publications Warehouse

    Tango, Peter J.; Schiff, K.; Trowbridge, P.R.; Sherwood, E.T.; Batiuk, R.A.

    2016-01-01

    Water quality monitoring is a cornerstone of environmental protection and ambient monitoring provides managers with the critical data they need to take informed action. Unlike site-specific monitoring that is at the heart of regulatory permit compliance, regional monitoring can provide an integrated, holistic view of the environment, allowing managers to obtain a more complete picture of natural variability and cumulative impacts, and more effectively prioritize management actions. By reviewing four long-standing regional monitoring programs that cover portions of all three coasts in the United States – Chesapeake Bay, Tampa Bay, Southern California Bight, and San Francisco Bay – important insights can be gleaned about the benefits that regional monitoring provides to managers. These insights include the underlying reasons that make regional monitoring programs successful, the challenges to maintain relevance and viability in the face of ever-changing technology, competing demands and shifting management priorities. The lessons learned can help other managers achieve similar successes as they seek to establish and reinvigorate their own monitoring programs.

  11. SEPG Europe 2012 Conference Proceedings

    DTIC Science & Technology

    2012-09-01

    Process Management http://www.sei.cmu.edu SEI markings v3.2/ DM-0000022 / 30 August 2011 Copyright 2012 Carnegie Mellon University This material...Change Management Decisions in Large Enterprise Transformation Programs 18 3.1 Abstract 18 3.2 Introduction 18 3.3 Barriers for Transformation 18...Case Study #3: Enterprise Transformation Through Enterprise Data Management (Investment and Asset Management ) 25 3.7 Conclusions and Recommendations 27

  12. Development of a Medicaid Behavioral Health Case-Mix Model

    ERIC Educational Resources Information Center

    Robst, John

    2009-01-01

    Many Medicaid programs have either fully or partially carved out mental health services. The evaluation of carve-out plans requires a case-mix model that accounts for differing health status across Medicaid managed care plans. This article develops a diagnosis-based case-mix adjustment system specific to Medicaid behavioral health care. Several…

  13. Case-Based Learning: Educating Future Human Service Managers

    ERIC Educational Resources Information Center

    Austin, Michael J.; Packard, Thomas

    2009-01-01

    Using teaching cases in professional education programs has gained increased attention in the past several decades. While the use of teaching cases has been an important part of social work education, the majority of current casebooks focus on micro or direct practice issues and settings. Over the past forty years only four major casebooks have…

  14. 76 FR 59658 - Certain Frozen Fish Fillets From the Socialist Republic of Vietnam: Extension of Time Limit for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... Program Manager Import Administration, from Emeka Chukwudebe, Case Analyst, Import administration, Re..., 2011. \\4\\ See Memorandum for All Interested Parties, from Emeka Chukwudebe, Case Analyst, Import... new shipper review to 300 days if it determines that the case is extraordinarily complicated. See 19...

  15. Caring for children with special healthcare needs in the managed care environment.

    PubMed

    Hawkins, Michelle R; Diehl-Svrjcek, Beth; Dunbar, Linda J

    2006-01-01

    Dramatic medical and technological advances over the past 15 years have resulted in the survival into adulthood of children with chronic health conditions. As this population subset has increased, the demand of caring for these children in the managed care arena has become challenging from a clinical, fiscal, and member satisfaction perspective. A disease management program was designed for children, ages birth through age 18, identified as having special needs at the time of birth or at any point throughout childhood related to disease processes such as diabetes, sickle cell disease, genetic aberrations, or the multiple complications of extreme prematurity. Components of the program included identification of the population, coordinated risk assessment, and ongoing case management interventions. Most important, outcome indicators were tracked to demonstrate program effectiveness. The formulation and function of a dedicated disease management database is also discussed.

  16. An inexact mixed risk-aversion two-stage stochastic programming model for water resources management under uncertainty.

    PubMed

    Li, W; Wang, B; Xie, Y L; Huang, G H; Liu, L

    2015-02-01

    Uncertainties exist in the water resources system, while traditional two-stage stochastic programming is risk-neutral and compares the random variables (e.g., total benefit) to identify the best decisions. To deal with the risk issues, a risk-aversion inexact two-stage stochastic programming model is developed for water resources management under uncertainty. The model was a hybrid methodology of interval-parameter programming, conditional value-at-risk measure, and a general two-stage stochastic programming framework. The method extends on the traditional two-stage stochastic programming method by enabling uncertainties presented as probability density functions and discrete intervals to be effectively incorporated within the optimization framework. It could not only provide information on the benefits of the allocation plan to the decision makers but also measure the extreme expected loss on the second-stage penalty cost. The developed model was applied to a hypothetical case of water resources management. Results showed that that could help managers generate feasible and balanced risk-aversion allocation plans, and analyze the trade-offs between system stability and economy.

  17. Towards Customer-Driven Management in Hospitality Education: A Case Study of the Higher Hotel Institute, Cyprus.

    ERIC Educational Resources Information Center

    Varnavas, Andreas P.; Soteriou, Andreas C.

    2002-01-01

    Presents and discusses the approach used by the Higher Hotel Institute in Cyprus to incorporate total quality management through establishment of a customer-driven management culture in its hospitality education program. Discusses how it collects and uses service-quality related data from future employers, staff, and students in pursuing this…

  18. SCIENCE FOR INTEGRATED WATERSHED MANAGEMENT: A MULTI-SCALE EXPERIMENTAL CASE STUDY LINKING LAND USE MANAGEMENT PRACTICES AND WATER QUALITY IN SOUTHERN OHIO

    EPA Science Inventory

    Although it is routine for watershed management programs to coincide the monitoring of land use impacts and water quality at different spatial scales, rarely are the data collected in a manner to elucidate the linkages among ecological systems across a drainage network. There rem...

  19. Dynamic analysis for solid waste management systems: an inexact multistage integer programming approach.

    PubMed

    Li, Yongping; Huang, Guohe

    2009-03-01

    In this study, a dynamic analysis approach based on an inexact multistage integer programming (IMIP) model is developed for supporting municipal solid waste (MSW) management under uncertainty. Techniques of interval-parameter programming and multistage stochastic programming are incorporated within an integer-programming framework. The developed IMIP can deal with uncertainties expressed as probability distributions and interval numbers, and can reflect the dynamics in terms of decisions for waste-flow allocation and facility-capacity expansion over a multistage context. Moreover, the IMIP can be used for analyzing various policy scenarios that are associated with different levels of economic consequences. The developed method is applied to a case study of long-term waste-management planning. The results indicate that reasonable solutions have been generated for binary and continuous variables. They can help generate desired decisions of system-capacity expansion and waste-flow allocation with a minimized system cost and maximized system reliability.

  20. An architecture model for multiple disease management information systems.

    PubMed

    Chen, Lichin; Yu, Hui-Chu; Li, Hao-Chun; Wang, Yi-Van; Chen, Huang-Jen; Wang, I-Ching; Wang, Chiou-Shiang; Peng, Hui-Yu; Hsu, Yu-Ling; Chen, Chi-Huang; Chuang, Lee-Ming; Lee, Hung-Chang; Chung, Yufang; Lai, Feipei

    2013-04-01

    Disease management is a program which attempts to overcome the fragmentation of healthcare system and improve the quality of care. Many studies have proven the effectiveness of disease management. However, the case managers were spending the majority of time in documentation, coordinating the members of the care team. They need a tool to support them with daily practice and optimizing the inefficient workflow. Several discussions have indicated that information technology plays an important role in the era of disease management. Whereas applications have been developed, it is inefficient to develop information system for each disease management program individually. The aim of this research is to support the work of disease management, reform the inefficient workflow, and propose an architecture model that enhance on the reusability and time saving of information system development. The proposed architecture model had been successfully implemented into two disease management information system, and the result was evaluated through reusability analysis, time consumed analysis, pre- and post-implement workflow analysis, and user questionnaire survey. The reusability of the proposed model was high, less than half of the time was consumed, and the workflow had been improved. The overall user aspect is positive. The supportiveness during daily workflow is high. The system empowers the case managers with better information and leads to better decision making.

  1. CASE/A - COMPUTER AIDED SYSTEM ENGINEERING AND ANALYSIS, ECLSS/ATCS SERIES

    NASA Technical Reports Server (NTRS)

    Bacskay, A.

    1994-01-01

    Design and analysis of Environmental Control and Life Support Systems (ECLSS) and Active Thermal Control Systems (ATCS) for spacecraft missions requires powerful software that is flexible and responsive to the demands of particular projects. CASE/A is an interactive trade study and analysis tool designed to increase productivity during all phases of systems engineering. The graphics-based command-driven package provides a user-friendly environment in which the engineer can analyze the performance and interface characteristics of an ECLS/ATC system. The package is useful during all phases of a spacecraft design program, from initial conceptual design trade studies to the actual flight, including pre-flight prediction and in-flight anomaly analysis. The CASE/A program consists of three fundamental parts: 1) the schematic management system, 2) the database management system, and 3) the simulation control and execution system. The schematic management system allows the user to graphically construct a system model by arranging icons representing system components and connecting the components with physical fluid streams. Version 4.1 contains 51 fully coded and documented default component routines. New components can be added by the user through the "blackbox" component option. The database management system supports the storage and manipulation of component data, output data, and solution control data through interactive edit screens. The simulation control and execution system initiates and controls the iterative solution process, displaying time status and any necessary diagnostic messages. In addition to these primary functions, the program provides three other important functional areas: 1) model output management, 2) system utility commands, and 3) user operations logic capacity. The model output management system provides tabular and graphical output capability. Complete fluid constituent mass fraction and properties data (mass flow, pressure, temperature, specific heat, density, and viscosity) is generated at user-selected output intervals and stored for reference. The Integrated Plot Utility (IPU) provides plotting capability for all data output. System utility commands are provided to enable the user to operate more efficiently in the CASE/A environment. The user is able to customize a simulation through optional operations FORTRAN logic. This user-developed code is compiled and linked with a CASE/A model and enables the user to control and timeline component operating parameters during various phases of the iterative solution process. CASE/A provides for transient tracking of the flow stream constituents and determination of their thermodynamic state throughout an ECLSS/ATCS simulation, performing heat transfer, chemical reaction, mass/energy balance, and system pressure drop analysis based on user-specified operating conditions. The program tracks each constituent through all combination and decomposition states while maintaining a mass and energy balance on the overall system. This allows rapid assessment of ECLSS designs, the impact of alternate technologies, and impacts due to changes in metabolic forcing functions, consumables usage, and system control considerations. CASE/A is written in FORTRAN 77 for the DEC VAX/VMS computer series, and requires 12Mb of disk storage and a minimum paging file quota of 20,000 pages. The program operates on the Tektronix 4014 graphics standard and VT100 text standard. The program requires a Tektronix 4014 or later graphics terminal, third party composite graphics/text terminal, or personal computer loaded with appropriate VT100/TEK 4014 emulator software. The use of composite terminals or personal computers with popular emulation software is recommended for enhanced CASE/A operations and general ease of use. The program is available on an unlabeled 9-track 6250 BPI DEC VAX BACKUP format magnetic tape. CASE/A development began in 1985 under contract to NASA/Marshall Space Flight Center. The latest version (4.1) was released in 1990. Tektronix and TEK 4014 are trademarks of Tektronix, Inc. VT100 is a trademark of Digital Equipment Corporation.

  2. The Development of an Interactive Computer-Based Training Program for Timely and Humane On-Farm Pig Euthanasia.

    PubMed

    Mullins, Caitlyn R; Pairis-Garcia, Monique D; Campler, Magnus R; Anthony, Raymond; Johnson, Anna K; Coleman, Grahame J; Rault, Jean-Loup

    2018-02-05

    With extensive knowledge and training in the prevention, management, and treatment of disease conditions in animals, veterinarians play a critical role in ensuring good welfare on swine farms by training caretakers on the importance of timely euthanasia. To assist veterinarians and other industry professionals in training new and seasoned caretakers, an interactive computer-based training program was created. It consists of three modules, each containing five case studies, which cover three distinct production stages (breeding stock, piglets, and wean to grower-finisher pigs). Case study development was derived from five specific euthanasia criteria defined in the 2015 Common Swine Industry Audit, a nationally recognized auditing program used in the US. Case studies provide information regarding treatment history, clinical signs, and condition severity of the pig and prompt learners to make management decisions regarding pig treatment and care. Once a decision is made, feedback is provided so learners understand the appropriateness of their decision compared to current industry guidelines. In addition to training farm personnel, this program may also be a valuable resource if incorporated into veterinary, graduate, and continuing education curricula. This innovative tool represents the first interactive euthanasia-specific training program in the US swine industry and offers the potential to improve timely and humane on-farm pig euthanasia.

  3. Using the Program Sustainability Assessment Tool to Assess and Plan for Sustainability

    PubMed Central

    Mainor, Avia; Moreland-Russell, Sarah; Maier, Ryan C.; Brossart, Laura; Luke, Douglas A.

    2014-01-01

    Implementing and growing a public health program that benefits society takes considerable time and effort. To ensure that positive outcomes are maintained over time, program managers and stakeholders should plan and implement activities to build sustainability capacity within their programs. We describe a 3-part sustainability planning process that programs can follow to build their sustainability capacity. First, program staff and stakeholders take the Program Sustainability Assessment Tool to measure their program’s sustainability across 8 domains. Next, managers and stakeholders use results from the assessment to inform and prioritize sustainability action planning. Lastly, staff members implement the plan and keep track of progress toward their sustainability goals. Through this process, staff can more holistically address the internal and external challenges and pressures associated with sustaining a program. We include a case example of a chronic disease program that completed the Program Sustainability Assessment Tool and engaged in program sustainability planning. PMID:24456644

  4. Program structure and counselor-client contact in outpatient substance abuse treatment.

    PubMed

    Knight, Danica K; Broome, Kirk M; Simpson, D Dwayne; Flynn, Patrick M

    2008-04-01

    To examine organizational structural attributes associated with counselor-client contact. Data were collected in 2004 and 2005 for a federally funded project, which simultaneously examines organizational structure, functioning, and resources among outpatient substance abuse treatment programs. The study uses a naturalistic design to investigate organizational structure measures-ownership, accreditation, and supplemental services-as predictors of time in counseling and case management, and caseload size, controlling for geographic differences. Directors at 116 outpatient drug-free treatment programs located in four regions across the U.S. (Great Lakes, Gulf Coast, Northwest, and Southeast) voluntarily completed a survey about program structure. Clients received more counseling hours in programs that were "intensive," publicly owned, accredited, and had a lower proportion of recently hired counselors. More case management hours were offered in "intensive," private-for-profit or publicly owned (versus private-nonprofit) programs, serving a lower proportion of dual-diagnosis clients, and providing more on-site supplemental services. Smaller caseloads were found in programs that were accredited and had a smaller average client census and a lower proportion of criminal justice referred clients. Organizational attributes are related to counselor-client contact and may have implications for staff turnover and service quality.

  5. A new DoD initiative: the Computational Research and Engineering Acquisition Tools and Environments (CREATE) program

    NASA Astrophysics Data System (ADS)

    Arevalo, S.; Atwood, C.; Bell, P.; Blacker, T. D.; Dey, S.; Fisher, D.; Fisher, D. A.; Genalis, P.; Gorski, J.; Harris, A.; Hill, K.; Hurwitz, M.; Kendall, R. P.; Meakin, R. L.; Morton, S.; Moyer, E. T.; Post, D. E.; Strawn, R.; Veldhuizen, D. v.; Votta, L. G.; Wynn, S.; Zelinski, G.

    2008-07-01

    In FY2008, the U.S. Department of Defense (DoD) initiated the Computational Research and Engineering Acquisition Tools and Environments (CREATE) program, a 360M program with a two-year planning phase and a ten-year execution phase. CREATE will develop and deploy three computational engineering tool sets for DoD acquisition programs to use to design aircraft, ships and radio-frequency antennas. The planning and execution of CREATE are based on the 'lessons learned' from case studies of large-scale computational science and engineering projects. The case studies stress the importance of a stable, close-knit development team; a focus on customer needs and requirements; verification and validation; flexible and agile planning, management, and development processes; risk management; realistic schedules and resource levels; balanced short- and long-term goals and deliverables; and stable, long-term support by the program sponsor. Since it began in FY2008, the CREATE program has built a team and project structure, developed requirements and begun validating them, identified candidate products, established initial connections with the acquisition programs, begun detailed project planning and development, and generated the initial collaboration infrastructure necessary for success by its multi-institutional, multidisciplinary teams.

  6. Content and Evaluation of the Benefits of Effective Exercise for Older Adults With Knee Pain Trial Physiotherapist Training Program.

    PubMed

    Holden, Melanie A; Whittle, Rebecca; Healey, Emma L; Hill, Susan; Mullis, Ricky; Roddy, Edward; Sowden, Gail; Tooth, Stephanie; Foster, Nadine E

    2017-05-01

    To explore whether participating in the Benefits of Effective Exercise for knee Pain (BEEP) trial training program increased physiotherapists' self-confidence and changed their intended clinical behavior regarding exercise for knee pain in older adults. Before/after training program evaluation. Physiotherapists were asked to complete a questionnaire before the BEEP trial training program, immediately after, and 12 to 18 months later (postintervention delivery in the BEEP trial). The questionnaire included a case vignette and associated clinical management questions. Questionnaire responses were compared over time and between physiotherapists trained to deliver each intervention within the BEEP trial. Primary care. Physiotherapists (N=53) who completed the BEEP trial training program. Not applicable. Self-confidence in the diagnosis and management of knee pain in older adults; and intended clinical behavior measured by a case vignette and associated clinical management questions. Fifty-two physiotherapists (98%) returned the pretraining questionnaire, and 44 (85%) and 39 (74%) returned the posttraining and postintervention questionnaires, respectively. Posttraining, self-confidence in managing older adults with knee pain increased, and intended clinical behavior regarding exercise for knee pain in older adults appeared more in line with clinical guidelines. However, not all positive changes were maintained in the longer-term. Participating in the BEEP trial training program increased physiotherapists' self-confidence and changed their intended clinical behavior regarding exercise for knee pain, but by 12 to 18 months later, some of these positive changes were lost. This suggests that brief training programs are useful, but additional strategies are likely needed to successfully maintain changes in clinical behavior over time. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. Supporting veterans' transitions from permanent supportive housing.

