Resource management and budgeting in critical care

2016 ◽  
Author(s):  
Jukka Takala
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Resource Management ◽  
Resource Use ◽  
Health Care Services ◽  
Care Process ◽  
Local Health ◽  
Planning Period ◽  
Actual Structure ◽  
Local Health Care

Resource management is a core task for intensive care unit (ICU) leadership. Budgeting covers optimizing resource use, planning for future needs, and continuous monitoring of actual resource use. Short-term budgeting is operational planning, whereas mid- and long-term budgeting should focus on strategy. Resource management is an integral and continuous part of the ICU management process. Hence, the regional and local availability of health care services rarely depends on rational or objective factors alone. For budgeting purposes, the needs for intensive care for the population of the main referral area of the hospital, the actual structure of the local health care system and probable changes during the strategic planning period should be considered. The resources needed for emergency admissions is relatively constant as long as the referral population the indications for intensive care and the treatments offered do not change. The ICU is part of a multidisciplinary, horizontal care process. The amount and level of care provided in all the participating units must be considered.

Part 5: Community Perception of Local Health Care Services

1991 ◽  
Vol 7 (5) ◽  
pp. 542-559 ◽  
Author(s):  
L. Gary Hart ◽  
Denise M. Lishner ◽  
Bruce A. Amundson
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Local Health ◽  
Community Perception ◽  
Care Services ◽  
Local Health Care

Mass-gathering Events: The Role of Advanced Nurse Practitioners in Reducing Referrals to Local Health Care Agencies

2016 ◽  
Vol 31 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Anthony E. Kemp
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Nurse Practitioners ◽  
Health Care Services ◽  
Local Health ◽  
Medical Team ◽  
Mass Gathering ◽  
Care Services ◽  
Local Health Care

AbstractIntroductionThe introduction of advanced practitioner roles has challenged the traditional boundaries of health care. While studies have been undertaken to understand the role of physicians in respect of mass-gathering medicine, the role of advanced nurse practitioners (ANPs) has not been investigated.ProblemDoes the presence of an ANP reduce the referral rates of patients presenting for medical care at mass-gathering events to external health care resources?MethodsA prospective observational study was undertaken to determine whether the presence of an ANP would reduce the patient referral rate to external health care services by first aiders and paramedics working within an event medical team. Patients identified as requiring referral were reviewed by an ANP as part of the on-site medical provision for four mass-gathering events in the south of England. Additionally, information was gathered identifying which patients would have been transported to hospital by ambulance compared to those actually transported following ANP review. Statistical analysis was undertaken for three key measures (referrals to all local health resources, referrals to hospital-based acute services, and transfers to hospital by ambulance).ResultsA rounded total of 842,000 people attended four mass-gathering events held over 14 days. Of these, 652 presented for medical care, many self-referring.Using a one-tailed Fisher’s Exact Test and Phi analysis, this study demonstrated statistically significant reductions in the overall referral of patients to all external health care resources (P<.001; φ=0.44), to the emergency department (ED; P<.001; φ=0.43), and a reduction in ambulance transport (P<.001; φ=0.42). Effect size analysis demonstrated a medium-sized effect evident for all of the above, which was also demonstrated in economic terms.The event medical team would have referred 105 (16.3%) of the 652 patient presentations to external health care services; 47 (7.2%) would have been transported by ambulance. In comparison, the ANP referred 23 patients (3.5%) with 11 (1.7%) being transported by ambulance. It also was noted that the first aiders and paramedics could be more selective in their referral habits that were focused primarily on the ED.ConclusionsAppropriately trained and experienced ANPs working within event medical teams have a positive impact on referral rates from mass-gathering events.KempAE. Mass-gathering events: the role of advanced nurse practitioners in reducing referrals to local health care agencies. Prehosp Disaster Med. 2016;31(1):58–63.

scholarly journals Continuity of care is associated with satisfaction with local health care services

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
E. Lautamatti ◽  
M. Sumanen ◽  
R. Raivio ◽  
K. J. Mattila
Keyword(s):  
Health Care ◽  
Continuity Of Care ◽  
Health Care Services ◽  
Local Health ◽  
Care Services ◽  
Local Health Care

scholarly journals Effective Containment of a COVID-19 Subregional Outbreak in Italy Through Strict Quarantine and Rearrangement of Local Health Care Services

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Sara Tedeschi ◽  
Lorenzo Badia ◽  
Fabio Berveglieri ◽  
Rodolfo Ferrari ◽  
Simona Coladonato ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
World Health ◽  
Nasopharyngeal Swab ◽  
Local Health ◽  
Telephone Contact ◽  
Care Services ◽  
Local Health Care ◽  
Emilia Romagna Region ◽  
Health Organization

