Establishing an independent mobile health program for chronic disease self-management support in bolivia.

Science.gov (United States)

Piette, John D; Valverde, Helen; Marinec, Nicolle; Jantz, Rachel; Kamis, Kevin; de la Vega, Carlos Lazo; Woolley, Timothy; Pinto, Bismarck

2014-01-01

Mobile health (m-health) work in low- and middle-income countries (LMICs) mainly consists of small pilot programs with an unclear path to scaling and dissemination. We describe the deployment and testing of an m-health platform for non-communicable disease (NCD) self-management support in Bolivia. Three hundred sixty-four primary care patients in La Paz with diabetes or hypertension completed surveys about their use of mobile phones, health and access to care. One hundred sixty-five of those patients then participated in a 12-week demonstration of automated telephone monitoring and self-management support. Weekly interactive voice response (IVR) calls were made from a platform established at a university in La Paz, under the direction of the regional health ministry. Thirty-seven percent of survey respondents spoke indigenous languages at home and 38% had six or fewer years of education. Eighty-two percent had a mobile phone, 45% used text messaging with a standard phone, and 9% had a smartphone. Smartphones were least common among patients who were older, spoke indigenous languages, or had less education. IVR program participants completed 1007 self-management support calls with an overall response rate of 51%. IVR call completion was lower among older adults, but was not related to patients' ethnicity, health status, or healthcare access. IVR health and self-care reports were consistent with information reported during in-person baseline interviews. Patients' likelihood of reporting excellent, very good, or good health (versus fair or poor health) via IVR increased during program participation and was associated with better medication adherence. Patients completing follow-up interviews were satisfied with the program, with 19/20 (95%) reporting that they would recommend it to a friend. By collaborating with LMICs, m-health programs can be transferred from higher-resource centers to LMICs and implemented in ways that improve access to self-management support among

Establishing an Independent Mobile Health Program for Chronic Disease Self-Management Support in Bolivia

Science.gov (United States)

Piette, John D.; Valverde, Helen; Marinec, Nicolle; Jantz, Rachel; Kamis, Kevin; de la Vega, Carlos Lazo; Woolley, Timothy; Pinto, Bismarck

2014-01-01

Background: Mobile health (m-health) work in low- and middle-income countries (LMICs) mainly consists of small pilot programs with an unclear path to scaling and dissemination. We describe the deployment and testing of an m-health platform for non-communicable disease (NCD) self-management support in Bolivia. Methods: Three hundred sixty-four primary care patients in La Paz with diabetes or hypertension completed surveys about their use of mobile phones, health and access to care. One hundred sixty-five of those patients then participated in a 12-week demonstration of automated telephone monitoring and self-management support. Weekly interactive voice response (IVR) calls were made from a platform established at a university in La Paz, under the direction of the regional health ministry. Results: Thirty-seven percent of survey respondents spoke indigenous languages at home and 38% had six or fewer years of education. Eighty-two percent had a mobile phone, 45% used text messaging with a standard phone, and 9% had a smartphone. Smartphones were least common among patients who were older, spoke indigenous languages, or had less education. IVR program participants completed 1007 self-management support calls with an overall response rate of 51%. IVR call completion was lower among older adults, but was not related to patients’ ethnicity, health status, or healthcare access. IVR health and self-care reports were consistent with information reported during in-person baseline interviews. Patients’ likelihood of reporting excellent, very good, or good health (versus fair or poor health) via IVR increased during program participation and was associated with better medication adherence. Patients completing follow-up interviews were satisfied with the program, with 19/20 (95%) reporting that they would recommend it to a friend. Conclusion: By collaborating with LMICs, m-health programs can be transferred from higher-resource centers to LMICs and implemented in ways that

Workplace Participatory Occupational Health/Health Promotion Program

Science.gov (United States)

Zhang, Yuan; Flum, Marian; Kotejoshyer, Rajashree; Fleishman, Jane; Henning, Robert; Punnett, Laura

2018-01-01

Nursing home employees experience high physical and psychosocial workloads, resulting in poor health outcomes. An occupational health/health promotion program, designed to facilitate employee participation, was initiated in three nursing homes. The aim of the current study was to evaluate facilitators and barriers of the program after 3-year implementation. Focus groups with employees and in-depth interviews with top and middle managers were conducted. The Social Ecological Model was used to organize the evaluation. Facilitators and barriers were reported from both managers’ and employees’ perspectives, and were categorized as intrapersonal, interpersonal, institutional, and corporate level. Management support, financial resources, and release time for participation were identified as the three most important factors. Supports from multiple levels including both human and environment, and managers and employees, are important for a successful participatory occupational health/health promotion program. PMID:26977705

Duty health physicist program at Byron Nuclear Power Station - a cost-effective way to manage routine plant health physics activities

International Nuclear Information System (INIS)

Goldsmith, D.G.; Carey, T.R.

1987-01-01

The Duty Health Physicist Program at Byron Station was established to deal with routine health physics tasks and provide an interface between frontline and upper radiation-chemistry management. The program consists of a weekly rotation of selected members of the health physics staff into the duty health physicist position to handle the assigned duty tasks. The tasks include, but are not limited to, daily isotopic and air sample review, effluent release package review, maximum permissible concentration calculations, dose approvals, as-low-as-reasonably-achievable action review of pending jobs, and general availability to answer questions and address problems in health-physics-related areas of plant operation. The daily attendance of the duty health physicist at the radiation-chemistry and station plan-of-the-day meetings has increased the overall presence and visibility of the health physics program to upper station management and other station departments. Since its inception in July of 1985, the Duty Health Physics Program has been a major contributor to the observed 50% reduction in reportable personnel errors in the radiation-chemistry department

School Health Connection Goes Electronic: Developing a Health Information Management System for New Orleans' School-Based Health Centers. Program Results Report

Science.gov (United States)

Rastorfer, Darl

2011-01-01

From February 2008 through April 2011, School Health Connection, a program of the Louisiana Public Health Institute, developed an electronic health information management system for newly established school-based health centers in Greater New Orleans. School Health Connection was established as part of a broader effort to restore community health…

Innovating in health care management education: development of an accelerated MBA and MPH degree program at Yale.

Science.gov (United States)

Pettigrew, Melinda M; Forman, Howard P; Pistell, Anne F; Nembhard, Ingrid M

2015-03-01

Increasingly, there is recognition of the need for individuals with expertise in both management and public health to help health care organizations deliver high-quality and cost-effective care. The Yale School of Public Health and Yale School of Management began offering an accelerated Master of Business Administration (MBA) and Master of Public Health (MPH) joint degree program in the summer of 2014. This new program enables students to earn MBA and MPH degrees simultaneously from 2 fully accredited schools in 22 months. Students will graduate with the knowledge and skills needed to become innovative leaders of health care organizations. We discuss the rationale for the program, the developmental process, the curriculum, benefits of the program, and potential challenges.

Medication therapy disease management: Geisinger's approach to population health management.

Science.gov (United States)

Jones, Laney K; Greskovic, Gerard; Grassi, Dante M; Graham, Jove; Sun, Haiyan; Gionfriddo, Michael R; Murray, Michael F; Manickam, Kandamurugu; Nathanson, Douglas C; Wright, Eric A; Evans, Michael A

2017-09-15

Pharmacists' involvement in a population health initiative focused on chronic disease management is described. Geisinger Health System has cultivated a culture of innovation in population health management, as highlighted by its ambulatory care pharmacy program, the Medication Therapy Disease Management (MTDM) program. Initiated in 1996, the MTDM program leverages pharmacists' pharmacotherapy expertise to optimize care and improve outcomes. MTDM program pharmacists are trained and credentialed to manage over 16 conditions, including atrial fibrillation (AF) and multiple sclerosis (MS). Over a 15-year period, Geisinger Health Plan (GHP)-insured patients with AF whose warfarin therapy was managed by the MTDM program had, on average, 18% fewer emergency department (ED) visits and 18% fewer hospitalizations per year than GHP enrollees with AF who did not receive MTDM services, with 23% lower annual total care costs. Over a 2-year period, GHP-insured patients with MS whose pharmacotherapy was managed by pharmacists averaged 28% fewer annual ED visits than non-pharmacist-managed patients; however, the mean annual total care cost was 21% higher among MTDM clinic patients. The Geisinger MTDM program has evolved over 20 years from a single pharmacist-run anticoagulation clinic into a large program focused on managing the health of an ever-growing population. Initial challenges in integrating pharmacists into the Geisinger patient care framework as clinical experts were overcome by demonstrating the MTDM program's positive impact on patient outcomes. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

[The operation of the health program SICALIDAD: the role of managers in primary care and hospitals].

Science.gov (United States)

Granados-Cosme, José Arturo; Tetelboin-Henrion, Carolina; Torres-Cruz, César; Pineda-Pérez, Dayana; Villa-Contreras, Blanca Margarita

2011-01-01

To characterize the role of quality managers in health care units and health districts, identifying the constraints they experience in their performance. An interview guide and a questionnaire were carried out and were applied to quality managers in nine states as well as in Mexico City´s Health Services, in a Reference Federal Hospital and in a National Institute of Health. These instruments were analyzed using SPSS and Atlas.ti software. The activities done by the managers depend on the organizational level of services, which can be a care unit or the health jurisdiction. For each of these, we identified different order constraints that affect the performance of the role of management in the strategies to improve the quality of the services for population without social insurance, which together make up the government program called Integrated Quality Health System. Jurisdictional managers are the link between care units and state authorities in the management of information, while the medical units' managers drive operational strategies to improve the quality. Although the health program is implemented with the personal and infrastructure of the health system, it requires a greater institutionalization and strengthening of its structure and integration, as well as greater human and material resources.

Value drivers: an approach for estimating health and disease management program savings.

Science.gov (United States)

Phillips, V L; Becker, Edmund R; Howard, David H

2013-12-01

Health and disease management (HDM) programs have faced challenges in documenting savings related to their implementation. The objective of this eliminate study was to describe OptumHealth's (Optum) methods for estimating anticipated savings from HDM programs using Value Drivers. Optum's general methodology was reviewed, along with details of 5 high-use Value Drivers. The results showed that the Value Driver approach offers an innovative method for estimating savings associated with HDM programs. The authors demonstrated how real-time savings can be estimated for 5 Value Drivers commonly used in HDM programs: (1) use of beta-blockers in treatment of heart disease, (2) discharge planning for high-risk patients, (3) decision support related to chronic low back pain, (4) obesity management, and (5) securing transportation for primary care. The validity of savings estimates is dependent on the type of evidence used to gauge the intervention effect, generating changes in utilization and, ultimately, costs. The savings estimates derived from the Value Driver method are generally reasonable to conservative and provide a valuable framework for estimating financial impacts from evidence-based interventions.

Management training in global health education: a Health Innovation Fellowship training program to bring healthcare to low-income communities in Central America.

Science.gov (United States)

Prado, Andrea M; Pearson, Andy A; Bertelsen, Nathan S

2018-01-01

Interprofessional education is increasingly recognized as essential for health education worldwide. Although effective management, innovation, and entrepreneurship are necessary to improve health systems, business schools have been underrepresented in global health education. Central America needs more health professionals trained in health management and innovation to respond to health disparities, especially in rural communities. This paper explores the impact of the Health Innovation Fellowship (HIF), a new training program for practicing health professionals offered jointly by the Central American Healthcare Initiative and INCAE Business School, Costa Rica. Launched in 2014, HIF's goal is to create a network of highly trained interdisciplinary health professionals in competencies to improve health of Central American communities through better health management. The program's fellows carried out innovative healthcare projects in their local regions. The first three annual cohorts (total of 43 fellows) represented all health-related professions and sectors (private, public, and civil society) from six Central American countries. All fellows attended four 1-week, on-site modular training sessions, received ongoing mentorship, and stayed connected through formal and informal networks and webinars through which they exchange knowledge and support each other. CAHI stakeholders supported HIF financially. Impact evaluation of the three-year pilot training program is positive: fellows improved their health management skills and more than 50% of the projects found either financial or political support for their implementation. HIF's strengths include that both program leaders and trainees come from the Global South, and that HIF offers a platform to collaborate with partners in the Global North. By focusing on promoting innovation and management at a top business school in the region, HIF constitutes a novel capacity-building effort within global health education. HIF

Innovating in Health Care Management Education: Development of an Accelerated MBA and MPH Degree Program at Yale

Science.gov (United States)

Forman, Howard P.; Pistell, Anne F.; Nembhard, Ingrid M.

2015-01-01

Increasingly, there is recognition of the need for individuals with expertise in both management and public health to help health care organizations deliver high-quality and cost-effective care. The Yale School of Public Health and Yale School of Management began offering an accelerated Master of Business Administration (MBA) and Master of Public Health (MPH) joint degree program in the summer of 2014. This new program enables students to earn MBA and MPH degrees simultaneously from 2 fully accredited schools in 22 months. Students will graduate with the knowledge and skills needed to become innovative leaders of health care organizations. We discuss the rationale for the program, the developmental process, the curriculum, benefits of the program, and potential challenges. PMID:25706023

On Management Matters: Why We Must Improve Public Health Management Through Action: Comment on "Management Matters: A Leverage Point for Health Systems Strengthening in Global Health".

Science.gov (United States)

Willacy, Erika; Bratton, Shelly

2015-09-30

Public health management is a pillar of public health practice. Only through effective management can research, theory, and scientific innovation be translated into successful public health action. With this in mind, the U.S. Centers for Disease Control and Prevention (CDC) has developed an innovative program called Improving Public Health Management for Action (IMPACT) which aims to address this critical need by building an effective cadre of public health managers to work alongside scientists to prepare for and respond to disease threats and to effectively implement public health programs. IMPACT is a 2-year, experiential learning program that provides fellows with the management tools and opportunities to apply their new knowledge in the field, all while continuing to serve the Ministry of Health (MoH). IMPACT will launch in 2016 in 2 countries with the intent of expanding to additional countries in future years resulting in a well-trained cadre of public health managers around the world. © 2016 by Kerman University of Medical Sciences.

An integrated approach for improving occupational health and safety management: the voluntary protection program in Taiwan.

Science.gov (United States)

Su, Teh-Sheng; Tsai, Way-Yi; Yu, Yi-Chun

2005-05-01

A voluntary compliance program for occupational health and safety management, Voluntary Protection Programs (VPP), was implemented with a strategy of cooperation and encouragement in Taiwan. Due to limitations on increasing the human forces of inspection, a regulatory-based guideline addressing the essence of Occupational Health and Safety Management Systems (OHSMS) was promulgated, which combined the resources of third parties and insurance providers to accredit a self-improving worksite with the benefits of waived general inspection and a merit contributing to insurance premium payment reduction. A designated institute accepts enterprise's applications, performs document review and organizes the onsite inspection. A final review committee of Council of Labor Affairs (CLA) confers a two-year certificate on an approved site. After ten years, the efforts have shown a dramatic reduction of occupational injuries and illness in the total number of 724 worksites granted certification. VPP worksites, in comparison with all industries, had 49% lower frequency rate in the past three years. The severity rate reduction was 80% in the same period. The characteristics of Taiwan VPP program and international occupational safety and health management programs are provided. A Plan-Do-Check-Act management cycle was employed for pursuing continual improvements to the culture fostered. The use of a quantitative measurement for assessing the performance of enterprises' occupational safety and health management showed the efficiency of the rating. The results demonstrate that an employer voluntary protection program is a promising strategy for a developing country.

The effects of a disease management program on self-reported health behaviors and health outcomes: evidence from the "Florida: a healthy state (FAHS)" Medicaid program.

Science.gov (United States)

Morisky, Donald E; Kominski, Gerald F; Afifi, Abdelmonem A; Kotlerman, Jenny B

2009-06-01

Premature morbidity and mortality from chronic diseases account for a major proportion of expenditures for health care cost in the United States. The purpose of this study was to measure the effects of a disease management program on physiological and behavioral health indicators for Medicaid patients in Florida. A two-year prospective study of 15,275 patients with one or more chronic illnesses (congestive heart failure, hypertension, diabetes, or asthma) was undertaken. Control of hypertension improved from baseline to Year 1 (adjusted odds ratio = 1.60, p management program benefited in terms of controlling hypertension, asthma symptoms, and cholesterol and blood glucose levels.

Experience of health-system pharmacy administration residents in a longitudinal human resource management program.

Science.gov (United States)

Amerine, Lindsey B Poppe; Granko, Robert P; Savage, Scott W; Daniels, Rowell; Eckel, Stephen F

2014-12-15

The experience of health-system pharmacy administration (HSPA) residents in a longitudinal human resource (HR) management program is described. The subsequent benefits to the residents, department, and profession are also discussed. Postgraduate year 2 HSPA residents at an academic medical center desired more responsibility for managing an operational area. To this end, a program was created in which these residents directly manage a small group of pharmacy technicians and report to a clinical manager or assistant director with oversight responsibility. These "resident managers" are responsible, under the direction of the area's clinical manager, for the personnel, schedule, time and attendance, and HR activities of the area. Resident managers have led and sustained operational improvement projects in their areas. In addition to providing learning experiences to residents, the HSPA residency program has also improved the operations of the areas in which these residents work. Benefits to the residents include conducting annual performance evaluations for employees with whom they have a relationship as it is a task every administrator completes. Resident managers at UNC have consistently stated that this longitudinal HR experience is one of the most rewarding and most challenging experiences offered in the two-year HSPA residency. The involvement of HSPA residents in longitudinal management responsibilities furthers residents' leadership success by providing trained managers who are ready to immerse themselves into practice postresidency, having employee engagement and HR skills as well as experiences with leading operational improvements. A longitudinal HR management experience was successfully incorporated into an HSPA residency combined Master of Science degree program. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Toward a joint health and disease management program. Toronto hospitals partner to provide system leadership.

Science.gov (United States)

Macleod, Anne Marie; Gollish, Jeffrey; Kennedy, Deborah; McGlasson, Rhona; Waddell, James

2009-01-01

The Joint Health and Disease Management Program in the Toronto Central Local Health Integration Network (TC LHIN) is envisioned as a comprehensive model of care for patients with hip and knee arthritis. It includes access to assessment services, education, self-management programs and other treatment programs, including specialist care as needed. As the first phase of this program, the hospitals in TC LHIN implemented a Hip and Knee Replacement Program to focus on improving access and quality of care, coordinating services and measuring wait times for patients waiting for hip or knee replacement surgery. The program involves healthcare providers, consumers and constituent hospitals within TC LHIN. The approach used for this program involved a definition of governance structure, broad stakeholder engagement to design program elements and plans for implementation and communication to ensure sustainability. The program and approach were designed to provide a model that is transferrable in its elements or its entirety to other patient populations and programs. Success has been achieved in creating a single wait list, developing technology to support referral management and wait time reporting, contributing to significant reductions in waits for timely assessment and treatment, building human resource capacity and improving patient and referring physician satisfaction with coordination of care.

Leadership development programs for health care middle managers: An exploration of the top management team member perspective.

Science.gov (United States)

Whaley, Alan; Gillis, William E

Hospitals throughout the United States establish leadership and management programs for their middle managers. Despite their pervasiveness and an increased emphasis on physician leadership, there is limited research regarding the development programs designed for clinical and nonclinical health care middle managers. Using two theoretical lenses, signaling and institutional theory, this exploratory study investigates mid-sized hospital development programs from the perspective of top management team (TMT) members. Our objective is to find out what types of programs hospitals have, how they are developed, and how they are evaluated. We conducted semistructured interviews with 13 TMT members in six purposefully selected hospitals and matched these interviews with program curricula. Careful coding of the data allowed us not only to show our data in a meaningful visual representation but also to show the progression of the data from raw form to aggregate themes in the qualitative research process. We identified four types of development programs used in the selected hospitals: (a) ongoing series, (b) curriculum-based, (c) management orientation, and (d) mentoring. Challenges existed in aligning the need for the program with program content. Communication occurred both through direct messaging regarding policies and procedures and through hidden signals. TMT members referenced other programs for guidance but were not always clear about what it is they wanted the programs to accomplish. Finally, there was limited program outcome measurement. Our small sample indicates that specific, structured, and comprehensive programs perform best. The better programs were always trying to improve but that most needed better accountability of tracking outcomes. In setting up a program, a collaborative approach among TMT members to establish what the needs are and how to measure outcomes worked well. Successful programs also tied in their leadership development with overall employee

Organizational Change Management For Health Equity: Perspectives From The Disparities Leadership Program.

Science.gov (United States)

Betancourt, Joseph R; Tan-McGrory, Aswita; Kenst, Karey S; Phan, Thuy Hoai; Lopez, Lenny

2017-06-01

Leaders of health care organizations need to be prepared to improve quality and achieve equity in today's health care environment characterized by a focus on achieving value and addressing disparities in a diverse population. To help address this need, the Disparities Solutions Center at Massachusetts General Hospital launched the Disparities Leadership Program in 2007. The leadership program is an ongoing, year-long, executive education initiative that trains leaders from hospitals, health plans, and health centers to improve quality and eliminate racial and ethnic disparities in health care. Feedback from participating organizations demonstrates that health care leaders seem to possess knowledge about what disparities are and about what should be done to eliminate them. Data collection, performance measurement, and multifaceted interventions remain the tools of the trade. However, the barriers to success are lack of leadership buy-in, organizational prioritization, energy, and execution, which can be addressed through organizational change management strategies. Project HOPE—The People-to-People Health Foundation, Inc.

It is possible: availability of lymphedema case management in each health facility in Togo. Program description, evaluation, and lessons learned.

Science.gov (United States)

Mathieu, Els; Dorkenoo, Ameyo M; Datagni, Michael; Cantey, Paul T; Morgah, Kodjo; Harvey, Kira; Ziperstein, Joshua; Drexler, Naomi; Chapleau, Gina; Sodahlon, Yao

2013-07-01

Lymphatic filariasis (LF) is a vector-borne parasitic disease that can clinically manifest as disabling lymphedema. Although the LF elimination program aims to reduce disability and to interrupt transmission, there has been a scarcity of disease morbidity management programs, particularly on a national scale. This report describes the implementation of the first nationwide LF lymphedema management program. The program, which was initiated in Togo in 2007, focuses on patient behavioral change. Its goal is two-fold: to achieve a sustainable program on a national-scale, and to serve as a model for other countries. The program has five major components: 1) train at least one health staff in lymphedema care in each health facility in Togo; 2) inform people with a swollen leg that care is available at their dispensary; 3) train patients on self-care; 4) provide a support system to motivate patients to continue self-care by training community health workers or family members and providing in home follow-up; and 5) integrate lymphedema management into the curriculum for medical staff. The program achieved the inclusion of lymphedema management in the routine healthcare package. The evaluation after three years estimated that 79% of persons with a swollen leg in Togo were enrolled in the program. The adherence rate to the proposed World Health Organization treatment of washing, exercise, and leg elevation was more than 70% after three years of the program, resulting in a stabilization of the lymphedema stage and a slight decrease in reported acute attacks among program participants. Health staff and patients consider the program successful in reaching and educating the patients. After the external funding ended, the morbidity management program is maintained through routine Ministry of Health activities.

"In this together": Social identification predicts health outcomes (via self-efficacy) in a chronic disease self-management program.

Science.gov (United States)

Cameron, James E; Voth, Jennifer; Jaglal, Susan B; Guilcher, Sara J T; Hawker, Gillian; Salbach, Nancy M

2018-03-05

Self-management programs are an established approach to helping people cope with the challenges of chronic disease, but the psychological mechanisms underlying their effectiveness are not fully understood. A key assumption of self-management interventions is that enhancing people's self-efficacy (e.g., via the development of relevant skills and behaviours) encourages adaptive health-related behaviors and improved health outcomes. However, the group-based nature of the programs allows for the possibility that identification with other program members is itself a social psychological platform for positive changes in illness-related confidence (i.e., group-derived efficacy) and physical and mental health. The researchers evaluated this hypothesis in a telehealth version of a chronic disease self-management program delivered in 13 rural and remote communities in northern Ontario, Canada (September 2007 to June 2008). Participants were 213 individuals with a self-reported physician diagnosis of chronic lung disease, heart disease, stroke, or arthritis. Measures of social identification, group-derived efficacy, and individual efficacy were administered seven weeks after baseline, and mental and physical health outcomes (health distress, psychological well-being, depression, vitality, pain, role limits, and disability) were assessed at four months. Structural equation modeling indicated that social identification was a positive predictor of group-derived efficacy and (in turn) individual self-efficacy (controlling for baseline), which was significantly associated with better physical and mental health outcomes. The results are consistent with growing evidence of the value of a social identity-based approach in various health and clinical settings. The success of chronic disease self-management programs could be enhanced by attending to and augmenting group identification during and after the program. Copyright © 2018 Elsevier Ltd. All rights reserved.

Implementing the MOVE! weight-management program in the Veterans Health Administration, 2007-2010: a qualitative study.

Science.gov (United States)

Weiner, Bryan J; Haynes-Maslow, Lindsey; Kahwati, Leila C; Kinsinger, Linda S; Campbell, Marci K

2012-01-01

One-third of US veterans receiving care at Veterans Health Administration (VHA) medical facilities are obese and, therefore, at higher risk for developing multiple chronic diseases. To address this problem, the VHA designed and nationally disseminated an evidence-based weight-management program (MOVE!). The objective of this study was to examine the organizational factors that aided or inhibited the implementation of MOVE! in 10 VHA medical facilities. Using a multiple, holistic case study design, we conducted 68 interviews with medical center program coordinators, physicians formally appointed as program champions, managers directly responsible for overseeing the program, clinicians from the program's multidisciplinary team, and primary care physicians identified by program coordinators as local opinion leaders. Qualitative data analysis involved coding, memorandum writing, and construction of data displays. Organizational readiness for change and having an innovation champion were most consistently the 2 factors associated with MOVE! implementation. Other organizational factors, such as management support and resource availability, were barriers to implementation or exerted mixed effects on implementation. Barriers did not prevent facilities from implementing MOVE! However, they were obstacles that had to be overcome, worked around, or accepted as limits on the program's scope or scale. Policy-directed implementation of clinical weight-management programs in health care facilities is challenging, especially when no new resources are available. Instituting powerful, mutually reinforcing organizational policies and practices may be necessary for consistent, high-quality implementation.

Modeling best practices in chronic disease management: the Arthritis Program at Southlake Regional Health Centre.

Science.gov (United States)

Bain, Lorna; Mierdel, Sandra; Thorne, Carter

2012-01-01

Researchers, hospital administrators and governments are striving to define competencies in interprofessional care and education, as well as to identify effective models in chronic disease management. For more than 25 years The Arthritis Program (TAP) at Southlake Regional Health Centre in Newmarket, Ontario, has actively practiced within these two interrelated priorities, which are now at the top of the healthcare agenda in Ontario and Canada. The approximately 135 different rheumatic conditions are the primary cause of long-term disability in Canada, affecting those from youth to the senior years, with an economic burden estimated at $4.4 billion (CAD$) annually, and growing. For the benefit of healthcare managers and their clients with chronic conditions, this article discusses TAP's history and demonstrable success, predicated on an educational model of patient self-management and self-efficacy. Also outlined are TAP's contributions in supporting evidence-based best practices in interprofessional collaboration and chronic disease management; approaches that are arguably understudied and under-practiced. Next steps for TAP include a larger role in empirical research in chronic-disease management and integration of a formal training program to benefit health professionals launching or expanding their interprofessional programs using TAP as the dynamic clinical example.

X-33/RLV System Health Management/Vehicle Health Management

Science.gov (United States)

Mouyos, William; Wangu, Srimal

1998-01-01

To reduce operations costs, Reusable Launch Vehicles (RLVS) must include highly reliable robust subsystems which are designed for simple repair access with a simplified servicing infrastructure, and which incorporate expedited decision-making about faults and anomalies. A key component for the Single Stage To Orbit (SSTO) RLV system used to meet these objectives is System Health Management (SHM). SHM incorporates Vehicle Health Management (VHM), ground processing associated with the vehicle fleet (GVHM), and Ground Infrastructure Health Management (GIHM). The primary objective of SHM is to provide an automated and paperless health decision, maintenance, and logistics system. Sanders, a Lockheed Martin Company, is leading the design, development, and integration of the SHM system for RLV and for X-33 (a sub-scale, sub-orbit Advanced Technology Demonstrator). Many critical technologies are necessary to make SHM (and more specifically VHM) practical, reliable, and cost effective. This paper will present the X-33 SHM design which forms the baseline for the RLV SHM, and it will discuss applications of advanced technologies to future RLVs. In addition, this paper will describe a Virtual Design Environment (VDE) which is being developed for RLV. This VDE will allow for system design engineering, as well as program management teams, to accurately and efficiently evaluate system designs, analyze the behavior of current systems, and predict the feasibility of making smooth and cost-efficient transitions from older technologies to newer ones. The RLV SHM design methodology will reduce program costs, decrease total program life-cycle time, and ultimately increase mission success.

Key Design Considerations When Calculating Cost Savings for Population Health Management Programs in an Observational Setting.

Science.gov (United States)

Murphy, Shannon M E; Hough, Douglas E; Sylvia, Martha L; Dunbar, Linda J; Frick, Kevin D

2018-02-08

To illustrate the impact of key quasi-experimental design elements on cost savings measurement for population health management (PHM) programs. Population health management program records and Medicaid claims and enrollment data from December 2011 through March 2016. The study uses a difference-in-difference design to compare changes in cost and utilization outcomes between program participants and propensity score-matched nonparticipants. Comparisons of measured savings are made based on (1) stable versus dynamic population enrollment and (2) all eligible versus enrolled-only participant definitions. Options for the operationalization of time are also discussed. Individual-level Medicaid administrative and claims data and PHM program records are used to match study groups on baseline risk factors and assess changes in costs and utilization. Savings estimates are statistically similar but smaller in magnitude when eliminating variability based on duration of population enrollment and when evaluating program impact on the entire target population. Measurement in calendar time, when possible, simplifies interpretability. Program evaluation design elements, including population stability and participant definitions, can influence the estimated magnitude of program savings for the payer and should be considered carefully. Time specifications can also affect interpretability and usefulness. © Health Research and Educational Trust.

Intersectorality in the 'Health in Schools' Program: an evaluation of the political-management process and working practices.

Science.gov (United States)

Sousa, Marta Caires de; Esperidião, Monique Azevedo; Medina, Maria Guadalupe

2017-06-01

This study analyzed inter-sectoral activities between the health and education sectors in implementing the Health in Schools program in a city within a metropolitan region in northeast Brazil. Analysis of the political-management process looked at the following dimensions: professional practices and subject understanding of intersectorality. The results show that subjects define intersectorality as partnership and joint efforts. Regarding decision making and resource mobilization, during program implementation we noticed that healthcare leads, and education tends to play a more peripheral role. Health activities in the schools use a biomedical approach and primarily consist of lectures. We believe that the program strengthened the relationship between these two sectors. However, intersectoral coordination in the political-management process and practices show weaknesses and limitations.

Concept Development for Software Health Management

Science.gov (United States)

Riecks, Jung; Storm, Walter; Hollingsworth, Mark

2011-01-01

This report documents the work performed by Lockheed Martin Aeronautics (LM Aero) under NASA contract NNL06AA08B, delivery order NNL07AB06T. The Concept Development for Software Health Management (CDSHM) program was a NASA funded effort sponsored by the Integrated Vehicle Health Management Project, one of the four pillars of the NASA Aviation Safety Program. The CD-SHM program focused on defining a structured approach to software health management (SHM) through the development of a comprehensive failure taxonomy that is used to characterize the fundamental failure modes of safety-critical software.

Effect of a health coaching self-management program for older adults with multimorbidity in nursing homes

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Park YH

2014-07-01

Full Text Available Yeon-Hwan Park,1,2 HeeKyung Chang31College of Nursing, 2The Research Institute of Nursing Science, Seoul National University, Seoul, South Korea; 3Seoul Women’s College of Nursing, Seoul, South KoreaBackground and aims: Although a growing number of older people are suffering from multimorbidity, most of the health problems related to multimorbidity can be improved by self-management. The aim of this study was to examine the effectiveness of a health coaching self-management program for older adults with multimorbidity in nursing homes. Methods: Older adults with multimorbidity from one nursing home in Korea were randomly allocated to either an intervention group (n=22 or conventional group (n=21. Participants in the intervention group met face to face with the researchers twice a week for 8 weeks, during which time the researchers engaged them in goal setting and goal performance using the strategies in the health coaching self-management program. Regular care was provided to the other participants in the conventional group. Results: Participants in the intervention group had significantly better outcomes in exercise behaviors (P=0.015, cognitive symptom management (P=0.004, mental stress management/relaxation (P=0.023, self-rated health (P=0.002, reduced illness intrusiveness (P<0.001, depression (P<0.001, and social/role activities limitations (P<0.001. In addition, there was a significant time-by-group interaction in self-efficacy (P=0.036. According to the goal attainment scales, their individual goals of oral health and stress reduction were achieved.Conclusion: The health coaching self-management program was successfully implemented in older adults with multimorbidity in a nursing home. Further research is needed to develop and evaluate the long-term effects of an intervention to enhance adherence to self-management and quality of life for older adults with multimorbidity.Keywords: chronic diseases, nursing intervention, older adults

What would it take? Stakeholders' views and preferences for implementing a health care manager program in community mental health clinics under health care reform.

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Cabassa, Leopoldo J; Gomes, Arminda P; Lewis-Fernández, Roberto

2015-02-01

Health care manager interventions can improve the physical health of people with serious mental illness (SMI). In this study, we used concepts from the theory of diffusion of innovations, the consolidated framework for implementation research and a taxonomy of implementation strategies to examine stakeholders' recommendations for implementing a health care manager intervention in public mental health clinics serving Hispanics with SMI. A purposive sample of 20 stakeholders was recruited from mental health agencies, primary care clinics, and consumer advocacy organizations. We presented participants a vignette describing a health care manager intervention and used semistructured qualitative interviews to examine their views and recommendations for implementing this program. Interviews were recorded, professionally transcribed, and content analyzed. We found that a blend of implementation strategies that demonstrates local relative advantage, addresses cost concerns, and enhances compatibility to organizations and the client population is critical for moving health care manager interventions into practice. © The Author(s) 2014.

[Research program for the Brazilian Unified Health System (SUS): the contribution to health management and services in Paraiba State, Brazil].

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Celino, Suely Deysny de Matos; Costa, Gabriela Maria Cavalcanti; França, Inácia Sátiro Xavier de; Araújo, Ednaldo Cavalcante de

2013-01-01

The shared management in health of the Research Program for the Unified Health System (PPSUS) has the purpose of funding research in priority areas for the health of the Brazilian population. The scope of this qualitative study is to understand the researchers' perception of the contribution of research funded by the PPSUS invitations to bid in the State of Paraiba, for resolving the priority health problems of the Paraiba population, for reducing regional inequalities in health and for bolstering the management of SUS. A documentary survey of the bids and final reports of research and a semi-structured interview with 28 coordinators of these studies was conducted. Triangulation strategy of data was used and subsequently subjected to content analysis, which converged with the categories: solving the health problems; reducing regional inequalities; contribution to management. Paraiba state needs adjustments such that the PPSUS can be fully implemented, ensuring that the knowledge generated can be converted into health policies and actions, since the research funded respond to the health needs of the population and difficulties in SUS management.

The contribution of the health management studies program to the professional status of graduates.

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Haller-Hayon, Orit; Korn, Liat; Magnezi, Racheli

2015-11-13

This study examines the contribution of the Health Management Bachelor's degree program at an Israeli university to the professional development of its graduates. The aims of this study were: To examine the perceived gaps between acquired knowledge and required knowledge within the workforce; To explore the potential changes in the graduates' occupation conditions or professional status following their studies; To test the contribution of the curricula content studied by the graduates to their understanding, knowledge and integration within the healthcare system; and to examine the graduates perceptions towards required content, that should be added to the curricula. A structured, self-reported questionnaire was administered to 182 Health Management Department individuals whom have graduated from the Bachelors program between the years 2005 and 2009. The majority of the graduates reported the existance of a knowledge gap (greater among males, young and single than among females, older and married graduates). Most of the courses which were ranked as the lowest contributing ones were related to Management (e.g. Mathematics for Social Sciences, Accounting Fundamentals, Finance Theory), while the graduates recommended the inclusion of additional components to the curricula. The study demonstrates that a perceived gap exists between the acquired and the required knowledge of the Health Management Studies graduates. Various changes have been reported by the graduates (such as wage raise and role changes), following their study completion, suggesting that the program has partially contributed to their professional status. A 'Learning by Sharing' forum of academic staff, employers and graduates is recommended.

Evaluation of a depression health management program to improve outcomes in first or recurrent episode depression.

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Aubert, Ronald E; Fulop, George; Xia, Fang; Thiel, Melinda; Maldonato, Debra; Woo, Cindy

2003-05-01

To evaluate the impact of telephone counseling and educational materials on medication adherence and persistency among members with newly diagnosed depression enrolled in a pharmacy benefit management-sponsored disease management program. Longitudinal cohort observation. The study population comprised 505 members with a new or recurrent episode of depression who consented and enrolled in a depression disease management program. After written consent was obtained, program participants received up to 4 telephone-counseling calls and 5 educational mailings focused on the importance of medication compliance, barriers to medication compliance, quality of life, symptoms, and satisfaction with the program. A control group of 3744 members was selected from client companies that opted not to offer the depression program. Measures of medication adherence, persistency with prescription drug therapy, and patient refill timeliness were computed for both groups and compared. Patients enrolled in the depression disease management program were significantly more likely to adhere to their medication regimen during acute (89.0% vs 67.7%, P management-sponsored health management depression program succeeded in encouraging patients with new or recurrent depression to stay on antidepressant medication and to reach treatment goals outlined by best practice guidelines.

Disease Management, Case Management, Care Management, and Care Coordination: A Framework and a Brief Manual for Care Programs and Staff.

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Ahmed, Osman I

2016-01-01

With the changing landscape of health care delivery in the United States since the passage of the Patient Protection and Affordable Care Act in 2010, health care organizations have struggled to keep pace with the evolving paradigm, particularly as it pertains to population health management. New nomenclature emerged to describe components of the new environment, and familiar words were put to use in an entirely different context. This article proposes a working framework for activities performed in case management, disease management, care management, and care coordination. The author offers standard working definitions for some of the most frequently used words in the health care industry with the goal of increasing consistency for their use, especially in the backdrop of the Centers for Medicaid & Medicare Services offering a "chronic case management fee" to primary care providers for managing the sickest, high-cost Medicare patients. Health care organizations performing case management, care management, disease management, and care coordination. Road map for consistency among users, in reporting, comparison, and for success of care management/coordination programs. This article offers a working framework for disease managers, case and care managers, and care coordinators. It suggests standard definitions to use for disease management, case management, care management, and care coordination. Moreover, the use of clear terminology will facilitate comparing, contrasting, and evaluating all care programs and increase consistency. The article can improve understanding of care program components and success factors, estimate program value and effectiveness, heighten awareness of consumer engagement tools, recognize current state and challenges for care programs, understand the role of health information technology solutions in care programs, and use information and knowledge gained to assess and improve care programs to design the "next generation" of programs.