    PubMed

    Montgomery, Ann Elizabeth; Cusack, Meagan C; Gabrielian, Sonya

    2017-12-01

    Little research has assessed the nature of veterans' departures from permanent supportive housing (PSH), which may be of positive valence (e.g., moving into more independent housing). This study aimed to identify participants appropriate for "graduation" from PSH and how to support their transitions. This mixed methods study used qualitative data from PSH program staff, 445 PSH participants' responses to a survey assessing their experiences and administrative records, and qualitative data from a subsample of 10 participants who graduated from the program. Participants were classified as "stayers" (retained in PSH for at least 600 days); "graduates" (exited with improvement in community integration); or "involuntary leavers" (exited for reasons of negative valence). Template analysis of qualitative data from PSH staff described graduation processes; qualitative data from participants were analyzed using a thematic analysis approach. The study compared veterans' characteristics using chi-square and analysis of variance (ANOVA) tests; a multinomial logistic regression assessed correlates of graduates' and involuntary leavers' exits from PSH. Approximately one half of participants who exited the program were graduates. Processes used by program staff to identify potential graduates varied. Participants' self-report of substance use and mental health problems was associated with involuntary leaver status. Frequency of case management, a trusting relationship between participant and case manager, and participants' receipt of compensation related to disability incurred during military service were associated with graduation. To support successful transitions from PSH, programs should focus on providing high-quality case management that may respond flexibly to participants' varying recovery needs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. Establishing a Latin American University Honors Program: The Case of Campus Monterrey, Tecnológico De Monterrey, Mexico

    ERIC Educational Resources Information Center

    Khan, Mohammed Ayub; Morales-Menendez, Ruben

    2012-01-01

    The university honors program of Campus Monterrey, Tecnológico de Monterrey, evolved from the international degree program that was first offered in the spring semester of 2002. Originally six programs were offered in the School of Business and School of Engineering: (1) BA Business Administration; (2) BA Financial Management; (3) BA Finance and…

  9. Managing Athletic Liability: An Assessment Guide.

    ERIC Educational Resources Information Center

    Burling, Philip; And Others

    1992-01-01

    A comprehensive risk-management program associated with athletic activities contains the following essential components: (1) policies and procedures; (2) training; (3) supervision; (4) corrective action; (5) review and revision; (6) legal counsel and support. Action steps follow each of these major areas. (29 case references) (MLF)

  10. Telerehabilitation booster sessions and remote patient monitoring in the management of chronic low back pain: A case series.

    PubMed

    Peterson, Seth

    2018-05-01

    Improvements in chronic low back pain (CLBP) seen in physical therapy do not appear to be retained over the long term. Booster sessions have been proposed, but barriers exist to their implementation. Telerehabilitation (TR) and remote patient monitoring (RPM) may be ways to circumvent these barriers. The purpose of this case series was to describe the implementation of TR booster sessions and RPM in three patients with CLBP. Three females with CLBP tracked their daily pain level and home exercise program adherence using a mobile phone application for 12 months following discharge from traditional face-to-face physical therapy. Synchronous audio and video TR booster sessions were conducted at months 1, 3, 6, and 12. All patients met their individual goals. They demonstrated excellent home exercise program adherence and self-efficacy. A temporary increase in pain was seen in all patients, but they managed solely with the TR booster sessions and without other healthcare resources. Satisfaction with the program was very high. This case series describes the use of TR booster sessions and RPM in three patients with CLBP. The positive results suggest this approach may be helpful in improving long-term management of patients with CLBP but demand further investigation.

  11. Recidivism of Offenders with Mental Illness Released from Prison to an Intensive Community Treatment Program

    ERIC Educational Resources Information Center

    Theurer, Gregory; Lovell, David

    2008-01-01

    An intensive case management treatment program for mentally ill offenders (MIOs) is outlined, and subsequent recidivism of participants is evaluated. Features of the program and its development are discussed. Sixty-four (64) participants released from state prison between 1998 and 2003 were matched with a group of MIOs released earlier on eight…

  12. Variables Influencing the Return on Investment in Management Training Programs: A Utility Analysis of 10 Swiss Cases

    ERIC Educational Resources Information Center

    Chochard, Yves; Davoine, Eric

    2011-01-01

    In this article, we present the utility analysis approach as an alternative and promising approach to measure the return on investment in managerial training programs. This approach, linking economic value with competencies developed by trainees, enables researchers and decision-makers to compare the return on investment from different programs in…

  13. Developing School Leaders: Practitioner Growth during an Advanced Leadership Development Program for Principals and Administrator-Trained Teachers

    ERIC Educational Resources Information Center

    Browne-Ferrigno, Tricia

    2007-01-01

    This article shares findings from an exploratory case study about an advanced school leadership development program designed specifically for practicing principals and administrator-trained teachers. The program was designed to help a high-need rural district transform its principalship from school management into learner-center leadership while…

  14. Program Evaluation and Replications of School-Based Mental Health Services and Family-Community Interventions with Chronically Disruptive Students

    ERIC Educational Resources Information Center

    Carpenter-Aeby, Tracy; Aeby, Victor G.

    2005-01-01

    Although outcomes for alternative schools may be mixed, it is generally agreed that counseling, therapy, group work, case management, and family-community involvement have been credited in some effective programs. This study examined program evaluations from 1994-1999 for an alternative school for chronically disruptive students (599 students,…

  15. Municipal solid waste management for total resource recycling: a case study on Haulien County in Taiwan.

    PubMed

    Chang, Yu-Min; Liu, Chien-Chung; Dai, Wen-Chien; Hu, Allen; Tseng, Chao-Heng; Chou, Chieh-Mei

    2013-01-01

    This work presents the enforcement performance of recent Haulien County, Taiwan municipal solid waste (MSW) recycling management programs. These programs include: Mandatory Refuse Sorting and Recycling, Diverse Bulk Waste Reuse, Pay-as-you-Discharge, Total Food Waste Recycling, Restricted Use on Plastic Shopping Bags & Plastic Tableware, Recycling Fund Management, and Ash Reuse. These programs provide incentives to reduce the MSW quantity growth rate. It was found that the recycled material fraction of MSW generated in 2001 was from 6.8%, but was 32.4% in 2010 and will increase stably by 2-5% yearly in the near future. Survey data for the last few years show that only 2.68% (based on total MSW generated) of food waste was collected in 2001. However, food waste was up to 9.7% in 2010 after the Total Food Waste Recycling program was implemented. The reutilization rate of bottom ash was 20% in 2005 and up to 65% in 2010 owing to Ash Reuse Program enforcement. A quantified index, the Total Recycle Index, was proposed to evaluate MSW management program performance. The demonstrated county will move toward a zero waste society in 2015 if the Total Recycle Index approaches 1.00. Exact management with available programs can lead to slow-growing waste volume and recovery of all MSW.

  16. A Cost Analysis of the Iowa Medicaid Primary Care Case Management Program

    PubMed Central

    Momany, Elizabeth T; Flach, Stephen D; Nelson, Forrest D; Damiano, Peter C

    2006-01-01

    Objective To determine the cost savings attributable to the implementation and expansion of a primary care case management (PCCM) program on Medicaid costs per member in Iowa from 1989 to 1997. Data Sources Medicaid administrative data from Iowa aggregated at the county level. Study Design Longitudinal analysis of costs per member per month, analyzed by category of medical expense using weighted least squares. We compared the actual costs with the expected costs (in the absence of the PCCM program) to estimate cost savings attributable to the PCCM program. Principal Findings We estimated that the PCCM program was associated with a savings of $66 million to the state of Iowa over the study period. Medicaid expenses were 3.8 percent less than what they would have been in the absence of the PCCM program. Effects of the PCCM program appeared to grow stronger over time. Use of the PCCM program was associated with increases in outpatient care and pharmaceutical expenses, but a decrease in hospital and physician expenses. Conclusions Use of a Medicaid PCCM program was associated with substantial aggregate cost savings over an 8-year period, and this effect became stronger over time. Cost reductions appear to have been mediated by substituting outpatient care for inpatient care. PMID:16899012

  17. Mental health issues in the workplace: a case for a new managerial approach.

    PubMed

    Dunnagan, T; Peterson, M; Haynes, G

    2001-12-01

    Anger, stress, and depression in the workplace are growing concerns among management. Traditionally, health outcomes have functioned under the realm of workplace health professionals. This study assessed whether a traditional worksite health promotion program had an impact on mental health factors. The results suggested that worksite health promotion programs play a limited role in ameliorating work-related mental health outcomes. Rather, management must play a greater role in addressing workplace stress, anger, and depression.

  18. It is possible: availability of lymphedema case management in each health facility in Togo. Program description, evaluation, and lessons learned.

    PubMed

    Mathieu, Els; Dorkenoo, Ameyo M; Datagni, Michael; Cantey, Paul T; Morgah, Kodjo; Harvey, Kira; Ziperstein, Joshua; Drexler, Naomi; Chapleau, Gina; Sodahlon, Yao

    2013-07-01

    Lymphatic filariasis (LF) is a vector-borne parasitic disease that can clinically manifest as disabling lymphedema. Although the LF elimination program aims to reduce disability and to interrupt transmission, there has been a scarcity of disease morbidity management programs, particularly on a national scale. This report describes the implementation of the first nationwide LF lymphedema management program. The program, which was initiated in Togo in 2007, focuses on patient behavioral change. Its goal is two-fold: to achieve a sustainable program on a national-scale, and to serve as a model for other countries. The program has five major components: 1) train at least one health staff in lymphedema care in each health facility in Togo; 2) inform people with a swollen leg that care is available at their dispensary; 3) train patients on self-care; 4) provide a support system to motivate patients to continue self-care by training community health workers or family members and providing in home follow-up; and 5) integrate lymphedema management into the curriculum for medical staff. The program achieved the inclusion of lymphedema management in the routine healthcare package. The evaluation after three years estimated that 79% of persons with a swollen leg in Togo were enrolled in the program. The adherence rate to the proposed World Health Organization treatment of washing, exercise, and leg elevation was more than 70% after three years of the program, resulting in a stabilization of the lymphedema stage and a slight decrease in reported acute attacks among program participants. Health staff and patients consider the program successful in reaching and educating the patients. After the external funding ended, the morbidity management program is maintained through routine Ministry of Health activities.

  19. It is Possible: Availability of Lymphedema Case Management in each Health Facility in Togo. Program Description, Evaluation, and Lessons Learned

    PubMed Central

    Mathieu, Els; Dorkenoo, Ameyo M.; Datagni, Michael; Cantey, Paul T.; Morgah, Kodjo; Harvey, Kira; Ziperstein, Joshua; Drexler, Naomi; Chapleau, Gina; Sodahlon, Yao

    2013-01-01

    Lymphatic filariasis (LF) is a vector-borne parasitic disease that can clinically manifest as disabling lymphedema. Although the LF elimination program aims to reduce disability and to interrupt transmission, there has been a scarcity of disease morbidity management programs, particularly on a national scale. This report describes the implementation of the first nationwide LF lymphedema management program. The program, which was initiated in Togo in 2007, focuses on patient behavioral change. Its goal is two-fold: to achieve a sustainable program on a national-scale, and to serve as a model for other countries. The program has five major components: 1) train at least one health staff in lymphedema care in each health facility in Togo; 2) inform people with a swollen leg that care is available at their dispensary; 3) train patients on self-care; 4) provide a support system to motivate patients to continue self-care by training community health workers or family members and providing in home follow-up; and 5) integrate lymphedema management into the curriculum for medical staff. The program achieved the inclusion of lymphedema management in the routine healthcare package. The evaluation after three years estimated that 79% of persons with a swollen leg in Togo were enrolled in the program. The adherence rate to the proposed World Health Organization treatment of washing, exercise, and leg elevation was more than 70% after three years of the program, resulting in a stabilization of the lymphedema stage and a slight decrease in reported acute attacks among program participants. Health staff and patients consider the program successful in reaching and educating the patients. After the external funding ended, the morbidity management program is maintained through routine Ministry of Health activities. PMID:23690550

  20. Shifting from presumptive to test-based management of malaria - technical basis and implications for malaria control in Ghana.

    PubMed

    Baiden, F; Malm, K; Bart-Plange, C; Hodgson, A; Chandramohan, D; Webster, J; Owusu-Agyei, S

    2014-06-01

    The presumptive approach was the World Health Organisation (WHO) recommended to the management of malaria for many years and this was incorporated into syndromic guidelines such as the Integrated Management of Childhood Illnesses (IMCI). In early 2010 however, WHO issued revised treatment guidelines that call for a shift from the presumptive to the test-based approach. Practically, this implies that in all suspected cases, the diagnosis of uncomplicated malaria should be confirmed using rapid test before treatment is initiated. This revision effectively brings to an end an era of clinical practice that span several years. Its implementation has important implications for the health systems in malaria-endemic countries. On the basis of research in Ghana and other countries, and evidence from program work, the Ghana National Malaria Control Program has issued revised national treatment guidelines that call for implementation of test-based management of malaria in all cases, and across all age groups. This article reviews the evidence and the technical basis for the shift to test-based management and examines the implications for malaria control in Ghana.

  1. Willingness to Pay for Drug Rehabilitation: Implications for Cost Recovery October 14, 2007

    PubMed Central

    Bishai, D.; Sindelar, J.; Ricketts, E. P.; Huettner, S.; Cornelius, L.; Lloyd, J. J.; Havens, J. R.; Latkin, C. A.; Strathdee, S. A.

    2008-01-01

    Objectives This study estimates the value that clients place on methadone maintenance and how this value varies with the effectiveness of treatment and availability of case management. We provide the first estimate of the price elasticity of the demand for drug treatment. Methods We interviewed 241 heroin users who had been referred to, but had not yet entered, methadone maintenance treatment in Baltimore, Maryland. We asked each subject to state a preference among three hypothetical treatment programs that varied across 3 domains: weekly fee paid by the client out-of-pocket ($5 to $100), presence/absence of case management, and time spent heroin-free (3 to 24 months). Each subject was asked to complete 18 orthogonal comparisons. Subsequently each subject was asked if they likely would enroll in their preferred choice among the set of three. We computed the expected willingness to pay (WTP) as the probability of enrollment times the fee considered in each choice considered from a multivariate logistic model that controlled for product attributes. We also estimated the price elasticity of demand. Results The median expected fee subjects were willing to pay for a program that offered 3 months of heroin-free time was $7.30 per week, rising to $17.11 per week for programs that offered 24 months of heroin-free time. The availability of case management increased median WTP by $5.64 per week. The price elasticity was −0.39 (SE 0.042). Conclusions Clients will pay more for higher rates of treatment success and for the presence of case management. Clients are willing to pay for drug treatment but the median willingness to pay falls short of the estimated program costs of $82 per week. Thus a combined approach of user fees and subsidization may be the optimal financing strategy for the drug treatment system. PMID:18207264

  2. Linking case management and community development.

    PubMed

    Austin, Carol D; McClelland, Robert W; Gursansky, Di

    2006-01-01

    Case management, in various forms, is now institutionalized as a core part of policy and programs designed to deliver home- and community-based services to older adults. The case management role, in theory, requires attention to both client and system goals, although in practice the system goals that have received most attention have been gatekeeping and resource allocation. While case managers have been admonished to find and develop resources in the community, this has primarily taken the form of including informal services in individual client care plans. What has been missing is focused attention to the potential of the community as a nurturing environment with the capacity to support older adults and their caregivers. Sustainable care for older adults cannot be achieved by formal service and family support alone. This article proposes the creation of linkages between case managers, who build the service arrangements for older people, and community developers, who are responsible for building community capacity and social capital. It is argued that this linkage is essential for establishing the foundations of a caring community with the capacity to support older people.

  3. Management practices to support donor transition: lessons from Avahan, the India AIDS Initiative.

    PubMed

    Bennett, Sara; Rodriguez, Daniela; Ozawa, Sachiko; Singh, Kriti; Bohren, Meghan; Chhabra, Vibha; Singh, Suneeta

    2015-06-13

    During 2009-2012, Avahan, a large donor funded HIV/AIDS prevention program in India was transferred from donor support and operation to government. This transition of approximately 200 targeted interventions (TIs), occurred in three tranches in 2009, 2011 and 2012. This paper reports on the management practices pursued in support of a smooth transition of the program, and addresses the extent to which standard change management practices were employed, and were useful in supporting transition. We conducted structured surveys of a sample of 80 TIs from the 2011 and 2012 rounds of transition. One survey was administered directly before transition and the second survey 12 month after transition. These surveys assessed readiness for transition and practices post-transition. We also conducted 15 case studies of transitioning TIs from all three rounds, and re-visited 4 of these 1-3 years later. Considerable evolution in the nature of relationships between key actors was observed between transition rounds, moving from considerable mistrust and lack of collaboration in 2009 toward a shared vision of transition and mutually respectful relationships between Avahan and government in later transition rounds. Management practices also evolved with the gradual development of clear implementation plans, establishment of the post of "transition manager" at state and national levels, identified budgets to support transition, and a common minimum programme for transition. Staff engagement was important, and was carried out relatively effectively in later rounds. While the change management literature suggests short-term wins are important, this did not appear to be the case for Avahan, instead a difficult first round of transition seemed to signal the seriousness of intentions regarding transition. In the Avahan case a number of management practices supported a smooth transition these included: an extended and sequenced time frame for transition; co-ownership and planning of transition by both donor and government; detailed transition planning and close attention to program alignment, capacity development and communication; engagement of staff in the transition process; engagement of multiple stakeholders post transition to promote program accountability and provide financial support; signaling by actors in charge of transition that they were committed to specified time frames.

