The worldwide burden of cancer warrants more effective and efficient cancer care management strategies (World Health Organization, 2003). Model of ambulatory care, in particular, has tremendous implications on patient and administrative outcomes (Knight, 2007; Lynch, Marcone & Kagan, 2007; Moore, Johnson, Fortner & Houts, 2008). Nevertheless, little is known about the pattern of practices and the clinic operations in this setting. As part of the hospital's ambulatory redesign program, this survey aims to: a) review and describe existing models of ambulatory care employed by key national and international cancer centres; b) identify models or elements within the models that are appropriate to be adopted for best practice.
Semi-structured interviews with 10 senior management members at 10 centres (N = 10) were conducted. Participants were asked to describe: a) model of ambulatory care employed by their institution (e.g., scope and model of ambulatory nursing practice); and b) strategies used to manage common patient care related issues in their institutions. Interviews were recorded and analyzed according to the objectives of this survey.
A majority of cancer centres employed models of care similar to the existing Hospital model of ambulatory care and are encountering similar challenges in care delivery. Therefore, it was not deemed appropriate to adopt any models from participating centres.
It is crucial for administrators to report and share best practices to ensure high-quality care. The survey of current practice did not yield sufficient data to adequately support the implementation of any specific models at the hospital's ambulatory care settings. Nevertheless, findings from the present review support the principles proposed for the new hospital model of ambulatory care.
An in-depth analysis of organizational risk management in healthcare, and in particular the concepts of Enterprise Risk Management (ERM), has identified a 5-part model that can be used by Canadian healthcare leaders as an evidence-supported approach to successful organizational risk management. The Model for Organizational Risk Management, termed "the Model," has been developed as a basis for linking the components of an ERM Framework into a Canadian health organization to overcome the barriers that commonly disrupt strategic risk management. The Model addresses how an ERM Framework can fit within an existing health organization by building off and enhancing existing processes and resources to ensure familiarity, acceptance, and sustainability of the risk management program. By approaching the Model in a stepwise fashion (based on individual organizational context), healthcare leaders are provided with a road map from which to advance their own organizational risk management program.
The aims of this study were to analyze the coherence between the concepts for nursing interventions in the Swedish VIPS model for nursing recording and the ISO Reference Terminology Model for Nursing Actions and to identify areas in the two models for further development. Seven Scandinavian experts analyzed the VIPS model's concepts for nursing interventions using prototypical examples of nursing actions, involving 233 units of analyses, and collaborated in mapping the two models. All nursing interventions in the VIPS model comprise actions and targets, but a few lack explicit expressions of means. In most cases, the recipient of care is implicit. Expressions for the aim of an action are absent from the ISO model. By this mapping we identified areas for future development of the VIPS model and the experience from nursing terminology work in Scandinavia can contribute to the international standardization efforts.
Prior to the early 1980s, two Winnipeg hospitals provided hemodialysis for all patients in Manitoba with chronic renal failure. Because no other hemodialysis centres existed, families were forced to relocate to the city. Because of these factors, the Manitoba Renal Failure Advisory Committee proposed the development of an outreach hemodialysis program. Under the auspices of the Health Sciences Centre in Winnipeg, this outreach program has evolved into the current Manitoba Local Centre Dialysis Program. Hemodialysis services are now available in an additional seven health care centres throughout Manitoba and northwestern Ontario. This program has benefited many and in some instances, families previously separated by distances of up to 500 miles have been reunited. Creativity has been one of the most essential ingredients in the evolution of this unique program.