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1.
J Nurs Adm ; 51(4): 227-231, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33734183

RESUMO

This case study describes how an innovative, triple-win, academic-practice partnership model can be used to deepen the clinical expertise of advanced practice registered nurse (APRN) students and improve rural Americans' access to quality patient care. It features the experience and strategies used by a school of nursing and a local rural hospital system collaborating to provide clinical experiences for APRN students pursuing doctor of nursing practice degrees.


Assuntos
Prática Avançada de Enfermagem/educação , Bacharelado em Enfermagem/organização & administração , Relações Interinstitucionais , Área Carente de Assistência Médica , População Rural/estatística & dados numéricos , Comportamento Cooperativo , Humanos , Maryland , Determinação de Necessidades de Cuidados de Saúde , Pesquisa em Educação de Enfermagem , Estudantes de Enfermagem/estatística & dados numéricos
2.
J Nurs Adm ; 51(3): 168-172, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33570375

RESUMO

This article describes an academic-clinical partnership program between a school of nursing and an American Nurse Credentialing Center Magnet®- and National Cancer Institute-designated Comprehensive Cancer Center based on a shared vision and multifaceted for optimal new graduate operating room (OR) recruitment and use of clinical partner resources. The program, now in its 3rd year, has a 100% retention rate among the cohorts. Implementing a multifaceted OR partnership program based on nursing theory is a strategy for workforce development to increase retention of new graduate OR nurses.


Assuntos
Bacharelado em Enfermagem/organização & administração , Hospitais de Ensino/organização & administração , Relações Interinstitucionais , Recursos Humanos de Enfermagem no Hospital/educação , Enfermagem de Centro Cirúrgico/educação , Enfermagem de Centro Cirúrgico/organização & administração , Sociedades de Enfermagem/organização & administração , Recursos Humanos/organização & administração , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , National Institutes of Health (U.S.) , Objetivos Organizacionais , Estados Unidos
3.
J Dev Behav Pediatr ; 42(3): 236-239, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33596007

RESUMO

ABSTRACT: The transition to virtual and hybrid schooling given the COVID-19 pandemic in the United States has upended the education system and may be widening gaps in service disparities, particularly for children with disabilities. Schools often function as "de facto" service systems for most children with disabilities, particularly those from racially and ethnically minoritized, economically vulnerable, and bilingual populations. The impact of school closures on children with disabilities poses significant ramifications for the medical, behavioral health, and educational systems in which they are served, necessitating the need for pediatric clinicians to collaborate with schools in purposeful ways. This commentary (1) presents an overview of the current guidance for providing school-based services to children with disabilities during the COVID context with many schools operating in virtual or hybrid formats, (2) reviews potential service inequities exacerbated by school closures and lack of on-site services, and (3) offers recommendations for collaborating with school staff and community agencies in support of children and families with disabilities.


Assuntos
/epidemiologia , Crianças com Deficiência/educação , Relações Interinstitucionais , Instituições Acadêmicas/organização & administração , Criança , Educação a Distância/métodos , Educação a Distância/organização & administração , Humanos , Estados Unidos
5.
Public Health Rep ; 136(1): 32-38, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33170094

RESUMO

Containing coronavirus disease 2019 (COVID-19) through case investigation and contact tracing is a crucial strategy for governmental public health agencies to control the spread of COVID-19 infection in the United States. Because of the recency of the pandemic, few examples of COVID-19 contact-tracing models have been shared among local, state, and federal public health officials to date. This case study of the Anne Arundel County Department of Health (Maryland) illustrates one model of contact-tracing activity developed early in the outbreak. We describe the contact-tracing effort's place within the broader county health agency Incident Command System, as well as the capabilities needed, team composition, special considerations, and major lessons learned by county health officials. Other local, state, tribal, territorial, and federal health officials and policy makers can use this case study to innovate, iterate, and further refine contact-tracing efforts to prevent the spread of COVID-19 infection and support community members in isolation or quarantine.


Assuntos
/epidemiologia , Busca de Comunicante/métodos , Pandemias/prevenção & controle , Comportamento Cooperativo , Relações Interinstitucionais , Maryland , Papel Profissional , Estados Unidos
9.
N C Med J ; 81(5): 320-323, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32900895

RESUMO

Preventing the adverse health impacts of wildfire smoke involves helping people understand if they are at risk, and the actions they can take to limit exposure. Cooperation between land managers, public health officials, and the health care system could alert the public to take actions that reduce wildfire smoke-related health risks.