  4. Engaging Vulnerable Adolescents in a Pregnancy Prevention Program: Perspectives of Prime Time Staff

    PubMed Central

    Tanner, Amanda E.; Secor-Turner, Molly; Garwick, Ann; Sieving, Renee; Rush, Kayci

    2011-01-01

    Introduction Evaluating interventions for reducing unintended adolescent pregnancy is necessary to ensure quality and efficacy. The purpose of this study was to examine core case management practices and processes for engaging high-risk girls in Prime Time, an intensive multi-component intervention from the perspectives of intervention program staff. Method Structured individual interviews were conducted with the entire Prime Time program staff (N=7) to assess successes and challenges in engaging adolescent girls at high risk for early pregnancy recruited from school and community clinics. Results Program staff described different capacities of adolescents to engage with the program (easy, middle and difficult connecting adolescents) and provided specific recommendations for working with different connectors. Discussion Findings from this study support the notion that preventive interventions with vulnerable groups of adolescents must pay careful attention to strategies for establishing trusting youth-adult relationships. The ability of staff (e.g., case managers, nurses) to engage with adolescents is a crucial step in improving health outcomes. The identified strategies are useful in helping adolescents build skills, motivations and supports needed for healthy behavior change. PMID:22726710

  5. Trauma Center Based Youth Violence Prevention Programs: An Integrative Review.

    PubMed

    Mikhail, Judy Nanette; Nemeth, Lynne Sheri

    2016-12-01

    Youth violence recidivism remains a significant public health crisis in the United States. Violence prevention is a requirement of all trauma centers, yet little is known about the effectiveness of these programs. Therefore, this systematic review summarizes the effectiveness of trauma center-based youth violence prevention programs. A systematic review of articles from MEDLINE, CINAHL, and PsychINFO databases was performed to identify eligible control trials or observational studies. Included studies were from 1970 to 2013, describing and evaluating an intervention, were trauma center based, and targeted youth injured by violence (tertiary prevention). The social ecological model provided the guiding framework, and findings are summarized qualitatively. Ten studies met eligibility requirements. Case management and brief intervention were the primary strategies, and 90% of the studies showed some improvement in one or more outcome measures. These results held across both social ecological level and setting: both emergency department and inpatient unit settings. Brief intervention and case management are frequent and potentially effective trauma center-based violence prevention interventions. Case management initiated as an inpatient and continued beyond discharge was the most frequently used intervention and was associated with reduced rearrest or reinjury rates. Further research is needed, specifically longitudinal studies using experimental designs with high program fidelity incorporating uniform direct outcome measures. However, this review provides initial evidence that trauma centers can intervene with the highest of risk patients and break the youth violence recidivism cycle. © The Author(s) 2015.

  6. Frail elderly patients. New model for integrated service delivery.

    PubMed Central

    Hébert, Rejean; Durand, Pierre J.; Dubuc, Nicole; Tourigny, André

    2003-01-01

    PROBLEM BEING ADDRESSED: Given the complex needs of frail older people and the multiplicity of care providers and services, care for this clientele lacks continuity. OBJECTIVE OF PROGRAM: Integrated service delivery (ISD) systems have been developed to improve continuity and increase the efficacy and efficiency of services. PROGRAM DESCRIPTION: The Program of Research to Integrate Services for the Maintenance of Autonomy (PRISMA) is an innovative ISD model based on coordination. It includes coordination between decision makers and managers of different organizations and services; a single entry point; a case-management process; individualized service plans; a single assessment instrument based on clients' functional autonomy, coupled with a case-mix classification system; and a computerized clinical chart for communicating between institutions and professionals for client monitoring. CONCLUSION: Preliminary results on the efficacy of this model showed a decreased incidence of functional decline, a decreased burden for caregivers, and a smaller proportion of older people wishing to enter institutions. PMID:12943358

  7. Workplace violence investigations and activation of the threat management teams in a multinational corporation.

    PubMed

    Peek-Asa, Corinne; Casteel, Carri; Rugala, Eugene; Romano, Steve; Ramirez, Marizen

    2013-11-01

    We examined threat management investigations conducted by a large multinational company. The company provided a database, removing any identifiers, of investigations by the corporate Threat Management Teams in 2009 and 2010. Rates were calculated using worker population data. During the 2-year study period, the company investigated threat management cases at a rate of 13.9 per 10,000 employees per year. Cases that activated a Threat Management Team were more likely to lead to corrective action (odds ratio = 2.0; 95% confidence interval = 1.08 to 3.87) and referral to the Employee Assistance Program (odds ratio = 4.8; 95% confidence interval = 3.00 to 7.77), but were not related to likelihood of termination. When the multidisciplinary teams were involved, cases were more likely to result in some type of action but were not more likely to lead to termination.

  8. 5 CFR 890.1027 - Cases where an additional fact-finding proceeding is required.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... proceeding is required. 890.1027 Section 890.1027 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1027 Cases where an additional...

  9. Simulation validation and management

    NASA Astrophysics Data System (ADS)

    Illgen, John D.

    1995-06-01

    Illgen Simulation Technologies, Inc., has been working interactive verification and validation programs for the past six years. As a result, they have evolved a methodology that has been adopted and successfully implemented by a number of different verification and validation programs. This methodology employs a unique case of computer-assisted software engineering (CASE) tools to reverse engineer source code and produce analytical outputs (flow charts and tables) that aid the engineer/analyst in the verification and validation process. We have found that the use of CASE tools saves time,which equate to improvements in both schedule and cost. This paper will describe the ISTI-developed methodology and how CASe tools are used in its support. Case studies will be discussed.

  10. Management of Type 2 Diabetes Mellitus through Telemedicine.

    PubMed

    Carallo, Claudio; Scavelli, Faustina Barbara; Cipolla, Maurizio; Merante, Valentina; Medaglia, Valeria; Irace, Concetta; Gnasso, Agostino

    2015-01-01

    Type 2 diabetes mellitus T2DM has a huge and growing burden on public health, whereas new care models are not implemented into clinical practice; in fact the purpose of this study was to test the effectiveness of a program of integrated care for T2DM, compared with ordinary diligence. "Progetto Diabete Calabria" is a new organizational model for the management of patients with diabetes mellitus, based on General Practitioners (GPs) empowerment and the use of a web-based electronic health record, shared in remote consultations among GPs and Hospital Consultants. One-year change in glucose and main cardiovascular risk factors control in 104 patients (Cases) following this integrated care program has been evaluated and compared with that of 208 control patients (Controls) matched for age, gender, and cardiometabolic profile, and followed in an ordinary outpatient medical management by the Consultants only. Both patient groups had Day Hospitals before and after the study period. The mean number of accesses to the Consultants during the study was 0.6 ± 0.9 for Cases, and 1.3 ± 1.5 for Controls (p<0.0001). At follow-up, glycated hemoglobin (HbA1c) significantly decreased from 58 ± 6 to 54 ± 8 mmol/mol in Cases only (p=0.01); LDL cholesterol decreased in both groups; body mass index decreased in Cases only, from 31.0 ± 4.8 to 30.5 ± 4.6 kg/m(2) (p=0.03). The present study demonstrates that a health care program based on GPs empowerment and taking care plus remote consultation with Consultants is at least as effective as standard outpatient management, in order to improve the control of T2DM.

  11. Management of Type 2 Diabetes Mellitus through Telemedicine

    PubMed Central

    Cipolla, Maurizio; Merante, Valentina; Medaglia, Valeria; Irace, Concetta; Gnasso, Agostino

    2015-01-01

    Background Type 2 diabetes mellitus T2DM has a huge and growing burden on public health, whereas new care models are not implemented into clinical practice; in fact the purpose of this study was to test the effectiveness of a program of integrated care for T2DM, compared with ordinary diligence. Methods "Progetto Diabete Calabria" is a new organizational model for the management of patients with diabetes mellitus, based on General Practitioners (GPs) empowerment and the use of a web-based electronic health record, shared in remote consultations among GPs and Hospital Consultants. One-year change in glucose and main cardiovascular risk factors control in 104 patients (Cases) following this integrated care program has been evaluated and compared with that of 208 control patients (Controls) matched for age, gender, and cardiometabolic profile, and followed in an ordinary outpatient medical management by the Consultants only. Both patient groups had Day Hospitals before and after the study period. Results The mean number of accesses to the Consultants during the study was 0.6±0.9 for Cases, and 1.3±1.5 for Controls (p<0.0001). At follow-up, glycated hemoglobin (HbA1c) significantly decreased from 58±6 to 54±8 mmol/mol in Cases only (p=0.01); LDL cholesterol decreased in both groups; body mass index decreased in Cases only, from 31.0±4.8 to 30.5±4.6 kg/m2 (p=0.03). Conclusions The present study demonstrates that a health care program based on GPs empowerment and taking care plus remote consultation with Consultants is at least as effective as standard outpatient management, in order to improve the control of T2DM. PMID:25974092

  12. Industrial demand side management: A status report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hopkins, M.F.; Conger, R.L.; Foley, T.J.

    This report provides an overview of and rationale for industrial demand side management (DSM) programs. Benefits and barriers are described, and data from the Manufacturing Energy Consumption Survey are used to estimate potential energy savings in kilowatt hours. The report presents types and examples of programs and explores elements of successful programs. Two in-depth case studies (from Boise Cascade and Eli Lilly and Company) illustrate two types of effective DSM programs. Interviews with staff from state public utility commissions indicate the current thinking about the status and future of industrial DSM programs. A comprehensive bibliography is included, technical assistance programsmore » are listed and described, and a methodology for evaluating potential or actual savings from projects is delineated.« less

  13. 7 CFR 1980.470 - Defaults by borrower.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Defaults by borrower. 1980.470 Section 1980.470...) PROGRAM REGULATIONS (CONTINUED) GENERAL Business and Industrial Loan Program § 1980.470 Defaults by... property management. A. In case of any monetary or significant non-monetary default under the loan...

  14. Action and Organizational Learning in an Elevator Company

    ERIC Educational Resources Information Center

    De Loo, Ivo

    2006-01-01

    Purpose: To highlight the relevance of management control in action learning programs that aim to foster organizational learning. Design/methodology/approach: Literature review plus case study. The latter consists of archival analysis and multiple interviews. Findings: When action learning programs are built around singular learning experiences,…

  15. Using archived data to measure operational benefits of ITS investments, volume 2 : region 1 incident response program.

    DOT National Transportation Integrated Search

    2004-06-01

    The objective of this project is to use the existing data, surveillance and communications infrastructure (to the extent possible) to : develop two case study evaluations for Oregon, including an evaluation of the COMET incident management program an...

  16. Caseload management skills for improved efficiency.

    PubMed

    Ervin, Naomi E

    2008-03-01

    This article provides information about caseload management, which was one of a group of six competencies identified by nurse administrators as needed by new baccalaureate graduates. Caseload management is an important skill for nurses who work with caseloads of patients or clients (e.g., home health nurses, public health nurses, case managers, ambulatory care nurses). Because inadequate information about caseload management is contained in community health nursing textbooks, continuing education and staff development programs need to include caseload management skills to improve the efficiency and quality of nursing care.

  17. Training the trainer: An educational course for training pain nursing specialists supported by the International Association for the Study of Pain (IASP).

    PubMed

    Cui, Jing; Zhou, Lingjun; Zhang, Lingjuan; Li, Li; Zhao, Jijun

    2013-12-01

    To train pain nursing specialists through a pain education program, 20 nurses from six hospitals in Shanghai Province and seven in six provinces of China received the training of 2-month pain education and 4-month clinical practice. This nonrandomized pilot study examined the results of tests before and after the program, case report evaluations, future plan evaluations, clinical practice, and satisfaction questionnaire. After the program, the score of the test increased significantly compared with that before the program (44.1 ± 3.19; paired-sample t = 10.363; p < .0001). All of the participants thought that the program had broadened their vision, 19 (95%) thought that the program had raised the level of their theoretical knowledge in pain management, 17 (85%) thought that the program had improved their skills in clinical practice, and 15 (75%) thought that the program had played a role in enhancing their research abilities. Considering the whole program, most students (n = 17; 85%) were quite satisfied, and 3 (15%) were simply satisfied. By content analysis of the opening questions, we found that the participants had deeper and broader ideas about nurses' role and pain nursing specialists' responsibilities in pain management. The program improved nurses' attitudes, knowledge, and skills in pain management. The participants recognized pain nursing specialists' responsibilities in pain management more clearly. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  18. The Use of Computer-Based Data Banks in the Teaching of Clinical Problem-Solving and Medical Case Management to Veterinary Students

    ERIC Educational Resources Information Center

    Conzelman, Gaylord M.; And Others

    1975-01-01

    Describes a program at the School of Veterinary Medicine, University of California at Davis to give students experience in diagnosis and management of urinary tract diseases. Students request from computer data banks that laboratory information they deem most useful in the medical management of each clinical problem. (JT)

  19. Is It Ethical for Patents to Be Issued for the Computer Algorithms that Affect Course Management Systems for Distance Learning?

    ERIC Educational Resources Information Center

    Moreau, Nancy

    2008-01-01

    This article discusses the impact of patents for computer algorithms in course management systems. Referring to historical documents and court cases, the positive and negative aspects of software patents are presented. The key argument is the accessibility to algorithms comprising a course management software program such as Blackboard. The…

  20. Universidad de Chile: Self-Assessment and Its Effects on University's Management

    ERIC Educational Resources Information Center

    Busco, Carolina; Dooner, Cecilia; d'Alencon, Andrés

    2018-01-01

    This paper presents a brief approach to the results of a case study of a university within the Chilean higher education system, focusing on the effects of self-assessment on the university's management of undergraduate and postgraduate programs from 2011 to 2014. The research hypothesis is that the university's management, as a dependent variable,…

  1. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Poncio, S.; Adkison, P.

    Coating costs are escalating due to increased awareness of the environment and safety and health issues. Owners can reduce the overall cost of maintenance painting projects through the implementation of a total quality program. This program should encompass project pre-planning, evaluation of safety and quality assurance programs, and analysis of employee absenteeism and turnover. The information presented is a case history of one utility's experience managing a maintenance painting program during a five-year period.

  2. Comparison of the Partner Institutions' Perceptions of the Cross-Border Higher Education Program and the Impact on Program Implementation: Case Studies of Two Sino-U.S. Business Management Programs

    ERIC Educational Resources Information Center

    Jie, Yiyun

    2011-01-01

    This study examined discrepancies and similarities between the partner institutions' perceptions of the motivations, expected outcomes, and desired strategies achieving such outcomes in their cross-border higher educational programs from a game theory perspective, in the context of Mainland China (hereafter referred to as China). By comparing the…

  3. A Review of Quality Assurance Methods to Assist Professional Record Keeping: Implications for Providers of Interpersonal Violence Treatment

    PubMed Central

    Bradshaw, Kelsey M.; Donohue, Brad; Wilks, Chelsey

    2014-01-01

    Errors have been found to frequently occur in the management of case records within mental health service systems. In cases involving interpersonal violence, such errors have been found to negatively impact service implementation and lead to significant trauma and fatalities. In an effort to ensure adherence to specified standards of care, quality assurance programs (QA) have been developed to monitor and enhance service implementation. These programs have generally been successful in facilitating record management. However, these systems are rarely disseminated, and not well integrated. Therefore, within the context of interpersonal violence, we provide an extensive review of evidence supported record keeping practices, and methods to assist in assuring these practices are implemented with adherence. PMID:24976786

  4. Organization and management of space grant programs

    NASA Technical Reports Server (NTRS)

    Sheppard, Sallie; Nichols, Steve

    1990-01-01

    The 21 Space Grant Programs represent a broad range of organizational structures which operate programs ranging in size from single university organizations to organizations including up to 41 members involving a composite of industrial organizations such as state agencies, and universities. Some of the space grant awards were made to organizations already in existence with on-going programs while other awards were made to consortia newly formed for the purpose of applying to the Space Grant Program. The workshop on organization and management of Space Grant Programs provided an opportunity for directors and program representatives to discuss and compare the relative advantages and disadvantages of the various models being used. This paper offers examples of the diversity of organizations, summarizes the common concerns to be met by each organizational model, and provides a case study of the Texas Space Grant Consortium organization.

  5. The Family Self-Sufficiency Program: HUD's Best Kept Secret for Promoting Employment and Asset Growth.

    ERIC Educational Resources Information Center

    Sard, Barbara

    This paper describes the Family Self-Sufficiency (FSS) program, an employment and savings incentive program for low-income families that have Section 8 vouchers or live in public housing. It consists of both case management services to help participants pursue employment and other goals and escrow accounts into which the public housing agency…

  6. MBA Programs between Ensuring Quality and Retaining Applicants: The Case of Sultan Qaboos University

    ERIC Educational Resources Information Center

    Manochehri, Nick-Naser; Al-Badi, Ali Hamad; Naqvi, Syed Jafar; Al-Solbi, Ali Nasser

    2008-01-01

    This study examined the selection process at the Sultan Qaboos University MBA program in relation to other respected institutions in the Gulf area and worldwide to determine the reason(s) for the high rate of attrition among students joining the MBA program. In addition, the study assessed the correlation between Graduate Management Admission Test…

  7. 76 FR 579 - Privacy Act of 1974; Computer Matching Program Between the Department of Housing and Urban...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-05

    ... Payment Accuracy Through a ``Do Not Pay List'' (June 18, 2010); 3. Office of Management and Budget M-10-13... operating Public Housing programs may now offer tenants the option to pay a flat rent, or an income-based... all cases, program administrators will resolve income discrepancies in consultation with tenants...

  8. A Case Study in Effectively Bridging the Business Skills Gap for the Information Technology Professional

    ERIC Educational Resources Information Center

    Gorman, Michael F.

    2011-01-01

    A longitudinal study of information technology (IT) managers at a Fortune 200 company in the Southwest United States was conducted to assess the effectiveness of a training program at bridging the perceived business skills gap for IT employees. A needs assessment was carried out, resulting in a 4-module training program. The program was evaluated…

  9. Community health workers providing government community case management for child survival in sub-Saharan Africa: who are they and what are they expected to do?