Disease management: findings from leading state programs.

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Wheatley, Ben

2002-12-01

Disease management programs are designed to contain costs by improving health among the chronically ill. More than 20 states are now engaged in developing and implementing Medicaid disease management programs for their primary care case management and fee-for-service populations.

Physiotherapists supporting self-management through health coaching: a mixed methods program evaluation.

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Dufour, Sinéad Patricia; Graham, Shane; Friesen, Josh; Rosenblat, Michael; Rous, Colin; Richardson, Julie

2015-01-01

To evaluate a program in support of chronic disease self-management (CDSM) that is founded on a health coaching (HC) approach, includes supervised exercise and mindfulness-based stress reduction components and is delivered within a private practice physiotherapy setting. An explanatory mixed method design, framed by theory-based program evaluation, was employed to evaluate an eight-week group-based program. Standardized self-rated and performance measures were evaluated pre- and post intervention. Additionally, participant focus groups were conducted following the intervention period. An inductive thematic approach was undertaken to analyze the qualitative data. Seventeen participants (N = 17) completed the study. Improvements were seen in both self-report and performance outcomes. Participants explained how and why they felt the program was beneficial. Six themes were generated: (1) group dynamic; (2) learning versus doing; (3) holism and comprehensive care; (4) self-efficacy and empowerment; (5) previous solutions versus new management strategies; and (6) healthcare provider support. This study established that a group program in support of CDSM founded on a HC approach demonstrated potential value from participants as well as favorable outcomes. A pragmatic randomized control trial is required to determine efficacy of this intervention.

The Self-Assessment Process and Impacts on the Health Information Management Program Performance: A Case Study

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Spohn, Renae

2015-01-01

This study examined how health information management (HIM) educational programs can use the Malcolm Baldrige National Quality Award Model (MBNQAM) educational criteria to meet the self-assessment requirement for Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) accreditation. An existing instrument, Quantum Performance Group's Organizational Assessment Survey authored by Dr. Mark Blazey, was used in this study. The instrument was designed to self-assess the entire organization. Results of the study demonstrate how the MBNQAM can be used to successfully self-assess HIM programs. This research adds to the body of literature surrounding the application of the MBNQAM for HIM programs and provides new information to deans, administrators, and educators that may be useful, as an added component, when self-assessing HIM programs. The results of this study will help to establish a foundation for HIM programs to strengthen the self-assessment process, providing a strong starting point for strategic planning prioritization for HIM program improvement initiatives. The improved process will help in maturing the HIM program while fulfilling accreditation requirements for self-assessment. As additional HIM programs formalize the self-assessment process, benchmarking opportunities with other HIM programs will be created. PMID:26755899

Does diabetes disease management save money and improve outcomes? A report of simultaneous short-term savings and quality improvement associated with a health maintenance organization-sponsored disease management program among patients fulfilling health employer data and information set criteria.

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Sidorov, Jaan; Shull, Robert; Tomcavage, Janet; Girolami, Sabrina; Lawton, Nadine; Harris, Ronald

2002-04-01

Little is known about the impact of disease management programs on medical costs for patients with diabetes. This study compared health care costs for patients who fulfilled health employer data and information set (HEDIS) criteria for diabetes and were in a health maintenance organization (HMO)-sponsored disease management program with costs for those not in disease management. We retrospectively examined paid health care claims and other measures of health care use over 2 years among 6,799 continuously enrolled Geisinger Health Plan patients who fulfilled HEDIS criteria for diabetes. Two groups were compared: those who were enrolled in an opt-in disease management program and those who were not enrolled. We also compared HEDIS data on HbA(1c) testing, percent not in control, lipid testing, diabetic eye screening, and kidney disease screening. All HEDIS measures were based on a hybrid method of claims and chart audits, except for percent not in control, which was based on chart audits only. Of 6,799 patients fulfilling HEDIS criteria for the diagnosis of diabetes, 3,118 (45.9%) patients were enrolled in a disease management program (program), and 3,681 (54.1%) were not enrolled (nonprogram). Both groups had similar male-to-female ratios, and the program patients were 1.4 years younger than the nonprogram patients. Per member per month paid claims averaged 394.62 dollars for program patients compared with 502.48 dollars for nonprogram patients (P 9.5%, as compared with 79 of 548 (14.4%) nonprogram patients. In this HMO, an opt-in disease management program appeared to be associated with a significant reduction in health care costs and other measures of health care use. There was also a simultaneous improvement in HEDIS measures of quality care. These data suggest that disease management may result in savings for sponsored managed care organizations and that improvements in HEDIS measures are not necessarily associated with increased medical costs.

Effectiveness of Telebehavioral Health Program Nurse Case Managers (NCM): Data Collection Tools and the Process for NCM-Sensitive Outcome Measures.

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Carlson, Judy; Cohen, Roslyn; Bice-Stephens, Wynona

2014-01-01

As a part of our nation's pursuit of improvements in patient care outcomes, continuity of care, and cost containment, the case manager has become a vital member on interdisciplinary teams and in health care agencies. Telebehavioral health programs, as a relatively new method of delivering behavioral health care, have recently begun to incorporate case management into their multidisciplinary teams. To determine the efficacy and efficiency of healthcare programs, program managers are charged with the determination of the outcomes of the care rendered to patient populations. However, programs that use telehealth methods to deliver care have unique structures in place that impact ability to collect outcome data. A military medical center that serves the Pacific region developed surveys and processes to distribute, administer, and collect information about a telehealth environment to obtain outcome data for the nurse case manager. This report describes the survey development and the processes created to capture nurse case manager outcomes. Additionally, the surveys and processes developed in this project for measuring outcomes may be useful in other settings and disciplines.

Perceived needs for the information communication technology (ICT)-based personalized health management program, and its association with information provision, health-related quality of life (HRQOL), and decisional conflict in cancer patients.

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Sim, Jin Ah; Chang, Yoon Jung; Shin, Aesun; Noh, Dong-Young; Han, Wonshik; Yang, Han-Kwang; Kim, Young Whan; Kim, Young Tae; Jeong, Seoung-Yong; Yoon, Jung-Hwan; Kim, Yoon Jun; Heo, Daesuk; Kim, Tae-You; Oh, Do-Youn; Wu, Hong-Gyun; Kim, Hak Jae; Chie, Eui Kyu; Kang, Keon Wook; Kim, Ju Han; Yun, Young Ho

2017-11-01

The use of information communication technology (ICT)-based tailored health management program can have significant health impacts for cancer patients. Information provision, health-related quality of life (HRQOL), and decision conflicts were analyzed for their relationship with need for an ICT-based personalized health management program in Korean cancer survivors. The health program needs of 625 cancer survivors from two Korean hospitals were analyzed in this cross-sectional study. Multivariate logistic regression was used to identify factors related to the need for an ICT-based tailored health management system. Association of the highest such need with medical information experience, HRQOL, and decision conflicts was determined. Furthermore, patient intentions and expectations for a web- or smartphone-based tailored health management program were investigated. Cancer survivors indicated high personalized health management program needs. Patients reporting the highest need included those with higher income (adjusted odds ratio [aOR], 1.70; 95% [confidence interval] CI, 1.10-2.63), those who had received enough information regarding helping themselves (aOR, 1.71; 95% CI, 1.09-2.66), and those who wished to receive more information (aOR, 1.59; 95% CI, 0.97-2.61). Participants with cognitive functioning problems (aOR, 2.87; 95%CI, 1.34-6.17) or appetite loss (aOR, 1.77; 95% CI, 1.07-2.93) indicated need for a tailored health care program. Patients who perceived greater support from the decision-making process also showed the highest need for an ICT-based program (aOR, 0.49; 95% CI, 0.30-0.82). We found that higher income, information provision experience, problematic HRQOL, and decisional conflicts are significantly associated with the need for an ICT-based tailored self-management program. Copyright © 2017 John Wiley & Sons, Ltd.

Seriously Implementing Health Capacity Strengthening Programs in Africa; Comment on “Implementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique”

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Luis Velez Lapão

2015-10-01

Full Text Available Faced with the challenges of healthcare reform, skills and new capabilities are needed to support the reform and it is of crucial importance in Africa where shortages affects the health system resilience. Edwards et al provides a good example of the challenge of implementing a mentoring program in one province in a sub-Saharan country. From this example, various aspects of strengthening the capacity of managers in healthcare are examined based on our experience in action-training in Africa, as mentoring shares many characteristics with action-training. What practical lessons can be drawn to promote the strengthening so that managers can better intervene in complex contexts? Deeper involvement of health authorities and more rigorous approaches are seriously desirable for the proper development of health capacity strengthening programs in Africa.

Management information systems in maternal and child health/family planning programs: a multi-country analysis.

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Keller, A

1991-01-01

A diagnosis was conducted of management information systems (MIS) for maternal and child health and family planning programs in 27 African, 5 Asian, and 8 Latin American and Caribbean countries. The diagnosis covered the collection and use of information on physical infrastructure, human resources, equipment/supplies, services provided, coverage attained, and program quality and impact. It was found that many programs do not produce certain basic input and output indicators and that even among those that do, information is too infrequently brought to bear on management decision-making. Constraints under which the MIS operate in these countries are identified, and some rudimentary calculations of what would be required to improve MIS functioning are made.

Health Beliefs Describing Patients Enrolling in Community Pharmacy Disease Management Programs.

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Luder, Heidi; Frede, Stacey; Kirby, James; King, Keith; Heaton, Pamela

2016-08-01

The purpose of this study was to survey new enrollees in a community pharmacy, employer-based diabetes and hypertension coaching program to describe the characteristics, health beliefs, and cues to action of newly enrolled participants. A 70-question, 5-point Likert-type survey was developed using constructs from the Health Belief Model (HBM), Theory of Planned Behavior (TPB), and Theory of Reasoned Action (TRA). New enrollees in the coaching programs completed the survey. Survey responses between controlled and uncontrolled patients and patient demographics were compared. Between November 2011 and November 2012, 154 patients completed the survey. Patients were fairly well controlled with a mean hemoglobin A1C of 7.3% and a mean blood pressure of 134/82 mm Hg. The strongest cue to action for enrollment was the financial incentives offered by the employer (mean: 3.33, median: 4). White patients were significantly more motivated by financial incentives. More patients indicated they had not enrolled previously in the program because they were unaware it was available (mean: 2.89, median 3.0) and these patients were more likely to have an uncontrolled condition (P ≤ 0.050). A top factor motivating patients to enroll in a disease management coaching program was the receipt of financial incentives. Significant differences in HBM, TPB, and TRA responses were seen for patients with different demographics. © The Author(s) 2015.

Human Health Countermeasures (HHC) Element Management Plan: Human Research Program. Revision B

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Norsk, Peter; Baumann, David

2012-01-01

NASA s Human Research Program (HRP) is an applied research and technology program within the Human Exploration and Operations Mission Directorate (HEOMD) that addresses human health and performance risk mitigation strategies in support of exploration missions. The HRP research and technology development is focused on the highest priority risks to crew health and safety with the goal of ensuring mission success and maintaining long-term crew health. Crew health and performance standards, defined by the NASA Chief Health and Medical Officer (CHMO), set the acceptable risk level for exploration missions. The HRP conducts research to inform these standards as well as provide deliverables, such as countermeasures, that ensure standards can be met to maximize human performance and mission success. The Human Health Countermeasures (HHC) Element was formed as part of the HRP to develop a scientifically-based, integrated approach to understanding and mitigating the health risks associated with human spaceflight. These health risks have been organized into four research portfolios that group similar or related risks. A fifth portfolio exists for managing technology developments and infrastructure projects. The HHC Element portfolios consist of: a) Vision and Cardiovascular; b) Exercise and Performance; c) Multisystem; d) Bone; and e) Technology and Infrastructure. The HHC identifies gaps associated with the health risks and plans human physiology research that will result in knowledge required to more fully understand risks and will result in validated countermeasures to mitigate risks.

Analysis of Workplace Health Education Performed by Occupational Health Managers in Korea

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Yeon-Ha Kim, RN, PhD

2016-09-01

Conclusions: “Analysis and planning” skill is priority training area for healthcare professionals and occupational health managers who managed nonmanufacturing industry. It is necessary to develop a training curriculum for occupational health managers that include improving analysis of worksites and plans for a health education program.

Reduction of sickness absence by an occupational health care management program focusing on self-efficacy and self-management.

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Linden, Michael; Muschalla, Beate; Hansmeier, Thomas; Sandner, Gabriele

2014-01-01

The aim of occupational health care management programs (OHMP) is to improve the health status of employees, increase work ability and reduce absence time. This includes better coping abilities, work-related self-efficacy and self-management which are important abilities that should be trained within OHMPs. To study the effectiveness of an OHMP including special interventions to enhance self-efficacy and self-management. Employees from the German Federal Pension Agency. Effects of an OHMP on sickness absence was studied by comparing an intervention group and two control groups. A core feature of the OHMP were group sessions with all members of working teams, focussing on self-efficacy and self management of the individual participant as well as the team as a group (focus groups). Participants in the OHMP were asked for their subjective evaluation of the focus groups. Rates of sickness absence were taken from the routine data of the employer. Participants of the OHMP indicated that they had learned better ways of coping and communication and that they had generated intentions to make changes in their working situation. The rate of sickness absence in the intervention group decreased from 9.26% in the year before the OHMP to 7.93% in the year after the program, while there was in the same time anincrease of 7.9% and 10.7% in the two control groups. The data suggest that OHMP with focus on self-efficacy and self management of individuals and teams are helpful in reducing work absenteeism.

A Practical Framework for Evaluating Health Services Management Educational Program: The Application of The Mixed-Method Sequential Explanatory Design

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Bazrafshan Azam

2015-07-01

Full Text Available Introduction:Health services managers are responsible for improving the efficiency and quality in delivering healthcare services. In this regard, Health Services Management (HSM programs have been widely established to provide health providers with skilled, professional managers to address those needs. It is therefore important to ascertain the quality of these programs. The purpose of this study was to synthesize and develop a framework to evaluate the quality of the Health Services Management (HSM program at Kerman University of Medical Sciences. Methods: This study followed a mixed-method sequential explanatory approach in which data were collected through a CIPP survey and semi-structured interviews. In phase 1, participants included 10 faculty members, 64 students and 90 alumni. In phase 2, in-depth semi-structured interviews and purposeful sampling were conducted with 27 participants to better understand their perceptions of the HSM program. All interviews were audio-taped and transcribed verbatim. NVivo N8 was used to analyze the qualitative data and extract the themes. Results: The data analysis revealed both positive and negative attitudes toward the HSM program. According to the CIPP survey, program objectives (74%, curriculum content (59.5% and graduate skills (79% were the major sources of dissatisfaction. However, most respondents (n=48 reported that the classes are well equipped and learning resources are well prepared (n=41. Most respondents (n=41 reported that the students are actively involved in classroom activities. The majority of respondents (n=43 pointed out that the instructors implemented appropriate teaching strategies. Qualitative analysis of interviews revealed that a regular community needs assessment, content revision and directing attention to graduate skills and expertise are the key solutions to improve the program’s quality.Conclusion: This study revealed to what extent the HSM program objectives is being

Facility Design and Health Management Program at the Sinnhuber Aquatic Research Laboratory.

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Barton, Carrie L; Johnson, Eric W; Tanguay, Robert L

2016-07-01

The number of researchers and institutions moving to the utilization of zebrafish for biomedical research continues to increase because of the recognized advantages of this model. Numerous factors should be considered before building a new or retooling an existing facility. Design decisions will directly impact the management and maintenance costs. We and others have advocated for more rigorous approaches to zebrafish health management to support and protect an increasingly diverse portfolio of important research. The Sinnhuber Aquatic Research Laboratory (SARL) is located ∼3 miles from the main Oregon State University campus in Corvallis, Oregon. This facility supports several research programs that depend heavily on the use of adult, larval, and embryonic zebrafish. The new zebrafish facility of the SARL began operation in 2007 with a commitment to build and manage an efficient facility that diligently protects human and fish health. An important goal was to ensure that the facility was free of Pseudoloma neurophilia (Microsporidia), which is very common in zebrafish research facilities. We recognize that there are certain limitations in space, resources, and financial support that are institution dependent, but in this article, we describe the steps taken to build and manage an efficient specific pathogen-free facility.

The Home Independence Program with non-health professionals as care managers: an evaluation

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Lewin G

2016-06-01

Full Text Available Gill Lewin,1 Karyn Concanen,2 David Youens3 1School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia; 2Silver Chain Group, Osborne Park, WA, Australia; 3Faculty of Health Science, Curtin University, Perth, WA, Australia Abstract: The Home Independence Program (HIP, an Australian restorative home care/reablement service for older adults, has been shown to be effective in reducing functional dependency and increasing functional mobility, confidence in everyday activities, and quality of life. These gains were found to translate into a reduced need for ongoing care services and reduced health and aged care costs over time. Despite these positive outcomes, few Australian home care agencies have adopted the service model – a key reason being that few Australian providers employ health professionals, who act as care managers under the HIP service model. A call for proposals from Health Workforce Australia for projects to expand the scope of practice of health/aged care staff then provided the opportunity to develop, implement, and evaluate a service delivery model, in which nonprofessionals replaced the health professionals as Care Managers in the HIP service. Seventy older people who received the HIP Coordinator (HIPC service participated in the outcomes evaluation. On a range of personal outcome measures, the group showed statistically significant improvement at 3 and 12 months compared to baseline. On each outcome, the improvement observed was larger than that observed in a previous trial in which the service was delivered by health professionals. However, differences in the timing of data collection between the two studies mean that a direct comparison cannot be made. Clients in both studies showed a similarly reduced need for ongoing home care services at both follow-up points. The outcomes achieved by HIPC, with non-health professionals as Care Managers, were positive and can be considered to compare favorably

Exploring Managers' Perspectives on MNCH Program in Pakistan: A Qualitative Study.

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Mariyam Sarfraz

Full Text Available Pakistan's Maternal, Newborn and Child Health (MNCH Program is faced with multiple challenges in service delivery, financial and logistic management, training and deployment of human resources, and integration within the existing health system. There is a lack of evidence on managerial aspects of the MNCH program management and implementation.This study used qualitative methods to explore the challenges national, provincial and district program managers have faced in implementing a community midwifery program in province of Punjab while also exploring future directions for the program under a devolved health system. While the program had been designed in earnest, the planning lacked critical elements of involving relevant stakeholders in design and implementation, socio-demographic context and capacity of the existing health system. Financial limitations, weak leadership and lack of a political commitment to the problem of maternal health have also had an impact on program implementation.Our study results suggest that there is a need to re-structure the program while ensuring sustainability and collaboration within the health sector to increase uptake of skilled birth attendance and improve maternal health care in Pakistan.

Disability management: corporate medical department management of employee health and productivity.

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Burton, W N; Conti, D J

2000-10-01

This study describes a proactive in-house program for managing short-term disability (STD) in the workforce of a very large banking system. The goals of this program were to (1) minimize the personal and economic impacts of STD by early intervention, (2) validate the extent and duration of STD, and (3) coordinate medical services and provide guidance to managers that would facilitate an early return to work. This program was made possible by the installation of a comprehensive database, called Occupational Medicine and Nursing Information System. This database mainly includes employees' claims for inpatient and outpatient health services, disability and workers' compensation benefits, wellness program participation, medical examinations and laboratory tests, use of prescription drugs, and results of Health Risk Appraisals. As a result of these efforts, STD event duration declined after this STD management program was implemented in locations heretofore outside the system, and by providing full pay for part-time work after STD, within the system as well. Of note, the average number of STD days per employee showed substantial variation by health plan, including the fact that it was higher (3.9 STD days/employee) for health maintenance organization participants than for indemnity plan members (2.7 STD days/employee).

Clinic Health Awareness Program Subsystem -

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Department of Transportation — Clinic Health Awareness Program Subystem (CHAPS) is a comprehensive system for recording, reporting, and analyzing a patient’s medical information and managing an...

Health Information Management Education: A Comparison of Faculty Mentoring in Traditional vs. Distance Education Programs

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Davidian, Marilyn R.

2010-01-01

Fifty years of research has demonstrated the value of faculty mentoring for students. The purpose of this research was to explore the faculty mentoring experiences among graduates of traditional and distance education programs in health information management professional education. The sample (n = 1039) was drawn from baccalaureate and masters…

Increasing physical activity for veterans in the Mental Health Intensive Case Management Program: A community-based intervention.

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Harrold, S Akeya; Libet, Julian; Pope, Charlene; Lauerer, Joy A; Johnson, Emily; Edlund, Barbara J

2018-04-01

Individuals with severe mental illness (SMI), experience increased mortality-20 years greater disparity for men and 15 years greater disparity for women-compared to the general population (Thornicroft G. Physical health disparities and mental illness: The scandal of premature mortality. Br J Psychiatr. 2011;199:441-442). Numerous factors contribute to premature mortality in persons with SMI, including suicide and accidental death (Richardson RC, Faulkner G, McDevitt J, Skrinar GS, Hutchinson D, Piette JD. Integrating physical activity into mental health services for persons with serious mental illness. Psychiatr Serv. 2005;56(3):324-331; Thornicroft G. Physical health disparities and mental illness: The scandal of premature mortality. Br J Psychiatr. 2011;199:441-442), but research has shown that adverse health behaviors-including smoking, low rate of physical activity, poor diet, and high alcohol consumption-also significantly contribute to premature deaths (Jones J. Life expectancy in mental illness. Psychiatry Services. 2010. Retrieved from http://psychcentral.com/news/2010/07/13/life-expectancy-in-mental-illness). This quality improvement (QI) project sought to improve health and wellness for veterans in the Mental Health Intensive Case Management Program (MHICM), which is a community-based intensive program for veterans with SMI at risk for decompensation and frequent hospitalizations. At the time of this QI project, the program had 69 veterans who were assessed and treated weekly in their homes. The project introduced a pedometer steps intervention adapted from the VA MOVE! Program-a physical activity and weight management program-with the addition of personalized assistance from trained mental health professionals in the veteran's home environment. Because a large percentage of the veterans in the MHICM program had high blood pressure and increased weight, these outcomes were the focus of this project. Through mental health case management involvement and

Global pest management program wins international award

OpenAIRE

Rich, Miriam Sommers

2009-01-01

An agricultural research program managed at Virginia Tech has won an international award for its work with pest-management practices that show economic benefits with minimal impact on health and the environment.

Medicaid and Children's Health Insurance Programs; Mental Health Parity and Addiction Equity Act of 2008; the Application of Mental Health Parity Requirements to Coverage Offered by Medicaid Managed Care Organizations, the Children's Health Insurance Program (CHIP), and Alternative Benefit Plans. Final rule.

Science.gov (United States)

2016-03-30

This final rule will address the application of certain requirements set forth in the Public Health Service Act, as amended by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, to coverage offered by Medicaid managed care organizations, Medicaid Alternative Benefit Plans, and Children’s Health Insurance Programs.

Cardiovascular Disease Self-Management: Pilot Testing of an mHealth Healthy Eating Program

Directory of Open Access Journals (Sweden)

Leila Pfaeffli Dale

2014-03-01

Full Text Available Cardiac rehabilitation (CR is crucial in the management of cardiovascular disease (CVD, yet attendance is poor. Mobile technology (mHealth offers a potential solution to increase reach of CR. This paper presents two development studies to determine mobile phone usage in adults with CVD and to evaluate the acceptability of an mHealth healthy eating CR program. Methods: CR attendees were surveyed to determine mobile phone usage rates. A second single-subject pilot study investigated perceptions of a 4-week theory-based healthy eating mHealth program and explored pre-post changes in self-efficacy. Results: 74 adults with CVD completed the survey (50/74 male; mean age 63 ± 10. Nearly all had mobile phones (70/74; 95% and used the Internet (69/74; 93%, and most were interested in receiving CR by text message (57/74; 77%. 20 participants took part in the healthy eating pilot study. Participants read all/most of the text messages, and most (19/20 thought using mobile technology was a good way to deliver the program. The website was not widely used as visiting the website was reported to be time consuming. Exploratory t-tests revealed an increase in heart healthy eating self-efficacy post program, in particular the environmental self-efficacy subset (Mean = 0.62, SD = 0.74, p = 0.001. Conclusions: Text messaging was seen as a simple and acceptable way to deliver nutrition information and behavior change strategies; however, future research is needed to determine the effectiveness of such programs.

Impact of an educational program on knowledge and practice of health care staff toward pharmaceutical waste management in Gaza, Palestine.

Science.gov (United States)

Tabash, Mohammed I; Hussein, Rim A; Mahmoud, Aleya H; El-Borgy, Mohamed D; Abu-Hamad, Bassam A

2016-04-01

In health care facilities, pharmaceutical waste is generally discharged down the drain or sent to landfill. Poor knowledge about their potential downstream impacts may be a primary factor for improper disposal behavior. The objective of this study was to determine the impact of an intervention program on knowledge and practice of health care staff regarding pharmaceutical waste management. The study was designed as a pre/posttest intervention study. Total sample size was 530 in the pre-intervention phase, and then a subsample of 69 individuals was selected for the intervention and the post-intervention phases. Paired-sample t test was used to assess the difference between pretest and follow-up test results. A statistically significant improvement in knowledge and practice was achieved (Ppharmaceutical waste management. In health care facilities, pharmaceutical waste is generally discharged down the drain or sent to landfill. A lack of knowledge about the potential impacts of this type of waste may be a leading factor in improper disposal behavior. Following an educational program, statistically significant improvement in knowledge and practice of health care staff as regards to pharmaceutical waste management (PWM) was achieved. It is thus recommended that authorities implement training-of-trainers (TOT) programs to educate health care staff on PWM and organize refreshment workshops regularly.

The Chronic Disease Self-Management Program: the experience of frequent users of health care services and peer leaders.

Science.gov (United States)

Hudon, Catherine; Chouinard, Maud-Christine; Diadiou, Fatoumata; Bouliane, Danielle; Lambert, Mireille; Hudon, Émilie

2016-04-01

Large amount of evidence supports the contribution of the Stanford Chronic Disease Self-Management Program (CDSMP) to a global chronic disease management strategy. However, many studies have suggested further exploring of the factors influencing acceptance and completion of participants in this program. This study aimed to describe and examine factors associated with acceptance and completion rates of the CDSMP among frequent users of health care services, and to highlight the experience of patients and peer leaders who facilitated the program. A descriptive design with mixed sequential data was used. Acceptance and completion rates were calculated and their relationship with patient characteristics was examined in regression analysis (n = 167). Interviews were conducted among patients who accepted (n = 11) and refused (n = 13) to participate and with the program coordinator. Focus groups were held with the seven peer leaders who facilitated the program. Data were analysed using thematic analysis. Of the 167 patients invited, 60 (36%) accepted to participate in the program. Group format was the most frequent reason to decline the invitation to participate. Twenty-eight participants (47%) completed the program. Participants who dropped out during the program raised different reasons such as poor health and too much heterogeneity among participants. Factors such as location, schedule, content, group composition and facilitation were considered as important elements contributing to the success of the program. The CDSMP could therefore be considered as a self-management support option for this vulnerable clientele, while taking measures to avoid too much heterogeneity among participants to improve completion rates. © The Author 2016. Published by Oxford University Press.

The national survey of health administration program graduates on management information systems education.

Science.gov (United States)

Zalkind, D; Malec, B

1988-01-01

A national survey of alumni of AUPHA programs from the classes of 1983, 1984, and 1985 was undertaken to assess their experiences in management information systems education, both formally and on the job. The survey covered 38 AUPHA graduate member programs and resulted in 1,181 responses. Over 40 percent of the alumni indicated that they had had an introductory management information systems (MIS) course in a health administration program. Since graduation, almost 90 percent have had some significant on-the-job involvement with computers, computer-generated information, or MIS. More than one-third of the respondents felt that their MIS course work did not adequately prepare them for what was expected on the job. Alumni stressed that microcomputer software applications, such as spreadsheets and data bases, are important areas for student hands-on experiences. When asked the importance of certain areas to be included in a required introductory MIS course, the alumni also recommended spreadsheet analysis and design, report writing and data presentation, and other management areas. Additional comments suggested more access to personal computers (PCs), more relevance in the curriculum to the "real world," and the importance of MIS to the career paths of alumni. Faculty suggestions from a 1984-85 survey are compared with alumni responses in order to identify curricular changes needed. Recommendations are outlined for consideration.

NASA Occupational Health Program FY98 Self-Assessment

Science.gov (United States)

Brisbin, Steven G.

1999-01-01

The NASA Functional Management Review process requires that each NASA Center conduct self-assessments of each functional area. Self-Assessments were completed in June 1998 and results were presented during this conference session. During FY 97 NASA Occupational Health Assessment Team activities, a decision was made to refine the NASA Self-Assessment Process. NASA Centers were involved in the ISO registration process at that time and wanted to use the management systems approach to evaluate their occupational health programs. This approach appeared to be more consistent with NASA's management philosophy and would likely confer status needed by Senior Agency Management for the program. During FY 98 the Agency Occupational Health Program Office developed a revised self-assessment methodology based on the Occupational Health and Safety Management System developed by the American Industrial Hygiene Association. This process was distributed to NASA Centers in March 1998 and completed in June 1998. The Center Self Assessment data will provide an essential baseline on the status of OHP management processes at NASA Centers. That baseline will be presented to Enterprise Associate Administrators and DASHO on September 22, 1998 and used as a basis for discussion during FY 99 visits to NASA Centers. The process surfaced several key management system elements warranting further support from the Lead Center. Input and feedback from NASA Centers will be essential to defining and refining future self assessment efforts.

[The German program for disease management guidelines. Results and perspectives].

Science.gov (United States)

Ollenschläger, Günter; Kopp, Ina

2007-05-15

The Program for National Disease Management Guidelines (German DM-CPG Program) is a joint initiative of the German Medical Association (umbrella organization of the German Chambers of Physicians), the Association of the Scientific Medical Societies (AWMF), and of the National Association of Statutory Health Insurance Physicians (NASHIP). The program aims at developing, implementing and continuously updating best-practice recommendations for countrywide and regional disease management programs in Germany. Since 2003 twelve national guidelines (topics: asthma, chronic obstructive pulmonary disease, HI (Chronic heart failure), CVD (Chronic coronary heart disease) back pain, depression, several aspects of diabetes) have been produced by use of a standardized procedure in accordance with internationally consented methodologies. For countrywide dissemination and implementation the program uses a wide range of specialist journals, continuous medical education and quality management programs. So far, 36 out of 150 national scientific medical associations, four allied health profession organizations, and twelve national consumer organizations have been participating in the DM-CPG Program. Studies to evaluate the program's effects on health-care providers' behavior and patients' outcomes are under way.

First German disease management program for breast cancer.

Science.gov (United States)

Rupprecht, Christoph

2005-01-01

The first disease management program contract for breast cancer in Germany was signed in 2002 between the Association of Regional of Physicians in North-Rhine and the statutory health insurance companies in Rhineland. At the heart of this unique breast cancer disease management program is a patient-centered network of health care professionals. The program's main objectives are: (1) to improve the quality of treatment and post-operative care for breast cancer patients, (2) to provide timely information and consultation empowering the patient to participate in decisionmaking, (3) to improve the interface between inpatient and outpatient care, and (4) to increase the number of breast-conserving surgeries.

A guide to performance management for the Health Information Manager.

Science.gov (United States)

Leggat, Sandra G

This paper provides a summary of human resource management practices that have been identified as being associated with better outcomes in performance management. In general, essential practices include transformational leadership and a coherent program of goal setting, performance monitoring and feedback. Some Health Information Managers may feel they require training assistance to develop the necessary skills in the establishment of meaningful work performance goals for staff and the provision of useful and timely feedback. This paper provides useful information to assist Health Information Managers enhance the performance of their staff.

The impact of a proactive chronic care management program on hospital admission rates in a German health insurance society.

Science.gov (United States)

Hamar, Brent; Wells, Aaron; Gandy, William; Haaf, Andreas; Coberley, Carter; Pope, James E; Rula, Elizabeth Y

2010-12-01

Hospital admissions are the source of significant health care expenses, although a large proportion of these admissions can be avoided through proper management of chronic disease. In the present study, we evaluate the impact of a proactive chronic care management program for members of a German insurance society who suffer from chronic disease. Specifically, we tested the impact of nurse-delivered care calls on hospital admission rates. Study participants were insured individuals with coronary artery disease, heart failure, diabetes, or chronic obstructive pulmonary disease who consented to participate in the chronic care management program. Intervention (n  = 17,319) and Comparison (n  = 5668) groups were defined based on records of participating (or not participating) in telephonic interactions. Changes in admission rates were calculated from the year prior to (Base) and year after program commencement. Comparative analyses were adjusted for age, sex, region of residence, and disease severity (stratification of 3 [least severe] to 1 [most severe]). Overall, the admission rate in the Intervention group decreased by 6.2% compared with a 14.9% increase in the Comparison group (P  management care calls can help reduce hospital admissions among German health insurance members with chronic disease.

Evaluating the impact of a disease management program for chronic complex conditions at two large northeast health plans using a control group methodology.

Science.gov (United States)

Schwerner, Henry; Mellody, Timothy; Goldstein, Allan B; Wansink, Daryl; Sullivan, Virginia; Yelenik, Stephan N; Charlton, Warwick; Lloyd, Kelley; Courtemanche, Ted

2006-02-01

The objective of this study was to observe trends in payer expenditures for plan members with one of 14 chronic, complex conditions comparing one group with a disease management program specific to their condition (the intervention group) and the other with no specific disease management program (the control group) for these conditions. The authors used payer claims and membership data to identify members eligible for the program in a 12-month baseline year (October 2001 to September 2002) and a subsequent 12-month program year (October 2002 to September 2003). Two payers were analyzed: one health plan with members primarily in New Jersey (AmeriHealth New Jersey [AHNJ]), where the disease management program was offered, and one affiliated large plan with members primarily in the metro Philadelphia area, where the program was not offered. The claims payment policy for both plans is identical. Intervention and control groups were analyzed for equivalence. The analysis was conducted in both groups over identical time periods. The intervention group showed statistically significant (p control group. Intervention group members showed a reduction in expenditures of -8%, while control group members showed an increase of +10% over identical time periods. Subsequent analyses controlling for outliers and product lines served to confirm the overall results. The disease management program is likely responsible for the observed difference between the intervention and control group results. A well-designed, targeted disease management program offered by a motivated, supportive health plan can play an important role in cost improvement strategies for members with complex, chronic conditions.

Workplace Violence Training Programs for Health Care Workers: An Analysis of Program Elements.

Science.gov (United States)

Arbury, Sheila; Hodgson, Michael; Zankowski, Donna; Lipscomb, Jane

2017-06-01

Commercial workplace violence (WPV) prevention training programs differ in their approach to violence prevention and the content they present. This study reviews 12 such programs using criteria developed from training topics in the Occupational Safety and Health Administration's (OSHA) Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers and a review of the WPV literature. None of the training programs addressed all the review criteria. The most significant gap in content was the lack of attention to facility-specific risk assessment and policies. To fill this gap, health care facilities should supplement purchased training programs with specific training in organizational policies and procedures, emergency action plans, communication, facility risk assessment, and employee post-incident debriefing and monitoring. Critical to success is a dedicated program manager who understands risk assessment, facility clinical operations, and program management and evaluation.

Is "disease management" the answer to our problems? No! Population health management and (disease) prevention require "management of overall well-being"

OpenAIRE

Cramm, Jane; Nieboer, Anna

2016-01-01

textabstractBackground: Disease management programs based on the chronic care model have achieved successful and long-term improvement in the quality of chronic care delivery and patients' health behaviors and physical quality of life. However, such programs have not been able to maintain or improve broader self-management abilities or social well-being, which decline over time in chronically ill patients. Disease management efforts, population health management initiatives and innovative pri...

Integrated approach for managing health risks at work--the role of occupational health nurses.

Science.gov (United States)

Marinescu, Luiza G

2007-02-01

Currently, many organizations are using a department-centered approach to manage health risks at work. In such a model, segregated departments are providing employee benefits such as health insurance, workers' compensation, and short- and long-term disability or benefits addressing work-life issues. In recent years, a new model has emerged: health and productivity management (HPM). This is an employee-centered, integrated approach, designed to increase efficiency, reduce competition for scarce resources, and increase employee participation in prevention activities. Evidence suggests that corporations using integrated HPM programs achieve better health outcomes for their employees, with consequent increased productivity and decreased absenteeism. Occupational health nurses are well positioned to assume leadership roles in their organizations by coordinating efforts and programs across departments that offer health, wellness, and safety benefits. To assume their role as change agents to improve employees' health, nurses should start using the language of business more often by improving their communication skills, computer skills, and ability to quantify and articulate results of programs and services to senior management.

Disease management programs for CKD patients: the potential and pitfalls.

Science.gov (United States)

Rocco, Michael V

2009-03-01

Disease management describes the use of a number of approaches to identify and treat patients with chronic health conditions, especially those that are expensive to treat. Disease management programs have grown rapidly in the United States in the past several years. These programs have been established for patients with chronic kidney disease (CKD), but some have been discontinued because of the high cost of the program. Disease management programs for CKD face unique challenges. Identification of patients with CKD is hampered by incomplete use of the International Classification of Diseases, Ninth Revision (ICD-9) codes for CKD by physicians and the less than universal use of estimated glomerular filtration rate from serum creatinine measurements to identify patients with an estimated glomerular filtration rate less than 60 mL/min/1.73 m(2). CKD affects multiple organ systems. Thus, a comprehensive disease management program will need to manage each of these aspects of CKD. These multiple interventions likely will make a CKD disease management program more costly than similar disease management programs designed for patients with diabetes mellitus, congestive heart failure, or other chronic diseases. The lack of data that can be used to develop effective disease management programs in CKD makes it difficult to determine goals for the management of each organ system affected by CKD. Finally, long periods of observation will be needed to determine whether a particular disease management program is effective in not only improving patient outcomes, but also decreasing both resource use and health care dollars. This long-term observation period is contrary to how most disease management contracts are written, which usually are based on meeting goals during a 1- to 3-year period. Until these challenges are resolved, it likely will be difficult to maintain effective disease management programs for CKD.

Experimental program for physics-of-failure modeling of electrolytic capacitors towards prognostics and health management

International Nuclear Information System (INIS)

Rana, Y.S.; Banerjee, Shantanab; Singh, Tej; Varde, P.V.

2017-01-01

Prognostics and Health Management (PHM) is a method used for predicting reliability of a component or system by assessing its current health and future operating conditions. A physics-of-failure (PoF)-based program on PHM for reliability prediction has been initiated at our institute. As part of the program, we aim at developing PoF-based models for degradation of electronic components and their experimental validation. In this direction, a database on existing PoF models for different electronic components has been prepared. We plan to experimentally determine the model constants and propose suitable methodology for PHM. Electrolytic capacitors are one of the most common passive components which find their applications in devices such as power supplies in aircrafts and printed circuit boards (PCBs) for regulation and protection of a nuclear reactor. Experimental studies have established that electrolytic capacitors degrade under electrical and thermal stress and tend to fail before their anticipated useful life at normal operating conditions. Equivalent series resistance (ESR) and capacitance (C) are the two main parameters used for monitoring health of such capacitors. In this paper, we present an experimental program for thermal and electrical overstress studies towards degradation models for electrolytic capacitors. (author)

Using systems science for population health management in primary care.