Assuntos
Exposição Ambiental/efeitos adversos , Relações Interinstitucionais , Fumaça/efeitos adversos , Incêndios Florestais , Conservação dos Recursos Naturais , Assistência à Saúde , Humanos , Saúde Pública , Risco
10.
Epidemiol Serv Saude ; 29(4): e2020499, 2020 09 04.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32901699

RESUMO

This article presents an experience report about integration between public and private health services, health service managers and the academy, for surveillance and control of the COVID-19 epidemic, in the municipality of Tubarão, Santa Catarina, Brazil. The city is home to a university and has a large flow of people from different parts of the country, as well as being one of the first municipalities in the state of Santa Catarina to report cases of community transmission of SARS-CoV-2. The measures adopted included the implementation of the COVID-19 Monitoring Committee, the Municipal Health Emergency Operations Center, and the COVID-19 Contingency Plan. After 100 days of pandemic, 5,979 cases had been reported, 431 (7.2%) had been confirmed, of which five (1.2%) died. Early decisions, such as the immediate suspension of business activities and crowded events, may have reduced the spread of the virus. The partnerships put into place have provided innovation and supported public service management in decision-making based upon scientific evidence.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Relações Interinstitucionais , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Parcerias Público-Privadas/organização & administração , Comitês Consultivos , Brasil/epidemiologia , Comunicação , Infecções por Coronavirus/transmissão , Implementação de Plano de Saúde , Humanos , Pneumonia Viral/transmissão , Vigilância da População/métodos
11.
Artigo em Inglês | MEDLINE | ID: mdl-32867360

RESUMO

BACKGROUND: Working toward a healthy living environment requires organizations from different policy domains and nongovernment partners involved in public health and the living environment to collaborate across sectors. The aim of this study is to understand how this cross-sector collaboration for a healthy living environment can be achieved. METHODS: The realist evaluation approach was used to investigate what strategies can be used in which contexts to achieve cross-sector collaboration. The "Collaborative Adaptive Health Networks" framework was used as a theoretical framework. Seventeen partners of three Dutch projects collaborating for a healthy living environment in different regions were interviewed about their experiences during the initiating phase of their projects. RESULTS: Seven themes for achieving cross-sector collaboration were identified, namely creating a feeling of equivalence, building trust, bridging different perspectives, providing clarity regarding roles and tasks, creating commitment, creating active engagement, and understanding whom to engage and when. For each theme, the strategies that were used, and why, were specified. CONCLUSION: This study provides new insights in how cross-sector collaboration for a healthy living environment can be achieved in different contexts. Whether the start of a cross-sectoral collaboration is successful is largely influenced by the choice of leadership and the interorganizational relations.


Assuntos
Comportamento Cooperativo , Relações Interinstitucionais , Organizações , Formulação de Políticas , Saúde Pública/métodos , Política de Saúde , Humanos , Liderança , Confiança
12.
Public Health Rep ; 135(1_suppl): 75S-81S, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32735184

RESUMO

Policies facilitating integration of public health programs can improve the public health response, but the literature on approaches to integration across multiple system levels is limited. We describe the efforts of the Massachusetts Department of Public Health to integrate its HIV, viral hepatitis, sexually transmitted infection (STI), and tuberculosis response through policies that mandated contracted organizations to submit specimens for testing to the Massachusetts State Public Health Laboratory; co-test blood specimens for HIV, hepatitis C virus (HCV), and syphilis; integrate HIV, viral hepatitis, and STI disease surveillance and case management in a single data system; and implement an integrated infectious disease drug assistance program. From 2014 through 2018, the number of tests performed by the Massachusetts State Public Health Laboratory increased from 16 321 to 33 674 for HIV, from 11 054 to 33 670 for HCV, and from 19 169 to 30 830 for syphilis. Service contracts enabled rapid response to outbreaks of HIV, hepatitis A, and hepatitis B. Key challenges included lack of a billing infrastructure at the Massachusetts State Public Health Laboratory; the need to complete negotiations with insurers and to establish a retained revenue account to receive health insurance reimbursements for testing services; and time to train testing providers in phlebotomy for required testing. Investing in laboratory infrastructure; creating billing mechanisms to maximize health insurance reimbursement; proactively engaging providers, community members, and other stakeholders; and building capacity to transform practices are needed. Using multilevel policy approaches to integrate the public health response to HIV, STI, viral hepatitis, and tuberculosis is feasible and adaptable to other public health programs.


