The paper presents an external respiratory failure (ERF) classification, a scientific rationale for its use in the clinical practice of departments of different profiles. The setting up of interclinical functional diagnostic laboratories and preventive health care facilities for the preclinical diagnosis of ERF is substantiated. The introduction of the classification of ERF into wide clinical practice is intended to form a social order for the design and purchase of diagnostic equipment for therapeutic-and-prophylactic institutions and to stimulate researches in clinical respiratory physiology, and to improve physicians' knowledge of this section of clinical science.
The Ministry of Health and Ministry Responsible for Seniors in British Columbia, Canada, has developed a comprehensive and integrated service delivery system for the care of the elderly and the disabled. This system has a single point of entry, and contains all of the major components of Long-Term Care and Home Care services under one administrative umbrella, the Continuing Care Division. This paper presents on overview of the Division's service delivery system and its planning framework. The latter provides a vehicle for decision makers to pro-actively re-allocate resources from residential services to community and home-based services within Continuing Care.
Many publicly funded education programs and organizations have developed business plans to enhance accountability. In the case of the Department of Dentistry at the University of Alberta, the main impetus for business planning was a persistent deficit in the annual operating fund since a merger of a stand-alone dental faculty with the Faculty of Medicine. The main challenges were to balance revenues with expenditures, to reduce expenditures without compromising quality of teaching, service delivery and research, to maintain adequate funding to ensure future competitiveness, and to repay the accumulated debt owed to the university. The business plan comprises key strategies in the areas of education, clinical practice and service, and research. One of the strategies for education was to start a BSc program in dental hygiene, which was accomplished in September 2000. In clinical practice, a key strategy was implementation of a clinic operations fee, which also occurred in September 2000. This student fee helps to offset the cost of clinical practice. In research, a key strategy has been to strengthen our emphasis on prevention technologies. In completing the business plan, we learned the importance of identifying clear goals and ensuring that the goals are reasonable and achievable; gaining access to high-quality data to support planning; and nurturing existing positive relationships with external stakeholders such as the provincial government and professional associations.
In this article we discuss the findings from a series of focus groups conducted as part of a 3-year, mixed-method evaluation of clinical programs in a large mental health and substance use treatment facility in Canada. We examined the perceptions of clinical personnel on the physical design of new treatment units and the impact on service delivery and the work environment. The new physical design appeared to support client recovery and reduce stigma; however, it brought certain challenges. Participants reported a compromised ability to monitor clients, a lack of designated therapeutic spaces, and insufficient workspace for staff. They also thought that physical design positively facilitated communication and therapeutic relationships among clinicians and clients, and increased team cohesion. We suggest that, from these findings, new avenues for research on achieving the important balance between client and staff needs in health facility design can be explored.
As educational climate strongly affects student achievement, satisfaction and success, it is important to get regular feedback from students on how they experience the educational environment. The Dundee Ready Education Environment Measure (DREEM) Inventory was administered on the same day to all first-, second- and third-year students at the Canadian Memorial Chiropractic College (CMCC) and the students were requested to complete the questionnaire as they were actually experiencing the educational environment at CMCC, and then to say what they would have wanted, or preferred it to be like. Valid returns were received from 146 (95%) first-, 123 (82%) second- and 73 (48%) third-year students (n = 342). The results indicated that the DREEM Inventory used in the Ideal mode, together with the responses in the Actual mode, could be used effectively to determine the dissonance between what they had and what they would have liked to have. It was found that there was a strong similarity in the areas of the educational environment that the different groups of students indicated as falling short of their ideal. The results of this study provided a useful basis for strategic planning and resource utilization.