Science.gov (United States)

Li, Yan; Kong, Nan; Lawley, Mark A; Pagán, José A

2014-10-01

Population health management is becoming increasingly important to organizations managing and providing primary care services given ongoing changes in health care delivery and payment systems. The objective of this study is to show how systems science methodologies could be incorporated into population health management to compare different interventions and improve health outcomes. The New York Academy of Medicine Cardiovascular Health Simulation model (an agent-based model) and data from the Behavioral Risk Factor Surveillance System were used to evaluate a lifestyle program that could be implemented in primary care practice settings. The program targeted Medicare-age adults and focused on improving diet and exercise and reducing weight. The simulation results suggest that there would be significant reductions projected in the proportion of the Medicare-age population with diabetes after the implementation of the proposed lifestyle program for a relatively long term (3 and 5 years). Similar results were found for the subpopulations with high cholesterol, but the proposed intervention would not have a significant effect in the proportion of the population with hypertension over a time period of Systems science methodologies can be useful to compare the health outcomes of different interventions. These tools can become an important component of population health management because they can help managers and other decision makers evaluate alternative programs in primary care settings. © The Author(s) 2014.

Future preparation of occupational health nurse managers.

Science.gov (United States)

Scalzi, C C; Wilson, D L; Ebert, R

1991-03-01

This article presents the results of a national survey of job activities of corporate level occupational health nurse managers. The survey was designed to identify the relative amount of time spent and importance attributed to specific areas of their current job. In general this sample tended to have more management experience and educational preparation than previously cited studies: over 50% had completed a graduate degree. The scores for importance and time spent were highly correlated. That is, occupational health corporate nurse managers seemed to allocate their time to job responsibilities they considered most important. Management activities related to policy, practice standards, quality assurance, staff development, and systems for client care delivery appear to represent the core responsibilities of occupational health nursing management. Curriculum recommendations for management positions in occupational health include: health policy, program planning, and evaluation; business strategy; applications of management information systems; quality assurance; and marketing.

Assessment of time management attitudes among health managers.

Science.gov (United States)

Sarp, Nilgun; Yarpuzlu, Aysegul Akbay; Mostame, Fariba

2005-01-01

These days, working people are finding it difficult to manage their time, get more done at work, and find some balance in their work and personal lives. Successful time management is often suggested to be a product of organizing skills, however, what works for one person may not work for others. Context current competence assessment formats for physicians, health professionals, and managers during their training years reliably test core knowledge and basic skills. However, they may underemphasize some important domains of professional medical practice. Thus, in addition to assessments of basic skills, new formats that assess clinical reasoning, expert judgment, management of ambiguity, professionalism, time management, learning strategies, and teamwork to promise a multidimensional assessment while maintaining adequate reliability and validity in classic health education and health care institutional settings are needed to be worked on. It should be kept in mind that institutional support, reflection, and mentoring must accompany the development of assessment programs. This study was designed to describe the main factors that consume time, effective hours of work, time management opportunities, and attitudes and behaviors of health professionals and managers on time management concept through assessment by the assessment tool Time Management Inquiry Form (TMIQ-F). The study was conducted at the State Hospital, Social Security Hospital, and University Hospital at Kirikkale, Turkey between October 1999 and January 2000, including 143 subjects defined as medical managers and medical specialists. According to the results, a manager should give priority to the concept of planning, which may be counted among the efficient time management techniques, and educate him/herself on time management.

Health-Based Capitation Risk Adjustment in Minnesota Public Health Care Programs

Science.gov (United States)

Gifford, Gregory A.; Edwards, Kevan R.; Knutson, David J.

2004-01-01

This article documents the history and implementation of health-based capitation risk adjustment in Minnesota public health care programs, and identifies key implementation issues. Capitation payments in these programs are risk adjusted using an historical, health plan risk score, based on concurrent risk assessment. Phased implementation of capitation risk adjustment for these programs began January 1, 2000. Minnesota's experience with capitation risk adjustment suggests that: (1) implementation can accelerate encounter data submission, (2) administrative decisions made during implementation can create issues that impact payment model performance, and (3) changes in diagnosis data management during implementation may require changes to the payment model. PMID:25372356

How compatible are participatory ergonomics programs with occupational health and safety management systems?

Science.gov (United States)

Yazdani, Amin; Neumann, W Patrick; Imbeau, Daniel; Bigelow, Philip; Pagell, Mark; Theberge, Nancy; Hilbrecht, Margo; Wells, Richard

2015-03-01

Musculoskeletal disorders (MSD) are a major cause of pain, disability, and costs. Prevention of MSD at work is frequently described in terms of implementing an ergonomics program, often a participatory ergonomics (PE) program. Most other workplace injury prevention activities take place under the umbrella of a formal or informal occupational health and safety management system (OHSMS). This study assesses the similarities and differences between OHSMS and PE as such knowledge could help improve MSD prevention activities. Methods Using the internationally recognized Occupational Health and Safety Assessment Series (OHSAS 18001), 21 OHSMS elements were extracted. In order to define PE operationally, we identified the 20 most frequently cited papers on PE and extracted content relevant to each of the OHSAS 18001 elements. The PE literature provided a substantial amount of detail on five elements: (i) hazard identification, risk assessment and determining controls; (ii) resources, roles, responsibility, accountability, and authority; (iii) competence, training and awareness; (iv) participation and consultation; and (v) performance measurement and monitoring. However, of the 21 OHSAS elements, the PE literature was silent on 8 and provided few details on 8 others. The PE literature did not speak to many elements described in OHSMS and even when it did, the language used was often different. This may negatively affect the effectiveness and sustainability of PE initiatives within organizations. It is expected that paying attention to the approaches and language used in management system frameworks could make prevention of MSD activities more effective and sustainable.

The eHealth Behavior Management Model: a stage-based approach to behavior change and management.

Science.gov (United States)

Bensley, Robert J; Mercer, Nelda; Brusk, John J; Underhile, Ric; Rivas, Jason; Anderson, Judith; Kelleher, Deanne; Lupella, Melissa; de Jager, André C

2004-10-01

Although the Internet has become an important avenue for disseminating health information, theory-driven strategies for aiding individuals in changing or managing health behaviors are lacking. The eHealth Behavior Management Model combines the Transtheoretical Model, the behavioral intent aspect of the Theory of Planned Behavior, and persuasive communication to assist individuals in negotiating the Web toward stage-specific information. It is here - at the point of stage-specific information - that behavioral intent in moving toward more active stages of change occurs. The eHealth Behavior Management Model is applied in three demonstration projects that focus on behavior management issues: parent-child nutrition education among participants in the U.S. Department of Agriculture Special Supplemental Nutrition Program for Women, Infants and Children; asthma management among university staff and students; and human immunodeficiency virus prevention among South African women. Preliminary results have found the eHealth Behavior Management Model to be promising as a model for Internet-based behavior change programming. Further application and evaluation among other behavior and disease management issues are needed.

Wealth from Health: an incentive program for disease and population management: a 12-year project.

Science.gov (United States)

Ratner, D; Louria, D; Sheffet, A; Fain, R; Curran, J; Saed, N; Bhaskar, S; Quereshi, M; Cable, G

2001-01-01

The future of healthcare is linked with its ability to face the challenges of consumerism. Disease and population management will represent the dominant style of healthcare delivery in the future. This article describes the Wealth from Health programs which utilize current and future technologies to help the healthcare system become a leader in healthcare delivery and to assist many communities at an affordable cost.

Developing a Physician Management & Leadership Program (PMLP) in Newfoundland and Labrador.

Science.gov (United States)

Maddalena, Victor; Fleet, Lisa

2015-01-01

This article aims to document the process the province of Newfoundland and Labrador used to develop an innovative Physician Management and Leadership Program (PMLP). The PMLP is a collaborative initiative among Memorial University (Faculty of Medicine and Faculty of Business), the Government of Newfoundland and Labrador, and the Regional Health Authorities. As challenges facing health-care systems become more complex there is a growing need for management and leadership training for physicians. Memorial University Faculty of Medicine and the Gardiner Centre in the Faculty of Business in partnership with Regional Health Authorities and the Government of Newfoundland and Labrador identified the need for a leadership and management education program for physician leaders. A provincial needs assessment of physician leaders was conducted to identify educational needs to fill this identified gap. A Steering Committee was formed to guide the design and implementation and monitor delivery of the 10 module Physician Management and Leadership Program (PMLP). Designing management and leadership education programs to serve physicians who practice in a large, predominately rural geographic area can be challenging and requires efficient use of available resources and technology. While there are many physician management and leadership programs available in Canada and abroad, the PMLP was designed to meet the specific educational needs of physician leaders in Newfoundland and Labrador.

Public health financial management competencies.

Science.gov (United States)

Honoré, Peggy A; Costich, Julia F

2009-01-01

The absence of appropriate financial management competencies has impeded progress in advancing the field of public health finance. It also inhibits the ability to professionalize this sector of the workforce. Financial managers should play a critical role by providing information relevant to decision making. The lack of fundamental financial management knowledge and skills is a barrier to fulfilling this role. A national expert committee was convened to examine this issue. The committee reviewed standards related to financial and business management practices within public health and closely related areas. Alignments were made with national standards such as those established for government chief financial officers. On the basis of this analysis, a comprehensive set of public health financial management competencies was identified and examined further by a review panel. At a minimum, the competencies can be used to define job descriptions, assess job performance, identify critical gaps in financial analysis, create career paths, and design educational programs.

Public health program planning logic model for community engaged type 2 diabetes management and prevention.

Science.gov (United States)

West, Joseph F

2014-02-01

Diabetes remains a growing epidemic with widening health inequity gaps in disease management, self-management knowledge, access to care and outcomes. Yet there is a paucity of evaluation tools for community engaged interventions aimed at closing the gaps and improving health. The Guide to Community Preventive Services (the Community Guide) developed by the Task Force on Community Preventive Services (the Task Force) at the Centers for Disease Control and Prevention (CDC) recommends two healthcare system level interventions, case management interventions and disease management programs, to improve glycemic control. However, as a public health resource guide for diabetes interventions a model for community engagement is a glaringly absent component of the Community Guide recommendations. In large part there are few evidence-based interventions featuring community engagement as a practice and system-level focus of chronic disease and Type 2 diabetes management. The central argument presented in this paper is that the absence of these types of interventions is due to the lack of tools for modeling and evaluating such interventions, especially among disparate and poor populations. A conceptual model emphasizing action-oriented micro-level community engagement is needed to complement the Community Guide and serve as the basis for testing and evaluation of these kinds of interventions. A unique logic model advancing the Community Guide diabetes recommendations toward measureable and sustainable community engagement for improved Type 2 diabetes outcomes is presented. Copyright © 2013 Elsevier Ltd. All rights reserved.

42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

Science.gov (United States)

2010-10-01

... PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.153 Drug utilization... 42 Public Health 3 2010-10-01 2010-10-01 false Drug utilization management, quality assurance, and medication therapy management programs (MTMPs). 423.153 Section 423.153 Public Health CENTERS FOR MEDICARE...

Health workers' views of a program to facilitate physical health care in mental health settings: implications for implementation and training.

Science.gov (United States)

Baker, Wendy; Harris, Melanie; Battersby, Malcolm

2014-12-01

Physical comorbidities shorten the lifespan of people with severe mental illness therefore mental health clinicians need to support service users in risk factor-related behaviour change. We investigated mental health care workers' views of a physical health self-management support program in order to identify implementation requirements. Qualitative interviews were conducted with workers who had differing levels of experience with a self-management support program. Themes were identified using interpretive descriptive analysis and then matched against domains used in implementation models to draw implications for successful practice change. Three main themes emerged related to: (1) understandings of disease management within job roles; (2) requirements for putting self-management support into practice; and (3) challenges of coordination in disease management. Priority domains from implementation models were inner and outer health service settings. While staff training is required, practice change for care which takes account of both mental and physical health also requires changes in organisational frameworks. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Chronic kidney disease management program in Shahreza, Iran.

Science.gov (United States)

Barahimi, Hamid; Aghighi, Mohammad; Aghayani, Katayon; Rahimi Foroushani, Abbas

2014-11-01

Chronic kidney disease (CKD) is a public health problem that needs an integrated program to be detected, monitored, and controlled. This study reports the results of a CKD program designed and implemented in Shahreza, Iran. After initial evaluation of CKD in Shahreza, a CKD management program was developed in the Ministry of Health and the pilot project was started in February 2011 in Shahreza rural areas. The patients at risk, including those with diabetes mellitus and hypertension, were tested with serum creatinine and urine albumin-creatinine ratio. The CKD management program included training, screening, monitoring, and controlling of weight, hypertension, diabetes mellitus, lipids, and vitamin D. This pilot program was organized in the rural population aged over 30 years who were suffering from hypertension, diabetes mellitus, or both, and resulted in the discovery of cases in various stages of CKD. The prevalence of CKD in this high-risk group was 21.5%. Persistent albuminuria and a glomerular filtration rate less than 60 mL/min/1.73 m(2) were 13% and 11%, respectively. The rate of CKD stages 1, 2, 3a, 3b, 4, and 5 were 2.75%, 6.82%, 10.08%, 0.92%, 0.31%, and 0.17% respectively. After 1 year of the program implemented, incidence rate of CKD was 24% and improvement rate was 21%. In diabetic patients, the mean of hemoglobin A1c decreased from 8.5 ± 1.9% to 7.5% ± 1.8%. Integration of CKD programs in primary health care is possible and results in improvement in management of CKD patients.

Health physics information management

International Nuclear Information System (INIS)

Schauss, R.D.

1982-01-01

The records that men have kept over the centuries have made the civilizations of man possible. Recorded history shows that our progress is closely correlated to man's ability to communicate recorded facts to others, and to effectively use knowledge gained by others. During the past few decades our ability to store and use information, and to reach larger audiences has grown dramatically. The advent of computers is discussed and their evolution to the state-of-the-art is described. Data bases, batch and on-line processing, centralized and distributed processing as well as other computer jargon are generally explained and examples are given as they apply specifically to health physics programs. It is proposed that systems designed to manage information cannot be adapted to health physics problems without extensive involvement of the HP who must use the computerized program. Specific problems which arise during the development of a computerized health physics program are explained

Factors contributing to intervention fidelity in a multi-site chronic disease self-management program.

Science.gov (United States)

Perrin, Karen M; Burke, Somer Goad; O'Connor, Danielle; Walby, Gary; Shippey, Claire; Pitt, Seraphine; McDermott, Robert J; Forthofer, Melinda S

2006-10-26

Disease self-management programs have been a popular approach to reducing morbidity and mortality from chronic disease. Replicating an evidence-based disease management program successfully requires practitioners to ensure fidelity to the original program design. The Florida Health Literacy Study (FHLS) was conducted to investigate the implementation impact of the Pfizer, Inc. Diabetes Mellitus and Hypertension Disease Self-Management Program based on health literacy principles in 14 community health centers in Florida. The intervention components discussed include health educator recruitment and training, patient recruitment, class sessions, utilization of program materials, translation of program manuals, patient retention and follow-up, and technical assistance. This report describes challenges associated with achieving a balance between adaptation for cultural relevance and fidelity when implementing the health education program across clinic sites. This balance was necessary to achieve effectiveness of the disease self-management program. The FHLS program was implemented with a high degree of fidelity to the original design and used original program materials. Adaptations identified as advantageous to program participation are discussed, such as implementing alternate methods for recruiting patients and developing staff incentives for participation. Effective program implementation depends on the talent, skill and willing participation of clinic staff. Program adaptations that conserve staff time and resources and recognize their contribution can increase program effectiveness without jeopardizing its fidelity.

Factors contributing to intervention fidelity in a multi-site chronic disease self-management program

Directory of Open Access Journals (Sweden)

Pitt Seraphine

2006-10-01

Full Text Available Abstract Background and objectives Disease self-management programs have been a popular approach to reducing morbidity and mortality from chronic disease. Replicating an evidence-based disease management program successfully requires practitioners to ensure fidelity to the original program design. Methods The Florida Health Literacy Study (FHLS was conducted to investigate the implementation impact of the Pfizer, Inc. Diabetes Mellitus and Hypertension Disease Self-Management Program based on health literacy principles in 14 community health centers in Florida. The intervention components discussed include health educator recruitment and training, patient recruitment, class sessions, utilization of program materials, translation of program manuals, patient retention and follow-up, and technical assistance. Results This report describes challenges associated with achieving a balance between adaptation for cultural relevance and fidelity when implementing the health education program across clinic sites. This balance was necessary to achieve effectiveness of the disease self-management program. The FHLS program was implemented with a high degree of fidelity to the original design and used original program materials. Adaptations identified as advantageous to program participation are discussed, such as implementing alternate methods for recruiting patients and developing staff incentives for participation. Conclusion Effective program implementation depends on the talent, skill and willing participation of clinic staff. Program adaptations that conserve staff time and resources and recognize their contribution can increase program effectiveness without jeopardizing its fidelity.

Human resource management in the Georgian National Immunization Program: a baseline assessment

Directory of Open Access Journals (Sweden)

Cohen-Kohler Jillian

2007-07-01

Full Text Available Abstract Background Georgia's health care system underwent dramatic reform after gaining independence in 1991. The decentralization of the health care system was one of the core elements of health care reform but reports suggest that human resource management issues were overlooked. The Georgian national immunization program was affected by these reforms and is not functioning at optimum levels. This paper describes the state of human resource management practices within the Georgian national immunization program in late 2004. Methods Thirty districts were selected for the study. Within these districts, 392 providers and thirty immunization managers participated in the study. Survey questionnaires were administered through face-to-face interviews to immunization managers and a mail survey was administered to immunization providers. Qualitative data collection involved four focus groups. Analysis of variance (ANOVA and Chi-square tests were used to test for differences between groups for continuous and categorical variables. Content analysis identified main themes within the focus groups. Results Weak administrative links exist between the Centres of Public Health (CPH and Primary Health Care (PHC health facilities. There is a lack of clear management guidelines and only 49.6% of all health providers had written job descriptions. A common concern among all respondents was the extremely inadequate salary. Managers cited lack of authority and poor knowledge and skills in human resource management. Lack of resources and infrastructure were identified as major barriers to improving immunization. Conclusion Our study found that the National Immunization Program in Georgia was characterized by weak organizational structure and processes and a lack of knowledge and skills in management and supervision, especially at peripheral levels. The development of the skills and processes of a well-managed workforce may help improve immunization rates, facilitate

Human resource management in the Georgian National Immunization Program: a baseline assessment.

Science.gov (United States)

Esmail, Laura C; Cohen-Kohler, Jillian Clare; Djibuti, Mamuka

2007-07-31

Georgia's health care system underwent dramatic reform after gaining independence in 1991. The decentralization of the health care system was one of the core elements of health care reform but reports suggest that human resource management issues were overlooked. The Georgian national immunization program was affected by these reforms and is not functioning at optimum levels. This paper describes the state of human resource management practices within the Georgian national immunization program in late 2004. Thirty districts were selected for the study. Within these districts, 392 providers and thirty immunization managers participated in the study. Survey questionnaires were administered through face-to-face interviews to immunization managers and a mail survey was administered to immunization providers. Qualitative data collection involved four focus groups. Analysis of variance (ANOVA) and Chi-square tests were used to test for differences between groups for continuous and categorical variables. Content analysis identified main themes within the focus groups. Weak administrative links exist between the Centres of Public Health (CPH) and Primary Health Care (PHC) health facilities. There is a lack of clear management guidelines and only 49.6% of all health providers had written job descriptions. A common concern among all respondents was the extremely inadequate salary. Managers cited lack of authority and poor knowledge and skills in human resource management. Lack of resources and infrastructure were identified as major barriers to improving immunization. Our study found that the National Immunization Program in Georgia was characterized by weak organizational structure and processes and a lack of knowledge and skills in management and supervision, especially at peripheral levels. The development of the skills and processes of a well-managed workforce may help improve immunization rates, facilitate successful implementation of remaining health care reforms and

The role of disease management programs in the health behavior of chronically ill patients.

Science.gov (United States)

Cramm, Jane Murray; Adams, Samantha A; Walters, Bethany Hipple; Tsiachristas, Apostolos; Bal, Roland; Huijsman, Robbert; Rutten-Van Mölken, Maureen P M H; Nieboer, Anna Petra

2014-04-01

Investigate the effects of disease management program (DMP) implementation on physical activity, smoking, and physical quality of life among chronically ill patients. This study used a mixed-methods approach involving qualitative (35 interviews with project managers) and quantitative (survey of patients from 18 DMPs) data collection. Questionnaire response rates were 51% (2010; 2619/5108) at T0 and 47% (2011; 2191/4693) at T1. Physical activity and the percentage of smokers improved significantly over time, whereas physical quality of life declined. After adjusting for patients' physical quality of life at T0, age, educational level, marital status, and gender, physical activity at T0 (pmanagers reported that DMPs improved patient-professional interaction. The ability to set more concrete targets improved patients' health behaviors. DMPs appear to improve physical activity among chronically ill patients over time. Furthermore, (changes in) health behavior are important for the physical quality of life of chronically ill patients. Redesigning care systems and implementing DMPs based on the chronic care model may improve health behavior among chronically ill patients. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Construction program management

CERN Document Server

Delaney, Joseph

2013-01-01

Although construction is one of the largest industries in the United States, it lags behind other industries in its implementation of modern management techniques such as those contained in the Standard for Program Management (the Standard) by the Project Management Institute (PMI(R)). Construction Program Management details the successful use of the PMI(R) approach for the construction of capital programs. It demonstrates, through case studies, how implementation of PMI's set of tools and techniques can improve the chances of program success. Exploring tactical and strategic management method

Line Program Environmental Management Audit: Formerly Utilized Sites Remedial Action Program

International Nuclear Information System (INIS)

1992-05-01

This report documents the results of the Line Program Environmental Management Audit completed for the Formerly Utilized Sites Remedial Action Program (FUSRAP). During this Audit, activities and records were reviewed and personnel interviewed at Oak Ridge, Tennessee. Additionally, since FUSRAP falls under the responsibility of the Office of the Assistant Secretary for Environmental Restoration and Waste Management, selected individuals from this office were interviewed in Washington, DC and Germantown, Maryland. The onsite portion of the FUSRAP Audit was conducted from March 16 through 27, 1992, by the US Department of Energy's Office of Environmental Audit (EH-24) located within the Office of the Assistant Secretary for Environment, Safety and Health (EH-1). The scope of the FUSRAP Line Program Environmental Management Audit was comprehensive and included all areas of environmental management with the exception of the National Environmental Policy Act (NEPA). Since the subject of compliance with and implementation of the requirements of NEPA is the responsibility of the DOE Headquarters Office of NEPA Oversight, management issues pertaining to NEPA were not investigated as part of this Audit

Managing chronic conditions care across primary care and hospital systems: lessons from an Australian Hospital Avoidance Risk Program using the Flinders Chronic Condition Management Program.

Science.gov (United States)

Lawn, Sharon; Zabeen, Sara; Smith, David; Wilson, Ellen; Miller, Cathie; Battersby, Malcolm; Masman, Kevin

2017-08-24

Objective The study aimed to determine the impact of the Flinders Chronic Condition Management Program for chronic condition self-management care planning and how to improve its use with Bendigo Health's Hospital Admission Risk Program (HARP). Methods A retrospective analysis of hospital admission data collected by Bendigo Health from July 2012 to September 2013 was undertaken. Length of stay during admission and total contacts post-discharge by hospital staff for 253 patients with 644 admissions were considered as outcome variables. For statistical modelling we used the generalised linear model. Results The combination of the HARP and Flinders Program was able to achieve significant reductions in hospital admissions and non-significant reduction in emergency department presentations and length of stay. The generalised linear model predicted that vulnerable patient groups such as those with heart disease (P=0.037) and complex needs (Pmanage chronic conditions through a greater focus on coordination and integration of care across primary care and hospital systems. In support of HARP, self-management interventions such as the Flinders Program aim to help individuals better manage their medical treatment and cope with the impact of the condition on their physical and mental wellbeing and thus reduce health services utilisation. What does this paper add? This paper sheds light on which patients might be more or less likely to benefit from the combination of the HARP and Flinders Program, with regard to their impact on reductions in hospital admissions, emergency department presentations and length of stay. This study also sheds light on how the Flinders Program could be better targeted towards and implemented among high-need and high-cost patients to lessen chronic disease burden on Australia's health system. What are the implications for practitioners? Programs targeting vulnerable populations and applying evidence-based chronic condition management and self-management

Waste Management Program management plan. Revision 1

International Nuclear Information System (INIS)

1997-02-01

As the prime contractor to the Department of Energy Idaho Operations Office (DOE-ID), Lockheed Martin Idaho Technologies Company (LMITCO) provides comprehensive waste management services to all contractors at the Idaho National Engineering and Environmental Laboratory (INEEL) through the Waste Management (WM) Program. This Program Management Plan (PMP) provides an overview of the Waste Management Program objectives, organization and management practices, and scope of work. This document will be reviewed at least annually and updated as needed to address revisions to the Waste Management's objectives, organization and management practices, and scope of work. Waste Management Program is managed by LMITCO Waste Operations Directorate. The Waste Management Program manages transuranic, low-level, mixed low-level, hazardous, special-case, and industrial wastes generated at or transported to the INEEL

Training for Better Management: Avante Zambézia, PEPFAR and Improving the Quality of Administrative Services Comment on "Implementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique".

Science.gov (United States)

Schwarcz, Sandra K; Rutherford, George W; Horvath, Hacsi

2015-07-23

The United States President's Emergency Plan for AIDS Relief (PEPFAR) emphasizes health systems strengthening as a cornerstone of programmatic success. Health systems strengthening, among other things, includes effective capacity building for clinical care, administrative management and public health practice. Avante Zambézia is a district-level in-service training program for administrative staff. It is associated with improved accounting practices and human resources and transportation management but not monitoring and evaluation. We discuss other examples of successful administrative training programs that vary in the proportion of time that is spent learning on the job and the proportion of time spent in classrooms. We suggest that these programs be more rigorously evaluated so that lessons learned can be generalized to other countries and regions. © 2015 by Kerman University of Medical Sciences.

Waste Management Program management plan. Revision 1

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-02-01

As the prime contractor to the Department of Energy Idaho Operations Office (DOE-ID), Lockheed Martin Idaho Technologies Company (LMITCO) provides comprehensive waste management services to all contractors at the Idaho National Engineering and Environmental Laboratory (INEEL) through the Waste Management (WM) Program. This Program Management Plan (PMP) provides an overview of the Waste Management Program objectives, organization and management practices, and scope of work. This document will be reviewed at least annually and updated as needed to address revisions to the Waste Management`s objectives, organization and management practices, and scope of work. Waste Management Program is managed by LMITCO Waste Operations Directorate. The Waste Management Program manages transuranic, low-level, mixed low-level, hazardous, special-case, and industrial wastes generated at or transported to the INEEL.

Use of the Management Oversight and Risk Tree (MORT) methodology in health-physics program appraisals

International Nuclear Information System (INIS)

Essig, T.H.; Gilchrist, R.L.

1981-06-01

In January 1980, Pacific Northwest Laboratory (PNL) assumed a major role in helping the Nuclear Regulatory Commission (NRC) conduct comprehensive health physics appraisals at 47 operating nuclear power plants. These appraisals required the development of an analytical technique that permitted a deductive analysis of a health-physics program on an element-by-element basis. The technique employed was a modification of the Management Oversight and risk Tree (MORT) analytical logic methodology used in probabilistic assessments. This paper includes the method used in establishing the appraisal guidelines and assigning the proper level of importance within the analytical tree structure. The system for ensuring the proper subdivision necessary for an adequate assessment of each area (e.g., exposure controls and radioactive waste management) will also be discussed. In addition to these major subjects, the generation of specific review questions that correspond to the analytical trees is addressed

Radiological accidents potentially important to human health risk in the U.S. Department of Energy waste management program

International Nuclear Information System (INIS)

Mueller, C.; Roglans-Ribas, J.; Folga, S.; Nabelssi, B.; Jackson, R.

1995-01-01

Human health risks as a consequence of potential radiological releases resulting from plausible accident scenarios constitute an important consideration in the US Department of Energy (DOE) national program to manage the treatment, storage, and disposal of wastes. As part of this program, the Office of Environmental Management (EM) is currently preparing a Programmatic Environmental Impact Statement (PEIS) that evaluates the risks that could result from managing five different waste types. This paper (1) briefly reviews the overall approach used to assess process and facility accidents for the EM PEIS; (2) summarizes the key inventory, storage, and treatment characteristics of the various DOE waste types important to the selection of accidents; (3) discusses in detail the key assumptions in modeling risk-dominant accidents; and (4) relates comparative source term results and sensitivities

Does a voucher program improve reproductive health service delivery and access in Kenya?

Science.gov (United States)

Njuki, Rebecca; Abuya, Timothy; Kimani, James; Kanya, Lucy; Korongo, Allan; Mukanya, Collins; Bracke, Piet; Bellows, Ben; Warren, Charlotte E

2015-05-23

Current assessments on Output-Based Aid (OBA) programs have paid limited attention to the experiences and perceptions of the healthcare providers and facility managers. This study examines the knowledge, attitudes, and experiences of healthcare providers and facility managers in the Kenya reproductive health output-based approach voucher program. A total of 69 in-depth interviews with healthcare providers and facility managers in 30 voucher accredited facilities were conducted. The study hypothesized that a voucher program would be associated with improvements in reproductive health service provision. Data were transcribed and analyzed by adopting a thematic framework analysis approach. A combination of inductive and deductive analysis was conducted based on previous research and project documents. Facility managers and providers viewed the RH-OBA program as a feasible system for increasing service utilization and improving quality of care. Perceived benefits of the program included stimulation of competition between facilities and capital investment in most facilities. Awareness of family planning (FP) and gender-based violence (GBV) recovery services voucher, however, remained lower than the maternal health voucher service. Relations between the voucher management agency and accredited facilities as well as existing health systems challenges affect program functions. Public and private sector healthcare providers and facility managers perceive value in the voucher program as a healthcare financing model. They recognize that it has the potential to significantly increase demand for reproductive health services, improve quality of care and reduce inequities in the use of reproductive health services. To improve program functioning going forward, there is need to ensure the benefit package and criteria for beneficiary identification are well understood and that the public facilities are permitted greater autonomy to utilize revenue generated from the voucher program.

Physical fitness and health education program at NASA Headquarters

Science.gov (United States)

Angotti, Cathy

1993-01-01

The topics discussed include the following: policy procedures to enter the NASA Headquarters Physical Fitness and Health Program; eligibility; TDY eligibility; health promotions offered; and general facility management.

Financial Management: Implementation of the Data Quality Management Control Program for the Military Health System (D-2002-141)

National Research Council Canada - National Science Library

2002-01-01

DoD health care managers should read this report. Military health care data is used for a variety of critical purposes, including managing patient care, determining the optimal health care system, and for financial management...

Health, safety and environmental research program

International Nuclear Information System (INIS)

Dinner, P.J.

1983-01-01

This report outlines the Health, Safety and Environmental Research Program being undertaken by the CFFTP. The Program objectives, relationship to other CFFTP programs, implementation plans and expected outputs are stated. Opportunities to build upon the knowledge and experience gained in safely managing tritium in the CANDU program, by addressing generic questions pertinent to tritium safety for fusion facilities, are identified. These opportunities exist across a broad spectrum of issues covering the anticipated behaviour of tritium in fusion facilities, the surrounding environment and in man

[The hospital perspective: disease management and integrated health care].

Science.gov (United States)

Schrappe, Matthias

2003-06-01

Disease Management is a transsectoral, population-based form of health care, which addresses groups of patients with particular clinical entities and risk factors. It refers both to an evidence-based knowledge base and corresponding guidelines, evaluates outcome as a continuous quality improvement process and usually includes active participation of patients. In Germany, the implementation of disease management is associated with financial transactions for risk adjustment between health care assurances [para. 137 f, Book V of Social Code (SGB V)] and represents the second kind of transsectoral care, besides a program designed as integrated health care according to para. 140 a ff f of Book V of Social Code. While in the USA and other countries disease management programs are made available by several institutions involved in health care, in Germany these programs are offered by health care insurers. Assessment of disease management from the hospital perspective will have to consider three questions: How large is the risk to compensate inadequate quality in outpatient care? Are there synergies in internal organisational development? Can the risk of inadequate funding of the global "integrated" budget be tolerated? Transsectoral quality assurance by valid performance indicators and implementation of a quality improvement process are essential. Internal organisational changes can be supported, particularly in the case of DRG introduction. The economic risk and financial output depends on the kind of disease being focussed by the disease management program. In assessing the underlying scientific evidence of their cost effectiveness, societal costs will have to be precisely differentiated from hospital-associated costs.

[Evaluating the effectiveness of a disease management program diabetes in the German Statutory Health Insurance: first results and methodological considerations].

Science.gov (United States)

Drabik, Anna; Graf, Christian; Büscher, Guido; Stock, Stephanie

2012-01-01

Disease management programs (DMPs) were implemented in the German Statutory Health Insurance (SHI) in a nationwide rollout in 2002. The explicit goal of the programs is to improve coordination and quality of care for the chronically ill (Sect. 137f, SGB V). To reach this goal extensive quality assurance measures in the programs are mandatory, enrolment and coordination of care rests with the primary care or DMP physician, treatment is based on evidence-based care guidelines, and patients are offered diabetes education classes to support self-management. The present study evaluates the DMP diabetes mellitus type II, a nationwide program offered by the BARMER, a German health insurance company. To minimize selection bias we formed a control group of administrative data using a propensity score matching approach. In comparison to the control group DMP participants have a significantly lower mortality rate, and their average drug and hospital costs are reduced. Enrolled patients also had a lower mean number of hospital stays and shorter hospital stays. These results indicate that the programs meet the initial goal of improving the quality of care for the chronically ill. Copyright © 2011. Published by Elsevier GmbH.

The duty health physicist program at Byron Nuclear Power Station

International Nuclear Information System (INIS)

Goldsmith, D.G.; Carey, T.R.

1987-01-01

The Duty Health Physicist Program at Byron Station was established to deal with routine health physics tasks and provide an interface between frontline and upper radiation-chemistry management. The program consists of a weekly rotation of selected members of the health physics staff into the duty health physicist position to handle the assigned duty tasks. The tasks include, but are not limited to, daily isotopic and air sample review, effluent release package review, maximum permissible concentration calculations, dose approvals, as-low-as-reasonably-achievable action review of pending jobs, and general availability to answer questions and address problems in health-physics-related areas of plant operation. The daily attendance of the duty health physicist at the radiation-chemistry and station plan-of-the-day meetings has increased the overall presence and visibility of the health physics program to upper station management and other station departments. Since its inception in July of 1985, the Duty Health Physics Program has been a major contributor to the observed 50% reduction in reportable personnel errors in the radiation-chemistry department (based on personnel-error-related deviation reports and license event reports generated on the radiation-chemistry department at Byron Station). Although difficulty to quantify, other important benefits of this program are also discussed in this paper

An operational health physics quality assurance program

International Nuclear Information System (INIS)

Costigan, S.A.; McAtee, J.L. III; Somers, W.M.; Huchton, R.L.

1996-01-01

DOE Order 5700.6C, Quality Assurance, stipulates QA requirements for all DOE activities. This order is now codified as 10CFR830.120, Nuclear Safety Management, Quality Assurance Requirements, which is applicable to DOE nuclear facilities. A Quality Assurance Management Plan (QAMP) was developed by the Health Physics Operations Group (ESH-1) at Los Alamos National Laboratory (LANL). The goal of the ESH-1 QAMP is to ensure that operational radiation protection activities meet the criteria outlined in DOE Order 5700.6C, DOE-ER-STD-6001-92 and 10CFR830.120. The ten required elements are QA Program, Personal Training and Qualifications, Quality Improvement, Documents and Records, Work Processes, Design, Procurement, Inspection and Acceptance Testing, Management Assessment and Independent Assessment. The QAMP has been useful for the development of QAMPs at nuclear facilities and has helped ensure uniformity of institutional requirements where Health Physics services are deployed to facilities. To implement a subset of QAMP requirements, a Quality Assurance Self-Evaluation Program (QASE) was established. This program provides a novel self-audit mechanism for the formal identification and correction of non-conforming items related to Operational Health Physics. Additionally, the QASE is a useful management tool for Radiological Control Technician Supervisors and staff and provides a tracking mechanism for ongoing problem areas. Data have been Collected for two calendar years on a number of concerns that fall into four general categories: radiological posting and labeling, instrumentation, monitoring requirements, and radiological documents/records

The Effectiveness of Hypertensive Management Programs and Social Support in Primary Health Care Systems: Preliminary Study

OpenAIRE

Pantip Sangprasert; Surasak Buranatrevedh; Duangnate Pipatsatitpong

2016-01-01

This quasi-experimental study used inclusion criteria obtaining samples taken from high-risk and grade I hypertensive patients aged 35 to 59 without hypertensive complications. The two related groups comprised 36 individuals. Both were enrolled in a hypertensive management program comprising health education strategies, respiratory training, advice on limiting salt and fat intake, exercise, group discussion with social support, telephon counseling, and home visits. Three perceptio...

Training for Better Management: Avante Zambézia, PEPFAR and Improving the Quality of Administrative Services; Comment on “Implementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique”

Directory of Open Access Journals (Sweden)

Sandra K. Schwarcz

2015-11-01

Full Text Available The United States President’s Emergency Plan for AIDS Relief (PEPFAR emphasizes health systems strengthening as a cornerstone of programmatic success. Health systems strengthening, among other things, includes effective capacity building for clinical care, administrative management and public health practice. Avante Zambéziais a district-level in-service training program for administrative staff. It is associated with improved accounting practices and human resources and transportation management but not monitoring and evaluation. We discuss other examples of successful administrative training programs that vary in the proportion of time that is spent learning on the job and the proportion of time spent in classrooms. We suggest that these programs be more rigorously evaluated so that lessons learned can be generalized to other countries and regions.

Educational support programs: Office of Civilian Radioactive Waste Management

International Nuclear Information System (INIS)

Williamson, R.C.

1989-01-01

The Office of Civilian Radioactive Waste Management (OCRWM) currently sponsors two educationally related programs: the Radioactive Waste Management Fellowship Program and the Radioactive Waste Management Research Program for Historically Black Colleges and Universities (HBCU). The graduate fellowship program was implemented in 1985 to meet the US Department of Energy's (DOE's) expected manpower needs for trained scientists and engineers to assist in carrying out the activities of the Nuclear Waste Policy Act. It is recognized that a shortage of master's and doctoral level scientists and engineers in disciplines supportive of the nation's high-level radioactive waste management (RWM) program may impede the DOE's ability to properly carry out its mission under the act. The fellowship program encourages talented undergraduate students to enter graduate programs designed to educate and train them in fields directly related to RWM. The program supports graduate students in various disciplines, including nuclear science and engineering, health physics, and certain area of geology and chemical engineering. It also encourages universities to support and improve research activities and academic programs related to the management of spent nuclear fuel and high-level radioactive waste

A diabetes self-management program designed for urban American Indians.