    PubMed

    George, Asha; Young, Mark; Nefdt, Rory; Basu, Roshni; Sylla, Mariame; Clarysse, Guy; Bannicq, Marika Yip; de Sousa, Alexandra; Binkin, Nancy; Diaz, Theresa

    2012-11-01

    We describe community health workers (CHWs) in government community case management (CCM) programs for child survival across sub-Saharan Africa. In sub-Saharan Africa, 91% of 44 United Nations Children's Fund (UNICEF) offices responded to a cross-sectional survey in 2010. Frequencies describe CHW profiles and activities in government CCM programs (N = 29). Although a few programs paid CHWs a salary or conversely, rewarded CHWs purely on a non-financial basis, most programs combined financial and non-financial incentives and had training for 1 week. Not all programs allowed CHWs to provide zinc, use timers, dispense antibiotics, or use rapid diagnostic tests. Many CHWs undertake health promotion, but fewer CHWs provide soap, water treatment products, indoor residual spraying, or ready-to-use therapeutic foods. For newborn care, very few promote kangaroo care, and they do not provide antibiotics or resuscitation. Even if CHWs are as varied as the health systems in which they work, more work must be done in terms of the design and implementation of the CHW programs for them to realize their potential.

  10. Discharge planning, nursing home placement, and the Internet.

    PubMed

    Collier, Eric J; Harrington, Charlene

    2005-01-01

    Effective discharge planning and well-coordinated case management related to nursing home (NH) placement are key services in acute-care hospitals. (1) identify the individuals and important factors involved in the discharge planning process; (2) describe the types/sources of information used by discharge planners to recommend specific nursing homes for patients and families; and (3) determine which methods are used to evaluate the quality of US nursing homes (NHs). Descriptive study, with a convenience sample of 41 discharge planners and case managers from California acute-care hospitals. This study found that patients, families, friends, and physicians are all involved in the discharge planning process along with discharge planners and/or case managers. Discharge planners/case managers were generally concerned about NH bed availability, geographic location, and financial considerations. Although the discharge planners and case managers were able to articulate important indicators of quality in NHs, such information was not routinely considered during discharge planning activities. Discharge planners and case managers need to play a more central role in the decision-making process related to the selection of a NH, especially because decisions are time-limited and can benefit from a well-planned discharge planning program that uses a variety of data on quality and costs. The widespread use of Internet-based information sources can be expanded to aid this process.

  11. An evaluation of the utilization of remote sensing in resource and environmental management of the Chesapeake Bay region

    NASA Technical Reports Server (NTRS)

    Fuller, D. B.; Harmon, D. M.; Fuller, K. B.

    1976-01-01

    A nine-month study was conducted to assess the effectiveness of the NASA Wallops Chesapeake Bay Ecological Program in remote sensing. The study consisted of a follow-up investigation and information analysis of actual cases in which remote sensing was utilized by management and research personnel in the Chesapeake Bay region. The study concludes that the NASA Wallops Chesapeake Bay Ecological Program is effective, both in terms of costs and performance.

  12. Actionable Science in the Gulf of Mexico: Connecting Researchers and Resource Managers

    NASA Astrophysics Data System (ADS)

    Lartigue, J.; Parker, F.; Allee, R.; Young, C.

    2017-12-01

    The National Oceanic and Atmospheric Administration (NOAA) RESTORE Science Program was established in the wake of the Deepwater Horizon oil spill to to carry out research, observation, and monitoring to support the long-term sustainability of the Gulf of Mexico ecosystem, including its fisheries. Administered in partnership with the US Fish and Wildlife Service, the Science Program emphasizes a connection between science and decision-making. This emphasis translated into an engagement process that allowed for resource managers and other users of information about the ecosystem to provide direct input into the science plan for the program. In developing funding opportunities, the Science Program uses structured conversations with resource managers and other decision makers to focus competitions on specific end user needs. When evaluating proposals for funding, the Science Program uses criteria that focus on applicability of a project's findings and products, end user involvement in project planning, and the approach for transferring findings and products to the end user. By including resource managers alongside scientific experts on its review panels, the Science Program ensures that these criteria are assessed from both the researcher and end user perspectives. Once funding decisions are made, the Science Program assigns a technical monitor to each award to assist with identifying and engaging end users. Sharing of best practices among the technical monitors has provided the Science Program insight on how best to bridge the gap between research and resource management and how to build successful scientist-decision maker partnerships. During the presentation, we will share two case studies: 1) design of a cooperative (fisheries scientist, fisheries managers, and fishers), Gulf-wide conservation and monitoring program for fish spawning aggregations and 2) development of habitat-specific ecosystem indicators for use by federal and state resource managers.

  13. Sexual Behaviors in Autism: Problems of Definition and Management.

    ERIC Educational Resources Information Center

    Realmuto, George M.; Ruble, Lisa A.

    1999-01-01

    Explores the problems of definition of sexual behaviors in individuals with autism and describes a case that highlights the difficulties of management. After failure of behavioral and educational programs, a testosterone-suppressing medication was used resulting in suppression of public masturbation behaviors and retention of the participant's…

  14. An Investigation of Computer-based Simulations for School Crises Management.

    ERIC Educational Resources Information Center

    Degnan, Edward; Bozeman, William

    2001-01-01

    Describes development of a computer-based simulation program for training school personnel in crisis management. Addresses the data collection and analysis involved in developing a simulated event, the systems requirements for simulation, and a case study of application and use of the completed simulation. (Contains 21 references.) (Authors/PKP)

  15. Conflicting Expertise and Uncertainty: Quality Assurance in High-Level Radioactive Waste Management.

    ERIC Educational Resources Information Center

    Fitzgerald, Michael R.; McCabe, Amy Snyder

    1991-01-01

    Dynamics of a large, expensive, and controversial surface and underground evaluation of a radioactive waste management program at the Yucca Mountain power plant are reviewed. The use of private contractors in the quality assurance study complicates the evaluation. This case study illustrates high stakes evaluation problems. (SLD)

  16. 45 CFR 263.0 - What definitions apply to this part?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) Management information systems not related to the tracking and monitoring of TANF requirements (e.g., for a... example, it excludes costs of providing diversion benefits and services, providing program information to... services, work supports, and case management. It also excludes costs for contracts devoted entirely to such...

  17. Call It Trash, Garbage or Refuse: Four Case Studies Illustrate Community Waste Management Options.

    ERIC Educational Resources Information Center

    Kazzi, John W.

    1990-01-01

    Describes four successful community programs dealing with waste management issues, developed with assistance from Keep America Beautiful System: litter prevention (Beatrice, Nebraska); composting yard waste (Centralia, Illinois); recycling (Lake Jackson, Texas); and waste-to-energy incineration (Gastonia, North Carolina). Notes related education…

  18. Educational Administration and Management. Reports Studies C.95.

    ERIC Educational Resources Information Center

    Turner, Trevor; Persaud, Ganga

    This case study reports results of research on the extent of nonformal education in Guyana; comparison of commitment in private and public enterprises; and financial support, program organization and management, learners' background and objectives, content and methodology, and evaluation strategy. The first two chapters describe the study's…

  19. Clarus multi-state regional demonstrations, evaluation of use case #4 : multi-state control strategy tool.

    DOT National Transportation Integrated Search

    2011-06-10

    This report provides the results of an independent evaluation of the Clarus Use Case #4 Multi-State Control Strategy Tool (MSCST). This tool, developed for the Road Weather Management Program of the Federal Highway Administration by a private contrac...

  20. 14 CFR 91.1049 - Personnel.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) Program manager flight, duty, and rest time considerations, and in all cases within the limits set forth in §§ 91.1057 through 91.1061. (3) Vacations. (4) Operational efficiencies. (5) Training. (6) Single... flight, duty, and rest time limits in §§ 91.1057 through 91.1061 in program operations. (d) Unless...

  1. 77 FR 38637 - Announcement of the Award of Single-Source Cooperative Agreement to Rubicon Programs, Inc., in...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-28

    ...-Prisoner Reentry activities to promote responsible fatherhood, family reunification, and economic stability... economic stability. The project will implement a program that includes comprehensive case management to... eliminate barriers to social and economic self-sufficiency for individuals preparing to reenter their...

  2. Teacher-Implemented Behavior Modification in a Case of Organically Based Epilepsy

    ERIC Educational Resources Information Center

    Balaschak, Barbara A.

    1976-01-01

    Significant reduction of seizures in an 11-year-old girl was achieved through a contingency management program implemented by her classroom teacher. The program was designed to shift the focus from her actual seizures to her seizure-free time periods. Seizures diminished over the total treatment period. (Author)

  3. The Safety "Use Case": Co-Developing Chemical Information Management and Laboratory Safety Skills

    ERIC Educational Resources Information Center

    Stuart, Ralph B.; McEwen, Leah R.

    2016-01-01

    The 2015 edition of the American Chemical Society's "Guidelines and Evaluation Procedures for Bachelor's Degree Programs" identifies six skill sets that undergraduate chemistry programs should instill in their students. In our roles as support staff for chemistry departments at two different institutions (one a Primarily Undergraduate…

  4. American Indian Adolescent Girls: Vulnerability to Sex Trafficking, Intervention Strategies

    ERIC Educational Resources Information Center

    Pierce, Alexandra

    2012-01-01

    The Minnesota Indian Women's Resource Center offers harm reduction programming to at-risk adolescent American Indian girls, including outreach, case management, advocacy, healthy sexuality education, and support groups. To evaluate program impact, participants are assessed at intake and every 6 months afterward for current vulnerability to…

  5. Diversity Training: Does It Make a Positive Impact?

    ERIC Educational Resources Information Center

    Deardorff, Karen Sickels; Heyman, Marjorie

    1999-01-01

    Examines the importance of diversity training for employees in all work environments and presents a case study of one training program delivered to facility management personnel at Ohio University. The diversity program components are described as are its positive results and potential pitfalls when presented at an institution. Concluding comments…

  6. The Rural Families Program Makes a Difference.

    ERIC Educational Resources Information Center

    Viegas, Swarna; Meek, Jim

    1998-01-01

    Rural outreach workers delivered a stress prevention and early intervention education on a one-on-one basis to strengthen families and communities over 6-9 weeks. Pre/posttest data from 934 cases revealed that the program benefited participants in the areas of decision making, communication, financial management, parenting, family relationships,…

  7. The Science Manager's Guide to Case Studies

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Branch, Kristi M.; Peffers, Melissa S.; Ruegg, Rosalie T.

    2001-09-24

    This guide takes the science manager through the steps of planning, implementing, validating, communicating, and using case studies. It outlines the major methods of analysis, describing their relative merits and applicability while providing relevant examples and sources of additional information. Well-designed case studies can provide a combination of rich qualitative and quantitative information, offering valuable insights into the nature, outputs, and longer-term impacts of the research. An objective, systematic, and credible approach to the evaluation of U.S. Department of Energy Office of Science programs adds value to the research process and is the subject of this guide.

  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.

  9. Thinking Inside the Box: The Health Cube Paradigm for Health and Wellness Program Evaluation and Design

    PubMed Central

    Harris, Sharon

    2013-01-01

    Abstract Appropriately constructed health promotions can improve population health. The authors developed a practical model for designing, evaluating, and improving initiatives to provide optimal value. Three independent model dimensions (impact, engagement, and sustainability) and the resultant three-dimensional paradigm were described using hypothetical case studies, including a walking challenge, a health risk assessment survey, and an individual condition management program. The 3-dimensional model is illustrated and the dimensions are defined. Calculation of a 3-dimensional score for program comparisons, refinements, and measurement is explained. Program 1, the walking challenge, had high engagement and impact, but limited sustainability. Program 2, the health risk assessment survey, had high engagement and sustainability but limited impact. Program 3, the on-site condition management program, had measurable impact and sustainability but limited engagement, because of a lack of program capacity. Each initiative, though successful in 2 dimensions, lacked sufficient evolution along the third axis for optimal value. Calculation of a 3-dimensional score is useful for health promotion program development comparison and refinements, and overall measurement of program success. (Population Health Management 2013;16:291–295) PMID:23869538

  10. Poliovirus Studies during the Endgame of the Polio Eradication Program.

    PubMed

    Arita, Minetaro

    2017-01-24

    Since the beginning of Global Polio Eradication Initiative in 1988, poliomyelitis cases caused by wild poliovirus (PV) have been drastically reduced, with only 74 cases reported in 2 endemic countries in 2015. The current limited PV transmission suggests that we are in the endgame of the polio eradication program. However, specific challenges have emerged in the endgame, including tight budget, switching of the vaccines, and changes in biorisk management of PV. To overcome these challenges, several PV studies have been implemented in the eradication program. Some of the responses to the emerging challenges in the polio endgame might be valuable in other infectious diseases eradication programs. Here, I will review challenges that confront the polio eradication program and current research to address these challenges.

  11. Training of medical staff positively influences postoperative pain management at home in children.

    PubMed

    Sepponen, K; Kokki, H; Ahonen, R

    1999-08-01

    The aim of this study was to describe how parents manage their child's postoperative pain at home following day-case surgery. The incidence of pain, different analgesics used and problems related to administering medications were the main interests of the study. A postal questionnaire was sent to the parents of 275 children who were under 8 years of age and had undergone an ear, nose and throat (ENT) day-case operation. The questionnaire was sent to the parents a week after discharge from hospital. Altogether, the parents of 227 children answered the questionnaire (response rate 83%). The study was divided into two phases (preintervention and postintervention), and incorporated a training program for doctors and nurses between these two phases. The training program aimed to improve the treatment practices of postoperative pain in children. Seventy-eight per cent of the children in the preintervention study and 75% in the postintervention study experienced at least mild pain after discharge. The training program for doctors and nurses affected the home treatment practices of postoperative pain. The proportion of parents treating their children increased from 68% to 80% after the training program (p = 0.028). Many parents faced problems while treating their children; for example, 19% (n = 30) of the children refused to take their medicine, and suppositories were regarded to be an especially unpleasant dosage form. However, no serious adverse effects were reported. We conclude that due to the pain experienced at home by the great majority of children following day-case ENT operations, parents need information on how to manage their child's pain. A training program for doctors and nurses can improve the treatment of children's pain even at home. Since some children dislike suppositories, it would be worth considering the use of small tablets or mixtures instead.

  12. An interval-based possibilistic programming method for waste management with cost minimization and environmental-impact abatement under uncertainty.

    PubMed

    Li, Y P; Huang, G H

    2010-09-15

    Considerable public concerns have been raised in the past decades since a large amount of pollutant emissions from municipal solid waste (MSW) disposal of processes pose risks on surrounding environment and human health. Moreover, in MSW management, various uncertainties exist in the related costs, impact factors and objectives, which can affect the optimization processes and the decision schemes generated. In this study, an interval-based possibilistic programming (IBPP) method is developed for planning the MSW management with minimized system cost and environmental impact under uncertainty. The developed method can deal with uncertainties expressed as interval values and fuzzy sets in the left- and right-hand sides of constraints and objective function. An interactive algorithm is provided for solving the IBPP problem, which does not lead to more complicated intermediate submodels and has a relatively low computational requirement. The developed model is applied to a case study of planning a MSW management system, where mixed integer linear programming (MILP) technique is introduced into the IBPP framework to facilitate dynamic analysis for decisions of timing, sizing and siting in terms of capacity expansion for waste-management facilities. Three cases based on different waste-management policies are examined. The results obtained indicate that inclusion of environmental impacts in the optimization model can change the traditional waste-allocation pattern merely based on the economic-oriented planning approach. The results obtained can help identify desired alternatives for managing MSW, which has advantages in providing compromised schemes under an integrated consideration of economic efficiency and environmental impact under uncertainty. Copyright 2010 Elsevier B.V. All rights reserved.

  13. Results from a national survey on chronic care management by health plans.

    PubMed

    Mattke, Soeren; Higgins, Aparna; Brook, Robert

    2015-05-01

    The growing burden of chronic disease necessitates innovative approaches to help patients and to ensure the sustainability of our healthcare system. Health plans have introduced chronic care management models, but systematic data on the type and prevalence of different approaches are lacking. Our goal was to conduct a systematic examination of chronic care management programs offered by health plans in the commercial market (ie, in products sold to employers and individuals. We undertook a national survey of a representative sample of health plans (70 plans, 36% response rate) and 6 case studies on health plans' programs to improve chronic care in the commercial market. The data underwent descriptive and bivariate analyses. All plans, regardless of size, location, and ownership, offer chronic care management programs, which identify eligible members from claims data and match them to interventions based on overall risk and specific care gaps. Plans then report information on care gaps to providers and offer self-management support to their members. While internal evaluations suggest that the interventions improve care and reduce cost, plans report difficulties in engaging members and providers. To overcome those obstacles, plans are integrating their programs into provider work flow, collaborating with providers on care redesign and leveraging patient support technologies. Our study shows that chronic care management programs have become a standard component of the overall approach used by health plans to manage the health of their members.

  14. An inexact multistage fuzzy-stochastic programming for regional electric power system management constrained by environmental quality.

    PubMed

    Fu, Zhenghui; Wang, Han; Lu, Wentao; Guo, Huaicheng; Li, Wei

    2017-12-01

    Electric power system involves different fields and disciplines which addressed the economic system, energy system, and environment system. Inner uncertainty of this compound system would be an inevitable problem. Therefore, an inexact multistage fuzzy-stochastic programming (IMFSP) was developed for regional electric power system management constrained by environmental quality. A model which concluded interval-parameter programming, multistage stochastic programming, and fuzzy probability distribution was built to reflect the uncertain information and dynamic variation in the case study, and the scenarios under different credibility degrees were considered. For all scenarios under consideration, corrective actions were allowed to be taken dynamically in accordance with the pre-regulated policies and the uncertainties in reality. The results suggest that the methodology is applicable to handle the uncertainty of regional electric power management systems and help the decision makers to establish an effective development plan.

