ISSN:1057-3631    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

At least 18 million people in the United States have asthma. Despite the publication of national guidelines, the delivery of care has not substantially changed. This article describes a program at Chicago city sites to improve the delivery of care to adults and children with asthma. Using consistent comprehensive patient education materials, innovative provider education, and a variety of continuous quality improvement interventions including creation of a designated practitioner, this project enhances partnership between patients and health care providers.

ISSN:1057-3631    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Understanding how quality improvement affects costs is important. Unfortunately, low-cost, reliable ways of measuring direct costs are scarce. This article builds on the principles of process improvement to develop a costing strategy that meets both criteria.Process-based costinghas 4 steps: developing a flowchart, estimating resource use, valuing resources, and calculating direct costs. To illustrate the technique, this article uses it to cost the care planning process in 3 long-term care facilities. We conclude thatprocess-based costingis easy to implement; generates reliable, valid data; and allows nursing managers to assess the costs of new or modified processes.

ISSN:1057-3631    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Patient satisfaction with nursing care in the emergency department (ED) was measured in 616 patients in California and Kentucky in the United States, Slovenia, and rural and urban Victoria in Australia. Patients were almost equally divided between men and women, primarily white, with a mean age of 44. They responded to the caring and teaching subscales of the Consumer Emergency Care Satisfaction Scale (CECSS). While scores indicated no differences in caring, the US and Slovenian groups reported greater satisfaction with teaching than did the Australian group. The subscale alpha coefficients were .87 for the caring subscale and .92 for the teaching subscale.

ISSN:1057-3631    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

The purpose of this research was to describe the characteristics of nurses who perform telephonic care quality assessment, or utilization review, prior to, concurrent with, and after medical interventions and hospitalizations. It compares these nurses demographically to nurses employed in other settings, discusses the nurses' perceptions of the nature of their work, examines assertions that utilization review is a nursing activity, and documents the nurses' education and training for ethical decision-making. Implications for nursing care quality are discussed.

ISSN:1057-3631    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This study assessed functional status changes among elderly persons (aged 65+) during the first 2 years following an elective coronary artery bypass graft. Physical functional status increased 39.1% from baseline to 1 year and 2.1% from 1 to 2 years. Role functioning increased 42.7% at 1 year and slightly decreased by 2.1% from 1 to 2 years postsurgery. From baseline to 1 year, female patients nearly doubled the percent gain of men for both Physical Function (+59.3% vs +33.9%, respectively) and Role Function (+62.0% vs +37.8%, respectively). Physical Function scores continued to increase from 1 to 2 years for women (+9.5%) compared to men (+0.7%). These findings suggest that elderly persons can expect postsurgical functional status to increase steadily during the first 2 years after surgery.

ISSN:1057-3631    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

School-based health centers have been proposed as an avenue to provide health care for vulnerable youth. Colorado has 45 school-based health centers that provided 50,000 visits to 18,600 vulnerable youth in the 1998–1999 school year. Sustainability of the centers, however, depends on the ability to obtain an ongoing stream of revenue including managed care contracts, which in turn depend on the center's ability to meet the standard of care in the community. School-based health centers should meet standards of care similar to those of community health centers including certification, credentialing of providers, and a systematic evaluation of the outcomes of services. This article reports on a statewide quality improvement program that established certification standards for school-based health centers, verified the credentials of providers at the centers, and measured quality of care in centers across the state.

ISSN:1057-3631    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Quality health care is a complex phenomenon. The factors contributing to quality in health care are as varied as the strategies needed to achieve this elusive goal. This article examines the impact of medical errors, health finance (insurance), moral hazard, and provider shortages on the quality of health care today in the United States. Emphasis is given to the need to restore public trust and to create a health care system that maximizes scarce physical, fiscal, and human resources.

ISSN:1057-3631    

出版商:OVID    

年代:2003

数据来源: OVID