Science.gov (United States)

Castro, Sarah; O'Toole, Mary; Brownson, Carol; Plessel, Kimberly; Schauben, Laura

2009-10-01

Although the American Indian population has a disproportionately high rate of type 2 diabetes, little has been written about culturally sensitive self-management programs in this population. Community and clinic partners worked together to identify barriers to diabetes self-management and to provide activities and services as part of a holistic approach to diabetes self-management, called the Full Circle Diabetes Program. The program activities and services addressed 4 components of holistic health: body, spirit, mind, and emotion. Seven types of activities or services were available to help participants improve diabetes self-management; these included exercise classes, educational classes, and talking circles. Ninety-eight percent of program enrollees participated in at least 1 activity, and two-thirds participated in 2 or more activities. Program participation resulted in a significant improvement in knowledge of resources for managing diabetes. The Full Circle Diabetes Program developed and implemented culturally relevant resources and supports for diabetes self-management in an American Indian population. Lessons learned included that a holistic approach to diabetes self-management, community participation, and stakeholder partnerships are needed for a successful program.

Results from a national survey on chronic care management by health plans.

Science.gov (United States)

Mattke, Soeren; Higgins, Aparna; Brook, Robert

2015-05-01

The growing burden of chronic disease necessitates innovative approaches to help patients and to ensure the sustainability of our healthcare system. Health plans have introduced chronic care management models, but systematic data on the type and prevalence of different approaches are lacking. Our goal was to conduct a systematic examination of chronic care management programs offered by health plans in the commercial market (ie, in products sold to employers and individuals. We undertook a national survey of a representative sample of health plans (70 plans, 36% response rate) and 6 case studies on health plans' programs to improve chronic care in the commercial market. The data underwent descriptive and bivariate analyses. All plans, regardless of size, location, and ownership, offer chronic care management programs, which identify eligible members from claims data and match them to interventions based on overall risk and specific care gaps. Plans then report information on care gaps to providers and offer self-management support to their members. While internal evaluations suggest that the interventions improve care and reduce cost, plans report difficulties in engaging members and providers. To overcome those obstacles, plans are integrating their programs into provider work flow, collaborating with providers on care redesign and leveraging patient support technologies. Our study shows that chronic care management programs have become a standard component of the overall approach used by health plans to manage the health of their members.

Implementation fidelity trajectories of a health promotion program in multidisciplinary settings: managing tensions in rehabilitation care.

Science.gov (United States)

Hoekstra, Femke; van Offenbeek, Marjolein A G; Dekker, Rienk; Hettinga, Florentina J; Hoekstra, Trynke; van der Woude, Lucas H V; van der Schans, Cees P

2017-12-01

��= - 1032, p = .303). Differences in organizational-level implementation fidelity trajectories did not result in outcome differences at patient-level. This suggests that an effective implementation fidelity trajectory is contingent on the local organization's conditions. More specifically, achieving stable high implementation fidelity required the management of tensions: realizing a localized change vision, while safeguarding the program's standardized core components and engaging the scarce physicians throughout the process. When scaling up evidence-informed health promotion programs, we propose to tailor the management of implementation tensions to local organizations' starting position, size, and circumstances. The Netherlands National Trial Register NTR3961 . Registered 18 April 2013.

Toward a national health risk management approach in Australia.

Science.gov (United States)

O'Donnell, Carol

2002-01-01

There has been increasing international consensus about the importance of competition for achieving national growth and community well-being. The Australian government accordingly has introduced policies to promote such competition. Major legislative review and many public inquiries have assisted implementation of national competition policy and the development of national goals and standards related to international agreements to promote health and sustainable development. Since the 1980s, Australia has had legislation that requires the identification and control of health risks arising at work. The management structures necessary for coordinated delivery of national programs designed for effective identification and control of health risks arising in communities to achieve national health and development goals are still being developed, however. Major difficulties related to this development are discussed. National health development programs should be approached primarily through establishment of regional partnerships between bodies responsible for managing community health, local government, and employment placement, in consultation with other relevant organizations and the community. Related research and evaluation programs are required.

Early Careerist Interest and Participation in Health Care Leadership Development Programs.

Science.gov (United States)

Thompson, Jon M; Temple, April

2015-01-01

Health care organizations are increasingly embracing leadership development programs. These programs include a variety of specific activities, such as formally structured leadership development, as well as mentoring, personal development and coaching, 360-degree feedback, and job enlargement, in order to increase the leadership skills of managers and high-potential staff. However, there is a lack of information on how early careerists in health care management view these programs and the degree to which they participate. This article reports on a study undertaken to determine how early careerists working in health care organizations view leadership development programs and their participation in such programs offered by their employers. Study findings are based on a survey of 126 early careerists who are graduates of an undergraduate health services administration program. We found varying levels of interest and participation in specific leadership development activities. In addition, we found that respondents with graduate degrees and those with higher compensation were more likely to participate in selected leadership development program activities. Implications of study findings for health care organizations and early careerists in the offering of, and participation in, leadership development programs are discussed.

The long-term effects of the health coaching self-management program for nursing-home residents.

Science.gov (United States)

Park, Yeon-Hwan; Moon, Sun-Hee; Ha, Ji-Yeon; Lee, Min-Hye

2017-01-01

Little is known about whether a self-management program for nursing-home residents (NHR) with cognitive impairment is likely to have an impact on the care of this growing population. This study aimed to evaluate the effects of the health-coaching self-management program for NHR (HCSMP-NHR) on 1) self-efficacy and goal attainment scaling (GAS), 2) health status and quality of life (QoL) among older people, including those with cognitive impairment, in Korean nursing homes. This was a cluster-randomized controlled trial. Participants in the intervention group (n=43, mean age =80.91±7.65 years) received the HCSMP-NHR intervention, composed of group health education and individual coaching, for 8 weeks. Conventional care was provided to the conventional group (n=47, mean age =80.19±7.53 years) during the same period. The effects of the HCSMP-NHR were measured three times: at baseline, week 9, and week 20. The intervention group showed better results for self-efficacy ( P =0.007), health distress ( P =0.007), depression ( P <0.001), and QoL ( P =0.04) at week 9. Mean GAS score of the intervention group gradually increased from -0.38 to 0.74. The time × group interaction showed that the intervention group had significant improvements in QoL ( P =0.047), and significant reductions in health distress ( P =0.016) and depression ( P <0.001), while showing no deterioration in shortness of breath ( P <0.001). Our study findings indicate that the HCSMP-NHR improved self-efficacy and GAS and enhanced the health status and QoL of NHR with chronic conditions who also had mild-to-moderate cognitive impairment. Moreover, these effects were successfully maintained over the 5 months of the trial. Further research is needed to establish the optimum intervention period and to assess the possibility of nationwide implementation of the HCSMP-NHR.

How a Fully Automated eHealth Program Simulates Three Therapeutic Processes: A Case Study.

Science.gov (United States)

Holter, Marianne T S; Johansen, Ayna; Brendryen, Håvar

2016-06-28

eHealth programs may be better understood by breaking down the components of one particular program and discussing its potential for interactivity and tailoring in regard to concepts from face-to-face counseling. In the search for the efficacious elements within eHealth programs, it is important to understand how a program using lapse management may simultaneously support working alliance, internalization of motivation, and behavior maintenance. These processes have been applied to fully automated eHealth programs individually. However, given their significance in face-to-face counseling, it may be important to simulate the processes simultaneously in interactive, tailored programs. We propose a theoretical model for how fully automated behavior change eHealth programs may be more effective by simulating a therapist's support of a working alliance, internalization of motivation, and managing lapses. We show how the model is derived from theory and its application to Endre, a fully automated smoking cessation program that engages the user in several "counseling sessions" about quitting. A descriptive case study based on tools from the intervention mapping protocol shows how each therapeutic process is simulated. The program supports the user's working alliance through alliance factors, the nonembodied relational agent Endre and computerized motivational interviewing. Computerized motivational interviewing also supports internalized motivation to quit, whereas a lapse management component responds to lapses. The description operationalizes working alliance, internalization of motivation, and managing lapses, in terms of eHealth support of smoking cessation. A program may simulate working alliance, internalization of motivation, and lapse management through interactivity and individual tailoring, potentially making fully automated eHealth behavior change programs more effective.

Targeted population health management can help a hospital grow market share.

Science.gov (United States)

Olson, Gary; Talbert, Pearson

2012-06-01

In 2005, St. Luke's Hospital in Chesterfield, Mo., launched the "Passport to Wellness" program to help employers reduce preventable illnesses by providing access to screenings, health education, health coaching, disease management, and healthy lifestyle programs. The program was designed to influence consumer choice of hospitals and physicians and influence health insurance purchasing decisions. St. Luke's program also met goals created by local businesses, including identifying health risks of each employer's workforce and reducing health-related costs.

Improving delivery of a health-promoting-environments program: experiences from Queensland Health.

Science.gov (United States)

Dwyer, S

1997-01-01

The purpose of this paper is to outline the key components of a statewide multisite health-promoting-environments program. Contemporary health-promotion programs in settings such as schools, workplaces and hospitals use organisational development theory to address the health issues of the setting, including the physical environment, the organisational environment, and the specific health needs of the employees and consumers of the service. Program principles include management of each project by the participant organisation or site (for example, a school or workplace), using resources available within the organisation and the local community, voluntary participation, social justice and participant-based priority setting, and evaluation and monitoring. Adoption of these principles implies a shift in the role of the health worker from implementer to facilitator. Based on the experience of Queensland Health, it is proposed that the essential building blocks of the health-promoting-environments program are an intersectoral policy base, a model for action, training and resources, local facilitators, support from local organisations, a supportive network of sites, marketing of the program, and a state-based evaluation and monitoring system. The program in Queensland was able to develop a significant number of these components over the 1990-1996 period. In regard to evaluation, process measures can be built around the program components; however, further research is required for development of impact indicators and benchmarks on quality.

Self-management support and training for patients with chronic and complex conditions improves health-related behaviour and health outcomes.

Science.gov (United States)

Harvey, Peter W; Petkov, John N; Misan, Gary; Fuller, Jeffrey; Battersby, Malcolm W; Cayetano, Teofilo N; Warren, Kate; Holmes, Paul

2008-05-01

The Sharing Health Care SA chronic disease self-management (CDSM) project in rural South Australia was designed to assist patients with chronic and complex conditions (diabetes, cardiovascular disease and arthritis) to learn how to participate more effectively in the management of their condition and to improve their self-management skills. Participants with chronic and complex conditions were recruited into the Sharing Health Care SA program and offered a range of education and support options (including a 6-week peer-led chronic disease self-management program) as part of the Enhanced Primary Care care planning process. Patient self-reported data were collected at baseline and subsequent 6-month intervals using the Partners in Health (PIH) scale to assess self-management skill and ability for 175 patients across four data collection points. Health providers also scored patient knowledge and self-management skills using the same scale over the same intervals. Patients also completed a modified Stanford 2000 Health Survey for the same time intervals to assess service utilisation and health-related lifestyle factors. Results show that both mean patient self-reported PIH scores and mean health provider PIH scores for patients improved significantly over time, indicating that patients demonstrated improved understanding of their condition and improved their ability to manage and deal with their symptoms. These results suggest that involvement in peer-led self-management education programs has a positive effect on patient self-management skill, confidence and health-related behaviour.

Sandia National Laboratories, California Chemical Management Program annual report.

Energy Technology Data Exchange (ETDEWEB)

Brynildson, Mark E.

2012-02-01

The annual program report provides detailed information about all aspects of the Sandia National Laboratories, California (SNL/CA) Chemical Management Program. It functions as supporting documentation to the SNL/CA Environmental Management System Program Manual. This program annual report describes the activities undertaken during the calender past year, and activities planned in future years to implement the Chemical Management Program, one of six programs that supports environmental management at SNL/CA. SNL/CA is responsible for tracking chemicals (chemical and biological materials), providing Material Safety Data Sheets (MSDS) and for regulatory compliance reporting according to a variety of chemical regulations. The principal regulations for chemical tracking are the Emergency Planning Community Right-to-Know Act (EPCRA) and the California Right-to-Know regulations. The regulations, the Hazard Communication/Lab Standard of the Occupational Safety and Health Administration (OSHA) are also key to the CM Program. The CM Program is also responsible for supporting chemical safety and information requirements for a variety of Integrated Enabling Services (IMS) programs primarily the Industrial Hygiene, Waste Management, Fire Protection, Air Quality, Emergency Management, Environmental Monitoring and Pollution Prevention programs. The principal program tool is the Chemical Information System (CIS). The system contains two key elements: the MSDS library and the chemical container-tracking database that is readily accessible to all Members of the Sandia Workforce. The primary goal of the CM Program is to ensure safe and effective chemical management at Sandia/CA. This is done by efficiently collecting and managing chemical information for our customers who include Line, regulators, DOE and ES and H programs to ensure compliance with regulations and to streamline customer business processes that require chemical information.

Formative evaluation of a proposed mHealth program for childhood illness management in a resource-limited setting in Peru

Directory of Open Access Journals (Sweden)

T. A. Calderón

2015-08-01

Full Text Available OBJECTIVE: To conduct a formative evaluation of a proposed mobile health (mHealth program designed to educate caregivers about management of common childhood illnesses. METHODS: A cluster-randomized sample (n = 220 of mothers in Cono Norte, Arequipa, Peru with at least one child under five completed an iPad-based survey. This descriptive study examined trends in mobile phone ownership and feasibility of and interest in mHealth across sociodemographic categories. Fisher's exact tests were used to evaluate associations. Univariate logistic regression models were fitted to calculate odds ratios and 95% confidence intervals. RESULTS: Of 220 participants, 82.3% and 95.0% reported mobile phone ownership and access, respectively. Ownership was significantly associated with educational level (P = 0.031; however, even among mothers with the lowest education, ownership approached 80%. Educational level and age, respectively, were associated with the ability to open (P < 0.001; P < 0.001, read (P < 0.001; P < 0.001, write (P < 0.001; P < 0.001, and send (P = 0.006; P = 0.047 text messages. Over 85% of mothers were interested in using their mobile phones to receive health advice for their child and to seek help during illness. Regression analyses revealed that ability to use a mobile phone was positively associated with the mother's intention to participate in the mHealth program. CONCLUSIONS: The study findings confirm widespread access to mobile phones and sufficient ability to utilize text messaging within this population of caregivers. In addition to access and feasibility, high levels of interest in using mobile phones for health-related purposes suggest the potential value associated with an mHealth program designed to improve childhood illness management in this community.

Making it local: Beacon Communities use health information technology to optimize care management.

Science.gov (United States)

Allen, Amy; Des Jardins, Terrisca R; Heider, Arvela; Kanger, Chatrian R; Lobach, David F; McWilliams, Lee; Polello, Jennifer M; Rein, Alison L; Schachter, Abigail A; Singh, Ranjit; Sorondo, Barbara; Tulikangas, Megan C; Turske, Scott A

2014-06-01

Care management aims to provide cost-effective, coordinated, non-duplicative care to improve care quality, population health, and reduce costs. The 17 communities receiving funding from the Office of the National Coordinator for Health Information Technology through the Beacon Community Cooperative Agreement Program are leaders in building and strengthening their health information technology (health IT) infrastructure to provide more effective and efficient care management. This article profiles 6 Beacon Communities' health IT-enabled care management programs, highlighting the influence of local context on program strategy and design, and describing challenges, lessons learned, and policy implications for care delivery and payment reform. The unique needs (eg, disease burden, demographics), community partnerships, and existing resources and infrastructure all exerted significant influence on the overall priorities and design of each community's care management program. Though each Beacon Community needed to engage in a similar set of care management tasks--including patient identification, stratification, and prioritization; intervention; patient engagement; and evaluation--the contextual factors helped shape the specific strategies and tools used to carry out these tasks and achieve their objectives. Although providers across the country are striving to deliver standardized, high-quality care, the diverse contexts in which this care is delivered significantly influence the priorities, strategies, and design of community-based care management interventions. Gaps and challenges in implementing effective community-based care management programs include: optimizing allocation of care management services; lack of available technology tailored to care management needs; lack of standards and interoperability; integrating care management into care settings; evaluating impact; and funding and sustainability.

Evaluation of two communication strategies to improve udder health management

NARCIS (Netherlands)

Jansen, J.; Renes, R.J.; Lam, T.J.G.M.

2010-01-01

Worldwide, programs to improve udder health are implemented using communication tools and methods that inform and persuade dairy farmers. This study evaluated 2 communication strategies used in a mastitis control program in the Netherlands. To improve farmers’ udder health management, tools such as

Introduction to: The Forest Health monitoring program

Science.gov (United States)

Barbara L. Conkling

2011-01-01

The National Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, produces an annual technical report on forest health as one of its products. The report is organized using the Criteria and Indicators for the Conservation and Sustainable Management of Temperate and Boreal Forests (Montréal Process Working Group 2007) as a...

Effect of an Integrated Health Management Program Based on Successful Aging in Korean Women.

Science.gov (United States)

Ahn, Okhee; Cha, Hye Gyeong; Chang, Soo Jung; Cho, Hyun-Choul; Kim, Hee Sun

2015-01-01

This study evaluates the efficacy of an integrated health management program (IHMP) based on successful aging in older women. A single group pretest and posttest research design was employed, with a sample of 33 older Korean women over 60 years registered in a public health center. The intervention, including exercise, health education, and social activities, was performed 3 hr per week for 12 weeks. Demographic characteristics, body composition, physical fitness, biomarkers, depression, and social support were measured. Data were analyzed with a Wilcoxon signed-rank test, statistical significance levels were set at p test (p < .001) were significantly improved. Systolic blood pressure (p < .003), diastolic blood pressure (p = .030), and blood cholesterol (p = .011) were significantly decreased. Depression (p = .043) was significantly decreased, and social support (p < .001) was significantly increased. Adopting and maintaining an IHMP can be useful to promote physical, psychological, and social functioning that lead to successful aging in older Korean women. © 2014 Wiley Periodicals, Inc.

14 CFR 91.1017 - Amending program manager's management specifications.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Amending program manager's management... Ownership Operations Program Management § 91.1017 Amending program manager's management specifications. (a... specifications; or (2) The program manager applies for the amendment of any management specifications, and the...

German diabetes management programs improve quality of care and curb costs.

Science.gov (United States)

Stock, Stephanie; Drabik, Anna; Büscher, Guido; Graf, Christian; Ullrich, Walter; Gerber, Andreas; Lauterbach, Karl W; Lüngen, Markus

2010-12-01

This paper reports the results of a large-scale analysis of a nationwide disease management program in Germany for patients with diabetes mellitus. The German program differs markedly from "classic" disease management in the United States. Although it combines important hallmarks of vendor-based disease management and the Chronic Care Model, the German program is based in primary care practices and carried out by physicians, and it draws on their personal relationships with patients to promote adherence to treatment goals and self-management. After four years of follow-up, overall mortality for patients and drug and hospital costs were all significantly lower for patients who participated in the program compared to other insured patients with similar health profiles who were not in the program. These results suggest that the German disease management program is a successful strategy for improving chronic illness care.

Environment, Safety, Health and Waste Management Plan

International Nuclear Information System (INIS)

1988-01-01

The mission of the Feed Materials Production Center (FMPC) is the production of high qaulity uranium metal for use by the US Department of Energy (DOE) in Defense Programs. In order to accomplish this mission and to maintain the FMPC as a viable facility in the DOE production complex, the facility must be brought into full compliance with all federal and state regulations and industry standards for environmental protection and worker safety. Where past practices have resulted in environmental insult, a comprehensive program of remediation must be implemented. The purpose of this combined Environment, Safety, Health and Waste Management Plan is to provide a road map for achieving needed improvements. The plan is structured to provide a comprehensive projection from the current fiscal year (FY) through FY 1994 of the programs, projects and funding required to achieve compliance. To do this, the plan is subdivided into chapters which discuss the applicable regulations;project schedules and funding requirements;details of the various programs for environment, safety, health and waste management;details of the ongoing National Environmental Policy Act (NEPA);the quality assurance program and the environmental monitoring program. 14 refs., 30 figs., 29 tabs

Program management system manual

International Nuclear Information System (INIS)

1989-08-01

OCRWM has developed a program management system (PMS) to assist in organizing, planning, directing and controlling the Civilian Radioactive Waste Management Program. A well defined management system is necessary because: (1) the Program is a complex technical undertaking with a large number of participants, (2) the disposal and storage facilities to be developed by the Program must be licensed by the Nuclear Regulatory Commission (NRC) and hence are subject to rigorous quality assurance (QA) requirements, (3) the legislation mandating the Program creates a dichotomy between demanding schedules of performance and a requirement for close and continuous consultation and cooperation with external entities, (4) the various elements of the Program must be managed as parts of an integrated waste management system, (5) the Program has an estimated total system life cycle cost of over $30 billion, and (6) the Program has a unique fiduciary responsibility to the owners and generators of the nuclear waste for controlling costs and minimizing the user fees paid into the Nuclear Waste Fund. This PMS Manual is designed and structured to facilitate strong, effective Program management by providing policies and requirements for organizing, planning, directing and controlling the major Program functions

Data for Program Management: An Accuracy Assessment of Data Collected in Household Registers by Community Health Workers in Southern Kayonza, Rwanda.

Science.gov (United States)

Mitsunaga, Tisha; Hedt-Gauthier, Bethany L; Ngizwenayo, Elias; Farmer, Didi Bertrand; Gaju, Erick; Drobac, Peter; Basinga, Paulin; Hirschhorn, Lisa; Rich, Michael L; Winch, Peter J; Ngabo, Fidele; Mugeni, Cathy

2015-08-01

Community health workers (CHWs) collect data for routine services, surveys and research in their communities. However, quality of these data is largely unknown. Utilizing poor quality data can result in inefficient resource use, misinformation about system gaps, and poor program management and effectiveness. This study aims to measure CHW data accuracy, defined as agreement between household registers compared to household member interview and client records in one district in Eastern province, Rwanda. We used cluster-lot quality assurance sampling to randomly sample six CHWs per cell and six households per CHW. We classified cells as having 'poor' or 'good' accuracy for household registers for five indicators, calculating point estimates of percent of households with accurate data by health center. We evaluated 204 CHW registers and 1,224 households for accuracy across 34 cells in southern Kayonza. Point estimates across health centers ranged from 79 to 100% for individual indicators and 61 to 72% for the composite indicator. Recording error appeared random for all but the widely under-reported number of women on modern family planning method. Overall, accuracy was largely 'good' across cells, with varying results by indicator. Program managers should identify optimum thresholds for 'good' data quality and interventions to reach them according to data use. Decreasing variability and improving quality will facilitate potential of these routinely-collected data to be more meaningful for community health program management. We encourage further studies assessing CHW data quality and the impact training, supervision and other strategies have on improving it.

Program Management System manual

International Nuclear Information System (INIS)

1986-01-01

The Program Management System (PMS), as detailed in this manual, consists of all the plans, policies, procedure, systems, and processes that, taken together, serve as a mechanism for managing the various subprograms and program elements in a cohesive, cost-effective manner. The PMS is consistent with the requirements of the Nuclear Waste Policy Act of 1982 and the ''Mission Plan for the Civilian Radioactive Waste Management Program'' (DOE/RW-0005). It is based on, but goes beyond, the Department of Energy (DOE) management policies and procedures applicable to all DOE programs by adapting these directives to the specific needs of the Civilian Radioactive Waste Management program. This PMS Manual describes the hierarchy of plans required to develop and maintain the cost, schedule, and technical baselines at the various organizational levels of the Civilian Radioactive Waste Management Program. It also establishes the management policies and procedures used in the implementation of the Program. These include requirements for internal reports, data, and other information; systems engineering management; regulatory compliance; safety; quality assurance; and institutional affairs. Although expanded versions of many of these plans, policies, and procedures are found in separate documents, they are an integral part of this manual. The PMS provides the basis for the effective management that is needed to ensure that the Civilian Radioactive Waste Management Program fulfills the mandate of the Nuclear Waste Policy Act of 1982. 5 figs., 2 tabs

Performance management models for public health: Public Health Accreditation Board/Baldrige connections, alignment, and distinctions.

Science.gov (United States)

Gorenflo, Grace G; Klater, David M; Mason, Marlene; Russo, Pamela; Rivera, Lillian

2014-01-01

The nationally known Malcolm Baldrige Award for Excellence ("Baldrige program") recognizes outstanding performance management and is specifically cited by the Public Health Accreditation Board (PHAB) as a potential framework for PHAB's requisite performance management system. The authors developed a crosswalk that identifies alignments between the 2 programs and is a highlight of the Quest for Exceptional Performance tool that is intended to help health departments capitalize on the connections between the 2 programs. To provide deeper insight into the most robust connections between the 2 programs. The authors developed a crosswalk by listing the PHAB measures, identifying corresponding Baldrige areas to address, and assigning a rating regarding the strength of the alignment. Subsequently, they generated a matrix with numerical scores reflecting the strength of the PHAB-Baldrige alignments that were then analyzed for frequency and strength of alignment by PHAB domain and by Baldrige category. The tool developers and 3 public health leaders with experience in the Baldrige program contributed to both the design and the analyses. The measures used reflected both the frequency and strength of alignments. Of the 123 alignments identified in the crosswalk, 39 were rated as high, 40 as medium, and 44 as low. The strongest connections were in the areas of performance management, quality improvement, strategic planning, workforce development, assessment and analysis, and customer service. While the areas with the most frequent and strongest connections provide the most useful basis for health departments pursuing Baldrige recognition or using Baldrige criteria as a framework for performance management, all alignments could be considered for both purposes.

Integrated employee assistance program/managed behavioral health plan utilization by persons with substance use disorders.

Science.gov (United States)

Merrick, Elizabeth S Levy; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M; Greenfield, Shelly F; McCann, Bernard

2011-04-01

New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral health care (MBHC) organization's integrated EAP/MBHC product (N = 1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan, and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of the clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. Copyright © 2011 Elsevier Inc. All rights reserved.

Program Management Tool

Science.gov (United States)

Gawadiak, Yuri; Wong, Alan; Maluf, David; Bell, David; Gurram, Mohana; Tran, Khai Peter; Hsu, Jennifer; Yagi, Kenji; Patel, Hemil

2007-01-01

The Program Management Tool (PMT) is a comprehensive, Web-enabled business intelligence software tool for assisting program and project managers within NASA enterprises in gathering, comprehending, and disseminating information on the progress of their programs and projects. The PMT provides planning and management support for implementing NASA programmatic and project management processes and requirements. It provides an online environment for program and line management to develop, communicate, and manage their programs, projects, and tasks in a comprehensive tool suite. The information managed by use of the PMT can include monthly reports as well as data on goals, deliverables, milestones, business processes, personnel, task plans, monthly reports, and budgetary allocations. The PMT provides an intuitive and enhanced Web interface to automate the tedious process of gathering and sharing monthly progress reports, task plans, financial data, and other information on project resources based on technical, schedule, budget, and management criteria and merits. The PMT is consistent with the latest Web standards and software practices, including the use of Extensible Markup Language (XML) for exchanging data and the WebDAV (Web Distributed Authoring and Versioning) protocol for collaborative management of documents. The PMT provides graphical displays of resource allocations in the form of bar and pie charts using Microsoft Excel Visual Basic for Application (VBA) libraries. The PMT has an extensible architecture that enables integration of PMT with other strategic-information software systems, including, for example, the Erasmus reporting system, now part of the NASA Integrated Enterprise Management Program (IEMP) tool suite, at NASA Marshall Space Flight Center (MSFC). The PMT data architecture provides automated and extensive software interfaces and reports to various strategic information systems to eliminate duplicative human entries and minimize data integrity

Prevalence of health promotion programs in primary health care units in Brazil

Science.gov (United States)

Ramos, Luiz Roberto; Malta, Deborah Carvalho; Gomes, Grace Angélica de Oliveira; Bracco, Mário M; Florindo, Alex Antonio; Mielke, Gregore Iven; Parra, Diana C; Lobelo, Felipe; Simoes, Eduardo J; Hallal, Pedro Curi

2014-01-01

OBJECTIVE Assessment of prevalence of health promotion programs in primary health care units within Brazil’s health system. METHODS We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. RESULTS Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. CONCLUSIONS Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil. PMID:25372175

The health physics programs in low-level radioactive waste management at the Institute of Nuclear Energy Research, Republic of China

International Nuclear Information System (INIS)

Chen, W-L.

1986-01-01

The primary mission of the health physics programs in low-level radioactive management is to ensure radiation safety for personnel and environment of the Institute of Nuclear Energy Research (INER), and also for the general public surrounding INER. In view of the above, the Health Physics programs in low-level radioactive waste management are divided into three sub-programs: the radiation control program, the environmental survey and bioassay program, and the radiation dosimetry supporting program. The general guidelines, responsibilities, and performance of these programs will be discussed in this paper in the following order. The responsibility of radiation control group is to conduct area monitoring and radiation surveillance for the radioactive waste treatment workers. It includes the control of radiation field level of the working area, servicing personnel dosimeters, instruction on radiation safety, and handling of radiation accidents. The responsibility of the environmental survey and bioassay group is to perform environmental surveys and bioassays. Environmental gamma monitoring stations were installed both on-site and off-site at INER. For bioassays, urine samples are taken from radioactive waste treatment workers, and for internal contamination checks of workers, total body counting systems are being used. The main responsibility of the radiation dosimetry group is to provide radiation dosimetrical support to the radiation control group and the environmental survey and bioassay group. Some typical work of the radiation dosimetry group is the qualitative assay and quantitative determination of radioactive samples, and calibration of dosimeters and survey meters

Health coaching in diabetes: empowering patients to self-manage.

Science.gov (United States)

Wong-Rieger, Durhane; Rieger, Francis P

2013-02-01

To effectively manage diabetes mellitus, patients must adhere to treatment recommendations and healthy lifestyle behaviors, but research shows many patients do not do this. Education is effective when combined with self-management support but peer-support programs do not lead to lasting changes. Health coaching, or professional support, can be highly effective if it focuses on developing self-efficacy and skills such as goal-setting, problem-solving and managing cognitive and emotional barriers. This overview discusses the benefits of patient self-management for chronic conditions such as diabetes, core competencies for health coaching, theoretical bases and principles of health coaching interventions, delivery methods and the evidence that health coaching works for diabetes self-management. Copyright © 2013 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Participatory management in today's health care setting

International Nuclear Information System (INIS)

Burnham, B.A.

1987-01-01

As the health care revolution progresses, so must the management styles of today's leaders. The authors must ask ourselves if we are managing tomorrow's work force or the work force of the past. Participatory management may better meet the needs of today's work force. This paper identifies the reasons participatory management is a more effective management style, the methods used to implement a participatory management program, its benefits (such as higher productivity and more efficient, effective implementation and acceptance of change), and the difficulties experienced

The standard for program management

CERN Document Server

2017-01-01

The Standard for Program Management – Fourth Edition differs from prior editions by focusing on the principles of good program management. Program activities have been realigned to program lifecycle phases rather than topics, and the first section was expanded to address the key roles of program manager, program sponsor and program management office. It has also been updated to better align with PMI’s Governance of Portfolios, Programs, and Projects: A Practice Guide.

One-Year Outcomes of an Integrated Multiple Sclerosis Disease Management Program.

Science.gov (United States)

Groeneweg, Marti; Forrester, Sara H; Arnold, Beth; Palazzo, Lorella; Zhu, Weiwei; Yoon, Paul; Scearce, Tim

2018-05-01

Multiple sclerosis (MS) is associated with high total health care cost, the majority of which is attributable to medications. Patients with MS are less likely to experience relapses, emergency department (ED) visits, and hospitalizations when they are adherent to disease-modifying treatments. Disease management programs are hypothesized to improve medication adherence thereby improving clinical and economic outcomes. To evaluate the clinical and economic effects of a specialty pharmacy and chronic disease management program for patients with MS from a health plan perspective. This study was a retrospective analysis using prescription drug claims, medical claims, and electronic medical record information (2013-2015) 1 year before and after enrollment in the disease management program for members with 24 months of continuous health plan coverage. Medication adherence was calculated using proportion of days covered (PDC). Relapse rate was defined as an MS outpatient visit associated with a corticosteroid dispense within 7 days of the visit or an MS hospitalization. Disease progression was assessed using the Modified Expanded Disability Status Scale (mEDSS). Resource use included outpatient visits, ED visits, and hospitalizations. Cost information was collected as health plan-paid amount and was reported in 2013 U.S. dollars. The analysis included 377 patients (mean age 55 years, 76.4% female). After enrollment in the program, 78.7% of the study group had a PDC of ≥ 0.80 compared with 70.0% before enrollment (P management for patients with MS can increase the proportion of patients adherent to medication. The increase in health plan spend on MS medications is not offset by savings in health care resource utilization. This study was funded by Kaiser Permanente Washington Health Research Institute and Kaiser Permanente Washington Pharmacy Administration. The authors have no disclosures to report.

Disabling health care? Medicaid managed care and people with disabilities in America

DEFF Research Database (Denmark)

Hiranandani, Vanmala Sunder

2011-01-01

Medicaid, America's largest government-funded health insurance program, plays a pivotal role in providing health services to eight million adults with disabilities. Since the mid-1990s, many Medicaid programs have aggressively introduced managed care, which reconfigures service delivery using...... business principles. Most states have insufficient experience in developing managed care plans for Medicaid beneficiaries with disabilities. Middle-aged adults with physical disabilities present their own constellation of health care issues that is not readily appreciated in health and social services....... The purpose of the study was to understand their experiences in accessing physical health care services and to ascertain the effects of managed care on their health and well-being. This study found beneficiaries encounter numerous barriers in accessing preventative, treatment, and acute care services. Overall...

The South Australia Health Chronic Disease Self-Management Internet Trial

Science.gov (United States)

Lorig, Kate; Ritter, Philip L.; Plant, Kathryn; Laurent, Diana D.; Kelly, Pauline; Rowe, Sally

2013-01-01

Objectives: To evaluate the effectiveness of an online chronic disease self-management program for South Australia residents. Method: Data were collected online at baseline, 6 months, and 12 months. The intervention was an asynchronous 6-week chronic disease self-management program offered online. The authors measured eight health status measures,…

Data Analysis of Occupational Health and Safety Management and Total Quality Management Systems

Directory of Open Access Journals (Sweden)

Ahmet Yakut

2013-01-01

Full Text Available In our study, Total Quality Management, Occupational Health and Safety on the effects of the construction industry, building sites of Istanbul evaluated with the results of the survey of 25 firms. For Occupational Health and Safety program, walked healthy, active employees in her role increased and will increase the importance of education. Due to non-implementation of the OHS system in our country enough, work-related accidents and deaths and injuries resulting from these accidents is very high. Firms as a result of the analysis, an effective health and safety management system needs to be able to fulfill their responsibilities. This system is designated as OHSAS 18001 Occupational Health and Safety Management System and the construction industry can be regarded as the imperatives.

Reusable Rocket Engine Advanced Health Management System. Architecture and Technology Evaluation: Summary

Science.gov (United States)

Pettit, C. D.; Barkhoudarian, S.; Daumann, A. G., Jr.; Provan, G. M.; ElFattah, Y. M.; Glover, D. E.

1999-01-01

In this study, we proposed an Advanced Health Management System (AHMS) functional architecture and conducted a technology assessment for liquid propellant rocket engine lifecycle health management. The purpose of the AHMS is to improve reusable rocket engine safety and to reduce between-flight maintenance. During the study, past and current reusable rocket engine health management-related projects were reviewed, data structures and health management processes of current rocket engine programs were assessed, and in-depth interviews with rocket engine lifecycle and system experts were conducted. A generic AHMS functional architecture, with primary focus on real-time health monitoring, was developed. Fourteen categories of technology tasks and development needs for implementation of the AHMS were identified, based on the functional architecture and our assessment of current rocket engine programs. Five key technology areas were recommended for immediate development, which (1) would provide immediate benefits to current engine programs, and (2) could be implemented with minimal impact on the current Space Shuttle Main Engine (SSME) and Reusable Launch Vehicle (RLV) engine controllers.

The health economic impact of disease management programs for COPD: a systematic literature review and meta-analysis.

Science.gov (United States)

Boland, Melinde R S; Tsiachristas, Apostolos; Kruis, Annemarije L; Chavannes, Niels H; Rutten-van Mölken, Maureen P M H

2013-07-03

There is insufficient evidence of the cost-effectiveness of Chronic Obstructive Pulmonary Disease (COPD) Disease Management (COPD-DM) programs. The aim of this review is to evaluate the economic impact of COPD-DM programs and investigate the relation between the impact on healthcare costs and health outcomes. We also investigated the impact of patient-, intervention, and study-characteristics. We conducted a systematic literature review to identify cost-effectiveness studies of COPD-DM. Where feasible, results were pooled using random-effects meta-analysis and explorative subgroup analyses were performed. Sixteen papers describing 11 studies were included (7 randomized control trials (RCT), 2 pre-post, 2 case-control). Meta-analysis showed that COPD-DM led to hospitalization savings of €1060 (95% CI: €2040 to €80) per patient per year and savings in total healthcare utilization of €898 (95% CI: €1566 to €231) (excl. operating costs). In these health economic studies small but positive results on health outcomes were found, such as the St Georges Respiratory Questionnaire (SGRQ) score, which decreased with 1.7 points (95% CI: 0.5-2.9). There was great variability in DM interventions-, study- and patient-characteristics. There were indications that DM showed greater savings in studies with: severe COPD patients, patients with a history of exacerbations, RCT study design, high methodological quality, few different professions involved in the program, and study setting outside Europe. COPD-DM programs were found to have favourable effects on both health outcomes and costs, but there is considerable heterogeneity depending on patient-, intervention-, and study-characteristics.

76 FR 31998 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2012

Science.gov (United States)

2011-06-02

... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar year 2012. This is... certain FEHB plans who receive covered health services in States with critical shortages of primary care...

75 FR 32972 - Federal Employees Health Benefits Program; Medically Underserved Areas for 2011

Science.gov (United States)

2010-06-10

... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program; Medically Underserved... Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar year 2011. This is... certain FEHB plans who receive covered health services in States with critical shortages of primary care...