  15. Food commodity pipeline management in transitional settings: challenges and lessons learned from the first USAID food development program in South Sudan

    PubMed Central

    Tappis, Hannah; Doocy, Shannon; Amoako, Stephen

    2013-01-01

    ABSTRACT Despite decades of support for international food assistance programs by the U.S. Agency for International Development (USAID) Office of Food for Peace, relatively little is known about the commodity pipeline and management issues these programs face in post-conflict and politically volatile settings. Based on an audit of the program's commodity tracking system and interviews with 13 key program staff, this case study documents the experiences of organizations implementing the first USAID-funded non-emergency (development) food assistance program approved for Sudan and South Sudan. Key challenges and lessons learned in this experience about food commodity procurement, transport, and management may help improve the design and implementation of future development food assistance programs in a variety of complex, food-insecure settings around the world. Specifically, expanding shipping routes in complex political situations may facilitate reliable and timely commodity delivery. In addition, greater flexibility to procure commodities locally, rather than shipping U.S.-procured commodities, may avoid unnecessary shipping delays and reduce costs. PMID:25276532

  16. The management of acute adverse effects of breast cancer treatment in general practice: a video-vignette study.

    PubMed

    Jiwa, Moyez; Long, Anne; Shaw, Tim; Pagey, Georgina; Halkett, Georgia; Pillai, Vinita; Meng, Xingqiong

    2014-09-03

    There has been a focus recently on the use of the Internet and email to deliver education interventions to general practitioners (GPs). The treatment of breast cancer may include surgery, radiotherapy, chemotherapy, and/or hormone treatment. These treatments may have acute adverse effects. GPs need more information on the diagnosis and management of specific adverse effects encountered immediately after cancer treatment. The goal was to evaluate an Internet-based educational program developed for GPs to advise patients with acute adverse effects following breast cancer treatment. During phase 1, participants viewed 6 video vignettes of actor-patients reporting 1 of 6 acute symptoms following surgery and chemotherapy and/or radiotherapy treatment. GPs indicated their diagnosis and proposed management through an online survey program. They received feedback about each scenario in the form of a specialist clinic letter, as if the patient had been seen at a specialist clinic after they had attended the GP. This letter incorporated extracts from local guidelines on the management of the symptoms presented. This feedback was sent to the GPs electronically on the same survey platform. In phase 2, all GPs were invited to manage similar cases as phase 1. Their proposed management was compared to the guidelines. McNemar test was used to compare data from phases 1 and 2, and logistic regression was used to explore the GP characteristics that were associated with inappropriate case management. A total of 50 GPs participated. Participants were younger and more likely to be female than other GPs in Australia. For 5 of 6 vignettes in phase 1, management was consistent with expert opinion in the minority of cases (6%-46%). Participant demographic characteristics had a variable effect on different management decisions in phase 1. The variables modeled explained 15%-28% of the differences observed. Diagnosis and management improved significantly in phase 2, especially for diarrhea, neutropenia, and seroma sample cases. The proportion of incorrect management responses was reduced to a minimum (25.3%-49.3%) in phase 2. There was evidence that providing feedback by experts on specific cases had an impact on GPs' knowledge about how to appropriately manage acute treatment adverse effects. This educational intervention could be targeted to support the implementation of shared care during cancer treatment.

  17. The Management of Acute Adverse Effects of Breast Cancer Treatment in General Practice: A Video-Vignette Study

    PubMed Central

    Pagey, Georgina; Halkett, Georgia; Pillai, Vinita; Meng, Xingqiong

    2014-01-01

    Background There has been a focus recently on the use of the Internet and email to deliver education interventions to general practitioners (GPs). The treatment of breast cancer may include surgery, radiotherapy, chemotherapy, and/or hormone treatment. These treatments may have acute adverse effects. GPs need more information on the diagnosis and management of specific adverse effects encountered immediately after cancer treatment. Objective The goal was to evaluate an Internet-based educational program developed for GPs to advise patients with acute adverse effects following breast cancer treatment. Methods During phase 1, participants viewed 6 video vignettes of actor-patients reporting 1 of 6 acute symptoms following surgery and chemotherapy and/or radiotherapy treatment. GPs indicated their diagnosis and proposed management through an online survey program. They received feedback about each scenario in the form of a specialist clinic letter, as if the patient had been seen at a specialist clinic after they had attended the GP. This letter incorporated extracts from local guidelines on the management of the symptoms presented. This feedback was sent to the GPs electronically on the same survey platform. In phase 2, all GPs were invited to manage similar cases as phase 1. Their proposed management was compared to the guidelines. McNemar test was used to compare data from phases 1 and 2, and logistic regression was used to explore the GP characteristics that were associated with inappropriate case management. Results A total of 50 GPs participated. Participants were younger and more likely to be female than other GPs in Australia. For 5 of 6 vignettes in phase 1, management was consistent with expert opinion in the minority of cases (6%-46%). Participant demographic characteristics had a variable effect on different management decisions in phase 1. The variables modeled explained 15%-28% of the differences observed. Diagnosis and management improved significantly in phase 2, especially for diarrhea, neutropenia, and seroma sample cases. The proportion of incorrect management responses was reduced to a minimum (25.3%-49.3%) in phase 2. Conclusions There was evidence that providing feedback by experts on specific cases had an impact on GPs’ knowledge about how to appropriately manage acute treatment adverse effects. This educational intervention could be targeted to support the implementation of shared care during cancer treatment. PMID:25274131

  18. Adapters, strugglers, and case managers: a typology of spouse caregivers.

    PubMed

    Davis, Linda Lindsey; Chestnutt, Deborah; Molloy, Margory; Deshefy-Longhi, Tess; Shim, Bomin; Gilliss, Catherine L

    2014-11-01

    Although family home care problems are frequently described in the health care literature, the ways in which families and other informal caregivers manage those problems are not often addressed. We conducted a descriptive analysis of interviews in which spouses caring for a partner with Alzheimer's or Parkinson's disease were asked to describe difficult home care problems and how they managed those problems. Analysis of these interviews indicated three recurring management styles. Adapters told stories about applying pre-existing skills to manage home care problems. Strugglers told stories of reoccurring home care problems for which they had few or no management strategies. Case managers' interview stories focused on the challenges of finding and coordinating home care services. These findings suggest that caregiving burden might be influenced more by the caregiver's management style than the demands of the care situation. Suggestions for tailoring support programs for the three types of caregivers are proposed. © The Author(s) 2014.

  19. 15 CFR 923.44 - State review on a case-by-case basis of actions affecting land and water uses subject to the...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 15 Commerce and Foreign Trade 3 2012-01-01 2012-01-01 false State review on a case-by-case basis of actions affecting land and water uses subject to the management program-Technique C. 923.44 Section 923.44 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION,...

  20. 15 CFR 923.44 - State review on a case-by-case basis of actions affecting land and water uses subject to the...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false State review on a case-by-case basis of actions affecting land and water uses subject to the management program-Technique C. 923.44 Section 923.44 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION,...

  1. Financial implications of a model heart failure disease management program for providers, hospital, healthcare systems, and payer perspectives.

    PubMed

    Whellan, David J; Reed, Shelby D; Liao, Lawrence; Gould, Stuart D; O'connor, Christopher M; Schulman, Kevin A

    2007-01-15

    Although heart failure disease management (HFDM) programs improve patient outcomes, the implementation of these programs has been limited because of financial barriers. We undertook the present study to understand the economic incentives and disincentives for adoption of disease management strategies from the perspectives of a physician (group), a hospital, an integrated health system, and a third-party payer. Using the combined results of a group of randomized controlled trials and a set of financial assumptions from a single academic medical center, a financial model was developed to compute the expected costs before and after the implementation of a HFDM program by 3 provider types (physicians, hospitals, and health systems), as well as the costs incurred from a payer perspective. The base-case model showed that implementation of HFDM results in a net financial loss to all potential providers of HFDM. Implementation of HFDM as described in our base-case analysis would create a net loss of US dollars 179,549 in the first year for a physician practice, US dollars 464,132 for an integrated health system, and US dollars 652,643 in the first year for a hospital. Third-party payers would be able to save US dollars 713,661 annually for the care of 350 patients with heart failure in a HFDM program. In conclusion, although HFDM programs may provide patients with improved clinical outcomes and decreased hospitalizations that save third-party payers money, limited financial incentives are currently in place for healthcare providers and hospitals to initiate these programs.

  2. Pilot Feasibility Study of an Oncology Financial Navigation Program.

    PubMed

    Shankaran, Veena; Leahy, Tony; Steelquist, Jordan; Watabayashi, Kate; Linden, Hannah; Ramsey, Scott; Schwartz, Naomi; Kreizenbeck, Karma; Nelson, Judy; Balch, Alan; Singleton, Erin; Gallagher, Kathleen; Overstreet, Karen

    2018-02-01

    Few studies have reported on interventions to alleviate financial toxicity in patients with cancer. We developed a financial navigation program in collaboration with our partners, Consumer Education and Training Services (CENTS) and Patient Advocate Foundation (PAF), to improve patient knowledge about treatment costs, provide financial counseling, and to help manage out-of-pocket expenses. We conducted a pilot study to assess the feasibility and impact of this program. Patients with cancer received a financial education course followed by monthly contact with a CENTS financial counselor and a PAF case manager for 6 months. We measured program adherence, self-reported financial burden and anxiety, program satisfaction, and type of assistance provided. Thirty-four patients (median age, 60.5 years) were consented (85% white and 50% commercially insured). Debt, income declines, and loans were reported by 55%, 55%, and 30% of patients, respectively. CENTS counselors assisted most often with budgeting, retirement planning, and medical bill questions. PAF case managers assisted with applications for appropriate insurance coverage, cost of living issues (eg, housing, transportation), and disability applications. High financial burden and anxiety about costs (4 or 5 on a Likert scale) were reported at baseline by 37% and 47% of patients, respectively. Anxiety about costs decreased over time in 33% of patients, whereas self-reported financial burden did not substantially change. Implementing an oncology financial navigation program is feasible, provides concrete assistance in navigating the cost of care, and mitigates anxiety about costs in a subset of patients. Future work will focus on measuring the program's impact on financial and clinical outcomes.

  3. Collaborative Care: Infant Mental Health Consultation in a Child Welfare Setting

    ERIC Educational Resources Information Center

    Wotherspoon, Evelyn; O'Neill-Laberge, Marlene; Rafaat, Susan; Pirie, June; Hammel, David; MacDonald, Liane

    2008-01-01

    The Collaborative Mental Health Care program offers infant mental health consultations to case managers in child protection offices throughout the city of Calgary, Alberta, Canada. Through case examples, the authors demonstrate why clinicians working with maltreated infants should expand the scope of their practice to include multidisciplinary…

  4. Shared responsibility for managing electronic waste: a case study of Maine, USA.

    PubMed

    Wagner, Travis P

    2009-12-01

    Based on high disposal and low recycling rates of electronic waste (e-waste) and continued exportation to developing countries, reliance on municipal responsibility for e-waste management has been unsuccessful in the United States. This case study examines Maine's program, which was the first US state to mandate producer responsibility for recycling household e-waste. Maine's program established a shared cost responsibility among producers, municipalities, and consumers. The study found that Maine's program resulted in a significant reduction in disposal and a corresponding increase in environmentally sound recycling. In the first 3 years of the program, 6.406 million kg of household e-waste was collected and recycled for a population of 1.32 million. The new program, implemented in 2006, increased the number of e-waste items collected and recycled by 108% in the first year, 170% in the second year, and 221% in the third year. The program decreased direct economic costs to municipalities and households because of the shared cost approach and for the first time established costs for producers. There was no empirical evidence indicating that producers have or will improve the recyclability of electronic products to reduce recycling costs. While other weaknesses were that found potentially limit the adoption of Maine's program, its positive aspects warrant consideration by other governments.

  5. Supporting patients treated for prostate cancer: a video vignette study with an email-based educational program in general practice.

    PubMed

    Jiwa, Moyez; Halkett, Georgia; Meng, Xingqiong; Pillai, Vinita; Berg, Melissa; Shaw, Tim

    2014-02-26

    Men who have been treated for prostate cancer in Australia can consult their general practitioner (GP) for advice about symptoms or side effects at any time following treatment. However, there is no evidence that such men are consistently advised by GPs and patients experience substantial unmet need for reassurance and advice. The intent of the study was to evaluate a brief, email-based educational program for GPs to manage standardized patients presenting with symptoms or side effects months or years after prostate cancer treatment. GPs viewed six pairs of video vignettes of actor-patients depicting men who had been treated for prostate cancer. The actor-patients presented problems that were attributable to the treatment of cancer. In Phase 1, GPs indicated their diagnosis and stated if they would prescribe, refer, or order tests based on that diagnosis. These responses were compared to the management decisions for those vignettes as recommended by a team of experts in prostate cancer. After Phase 1, all the GPs were invited to participate in an email-based education program (Spaced Education) focused on prostate cancer. Participants received feedback and could compare their progress and their performance with other participants in the study. In Phase 2, all GPs, regardless of whether they had completed the program, were invited to view another set of six video vignettes with men presenting similar problems to Phase 1. They again offered a diagnosis and stated if they would prescribe, refer, or order tests based on that diagnosis. In total, 64 general practitioners participated in the project, 57 GPs participated in Phase 1, and 45 in Phase 2. The Phase 1 education program was completed by 38 of the 57 (59%) participants. There were no significant differences in demographics between those who completed the program and those who did not. Factors determining whether management of cases was consistent with expert opinion were number of sessions worked per week (OR 0.78, 95% CI 0.67-0.90), site of clinical practice (remote practice, OR 2.25, 95% CI 1.01-5.03), number of patients seen per week (150 patients or more per week, OR 10.66, 95% CI 3.40-33.48), and type of case viewed. Completion of the Spaced Education did impact whether patient management was consistent with expert opinion (not completed, OR 0.88, 95% CI 0.5-1.56). The management of standardized patients by GPs was particularly unlikely to be consistent with expert opinion in the management of impotence and bony metastasis. There was no evidence from this standardized patient study that Spaced Education had an impact on the management of patients in this context. However, the program was not completed by all participants. Practitioners with a greater clinical load were more likely to manage cases as per expert opinion.

  6. What happens when capitated behavioral health comes to town? The transition from the Fort Bragg demonstration to a capitated managed behavioral health contract.

    PubMed

    Heflinger, C A; Northrup, D A

    2000-11-01

    Capitated managed care contracts for behavioral health services are becoming more prevalent across the country in both public and private sectors. This study followed the transition from a demonstration project for child mental health services to a capitated managed behavioral health care contract with a for-profit managed care company. The focus of the study was on the impact--at both the service system and the individual consumer level--pertaining to the start-up and maintenance of a capitated managed behavioral health program. A case study using multiple methods and multiple sources of information incorporated a program fidelity framework that examined micro to macro levels of program implementation. The findings of this study include the following: access to services decreased, the lengths of stay and average daily census in the more intensive levels of treatment declined, difficult-to-treat children were shifted to the public sector, and ratings of service system performance and coordination fell.

  7. Northern Alberta remote teleglaucoma program: clinical outcomes and patient disposition.

    PubMed

    Verma, Sanam; Arora, Sourabh; Kassam, Faazil; Edwards, Marianne C; Damji, Karim F

    2014-04-01

    To review the diagnostic outcomes and clinical referral pathways of patients assessed and managed through a collaborative care patient-centred teleglaucoma program. Retrospective cohort study. Eligible patients were those assessed by the referring optometrist or ophthalmologist to be open-angle glaucoma suspects or to have definite early open-angle glaucoma. A glaucoma specialist graded each case through virtual consultation. Clinical referral pathways were noted: in-person consultation with glaucoma specialist, repeat teleconsultation, collaborative glaucoma management with optometrist, or referral for nonglaucomatous ophthalmic pathology. A total of 247 patients were referred to the program from 2008 to 2012. Of all teleconsults, 31.1% were diagnosed with glaucoma, 42.1% were suspects, and 26.7% were unaffected. Of all patients, 27% were referred for in-person glaucoma evaluation; 69% of patients could be managed by their referring optometrist, with 48% of patients requiring repeat teleconsultation. Treatment was initiated before being seen for 87% of patients with definite glaucoma and 28% of glaucoma suspects. Of all patients seen through the remote teleglaucoma program, most did not require an in-person consultation with an ophthalmologist and could be managed through distance collaboration. For the approximately one third who were diagnosed with glaucoma based on virtual assessment, medication was started in the majority of cases and in-person consultation was arranged. Further studies to validate and consider cost-effectiveness of this system are under way. © 2013 Canadian Ophthalmological Society Published by Canadian Ophthalmological Society All rights reserved.

  8. Internet-based stress management for women with preterm labour--a case-based experience report.

    PubMed

    Scherer, Sandra; Urech, Corinne; Hösli, Irene; Tschudin, Sibil; Gaab, Jens; Berger, Thomas; Alder, Judith

    2014-12-01

    Pregnant women with preterm labour (PTL) in pregnancy often experience increased distress and anxieties regarding both the pregnancy and the child's health. The pathogenesis of PTL is, among other causes, related to the stress-associated activation of the maternal-foetal stress system. In spite of these psychobiological associations, only a few research studies have investigated the potential of psychological stress-reducing interventions. The following paper will present an online anxiety and stress management self-help program for pregnant women with PTL. Structure and content of the program will be illustrated by a case-based experience report. L.B., 32 years (G3, P1), was recruited at gestational week 27 while hospitalized for PTL for 3 weeks. She worked independently through the program for 6 weeks and had regular written contact with a therapist. Processing the program had a positive impact on L.B.'s anxiety and stress levels, as well as on her experienced depressive symptoms and bonding to the foetus. As PTL and the risk of PTB are associated with distress, psychological stress-reducing interventions might be beneficial. This study examines the applicability of an online intervention for pregnant women with PTL. The case report illustrates how adequate low-threshold psychological support could be provided to these women.

