RESUMO
It is estimated that 3 million persons in the United States have congestive heart failure. This diagnosis accounts for more than 5% of total health expenditures. A method to decrease the costs of health care was initiated through the partners-in-care model of collaborative practice. A research study exploring the use of nurse case managers in collaboration with cardiologists and primary care physicians is being conducted with persons older than 65 years. This care encompasses both inpatient and outpatient care. The intervention comprises nurse visits in the hospital and in the home as well as telephone support for 6 months after the index hospitalization. The outcomes of quality of life, functional status, mortality, morbidity, and costs are being examined. Collaborative health care partnerships may be an effective strategy to decrease health care costs and improve quality of life and functional status of older persons with congestive heart failure.
Assuntos
Cardiologia/organização & administração , Administração de Caso/organização & administração , Comportamento Cooperativo , Medicina de Família e Comunidade/organização & administração , Insuficiência Cardíaca/terapia , Relações Interprofissionais , Modelos Organizacionais , Equipe de Assistência ao Paciente/organização & administração , Idoso , Controle de Custos , Feminino , Humanos , MasculinoRESUMO
Innovation to improve the quality of structure and process in health care organization is reported in this case example of change in an academic medical center. Interactive planning and the circular organization design concept were the driving principles and methods. This report presents the needs for and initial obstructions to change, planning and project design work, a description of the change process, and illustrative accomplishments to date--two cases, one of conscious sedation policy and one of nuisance pages. Evaluative criteria for judging the progress and lessons of the project regarding key design characteristics also are included.
Assuntos
Centros Médicos Acadêmicos/organização & administração , Reestruturação Hospitalar/organização & administração , Garantia da Qualidade dos Cuidados de Saúde/organização & administração , Eficiência Organizacional , Humanos , Satisfação no Emprego , Objetivos Organizacionais , Avaliação de Resultados em Cuidados de Saúde , Pennsylvania , Recursos Humanos em Hospital , Comitê de Profissionais/organização & administraçãoRESUMO
The authors describe the evaluation of their Critical Care Internship Program. The program was evaluated by job knowledge and clinical performance of graduate nurses compared to nurses with past critical care or medical-surgical experience.
Assuntos
Cuidados Críticos , Educação de Pós-Graduação em Enfermagem , Internato não Médico , Currículo , Avaliação Educacional , Hospitais Universitários , Pennsylvania , Avaliação de Programas e Projetos de SaúdeRESUMO
This paper reports on the design, presentation, and evaluation of a graduate university course in quality assurance and utilization review. The authors cite the need for expanded course offerings in this field and present descriptions of the course design and student participants, including program location, objectives, learning themes and content, instructor team, students, and course process. Student feedback is reported including comments on course strengths and needs, teaching methods, and learning evaluation. Additional work requirements are cited.