A knowledge management tool for public health: health-evidence.ca

Directory of Open Access Journals (Sweden)

Dobbins Maureen

2010-08-01

Full Text Available Abstract Background The ultimate goal of knowledge translation and exchange (KTE activities is to facilitate incorporation of research knowledge into program and policy development decision making. Evidence-informed decision making involves translation of the best available evidence from a systematically collected, appraised, and analyzed body of knowledge. Knowledge management (KM is emerging as a key factor contributing to the realization of evidence-informed public health decision making. The goal of health-evidence.ca is to promote evidence-informed public health decision making through facilitation of decision maker access to, retrieval, and use of the best available synthesized research evidence evaluating the effectiveness of public health interventions. Methods The systematic reviews that populate health evidence.ca are identified through an extensive search (1985-present of 7 electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, Sociological Abstracts, BIOSIS, and SportDiscus; handsearching of over 20 journals; and reference list searches of all relevant reviews. Reviews are assessed for relevance and quality by two independent reviewers. Commonly-used public health terms are used to assign key words to each review, and project staff members compose short summaries highlighting results and implications for policy and practice. Results As of June 2010, there are 1913 reviews in the health-evidence.ca registry in 21 public health and health promotion topic areas. Of these, 78% have been assessed as being of strong or moderate methodological quality. Health-evidence.ca receives approximately 35,000 visits per year, 20,596 of which are unique visitors, representing approximately 100 visits per day. Just under half of all visitors return to the site, with the average user spending six minutes and visiting seven pages per visit. Public health nurses, program managers, health promotion workers, researchers, and program coordinators are

Repository-Based Software Engineering Program: Working Program Management Plan

Science.gov (United States)

1993-01-01

Repository-Based Software Engineering Program (RBSE) is a National Aeronautics and Space Administration (NASA) sponsored program dedicated to introducing and supporting common, effective approaches to software engineering practices. The process of conceiving, designing, building, and maintaining software systems by using existing software assets that are stored in a specialized operational reuse library or repository, accessible to system designers, is the foundation of the program. In addition to operating a software repository, RBSE promotes (1) software engineering technology transfer, (2) academic and instructional support of reuse programs, (3) the use of common software engineering standards and practices, (4) software reuse technology research, and (5) interoperability between reuse libraries. This Program Management Plan (PMP) is intended to communicate program goals and objectives, describe major work areas, and define a management report and control process. This process will assist the Program Manager, University of Houston at Clear Lake (UHCL) in tracking work progress and describing major program activities to NASA management. The goal of this PMP is to make managing the RBSE program a relatively easy process that improves the work of all team members. The PMP describes work areas addressed and work efforts being accomplished by the program; however, it is not intended as a complete description of the program. Its focus is on providing management tools and management processes for monitoring, evaluating, and administering the program; and it includes schedules for charting milestones and deliveries of program products. The PMP was developed by soliciting and obtaining guidance from appropriate program participants, analyzing program management guidance, and reviewing related program management documents.

The FAA Health Awareness Program: Results of the 1998 Customer Service Assessment Survey

National Research Council Canada - National Science Library

Hilton, Thomas

2000-01-01

... (even if they did not realize that the event was HAP-sponsored). In terms of attendance, the most popular HAP information programs were health fairs, health awareness lectures, and stress management awareness programs...

Outcomes at 18 Months From a Community Health Worker and Peer Leader Diabetes Self-Management Program for Latino Adults.

Science.gov (United States)

Spencer, Michael S; Kieffer, Edith C; Sinco, Brandy; Piatt, Gretchen; Palmisano, Gloria; Hawkins, Jaclynn; Lebron, Alana; Espitia, Nicolaus; Tang, Tricia; Funnell, Martha; Heisler, Michele

2018-04-27

This study evaluated the effectiveness of a community health worker (CHW) diabetes self-management education (DSME) program, followed by two different approaches to maintain improvements in HbA 1c and other clinical and patient-centered outcomes over 18 months. The study randomized 222 Latino adults with type 2 diabetes and poor glycemic control from a federally qualified health center to 1 ) a CHW-led, 6-month DSME program or 2 ) enhanced usual care (EUC). After the 6-month program, participants randomized to the CHW-led DSME were further randomized to 1 ) 12 months of CHW-delivered monthly telephone outreach (CHW-only) or 2 ) 12 months of weekly group sessions delivered by peer leaders (PLs) with telephone outreach to those unable to attend (CHW+PL). The primary outcome was HbA 1c . Secondary outcomes were blood pressure, lipid levels, diabetes distress, depressive symptoms, understanding of diabetes self-management, and diabetes social support. Assessments were conducted at baseline and at 6, 12, and 18 months. Participants in the CHW intervention at the 6-month follow-up had greater decreases in HbA 1c (-0.45; 95% CI -0.87, -0.03; P diabetes distress (-0.3; 95% CI -0.6, -0.03; P diabetes distress at 12 and 18 months. CHW+PL participants also had significantly fewer depressive symptoms at 18 months compared with EUC (-2.2; 95% CI -4.1, -0.3; P diabetes social support and in understanding of diabetes self-management at 6 months relative to EUC, but these intervention effects were not sustained at 18 months. This study demonstrates the effectiveness of a 6-month CHW intervention on key diabetes outcomes and of a volunteer PL program in sustaining key achieved gains. These are scalable models for health care centers in low-resource settings for achieving and maintaining improvements in key diabetes outcomes. © 2018 by the American Diabetes Association.

A generic hazardous waste management training program

International Nuclear Information System (INIS)

Carter, R.J.; Karnofsky, B.

1988-01-01

The main purpose of this training program element is to familiarize personnel involved in hazardous waste management with the goals of RCRA and how they are to be achieved. These goals include: to protect health and the environment; to conserve valuable material and energy resources; to prohibit future open dumping on the land; to assure that hazardous waste management practices are conducted in a manner which protects human health and the environment; to insure that hazardous waste is properly managed thereby reducing the need for corrective actions in the future; to establish a national policy to reduce or eliminate the generation of hazardous waste, wherever feasible. Another objective of this progam element is to present a brief overview of the RCRA regulations and how they are implemented/enforced by the Environmental Protection Agency (EPA) and each of the fifty states. This element also discusses where the RCRA regulations are published and how they are updated. In addition it details who is responsible for compliance with the regulations. Finally, this part of the training program provides an overview of the activities and materials that are regulated. 1 ref

Implementing program-wide awareness about recovery in a large mental health and addictions program.

Science.gov (United States)

McVanel-Viney, Sarah; Younger, Jodi; Doyle, Winnie; Kirkpatrick, Helen

2006-01-01

St. Joseph's Healthcare Hamilton conceptualized a multi-step plan for implementing a recovery oriented service delivery approach within their Mental Health and Addictions Program. This brief report discusses the first phase of this plan which included building awareness of recovery utilizing Anthony's (2000) system standards to develop a needs assessment for managers and senior team members. The survey had three purposes: to increase managers' awareness about recovery; to allow managers to express concerns that they had with this paradigm; and to afford managers an opportunity to explore the ways in which their service was and was not operating in a recovery oriented way. Initiatives designed to build awareness throughout the program are discussed.

Addressing the Health and Wellness Needs of Vulnerable Rockaway Residents in the Wake of Hurricane Sandy: Findings From a Health Coaching and Community Health Worker Program.

Science.gov (United States)

Russell, David; Oberlink, Mia R; Shah, Shivani; Evans, Lauren; Bassuk, Karen

To describe the design and participants of a program that employed health coaches and community health workers to address the social, health, and long-term disaster recovery needs of Rockaway residents roughly 2 years after Hurricane Sandy made landfall. Baseline and exit questionnaires, containing demographic, health, and health care utilization measures, were administered to participants at the start and end of the program. Enrollment and encounter information was captured in program administrative records. Descriptive statistics were used to summarize participant characteristics, personal goals, referrals to local organizations and agencies, and outcomes. Qualitative analyses were used to identify recurring themes in challenges faced by participants and barriers to health and wellness. The program served 732 community residents, of whom 455 (62%) completed baseline and exit questionnaires. Participants were directly and/or indirectly impacted by Hurricane Sandy through property damage, closures of health care facilities, limited employment opportunities, and trouble securing affordable housing. Furthermore, many participants faced considerable adversities and struggled to manage chronic health conditions. Personal goals set by participants included locating health care and other resources (44%), weight management and healthy eating (35%), and self-management of chronic conditions (24%). Health coaches and community health workers engaged participants an average of 4 times-providing counseling and referrals to local organizations and services, including medical and dental services (29%), city-issued identification cards (27%), and health insurance and other entitlements (23%). Comparisons of baseline and exit surveys indicated significant improvements in self-reported health, health care utilization, and confidence managing health issues. No significant improvement was observed in the use of preventive health care services. The program represents a model for

77 FR 60128 - Noncompetitive Supplements to Nursing Assistant and Home Health Aide Program Grantees

Science.gov (United States)

2012-10-02

... Noncompetitive Supplements to Nursing Assistant and Home Health Aide Program Grantees AGENCY: Health Resources... expansion supplements of $100,000 to 10 Nursing Assistant and Home Health Aide (NAHHA) Program grantees to... Management; Care Coordination and Follow Up; and Behavioral Health and Social Support for Home Health Aides...

A Qualitative Study Exploring Facilitators for Improved Health Behaviors and Health Behavior Programs: Mental Health Service Users’ Perspectives

Directory of Open Access Journals (Sweden)

Candida Graham

2014-01-01

Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.

Development and Evaluation of Digital Game-Based Training for Managers to Promote Employee Mental Health and Reduce Mental Illness Stigma at Work: Quasi-Experimental Study of Program Effectiveness.

Science.gov (United States)

Hanisch, Sabine Elisabeth; Birner, Ulrich Walter; Oberhauser, Cornelia; Nowak, Dennis; Sabariego, Carla

2017-08-04

To counteract the negative impact of mental health problems on business, organizations are increasingly investing in mental health intervention measures. However, those services are often underused, which, to a great extent, can be attributed to fear of stigmatization. Nevertheless, so far only a few workplace interventions have specifically targeted stigma, and evidence on their effectiveness is limited. The objective of this study was to develop and evaluate a digital game-based training program for managers to promote employee mental health and reduce mental illness stigma at work. We describe the empirical development of Leadership Training in Mental Health Promotion (LMHP), a digital game-based training program for leaders. A 1-group pre-post design and a 3-month follow-up were used for training evaluation. We applied multilevel growth models to investigate change over time in the dependent variables knowledge, attitudes, self-efficacy, and intentions to promote employee mental health in 48 managers of a global enterprise in the United Kingdom. Participants were mainly male (44/48, 92%) and ranged in age from 32 to 58 (mean 46.0, SD 7.2) years. We found a positive impact of the Web-based training program on managers' knowledge of mental health and mental illness (Pemployee mental health, which was initially high. Results provide first evidence of the effectiveness of LMHP to positively affect managers' skills to promote employee mental health at work. Furthermore, the high rate of participation in LMHP (48/54, 89%) supports the use of digital game-based interventions to increase user engagement and user experience in mental health programs at work. ©Sabine Elisabeth Hanisch, Ulrich Walter Birner, Cornelia Oberhauser, Dennis Nowak, Carla Sabariego. Originally published in JMIR Mental Health (http://mental.jmir.org), 04.08.2017.

Federal Employees Health Benefits Program (FEHBP) Plan Information

Data.gov (United States)

Office of Personnel Management — A list of all Federal Employees Health Benefits Program (FEHBP) plans available in each state, as well as links to the plan brochures, changes for each plan from the...

Evaluation of computerized health management information system for primary health care in rural India

Directory of Open Access Journals (Sweden)

Singh Satyavir

2010-11-01

Full Text Available Abstract Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS, New Delhi has a computerized Health Management Information System (HMIS since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Methods The data for evaluation were collected by in-depth interviews of the stakeholders i.e. program managers (authors and health workers. Health Workers from AIIMS and Non-AIIMS Primary Health Centers were interviewed to compare the manual with computerized HMIS. A cost comparison between the two methods was carried out based on market costs. The resource utilization for both manual and computerized HMIS was identified based on workers' interviews. Results There have been no major hardware problems in use of computerized HMIS. More than 95% of data was found to be accurate. Health workers acknowledge the usefulness of HMIS in service delivery, data storage, generation of workplans and reports. For program managers, it provides a better tool for monitoring and supervision and data management. The initial cost incurred in computerization of two Primary Health Centers was estimated to be Indian National Rupee (INR 1674,217 (USD 35,622. Equivalent annual incremental cost of capital items was estimated as INR 198,017 (USD 4213. The annual savings is around INR 894,283 (USD 11,924. Conclusion The major advantage of computerization has been in saving of time of health workers in record keeping and report generation. The initial capital costs of computerization can be recovered within two years of implementation if the system is fully operational. Computerization has enabled implementation of a good system for service delivery, monitoring and supervision.

Heat stress management program improving worker health and operational effectiveness: a case study.

Science.gov (United States)

Huss, Rosalyn G; Skelton, Scott B; Alvis, Kimberly L; Shane, Leigh A

2013-03-01

Heat stress monitoring is a vital component of an effective health and safety program when employees work in exceptionally warm environments. Workers at hazardous waste sites often wear personal protective equipment (PPE), which increases the body heat stress load. No specific Occupational Safety and Health Administration (OSHA) regulations address heat stress; however, OSHA does provide several guidance documents to assist employers in addressing this serious workplace health hazard. This article describes a heat stress and surveillance plan implemented at a hazardous waste site as part of the overall health and safety program. The PPE requirement for work at this site, coupled with extreme environmental temperatures, made heat stress a significant concern. Occupational health nurses and industrial hygienists developed a monitoring program for heat stress designed to prevent the occurrence of significant heat-related illness in site workers. The program included worker education on the signs of heat-related illness and continuous physiologic monitoring to detect early signs of heat-related health problems. Biological monitoring data were collected before workers entered the exclusion zone and on exiting the zone following decontamination. Sixty-six site workers were monitored throughout site remediation. More than 1,700 biological monitoring data points were recorded. Outcomes included improved worker health and safety, and increased operational effectiveness. Copyright 2013, SLACK Incorporated.

Effect of management, marketing, and certified health programs on the sale price of beef calves sold through a livestock video auction service from 1995 through 2009.

Science.gov (United States)

Seeger, Jon T; King, Michael E; Grotelueschen, Dale M; Rogers, Glenn M; Stokka, Gerald S

2011-08-15

To evaluate and update the previously quantified effects of management, marketing, and certified health programs on the sale price of beef calves sold through a livestock video auction service. Longitudinal study. 41,657 lots representing 5,042,272 beef calves sold from 1995 through 2009. Data describing each lot of beef calves marketed from 1995 through 2009 by a livestock video auction service were obtained from sale catalogues. For each year of the study, multiple regression analysis was used to quantify the effect of management, marketing, and certified health programs on sale price. Sale date, base sale weight, quadratic effect of base weight, sex of calf, region of origin, breed description, inclusion in a certified health program, and number of calves in the lot significantly affected sale price for every year of the study. Variation in body weight, flesh score, and number of days between sale and delivery date had significant effects on price in most of the years; frame score and calves with horns affected price in 7 of 15 years; age and source verification influenced sale price in every year since source verification was introduced in 2005; and the auction service's progressive genetics program increased price during the 1 year that program was available. Some management, marketing, and certified health initiatives have consistently increased the sale price of beef calves, and producers can increase the price of their calves by implementing these practices.

DEFENSE PROGRAMS RISK MANAGEMENT FRAMEWORK

Directory of Open Access Journals (Sweden)

Constantin PREDA

2012-01-01

Full Text Available For the past years defense programs have faced delays in delivering defense capabilities and budget overruns. Stakeholders are looking for ways to improve program management and the decision making process given the very fluid and uncertain economic and political environment. Consequently, they have increasingly resorted to risk management as the main management tool for achieving defense programs objectives and for delivering the defense capabilities strongly needed for the soldiers on the ground on time and within limited defense budgets. Following a risk management based decision-making approach the stakeholders are expected not only to protect program objectives against a wide range of risks but, at the same time, to take advantage of the opportunities to increase the likelihood of program success. The prerequisite for making risk management the main tool for achieving defense programs objectives is the design and implementation of a strong risk management framework as a foundation providing an efficient and effective application of the best risk management practices. The aim of this paper is to examine the risk management framework for defense programs based on the ISO 31000:2009 standard, best risk management practices and the defense programs’ needs and particularities. For the purposes of this article, the term of defense programs refers to joint defense programs.

Development and feasibility of an evidence-informed self-management education program in pediatric concussion rehabilitation.

Science.gov (United States)

Hunt, Anne W; De Feo, Luciano; Macintyre, Jennifer; Greenspoon, Dayna; Dick, Talia; Mah, Katherine; Paniccia, Melissa; Provvidenza, Christine; Reed, Nick

2016-08-17

Concussion is a considerable public health problem in youth. However, identifying, understanding and implementing best evidence informed recovery guidelines may be challenging for families given the vast amount of information available in the public domains (e.g. Internet). The objective of this study was to develop, implement and evaluate the feasibility of an evidence-informed self-management education program for concussion recovery in youth. Synthesis of best evidence, principles of knowledge translation and exchange, and expert opinion were integrated within a self-management program framework to develop a comprehensive curriculum. The program was implemented and evaluated in a children's rehabilitation hospital within a universal health care system. A retrospective secondary analysis of anonymous data from a program evaluation survey was used to evaluate program feasibility, to identify features of importance to program participants and to assess changes in participants' knowledge. The program, "Concussion & You" includes a comprehensive, evidence informed, population specific curriculum that teaches participants practical strategies for management of return to school and play, sleep, nutrition, relaxation and energy conservation. A 'wheel of health' is used to facilitate participants' self-management action plan. Results from eighty-seven participant surveys indicate that the program is feasible and participant knowledge increased in all areas of the program with the highest changes reported in knowledge about sleep hygiene, rest and energy conservation. Findings indicate that "Concussion & You" is a feasible program that is acceptable to youth and their families, and fills a health system service gap.

Medical cost savings for participants and nonparticipants in health risk assessments, lifestyle management, disease management, depression management, and nurseline in a large financial services corporation.

Science.gov (United States)

Serxner, Seth; Alberti, Angela; Weinberger, Sarah

2012-01-01

To compare changes in medical costs between participants and nonparticipants in five different health and productivity management (HPM) programs. Quasi-experimental pre/post intervention study. A large financial services corporation. A cohort population of employees enrolled in medical plans (n  =  49,723) [corrected]. A comprehensive HPM program, which addressed health risks, acute and chronic conditions, and psychosocial disorders from 2005 to 2007. Incentives were used to encourage health risk assessment participation in years 2 and 3. Program participation and medical claims data were collected for members at the end of each program year to assess the change in total costs from the baseline period. Analysis . Multivariate analyses for participation categories were conducted comparing baseline versus program year cost differences, controlling for demographics. All participation categories yielded a lower cost increase compared to nonparticipation and a positive return on investment (ROI) for years 2 and 3, resulting in a 2.45∶1 ROI for the combined program years. Medical cost savings exceeded program costs in a wide variety of health and productivity management programs by the second year.

Teaching children about mental health and illness: a school nurse health education program.

Science.gov (United States)

Desocio, Janiece; Stember, Lisa; Schrinsky, Joanne

2006-04-01

A mental health education program designed by school nurses for children ages 10- 12 was developed in 2000-2001 and expanded with broader distribution in 2004-2005. Six classroom sessions, each 45 minutes in length, provided information and activities to increase children's awareness of mental health and illness. Education program content included facts about the brain's connection to mental health, information about healthy ways to manage stress, resources and activities to promote mental health, common mental health problems experienced by children, and how to seek help for mental health problems. Classes included a combination of didactic presentation and open discussion, encouraging students to ask questions and allowing the school nurse to correct misinformation. Analysis of pre- and posttests from 370 elementary and middle school students revealed statistically significant improvements in their knowledge of mental health and mental illness.

Implementing Health-Promoting Leadership in Municipal Organizations: Managers’ Experiences with a Leadership Program

Directory of Open Access Journals (Sweden)

Robert Larsson

2015-03-01

Full Text Available The aim of this study was to analyze how line and middle managers experience and describe barriers and enablers in the implementation of a health-promoting leadership program in municipal organizations. A qualitative case study design was applied to examine the leadership program in a case involving implementation of an organizational health intervention. Data were mainly collected using semi-structured interviews with line and middle managers participating in the leadership program. Interviews with senior managers, notes from meetings/workshops, and written action plans were used as complementary data. The interview data were analyzed using a thematic analysis, and the complementary data using a summative content analysis. The findings show that the interviewed line and middle managers experienced this leadership program as a new approach in leadership training because it is based primarily on employee participation. Involvement and commitment of the employees was considered a crucial enabler in the implementation of the leadership program. Other enablers identified include action plans with specific goals, earlier experiences of organizational change, and integration of the program content into regular routines and structures. The line and middle managers described several barriers in the implementation process, and they described various organizational conditions, such as high workload, lack of senior management support, politically initiated projects, and organizational change, as challenges that limited the opportunities to be drivers of change. Taken together, these barriers interfered with the leadership program and its implementation. The study contributes to the understanding of how organizational-level health interventions are implemented in public sector workplaces.

Case manager satisfaction in public health.

Science.gov (United States)

Schutt, Russell K; Fawcett, Jacqueline; Gall, Gail B; Harrow, Brooke; Woodford, Mary Lou

2010-01-01

The purpose of this study was to examine correlates of case managers' satisfaction with their work, services, and service network and to identify connections to service performance and service costs. A decentralized public health program that exemplifies the trend toward more diverse clients and networked services. A mixed method design with 34 case managers. As hypothesized, the case managers' experiences with clients and the service network, and their service effectiveness, were associated with their satisfaction with their jobs and the services they provide. Satisfaction was also positively associated with more timely service delivery. These associations were explained in part by case managers' education and training. Case managers can achieve high levels of job and service satisfaction in outreach programs serving a diverse client population in a decentralized service network. Case managers' job and service satisfaction improves with reduced service problems and service delays and when case managers can devise work-arounds for persistent service problems. Using advanced practice nurses (APN) and providing more on-the-job training may increase case manager satisfaction with their jobs and the services they provide. Special efforts may be needed to prevent a decline in job satisfaction with years of experience.

What Do High-Risk Patients Value? Perspectives on a Care Management Program.

Science.gov (United States)

Ganguli, Ishani; Orav, E John; Weil, Eric; Ferris, Timothy G; Vogeli, Christine

2018-01-01

There is growing interest in coordinating care for high-risk patients through care management programs despite inconsistent results on cost reduction. Early evidence suggests patient-centered benefits, but we know little about how participants engage with the programs and what aspects they value. To explore care management program participants' awareness and perceived utility of program offerings. Cross-sectional telephone survey administered December 2015-January 2016. Patients enrolled in a Boston-area primary care-based care management program. Our main outcome was the number of topics in which patients reported having "very helpful" interactions with their care team in the past year. We analyzed awareness of one's care manager as an intermediate outcome, and then as a primary predictor of the main outcome, along with patient demographics, years in the program, attitudes, and worries as secondary predictors. The survey response rate was 45.8% (n = 1220); non-respondents were similar to respondents. More respondents reported worrying about family (72.8%) or financial issues (52.5%) than about their own health (41.6%). Seventy-four percent reported care manager awareness, particularly women (OR 1.33, 95% CI 1.01-1.77) and those with more years in the program (OR 1.16, 95% CI 1.03-1.30). While interaction rates ranged from 19.8% to 72.4% across topics, 81.3% rated at least one interaction as very helpful. Those who were aware of their care manager reported very helpful interactions on more topics (OR 2.77, 95% CI 2.15-3.56), as did women (OR 1.25, 95% CI 1.00-1.55), younger respondents (OR 0.98 for older age, 95% CI 0.97-0.99), and those with higher risk scores (OR 1.04, 95% CI 1.02-1.06), preference for deferring treatment decisions to doctors (OR 2.00, 95% CI 1.60-2.50), and reported control over their health (OR 1.67, 95% CI 1.33-2.10). High-risk patients reported helpful interactions with their care team around medical and social determinants of health

Managing the Social Determinants of Health: Part I: Fundamental Knowledge for Professional Case Management.

Science.gov (United States)

Fink-Samnick, Ellen

PRIMARY PRACTICE SETTING(S):: Applicable to health and behavioral health settings, wherever case management is practiced. The SDH pose major challenges to the health care workforce in terms of effective resource provision, health and behavioral health treatment planning plus adherence, and overall coordination of care. Obstacles and variances to needed interventions easily lead to less than optimal outcomes for case managers and their health care organizations. Possessing sound knowledge and clear understanding of each SDH, the historical perspectives, main theories, and integral dynamics, as well as creative resource solutions, all support a higher level of intentional and effective professional case management practice. Those persons and communities impacted most by the SDH comprise every case management practice setting. These clients can be among the most vulnerable and disenfranchised members of society, which can easily engender biases on the part of the interprofessional workforce. They are also among the costliest to care for with 50% of costs for only 5% of the population. Critical attention to knowledge about managing the SDH leverages and informs case management practice, evolves more effective programming, and enhances operational outcomes across practice settings.

Making Technology Ready: Integrated Systems Health Management

Science.gov (United States)

Malin, Jane T.; Oliver, Patrick J.

2007-01-01

This paper identifies work needed by developers to make integrated system health management (ISHM) technology ready and by programs to make mission infrastructure ready for this technology. This paper examines perceptions of ISHM technologies and experience in legacy programs. Study methods included literature review and interviews with representatives of stakeholder groups. Recommendations address 1) development of ISHM technology, 2) development of ISHM engineering processes and methods, and 3) program organization and infrastructure for ISHM technology evolution, infusion and migration.

Effects of managed care on service use and access for publicly insured children with chronic health conditions.

Science.gov (United States)

Davidoff, Amy; Hill, Ian; Courtot, Brigette; Adams, Emerald

2007-05-01

Our goal was to estimate the effects of managed care program type on service use and access for publicly insured children with chronic health conditions. Data on Medicaid and State Children's Health Insurance Program managed care programs were linked by county and year to pooled data from the 1997-2002 National Health Interview Survey. We used multivariate techniques to examine the effects of managed care program type, relative to fee-for-service, on a broad array of service use and access outcomes. Relative to fee-for-service, managed care program assignment was associated with selected reductions in service use but not with deterioration in reported access. Capitated managed care plans with mental health or specialty carve-outs were associated with a 7.4-percentage-point reduction in the probability of a specialist visit, a 6.3-percentage-point reduction in the probability of a mental health specialty visit, and a 5.9-percentage-point decrease in the probability of regular prescription drug use. Reductions in use associated with primary care case management and integrated capitated programs (without carve-outs) were more limited, and integrated capitated plans were associated with a reduction in unmet medical care need. We failed to find significant effects of special managed care programs for children with chronic health conditions. Managed care is associated with reduced service use, particularly when capitated programs carve out services. This finding is of key policy importance, as the proportion of children enrolled in plans with carve-out arrangements has been increasing over time. It is not possible to determine whether reductions in services represent better care management or skimping. However, despite the reductions in use, we did not observe a corresponding increase in perceived unmet need; thus, the net change may represent improved care management.

Effectiveness of a Multilevel Workplace Health Promotion Program on Vitality, Health, and Work-Related Outcomes.

Science.gov (United States)

Hendriksen, Ingrid J M; Snoijer, Mirjam; de Kok, Brenda P H; van Vilsteren, Jeroen; Hofstetter, Hedwig

2016-06-01

Evaluation of the effectiveness of a workplace health promotion program on employees' vitality, health, and work-related outcomes, and exploring the influence of organizational support and the supervisors' role on these outcomes. The 5-month intervention included activities at management, team, and individual level targeting self-management to perform healthy behaviors: a kick-off session, vitality training sessions, workshops, individual coaching, and intervision. Outcome measures were collected using questionnaires, health checks, and sickness absence data at baseline, after the intervention and at 10 months follow-up. For analysis linear and generalized mixed models were used. Vitality, work performance, sickness absence, and self-management significantly improved. Good organizational support and involved supervisors were significantly associated with lower sickness absence. Including all organizational levels and focusing on increasing self-management provided promising results for improving vitality, health, and work-related outcomes.

Process evaluation of the Living Green, Healthy and Thrifty (LiGHT) web-based child obesity management program: combining health promotion with ecology and economy.

Science.gov (United States)

Jogova, Maria; Song, Joshua Eun-Soo; Campbell, Audrey Clare; Warbuton, Darren; Warshawski, Tom; Chanoine, Jean-Pierre

2013-04-01

To conduct a process evaluation of the Living Green, Healthy and Thrifty (LiGHT) program, a novel virtual child obesity management program that combines health promotion with ecology and economy (Phase 1). We carried out a mixed methods process evaluation involving qualitative and quantitative data collection in 3 phases: among 3 child-parent units, (group 1) that informed program development; 9 child-parent units (group 2) that tested the draft program and further aided program refinement; and 17 child-parent units (group 3) for a 4-week pilot of the program. In the program pilot, we assessed participants' knowledge and readiness to change pre- and postintervention and explored perceptions of the program. Participants generally felt that the online format for program delivery was convenient and accessible, the content was practical, and the integration of health-environment-economy was well received. Many parents also appreciated the involvement of the family. However, the lack of visual appeal and overabundance of text was identified as a challenge, and children/youth in particular requested assurance that their personal information (e.g. weight) was not seen by their parents. The online method of program delivery holds the unique challenge of requiring special efforts to create a sense of personal connection and community. The presence of a "Way-finder" to assist participants and discussion boards/forums are potential solutions. The LiGHT online weight management program offers an accessible, convenient weight management resource that children and families appreciate for its availability, broader educational scope, and practicality. Outcome evaluation of LiGHT will be carried out in Phase 2 of the project. Copyright © 2013 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Alberta Healthy Living Program--a model for successful integration of chronic disease management services.

Science.gov (United States)

Morrin, Louise; Britten, Judith; Davachi, Shahnaz; Knight, Holly

2013-08-01

The most common presentation of chronic disease is multimorbidity. Disease management strategies are similar across most chronic diseases. Given the prevalence of multimorbidity and the commonality in approaches, fragmented single disease management must be replaced with integrated care of the whole person. The Alberta Healthy Living Program, a community-based chronic disease management program, supports adults with, or at risk for, chronic disease to improve their health and well being. Participants gain confidence and skills in how to manage their chronic disease(s) by learning to understand their health condition, make healthy eating choices, exercise safely and cope emotionally. The program includes 3 service pillars: disease-specific and general health patient education, disease-spanning supervised exercise and Better Choices, Better Health(TM) self-management workshops. Services are delivered in the community by an interprofessional team and can be tailored to target specific diverse and vulnerable populations, such as Aboriginal, ethno-cultural and francophone groups and those experiencing homelessness. Programs may be offered as a partnership between Alberta Health Services, primary care and community organizations. Common standards reduce provincial variation in care, yet maintain sufficient flexibility to meet local and diverse needs and achieve equity in care. The model has been implemented successfully in 108 communities across Alberta. This approach is associated with reduced acute care utilization and improved clinical indicators, and achieves efficiencies through an integrated, disease-spanning patient-centred approach. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Environment Health & Safety Research Program. Organization and 1979-1980 Publications

Energy Technology Data Exchange (ETDEWEB)

None

1981-01-01

This document was prepared to assist readers in understanding the organization of Pacific Northwest Laboratory, and the organization and functions of the Environment, Health and Safety Research Program Office. Telephone numbers of the principal management staff are provided. Also included is a list of 1979 and 1980 publications reporting on work performed in the Environment, Health and Safety Research Program, as well as a list of papers submitted for publication.

Management in oral health in the line of maternal child care: Analysis of Program ‘Sorria Bombeirinho’ Dental Polyclinic of the Fire Brigade of the Federal District, Brazil.

Directory of Open Access Journals (Sweden)

Jéssica Nascimento SILVA

2015-02-01

Full Text Available Oral health can not be separated from general health and directly influences the quality of life and self-esteem of the individual. Preventive programs accompanying children from birth are fundamental to the development of a healthy dentition without caries or other sequelae due to para- functional habits. Moreover, it is very important that the manager understands the user’s view in relation to the health service, so that it feels safe and welcomed. This study aimed to examine the program of maternal and child dental care Dental Polyclinic line in the Fire Brigade of the Federal District (PODON - CBMDF. Thus, we evaluated the perception of those responsible for children 0-2 years attending the first phase of the program in the period 2011-2013 and oral health conditions thereof. This research was exploratory, using a quantitative approach, the applied nature, where there was a field study, occurring in 2 steps: a questionnaire to managers and analysis of medical records of patients. Microsoft Excel 2007 software was used for statistical analysis. After tabulation and interpretation thereof, a report was made, and the same was delivered to program management. The questionnaire to parents identified that they are very satisfied with the actions and services of the program and the institution. The analysis of the records showed that of the 75 children studied, 67 (89 % had oral disease during follow-up. Thus, the program appears to be effective in preventing early childhood caries in early childhood.

A review of health leadership and management capacity in the Solomon Islands.

Science.gov (United States)

Asante, Augustine; Roberts, Graham; Hall, John

2012-04-01

ACCESS AND UTILISATION OF HEALTH CARE: The armed conflict that engulfed the Solomon Islands between 1998 and 2003 significantly disrupted the provision of health care especially in rural and remote areas. There is one doctor for 3,300 people and approximately 13 nurses and midwives for 10,000 people. Despite limitations 87% of people seek health care when sick. FINANCING THE HEALTH SYSTEM: The SIG placed a series of reservations on ministerial goods and services budgets that effectively the budget by 33%, severely impacting provincial budgets and resulting in acquired debts. Shortfalls have been addressed by allocating Health Sector Support Program funds to the provinces to allow services to continue, a strategy that will likely recur, but by which donor support replaces government provision Provincial health accountants have received training in MYOB in 2009 but acquittal systems require higher level accounting skills for reports to be submitted on time to permit the release of subsequent funding tranches. HUMAN RESOURCES FOR HEALTH: The shortage of doctors and specialists is a key challenge. As at December 2010, there were a total of 2,728 health workers in the public sector in Solomon Islands. Staff costs consume on average 55% of provincial health grants Filled Public Service Division staff establishments and budgetary reservations have reduced the ability to meet the salary and wage costs of new graduates. Solomon Islands is currently negotiating to assist Vanuatu in filling its nursing staff vacancies with its surplus The return of 75 Cuban trained medical officers from 2013 presents the management challenge of accessing budget provisions for so many new positions and in funding the infrastructure needed to house, equip and maintain them in service. HEALTH MANAGEMENT STRUCTURE: Provincial health managers are operationally responsive to local needs, managerially responsible to provincial governments, while being concerned with adherence to central MHMS policy

Supporting self-management of chronic health conditions: common approaches.

Science.gov (United States)

Lawn, Sharon; Schoo, Adrian

2010-08-01

The aims of this paper are to provide a description of the principles of chronic condition self-management, common approaches to support currently used in Australian health services, and benefits and challenges associated with using these approaches. We examined literature in this field in Australia and drew also from our own practice experience of implementing these approaches and providing education and training to primary health care professionals and organizations in the field. Using common examples of programs, advantages and disadvantages of peer-led groups (Stanford Courses), care planning (The Flinders Program), a brief primary care approach (the 5As), motivational interviewing and health coaching are explored. There are a number of common approaches used to enhance self-management. No one approach is superior to other approaches; in fact, they are often complimentary. The nature and context for patients' contact with services, and patients' specific needs and preferences are what must be considered when deciding on the most appropriate support mode to effectively engage patients and promote self-management. Choice of approach will also be determined by organizational factors and service structures. Whatever self-management support approaches used, of importance is how health services work together to provide support. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Adaptation of intensive mental health intensive case management to rural communities in the Veterans Health Administration.

Science.gov (United States)

Mohamed, Somaia

2013-03-01

There has been increasing concern in recent years about the availability of mental health services for people with serious mental illness in rural areas. To meet these needs the Department of Veterans Affairs (VA) implemented the Rural Access Networks for Growth Enhancement (RANGE) program, in 2007, modeled on the Assertive Community Treatment (ACT) model. This study uses VA administrative data from the RANGE program (N = 343) to compare client characteristics at program entry, patterns of service delivery, and outcomes with those of Veterans who received services from the general VA ACT-like program (Mental Health Intensive Case Management (MHICM) (N = 3,077). Veterans in the rural program entered treatment with similar symptom severity, less likelihood of being diagnosed with schizophrenia and having had long-term hospitalization, but significantly higher suicidality index scores and greater likelihood of being dually diagnosed compared with those in the general program. RANGE Veterans live further away from their treatment teams but did not differ significantly in measures of face-to-face treatment intensity. Similar proportions of RANGE and MHICM Veterans were reported to have received rehabilitation services, crisis intervention and substance abuse treatment. The rural programs had higher scores on overall satisfaction with VA mental health care than general programs, slightly poorer outcomes on quality of life and on the suicidality index but no significant difference on other outcomes. These data demonstrate the clinical need, practical feasibility and potential effectiveness of providing intensive case management through small specialized case management teams in rural areas.

Knowledge management program

International Nuclear Information System (INIS)

Henderson, T.

2013-01-01

To capture and retain the CANDU experience from a wider CANDU base and transfer knowledge and experience to our members, supplier participants and universities in a cost effective manner. Major focus area of the program is knowledge management joint projects, generic training delivery, inter-utilities mentoring and technical support, public education programs. The path forward is execution of transition of OPG NPDS Program as an ongoing program in COG with member funding, pursue opportunities to provide member utilities with additional leadership and train-the-trainer training and grow the knowledge management activities by 20% per year based on 2013/2014 results.

Knowledge management program

Energy Technology Data Exchange (ETDEWEB)

Henderson, T. [CANDU Owners' Group, Toronto, Ontario (Canada)

2013-07-01

To capture and retain the CANDU experience from a wider CANDU base and transfer knowledge and experience to our members, supplier participants and universities in a cost effective manner. Major focus area of the program is knowledge management joint projects, generic training delivery, inter-utilities mentoring and technical support, public education programs. The path forward is execution of transition of OPG NPDS Program as an ongoing program in COG with member funding, pursue opportunities to provide member utilities with additional leadership and train-the-trainer training and grow the knowledge management activities by 20% per year based on 2013/2014 results.

A risk communication case study: the Nevada risk assessment/management program

International Nuclear Information System (INIS)

Hechanova, A.E.

2001-01-01

The Nevada Risk Assessment/Management Program is part of a national effort by the U.S. Department of Energy (Grant DE-FG01-96EW56093) to develop new sources of information and approaches to risk assessment, risk management, risk communication and public outreach as these objectives relate to the ecological and human health effects of radioactive and hazardous material management and site remediation activities. This paper reviews the innovation behind the Nevada Risk Assessment/Management Program and presents a synopsis of the effort that began in 1995 and will officially conclude on April 30, 2000. (author)

Health services management development: what formal knowledge should support the skills and experience required?

Science.gov (United States)

Ritchie, David J; Yen, Margaret L

2013-05-01

This study reports on an analysis of 17 postgraduate programs in health services management. Public information was collected from websites in February 2010. Data analysed included core subject abstracts, admission requirements and length and aims of each course. Findings indicate that only three out of 16 subjects identified as core are common to more than 50% of the programs, with the eight most common individual subjects appearing in only a third of programs. This suggests diversity in what is deemed core foundational knowledge in managing health services and the approach taken to management development. We believe there should be greater consensus on core subjects in a specialist health services management qualification. WHAT IS KNOWN ABOUT THE TOPIC? With changes in the organisational structure of health organisations in Australia over the past two decades, managerial positions and roles have also changed. The educational preparation for those managerial roles would also be expected to have changed but core foundational knowledge should remain similar between the various academic institutions.WHAT DOES THIS PAPER ADD? This paper indicates greater diversity in core knowledge areas in health services management education than expected despite a similar target audience.WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? There are differences in what are deemed to be core foundational areas of knowledge required in specialist management development between academic programs. Management development requires a balance between knowledge, skills and experience and intending st

Building capacity for HIV/AIDS program leadership and management in Uganda through mentored Fellowships.