  9. Impact of the residential conservation service program on natural gas and electric utilities. Appendix B

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    An assessment of the RCS program is provided from the perspective of eleven case study utilities. First, an introduction to the role and value of conservation in utility strategic planning is presented. The interplay of various utility system characteristics is shown to be the primary determinant of the value of conservation efforts from the utility's point of view. Simplified typologies of utilities are developed to aid in the identification of those combinations of the utility characteristics that will favor the adoption of the utility sponsored strategic conservation efforts. The integration of the RCS program with other utility conservation and loadmore » management programs is explored for the eleven case study utilities. Reference is made to the simplified typologies in order to show, through actual program experience, how the strategic position of the utility company affects its adoption of this federal program. Evaluative studies done by the eleven case study utilities of the RCS program are reviewed. Results are presented and the methodologies are critiqued. Conclusions regarding the RCS program from the utility perspective are presented.« less

  10. What can a pilot congestive heart failure disease management program tell us about likely return on investment?: A case study from a program offered to federal employees.

    PubMed

    vanVonno, Catherine J; Ozminkowski, Ronald J; Smith, Mark W; Thomas, Eileen G; Kelley, Doniece; Goetzel, Ron; Berg, Gregory D; Jain, Susheel K; Walker, David R

    2005-12-01

    In 1999, the Blue Cross and Blue Shield Federal Employee Program (FEP) implemented a pilot disease management program to manage congestive heart failure (CHF) among members. The purpose of this project was to estimate the financial return on investment in the pilot CHF program, prior to a full program rollout. A cohort of 457 participants from the state of Maryland was matched to a cohort of 803 nonparticipants from a neighboring state where the CHF program was not offered. Each cohort was followed for 12 months before the program began and 12 months afterward. The outcome measures of primary interest were the differences over time in medical care expenditures paid by FEP and by all payers. Independent variables included indicators of program participation, type of heart disease, comorbidity measures, and demographics. From the perspective of the funding organization (FEP), the estimated return on investment for the pilot CHF disease management program was a savings of $1.08 in medical expenditure for every dollar spent on the program. Adding savings to other payers as well, the return on investment was a savings of $1.15 in medical expenditures per dollar spent on the program. The amount of savings depended upon CHF risk levels. The value of a pilot initiative and evaluation is that lessons for larger-scale efforts can be learned prior to full-scale rollout.

  11. Cost-effectiveness of 'Program We Care' for patients with chronic obstructive pulmonary disease: A case-control study.

    PubMed

    Wong, Eliza Mi Ling; Lo, Shuk Man; Ng, Ying Chu; Lee, Larry Lap Yip; Yuen, T M Y; Chan, Jimmy Tak Shing; Chair, Sek Ying

    2016-07-01

    To evaluate the effectiveness of a discharge program for patients with chronic obstructive pulmonary disease (COPD) patients on discharge from an emergency medical ward on discharge home rate, hospital length of stay (LOS), inpatient admission rate and cost. Frequent visits to the emergency department (ED) and subsequent hospital admission are common among patients with COPD, which adds a burden to ED and hospital care. A discharge program was implemented in an ED emergency medical ward. The program consisted of multidisciplinary care, discharge planning, discharge health education on disease management, and continued support from the community nursing services. A retrospective case-control study was used. Data were retrieved and compared between 478 COPD program cases and 478 COPD non-program cases. No significant difference was found in age, gender, and triage category, LOS in ED, and readmission rate between the program and non-program groups. The program group demonstrated a significantly higher discharge home rate from the ED (33.89% vs. 20.08%) and fewer medical admissions (40.59% vs. 55.02%) compared with the non-program group, resulting in lower total medical costs after the program was implemented. The program provides insight on the strategic planning for discharge care in a short stay unit of emergency department. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Logistics of Guinea Worm Disease Eradication in South Sudan

    PubMed Central

    Jones, Alexander H.; Becknell, Steven; Withers, P. Craig; Ruiz-Tiben, Ernesto; Hopkins, Donald R.; Stobbelaar, David; Makoy, Samuel Yibi

    2014-01-01

    From 2006 to 2012, the South Sudan Guinea Worm Eradication Program reduced new Guinea worm disease (dracunculiasis) cases by over 90%, despite substantial programmatic challenges. Program logistics have played a key role in program achievements to date. The program uses disease surveillance and program performance data and integrated technical–logistical staffing to maintain flexible and effective logistical support for active community-based surveillance and intervention delivery in thousands of remote communities. Lessons learned from logistical design and management can resonate across similar complex surveillance and public health intervention delivery programs, such as mass drug administration for the control of neglected tropical diseases and other disease eradication programs. Logistical challenges in various public health scenarios and the pivotal contribution of logistics to Guinea worm case reductions in South Sudan underscore the need for additional inquiry into the role of logistics in public health programming in low-income countries. PMID:24445199

  13. Logistics of Guinea worm disease eradication in South Sudan.

    PubMed

    Jones, Alexander H; Becknell, Steven; Withers, P Craig; Ruiz-Tiben, Ernesto; Hopkins, Donald R; Stobbelaar, David; Makoy, Samuel Yibi

    2014-03-01

    From 2006 to 2012, the South Sudan Guinea Worm Eradication Program reduced new Guinea worm disease (dracunculiasis) cases by over 90%, despite substantial programmatic challenges. Program logistics have played a key role in program achievements to date. The program uses disease surveillance and program performance data and integrated technical-logistical staffing to maintain flexible and effective logistical support for active community-based surveillance and intervention delivery in thousands of remote communities. Lessons learned from logistical design and management can resonate across similar complex surveillance and public health intervention delivery programs, such as mass drug administration for the control of neglected tropical diseases and other disease eradication programs. Logistical challenges in various public health scenarios and the pivotal contribution of logistics to Guinea worm case reductions in South Sudan underscore the need for additional inquiry into the role of logistics in public health programming in low-income countries.

  14. An economic decision-making support system for selection of reproductive management programs on dairy farms.

    PubMed

    Giordano, J O; Fricke, P M; Wiltbank, M C; Cabrera, V E

    2011-12-01

    Because the reproductive performance of lactating dairy cows influences the profitability of dairy operations, predicting the future reproductive and economic performance of dairy herds through decision support systems would be valuable to dairy producers and consultants. In this study, we present a highly adaptable tool created based on a mathematical model combining Markov chain simulation with partial budgeting to obtain the net present value (NPV; $/cow per year) of different reproductive management programs. The growing complexity of reproductive programs used by dairy farms demands that new decision support systems precisely reflect the events that occur on the farm. Therefore, the model requires productive, reproductive, and economic input data used for simulation of farm conditions to account for all factors related to reproductive management that increase costs and generate revenue. The economic performance of 3 different reproductive programs can be simultaneously compared with the current model. A program utilizing 100% visual estrous detection (ED) for artificial insemination (AI) is used as a baseline for comparison with 2 other programs that may include 100% timed AI (TAI) as well as any combination of TAI and ED. A case study is presented in which the model was used to compare 3 different reproductive management strategies (100% ED baseline compared with two 100% TAI options) using data from a commercial farm in Wisconsin. Sensitivity analysis was then used to assess the effect of varying specific reproductive parameters on the NPV. Under the simulated conditions of the case study, the model indicated that the two 100% TAI programs were superior to the 100% ED program and, of the 100% TAI programs, the one with the higher conception rate (CR) for resynchronized AI services was economically superior despite having higher costs and a longer interbreeding interval. A 4% increase in CR for resynchronized AI was sufficient for the inferior 100% TAI to outperform the superior program. Adding ED to the 100% TAI programs was only beneficial for the program with the lower CR. The improvement in service rate required for the 100% ED program to have the same NPV as the superior 100% TAI program was 12%. The decision support system developed in this study is a valuable tool that may be used to assist dairy producers and industry consultants in selecting the best farm-specific reproductive management strategy. Copyright © 2011 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  15. School Cafeteria Operations: Separating Myth from Reality

    ERIC Educational Resources Information Center

    Weeks, Richard

    2011-01-01

    School officials often assume that the food service director or management company should be the one concerned with the cafeteria program's management details. But of course that's not the case. Cafeteria operations affect the school business bottom line, so they indeed fall under the purview of school business officials. Not only should school…

  16. Fire in the Wildland–Urban Interface

    Treesearch

    Evan Mercer; Wayne Zipperer

    2012-01-01

    In this chapter we provide an overview of the socio-economic and ecological effects and trends of wildfire in the WUI, methods for assessing wildfire risk in the WUI, approaches to managing the wildfire problem including fuels management, home construction and design, and community action programs. This overview is combined with two case studies analyzing wildfire risk...

  17. Managing Learning Experiences in an AACSB Environment: Beyond the Classroom

    ERIC Educational Resources Information Center

    Spruell, James; Hawkins, Al; Vicknair, David

    2009-01-01

    The study explores the development and management of a rich learning environment that extends the traditional classroom to include significant co-curricular programs. Learning enrichment is guided by the individual mission of the business school, accreditation agency (AACSB), and in our case, the Jesuit mission. That central framework provides a…

  18. Promoting "Quality" Feedback: First-Year Teachers' Self-Reports on Their Development as Classroom Managers

    ERIC Educational Resources Information Center

    Kwok, Andrew

    2018-01-01

    Through a program wide survey (n = 87) and qualitative data of five case participants, this mixed methods study explores how teachers develop as urban classroom managers throughout their first year. Results indicate teachers learned from programmatic training and personnel, school personnel, and classroom experience. Specifically, personnel who…

  19. Leadership & Spirit: Rejuvenating an Organization from the Bottom Up.

    ERIC Educational Resources Information Center

    Dance, Terry

    Using a case study which documents the creation of the Access and Program Development Division at George Brown College, a large urban community college in Ontario, Canada, this paper explores the nature of leadership in educational management. Introductory material argues that leadership in management should be defined as a performing art rather…

  20. Emergency Management of Sexually Abused Children. The Role of the Pediatric Resident.

    ERIC Educational Resources Information Center

    Orr, Donald P.; Prietto, Susan V.

    1979-01-01

    A program for the initial pediatric evaluation and management of sexually abused children is offered as one possible model for other training centers. Cases of 100 sexually abused children (mean age 9.2 years) seen by pediatric residents are reviewed. Journal availability: American Medical Association, 535 North Dearborn Street, Chicago, Illinois…

  1. Managing Welfare Reform in Five States: The Challenge of Devolution.

    ERIC Educational Resources Information Center

    Liebschutz, Sarah F., Ed.

    This book analyzes the responses of five states (Florida, Mississippi, New York, Washington, and Wisconsin) to challenges posed by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 to alter state welfare programs and management systems. Using case studies, the book highlights similarities and differences in the states'…

  2. A virtual patient software program to improve pharmacy student learning in a comprehensive disease management course.

    PubMed

    Douglass, Mark A; Casale, Jillian P; Skirvin, J Andrew; DiVall, Margarita V

    2013-10-14

    To implement and assess the impact of a virtual patient pilot program on pharmacy students' clinical competence skills. Pharmacy students completed interactive software-based patient case scenarios embedded with drug-therapy problems as part of a course requirement at the end of their third year. Assessments included drug-therapy problem competency achievement, performance on a pretest and posttest, and pilot evaluation survey instrument. Significant improvements in students' posttest scores demonstrated advancement of clinical skills involving drug-therapy problem solving. Students agreed that completing the pilot program improved their chronic disease management skills and the program summarized the course series well. Using virtual patient technology allowed for assessment of student competencies and improved learning outcomes.

  3. Making Connections That Work: Partnerships between Vocational Rehabilitation and Chemical Dependency Treatment Programs.

    ERIC Educational Resources Information Center

    Hitchen, Sheila R.

    2001-01-01

    Clients in recovery from substance abuse are eligible for and can benefit from vocational rehabilitation (VR) services. VR, its history, its case management format, and American Indian tribal VR programs are discussed. A partnership between an American Indian substance abuse treatment center and Oregon state VR services is described, and…

  4. 75 FR 29877 - Affordable Housing Program Amendments: Federal Home Loan Bank Mortgage Refinancing Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-28

    ... Banks with greater flexibility to manage the timing of the counseling required for households, and gives the Banks discretion to permit members to determine, prior to counseling, whether a household could... AHP refinancing set-aside program prior to counseling. In all cases, the household must obtain the...

  5. Academic Case Managers: Evaluating a Middle School Intervention for Children At-Risk

    ERIC Educational Resources Information Center

    Van Kannel-Ray, Nancy; Lacefield, Warren E.; Zeller, Pamela J.

    2008-01-01

    For the past eight years, Midwest Educational Research Consortium (MERC), located at Western Michigan University, received two multi-million dollar grants through a U.S. Department of Education program entitled Gaining Early Awareness and Undergraduate Programs (GEAR UP). GEAR UP is a school/university partnership using a cohort model with the…

  6. Research-Based Online Course Development for Special Education Teacher Preparation

    ERIC Educational Resources Information Center

    Johnson, Lewis R.

    2004-01-01

    Distance education utilizing online courses has emerged as an area of program development for many teacher education programs. Online course learning management systems, such as Blackboard.com, have made putting a course online a relatively simple task; however, in many cases, the online course is little more than a correspondence course with a…

  7. SUCCESS Program Planning/Evaluation Report for 1992-93. Focus on Program Evaluation.

    ERIC Educational Resources Information Center

    Sallade, Ronald; Erickson, Cynthia L.

    To address the needs of at-risk children, Project SUCCESS of the Des Moines (Iowa) public schools provides employment, health, mental health, and social services in a comprehensive one-stop shopping manner at public schools. Coordinated services are provided through direct provision of services, case management, and referral as appropriate. The…

  8. Improving the Transition Outcomes of Low-Income Minority Youth with Disabilities

    ERIC Educational Resources Information Center

    Balcazar, Fabricio E.; Taylor-Ritzler, Tina; Dimpfl, Shawn; Portillo-Pena, Nelson; Guzman, Alberto; Schiff, Rachel; Murvay, Michele

    2012-01-01

    This study describes the results of a program developed to improve the transition outcomes of low-income minority youth with disabilities. The program relies on case management support to facilitate interagency collaboration. The participants included 164 graduates from special education and 26 youth from an equivalent comparison group. Two case…

  9. 78 FR 48441 - Office of Urban Indian Health Programs Proposed Single Source Grant With Native American...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-08

    ... outreach and case management, the program has expanded offering to include on-site dental service and... Care: Customer service is the key to quality care. Treating patients well is the first step to improving quality and access. This area also incorporates Best Practices in customer service. Identify...

  10. One Shot Wonders Don't Work: A Causal-Comparative Case Study.

    ERIC Educational Resources Information Center

    Bramwell, K.; Forrester, S.; Houle, B.; Larocque, J.; Villeneuve, L.; Priest, S.

    1997-01-01

    A company division of 72 people that had participated in an adventure training program one year earlier was surveyed to identify the longitudinal impacts of adventure training on corporate managers, attitudes toward adventure training, and changes in work behavior. Results showed positive changes that were short-lived without follow-up programs.…

  11. Matching Applicants with Services: Initial Assessments in the Milwaukee County W-2 Program.

    ERIC Educational Resources Information Center

    Gooden, Susan; Doolittle, Fred; Glispie, Ben

    The initial client assessment procedures used by case managers in the Wisconsin Works (W-2) program in Milwaukee County, Wisconsin, were examined. Data were collected through the following activities: (1) observations of 100 financial and employment planner (FEP)-applicant intake interviews; (2) an examination of administrative data to learn how…

  12. Developing Customized Programs for Steel and Other Heavy Industries: A Case Study.

    ERIC Educational Resources Information Center

    Day, Philip R., Jr.

    1984-01-01

    This article discusses the successful implementation of a unique customized training program for steel and other industries. A contextual framework for understanding both the process and the product is presented. Traditional labor management problems are examined as well as the DACUM (Developing a Curriculum) procedure of identifying job-related…

  13. Trees and business district preferences: a case study of Athens, Georgia, U.S.

    Treesearch

    Kathleen L. Wolf

    2004-01-01

    As a National Main Street program participant, Athens, Georgia, U.S., has included streetscape tree plantings in economic development efforts. The Main Street program assists downtown merchant groups with physical improvements planning in order to create vital retail environments. If comprehensively managed, the urban forest can be a...

  14. Construction Management Program Builds Financial Development from the Ground up

    ERIC Educational Resources Information Center

    Nobe, Michael D.; Shuler, Scott; Grosse, Larry

    2007-01-01

    Recent economic and legislative changes have hit higher education hard and threaten the financial viability of many educational programs nationwide. With state support dwindling to less than 10 percent in some cases, institutions across the nation face a financial crisis. Many strategies have been explored and implemented, from campaigns to…

  15. Difficult airway response team: a novel quality improvement program for managing hospital-wide airway emergencies.

    PubMed

    Mark, Lynette J; Herzer, Kurt R; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I; Berkow, Lauren C; Haut, Elliott R; Hillel, Alexander T; Miller, Christina R; Feller-Kopman, David J; Schiavi, Adam J; Xie, Yanjun J; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W; Mirski, Marek A

    2015-07-01

    Difficult airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency airway management outside the operating room is particularly challenging. We developed a quality improvement program-the Difficult Airway Response Team (DART)-to improve emergency airway management outside the operating room. DART was implemented by a team of anesthesiologists, otolaryngologists, trauma surgeons, emergency medicine physicians, and risk managers in 2005 at The Johns Hopkins Hospital in Baltimore, Maryland. The DART program had 3 core components: operations, safety, and education. The operations component focused on developing a multidisciplinary difficult airway response team, standardizing the emergency response process, and deploying difficult airway equipment carts throughout the hospital. The safety component focused on real-time monitoring of DART activations and learning from past DART events to continuously improve system-level performance. This objective entailed monitoring the paging system, reporting difficult airway events and DART activations to a Web-based registry, and using in situ simulations to identify and mitigate defects in the emergency airway management process. The educational component included development of a multispecialty difficult airway curriculum encompassing case-based lectures, simulation, and team building/communication to ensure consistency of care. Educational materials were also developed for non-DART staff and patients to inform them about the needs of patients with difficult airways and ensure continuity of care with other providers after discharge. Between July 2008 and June 2013, DART managed 360 adult difficult airway events comprising 8% of all code activations. Predisposing patient factors included body mass index >40, history of head and neck tumor, prior difficult intubation, cervical spine injury, airway edema, airway bleeding, and previous or current tracheostomy. Twenty-three patients (6%) required emergent surgical airways. Sixty-two patients (17%) were stabilized and transported to the operating room for definitive airway management. There were no airway management-related deaths, sentinel events, or malpractice claims in adult patients managed by DART. Five in situ simulations conducted in the first program year improved DART's teamwork, communication, and response times and increased the functionality of the difficult airway carts. Over the 5-year period, we conducted 18 airway courses, through which >200 providers were trained. DART is a comprehensive program for improving difficult airway management. Future studies will examine the comparative effectiveness of the DART program and evaluate how DART has impacted patient outcomes, operational efficiency, and costs of care.

