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Integrated institution - community rehabilitation in developed countries: a proposal

DISABILITY AND REHABILITATION 2000年第6期22卷 266-274页

作者： Eldar, R Loewenstein Hosp & Rehabil Ctr Fleischman Unit Study Disabil Rehabil Ctr IL-43000 Raanana Israel

Purpose: To propose a system for the provision of comprehensive, coordinated rehabilitation services that would meet all the needs of persons with disability in a timely and cost-effective manner. Methods: Study of the literature pertaining to features of settings available for the delivery of medical rehabilitation in developed countries;presentation of the evolution of a tertiary rehabilitation centre into an institution practicing community-oriented rehabilitation. Review of various issues and implications of integrating institutional-based and community-based rehabilitation. Results: Rehabilitation settings differ in skills and resources and consequently, in the treatment, care and concern they are able to offer. It is essential to find the balance between medical, nursing and social needs of persons with disability and their requirements for skills and resources at a given time, and to provide rehabilitation, support and guidance in the setting most appropriate to these requirements and needs at the lowest cost possible. Conclusion: The integration of the rehabilitation institution of a region with secondary and primary care of the region, into one functional entity for the purposes of providing the needed services, would enable finding the most appropriate setting, and facilitate addressing all needs, as well as increase the availability and accessibility of comprehensive rehabilitation at an affordable cost. This could be a viable way of providing rehabilitation in developed countries of Europe, where the need for it is expected to rise in excess of the population increase.

关键词：社区卫生服务/组织和管理病人医护连续性/组织和管理发达国家残疾人以色列康复/组织和管理人类

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Motor accident and workers' compensation insurance design for high-quality health outcomes and cost containment

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DISABILITY AND REHABILITATION 2000年第1-2期22卷 88-96页

作者： O'Donnell, C Fac Hlth Sci Dept Behav Sci Lidcombe NSW 2141 Australia

This paper studies scheme structure and information concerning rehabilitation outcome for claimants under the NSW Motor Accidents Scheme and the NSW Workers' Compensation Scheme. It argues that to ensure effective rehabilitation there is a need for consistent, national accident schemes which provide services regardless of fault. In general, health outcomes will be improved if dispute resolution and estimation of level of disability occur in a context which avoids adversarialism. On the other hand, negligence could best be punished and compensation provided to victims as a result of prosecution for breach of duty of care under the relevant protective legislation. Other vital elements in injury prevention and rehabilitation are more effective risk management, worker representation and information provision at the workplace level. Comparable performance measures for rehabilitation and other service providers are also necessary for the attainment of quality management and evidence-based medicine.

关键词：事故交通/经济学费用控制卫生保健费用法规新南威尔士卫生保健质量康复/经济学康复/组织和管理危险处理工人补偿金/经济学工人补偿金/组织和管理人类

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Community-based service delivery in rehabilitation: The promise and the paradox

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DISABILITY AND REHABILITATION 2000年第10期22卷 435-445页

作者： Kendall, E Buys, N Larner, J Griffith Univ Ctr Human Serv Nathan Qld 4111 Australia

Purpose: According to many researchers, rehabilitation is being prevented from developing as a distinct profession due to two major problems. First, it has been claimed that rehabilitation is in need of a professional identity and a sense of cohesion if it is to emerge as a discipline. Second, it has been recognized that there is a need for a rehabilitation framework to challenge the restorative approach that continues to dominate rehabilitation, linking it back to the medical model from which it has attempted to escape. The model of community-based rehabilitation (CBR) is offered as a model that can provide the impetus for an attitudinal shift from the restorative tradition and unite rehabilitation workers through a cohesive framework. Method: Unfortunately, the implementation of community based rehabilitation in urban societies has been disappointing. The current paper is a conceptual discussion of community-based rehabilitation that explores some potential causes of this poor implementation. Results: To some extent, the implementation failure of community-based rehabilitation can be attributed to the paradoxes that are inherent in its fundamental constructs-empowerment and community inclusion. These paradoxes occur at a conceptual level, a practical level and a contextual level. Conclusions: Some solutions are offered to enable the paradigm to be implemented more fully. In particular, it is suggested that there is a need to develop useful working definitions of these constructs, favourable attitudes among rehabilitation workers and a focus on community development.