Science.gov (United States)

Matovu, Joseph K B; Wanyenze, Rhoda K; Mawemuko, Susan; Wamuyu-Maina, Gakenia; Bazeyo, William; Olico-Okui; Serwadda, David

2011-02-24

Around the world, health professionals and program managers are leading and managing public and private health organizations with little or no formal management and leadership training and experience. To describe an innovative 2-year, long-term apprenticeship Fellowship training program implemented by Makerere University School of Public Health (MakSPH) to strengthen capacity for leadership and management of HIV/AIDS programs in Uganda. IMPLEMENTATION PROCESS: The program, which began in 2002, is a 2-year, full-time, non-degree Fellowship. It is open to Ugandan nationals with postgraduate training in health-related disciplines. Enrolled Fellows are attached to host institutions implementing HIV/AIDS programs and placed under the supervision of host institution and academic mentors. Fellows spend 75% of their apprenticeship at the host institutions while the remaining 25% is dedicated to didactic short courses conducted at MakSPH to enhance their knowledge base. Overall, 77 Fellows have been enrolled since 2002. Of the 57 Fellows who were admitted between 2002 and 2008, 94.7% (54) completed the Fellowship successfully and 50 (92.3%) are employed in senior leadership and management positions in Uganda and internationally. Eighty-eight percent of those employed (44/54) work in institutions registered in Uganda, indicating a high level of in-country retention. Nineteen of the 20 Fellows who were admitted between 2009 and 2010 are still undergoing training. A total of 67 institutions have hosted Fellows since 2002. The host institutions have benefited through staff training and technical expertise from the Fellows as well as through grant support to Fellows to develop and implement innovative pilot projects. The success of the program hinges on support from mentors, stakeholder involvement, and the hands-on approach employed in training. The Fellowship Program offers a unique opportunity for hands-on training in HIV/AIDS program leadership and management for both

Building capacity for HIV/AIDS program leadership and management in Uganda through mentored Fellowships

Directory of Open Access Journals (Sweden)

Joseph K.B. Matovu

2011-02-01

Full Text Available Background: Around the world, health professionals and program managers are leading and managing public and private health organizations with little or no formal management and leadership training and experience. Objective: To describe an innovative 2-year, long-term apprenticeship Fellowship training program implemented by Makerere University School of Public Health (MakSPH to strengthen capacity for leadership and management of HIV/AIDS programs in Uganda. Implementation process: The program, which began in 2002, is a 2-year, full-time, non-degree Fellowship. It is open to Ugandan nationals with postgraduate training in health-related disciplines. Enrolled Fellows are attached to host institutions implementing HIV/AIDS programs and placed under the supervision of host institution and academic mentors. Fellows spend 75% of their apprenticeship at the host institutions while the remaining 25% is dedicated to didactic short courses conducted at MakSPH to enhance their knowledge base. Achievements: Overall, 77 Fellows have been enrolled since 2002. Of the 57 Fellows who were admitted between 2002 and 2008, 94.7% (54 completed the Fellowship successfully and 50 (92.3% are employed in senior leadership and management positions in Uganda and internationally. Eighty-eight percent of those employed (44/54 work in institutions registered in Uganda, indicating a high level of in-country retention. Nineteen of the 20 Fellows who were admitted between 2009 and 2010 are still undergoing training. A total of 67 institutions have hosted Fellows since 2002. The host institutions have benefited through staff training and technical expertise from the Fellows as well as through grant support to Fellows to develop and implement innovative pilot projects. The success of the program hinges on support from mentors, stakeholder involvement, and the hands-on approach employed in training. Conclusion: The Fellowship Program offers a unique opportunity for hands

Human resource management in the Georgian National Immunization Program: a baseline assessment

OpenAIRE

Cohen-Kohler Jillian; Esmail Laura C; Djibuti Mamuka

2007-01-01

Abstract Background Georgia's health care system underwent dramatic reform after gaining independence in 1991. The decentralization of the health care system was one of the core elements of health care reform but reports suggest that human resource management issues were overlooked. The Georgian national immunization program was affected by these reforms and is not functioning at optimum levels. This paper describes the state of human resource management practices within the Georgian national...

Occupational Safety and Health Program at the West Valley Demonstration Project

International Nuclear Information System (INIS)

L. M. Calderon

1999-01-01

The West Valley Nuclear Services Co. LLC (WVNS) is committed to provide a safe, clean, working environment for employees, and to implement U.S. Department of Energy (DOE) requirements affecting worker safety. The West Valley Demonstration Project (WVDP) Occupational Safety and Health Program is designed to protect the safety, health, and well-being of WVDP employees by identifying, evaluating, and controlling biological, chemical, and physical hazards in the work place. Hazards are controlled within the requirements set forth in the reference section at the end of this report. It is the intent of the WVDP Occupational Safety and Health Program to assure that each employee is provided with a safe and healthy work environment. This report shows the logical path toward ensuring employee safety in planning work at the WVDP. In general, planning work to be performed safely includes: combining requirements from specific programs such as occupational safety, industrial hygiene, radiological control, nuclear safety, fire safety, environmental protection, etc.; including WVDP employees in the safety decision-making processes; pre-planning using safety support re-sources; and integrating the safety processes into the work instructions. Safety management principles help to define the path forward for the WVDP Occupational Safety and Health Program. Roles, responsibilities, and authority of personnel stem from these ideals. WVNS and its subcontractors are guided by the following fundamental safety management principles: ''Protection of the environment, workers, and the public is the highest priority. The safety and well-being of our employees, the public, and the environment must never be compromised in the aggressive pursuit of results and accomplishment of work product. A graded approach to environment, safety, and health in design, construction, operation, maintenance, and deactivation is incorporated to ensure the protection of the workers, the public, and the environment

[Organization and functioning of health services of the IMSS-Solidaridad program].

Science.gov (United States)

Velázquez-Díaz, G

1992-01-01

In this report the organization and performance of the IMSS-Solidaridad Program of Mexico is described. This program is managed by the Mexican Institute for Social Security, which services 10.5 million inhabitants of the rural underserved areas, with federal government resources in 18 states. This study compares the structure and functioning of the IMSS-Solidaridad Program with Local Health Systems, as they have been proposed by the Panamerican Health Organization for country members and by the Ministry of Health of Mexico, particularly in relation to the decision-making process at local level. Some assets and limitations of the IMSS-Solidaridad Program are analyzed and, finally, concrete procedures to improve coordination between the IMSS-Solidaridad Program and other health services for similar populations (populations without social security protection) in Mexico are suggested, with the purpose of using resources more adequately and succeed in the national goal to achieve equity in health.

Parkinson’s Disease Biomarkers Program Data Management Resource (PDBP DMR)

Data.gov (United States)

U.S. Department of Health & Human Services — The NINDS Parkinson’s Disease (PD) Biomarkers Program Data Management Resource enables web-based data entry for clinical studies supporting PD biomarker development,...

Public health program capacity for sustainability: a new framework.

Science.gov (United States)

Schell, Sarah F; Luke, Douglas A; Schooley, Michael W; Elliott, Michael B; Herbers, Stephanie H; Mueller, Nancy B; Bunger, Alicia C

2013-02-01

and implementing prevention and intervention programs. The sustainability framework will be useful for public health decision makers, program managers, program evaluators, and dissemination and implementation researchers.

76 FR 64110 - Safety and Health Management Programs for Mines

Science.gov (United States)

2011-10-17

... section of this notice. Comment Dates: MSHA will hold the date for comments open until all meetings are... Identification, including workplace inspections for violations of mandatory health and safety standards. Hazard.... Improved communication. Increased productivity. Increased and improved worker and management involvement in...

INTEGRATING HEALTH TECHNOLOGY ASSESSMENT PRINCIPLES IN FORMULARY MANAGEMENT.

Science.gov (United States)

Teng, Monica; Khoo, Ai Leng; Zhao, Ying Jiao; Lin, Liang; Lim, Boon Peng

2016-01-01

Effective formulary management in healthcare institutions safeguards rational drug use and optimizes health outcomes. We implemented a formulary management program integrating the principles of health technology assessment (HTA) to improve the safe, appropriate, and cost-effective use of medicine in Singapore. A 3-year formulary management program was initiated in 2011 in five public healthcare institutions. This program was managed by a project team comprising HTA researchers. The project team worked with institutional pharmacy and therapeutics (P&T) committees to: (i) develop tools for formulary drug review and decision making; (ii) enhance the HTA knowledge and skills of formulary pharmacists and members of P&T committees; (iii) devise a prioritization framework to overcome resource constraints and time pressure; and (iv) conceptualize and implement a framework to review existing formulary. Tools that facilitate drug request submission, drug review, and decision making were developed for formulary drug inclusion. A systematic framework to review existing formulary was also developed and tested in selected institutions. A competency development plan was rolled out over 2 years to enhance formulary pharmacists' proficiency in systematic literature search and review, meta-analysis, and pharmacoeconomic evaluation. The plan comprised training workshops and on-the-job knowledge transfer between the project team and institutional formulary pharmacists through collaborating on selected drug reviews. A resource guide that consolidated the tools and templates was published to encourage the adoption of best practices in formulary management. Based on the concepts of HTA, we implemented an evidence-based approach to optimize formulary management.

Space program management methods and tools

CERN Document Server

Spagnulo, Marcello; Balduccini, Mauro; Nasini, Federico

2013-01-01

Beginning with the basic elements that differentiate space programs from other management challenges, Space Program Management explains through theory and example of real programs from around the world, the philosophical and technical tools needed to successfully manage large, technically complex space programs both in the government and commercial environment. Chapters address both systems and configuration management, the management of risk, estimation, measurement and control of both funding and the program schedule, and the structure of the aerospace industry worldwide.

Evaluating Performance of Safety Management and Occupational Health Using Total Quality Safety Management Model (TQSM

Directory of Open Access Journals (Sweden)

E Mohammadfam

2015-11-01

Full Text Available Introduction: All organizations, whether public or private, necessitate performance evaluation systems in regard with growth, stability, and development in the competitive fields. One of the existing models for performance evaluation of occupational health and safety management is Total Quality Safety Management model (TQSM. Therefore, the present study aimed to evaluate performance of safety management and occupational health utilizing TQSM model. Methods: In this descriptive-analytic study, the population consisted of 16 individuals, including managers, supervisors, and members of technical protection and work health committee. Then the participants were asked to respond to TQSM questionnaire before and after the implementation of Occupational Health & Safety Advisory Services 18001 (OHSAS18001. Ultimately, the level of each program as well as the TQSM status were determined before and after the implementation of OHSAS18001. Results: The study results showed that the scores obtained by the company before OHSAS 18001’s implementation, was 43.7 out of 312. After implementing OHSAS 18001 in the company and receiving the related certificate, the total score of safety program that company could obtain was 127.12 out of 312 demonstrating a rise of 83.42 scores (26.8%. The paired t-test revealed that mean difference of TQSM scores before and after OHSAS 18001 implementation was proved to be significant (p> 0.05. Conclusion: The study findings demonstrated that TQSM can be regarded as an appropriate model in order to monitor the performance of safety management system and occupational health, since it possesses the ability to quantitatively evaluate the system performance.

76 FR 39857 - Alaska Coastal Management Program Withdrawal From the National Coastal Management Program Under...

Science.gov (United States)

2011-07-07

... DEPARTMENT OF COMMERCE National Oceanic Atmospheric Administration Alaska Coastal Management Program Withdrawal From the National Coastal Management Program Under the Coastal Zone Management Act (CZMA) AGENCY: Office of Ocean and Coastal Resource Management (OCRM), National Ocean Service (NOS...

FLUOR HANFORD SAFETY MANAGEMENT PROGRAMS

Energy Technology Data Exchange (ETDEWEB)

GARVIN, L. J.; JENSEN, M. A.

2004-04-13

This document summarizes safety management programs used within the scope of the ''Project Hanford Management Contract''. The document has been developed to meet the format and content requirements of DOE-STD-3009-94, ''Preparation Guide for US. Department of Energy Nonreactor Nuclear Facility Documented Safety Analyses''. This document provides summary descriptions of Fluor Hanford safety management programs, which Fluor Hanford nuclear facilities may reference and incorporate into their safety basis when producing facility- or activity-specific documented safety analyses (DSA). Facility- or activity-specific DSAs will identify any variances to the safety management programs described in this document and any specific attributes of these safety management programs that are important for controlling potentially hazardous conditions. In addition, facility- or activity-specific DSAs may identify unique additions to the safety management programs that are needed to control potentially hazardous conditions.

14 CFR 91.1003 - Management contract between owner and program manager.

Science.gov (United States)

2010-01-01

... program manager. 91.1003 Section 91.1003 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... RULES Fractional Ownership Operations § 91.1003 Management contract between owner and program manager. Each owner must have a contract with the program manager that— (a) Requires the program manager to...

Stakeholder's perspective: Sustainability of a community health worker program in Afghanistan.

Science.gov (United States)

Najafizada, Said Ahmad Maisam; Labonté, Ronald; Bourgeault, Ivy Lynn

2017-02-01

The objectives of this study were two-fold: 1) to examine how different stakeholders define sustainability, and 2) to identify barriers to and facilitators of the sustainability of the Afghan CHW program. We interviewed 63 individual key informants, and conducted 11 focus groups [35 people] with policymakers, health managers, community health workers, and community members across Afghanistan. The participants were purposefully selected to provide a wide range of perspectives. Different stakeholders define sustainability differently. Policymakers emphasize financial resources; health managers, organizational operations; and community-level stakeholders, routine frontline activities. The facilitators they identify include integration into the health system, community support, and capable human resources. Barriers they noted include lack of financial resources, poor program design and implementation, and poor quality of services. Measures to ensure sustainability could be national revenue allocation, health-specific taxation, and community financing. Sustainability is complicated and has multiple facets. The plurality of understanding of sustainability among stakeholders should be addressed explicitly in the program design. To ensure sustainability, there is a need for a coordinated effort amongst all stakeholders. Copyright © 2016 Elsevier Ltd. All rights reserved.

The chronic care model versus disease management programs: a transaction cost analysis approach.

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Leeman, Jennifer; Mark, Barbara

2006-01-01

The present article applies transaction cost analysis as a framework for better understanding health plans' decisions to improve chronic illness management by using disease management programs versus redesigning care within physician practices.

Surplus Facilities Management Program

International Nuclear Information System (INIS)

Coobs, J.H.

1983-01-01

This is the second of two programs that are concerned with the management of surplus facilities. The facilities in this program are those related to commercial activities, which include the three surplus experimental and test reactors [(MSRE, HRE-2, and the Low Intensity Test Reactor (LITR)] and seven experimental loops at the ORR. The program is an integral part of the Surplus Facilities Management Program, which is a national program administered for DOE by the Richland Operations Office. Very briefly reported here are routine surveillance and maintenance of surplus radioactively contaminated DOE facilities awaiting decommissioning

Environmental Management Waste Management Facility (EMWMF) Site-Specific Health and Safety Plan, Oak Ridge, Tennessee

Energy Technology Data Exchange (ETDEWEB)

Flynn, N.C. Bechtel Jacobs

2008-04-21

The Bechtel Jacobs Company LLC (BJC) policy is to provide a safe and healthy workplace for all employees and subcontractors. The implementation of this policy requires that operations of the Environmental Management Waste Management Facility (EMWMF), located one-half mile west of the U.S. Department of Energy (DOE) Y-12 National Security Complex, be guided by an overall plan and consistent proactive approach to environment, safety and health (ES&H) issues. The BJC governing document for worker safety and health, BJC/OR-1745, 'Worker Safety and Health Program', describes the key elements of the BJC Safety and Industrial Hygiene (IH) programs, which includes the requirement for development and implementation of a site-specific Health and Safety Plan (HASP) where required by regulation (refer also to BJC-EH-1012, 'Development and Approval of Safety and Health Plans'). BJC/OR-1745, 'Worker Safety and Health Program', implements the requirements for worker protection contained in Title 10 Code of Federal Regulations (CFR) Part 851. The EMWMF site-specific HASP requirements identifies safe operating procedures, work controls, personal protective equipment, roles and responsibilities, potential site hazards and control measures, site access requirements, frequency and types of monitoring, site work areas, decontamination procedures, and outlines emergency response actions. This HASP will be available on site for use by all workers, management and supervisors, oversight personnel and visitors. All EMWMF assigned personnel will be briefed on the contents of this HASP and will be required to follow the procedures and protocols as specified. The policies and procedures referenced in this HASP apply to all EMWMF operations activities. In addition the HASP establishes ES&H criteria for the day-to-day activities to prevent or minimize any adverse effect on the environment and personnel safety and health and to meet standards that define acceptable

Evaluation of two communication strategies to improve udder health management.

Science.gov (United States)

Jansen, J; Renes, R J; Lam, T J G M

2010-02-01

Worldwide, programs to improve udder health are implemented using communication tools and methods that inform and persuade dairy farmers. This study evaluated 2 communication strategies used in a mastitis control program in the Netherlands. To improve farmers' udder health management, tools such as instruction cards, treatment plans, checklists and software were developed following an argument-based comprehensive "central route." These tools were used during on-farm study group meetings for farmers organized by veterinarians and also during individual veterinarian-farmer interactions. The second strategy aimed at adopting a single management practice to increase the use of milking gloves during milking. This approach followed a straightforward "peripheral" route that used implicit persuasion techniques. Results of an online survey of 374 Dutch dairy farmers showed that most farmers were able and willing to use the educational management tools to increase udder health on their farms. They evaluated the tools positively regardless of the mastitis problems on their farms. This seems to indicate that the central route of communication is most effective when farmers are motivated to work on udder health in general. Results of repeated random telephone surveys before, during, and after the campaign on the use of milking gloves showed that the use of gloves increased from 20.9 to 42.0% of the respondents. Respondents' opinions about milking gloves also changed favorably, indicating that a relatively short peripheral campaign on a single action can have a sustained effect on farmers' behavior. Both communication strategies seem to be potentially successful in disseminating knowledge to a specific target group of farmers and in changing that group's behavior. However, to reach as many farmers as possible, the strategies should be combined. When optimizing these strategies, both the farmers' motivation to work on udder health and the aim of the campaign should be considered

Building capacity in health facility management: guiding principles for skills transfer in Liberia.

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Rowe, Laura A; Brillant, Sister Barbara; Cleveland, Emily; Dahn, Bernice T; Ramanadhan, Shoba; Podesta, Mae; Bradley, Elizabeth H

2010-03-18

Management training is fundamental to developing human resources for health. Particularly as Liberia revives its health delivery system, facility and county health team managers are central to progress. Nevertheless, such management skills are rarely prioritized in health training, and sustained capacity building in this area is limited. We describe a health management delivery program in which a north and south institution collaborated to integrate classroom and field-based training in health management and to transfer the capacity for sustained management development in Liberia. We developed and implemented a 6-month training program in health management skills (i.e. strategic problem solving, financial management, human resource management and leadership) delivered by Yale University and Mother Patern College from Liberia, with support from the Clinton HIV/AIDS Initiative. Over three 6-month cycles, responsibility for course instruction was transferred from the north institution to the south institution. A self-administered survey was conducted of all participants completing the course to measure changes in self-rated management skills, the degree to which the course was helpful and met its stated objectives, and faculty members' responsiveness to participant needs as the transfer process occurred. Respondents (n=93, response rate 95.9%) reported substantial improvement in self-reported management skills, and rated the helpfulness of the course and the degree to which the course met its objectives highly. Levels of improvement and course ratings were similar over the three cohorts as the course was transferred to the south institution. We suggest a framework of five elements for implementing successful management training programs that can be transferred and sustained in resource-limited settings, including: 1) use a short-course format focusing on four key skill areas with practical tools; 2) include didactic training, on-site projects, and on-site mentoring; 3

Building capacity in health facility management: guiding principles for skills transfer in Liberia

Directory of Open Access Journals (Sweden)

Dahn Bernice T

2010-03-01

Full Text Available Abstract Background Management training is fundamental to developing human resources for health. Particularly as Liberia revives its health delivery system, facility and county health team managers are central to progress. Nevertheless, such management skills are rarely prioritized in health training, and sustained capacity building in this area is limited. We describe a health management delivery program in which a north and south institution collaborated to integrate classroom and field-based training in health management and to transfer the capacity for sustained management development in Liberia. Methods We developed and implemented a 6-month training program in health management skills (i.e. strategic problem solving, financial management, human resource management and leadership delivered by Yale University and Mother Patern College from Liberia, with support from the Clinton HIV/AIDS Initiative. Over three 6-month cycles, responsibility for course instruction was transferred from the north institution to the south institution. A self-administered survey was conducted of all participants completing the course to measure changes in self-rated management skills, the degree to which the course was helpful and met its stated objectives, and faculty members' responsiveness to participant needs as the transfer process occurred. Results Respondents (n = 93, response rate 95.9% reported substantial improvement in self-reported management skills, and rated the helpfulness of the course and the degree to which the course met its objectives highly. Levels of improvement and course ratings were similar over the three cohorts as the course was transferred to the south institution. We suggest a framework of five elements for implementing successful management training programs that can be transferred and sustained in resource-limited settings, including: 1 use a short-course format focusing on four key skill areas with practical tools; 2 include

NON-COMMUNICABLE DISEASE PROGRAM IN AMPANGAN HEALTH CLINIC

Directory of Open Access Journals (Sweden)

MASTURA I

2010-01-01

Full Text Available Non-communicable diseases (NCDs represent among the most common and debilitating conditions seen in primary care. Patients’ care will often involves multiple providers and follow-up requires persistence by patients and clinicians alike, therefore ideal outcomes are often difficult to achieve. The need for better disease management policies and practice is growing. This is due to the changing demographic profile of the population, the increasing cost of managing people in acute care hospitals and the availability of new technologies and services. All these changes enable a different care paradigm which is more cost effective and provides people with chronic conditions an improved quality of life. Management of the NCDs therefore offers an excellent opportunity to practice chronic disease management - a systems approach designed to ensure excellent care. The NCD team has developed a comprehensive approach to chronic disease care. We would like to describe the NCD Program in Ampangan Health Clinic which represents many typical government health clinics in Malaysia and the processes by which it was developed. Included are specific examples of the tools and how they can be used by individual clinicians incaring for patients. The integration of Chronic Disease Management Services into health care systems is the direction being undertaken to tackle the burden of chronic disease. Disease management supports the shift in healthcare from an emphasis on managing the acute episode to managing the entire disease course, highlighting both prevention and maintenance of wellbeing for patients with chronic diseases. Disease management promotes better integration and coordination of care across all aspects of the health sector.

[Management committees in health services: an empirical study].

Science.gov (United States)

Cecilio, Luiz Carlos de Oliveira

2010-03-01

The aim of the article, based on field data collected from a continuing education program for primary health clinic administrators, was to analyze the functioning of a health service management strategy called "management committees". Different meanings and operational modalities emerged in the committees. Various antimonies appeared in the way the committees operate (autonomy versus heteronomy, reproduction of "instituted" versus "instituting" processes, and communicative versus instrumental reasoning), thus reflecting the level of complexity in this management mechanism. Healthcare provision per se by the clinics only appeared occasionally on the committees' agenda, which mainly focused on administrative issues. The article suggests that further research is needed on the coordinator's involvement in the field of forces constituting the management committee, besides developing pedagogical strategies to support the clinic coordinators and health teams in building the committees. The primary data were submitted to an epistemological discussion anchored in the idea of double hermeneutics, multiple validation of research results, and the relationship between theory and practice.

An employee total health management-based survey of Iowa employers.

Science.gov (United States)

Merchant, James A; Lind, David P; Kelly, Kevin M; Hall, Jennifer L

2013-12-01

To implement an Employee Total Health Management (ETHM) model-based questionnaire and provide estimates of model program elements among a statewide sample of Iowa employers. Survey a stratified random sample of Iowa employers, and characterize and estimate employer participation in ETHM program elements. Iowa employers are implementing less than 30% of all 12 components of ETHM, with the exception of occupational safety and health (46.6%) and workers' compensation insurance coverage (89.2%), but intend modest expansion of all components in the coming year. The ETHM questionnaire-based survey provides estimates of progress Iowa employers are making toward implementing components of Total Worker Health programs.

[Implementation and evaluation of case management in Catalonia: the ISP-SMD program].

Science.gov (United States)

Balsera Gómez, J; Rodríguez Medina, C; Caba Calvet, R; Vega Prada, R; Ruiz Ureña, H; Berruezo Ortiz, L; Clusa Gironella, D; Rodríguez Montes, M J; Haro Abad, J M

2002-01-01

The pilot study of the Individualized Service Program for people with Severe Mental Disorders (ISP-SMD) consists of the implementation of case management services in Catalonia. The ISP-SMD has been implemented in two health care sectors and will be expanded to the rest of Catalonia in the next years. The program serves people with persistent mental disorders who have serious social or family problems and/or who have inadequate mental health service use (high use of inpatient services, no use of community services). The ISP-SMD is a community intervention program that focuses its activities on direct care and coordination between services. Thirty patients have been included in the evaluation. The results of the pilot study have shown that, compared to the year before entering the program, the patients show better clinical status, they decrease their unmet need level, they have more appropriate use of health services and have lower treatment costs. Satisfaction of the patients, family members and professionals with the program is very high. It is possible to adapt and implement case management services in Catalonia. When implemented, they improve patient quality of life.

[Educative programs based on self-management: an integrative review].

Science.gov (United States)

Nascimento, Luciana da Silva; de Gutierrez, Maria Gaby Rivero; De Domenico, Edvane Birelo Lopes

2010-06-01

The objective was to identify definitions and/or explanations of the term self-management in educative programs that aim its development. The authors also aimed to describe the educative plans and results of the educative programs analyzed. As a methodology we used integrative review, with 15 published articles (2002 the 2007). The inclusion criteria was: the occurrence of the term self-management; the existence of an educative program for the development of self-management; to be related to the area of the health of the adult. Self-management means the improvement or acquisition of abilities to solve problems in biological, social and affective scopes. The review pointed to different educational methodologies. However, it also showed the predominance of traditional methods, with conceptual contents and of physiopathological nature. The learning was evaluated as favorable, with warns in relation to the application in different populations and contexts and to the increase of costs of the educative intervention. It was concluded that research has evidenced the importance of the education for self-management, but lacked in strength for not relating the biopsychosocial demands of the chronic patient and for not describing in detail the teaching and evaluation methodologies employed.

Evaluation of Medicare Health Support chronic disease pilot program.

Science.gov (United States)

Cromwell, Jerry; McCall, Nancy; Burton, Joe

2008-01-01

The Medicare Program is conducting a randomized trial of care management services among fee-for-service (FFS) beneficiaries called the Medicare Health Support (MHS) pilot program. Eight disease management (DM) companies have contracted with CMS to improve clinical quality, increase beneficiary and provider satisfaction, and achieve targeted savings for chronically ill Medicare FFS beneficiaries. In this article, we present 6-month intervention results on beneficiary selection and participation rates, mortality rates, trends in hospitalizations, and success in achieving Medicare cost savings. Results to date indicate limited success in achieving Medicare cost savings or reducing acute care utilization.

[The German program for disease management guidelines: evaluation by use of quality indicators].

Science.gov (United States)

Kopp, Ina B; Geraedts, Max; Jäckel, Wilfried H; Altenhofen, Lutz; Thomeczek, Christian; Ollenschläger, Günter

2007-08-15

The Program for National Disease Management Guidelines (German DM-CPG Program) in Germany aims at the implementation of best-practice recommendations for prevention, acute care, rehabilitation and chronic care in the setting of disease management programs and integrated health-care systems. Like other guidelines, DM-CPG need to be assessed regarding their influence on structures, processes and outcomes of care. However, quality assessment in integrated health-care systems is challenging. On the one hand, a multitude of potential domains for measurement, actors and perspectives need to be considered. On the other hand, measures need to be identified that assess the function of the diagnostic and therapeutic chain in terms of cooperation and coordination of care. The article reviews methods and use of quality indicators in the context of the German DM-CPG Program.

Economic effectiveness of disease management programs: a meta-analysis.

Science.gov (United States)

Krause, David S

2005-04-01

The economic effectiveness of disease management programs, which are designed to improve the clinical and economic outcomes for chronically ill individuals, has been evaluated extensively. A literature search was performed with MEDLINE and other published sources for the period covering January 1995 to September 2003. The search was limited to empirical articles that measured the direct economic outcomes for asthma, diabetes, and heart disease management programs. Of the 360 articles and presentations evaluated, only 67 met the selection criteria for meta-analysis, which included 32,041 subjects. Although some studies contained multiple measurements of direct economic outcomes, only one average effect size per study was included in the meta-analysis. Based on the studies included in the research, a meta-analysis provided a statistically significant answer to the question of whether disease management programs are economically effective. The magnitude of the observed average effect size for equally weighted studies was 0.311 (95% CI = 0.272-0.350). Statistically significant differences of effect sizes by study design, disease type and intensity of disease management program interventions were not found after a moderating variable, disease severity, was taken into consideration. The results suggest that disease management programs are more effective economically with severely ill enrollees and that chronic disease program interventions are most effective when coordinated with the overall level of disease severity. The findings can be generalized, which may assist health care policy makers and practitioners in addressing the issue of providing economically effective care for the growing number of individuals with chronic illness.

Financial coping strategies of mental health consumers: managing social benefits.

Science.gov (United States)

Caplan, Mary Ager

2014-05-01

Mental health consumers depend on social benefits in the forms of supplemental security income and social security disability insurance for their livelihood. Although these programs pay meager benefits, little research has been undertaken into how this population makes ends meet. Using a qualitative approach, this study asks what are the financial coping strategies of mental health consumers? Seven approaches were identified: subsidies, cost-effective shopping, budgeting, prioritizing, technology, debt management, and saving money. Results illustrate the resourcefulness of mental health consumers in managing meager social benefits and highlight the need to strengthen community mental health efforts with financial capabilities education.

Web based Health Education, E-learning, for weight management.

Science.gov (United States)

Heetebry, Irene; Hatcher, Myron; Tabriziani, Hossein

2005-12-01

Obesity is a major health problem across the United States and becoming a progressive world wide problem. An overweight person could access the weight management program and develop a personalized weight reduction plan. The customer enters specific data to personalize the program and in the future an artificial intelligence program can evaluate customer behavior and adjust accordingly. This is an on-line program with class room support, offered as back up when desired by the patient.

Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching

Directory of Open Access Journals (Sweden)

Cheryl Dye

2018-04-01

Full Text Available The purpose of the study was to pilot test a model to reduce hospital readmissions and emergency department use of rural, older adults with chronic diseases discharged from home health services (HHS through the use of volunteers. The study’s priority population consistently experiences poorer health outcomes than their urban counterparts due in part to lower socioeconomic status, reduced access to health services, and incidence of chronic diseases. When they are hospitalized for complications due to poorly managed chronic diseases, they are frequently readmitted for the same conditions. This pilot study examines the use of volunteer community members who were trained as Health Coaches to mentor discharged HHS patients in following the self-care plan developed by their HHS RN; improving chronic disease self-management behaviors; reducing risk of falls, pneumonia, and flu; and accessing community resources. Program participants increased their ability to monitor and track their chronic health conditions, make positive lifestyle changes, and reduce incidents of falls, pneumonia and flu. Although differences in the ED and hospital admission rates after discharge from HHS between the treatment and comparison group (matched for gender, age, and chronic condition were not statistically significant, the treatment group’s rate was less than the comparison group thus suggesting a promising impact of the HC program (90 day: 263 comparison vs. 129 treatment; p = 0.65; 180 day 666.67 vs. 290.32; p = 0.19. The community health coach model offers a potential approach for improving the ability of discharged older home health patients to manage chronic conditions and ultimately reduce emergent care.

International collaboration in health promotion and disease management: implications of U.S. health promotion efforts on Japan's health care system.

Science.gov (United States)

Pelletier, Kenneth R

2005-01-01

For more than 25 years, health promotion and disease management interventions have been conducted by large employers in the United States. Today there are more than 100 studies of such multifactorial, comprehensive interventions that all demonstrate positive clinical outcomes. For those interventions that have also been evaluated for return on investment, all but one have demonstrated cost-effectiveness. This article is an evidence-based overview of the clinical and cost outcomes research to elaborate on the insights gained from this research in the areas of implementation and evaluation of such programs; integration of health promotion and disease management programs into conventional, occupational medicine; accessing difficult to reach populations, such as mobile workers, retirees, and/or dependents; areas of potential conflict of interest and privacy/confidentiality issues; health consequences of downsizing and job strain; and, finally, recommendations for improved integration and evaluation of such programs for both clinical and cost outcomes. With medical costs rapidly escalating again on a global scale, these interventions with evidence of both clinical and cost outcomes can provide the foundation to improve the health, performance, and productivity of both individuals and their corporations.

Functioning of primary health care in opinion of managers of primary health care units.

Science.gov (United States)

Bojar, I; Wdowiak, L; Kwiatosz-Muc, M

2006-01-01

The aim of the research is to get to know opinions of primary health care managers concerning working of primary health care and concerning quality of medical services offered by family doctors out-patient clinics. The research among managers of primary health care units took place in all out-patient clinics in Lublin province. Research instrument was survey questionnaire of authors own construction. Results were statistically analyzed. From 460 surveys sent, 108 questionnaires were accepted to analysis. Majority of managers of out-patient clinics of primary health care is satisfied with the way and the quality of work of employed staff. In opinion of 71.3% of managers access to family doctor services is very good. Availability of primary health care services is better estimated by managers of not public units. The occupied local provide comfortable work for the staff in opinion of 78.5% of surveyed managers of out-patient clinics. Managers estimate the level of their services as very good (37.96%) and good (37.96%) comparing to other such a subjects present in the market. Internal program of improving quality is run in 22% of out-patient clinics, which were investigated. Managers of primary health care units assess the quality of their services as good and very good. They estimate positively the comfort and politeness in serving patients as well as technical status of equipment and the lodging. They assess availability of their services as very good. Large group of managers of family doctors practices recognizes neighborhood practices as a competitors.

A suicide awareness and intervention program for health professional students.

Science.gov (United States)

De Silva, Eve; Bowerman, Lisa; Zimitat, Craig

2015-01-01

Many emergency service professionals and health professionals play important roles in the assessment and management of suicide risk but often receive inadequate mental health training in this area. A 'Suicide Awareness and Intervention Program' (SAIP) was developed for first year medical, paramedical and pharmacy students at the University of Tasmania, Australia. The program aimed to increase students' knowledge and awareness about suicide-related issues, develop interpersonal skills around suicide screening and increase awareness of available support services. A 5-hour experiential SAIP was embedded within the curriculum. A pre and post evaluation of knowledge, skills and attitudes was conducted, with an open-ended follow-up survey regarding use of what was learned in the program. Pre and post SAIP surveys showed significant improvement inknowledge and practical skills. Feedback from students and the counselling service indicated enduring impact of the program. Participation in the SAIP increased knowledge, skills and attitudes related to the assessment and management of individuals at risk for suicide, and the application of this ability to students' personal and professional lives.

Intervention mapping protocol for developing a theory-based diabetes self-management education program.

Science.gov (United States)

Song, Misoon; Choi, Suyoung; Kim, Se-An; Seo, Kyoungsan; Lee, Soo Jin

2015-01-01

Development of behavior theory-based health promotion programs is encouraged with the paradigm shift from contents to behavior outcomes. This article describes the development process of the diabetes self-management program for older Koreans (DSME-OK) using intervention mapping (IM) protocol. The IM protocol includes needs assessment, defining goals and objectives, identifying theory and determinants, developing a matrix to form change objectives, selecting strategies and methods, structuring the program, and planning for evaluation and pilot testing. The DSME-OK adopted seven behavior objectives developed by the American Association of Diabetes Educators as behavioral outcomes. The program applied an information-motivation-behavioral skills model, and interventions were targeted to 3 determinants to change health behaviors. Specific methods were selected to achieve each objective guided by IM protocol. As the final step, program evaluation was planned including a pilot test. The DSME-OK was structured as the 3 determinants of the IMB model were intervened to achieve behavior objectives in each session. The program has 12 weekly 90-min sessions tailored for older adults. Using the IM protocol in developing a theory-based self-management program was beneficial in terms of providing a systematic guide to developing theory-based and behavior outcome-focused health education programs.

An international randomized study of a home-based self-management program for severe COPD: the COMET.

Science.gov (United States)

Bourbeau, Jean; Casan, Pere; Tognella, Silvia; Haidl, Peter; Texereau, Joëlle B; Kessler, Romain

2016-01-01

Most hospitalizations and costs related to COPD are due to exacerbations and insufficient disease management. The COPD patient Management European Trial (COMET) is investigating a home-based multicomponent COPD self-management program designed to reduce exacerbations and hospital admissions. Multicenter parallel randomized controlled, open-label superiority trial. Thirty-three hospitals in four European countries. A total of 345 patients with Global initiative for chronic Obstructive Lung Disease III/IV COPD. The program includes extensive patient coaching by health care professionals to improve self-management (eg, develop skills to better manage their disease), an e-health platform for reporting frequent health status updates, rapid intervention when necessary, and oxygen therapy monitoring. Comparator is the usual management as per the center's routine practice. Yearly number of hospital days for acute care, exacerbation number, quality of life, deaths, and costs.

1998 Environmental Management Science Program Annual Report

International Nuclear Information System (INIS)

1999-01-01

The Environmental Management Science Program (EMSP) is a collaborative partnership between the DOE Office of Environmental Management (EM), Office of Science (DOE-SC), and the Idaho Operations Office (DOE-ID) to sponsor basic environmental and waste management related research. Results are expected to lead to reduction of the costs, schedule, and risks associated with cleaning up the nation's nuclear complex. The EMSP research portfolio addresses the most challenging technical problems of the EM program related to high level waste, spent nuclear fuel, mixed waste, nuclear materials, remedial action, decontamination and decommissioning, and health, ecology, or risk. The EMSP was established in response to a mandate from Congress in the fiscal year 1996 Energy and Water Development Appropriations Act. Congress directed the Department to ''provide sufficient attention and resources to longer-term basic science research which needs to be done to ultimately reduce cleanup costs, develop a program that takes advantage of laboratory and university expertise, and seek new and innovative cleanup methods to replace current conventional approaches which are often costly and ineffective''. This mandate followed similar recommendations from the Galvin Commission to the Secretary of Energy Advisory Board. The EMSP also responds to needs identified by National Academy of Sciences experts, regulators, citizen advisory groups, and other stakeholders

Digital health intervention as an adjunct to a workplace health program in hypertension.