  16. Overview of a pharmacist anticoagulation certificate program.

    PubMed

    Kirk, Julienne K; Edwards, Rebecca; Brewer, Andrew; Miller, Cathey; Bray, Bryan; Groce, James B

    2017-07-01

    To describe the design of an ongoing anticoagulation certificate program and annual renewal update for pharmacists. Components of the anticoagulation certificate program include home study, pre- and posttest, live sessions, case discussions with evaluation and presentation, an implementation plan, and survey information (program evaluation and use in practice). Clinical reasoning skills were assessed through case work-up and evaluation prior to live presentation. An annual renewal program requires pharmacists to complete home study and case evaluations. A total of 361 pharmacists completed the anticoagulation certificate program between 2002 and 2015. Most (62%) practiced in ambulatory care and 38% in inpatient care settings (8% in both). In the past four years, 71% were working in or starting anticoagulation clinics in ambulatory and inpatient settings. In their evaluations of the program, an average of 90% of participants agreed or strongly agreed the lecture material was relevant and objectives were met. Pharmacists are able to apply knowledge and skills in management of anticoagulation. This structured practice-based continuing education program was intended to enhance pharmacy practice and has achieved that goal. The certificate program in anticoagulation was relevant to pharmacists who attended the program. Copyright © 2017. Published by Elsevier Inc.

  17. Workflow technology: the new frontier. How to overcome the barriers and join the future.

    PubMed

    Shefter, Susan M

    2006-01-01

    Hospitals are catching up to the business world in the introduction of technology systems that support professional practice and workflow. The field of case management is highly complex and interrelates with diverse groups in diverse locations. The last few years have seen the introduction of Workflow Technology Tools, which can improve the quality and efficiency of discharge planning by the case manager. Despite the availability of these wonderful new programs, many case managers are hesitant to adopt the new technology and workflow. For a myriad of reasons, a computer-based workflow system can seem like a brick wall. This article discusses, from a practitioner's point of view, how professionals can gain confidence and skill to get around the brick wall and join the future.

  18. Crisis Intervention and the Military Family: A Model Installation Program.

    DTIC Science & Technology

    1988-03-07

    abuse to less serious problems like budget management and good parenting techniques. Family dysfunction is defined in two categories: High and low...serious problems like budget management and good parenting techniques. Family dysfunction is defined in two categories: High and low intensity conflict. The...system activated to deal with the problem through the Family N, Advocacy Case Management Team. It is an excellent system that protects, helps and

  19. Life as a NATO Engineer

    DTIC Science & Technology

    2010-08-01

    NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND...management; leads military in case of specialized survey; supervises more than 25 local civilian employees ; acts as technical expert during contract...Security Assistance Force Head- quarters Camp. I knew I could handle the job of project manager, but wondered about acting as contract manager, technical ex

  20. Building Connections among Lands, People and Communities: A Case Study of Benefits-Based Management Plan Development for the Gunnison Gorge National Conservation Area

    Treesearch

    Richard C. Knopf; Kathleen L. Andereck; Karen Tucker; Bill Bottomly; Randy J. Virden

    2004-01-01

    Purpose of Study This paper demonstrates how a Benefits-Based Management paradigm has been useful in guiding management plan development for an internationally significant natural resource – the Gunnison Gorge National Conservation Area (GGNCA) in Colorado. Through a program of survey research, a database on benefits desired by various stakeholder groups was created....

  1. The Physics Entrepreneurship Program at Case Western Reserve University

    NASA Astrophysics Data System (ADS)

    Taylor, Cyrus

    2001-10-01

    The Physics Entrepreneurship Program is a new, two-year Master's Program designed to empower physicists as entrepreneurs. Launched by the Dept. of Physics at Case Western Reserve University in close cooperation with the Weatherhead School of Management, the program is now in its second year. This innovative new program has already attracted important attention from the business community, including seed funding of a student launched venture, international press coverage, including an article in Business Week, and government interest, including an invitation to brief the Advisory Board of the Mathematical and Physical Sciences Division of the National Science Foundation. This talk will discuss the structure and content of the program, the lessons we are learning, and early indicators of success including a student-launched new business venture that has already secured more than $ 250,000 in seed funding.

  2. Proceedings of the Colorado River Basin Science and Resource Management Symposium, November 18-20, 2008, Scottsdale, Arizona

    USGS Publications Warehouse

    Melis, Theodore S.; Hamill, John F.; Bennett, Glenn E.; Coggins,, Lewis G.; Grams, Paul E.; Kennedy, Theodore A.; Kubly, Dennis M.; Ralston, Barbara E.

    2010-01-01

    Since the 1980s, four major science and restoration programs have been developed for the Colorado River Basin to address primarily the conservation of native fish and other wildlife pursuant to the Endangered Species Act (ESA): (1) Recovery Implementation Program for Endangered Fish Species in the Upper Colorado River Basin (commonly called the Upper Colorado River Endangered Fish Recovery Program) (1988); (2) San Juan River Basin Recovery Implementation Program (1992); (3) Glen Canyon Dam Adaptive Management Program (1997); and (4) Lower Colorado River Multi-Species Conservation Program (2005). Today, these four programs, the efforts of which span the length of the Colorado River, have an increasingly important influence on water management and resource conservation in the basin. The four efforts involve scores of State, Federal, and local agencies; Native American Tribes; and diverse stakeholder representatives. The programs have many commonalities, including similar and overlapping goals and objectives; comparable resources and threats to those resources; and common monitoring, research, and restoration strategies. In spite of their commonalities, until recently there had been no formal opportunity for information exchange among the programs. To address this situation, the U.S. Geological Survey (USGS) worked in coordination with the four programs and numerous Federal and State agencies to organize the first Colorado River Basin Science and Resource Management Symposium, which took place in Scottsdale, AZ, in November 2008. The symposium's primary purpose was to promote an exchange of information on research and management activities related to the restoration and conservation of the Colorado River and its major tributaries. A total of 283 managers, scientists, and stakeholders attended the 3-day symposium, which included 87 presentations and 27 posters. The symposium featured plenary talks by experts on a variety of topics, including overviews of the four restoration programs, water-management actions aimed at restoring native fish habitat, climate change, assessments of the status of native and nonnative fish populations, and Native American perspectives. Intermixed with plenary talks were four concurrent technical sessions that addressed the following important topics: (1) effects of dam and reservoir operations on downstream physical and biological resources; (2) native fish propagation and genetic management and associated challenges in co-managing native and nonnative fish in the Colorado River; (3) monitoring program design, case studies, and links to management; and (4) riparian system restoration, monitoring, and exotic species control efforts.

  3. Defined contribution defined: health insurance for the next century.

    PubMed

    Marhula, D C; Shannon, E G

    2001-01-01

    The consumerism movement will dramatically affect the current payer model and present a new series of challenges for managed care organizations. Employers will fuel the changes, as they create health benefit programs that are modeled after retirement programs. In these cases, employers will shift a major portion of financial responsibility to employees, who will be asked to make buying decisions often previously determined by managed care organizations. New business entities known as health navigators will be formed to aid consumers. However, many structural and policy obstacles may slow or transform the consumerism movement.

  4. Leadership Training at First Bank of Nigeria: A Case Study

    ERIC Educational Resources Information Center

    Lawal, Fatai; Thompson, Randall; Thompson, Elizabeth

    2016-01-01

    The purpose of this qualitative exploratory case study was to identify components of an exemplary leadership development program that might serve as a framework for training leaders for banking organizations in Nigeria. We recruited 30 managers, supervisors, and officers with at least 10 years of banking experience to explore leadership…

  5. Meeting EFA: Bangladesh Rural Advancement Committee (BRAC) Primary Schools. Case Study

    ERIC Educational Resources Information Center

    Chaboux, Collette

    2006-01-01

    This case study describes the Bangladesh Rural Advancement Committee (BRAC), which was formed to explore ways to help children from its rural development program gain access to improved education. Working mainly in rural areas, BRAC focused on improved quality through improved education service delivery, management detail, and finance. While…

  6. Modifying the Curriculum: Teaching Clinical Students about Caring for Patients with Disabilities.

    ERIC Educational Resources Information Center

    Ettinger, Ellen Richter

    2002-01-01

    Examines how the curricula of optometry programs can be modified to prepare graduates to meet the needs of patients from special populations. Addresses student attitudes and the clinical encounter, including the case history, clinical examination, clinical decision making and determination of patient management plans, and case discussion of the…

  7. Workshop Organization and Management in Adult Education. Case Study of the MOBRAL System.

    ERIC Educational Resources Information Center

    da Costa, Lamartine Pereira

    This case study of the organizational structure of the Brazilian Literacy Movement (MOBRAL) describes the various organizational changes made as the mediating agency attempted to develop a large-scale national program within the existing social structure. Steps in the organization's development are traced from: (1) Beginnings in 1970 under the…

  8. Factoring quality laboratory diagnosis into the malaria control agenda for sub-Saharan Africa.

    PubMed

    Aidoo, Michael

    2013-09-01

    Recent progress in malaria control in sub-Saharan Africa has been achieved primarily through provision of insecticide-treated nets, indoor residual spraying, and antimalarial drugs. Although these interventions are important, proper case identification and accurate measurement of their impact depend on quality diagnostic testing. Current availability of diagnostic testing for malaria in sub-Saharan Africa is inadequate to support disease management, prevention programs, and surveillance needs. Challenges faced include a dearth of skilled workforce, inadequate health systems infrastructure, and lack of political will. A coordinated approach to providing pre-service clinical and laboratory training together with systems that support a scale-up of laboratory services could provide means not only for effective malaria case management but also, management of non-malaria febrile illnesses, disease surveillance, and accurate control program evaluation. A synthesis of the challenges faced in ensuring quality malaria testing and how to include this information in the malaria control and elimination agenda are presented.

  9. 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.

  10. MILS in a general surgery unit: learning curve, indications, and limitations.

    PubMed

    Patriti, Alberto; Marano, Luigi; Casciola, Luciano

    2015-06-01

    Minimally invasive liver surgery (MILS) is going to be a method with a wide diffusion even in general surgery units. Organization, learning curve effect, and the environment are crucial issues to evaluate before starting a program of minimally invasive liver resections. Analysis of a consecutive series of 70 patients has been used to define advantages and limits of starting a program of MILS in a general surgery unit. Seventeen MILS have been calculated with the cumulative sum method as the number of cases to complete the learning curve. Operative times [270 (60-480) vs. 180 (15-550) min; p 0.01] and rate of conversion (6/17 vs. 5/53; p 0.018) decrease after this number of cases. More complex cases can be managed after a proper optimization of all steps of liver resection. When a high confidence of the medical and nurse staff with MILS is reached, economical and strategic issues should be evaluated in order to establish a multidisciplinary hepatobiliary unit independent from the general surgery unit to manage more complex cases.

  11. Recovery Audit Contractor medical necessity readiness: one health system's journey.

    PubMed

    Scott, Judith A; Camden, Mindy

    2011-01-01

    To develop a sustainable approach to Recovery Audit Contractor medical necessity readiness that mitigates the regulatory and financial risks of the organization. Acute care hospitals. Utilizing the model for improvement and plan-do-study-act methodology, this health system designed and implemented a medical necessity case management program. We focused on 3 areas for improvement: medical necessity review accuracy, review timeliness, and physician adviser participation for secondary reviews. Over several months, we improved accuracy and timeliness of our medical necessity reviews while also generating additional inpatient revenue for the health system. We successfully enhanced regulatory compliance and reduced our financial risks associated with Recovery Audit Contractor medical necessity audits. A successful medical necessity case management program can not only enhance regulatory compliance and reduce the amount of payments recouped by Medicare, but also generate additional inpatient revenue for your organization. With health care reform and accountable care organizations on the horizon, hospitals must find ways to protect and enhance revenue in order to carry out their missions. This is one way for case managers to help in that cause, to advocate for the care of their patients, and to bring value to the organization.

  12. A duality theorem-based algorithm for inexact quadratic programming problems: Application to waste management under uncertainty

    NASA Astrophysics Data System (ADS)

    Kong, X. M.; Huang, G. H.; Fan, Y. R.; Li, Y. P.

    2016-04-01

    In this study, a duality theorem-based algorithm (DTA) for inexact quadratic programming (IQP) is developed for municipal solid waste (MSW) management under uncertainty. It improves upon the existing numerical solution method for IQP problems. The comparison between DTA and derivative algorithm (DAM) shows that the DTA method provides better solutions than DAM with lower computational complexity. It is not necessary to identify the uncertain relationship between the objective function and decision variables, which is required for the solution process of DAM. The developed method is applied to a case study of MSW management and planning. The results indicate that reasonable solutions have been generated for supporting long-term MSW management and planning. They could provide more information as well as enable managers to make better decisions to identify desired MSW management policies in association with minimized cost under uncertainty.

  13. 48 CFR 307.104-70 - Acquisition strategy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    .... Program and Project Managers responsible for major IT capital investments (and for any other investments... for major IT capital investments as part of the planned investment's business case, usually during the...

  14. Implementation of a decentralized community-based treatment program to improve the management of Buruli ulcer in the Ouinhi district of Benin, West Africa

    PubMed Central

    Amoussouhoui, Arnaud Setondji; Wadagni, Anita Carolle; Johnson, Roch Christian; Aoulou, Paulin; Agbo, Inès Elvire; Houezo, Jean-Gabin; Boyer, Micah; Nichter, Mark

    2018-01-01

    Background Mycobacterium ulcerans infection, commonly known as Buruli ulcer (BU), is a debilitating neglected tropical disease. Its management remains complex and has three main components: antibiotic treatment combining rifampicin and streptomycin for 56 days, wound dressings and skin grafts for large ulcerations, and physical therapy to prevent functional limitations after care. In Benin, BU patient care is being integrated into the government health system. In this paper, we report on an innovative pilot program designed to introduce BU decentralization in Ouinhi district, one of Benin’s most endemic districts previously served by centralized hospital-based care. Methodology/Principal findings We conducted intervention-oriented research implemented in four steps: baseline study, training of health district clinical staff, outreach education, outcome and impact assessments. Study results demonstrated that early BU lesions (71% of all detected cases) could be treated in the community following outreach education, and that most of the afflicted were willing to accept decentralized treatment. Ninety-three percent were successfully treated with antibiotics alone. The impact evaluation found that community confidence in decentralized BU care was greatly enhanced by clinic staff who came to be seen as having expertise in the care of most chronic wounds. Conclusions/Significance This study documents a successful BU outreach and decentralized care program reaching early BU cases not previously treated by a proactive centralized BU program. The pilot program further demonstrates the added value of integrated wound management for NTD control. PMID:29529087

  15. Implementation of a decentralized community-based treatment program to improve the management of Buruli ulcer in the Ouinhi district of Benin, West Africa.

    PubMed

    Amoussouhoui, Arnaud Setondji; Sopoh, Ghislain Emmanuel; Wadagni, Anita Carolle; Johnson, Roch Christian; Aoulou, Paulin; Agbo, Inès Elvire; Houezo, Jean-Gabin; Boyer, Micah; Nichter, Mark

    2018-03-01

    Mycobacterium ulcerans infection, commonly known as Buruli ulcer (BU), is a debilitating neglected tropical disease. Its management remains complex and has three main components: antibiotic treatment combining rifampicin and streptomycin for 56 days, wound dressings and skin grafts for large ulcerations, and physical therapy to prevent functional limitations after care. In Benin, BU patient care is being integrated into the government health system. In this paper, we report on an innovative pilot program designed to introduce BU decentralization in Ouinhi district, one of Benin's most endemic districts previously served by centralized hospital-based care. We conducted intervention-oriented research implemented in four steps: baseline study, training of health district clinical staff, outreach education, outcome and impact assessments. Study results demonstrated that early BU lesions (71% of all detected cases) could be treated in the community following outreach education, and that most of the afflicted were willing to accept decentralized treatment. Ninety-three percent were successfully treated with antibiotics alone. The impact evaluation found that community confidence in decentralized BU care was greatly enhanced by clinic staff who came to be seen as having expertise in the care of most chronic wounds. This study documents a successful BU outreach and decentralized care program reaching early BU cases not previously treated by a proactive centralized BU program. The pilot program further demonstrates the added value of integrated wound management for NTD control.

  16. Apollo management: A key to the solution of the social-economical dilemma - The transferability of space-travel managerial techniques to the civil sector

    NASA Technical Reports Server (NTRS)

    Puttkamer, J. V.

    1973-01-01

    An analysis has been conducted to find out whether the management techniques developed in connection with the Apollo project could be used for dealing with such urgent problems of modern society as the crisis of the cities, the increasing environmental pollution, and the steadily growing traffic. Basic concepts and definitions of program and system management are discussed together with details regarding the employment of these concepts in connection with the solution of the problems of the Apollo program. Principles and significance of a systems approach are considered, giving attention to planning, system analysis, system integration, and project management. An application of the methods of project management to the problems of the civil sector is possible if the special characteristics of each particular case are taken into account.

