The Emory Global Health Institute: developing partnerships to improve health through research, training, and service.

The authors discuss the Emory Global Health Institute, an organization that advances Emory University's global health efforts by providing guidance and financial support to Emory faculty, students, and alumni as they develop and implement global health initiatives. They discuss both the external and internal factors that led to the September 2006 establishment of the institute, as well as Emory's existing global health strengths on which it was founded. These strengths include Emory's schools of medicine, nursing, and public health, which were already deeply engaged in global health work, and Emory's long-standing partnerships with government agencies, nongovernmental organizations, and other academic institutions working on a variety of global health problems. The institute serves as an internal resource for the entire Emory University community as its members work to solve critical global health issues around the world. The authors discuss the institute's vision, mission, goals, activities, and early accomplishments. They also discuss the institute's plans for the future and the challenges they foresee. In addition, the authors emphasize that it is important for academic institutions to establish strong global partnerships. Universities are much more likely to be successful in both launching and sustaining global health programs if they work in a true partnership with people who know firsthand what their health concerns are and how to best address them in their communities. The authors conclude that global health provides an opportunity for academic institutions to put aside their competitive tendencies and work collaboratively to address global health challenges.

The effect of external feedback on the management of medicare inpatients with congestive heart failure.

The purpose of this study was to compare the effect of 2 feedback strategies on the adherence to congestive heart failure (CHF) guidelines. Thirty-two hospitals in 4 states were randomized to receive either a written feedback intervention (low-intensity intervention [LII]) or an intervention involving feedback, a physician liaison, and quality improvement tools (high-intensity intervention [HII]). CHF quality indicators were assessed, and quality managers were interviewed at baseline and remeasurement. No significant changes in quality indicators were found as a result of either intervention. Seventy-eight percent of quality managers indicated that hospital project implementation had not begun until shortly before remeasurement. HII quality managers perceived the CHF project as significantly more successful compared with LII quality managers (63% versus 13%, P < .01). Evaluation of the effects of external feedback on practice behavior requires sufficient time for organizational and individual clinician change to occur. Physician liaisons may play a role in facilitating this change.