Abstract Background Since the beginning of the pandemic, the epidemiology of coronavirus disease 2019 (COVID-19) in Italy has been characterized by the occurrence of subnational outbreaks. The World Health Organization recommended building the capacity to rapidly control COVID-19 clusters of cases in order to avoid the spread of the disease. This study describes a subregional outbreak of COVID-19 that occurred in the Emilia Romagna region, Italy, and the intervention undertaken to successfully control it. Methods Cases of COVID-19 were defined by a positive reverse transcriptase polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on nasopharyngeal swab. The outbreak involved the residential area of a small town, with ~10 500 inhabitants in an area of 9 km2. After the recognition of the outbreak, local health care authorities implemented strict quarantine and a rearrangement of health care services, consisting of closure of general practitioner outpatient clinics, telephone contact with all residents, activation of health care units to visit at-home patients with symptoms consistent with COVID-19, and a dedicated Infectious Diseases ambulatory unit at the nearest hospital. Results The outbreak lasted from February 24 to April 6, 2020, involving at least 170 people with a cumulative incidence of 160 cases/10 000 inhabitants; overall, 448 inhabitants of the municipality underwent at least 1 nasopharyngeal swab to detect SARS-CoV-2 (positivity rate, 38%). Ninety-three people presented symptoms before March 11 (pre-intervention period), and 77 presented symptoms during the postintervention period (March 11–April 6). Conclusions It was possible to control this COVID-19 outbreak by prompt recognition and implementation of a targeted local intervention.

Building Health Communities: Local Health Care Networks in Maryland

2019 ◽  
Vol 50 (1) ◽  
pp. 62-76 ◽  
Author(s):  
Aaron Wachhaus
Keyword(s):  
Health Care ◽  
Local Level ◽  
Collaborative Networks ◽  
Local Health ◽  
Exploratory Research ◽  
The Public ◽  
Health Care Networks ◽  
Local Health Care ◽  
Health Communities ◽  
Treatment Of Obesity

Combatting chronic disease (prevention and treatment of obesity, diabetes, heart health, and stroke) requires action at the local level, both to educate the public and to provide health services. Effective collaboration among local organizations devoted to educating the public about, and treating patients of, these diseases is a key component of successful health care. To better understand local efforts, a social network analysis of five local health care networks spanning eight counties in Maryland was conducted. The purpose of this exploratory research was to discover whether collaborative networks exist at the local level, to map the networks, and to assess their strengths and needs.

Creating Academic and Health Care Partnerships that Impact Public Health

2015 ◽  
Vol 4 (4) ◽  
pp. 378-384
Author(s):  
Peter W. Grandjean ◽  
Burritt W. Hess ◽  
Nicholas Schwedock ◽  
Jackson O. Griggs ◽  
Paul M. Gordon
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Professional Training ◽  
Local Health ◽  
Care Providers ◽  
Research Partnerships ◽  
Local Health Care ◽  
Training Community ◽  
The University

Kinesiology programs are well positioned to create and develop partnerships within the university, with local health care providers, and with the community to integrate and enhance the activities of professional training, community service, public health outreach, and collaborative research. Partnerships with medical and health care organizations may be structured to fulfill accreditation standards and the objectives of the “Exercise is Medicine®” initiative to improve public health through primary prevention. Barriers of scale, location, time, human resources, and funding can be overcome so all stakeholder benefits are much greater than the costs.

scholarly journals (A4) Emergency Health Interventions in Earthquakes: Red Cross Experience from Haiti and Chile, 2010

2011 ◽  
Vol 26 (S1) ◽  
pp. s2-s2
Author(s):  
P. Saaristo ◽  
T. Aloudat
Keyword(s):  
Health Care ◽  
Emergency Response ◽  
Red Cross ◽  
Local Health ◽  
Basic Health ◽  
Basic Health Care ◽  
Health Response ◽  
Local Health Care ◽  
Local Health Care System ◽  
Rapid Deployment

On 12 January 2010, the fate of Haiti and its people shifted with the ground beneath them as the strongest earthquake in 200 years, and a series of powerful aftershocks demolished the capital and multiple areas throughout the southern coast in thirty seconds, leaving some 220,000 people dead, and 300,000 persons injured. On 27 February 2010, at 03:35 hours local time, an earthquake of magnitude 8.8 struck Chile. As a consequence, the tsunami generated affected a coastal strip of more than 500 kilometers. Approximately 1.5 million people were affected and thousands lost their homes and livelihoods. The emergency health response of the International Red Cross Movement to both disasters was immediate, powerful and dynamic. The IFRC deployed seven emergency response units (ERU) to Haiti: one 150-bed referral hospital, one Rapid Deployment Emergency Hospital, and five basic health care units. One surgical hospital and two Basic Health Care Units were deployed to Chile. The ERU system of the IFRC is a flexible and dynamic tool for emergency health response in shifting and challenging environments. Evaluations show that the system performs well during urban and rural disasters. Despite a very different baseline in the two contexts, the ERU system of IFRC can adapt to the local needs. As panorama of pathology in the aftermath of an earthquake changes, the ERU system adapts and continues supporting the local health care system in its recovery.

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