  17. Application of the critical pathway and integrated case teaching method to nursing orientation.

    PubMed

    Goodman, D

    1997-01-01

    Nursing staff development programs must be responsive to current changes in healthcare. New nursing staff must be prepared to manage continuous change and to function competently in clinical practice. The orientation pathway, based on a case management model, is used as a structure for the orientation phase of staff development. The integrated case is incorporated as a teaching strategy in orientation. The integrated case method is based on discussion and analysis of patient situations with emphasis on role modeling and integration of theory and skill. The orientation pathway and integrated case teaching method provide a useful framework for orientation of new staff. Educators, preceptors and orientees find the structure provided by the orientation pathway very useful. Orientation that is developed, implemented and evaluated based on a case management model with the use of an orientation pathway and incorporation of an integrated case teaching method provides a standardized structure for orientation of new staff. This approach is designed for the adult learner, promotes conceptual reasoning, and encourages the social and contextual basis for continued learning.

  18. The 3-year disease management effect: understanding the positive return on investment.

    PubMed

    Nyman, John A; Jeffery, Molly Moore; Abraham, Jean M; Jutkowitz, Eric; Dowd, Bryan E

    2013-11-01

    Conventional wisdom suggests that health promotion programs yield a positive return on investment (ROI) in year 3. In the case of the University of Minnesota's program, a positive ROI was achieved in the third year, but it was due entirely to the effectiveness of the disease management (DM) program. The objective of this study is to investigate why. Differences-in-differences regression equations were estimated to determine the effect of DM participation on spending (overall and service specific), hospitalizations, and avoidable hospitalizations. Disease management participation reduced expenditures overall, and especially in the third year for employees, and reduced hospitalizations and avoidable hospitalizations. The positive ROI at Minnesota was due to increased effectiveness of DM in the third year (mostly due to fewer hospitalizations) but also to the simple durability of the average DM effect.

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

    PubMed

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

    2016-08-01

    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. 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. 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. 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. Copyright© the College of Family Physicians of Canada.

  20. SWOT analysis of program design and implementation: a case study on the reduction of maternal mortality in Afghanistan.

    PubMed

    Ahmadi, Qudratullah; Danesh, Homayoon; Makharashvili, Vasil; Mishkin, Kathryn; Mupfukura, Lovemore; Teed, Hillary; Huff-Rousselle, Maggie

    2016-07-01

    This case study analyzes the design and implementation of the Basic Package of Health Services (BPHS) in Afghanistan by synthesizing the literature with a focus on maternal health services. The authors are a group of graduate students in the Brandeis University International Health Policy and Management Program and Sustainable International Development Program who used the experience in Afghanistan to analyze an example of successfully implementing policy; two of the authors are Afghan physicians with direct experience in implementing the BPHS. Data is drawn from a literature review, and a unique aspect of the case study is the application of the business-oriented SWOT analysis to the design and implementation of the program that successfully targeted lowering maternal mortality in Afghanistan. It provides a useful example of how SWOT analysis can be used to consider the reasons for, or likelihood of, successful or unsuccessful design and implementation of a policy or program. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  1. Understanding the economics of succeeding in disease management.

    PubMed

    Shulkin, D J

    1999-04-01

    If implemented with the proper resource commitment, disease management can have a significant effect on the health of an organization's patient population. However, it is unlikely that even the noblest of strategic initiatives will survive long without a compelling business imperative. After analyzing the business case, many organizations have committed large amounts of resources to building disease management programs. Yet these issues are still being formulated. The author discusses five issues that are key to understanding the economics of disease management.

  2. Initial Experience of an Anesthesiology-based Service for Perioperative Management of Pacemakers and Implantable Cardioverter Defibrillators.

    PubMed

    Rooke, G Alec; Lombaard, Stefan A; Van Norman, Gail A; Dziersk, Jörg; Natrajan, Krishna M; Larson, Lyle W; Poole, Jeanne E

    2015-11-01

    Management of cardiovascular implantable electronic devices (CIEDs), including pacemakers and implantable cardioverter defibrillators, for surgical procedures is challenging due to the increasing number of patients with CIEDs and limited availability of trained providers. At the authors' institution, a small group of anesthesiologists were trained to interrogate CIEDs, devise a management plan, and perform preoperative and postoperative programming and device testing whenever necessary. Patients undergoing surgery between October 1, 2009 and June 30, 2013 at the University of Washington Medical Center were included in a retrospective chart review to determine the number of devices actively managed by the Electrophysiology/Cardiology Service (EPCS) versus the Anesthesiology Device Service (ADS), changes in workload over time, surgical case delays due to device management, and errors and problems encountered in device programming. The EPCS managed 254 CIEDs, the ADS managed 548, and 227 by neither service. Over time, the ADS providers managed an increasing percentage of devices with decreasing supervision from the EPCS. Only two CIEDs managed by the ADS required immediate assistance from the EPCS. Patients who were unstable postoperatively were referred to the EPCS. Although numerous issues in programming were encountered, primarily when restoring demand pacing after programming asynchronous pacing for surgery, no patient harm resulted from ADS or EPCS management of CIEDs. An ADS can provide safe CIED management for surgery, but it requires specialized provider training and strong support from the EPCS. Due to the complexity of CIED management, an ADS will likely only be feasible in high-volume settings.

  3. Integrated planning for regional development planning and water resources management under uncertainty: A case study of Xining, China

    NASA Astrophysics Data System (ADS)

    Fu, Z. H.; Zhao, H. J.; Wang, H.; Lu, W. T.; Wang, J.; Guo, H. C.

    2017-11-01

    Economic restructuring, water resources management, population planning and environmental protection are subjects to inner uncertainties of a compound system with objectives which are competitive alternatives. Optimization model and water quality model are usually used to solve problems in a certain aspect. To overcome the uncertainty and coupling in reginal planning management, an interval fuzzy program combined with water quality model for regional planning and management has been developed to obtain the absolutely ;optimal; solution in this study. The model is a hybrid methodology of interval parameter programming (IPP), fuzzy programing (FP), and a general one-dimensional water quality model. The method extends on the traditional interval parameter fuzzy programming method by integrating water quality model into the optimization framework. Meanwhile, as an abstract concept, water resources carrying capacity has been transformed into specific and calculable index. Besides, unlike many of the past studies about water resource management, population as a significant factor has been considered. The results suggested that the methodology was applicable for reflecting the complexities of the regional planning and management systems within the planning period. The government policy makers could establish effective industrial structure, water resources utilization patterns and population planning, and to better understand the tradeoffs among economic, water resources, population and environmental objectives.

  4. Feasibility Study on the Use of Computer Managed Learning in Secondary Schools in the U.S.A.

    ERIC Educational Resources Information Center

    Charp, Sylvia

    A brief description of computer managed instruction (CMI), including its applications and capabilities, introduces case studies of schools in the United States that are using three different CMI systems. The first system discussed is the Comprehensive Achievement Monitoring (CAM) Program, which was developed by a small school district (Hopkins,…

  5. Mismanagement and Quality Circles: How Middle Managers Influence Direct Participation.

    ERIC Educational Resources Information Center

    Brennan, Maire

    1991-01-01

    Case studies of five Scottish companies found that four of their quality circles programs had ceased. Essential to the success of quality circles were changes in the systems of reward, communication, and decision making and the cooperation and support of middle managers, who may see quality circles as a threat and who control the resources they…

  6. Analyzing the Implementation of Nutrient Management Plans by Farmers: Implications for Extension Education

    ERIC Educational Resources Information Center

    Tao, Haiying; Morris, Thomas F.; Bravo-Ureta, Boris; Meinert, Richard

    2016-01-01

    We conducted case studies on four Connecticut dairy farms to evaluate how well farmers implemented their nutrient management plans (NMPs). Our findings can help Extension educators develop programs to improve NMPs and NMP adoption by farmers. We identified three educational topic areas that would likely increase NMP understanding and acceptance:…

  7. Cross-cultural management of pest animal damage: a case study of feral buffalo control in Australia's Kakadu National Park.

    PubMed

    Robinson, Cathy J; Whitehead, Peter

    2003-10-01

    Government agencies responsible for pest animal management often assume that their views and assumptions about the benefits of control are widely shared, especially if these pests are exotics. This was certainly the case when tens of thousands of feral Asian water buffalo (Bubalus bubalis) were to be culled in Australia's Kakadu National Park as part of a national Brucellosis and Tuberculosis Eradication Campaign (BTEC). Implementation of the campaign sparked considerable dispute between officials and aboriginal and non-aboriginal interests about the risks posed by buffalo relative to their value as a potential resource. Drawing upon a variety of written and oral sources relating to the era of buffalo control in Kakadu, this paper critically analyzes the way in which detriment caused by buffalo was appraised and managed under the BTEC program. In particular, the paper focuses the ways in which the BTEC program affected aboriginal people in Kakadu, who view buffalo as a source of customary and economic benefit as well as a source of change on their lands. The paper then considers what lessons can be learned from the BTEC for the development of sensible feral management objectives and strategies. It is argued that effective management of feral animals such as buffalo will require environmental managers to engage with local people and involve them in the definition and management of pest animal damage and methods of control.

  8. Participatory forest management in Ethiopia: learning from pilot projects.

    PubMed

    Ameha, Aklilu; Larsen, H O; Lemenih, Mulugeta

    2014-04-01

    Different arrangements of decentralized forest management have been promoted as alternatives to centralized and top down approaches to halt tropical deforestation and forest degradation. Ethiopia is one of the countries piloting one of these approaches. To inform future programs and projects it is essential to learn from existing pilots and experiences. This paper analyses five of the pilot participatory forest management (PFM) programs undertaken in Ethiopia. The study is based on the Forest User Group (FUG) members' analyses of the programs using selected outcome variables: forest income, change in forest conditions, forest ownership feelings and effectiveness of FUGs as forest managing institutions. These variables were assessed at three points in time-before the introduction of PFM, during the project implementation and after the projects ended. Data were collected using group discussions, key informant interviews and transect walks through the PFM forests. The results show that in all of the five cases the state of the forest is perceived to have improved with the introduction of PFM, and in four of the cases the improvement was maintained after projects ended. Regulated access to the forests following introduction of PFM was not perceived to have affected forest income negatively. There are, however, serious concerns about the institutional effectiveness of the FUGs after projects ended, and this may affect the success of the PFM approach in the longer term.

  9. The Future of Utility Customer-Funded Energy Efficiency Programs in the United States: Projected Spending and Savings to 2025

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Barbose, Galen; Goldman, Charles; Hoffman, Ian

    2012-09-11

    We develop projections of future spending on, and savings from, energy efficiency programs funded by electric and gas utility customers in the United States, under three scenarios through 2025. Our analysis, which updates a previous LBNL study, relies on detailed bottom-up modeling of current state energy efficiency policies, regulatory decisions, and demand-side management and utility resource plans. The three scenarios are intended to represent a range of potential outcomes under the current policy environment (i.e., without considering possible major new policy developments). By 2025, spending on electric and gas efficiency programs (excluding load management programs) is projected to double frommore » 2010 levels to $9.5 billion in the medium case, compared to $15.6 billion in the high case and $6.5 billion in the low case. Compliance with statewide legislative or regulatory savings or spending targets is the primary driver for the increase in electric program spending through 2025, though a significant share of the increase is also driven by utility DSM planning activity and integrated resource planning. Our analysis suggests that electric efficiency program spending may approach a more even geographic distribution over time in terms of absolute dollars spent, with the Northeastern and Western states declining from over 70% of total U.S. spending in 2010 to slightly more than 50% in 2025, with the South and Midwest splitting the remainder roughly evenly. Under our medium case scenario, annual incremental savings from customer-funded electric energy efficiency programs increase from 18.4 TWh in 2010 in the U.S. (which is about 0.5% of electric utility retail sales) to 28.8 TWh in 2025 (0.8% of retail sales). These savings would offset the majority of load growth in the Energy Information Administration’s most recent reference case forecast, given specific assumptions about the extent to which future energy efficiency program savings are captured in that forecast. However, the pathway that customer-funded efficiency programs ultimately take will depend on a series of key challenges and uncertainties associated both with the broader market and policy context and with the implementation and regulatory oversight of the energy efficiency programs themselves.« less

  10. The disease management approach to cost containment.

    PubMed

    Goldstein, R

    1998-01-01

    Disease management has been around a long time, certainly since Pasteur. Its initial focus was to eliminate or contain epidemics. In the 20th century, American public health scientists and officials have used disease management to address a high-risk, often poor population. Currently, the population-based principles of disease management, including disease prevention activities, are being applied to noninfectious diseases. Two examples of public health disease prevention strategies are vaccinations and chlorination of water. Hospitals are now providing post-hospital disease management programs for selected chronic conditions that account for a high volume of repeat admissions or emergency department visits, such as chronic heart failure, asthma, and cancer. In other words, hospitals are spending money on a program that, if done right, will reduce their inpatient revenues. They are doing so for various reasons (e.g., because they have established at-risk financial partnerships with their physicians, or possibly because other area hospitals are doing it, or possibly because they want to keep the ancillaries [x-rays, laboratory, pharmacy, ambulatory surgery, etc]). Regardless of the reasons, hospital case managers will be charged with referring qualified patients to both hospital-based and provider-based disease management programs.

  11. Determining when to change course in management actions.

    PubMed

    Ng, Chooi Fei; McCarthy, Michael A; Martin, Tara G; Possingham, Hugh P

    2014-12-01

    Time is of the essence in conservation biology. To secure the persistence of a species, we need to understand how to balance time spent among different management actions. A new and simple method to test the efficacy of a range of conservation actions is required. Thus, we devised a general theoretical framework to help determine whether to test a new action and when to cease a trial and revert to an existing action if the new action did not perform well. The framework involves constructing a general population model under the different management actions and specifying a management objective. By maximizing the management objective, we could generate an analytical solution that identifies the optimal timing of when to change management action. We applied the analytical solution to the case of the Christmas Island pipistrelle bat (Pipistrelle murrayi), a species for which captive breeding might have prevented its extinction. For this case, we used our model to determine whether to start a captive breeding program and when to stop a captive breeding program and revert to managing the species in the wild, given that the management goal is to maximize the chance of reaching a target wild population size. For the pipistrelle bat, captive breeding was to start immediately and it was desirable to place the species in captivity for the entire management period. The optimal time to revert to managing the species in the wild was driven by several key parameters, including the management goal, management time frame, and the growth rates of the population under different management actions. Knowing when to change management actions can help conservation managers' act in a timely fashion to avoid species extinction. © 2014 Society for Conservation Biology.

  12. 38 CFR 21.430 - Accountability for authorization and payment of training and rehabilitation services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Employment (VR&E) Officer's review of program costs. The VR&E Officer will review the program costs for the... for a calendar year exceeds $25,000. The VR&E Officer may not delegate this responsibility. The case manager will neither sign a rehabilitation plan nor authorize expenditures before the VR&E Officer...

  13. A Case Study to Explore the Impact of Knowledge Management Systems on Workplace Diversity Programs

    ERIC Educational Resources Information Center

    Gautier, Michael

    2012-01-01

    The ongoing debate over the definition and application of workplace diversity policies results in a wide range of viewpoints. There are a number of theoreticians who feel that if diversity is more than avoidance of discrimination, that the traditional body of anti-discrimination programs such as the Equal Employment Opportunity (EEO) efforts…

  14. 38 CFR 21.430 - Accountability for authorization and payment of training and rehabilitation services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Employment (VR&E) Officer's review of program costs. The VR&E Officer will review the program costs for the... for a calendar year exceeds $25,000. The VR&E Officer may not delegate this responsibility. The case manager will neither sign a rehabilitation plan nor authorize expenditures before the VR&E Officer...

  15. 38 CFR 21.430 - Accountability for authorization and payment of training and rehabilitation services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Employment (VR&E) Officer's review of program costs. The VR&E Officer will review the program costs for the... for a calendar year exceeds $25,000. The VR&E Officer may not delegate this responsibility. The case manager will neither sign a rehabilitation plan nor authorize expenditures before the VR&E Officer...

  16. 38 CFR 21.430 - Accountability for authorization and payment of training and rehabilitation services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Employment (VR&E) Officer's review of program costs. The VR&E Officer will review the program costs for the... for a calendar year exceeds $25,000. The VR&E Officer may not delegate this responsibility. The case manager will neither sign a rehabilitation plan nor authorize expenditures before the VR&E Officer...

  17. Evaluation of Distance Education Components of e-MBA Program--A Case Study

    ERIC Educational Resources Information Center

    Gunes, Ali; Altintas, Tugba

    2013-01-01

    By 2008-2009 educational year, distance education e-MBA Program have been added to Graduate School of Social Sciences of Istanbul Aydin University. The distance education components that were used included asynchronous education, synchronous education, exams, the learning management system-web site and a remote live-support desk. At the end of the…

  18. Workforce Readiness: Changes in Critical Thinking Skills of Adult Learners in an Accelerated Undergraduate Degree Program

    ERIC Educational Resources Information Center

    Slemp, Kathleen N.

    2012-01-01

    This mixed-method case study explored the change in critical thinking skills over the span of the adult student's accelerated lock-step cohort experience pursuing an organizational management and leadership degree completion program at a liberal arts institution in the Midwest. Three areas of research informed this study: workforce readiness,…

  19. Administrative Decision-Making in a Time of Resource Decline: The Case of California's Beginning Teacher Support and Assessment Program

    ERIC Educational Resources Information Center

    Reimann, Jason Daniel

    2011-01-01

    This dissertation is a qualitative study on the decision-making of administrators within California's Beginning Teacher Support and Assessment (BTSA) teacher induction program. The study focuses on examining how declining resources act as a pressure, how well-established research on cutback management predict the behaviors of the BTSA…

  20. Building Self-Sufficiency among Welfare-Dependent Teenage Parents: Lessons from the Teenage Parent Demonstration.

    ERIC Educational Resources Information Center

    Maynard, Rebecca, Ed.

    This report synthesizes first-phase evaluation results of the Teenage Parent Demonstration program. This program, whose cornerstone is case management, responded to three concerns: (1) rising welfare caseloads; (2) persistently high rates of teenage pregnancies and births; and (3) the high probability that teenage parents will go onto welfare and…

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