关键词：社区卫生服务/组织和管理卫生保健提供模型理论病人参与康复/组织和管理人类

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Achieving faster quality improvement through the 24-hour team.

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Journal for healthcare quality : official publication of the National Association for Healthcare Quality 1999年第4期21卷 4-10页

作者： Carboneau, C.E. Great Plains Regional Medical Center North Platte NE United States

This article describes how Great Plains Regional Medical Center (GPRMC) in North Platte, NE, changed its quality improvement (QI) methodology and its mind-set toward team time management to accelerate its improvement efforts. The "24-hour road map" and the improved FOCUS-PDSA methodology, coupled with strong leadership, make up the team time management element that has been missing from healthcare quality improvement but is critically needed to accelerate the process. At GPRMC, a major criterion for success is now a 6-month-or-less improvement cycle for cross-functional teams to complete their QI efforts. The lessons learned at GPRMC can help others in healthcare improve quality, lower costs, and do both more quickly.

关键词：病人预约和时间安排教育继续医院管理/标准机构管理小组领导管理质量小组模型组织管理内布拉斯加规划技术过程评价(卫生保健) 康复/组织和管理时间和运动研究全面质量管理/方法全面质量管理/组织和管理

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The Supervisory Skills of Rehabilitation Managers

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Canadian Journal of Occupational Therapy 1985年第3期52卷 113-117页

作者： Stan, L. Joanne Division of Occupational Therapy School of Rehabilitation Medicine University of British Columbia Vancouver B.C. Canada

This study was undertaken to investigate the continuing education needs of rehabilitation managers in the area of supervision and management. The human relations supervisory ability of 61 managers was measured using a standardized inventory, yielding scores in jive areas of human relations related to supervision. Results indicated that the managers possessed a higher degree of human relations supervisory ability than either industrial managers or another group of allied health supervisors. Respondents were strong in problem-solving, motivating employees, and fostering positive attitudes, and weak in their understanding of learning and training principles. No relationship was shown between previous management education and supervisory ability. Experience and consultation with others were cited more frequently than formal learning, as resources for acquiring supervisory skills. Supervisory ability was positively related to number of employees supervised, and to length of time in a management position. © 1985, Canadian Association of Occupational Therapists (CAOT). All rights reserved.

关键词：行政管理人员/教育英属哥伦比亚教育继续医院康复/组织和管理

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Acupuncture education and integration in the physical medicine and rehabilitation residency

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Physical Medicine and Rehabilitation Clinics of North America 1999年第3期10卷 755-765页

作者： Braverman, S.E. Dept. of PM and R Bldg 2 Walter Reed Army Medical Center Washington DC 20307-5001 United States

Acupuncture is a growing field of interest to patients, medical students, and physicians. This article outlines the educational efforts and requirements to teach and practice acupuncture in the United States. A rationale for integrating acupuncture into physical medicine and rehabilitation residency programs is included. This article provides a structure for determining the type of education goals and plans most suited to a particular residency.

关键词：课程教育医学研究生教育考核实习医师和住院医师职务物理医学/教育物理医学/组织和管理方案评价康复/教育康复/组织和管理美国女(雌)性人类男(雄)性

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Training for Independent Living Unit: Its Function in a Rehabilitation Convalescent Setting

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Canadian Journal of Occupational Therapy 1982年第5期49卷 159-162页

作者： Bitensky, Nicol Mendelsohn, Felice Staff Occupational Therapist Department of Physical Medicine Julius Richardson Convalescent Hospital Montreal Quebec Canada

This article describes a Geriatric Self-Care Unit in a 92 bed Rehabilitation Convalescent Hospital. Ten beds are set aside for this unit. The overall goal of the Self Care Unit (S.C.U.) is to facilitate the patients' discharge into the community. This pilot project has been in effect for six months with 47 patients having completed the program. Results of the program, it's problem areas and progress are outlined. © 1982, Canadian Association of Occupational Therapists (CAOT). All rights reserved.

关键词：日常生活活动病人医护连续性医院病床数 100张以下医院专科病房/组织和管理医院康复/组织和管理魁北克自我护理病房/组织和管理

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上海启动万名癌症患者整体康复行动

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上海医药 2002年第3期23卷 132页

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