Contract anesthesia: the good news and the challenge.

The dramatic pace of change in health care is intimidating, and results can be unpredictable and often negative. The practice of contract anesthesia delivery is an excellent example of how a clinical microsystem interacts with the constant change common in today's health care environment. This article identifies many of the issues of concern in contract anesthesia. Awareness of issues will afford nurses, nurse anesthetists, and managers a structure for a smooth, safe, and effective transition of contracting providers.

The SEARCH Project: Acquainting Students in the Health Professions with Interprofessional Care.

The SEARCH NH project (Student Experiences and Rotations in Community Health in New Hampshire) was a 3-year collaboration of the New Hampshire Area Health Education Center, four educational institutions, and four community health centers. The purpose was to introduce students in the health professions to interprofessional care in underserved areas. It was funded by the National Health Services Corps. The background of the project, its development, and findings are described. Seventy-four students from undergraduate and graduate nursing programs, a physician assistant program, and a medical school participated. Prior to a focused immersion experience in a community health center, they were exposed didactically to concepts of interprofessional care. Findings from the collaborative project are reported using a clinical microsystems framework to analyze student reflections on their experiences and resultant learning. In quotes offered as exemplars, students report increased appreciation of the clinical microsystem's 5 Ps: purpose, professionals, patients, patterns, and processes in interprofessional work.