Homelessness is a social condition increasing in frequency and severity across Canada. Interventions to end and prevent homelessness include effective case management in addition to an affordable housing provision. Little standardization exists for service providers to guide their decision making in developing and maintaining effective case management programs. The purpose of this 2-part article is to articulate dimensions of promising practice for case managers working in a "Housing First" context. Part 1 discusses research processes and findings and Part 2 articulates the 6 dimensions of quality.
Practice settings include community-based organizations that employ and support case managers whose primary role is moving people from homelessness into permanent supportive housing.
Six dimensions of promising practice are critically important to reducing barriers, improving sector collaboration, and ensuring that case managers have appropriate and effective training and support. Dimensions of promising practice are (1) collaboration and cooperation-a true team approach; (2) right matching of services-person-centered; (3) contextual case management-culture and flexibility; (4) the right kind of engagement-relationships and advocacy; (5) coordinated and well-managed system-ethics and communication; and (6) evaluation for success-support and training.
Effective, coordinated case management, in addition to permanent affordable housing has the potential to reduce a person's or family's homelessness permanently. Organizations and professionals working in this context have the opportunity to improve processes, reduce burnout, collaborate and standardize, and, most importantly, efficiently and permanently end someone's homelessness with the help of dimensions of quality for case management.
The article presents public health system characterized by public responsibility for health of citizen under various forms of property. The issues of management, planning, financing and organization of health care are discussed.
The article emphasizes that the palliative medical care is considered in the Federal law "On the fundamentals of health care of citizen in the Russian Federation" (2011)as one of the types of medical care of population. The Orders of delivery of palliative care to adult population and children are in the process of development to determine in perspective the formation of palliative care services in the regions. The successful development of this service needs a clear-cut definition of palliative care to formulate the corresponding tasks and contingents of patients. The Preference is to be given to the definition which considers palliative medical care as a medical care of patients with diagnosis of active incurable progressing disease at the stage when possibilities of specialized/radical treatment are exhausted or limited.
The article presents main characteristics of development of ambulatory polyclinic care to population exemplified by North East administrative okrug of Moscow under implementation of three-level system according program of modernization of metropolitan health care.
The analysis was applied concerning distribution of patients' flow depending on nosology forms of diseases and departments of hospital. The integrated value included number of treated patients and duration of treatment. The study established that the main groups of diseases determining the load on corresponding departments of hospital are cerebro-vascular diseases in neurologic department; diabetes mellitus in endocrinology department; pneumonia, chronic bronchitis and asthma in pulmonology department; urolithiasis in urology department; abnormal bleedings of female genitals in gynecology department; trauma of femur in traumatology department; cholelithiasis and cholecystitis in general surgery department. The developed differentiation of patients' flows makes it possible to determine the demand of diagnostic and treatment technologies in the particular hospital.
The article deals with the results of study of factual volumes of medical care according its main services provided to total population and to people older than able-bodied population in Nizhny Novgorod oblast. The study demonstrated that during last ten years, the character of organization and application of main volumes of medical care to people older than able-bodied population factually had no changes and does not correspond to the planned volumes of territorial program of public guarantees of free medical care. The increase of volume of emergency medical care in functioning of ambulance and emergency care service shortens possibilities of emergency medical care support and promote misallocation of financial resources. The level of medical care support of people older than able-bodied population in day-and-night hospitals is high at the same time it is lower in nursing departments and out-patient clinics. To provide the accessibility and quality of medical services to people older than able-bodied population the restructuration of medical care is needed to increase the volume of hospital-substituting types of medical care and to organize the service of specialized palliative care primarily for oncological patients.