Science.gov (United States)

Senecal, Conor; Widmer, R Jay; Johnson, Matthew P; Lerman, Lilach O; Lerman, Amir

2018-05-30

Hypertension is a common and difficult-to-treat condition; digital health tools may serve as adjuncts to traditional pharmaceutical and lifestyle-based interventions. Using a retrospective observational study we sought to evaluate the effect of a desktop and mobile digital health intervention (DHI) as an adjunct to a workplace health program in those previously diagnosed with hypertension. As part of a workplace health program, 3330 patients were identified as previously diagnosed with hypertension. A DHI was made available to participants providing motivational and educational materials assisting in the management of hypertension. We evaluated changes in blood pressure, weight, and body mass index (BMI) between users and nonusers based on login frequency to the DHI using multivariate regression through the five visits over the course of 1 year. One thousand six hundred twenty-two (49%) participants logged into the application at least once. DHI users had significant greater improvements in systolic blood pressure (SBP; -2.79 mm Hg), diastolic blood pressure (-2.12 mm Hg), and BMI (-0.23 kg/m 2 ) at 1 year. Increased login frequency was significantly correlated with reductions in SBP, diastolic blood pressure, weight, and BMI (P ≤ .014). This large, observational study provides evidence that a DHI as an adjunct to a workplace health program is associated with greater improvement in blood pressure and BMI at 1 year. This study adds to the growing body of evidence that DHIs may be useful in augmenting the treatment of hypertension in addition to traditional management with pharmaceuticals and lifestyle changes. Copyright © 2018 American Heart Association. Published by Elsevier Inc. All rights reserved.

An Innovative Program in the Science of Health Care Delivery: Workforce Diversity in the Business of Health.

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Essary, Alison C; Wade, Nathaniel L

2016-01-01

According to the most recent statistics from the National Center for Education Statistics, disparities in enrollment in undergraduate and graduate education are significant and not improving commensurate with the national population. Similarly, only 12% of graduating medical students and 13% of graduating physician assistant students are from underrepresented racial and ethnic groups. Established in 2012 to promote health care transformation at the organization and system levels, the School for the Science of Health Care Delivery is aligned with the university and college missions to create innovative, interdisciplinary curricula that meet the needs of our diverse patient and community populations. Three-year enrollment trends in the program exceed most national benchmarks, particularly among students who identify as Hispanic and American Indian/Alaska Native. The Science of Health Care Delivery program provides students a seamless learning experience that prepares them to be solutions-oriented leaders proficient in the business of health care, change management, innovation, and data-driven decision making. Defined as the study and design of systems, processes, leadership and management used to optimize health care delivery and health for all, the Science of Health Care Delivery will prepare the next generation of creative, diverse, pioneering leaders in health care.

Effect of Medicaid disease management programs on emergency admissions and inpatient costs.

Science.gov (United States)

Conti, Matthew S

2013-08-01

To determine the impact of state Medicaid diabetes disease management programs on emergency admissions and inpatient costs. National InPatient Sample sponsored by the Agency for Healthcare Research and Quality Project for the years from 2000 to 2008 using 18 states. A difference-in-difference methodology compares costs and number of emergency admissions for Washington, Texas, and Georgia, which implemented disease management programs between 2000 and 2008, to states that did not undergo the transition to managed care (N = 103). Costs and emergency admissions were extracted for diabetic Medicaid enrollees diagnosed in the reform and non-reform states and collapsed into state and year cells. In the three treatment states, the implementation of disease management programs did not have statistically significant impacts on the outcome variables when compared to the control states. States that implemented disease management programs did not achieve improvements in costs or the number of emergency of admissions; thus, these programs do not appear to be an effective way to reduce the burden of this chronic disease. © Health Research and Educational Trust.

[The German program for disease management guidelines. Background, methods, and development process].

Science.gov (United States)

Ollenschläger, Günter; Kopp, Ina; Lelgemann, Monika; Sänger, Sylvia; Heymans, Lothar; Thole, Henning; Trapp, Henrike; Lorenz, Wilfried; Selbmann, Hans-Konrad; Encke, Albrecht

2006-10-15

The Program for National Disease Management Guidelines (German DM-CPG Program) was established in 2002 by the German Medical Association (umbrella organization of the German Chambers of Physicians) and joined by the Association of the Scientific Medical Societies (AWMF; umbrella organization of more than 150 professional societies) and by the National Association of Statutory Health Insurance Physicians (NASHIP) in 2003. The program provides a conceptual basis for disease management, focusing on high-priority health-care topics and aiming at the implementation of best practice recommendations for prevention, acute care, rehabilitation and chronic care. It is organized by the German Agency for Quality in Medicine, a founding member of the Guidelines International Network (G-I-N). The main objective of the German DM-CPG Program is to establish consensus of the medical professions on evidence-based key recommendations covering all sectors of health-care provision and facilitating the coordination of care for the individual patient through time and across interfaces. Within the last year, DM-CPGs have been published for asthma, chronic obstructive pulmonary disease, type 2 diabetes, and coronary heart disease. In addition, experts from national patient self-help groups have been developing patient guidance based upon the recommendations for health-care providers. The article describes background, methods, and tools of the DM-CPG Program, and is the first of a publication series dealing with innovative recommendations and aspects of the program.

Standardising the Lay: Logics of Change in Programs of Disease Self-management

Directory of Open Access Journals (Sweden)

Annegrete Juul Nielsen

2012-11-01

Full Text Available The health political discourse on self-care is dominated by the view that the selfmanaging patient represents a more democratic and patient-centric perspective, as he or she is believed to renegotiate the terms on which patient participation in health care has hitherto taken place. The self-managing patient is intended as a challenge to traditional medical authority by introducing lay methods of knowing disease. Rather than a meeting between authoritative professionals and vulnerable patients, the self-managing patient seeks to open up new spaces for a meeting between experts. The present paper questions these assumptions through an ethnographic exploration of a patient-led self-management program called the Chronic Disease Self-Management Program. The program is concerned with what its developers call the social and mental aspects of living with a chronic disease and uses trained patients as role models and program leaders. Drawing inspiration from Annemarie Mol’s term ‘logic’, we explore the rationale of ‘situations of selfmanagement’ and identify what we call a ‘logic of change’, which involves very specific ideas on how life with a chronic condition should be dealt with and directs attention towards particular manageable aspects of life with a chronic condition. This logic of change entails, we argue, a clash not between ‘medical’ and ‘lay’ forms of knowledge but between different logics or perceptions of how transformation can be achieved: through open-ended and ongoing reflection and experimentation in social settings or through standardised trajectories of change. Returning to the literature on lay forms of knowledge and illness perspectives, we question whether programs such as the Chronic Disease Self-Management Program – despite its apparent patient-centric perspective – reproduces classical hierarchical relations between lay and expert knowledge, albeit in new forms.

Effect of Workplace Weight Management on Health Care Expenditures and Quality of Life.

Science.gov (United States)

Michaud, Tzeyu L; Nyman, John A; Jutkowitz, Eric; Su, Dejun; Dowd, Bryan; Abraham, Jean M

2016-11-01

We examined the effectiveness of the weight management program used by the University of Minnesota in reducing health care expenditures and improving quality of life of its employees, and also in reducing their absenteeism during a 3-year intervention. A differences-in-differences regression approach was used to estimate the effect of weight management participation. We further applied ordinary least squares regression models with fixed effects to estimate the effect in an alternative analysis. Participation in the weight management program significantly reduced health care expenditures by $69 per month for employees, spouses, and dependents, and by $73 for employees only. Quality-of-life weights were 0.0045 points higher for participating employees than for nonparticipating ones. No significant effect was found for absenteeism. The workplace weight management used by the University of Minnesota reduced health care expenditures and improved quality of life.

Healthcare organization-education partnerships and career ladder programs for health care workers.

Science.gov (United States)

Dill, Janette S; Chuang, Emmeline; Morgan, Jennifer C

2014-12-01

Increasing concerns about quality of care and workforce shortages have motivated health care organizations and educational institutions to partner to create career ladders for frontline health care workers. Career ladders reward workers for gains in skills and knowledge and may reduce the costs associated with turnover, improve patient care, and/or address projected shortages of certain nursing and allied health professions. This study examines partnerships between health care and educational organizations in the United States during the design and implementation of career ladder training programs for low-skill workers in health care settings, referred to as frontline health care workers. Mixed methods data from 291 frontline health care workers and 347 key informants (e.g., administrators, instructors, managers) collected between 2007 and 2010 were analyzed using both regression and fuzzy-set qualitative comparative analysis (QCA). Results suggest that different combinations of partner characteristics, including having an education leader, employer leader, frontline management support, partnership history, community need, and educational policies, were necessary for high worker career self-efficacy and program satisfaction. Whether a worker received a wage increase, however, was primarily dependent on leadership within the health care organization, including having an employer leader and employer implementation policies. Findings suggest that strong partnerships between health care and educational organizations can contribute to the successful implementation of career ladder programs, but workers' ability to earn monetary rewards for program participation depends on the strength of leadership support within the health care organization. Copyright © 2014 Elsevier Ltd. All rights reserved.

Social Determinants of Health in Managed Care Payment Formulas.

Science.gov (United States)

Ash, Arlene S; Mick, Eric O; Ellis, Randall P; Kiefe, Catarina I; Allison, Jeroan J; Clark, Melissa A

2017-10-01

Managed care payment formulas commonly allocate more money for medically complex populations, but ignore most social determinants of health (SDH). To add SDH variables to a diagnosis-based payment formula that allocates funds to managed care plans and accountable care organizations. Using data from MassHealth, the Massachusetts Medicaid and Children's Health Insurance Program, we estimated regression models predicting Medicaid spending using a diagnosis-based and SDH-expanded model, and compared the accuracy of their cost predictions overall and for vulnerable populations. MassHealth members enrolled for at least 6 months in 2013 in fee-for-service (FFS) programs (n = 357 660) or managed care organizations (MCOs) (n = 524 607). We built cost prediction models from a fee-for-service program. Predictors in the diagnosis-based model are age, sex, and diagnoses from claims. The SDH model adds predictors describing housing instability, behavioral health issues, disability, and neighborhood-level stressors. Overall model explanatory power and overpayments and underpayments for subgroups of interest for all Medicaid-reimbursable expenditures excepting long-term support services (mean annual cost = $5590 per member). We studied 357 660 people who were FFS participants and 524 607 enrolled in MCOs with a combined 806 889 person-years of experience. The FFS program experience included more men (49.6% vs 43.6%), older patients (mean age of 26.1 years vs 21.6 years), and sicker patients (mean morbidity score of 1.16 vs 0.89) than MCOs. Overall, the SDH model performed well, but only slightly better than the diagnosis-based model, explaining most of the spending variation in the managed care population (validated R2 = 62.4) and reducing underpayments for several vulnerable populations. For example, raw costs for the quintile of people living in the most stressed neighborhoods were 9.6% ($537 per member per year) higher than average. Since greater

77 FR 43127 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2013

Science.gov (United States)

2012-07-23

... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... determination of the States that qualify as Medically Underserved Areas under the Federal Employees Health... law that mandates special consideration for enrollees of certain FEHB plans who receive covered health...

78 FR 50119 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2014

Science.gov (United States)

2013-08-16

... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... determination of the states that qualify as Medically Underserved Areas under the Federal Employees Health... law that mandates special consideration for enrollees of certain FEHB plans who receive covered health...

Nevada Risk Assessment/Management Program scientific peer review

International Nuclear Information System (INIS)

Bentz, E.J. Jr.; Bentz, C.B.; O'Hora, T.D.; Chen, S.Y.

1997-01-01

The 1,350 square-mile Nevada Test Site and additional sites in Nevada served as the continental sites for US nuclear weapons testing from 1951 to 1992. The Nevada Risk Assessment/Management Program (NRAMP) is a currently on-going effort of the Harry Reid Center for Environmental Studies at the University of Nevada, Las Vegas (UNLV) and the firm of E. J. Bentz and Associates, Inc., in cooperation with the US Department of Energy (DOE) Environmental Management Program. Argonne National Laboratory is one of several public and private organizations supporting personnel appointed by the NRAMP to the NRAMP Scientific Peer Review Panel. The NRAMP is part of a national effort by the DOE to develop new sources of information and approaches to risk assessment, risk management, risk communication, and public outreach relevant to the ecological and human health effects of radioactive and hazardous materials management and site remediation activities. This paper describes the development, conduct, and current results of the scientific peer review process which supports the goals of the NRAMP

A mixed methods inquiry: How dairy farmers perceive the value(s of their involvement in an intensive dairy herd health management program

Directory of Open Access Journals (Sweden)

Kristensen Erling

2008-12-01

Full Text Available Abstract Background Research has been scarce when it comes to the motivational and behavioral sides of farmers' expectations related to dairy herd health management programs. The objectives of this study were to explore farmers' expectations related to participation in a health management program by: 1 identifying important ambitions, goals and subjective well-being among farmers, 2 submitting those data to a quantitative analysis thereby characterizing perspective(s of value added by health management programs among farmers; and 3 to characterize perceptions of farmers' goals among veterinarians. Methods The subject was initially explored by means of literature, interviews and discussions with farmers, herd health management consultants and researchers to provide an understanding (a concourse of the research entity. The concourse was then broken down into 46 statements. Sixteen Danish dairy farmers and 18 veterinarians associated with one large nationwide veterinary practice were asked to rank the 46 statements that defined the concourse. Next, a principal component analysis was applied to identify correlated statements and thus families of perspectives between respondents. Q-methodology was utilized to represent each of the statements by one row and each respondent by one column in the matrix. A subset of the farmers participated in a series of semi-structured interviews to face validate the concourse and to discuss subjects like animal welfare, veterinarians' competences as experienced by the farmers and time constraints in the farmers' everyday life. Results Farmers' views could be described by four families of perspectives: Teamwork, Animal welfare, Knowledge dissemination, and Production. Veterinarians believed that farmers' primary focus was on production and profit, however, farmers' valued teamwork and animal welfare more. Conclusion The veterinarians in this study appear to focus too much on financial performance and increased

A mixed methods inquiry: How dairy farmers perceive the value(s) of their involvement in an intensive dairy herd health management program.

Science.gov (United States)

Kristensen, Erling; Enevoldsen, Carsten

2008-12-18

Research has been scarce when it comes to the motivational and behavioral sides of farmers' expectations related to dairy herd health management programs. The objectives of this study were to explore farmers' expectations related to participation in a health management program by: 1) identifying important ambitions, goals and subjective well-being among farmers, 2) submitting those data to a quantitative analysis thereby characterizing perspective(s) of value added by health management programs among farmers; and 3) to characterize perceptions of farmers' goals among veterinarians. The subject was initially explored by means of literature, interviews and discussions with farmers, herd health management consultants and researchers to provide an understanding (a concourse) of the research entity. The concourse was then broken down into 46 statements. Sixteen Danish dairy farmers and 18 veterinarians associated with one large nationwide veterinary practice were asked to rank the 46 statements that defined the concourse. Next, a principal component analysis was applied to identify correlated statements and thus families of perspectives between respondents. Q-methodology was utilized to represent each of the statements by one row and each respondent by one column in the matrix. A subset of the farmers participated in a series of semi-structured interviews to face validate the concourse and to discuss subjects like animal welfare, veterinarians' competences as experienced by the farmers and time constraints in the farmers' everyday life. Farmers' views could be described by four families of perspectives: Teamwork, Animal welfare, Knowledge dissemination, and Production. Veterinarians believed that farmers' primary focus was on production and profit, however, farmers' valued teamwork and animal welfare more. The veterinarians in this study appear to focus too much on financial performance and increased production when compared to most of the participating farmers

Assessing the Effect of a Personal Health Management System Within Retirement Communities: A Preliminary Investigation.

Science.gov (United States)

Slivinske, Lee R.; Kosberg, Jordan I.

1984-01-01

Describes a holistic health care program (Personal Health Management System) initiated within several retirement communities. Initial findings suggested that program participants experienced significant increases in their health and well-being while nonequivalent control group subjects did not. Conceptual and methodological issues are discussed.…

The Role of Consumer-Controlled Personal Health Management Systems in the Evolution of Employer-Based Health Care Benefits.

Science.gov (United States)

Jones, Spencer S; Caloyeras, John; Mattke, Soeren

2011-01-01

The passage of the Patient Protection and Affordable Care Act has piqued employers' interest in new benefit designs because it includes numerous provisions that favor cost-reducing strategies, such as workplace wellness programs, value-based insurance design (VBID), and consumer-directed health plans (CDHPs). Consumer-controlled personal health management systems (HMSs) are a class of tools that provide encouragement, data, and decision support to individuals. Their functionalities fall into the following three categories: health information management, promotion of wellness and healthy lifestyles, and decision support. In this study, we review the evidence for many of the possible components of an HMS, including personal health records, web-based health risk assessments, integrated remote monitoring data, personalized health education and messaging, nutrition solutions and physical activity monitoring, diabetes-management solutions, medication reminders, vaccination and preventive-care applications, integrated incentive programs, social-networking tools, comparative data on price and value of providers, telehealth consultations, virtual coaching, and an integrated nurse hotline. The value of the HMS will be borne out as employers begin to adopt and implement these emerging technologies, enabling further assessment as their benefits and costs become better understood.

14 CFR 1214.1706 - Program management.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Program management. 1214.1706 Section 1214... Participants § 1214.1706 Program management. The Associate Administrator for Space Flight is responsible for program management under the direction of the Committee chairperson. ...

Physicians in health care management: 2. Managing performance: who, what, how and when?

OpenAIRE

Lemieux-Charles, L

1994-01-01

Physicians are becoming more involved in performance management as hospitals restructure to increase effectiveness. Although physicians are not hospital employees, they are subject to performance appraisals because the hospitals are accountable to patients and the community for the quality of hospital services. The performance of a health care professional may be appraised by the appropriate departmental manager, by other professionals in a team or program or by peers, based on prior agreemen...

Communicating Risk to Program Managers

Science.gov (United States)

Shivers, C. Herbert

2005-01-01

Program Managers (PM) can protect program resources and improve chances of success by anticipating, understanding and managing risks. Understanding the range of potential risks helps one to avoid or manage the risks. A PM must choose which risks to accept to reduce fire fighting, must meet the expectations of stakeholders consistently, and avoid falling into costly "black holes" that may open. A good risk management process provides the PM more confidence to seize opportunities save money, meet schedule, even improve relationships with people important to the program. Evidence of managing risk and sound internal controls can mean better support from superiors for the program by building a trust and reputation from being on top of issues. Risk managers have an obligation to provide the PM with the best information possible to allow the benefits to be realized (Small Business Consortium, 2004). The Institute for Chartered Accountants in England and Wales sees very important benefits for companies in providing better information about what they do to assess and manage key business risks. Such information will: a) provide practical forward-looking information; b) reduce the cost of capital; c) encourage better risk management; and d) improve accountability for stewardship, investor protection and the usefulness of financial reporting. We are particularly convinced that enhanced risk reporting will help listed companies obtain capital at the lowest possible cost (The Institute of Chartered Accountants in England &Wales, June 2002). Risk managers can take a significant role in quantifying the success of their department and communicating those figures to executive (program) management levels while pushing for a broader risk management role. Overall, risk managers must show that risk management work matters in the most crucial place-the bottom line- as they prove risk management can be a profit center (Sullivan, 2004).

Intelligent Vehicle Health Management

Science.gov (United States)

Paris, Deidre E.; Trevino, Luis; Watson, Michael D.

2005-01-01

As a part of the overall goal of developing Integrated Vehicle Health Management systems for aerospace vehicles, the NASA Faculty Fellowship Program (NFFP) at Marshall Space Flight Center has performed a pilot study on IVHM principals which integrates researched IVHM technologies in support of Integrated Intelligent Vehicle Management (IIVM). IVHM is the process of assessing, preserving, and restoring system functionality across flight and ground systems (NASA NGLT 2004). The framework presented in this paper integrates advanced computational techniques with sensor and communication technologies for spacecraft that can generate responses through detection, diagnosis, reasoning, and adapt to system faults in support of INM. These real-time responses allow the IIVM to modify the affected vehicle subsystem(s) prior to a catastrophic event. Furthermore, the objective of this pilot program is to develop and integrate technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce costs of operations. Recent investments in avionics, health management, and controls have been directed towards IIVM. As this concept has matured, it has become clear the INM requires the same sensors and processing capabilities as the real-time avionics functions to support diagnosis of subsystem problems. New sensors have been proposed, in addition, to augment the avionics sensors to support better system monitoring and diagnostics. As the designs have been considered, a synergy has been realized where the real-time avionics can utilize sensors proposed for diagnostics and prognostics to make better real-time decisions in response to detected failures. IIVM provides for a single system allowing modularity of functions and hardware across the vehicle. The framework that supports IIVM consists of 11 major on-board functions necessary to fully manage a space vehicle maintaining crew safety and mission

Quality Management Program

International Nuclear Information System (INIS)

1991-10-01

According to section 35.32, ''Quality Management Program,'' of 10 CFR Part 35, ''Medical Use of Byproduct Material,'' applicants or licensees, as applicable, are required to establish a quality management (QM) program. This regulatory guide provides guidance to licensees and applicants for developing policies and procedures for the QM program. This guide does not restrict or limit the licensee from using other guidance that may be equally useful in developing a QM program, e.g., information available from the Joint Commission on Accreditation of Healthcare Organizations or the American College of Radiology. Any information collection activities mentioned in this regulatory guide are contained as requirements in 10 CFR Part 35, which provides the regulatory basis for this guide. This information collection requirements in 10 CFR Part 35 have been cleared under OMB Clearance No. 3150-0010

Guide to safe work : fatigue management : an employer's guide to designing and implementing a fatigue management program. 2 ed.

Energy Technology Data Exchange (ETDEWEB)

NONE

2007-02-15

The impacts of fatigue on workplace safety are now commonly recognized. Many employers now wish to include fatigue management as part of their overall health and safety programs. This guide to fatigue management was written to help companies in the petroleum industry design and implement effective fatigue management programs that reduce incidents and injuries among employees. The guide provided information about workplace fatigue and discussed fatigue management issues and strategies. It was suggested that workplace culture can play a significant role in managing fatigue by allowing fatigue factors to be quickly recognized and managed. Employers who wish to build fatigue management programs should involve all levels of employees, and should consider all workplace practices and procedures. Consideration must also be given to the development of employee competency in managing fatigue. The guide included step-by-step recommendations for implementing a fatigue management program. It was concluded that the benefits of fatigue management include reduced worker absence and turnover, as well as avoiding the costs of safety incidents. 1 tab., 1 fig.

10 CFR 800.002 - Program management.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Program management. 800.002 Section 800.002 Energy DEPARTMENT OF ENERGY LOANS FOR BID OR PROPOSAL PREPARATION BY MINORITY BUSINESS ENTERPRISES SEEKING DOE CONTRACTS AND ASSISTANCE General § 800.002 Program management. Program management responsibility for...

30 CFR 401.12 - Program management.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Program management. 401.12 Section 401.12 Mineral Resources GEOLOGICAL SURVEY, DEPARTMENT OF THE INTERIOR STATE WATER RESEARCH INSTITUTE PROGRAM Application and Management Procedures § 401.12 Program management. (a) Upon approval of each fiscal year's...

30 CFR 402.13 - Program management.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Program management. 402.13 Section 402.13... WATER-RESOURCES TECHNOLOGY DEVELOPMENT PROGRAM Application, Evaluation, and Management Procedures § 402.13 Program management. (a) After the conclusion of negotiations, the USGS will transmit a grant or...

Health and safety information program for hazardous materials

International Nuclear Information System (INIS)

O'Brien, M.P.; Fallon, N.J.; Kuehner, A.V.

1979-01-01

The system is used as a management tool in several safety and health programs. It is used to: trace the use of hazardous materials and to determine monitoring needs; inform the occupational physician of the potential health problems associated with materials ordered by a given individual; inform the fire and rescue group of hazardous materials in a given building; provide waste disposal recommendations to the hazardous waste management group; assist the hazardous materials shipping coordinator in identifying materials which are regulated by the Department of Transportation; and guide management decisions in the area of recognizing and rectifying unsafe conditions. The information system has been expanded from a manual effort to provide a brief description of health hazards of chemicals used at the lab to a computerized health and safety information system which serves the needs of all personnel who may encounter the material in the course of their work. The system has been designed to provide information needed to control the potential problems associated with a hazardous material up to the time that it is consumed in a given operation or is sent to the waste disposal facility

The Medicare Health Outcomes Survey program: Overview, context, and near-term prospects

Directory of Open Access Journals (Sweden)

Miller Nancy A

2004-07-01

Full Text Available Abstract In 1996, the Centers for Medicare & Medicaid Services (CMS initiated the development of the Medicare Health Outcomes Survey (HOS. It is the first national survey to measure the quality of life and functional health status of Medicare beneficiaries enrolled in managed care. The program seeks to gather valid and reliable health status data in Medicare managed care for use in quality improvement activities, public reporting, plan accountability and improving health outcomes based on competition. The context that led to the development of the HOS was formed by the convergence of the following factors: 1 a recognized need to monitor the performance of managed care plans, 2 technical expertise and advancement in the areas of quality measurement and health outcomes assessment, 3 the existence of a tested functional health status assessment tool (SF-36®1, which was valid for an elderly population, 4 CMS leadership, and 5 political interest in quality improvement. Since 1998, there have been six baseline surveys and four follow up surveys. CMS, working with its partners, performs the following tasks as part of the HOS program: 1 Supports the technical/scientific development of the HOS measure, 2 Certifies survey vendors, 3 Collects Health Plan Employer Data and Information Set(HEDIS®2 HOS data, 4 Cleans, scores, and disseminates annual rounds of HOS data, public use files and reports to CMS, Quality Improvement Organizations (QIOs, Medicare+Choice Organizations (M+COs, and other stakeholders, 5 Trains M+COs and QIOs in the use of functional status measures and best practices for improving care, 6 Provides technical assistance to CMS, QIOs, M+COs and other data users, and 7 Conducts analyses using HOS data to support CMS and HHS priorities. CMS has recently sponsored an evaluation of the HOS program, which will provide the information necessary to enhance the future administration of the program. Information collected to date reveals that the

Predicting changes in hypertension control using electronic health records from a chronic disease management program.

Science.gov (United States)

Sun, Jimeng; McNaughton, Candace D; Zhang, Ping; Perer, Adam; Gkoulalas-Divanis, Aris; Denny, Joshua C; Kirby, Jacqueline; Lasko, Thomas; Saip, Alexander; Malin, Bradley A

2014-01-01

Common chronic diseases such as hypertension are costly and difficult to manage. Our ultimate goal is to use data from electronic health records to predict the risk and timing of deterioration in hypertension control. Towards this goal, this work predicts the transition points at which hypertension is brought into, as well as pushed out of, control. In a cohort of 1294 patients with hypertension enrolled in a chronic disease management program at the Vanderbilt University Medical Center, patients are modeled as an array of features derived from the clinical domain over time, which are distilled into a core set using an information gain criteria regarding their predictive performance. A model for transition point prediction was then computed using a random forest classifier. The most predictive features for transitions in hypertension control status included hypertension assessment patterns, comorbid diagnoses, procedures and medication history. The final random forest model achieved a c-statistic of 0.836 (95% CI 0.830 to 0.842) and an accuracy of 0.773 (95% CI 0.766 to 0.780). This study achieved accurate prediction of transition points of hypertension control status, an important first step in the long-term goal of developing personalized hypertension management plans.

Predicting changes in hypertension control using electronic health records from a chronic disease management program

Science.gov (United States)

Sun, Jimeng; McNaughton, Candace D; Zhang, Ping; Perer, Adam; Gkoulalas-Divanis, Aris; Denny, Joshua C; Kirby, Jacqueline; Lasko, Thomas; Saip, Alexander; Malin, Bradley A

2014-01-01

Objective Common chronic diseases such as hypertension are costly and difficult to manage. Our ultimate goal is to use data from electronic health records to predict the risk and timing of deterioration in hypertension control. Towards this goal, this work predicts the transition points at which hypertension is brought into, as well as pushed out of, control. Method In a cohort of 1294 patients with hypertension enrolled in a chronic disease management program at the Vanderbilt University Medical Center, patients are modeled as an array of features derived from the clinical domain over time, which are distilled into a core set using an information gain criteria regarding their predictive performance. A model for transition point prediction was then computed using a random forest classifier. Results The most predictive features for transitions in hypertension control status included hypertension assessment patterns, comorbid diagnoses, procedures and medication history. The final random forest model achieved a c-statistic of 0.836 (95% CI 0.830 to 0.842) and an accuracy of 0.773 (95% CI 0.766 to 0.780). Conclusions This study achieved accurate prediction of transition points of hypertension control status, an important first step in the long-term goal of developing personalized hypertension management plans. PMID:24045907

20 CFR 638.800 - Program management.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Program management. 638.800 Section 638.800... TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Administrative Provisions § 638.800 Program management. (a) The Job Corps Director shall establish and use internal program management procedures sufficient...

Environmental Restoration Program Management Control Plan

International Nuclear Information System (INIS)

1991-09-01

This Management Control Plan has been prepared to define the Energy Systems approach to managing its participation in the US DOE's Environmental Restoration (ER) Program in a manner consistent with DOE/ORO 931: Management Plan for the DOE Field Office, Oak Ridge, Decontamination and Decommissioning Program; and the Energy Systems Environmental Restoration Contract Management Plan (CMP). This plan discusses the systems, procedures, methodology, and controls to be used by the program management team to attain these objectives

Disability management: the application of preventive measures, health promotion and case management in Italy.

Science.gov (United States)

La Torre, G; De Giusti, M; Mannocci, A; De Waure, C; Agostinelli, A; Schena, S; Capelli, G; Ricciardi, W; Boccia, A; Damiani, G; von Pinoci, M; Fanton, C; Federico, B

2009-03-01

Disability Management can be defined as a practice to improve workers' health and to reduce the impact and costs of disability. The aim of the study was to estimate the diffusion of DM in Italian companies. A survey was conducted using a questionnaire, the Worksite Disability Management Audit. The questionnaire was structured into five parts addressing the following domains: 1) characteristics of the company; 2) health promotion activities; 3) preventive measures; 4) case management; 5) disability management. We selected public and private companies and collected information by direct interview. Twenty companies entered the survey. Twelve Companies (60%) indicated that health promotion programs and sensibilisation campaigns are usually carried out. The presence of an individual who provided workplace safety indications and materials was stated by 19 companies (95%). Periodical medical examinations are carried out by 19 companies (95%); 16 (80%) have an evaluation process for ergonomics concerns. Risk assessment and analysis are performed by all companies and the security procedures and policies are updated at least once in a year in 40% of cases. Health status monitoring of injured workers is performed in eight (40%) of the companies, while Disability Management is present as a whole in only three companies. This survey highlights that Disability Management is not undertaken in most companies and that, where applied, there is still confusion and disorganization about ways to promote health and manage workers' illness and disability. Hence, there is still the need to promote an all-inclusive evaluation and management of workers' safety, illness and disabilities.

National Synchrotron Light Source Facility Manual Maintenance Management Program. Revision 1

Energy Technology Data Exchange (ETDEWEB)

Fewell, N.

1993-12-01

The purpose of this program s to meet the policy and objectives for the management and performance of cost-effective maintenance and repair of the National Synchrotron Light Source, as required by the US Department of Energy order DOE 433O.4A. It is the DOE`s policy that: The maintenance management program for the NSLS be consistent with this Order and that NSLS property is maintained in a manner which promotes operational safety, worker health, environmental protection and compliance, property preservation, and cost-effectiveness while meeting the NSLS`s programmatic mission. Structures, components and systems (active and passive) that are imporant to safe operation of the NSLS shall be subject to a maintenance program to ensure that they meet or exceed their design requirements throughout the life of the NSLS. Periodic examination of structures, systems components and equipment be performed to determine deterioration or technical obsolescence which may threaten performance and/or safety. Primary responsibility, authority, and accountability for the direction and management of the maintenance program at the NSLS reside with the line management assigned direct programmatic responsibility. Budgeting and accounting for maintenance programs are consistent with DOE Orders guidance.

Barriers to Engagement in a Workplace Weight Management Program: A Qualitative Study.

Science.gov (United States)

Clancy, Shayna M; Stroo, Marissa; Schoenfisch, Ashley; Dabrera, Thushani; Østbye, Truls

2018-03-01

To investigate (1) why some participants in a workplace weight management program were more engaged in the program, (2) specific barriers and facilitators for engagement and weight loss, and (3) suggest how workplaces may better engage employees in these programs to improve their effectiveness. Qualitative study (8 focus groups). A large academic university and medical system. Twenty-six (5%) of the 550 employees who participated in a weight management program as part of the Steps to Health study. A trained moderator guided the audio-recorded focus groups. Transcripts were analyzed using the directed content analysis approach. Participants faced numerous barriers to engagement in workplace weight management programs, both within and outside the workplace. Participants viewed the coaches positively and reported that the coaches had a strong influence on their engagement in the program. Participants suggested increased frequency and variety of contact by coaches, on-site group exercise classes, and tailored educational materials. Workplace weight management programs may be improved by being more flexible around participants' schedules and changing needs, by increasing access to affordable, convenient exercise facilities, and by implementing institutional changes that encourage healthy eating and physical activity during the workday. Employers should measure program engagement and solicit participant feedback to ensure that the programs are appropriate and delivered in an optimal manner.

A qualitative evaluation of medication management services in six Minnesota health systems.

Science.gov (United States)

Sorensen, Todd D; Pestka, Deborah; Sorge, Lindsay A; Wallace, Margaret L; Schommer, Jon

2016-03-01

The initiation, establishment, and sustainability of medication management programs in six Minnesota health systems are described. Six Minnesota health systems with well-established medication management programs were invited to participate in this study: Essentia Health, Fairview Health Services, HealthPartners, Hennepin County Medical Center, Mayo Clinic, and Park Nicollet Health Services. Qualitative methods were employed by conducting group interviews with key staff from each institution who were influential in the development of medication management services within their organization. Kotter's theory of eight steps for leading organizational change served as the framework for the question guide. The interviews were audio recorded, transcribed, and analyzed for recurring and emergent themes. A total of 13 distinct themes were associated with the successful integration of medication management services across the six healthcare systems. Identified themes clustered within three stages of Kotter's model for leading organizational change: creating a climate for change, engaging and enabling the whole organization, and implementing and sustaining change. The 13 themes included (1) external influences, (2) pharmacists as an untapped resource, (3) principles and professionalism, (4) organizational culture, (5) momentum champions, (6) collaborative relationships, (7) service promotion, (8) team-based care, (9) implementation strategies, (10) overcoming challenges, (11) supportive care model process, (12) measuring and reporting results, and (13) sustainability strategies. A qualitative survey of six health systems that successfully implemented medication management services in ambulatory care clinics revealed that a supportive culture and team-based collaborative care are among the themes identified as necessary for service sustainability. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

The Role of Managers in Employee Wellness Programs: A Mixed-Methods Study.

Science.gov (United States)

Passey, Deborah G; Hammerback, Kristen; Huff, Aaron; Harris, Jeffrey R; Hannon, Peggy A

2018-01-01

The purpose of this study is to evaluate managers' barriers and facilitators to supporting employee participation in the Washington State Wellness program. Exploratory sequential mixed methods. Four Washington State agencies located in Olympia and Tumwater, Washington. State employees in management positions (executive, middle, and line), whose job includes supervision of subordinates and responsibility for the performance and conduct of a subunit or group. We interviewed 23 managers and then used the results to create a survey that was fielded to all managers at the 4 agencies. The survey response rate was 65% (n = 607/935). We used qualitative coding techniques to analyze interview transcripts and descriptive statistics to summarize survey data. We used the Total Worker Health framework to organize our findings and conclusions. Managers support the wellness program, but they also face challenges with accommodating employees' participation due to workload, scheduling inflexibility, and self-efficacy to discuss wellness with direct reports. About half the managers receive support from the manager above them, and most have not received training on the wellness program. Our findings point to several strategies that can strengthen managers' role in supporting the wellness program: the provision of training, targeted messages, formal expectations, and encouragement (from the manager above) to support employees' participation.

The NASA risk management program

International Nuclear Information System (INIS)

Buchbinder, B.; Philipson, L.L.

1989-01-01

This paper reports that the NASA Risk Management Program has been established to ensure the appropriate application of risk-based procedures in support of the elimination, reduction, or acceptance of significant safety risks of concern in NASA. The term appropriate is emphasized, in that the particular procedures applied to each given risk are to reflect its character and prioritized importance, the technological and economic feasibility of its treatment. A number of key documents have been produced in support of this implementation. Databases, risk analysis tools, and risk communication procedures requisite to the execution of the risk management functions also are being developed or documented. Several risk management applications have been made and a comprehensive application to a major new NASA program is underway. This paper summarizes the development and current status of the NASA Risk Management Program. Some principal actions that have been carried out in NASA in consonance with the program are noted particularly, and views are presented on the program's likely future directions

Excel 2016 for health services management statistics a guide to solving problems

CERN Document Server

Quirk, Thomas J

2016-01-01

This book shows the capabilities of Microsoft Excel in teaching health services management statistics effectively. Similar to the previously published Excel 2013 for Health Services Management Statistics, this book is a step-by-step exercise-driven guide for students and practitioners who need to master Excel to solve practical health service management problems. If understanding statistics isn’t your strongest suit, you are not especially mathematically-inclined, or if you are wary of computers, this is the right book for you. Excel, a widely available computer program for students and managers, is also an effective teaching and learning tool for quantitative analyses in health service courses. Its powerful computational ability and graphical functions make learning statistics much easier than in years past. However, Excel 2016 for Health Services Management Statistics: A Guide to Solving Practical Problems is the first book to capitalize on these improvements by teaching students and managers how to apply...

Predictors of dropout in the German disease management program for type 2 diabetes.

Science.gov (United States)

Fullerton, Birgit; Erler, Antje; Pöhlmann, Boris; Gerlach, Ferdinand M

2012-01-10

To improve and assess the effectiveness of disease management programs (DMPs), it is critical to understand how many people drop out of disease management programs and why. We used routine data provided by a statutory health insurance fund from the regions North Rhine, North Wurttemberg and Hesse. As part of the German DMP for type 2 diabetes, the insurance fund received regular documentation of all members participating in the program. We followed 10,989 patients who enrolled in the DMP between July 2004 and December 2005 until the end of 2007 to study how many patients dropped out of the program. Dropout was defined based on the discontinuation of program documentation on a particular patient, excluding situations in which the patient died or left the insurance fund. Predictors of dropout, assessed at the time of program enrolment, were explored using logistic regression analysis. 5.5% of the patients dropped out of the disease management program within the observation period. Predictors of dropout at the time of enrolment were: region; retirement status; the number of secondary diseases; presence of a disabling secondary disease; doctor's recommendations to stop smoking or to seek nutritional counselling; and the completion and outcome of the routine foot and eye exams. Different trends of dropout were observed among retired and employed patients: retired patients of old age, who possibly drop out of the program due to other health care priorities and employed people of younger age who have not yet developed many secondary diseases, but were recommended to change their lifestyle. Overall, dropout rates for the German disease management programs for type 2 diabetes were low compared to other studies. Factors assessed at the time of program enrolment were predictive of later dropout and should be further studied to provide information for future program improvements.