Assuntos
Serviços Contratados/organização & administração , Seguro Saúde/organização & administração , Administração em Saúde Pública/métodos , Vigilância em Saúde Pública/métodos , Doenças Sexualmente Transmissíveis/diagnóstico , Serviços Contratados/economia , Serviços Contratados/normas , Política de Saúde , Acesso aos Serviços de Saúde , Hepatite/diagnóstico , Humanos , Seguro Saúde/economia , Seguro Saúde/legislação & jurisprudência , Seguro Saúde/normas , Reembolso de Seguro de Saúde/economia , Reembolso de Seguro de Saúde/legislação & jurisprudência , Reembolso de Seguro de Saúde/normas , Relações Interinstitucionais , Massachusetts , Estudos de Casos Organizacionais , Avaliação de Programas e Projetos de Saúde , Administração em Saúde Pública/economia , Administração em Saúde Pública/legislação & jurisprudência , Administração em Saúde Pública/normas , Sífilis/diagnóstico
13.
Public Health Rep ; 135(1_suppl): 65S-74S, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32735198

RESUMO

In 2014, New York State became the first jurisdiction to launch a statewide initiative to end AIDS by reducing the number of persons living with HIV for the first time since effective HIV treatment became available. The Ending the Epidemic (ETE) initiative encompasses (1) identifying and linking undiagnosed persons with HIV to care, (2) retaining persons with HIV in care, and (3) facilitating access to preexposure prophylaxis for persons at risk for acquiring HIV. We used a framework for public health program implementation to describe key characteristics of the ETE initiative, present progress toward 13 ETE target metrics, and identify areas in need of increased programming. We provide evidence suggesting that New York State is on track to end AIDS as an epidemic by the end of 2020. As of 2017, 76% of progress toward our primary ETE target had been achieved. Substantial progress on several additional metrics critical to decreasing HIV prevalence and to improving the health of persons living with HIV had also been achieved. Lessons learned included the following: (1) ETE-based programming should be tailored to each jurisdiction's unique political and social climate, HIV epidemiology, fiscal resources, and network of HIV service providers; (2) key stakeholders should be involved in developing ETE metrics and setting targets; (3) performance-based measurement and timely communication to key stakeholders in real time are essential; and (4) examining trends in HIV prevention and care metrics is important for developing realistic ETE timelines.


Assuntos
Epidemias/prevenção & controle , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Comunicação , Infecções por HIV/diagnóstico , Infecções por HIV/terapia , Acesso aos Serviços de Saúde/organização & administração , Humanos , Relações Interinstitucionais , New York , Cooperação do Paciente , Política , Profilaxia Pré-Exposição , Prevalência , Avaliação de Programas e Projetos de Saúde , Características de Residência , Fatores Socioeconômicos
14.
BMC Public Health ; 20(Suppl 2): 1058, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787895

RESUMO

BACKGROUND: Thoughtful and equitable engagement with international partners is key to successful research. STRIPE, a consortium of 8 academic and research institutions across the globe whose objective is to map, synthesize, and disseminate lessons learned from polio eradication, conducted a process evaluation of this partnership during the project's first year which focused on knowledge mapping activities. METHODS: The STRIPE consortium is led by Johns Hopkins University (JHU) in partnership with 6 universities and 1 research consultancy organization in polio free, at-risk, and endemic countries. In December 2018 JHU team members submitted written reflections on their experiences (n = 9). We held calls with each consortium member to solicit additional feedback (n = 7). To establish the partnership evaluation criteria we conducted preliminary analyses based on Blackstock's framework evaluating participatory research. In April 2019, an in-person consortium meeting was held; one member from each institution was asked to join a process evaluation working group. This group reviewed the preliminary criteria, adding, subtracting, and combining as needed; the final evaluation criteria were applied to STRIPE's research process and partnership and illustrative examples were provided. RESULTS: Twelve evaluation criteria were defined and applied by each member of the consortium to their experience in the project. These included access to resources, expectation setting, organizational context, external context, quality of information, relationship building, transparency, motivation, scheduling, adaptation, communication and engagement, and capacity building. For each criteria members of the working group reflected on general and context-specific challenges and potential strategies to overcome them. Teams suggested providing more time for recruitment, training, reflection, pre-testing. and financing to alleviate resource constraints. Given the large scope of the project, competing priorities, and shifting demands the working group also suggested a minimum of one full-time project coordinator in each setting to manage resources. CONCLUSION: Successful management of multi-country, multicentered implementation research requires comprehensive communication tools (which to our knowledge do not exist yet or are not readily available), expectation setting, and institutional support. Capacity building activities that address human resource needs for both individuals and their institutions should be incorporated into early project planning.