[Survey among livestock practices on herd health management and an Internet-based animal health portal in Switzerland].

Science.gov (United States)

von Tavel, L; Buri, S; Witschi, U; Kirchhofer, M

2009-12-01

The importance of herd health management in Switzerland, its implementation by veterinarians as well as their willingness to collaborate within an Internet portal have been assessed by a questionnaire. The portal is meant to serve the genetic evaluation, the veterinary herd health management and the obligation to record treatments; it should be at disposal for all users in form of a central database. For the survey, questionnaires were sent to 784 veterinarians (mixed and livestock practices) in Switzerland. Amongst them, 217 (27.7 %) questionnaires could be evaluated. 125 veterinarians already offer a herd health management service and 147 veterinarians are inclined to collaborate in a central registration of animal health data. In this context, they are interested in an efficient veterinary herd health management program, which will allow direct exchange of data with farmers via an Internet portal. However, they fear a lack of interest of their customers and express some concern regarding data protection. The portal providers must therefore consider the needs of all potential users in order to succeed in this project. At this condition, the veterinarians are prepared to spread herd health management amongst the breeders by means of the animal health portal.

Qualifications and Competencies for Population Health Management Positions: A Content Analysis of Job Postings.

Science.gov (United States)

Meyer, Melanie

2017-12-01

The need for population health management expertise has increased as the health care industry shifts toward value-based care. However, many organizations report hiring gaps as they seek to fill positions. The purpose of this study was to analyze the types of population health management positions for which health care organizations are hiring, including qualifications and competencies required for these positions. A content analysis was conducted on 271 job postings collected during a 2-month period. A typology of qualifications and competencies was developed based on the content analysis. Profiles were generated for the top 5 job title classifications: directors, coordinators, care managers, analysts, and specialists. This study highlights the investment health care organizations are making in population health management and the prominent role these positions are playing in the health care environment today. Many organizations are building out population health management teams resulting in multiple positions at different levels being added. As the market demands competent candidates who are equipped with specialized population health expertise as well as practical experience in program development, technology applications, care management, and analytics, professional education programs will need to adapt curricula to address the required areas. Competencies for specific job title classifications may need further evaluation and refinement over time. Study results can be used by organizations for strategic planning, by educators to target needed qualifications and competencies, and by researchers and policy advisors to assess progress toward value-based care.

Integrating Environmental Management of Asthma into Pediatric Health Care: What Worked and What Still Needs Improvement?

Science.gov (United States)

Roberts, James R; Newman, Nicholas; McCurdy, Leyla E; Chang, Jane S; Salas, Mauro A; Eskridge, Bernard; De Ybarrondo, Lisa; Sandel, Megan; Mazur, Lynnette; Karr, Catherine J

2016-12-01

The National Environmental Education Foundation (NEEF) launched an initiative in 2005 to integrate environmental management of asthma into pediatric health care. This study, a follow-up to a 2013 study, evaluated the program's impact and assessed training results by 5 new faculty champions. We surveyed attendees at training sessions to measure knowledge and the likelihood of asking about and managing environmental triggers of asthma. To conduct the program evaluation, a workshop was held with the faculty champions and NEEF staff in which we identified major program benefits, as well as challenges and suggestions for the future. Trainee baseline knowledge of environmental triggers was low, but they reported robust improvement in environmental triggers knowledge and intention to recommend environmental management. The program has a broad, national scope, reaching more than 12 000 physicians, health care providers, and students, and some faculty champions successfully integrated materials into health record. Program barriers and future endeavors were identified.

Development and Evaluation of Digital Game-Based Training for Managers to Promote Employee Mental Health and Reduce Mental Illness Stigma at Work: Quasi-Experimental Study of Program Effectiveness

Science.gov (United States)

Birner, Ulrich Walter; Oberhauser, Cornelia; Nowak, Dennis; Sabariego, Carla

2017-01-01

Background To counteract the negative impact of mental health problems on business, organizations are increasingly investing in mental health intervention measures. However, those services are often underused, which, to a great extent, can be attributed to fear of stigmatization. Nevertheless, so far only a few workplace interventions have specifically targeted stigma, and evidence on their effectiveness is limited. Objective The objective of this study was to develop and evaluate a digital game-based training program for managers to promote employee mental health and reduce mental illness stigma at work. Methods We describe the empirical development of Leadership Training in Mental Health Promotion (LMHP), a digital game-based training program for leaders. A 1-group pre-post design and a 3-month follow-up were used for training evaluation. We applied multilevel growth models to investigate change over time in the dependent variables knowledge, attitudes, self-efficacy, and intentions to promote employee mental health in 48 managers of a global enterprise in the United Kingdom. Participants were mainly male (44/48, 92%) and ranged in age from 32 to 58 (mean 46.0, SD 7.2) years. Results We found a positive impact of the Web-based training program on managers’ knowledge of mental health and mental illness (Pemployee mental health, which was initially high. Conclusions Results provide first evidence of the effectiveness of LMHP to positively affect managers’ skills to promote employee mental health at work. Furthermore, the high rate of participation in LMHP (48/54, 89%) supports the use of digital game-based interventions to increase user engagement and user experience in mental health programs at work. PMID:28778839

Occupational health, waste management, and environmental research program of the Health Division 1981. Progress report

International Nuclear Information System (INIS)

Voelz, G.L.

1983-09-01

The primary responsibility of the Health Division at the Los Alamos National Laboratory is to provide effective programs in health, safety, waste processing, and environmental protection for the Laboratory. During 1981, evaluations of respiratory protective equipment included 3 special DOE contractor supplied-air suits or hoods and 10 commercial supplied-air devices. Preliminary results of chemical permeation tests of different protective garment materials are reported. Industrial hygiene field studies of oil shale work were conducted at the Geokinetics true in situ facility and the Rio Blanco modified in situ facility. An occupational medical survey of workers at the Geokinetics, Inc., facility was completed. Research on the generation and characterization of aerosols was continued for inhalation studies of man-made mineral fibers and oil shale aerosols. The distribution of 241 Am in a whole body was determined by tissue analyses. Preliminary results of mortality in workers formerly employed at the Rocky Flats plant were reported. A simplified method for the analysis of plutonium in urine has been developed. Instrumentation development resulted in a portable computer system for field data analysis and a small, computerized, wristwatch-style radiation dosimeter. Environmental surveillance at Los Alamos during 1981 showed the highest estimated radiation dose due to Laboratory operations is about 4% of the dose due to the natural radioactivity here. A study was completed on alternative strategies for long-term management of Los Alamos transuranic wastes. A successful 10-day test burn of pentachlorophenol-contaminated wastes was conducted in the Controlled Air Incinerator. Decontamination factors for five fission products in the off-gas handling system of the incinerator were measured

Risk Management for Study Abroad Programs: Issues and Resources to Inform Program Development, Administration, and Training

Science.gov (United States)

Rhodes, Gary

2014-01-01

This chapter provides a practical background to the health and safety risks and challenges for U.S. colleges and universities and other program providers. Potential risks, field-based guidelines, good practices, and resources to support the management of risks by study abroad offices will be covered.

The patient’s voice: an exploratory study of the impact of a group self-management support program

Directory of Open Access Journals (Sweden)

Johnston Sharon

2012-06-01

Full Text Available Abstract Background Given the potential value of self-management support programs for people with chronic diseases, it is vital to understand how they influence participants’ health attitudes and behaviours. The Stanford Chronic Disease Self-Management Program (CDSMP, the most well-known and widely studied such program, is funded in many provinces and jurisdictions throughout Canada. However, there is little published evidence on its impact in the Canadian health-care system. We studied participants’ reactions and perceived impacts of attending the Stanford program in one Ontario health region so we could assess its value to the health region. The study asked: What are participants’ reactions and perceived impacts of attending the Stanford CDSMP? Methods This mixed methods exploratory study held four focus groups approximately one year after participants attended a Stanford program workshop. At the beginning of each session, participants filled out a survey on the type and frequency of community and health resources used for their self-management. During the sessions, a moderator guided the discussion, asking about such things as long-term impact of the program on their lives and barriers to self-management of their chronic conditions. Results Participants perceived diverse effects of the workshop: from having a profound impact on one area to affecting all aspects of their lives. A change in physical activity patterns was the most prominent behaviour change, noted by over half the participants. Other recurrent effects included an improved sense of social connection and better coping skills. Barriers to self-management were experienced by almost all participants with several dominant themes emerging including problems with the health system and patient-physician interaction. Participants reported a wide variety of resources used in their self-management, and in some cases, an increase in use was noted for some resources. Conclusions Self-management

Sport Management Graduate Programs: Characteristics of Effectiveness.

Science.gov (United States)

Li, Ming; And Others

1994-01-01

Reports a study that examined the characteristics that enable graduate sport management programs to achieve their objectives. Surveys of sport management educators found they agreed on 11 characteristics that indicated a sport management program's effectiveness. Respondents believed an effective program should produce sport managers, not…

A couples’ based self-management program for heart failure: Results of a feasibility study

Directory of Open Access Journals (Sweden)

Ranak Trivedi

2016-08-01

Full Text Available Background: Heart failure (HF is associated with frequent exacerbations and shortened lifespan. Informal caregivers such as significant others often support self-management in patients with HF. However, existing programs that aim to enhance self-management seldom engage informal caregivers or provide tools that can help alleviate caregiver burden or improve collaboration between patients and their informal caregivers. Objective: To develop and pilot test a program targeting the needs of self-management support among HF patients as well as their significant others. Methods: We developed the Dyadic Health Behavior Change model and conducted semi-structured interviews to determine barriers to self-management from various perspectives. Participants’ feedback was used to develop a family-centered self-management program called SUCCEED: Self-management Using Couples’ Coping EnhancEment in Diseases. The goals of this program are to improve HF self-management, quality of life, communication within couples, relationship quality, and stress and caregiver burden. We conducted a pilot study with 17 Veterans with HF and their significant others to determine acceptability of the program. We piloted psychosocial surveys at baseline and after participants’ program completion to evaluate change in depressive symptoms, caregiver burden, self-management of HF, communication, quality of relationship, relationship mutuality, and quality of life. Results: Of the 17 couples, 14 completed at least 1 SUCCEED session. Results showed high acceptability for each of SUCCEED’s sessions. At baseline, patients reported poor quality of life, clinically significant depressive symptoms, and inadequate self-management of HF. After participating in SUCCEED, patients showed improvements in self-management of HF, communication, and relationship quality, while caregivers reported improvements in depressive symptoms and caregiver burden. Quality of life of both patients and

Federal Employees Health Benefits Program and Federal Employees Dental and Vision Insurance Program: eligibility for Pathway Programs participants. Interim final rule with request for comments.

Science.gov (United States)

2014-01-06

The U.S. Office of Personnel Management (OPM) is issuing an interim final regulation to update the Federal Employees Health Benefits Program (FEHBP) and the Federal Employees Dental and Vision Insurance Program (FEDVIP) regulations to reflect updated election opportunities for participants in the Pathways Programs. The Pathways Programs were created by Executive Order (E.O.) 13562, signed by the President on December 27, 2010, and are designed to enable the Federal Government to compete effectively for students and recent graduates by improving its recruitment efforts through internships and similar programs with Federal agencies. This interim final rule furthers these recruitment and retention efforts by providing health insurance, as well as dental and vision benefits, to eligible program participants and their families.

Impact of a chronic disease self-management program on health care utilization in rural communities: a retrospective cohort study using linked administrative data.

Science.gov (United States)

Jaglal, Susan B; Guilcher, Sara J T; Hawker, Gillian; Lou, Wendy; Salbach, Nancy M; Manno, Michael; Zwarenstein, Merrick

2014-05-01

Internationally, chronic disease self-management programs (CDSMPs) have been widely promoted with the assumption that confident, knowledgeable patients practicing self-management behavior will experience improved health and utilize fewer healthcare resources. However, there is a paucity of published data supporting this claim and the majority of the evidence is based on self-report. We used a retrospective cohort study using linked administrative health data. Data from 104 tele-CDSMP participants from 13 rural and remote communities in the province of Ontario, Canada were linked to administrative databases containing emergency department (ED) and physician visits and hospitalizations. Patterns of health care utilization prior to and after participation in the tele-CDSMP were compared. Poisson Generalized Estimating Equations regression was used to examine the impact of the tele-CDSMP on health care utilization after adjusting for covariates. There were no differences in patterns of health care utilization before and after participating in the tele-CDSMP. Among participants ≤ 66 years, however, there was a 34% increase in physician visits in the 12 months following the program (OR = 1.34, 95% CI 1.11-1.61) and a trend for decreased ED visits in those >66 years (OR = 0.59, 95% CI 0.33-1.06). This is the first study to examine health care use following participation in the CDSMP in a Canadian population and to use administrative data to measure health care utilization. Similar to other studies that used self-report measures to evaluate health care use we found no differences in health care utilization before and after participation in the CDSMP. Future research needs to confirm our findings and examine the impact of the CDSMP on health care utilization in different age groups to help to determine whether these interventions are more effective with select population groups.

mHealth medication and blood pressure self-management program in Hispanic hypertensives: a proof of concept trial

Directory of Open Access Journals (Sweden)

Sieverdes JC

2013-10-01

Full Text Available John C Sieverdes,1 Mathew Gregoski,1 Sachin Patel,1 Deborah Williamson,1 Brenda Brunner-Jackson,1 Judith Rundbaken,1 Eveline Treiber,1 Lydia Davidson,1 Frank A Treiber1,21Technology Applications Center for Healthful Lifestyles, College of Nursing, 2College of Medicine, Medical University of South Carolina, Charleston, SC, USAAbstract: Patient nonadherence to medication regimens and provider therapeutic inertia (failure to respond in timely manner to clinical data are two primary contributors to ineffective chronic disease management. This 3-month proof of concept trial used an iterative design approach guided by self-determination theory and the technology acceptance model to develop a culturally sensitive, patient-centered, and provider-centered mobile health medication and blood pressure self-management program. Cellular connected electronic medication trays provided reminder signals for patients to take medications and smartphone messaging reminded patients to take at-home blood pressures using a Bluetooth-enabled monitor. Providers were given bimonthly feedback. Motivational and reinforcement text and audio messages were sent based upon medication adherence rates and blood pressure levels. Ten Hispanics with uncontrolled essential hypertension were randomized to standard care and Smartphone Medication Adherence Stops Hypertension (SMASH intervention groups. Primary outcomes of provider and patient acceptability of the program were found to be high. Retention rates for the 3-month program were 100%, with mean ± standard deviation overall medication adherence for the SMASH group at 97.2% ± 2.8%, with all strongly believing the program helped them remember to take their medication. SMASH participants measured their blood pressure every 3 days 83.2% ± 6.0% of the time and completed 89.2% ± 19.06% of the expected readings. Nonparametric tests showed statistical significance for resting blood pressure changes between groups at months 2 (P = 0

Guide for Operational Configuration Management Program including the adjunct programs of design reconstitution and material condition and aging management

International Nuclear Information System (INIS)

1993-11-01

This standard presents program criteria and implementation guidance for an operational configuration management program for DOE nuclear and non-nuclear facilities in the operational phase. Portions of this standard are also useful for other DOE processes, activities, and programs. This Part 1 contains foreword, glossary, acronyms, bibliography, and Chapter 1 on operational configuration management program principles. Appendices are included on configuration management program interfaces, and background material and concepts for operational configuration management

[Chronic Disease Self-management Support for People with a Migrant Background: towards a Peer-led Group Program to Improve Equity in Health].

Science.gov (United States)

Zanoni, S; Gabriel, E; Salis Gross, C; Deppeler, M; Haslbeck, J

2018-03-01

Limited health literacy and language skills are barriers for people with a migrant background (PMB) to access health information and healthcare services, in particular for those living with chronic conditions. During the introduction of a peer-led Stanford chronic disease self-management course in Switzerland, special interest in the program as well as motivation of PMB was observed. In response, we examined if the program can be implemented in German for people with limited language skills. This explorative study is part of the evaluation study on introducing the adapted Stanford program in Switzerland and German-speaking Europe. Following the principles of Grounded Theory, semi-structured focus group and individual interviews were conducted with course participants, leaders and coordinators (n=30) and analyzed thematically. The focus was on the feasibility, satisfaction and course content. In principle, the program seems to have positive value for PMB, may work for them in German, have high relevance for everyday life and give an impetus for social integration. The need for and extent of modification of the program for PMB has to be further explored in order to make it more accessible for vulnerable groups. © Georg Thieme Verlag KG Stuttgart · New York.

Planning for a smooth transition: evaluation of a succession planning program for prospective nurse unit managers.

Science.gov (United States)

Manning, Vicki; Jones, Alan; Jones, Pamela; Fernandez, Ritin S

2015-01-01

The current and projected nurse workforce shortage has created significant pressure on health care organizations to examine their approach to managing talent. This includes the need for strategic development of new formal leaders. This article reports on a succession planning program for prospective nursing unit managers. Eight prospective management candidates participated in a Future Nursing Unit Managers program. The effectiveness of the program was measured through a comparison of pre- and postprogram surveys relating to participants' perception of personal managerial and leadership skills. Significant differences in scores from baseline to 6-month follow-up surveys were observed in the participants' confidence in undertaking the nursing unit manager role and in their management skills. Investment in structured programs to prepare nurses for leadership roles is strongly recommended as a management workforce strategy.

Effects of Medicaid disease management programs on medical expenditures: Evidence from a natural experiment in Georgia.

Science.gov (United States)

Kranker, Keith

2016-03-01

In recent decades, most states' Medicaid programs have introduced disease management programs for chronically ill beneficiaries. Interventions assist beneficiaries and their health care providers to appropriately manage chronic health condition(s) according to established clinical guidelines. Cost containment has been a key justification for the creation of these programs despite mixed evidence they actually save money. This study evaluates the effects of a disease management program in Georgia by exploiting a natural experiment that delayed the introduction of high-intensity services for several thousand beneficiaries. Expenditures for medical claims decreased an average of $89 per person per month for the high- and moderate-risk groups, but those savings were not large enough to offset the total costs of the program. Impacts varied by the intensity of interventions, over time, and across disease groups. Heterogeneous treatment effect analysis indicates that decreases in medical expenditures were largest at the most expensive tail of the distribution. Copyright © 2016 Elsevier B.V. All rights reserved.

Tribal Waste Management Program

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The EPA’s Tribal Waste Management Program encourages environmentally sound waste management practices that promote resource conservation through recycling, recovery, reduction, clean up, and elimination of waste.

20 CFR 632.76 - Program management systems.

Science.gov (United States)

2010-04-01

... management and participant tracking systems in accordance with § 632.32 and § 632.77. The principal... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Program management systems. 632.76 Section... NATIVE AMERICAN EMPLOYMENT AND TRAINING PROGRAMS Program Design and Management § 632.76 Program...

40 CFR 130.11 - Program management.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Program management. 130.11 Section 130... PLANNING AND MANAGEMENT § 130.11 Program management. (a) State agencies may apply for grants under sections 106, 205(j) and 205(g) to carry out water quality planning and management activities. Interstate...

GROUNDWATER PROTECTION MANAGEMENT PROGRAM DESCRIPTION.

Energy Technology Data Exchange (ETDEWEB)

PAQUETTE,D.E.; BENNETT,D.B.; DORSCH,W.R.; GOODE,G.A.; LEE,R.J.; KLAUS,K.; HOWE,R.F.; GEIGER,K.

2002-05-31

THE DEPARTMENT OF ENERGY ORDER 5400.1, GENERAL ENVIRONMENTAL PROTECTION PROGRAM, REQUIRES THE DEVELOPMENT AND IMPLEMENTATION OF A GROUNDWATER PROTECTION PROGRAM. THE BNL GROUNDWATER PROTECTION MANAGEMENT PROGRAM DESCRIPTION PROVIDES AN OVERVIEW OF HOW THE LABORATORY ENSURES THAT PLANS FOR GROUNDWATER PROTECTION, MONITORING, AND RESTORATION ARE FULLY DEFINED, INTEGRATED, AND MANAGED IN A COST EFFECTIVE MANNER THAT IS CONSISTENT WITH FEDERAL, STATE, AND LOCAL REGULATIONS.

Development and Validation of an Online Program for Promoting Self-Management among Korean Patients with Chronic Hepatitis B

Directory of Open Access Journals (Sweden)

Jinhyang Yang

2013-01-01

Full Text Available The hepatitis B virus is second only to tobacco as a known human carcinogen. However, chronic hepatitis B usually does not produce symptoms and people feel healthy even in the early stages of live cancer. Therefore, chronically infected people should perceive it as a serious health problem and move on to appropriate health behaviour. The purpose of this paper is to develop and validate an online program for promoting self-management among Korean patients with chronic hepatitis B. The online program was developed using a prototyping approach and system developing life cycle method, evaluated by users for their satisfaction with the website and experts for the quality of the site. To evaluate the application of the online program, knowledge and self-management compliance of the subjects were measured and compared before and after the application of the online program. There were statistically significant increases in knowledge and self-management compliance in the user group. An online program with high accessibility and applicability including information, motivation, and behavior skill factors can promote self-management of the patient with chronic hepatitis B. Findings from this study allow Korean patients with chronic hepatitis B to engage in proactive and effective health management in the community or clinical practice.

Investing in health information management: The right people, in the right place, at the right time.

Science.gov (United States)

Ayodeji Makinde, Olusesan; Mami, Mohammed Ibrahim; Oweghoro, Benson Macaulay; Oyediran, Kolawole Azeez; Mullen, Stephanie

2016-08-01

To describe the process adopted to review the academic curriculum for training health information management professionals in Nigeria. Health information management professionals are responsible for managing patients' health service records and hospital information systems across health facilities in Nigeria. An assessment found many are inadequately skilled in information and communications technology (ICT) skills believed to be needed for them to play leadership roles in hospital information systems and function effectively. This was traced to a dearth of relevant ICT courses in their academic training curriculum. A review of the curriculum for training health information management professionals was instituted following an agreed need to address these issues. Health records management is evolving across the world including the developing countries. This advancement requires evolution of training programs to meet the increasing application of ICT in this sector. After several sessions, a new curriculum that addresses all the identified educational deficiencies has been developed. It is believed that this step will help improve the quality of training programs. © The Author(s) 2016.

Excel 2013 for health services management statistics a guide to solving practical problems

CERN Document Server

Quirk, Thomas J

2016-01-01

This book shows the capabilities of Microsoft Excel to teach health services management statistics effectively. Similar to the previously published Excel 2010 for Health Services Management Statistics, this book is a step-by-step exercise-driven guide for students and practitioners who need to master Excel to solve practical health services management problems. If understanding statistics isn’t your strongest suit, you are not especially mathematically-inclined, or if you are wary of computers, this is the right book for you. Excel, a widely available computer program for students and managers, is also an effective teaching and learning tool for quantitative analyses in health services management courses. Its powerful computational ability and graphical functions make learning statistics much easier than in years past. However, Excel 2013 for Health Services Management Statistics: A Guide to Solving Practical Problems is the first book to capitalize on these improvements by teaching students and managers ho...

The political economy of a public health case management program's transition into medical homes.

Science.gov (United States)

Wells, Rebecca; Cilenti, Dorothy; Issel, L Michele

2015-11-01

Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent. Published by Elsevier Ltd.

School Health: Findings from Evaluated Programs.

Science.gov (United States)

Public Health Service (DHHS), Rockville, MD. Office of Disease Prevention and Health Promotion.

This publication presents findings from evaluations of many school health programs from across the United States. Each program includes at least one of the following eight components of a comprehensive school health program: health education, clinical services, counseling and mental health services, school environment, school food programs,…

Who's in charge here anyway? Managing the management split in mental health organizations.

Science.gov (United States)

Eilenberg, J; Townsend, E J; Oudens, E

2000-05-01

Most mental health organizations are run by chief executive officers (CEOs) who are not physicians, with medical directors reporting to the CEOs. In this article the historical and organizational origins of this arrangement are reviewed. The well known disadvantages of shared management are discussed, as are the less obvious advantages. Through case vignettes the authors illustrate how bifurcated leadership can promote productive and creative administrative decisions. Guidelines are offered for strengthening collaborations between non-medical and medical mental health program directors.

Knowledge management as a mediator for the efficacy of transformational leadership and quality management initiatives in U.S. health care.

Science.gov (United States)

Gowen, Charles R; Henagan, Stephanie C; McFadden, Kathleen L

2009-01-01

The health care industry has become one of the largest sectors of the U.S. economy and provides the greatest job growth of any industry. With such growth, effective leadership, knowledge management, and quality programs can ameliorate patient safety outcomes and improve organizational performance. This exploratory study examines the efficacy of transformational leadership, knowledge management, and quality initiatives, each of which has been proven effective in health care organizations. The literature has neglected the relationships among these three types of programs, although they are increasingly implemented simultaneously now. This research tests the degree to which knowledge management could act as a mediator of the effects transformational leadership and quality management have on organizational performance for hospitals. Our survey of U.S. hospitals utilizes validated scales from the literature. By calling and e-mailing quality and other department directors, the data set includes responses from all 50 states in our sample of 370 U.S. hospitals. Statistical tests confirmed acceptable regional distribution, interrater reliability, and control variable characteristics for our sample. Structural equation modeling is used to test the research hypotheses. These preliminary results reveal that transformational leadership and quality management improve knowledge management. In addition, transformational leadership is fully mediated by knowledge responsiveness and quality management is partially mediated by knowledge responsiveness for their effects on organizational performance. The unique contribution of this study includes the suggestion that greater transformational leadership skills are important for health care executives to motivate successful knowledge management initiatives. Secondly, continuous improvements in quality management programs have significant positive impacts on knowledge management and organizational outcomes in hospitals. Finally, successful

Smartloss: A Personalized Mobile Health Intervention for Weight Management and Health Promotion.

Science.gov (United States)

Martin, Corby K; Gilmore, L Anne; Apolzan, John W; Myers, Candice A; Thomas, Diana M; Redman, Leanne M

2016-03-16

Synonymous with increased use of mobile phones has been the development of mobile health (mHealth) technology for improving health, including weight management. Behavior change theory (eg, the theory of planned behavior) can be effectively encapsulated into mobile phone-based health improvement programs, which is fostered by the ability of mobile phones and related devices to collect and transmit objective data in near real time and for health care or research professionals and clients to communicate easily. To describe SmartLoss, a semiautomated mHealth platform for weight loss. We developed and validated a dynamic energy balance model that determines the amount of weight an individual will lose over time if they are adherent to an energy intake prescription. This model was incorporated into computer code that enables adherence to a prescribed caloric prescription determined from the change in body weight of the individual. Data from the individual are then used to guide personalized recommendations regarding weight loss and behavior change via a semiautomated mHealth platform called SmartLoss, which consists of 2 elements: (1) a clinician dashboard and (2) a mobile phone app. SmartLoss includes and interfaces with a network-connected bathroom scale and a Bluetooth-connected accelerometer, which enables automated collection of client information (eg, body weight change and physical activity patterns), as well as the systematic delivery of preplanned health materials and automated feedback that is based on client data and is designed to foster prolonged adherence with body weight, diet, and exercise goals. The clinician dashboard allows for efficient remote monitoring of all clients simultaneously, which may further increase adherence, personalization of treatment, treatment fidelity, and efficacy. Evidence of the efficacy of the SmartLoss approach has been reported previously. The present report provides a thorough description of the SmartLoss Virtual Weight

Evaluation of a Self-Management Program for Gastroesophageal Reflux Disease in China.

Science.gov (United States)

Xu, Wenhong; Sun, Changxian; Lin, Zheng; Lin, Lin; Wang, Meifeng; Zhang, Hongjie; Song, Yulei

2016-01-01

Gastroesophageal reflux disease is a chronic disease with a high incidence worldwide. The various symptoms have substantial impact on the quality of life of affected individuals. A long-term self-management program can increase the ability of patients to make behavioral changes, and health outcomes can improve as a consequence. This study's aim was to evaluate the effectiveness of a self-management program for gastroesophageal reflux disease. A total of 115 patients with gastroesophageal reflux disease were allocated to the experimental group and the control group. The former received self-management intervention along with conventional drug therapy, whereas the latter received standard outpatient care and conventional drug therapy. After the clinical trial, the control group also received the same self-management intervention. The levels of self-management behaviors, self-efficacy, gastroesophageal reflux disease symptoms, and psychological condition were compared. Those in the experimental group demonstrated significantly higher self-efficacy for managing their illness, showed positive changes in self-management behaviors, and had comparatively better remission of symptoms and improvement in psychological distress. The program helped patients with gastroesophageal reflux disease self-manage their illness as possible.

Is "disease management" the answer to our problems? No! Population health management and (disease) prevention require "management of overall well-being".

Science.gov (United States)

Cramm, Jane Murray; Nieboer, Anna Petra

2016-09-21

Disease management programs based on the chronic care model have achieved successful and long-term improvement in the quality of chronic care delivery and patients' health behaviors and physical quality of life. However, such programs have not been able to maintain or improve broader self-management abilities or social well-being, which decline over time in chronically ill patients. Disease management efforts, population health management initiatives and innovative primary care solutions are still mainly focused on clinical and functional outcomes and health behaviors (e.g., smoking cessation, exercise, and diet) failing to address individuals' overall quality of life and well-being. Individuals' ability to achieve well-being can be assessed with great specificity through the application of social production function (SPF) theory. This theory asserts that people produce their own well-being by trying to optimize the achievement of instrumental goals (stimulation, comfort, status, behavioral confirmation, affection) that provide the means to achieve the larger, universal goals of physical and social well-being. A shift in focus from the management of physical function, disease limitations, and lifestyle behaviors alone to an approach that fosters self-management abilities such as self-efficacy and resource investment as well as overall quality of life, is urgently needed. Disease management interventions should be aimed at adequately addressing all difficulties chronically ill patients face in life, such as the effects of pain and fatigue on the ability to maintain a job and social life and to participate in activities promoting physical and social well-being. Patients' ability to maintain engagement in stimulating work and social activities with the people who are important to them may be even more important than aspects of disease self-management such as blood pressure or glycemic control. Interventions should aim to make chronically ill patients capable of

Potential transportation demand management programs and measures

Energy Technology Data Exchange (ETDEWEB)

Litman, T. [Victoria Transport Policy Institute, Victoria, BC (Canada)

1997-02-07

The advantages of transportation demand management (TDM) programs were discussed. TDM includes several policies, programs and measures designed to change travel patterns. TDM programs include commute trip reductions, pricing policies, land use management strategies, and programs to support alternative modes of transportation such as public transit, carpooling, bicycling, walking and telecommuting. TDM programs are designed to reduce traffic congestion and air pollution. Some other TDM programs and measures include: enabling programs, alternative mode encouragement, driving disincentives, parking programs, marginalizing user costs, reducing automobile ownership, and land use management.

Managing problem employees: a model program and practical guide.

Science.gov (United States)

Miller, Laurence

2010-01-01

This article presents a model program for managing problem employees that includes a description ofthe basic types of problem employees and employee problems, as well as practical recommendations for. (1) selection and screening, (2) education and training, (3) coaching and counseling, (4) discipline, (5) psychological fitness-for-duty evaluations, (6) mental health services, (7) termination, and (8) leadership and administrative strategies. Throughout, the emphasis on balancing the need for order and productivity in the workplace with fairness and concern for employee health and well-being.

Enhancing knowledge and attitudes in pain management: a pain management education program for nursing home staff.

Science.gov (United States)

Tse, Mimi Mun Yee; Ho, Suki S K

2014-03-01

The aim of the study was to examine the effectiveness of a pain management program (PMP) in enhancing the knowledge and attitudes of health care workers in pain management. Many nursing home residents suffer from pain, and treatment of pain is often inadequate. Failure of health care workers to assess pain and their insufficient knowledge of pain management are barriers to adequate treatment. It was a quasiexperimental pretest and posttest study. Four nursing homes were approached, and 88 staff joined the 8-week PMP. Demographics and the knowledge and attitudes regarding pain were collected with the use of the Nurse's Knowledge and Attitudes Survey Regarding Pain-Chinese version (NKASRP-C) before and after the PMP. A deficit in knowledge and attitudes related to pain management was prominent before the PMP, and there was a significant increase in pain knowledge and attitudes from 7.9 ± SD 3.52 to 19.2 ± SD4.4 (p nursing staff and enable them to provide adequate and appropriate care to older persons in pain. PMPs for nurses and all health care professionals are important in enhancing care for older adults and to inform policy on the provision of pain management. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

In-House Energy Management Program Plan

International Nuclear Information System (INIS)

1991-01-01

DOE facilities are required to develop a documented energy management program encompassing owned and leased facilities and vehicles and equipment. The program includes an Energy Management Plan consistent with the requirements of the DOE ten-year In-House Energy Management Plan, an ECP specifying actions associated with the sudden disruption in the supply of critical fuels, an Energy Management Committee comprised of WIPP employees, and reporting criteria for quarterly energy consumption reporting to DOE Headquarters. The In-House Energy Management Program will include an implementation plan, a budget, and an interaction and coordination plan. The goal of this program is to sensitize the WIPP employees to the energy consequences of their actions and to motivate them to use energy more efficiently. To achieve this goal, the program is designed to both improve energy conservation at the WIPP through the direct efforts of every employee, and to encourage employees to take the lead in conserving energy at home, on the road, and in the community

NPP Krsko Aging Management Program

International Nuclear Information System (INIS)

Glaser, B.; Spiler, J.

2002-01-01

As a part of Periodic Safety Review Program (PSR) NEK will review and perform some activities related to Equipment Qualification (EQ) and Aging Management Program (AMP). (EQ) and AMP are safety factors, which need to be assessed during PSR. The goal of PSR and AMP is to determine aging effects and give the conclusion whether the plant has been managed to control aging related degradations and that safety margins are maintained. The parallel goal is also to establish AMP for future plant operation and provide basis for possible Life Extension Program. NEK will develop NEK Aging and Life Cycle Management Program, similar by format and content to one determined by License Renewal program. The bases are in 10CFR54, and NEI 95-10 Industry Guidelines for 10 CFR 54 implementation. The process of establishment the AMP is to be done in two steps. The first step is dealing with SSC's (Systems Structures and Components) scoping and screening and identification of TLAA's (Time Limited Aging Analyses). That means, that a database of all SSC's and TLAA's will be created and then evaluated within AMP program. Based on the scope in first phase an evaluation will be performed in step two. NEK will maintain AMP program as a living program that may be also used for Life Extension and Life Cycle Management. This paper will present and describe AMP, scoping and screening process and the results achieved through the first phase of the project.(author)

Establishments of scientific radiation protection management program

International Nuclear Information System (INIS)

Pan Ziqiang

1988-01-01

Some aspects for establishing the radiation protection management program have been discussed. Radiation protection management program includes: definite aims of management, complete data register, strict supervision system, and scientific management methodology

Investigation of health care waste management in Binzhou District, China

International Nuclear Information System (INIS)

Ruoyan, Gai; Xu Lingzhong; Li Huijuan; Zhou Chengchao; He Jiangjiang; Yoshihisa, Shirayama; Tang Wei; Chushi, Kuroiwa

2010-01-01

In China, national regulations and standards for health care waste management were implemented in 2003. To investigate the current status of health care waste management at different levels of health care facilities (HCF) after the implementation of these regulations, one tertiary hospital, one secondary hospital, and four primary health care centers from Binzhou District were visited and 145 medical staff members and 24 cleaning personnel were interviewed. Generated medical waste totaled 1.22, 0.77, and 1.17 kg/bed/day in tertiary, secondary, and primary HCF, respectively. The amount of medical waste generated in primary health care centers was much higher than that in secondary hospitals, which may be attributed to general waste being mixed with medical waste. This study found that the level of the HCF, responsibility for medical waste management in departments and wards, educational background and training experience can be factors that determine medical staff members' knowledge of health care waste management policy. Regular training programs and sufficient provision of protective measures are urgently needed to improve occupational safety for cleaning personnel. Financing and administrative monitoring by local authorities is needed to improve handling practices and the implementation of off-site centralized disposal in primary health care centers.

National findings regarding health IT use and participation in health care delivery reform programs among office-based physicians.

Science.gov (United States)

Heisey-Grove, Dawn; Patel, Vaishali

2017-01-01

Our objective was to characterize physicians' participation in delivery and payment reform programs over time and describe how participants in these programs were using health information technology (IT) to coordinate care, engage patients, manage patient populations, and improve quality. A nationally representative cohort of physicians was surveyed in 2012 (unweighted N = 2567) and 2013 (unweighted N = 2399). Regression analyses used those survey responses to identify associations between health IT use and participation in and attrition from patient-centered medical homes (PCMHs), accountable care organizations (ACOs), and pay-for-performance programs (P4Ps). In 2013, 45% of physicians participated in PCMHs, ACOs, or P4Ps. While participation in each program increased (P payment reform programs increased between 2012 and 2013. Participating physicians were more likely to use health IT. There was significant attrition from and switching between PCMHs, ACOs, and P4Ps. This work provides the basis for understanding physician participation in and attrition from delivery and payment reform programs, as well as how health IT was used to support those programs. Understanding health IT use by program participants may help to identify factors enabling a smooth transition to alternative payment models. Published by Oxford University Press on behalf of the American Medical Informatics Association 2016. This work is written by US Government employees and is in the public domain in the United States.

Use of behavioral change techniques in web-based self-management programs for type 2 diabetes patients: systematic review.

Science.gov (United States)

van Vugt, Michael; de Wit, Maartje; Cleijne, Wilmy H J J; Snoek, Frank J

2013-12-13

Type 2 diabetes mellitus (T2DM) is a highly prevalent chronic metabolic disease characterized by hyperglycemia and cardiovascular risks. Without proper treatment, T2DM can lead to long-term complications. Diabetes self-management is recognized as the cornerstone of overall diabetes management. Web-based self-management programs for T2DM patients can help to successfully improve patient health behaviors and health-related outcomes. Theories can help to specify key determinants of the target behaviors and behavior change strategies required to arrive at the desired health outcomes, which can then be translated into specific behavioral techniques or strategies that patients can learn to apply in their daily life. From previous reviews of a wide range of online diabetes self-management tools and programs, it appears that it is still unclear which behavioral change techniques (BCTs) are primarily used and are most effective when it comes to improving diabetes self-management behaviors and related health outcomes. We set out to identify which BCTs are being applied in online self-management programs for T2DM and whether there is indication of their effectiveness in relation to predefined health outcomes. Articles were systematically searched and screened on the mentioned use of 40 BCTs, which were then linked to reported statistically significant improvements in study outcomes. We found 13 randomized controlled trials reporting on 8 online self-management interventions for T2DM. The BCTs used were feedback on performance, providing information on consequences of behavior, barrier identification/problem solving, and self-monitoring of behavior. These BCTs were also linked to positive outcomes for health behavior change, psychological well-being, or clinical parameters. A relatively small number of theory-based online self-management support programs for T2DM have been reported using only a select number of BCTs. The development of future online self-management