Assuntos
Saúde Global , Relações Interinstitucionais , Cooperação Internacional , Pesquisa/organização & administração , Erradicação de Doenças , Humanos , Poliomielite/prevenção & controle , Estados Unidos
15.
BMC Public Health ; 20(Suppl 2): 1197, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787958

RESUMO

BACKGROUND: Complex global initiatives, like the Global Polio Eradication Initiative (GPEI), have prevented millions of paralyses and improved the health status of diverse populations. Despite the logistical challenges these initiatives must overcome at several levels, scant methods exist for systematically identifying and reaching a range of actors involved in their implementation. As a result, efforts to document the lessons learned from such initiatives are often incomplete. This paper describes the development and application of the Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) systematic approach for identifying a comprehensive sample of actors involved in the GPEI. RESULTS: The survey for collecting lessons learned from the GPEI was conducted at the global level and within seven countries that represented GPEI operational contexts. Standard organizational and operational levels, as well as goals of program activities, were defined across contexts. Each survey iteration followed similar methodologies to theorize a target population or "universe" of all polio-related actors in the study area, enumerate a source population of specific individuals within the target population, and administer the survey to individuals within the source population. Based on the systematic approach used to obtain a comprehensive sample for lessons learned in GPEI, steps for obtaining a comprehensive sample for studying complex initiatives can be summarized as follows: (i) State research goal(s); (ii) Describe the program of interest; (iii) Define a sampling universe to meet these criteria; (iv) Estimate the size of the sampling universe; (v) Enumerate a source population within the universe that can be feasibly reached for sampling; (vi) Sample from the source population; and (vii) Reflect on the process to determine strength of inferences drawn. CONCLUSIONS: The application of these methods can inform future evaluations of complex public health initiatives, resulting in better adoption of lessons learned, ultimately improving efficacy and efficiency, and resulting in significant health gains. Their use to administer the STRIPE lessons learned survey reflects experiences related to implementation challenges and strategies used to overcome barriers from actors across an extensive range of organizational, programming, and contextual settings.


Assuntos
Erradicação de Doenças/organização & administração , Saúde Global , Relações Interinstitucionais , Poliomielite/prevenção & controle , Humanos , Inquéritos e Questionários
16.
J Exp Med ; 217(9)2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32735669

RESUMO

The response to the COVID-19 crisis across most research institutions mandated ceasing nonessential research activities in order to minimize the spread of the virus in our communities. With minimal notice, experiments were terminated, cell lines were frozen, mouse colonies were culled, and trainees were prevented from performing bench research. Still, despite the interruption of experimental productivity, the shutdown has proven for many PIs and trainees that doing and thinking science are not activities that are bound to the laboratory. Furthermore, the shutdowns have solidified important emerging trends and forced us to further innovate to get the most out of working remotely. We hope that some of these innovations, hard-gained in this difficult time, will persist and develop into new paradigms-lessons that will improve our science and our relationship to the climate and community beyond the current pandemic.


Assuntos
Pesquisa Biomédica/tendências , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Animais , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Congressos como Assunto , Humanos , Relações Interinstitucionais , Pandemias , Pesquisadores
17.
Rev. adm. pública (Online) ; 54(4): 663-677, jul.-ago. 2020. graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1136989

RESUMO

Resumo Este artigo analisa como o federalismo brasileiro tem afetado o combate à COVID-19. Tendo por base uma análise histórico-institucional do caso brasileiro, busca-se compreender como o modelo federativo construído pelo governo Bolsonaro influenciou as respostas ao combate da pandemia no país, bem como os resultados do confronto de dois modelos federativos nesse processo. De um lado, o ideário e as estruturas institucionais da Constituição de 1988 com características cooperativas e forte coordenação federal. De outro, o federalismo bolsonarista baseia-se numa visão dualista de relações intergovernamentais, com menor participação da União na redução de desigualdades territoriais e no apoio a governos subnacionais, além da postura centralizadora e hierárquica nas questões de impacto nacional. O estudo mostra que o federalismo bolsonarista aumentou o conflito com governos subnacionais e tem descoordenado políticas públicas de enfrentamento à pandemia. Conclui-se que as crises sanitária e federativa caminham juntas e trazem à tona uma questão chave: a importância da coordenação governamental nas políticas públicas de enfrentamento à pandemia.


Resumen Este artículo analiza cómo el federalismo brasileño ha afectado la lucha contra la COVID-19. A partir de un análisis histórico-institucional del caso brasileño, buscamos comprender cómo el modelo federativo construido por el gobierno de Bolsonaro influyó en las respuestas para combatir la pandemia en el país, así como los resultados de la confrontación de dos modelos federativos en este proceso. Por un lado, el ideario y las estructuras institucionales de la Constitución de 1988 con características cooperativas y una fuerte coordinación federal. Por otro, el federalismo bolsonarista que se basa en una visión dualista de las relaciones intergubernamentales, con menos participación del Gobierno Federal en la reducción de las desigualdades territoriales y en el apoyo a los gobiernos subnacionales, además de la postura centralizadora y jerárquica en materias de impacto nacional. El estudio muestra que el federalismo bolsonarista ha aumentado el conflicto con los gobiernos subnacionales y ha descoordinado las políticas públicas de combate a la pandemia. Se concluye que las crisis sanitaria y federativa van juntas y plantean una cuestión clave: la importancia de la coordinación gubernamental en la implementación de políticas públicas de enfrentamiento a la pandemia y sus efectos sociales y económicos.


Abstract This article analyzes how federalism has affected policy responses to the COVID-19 pandemic in Brazil. Through historical-institutional analysis, the study examines how the model of federalism adopted by President Bolsonaro's government influenced policy responses to the pandemic in the country. In addition, the research points out the existence of two models of federalism in the case analyzed, addressing the outcomes of the confrontation between them. The first model refers to ideas and institutional structures that have emerged since the 1988 Brazilian Federal Constitution with cooperative features and strong federal coordination. The second, named "Bolsonaro's federalism," is based on a dualistic view of intergovernmental relations with little participation of the federal government in reducing territorial inequalities and supporting subnational governments, while centralizing issues of national importance and adopting a hierarchical stance. The study shows that Bolsonaro's government increased the conflict with subnational governments and jeopardized the coordination of policy responses to the COVID-19 pandemic. We conclude that healthcare and federative crises go together and raise a key question: what is the importance of governmental coordination to implement policies to respond to the pandemic and its social and economic effects?


Assuntos
Humanos , Masculino , Feminino , Política Pública , Infecções por Coronavirus , Federalismo , Governo Federal , Relações Interinstitucionais
19.
N C Med J ; 81(4): 221-227, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32641453

RESUMO

BACKGROUND After a hospital stay, many older adults rely on their caregivers for assistance at home. Empirical evidence demonstrates that caregiver support programs in hospital-to-home transitions are associated with favorable caregiver and patient outcomes. We tested the feasibility of implementing the Duke Elder Family/Caregiver Training (DEFT) program in an academic medical center.METHODS: We recruited adult caregivers of homebound patients who were aged 55 years or older from Duke University Hospital in Durham, North Carolina. Caregivers attended a face-to-face caregiver training and received two telephone checks after hospital discharge with DEFT services ending at 14 days of hospital discharge. We used a one-item survey to measure overall DEFT satisfaction. We also monitored 30-day readmissions of patients whose caregivers completed the DEFT program.RESULTS: The DEFT Center received 104 consult orders in six months. Of these, 61 agreed to participate but nine caregivers were unable to schedule the DEFT training and three decided to eventually withdraw from participation. Forty-nine caregivers received the DEFT training, 12 of whom were ineligible to continue because of change in patients' disposition plan. Of the remaining 37 caregivers, 15 completed the full program and reported high satisfaction; one patient was readmitted within 30 days of discharge.LIMITATIONS: The DEFT implementation was based on academic-medical partnership and relied on electronic medical records for consult and documentation. Replicability and generalizability of findings are limited to settings with similar capabilities and resources.CONCLUSION: The implementation of a caregiver training and support program in an academic medical center was feasible and was associated with favorable preliminary outcomes.


Assuntos
Centros Médicos Acadêmicos/organização & administração , Cuidadores/educação , Relações Interinstitucionais , Apoio Social , Idoso , Estudos de Viabilidade , Humanos , Pessoa de Meia-Idade , North Carolina , Avaliação de Programas e Projetos de Saúde
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