This paper seeks to review the legal and policy trends facing nurses and, in so doing, indicates the numerous medico-legal and ethical issues confronting the nursing profession. At the same time, it is important to note that many of these developments have a wider impact, affecting not just those involved directly in health care. It is only by way of a collaborative effort that a suitable path ...

Noncompliance with medical instructions is a major problem in health care. In areas of the world where traditional and Western systems co-exist, failure to follow medical directives has been attributed to the conscious rejection of Western medical beliefs and values by the indigenous population. This study provides evidence that the absence of shared concepts between practitioners and patients ...

Hospitals are under significant pressure from payers to reduce costs. The single largest fixed cost for a hospital is inpatient beds, yet there is significant variation in hospital capacity utilization. We study bed capacity in New York City hospital obstetrics units and find that while many hospitals have an insufficient number of beds to provide timely access to care, overall there is signifi...

There is a real need for innovation in health care delivery, as well as in medicine, to address related challenges of access, quality, and affordability through new and creative approaches. Health care environments must foster innovation, not just allowing it but actively encouraging it to happen anywhere and at every level in health care and medicine-from the laboratory, to the operating room,...

Quality improvement (QI) efforts are an indispensable aspect of health care delivery, particularly in an environment of increasing financial and regulatory pressures. The ability to test predictions of proposed changes to flow, policy, staffing, and other process-level changes using discrete event simulation (DES) has shown significant promise and is well reported in the literature. This articl...

The escalating costs of inpatient care have resulted in the increased utilization of outpatient facilities and home care. As the sites of care proliferate, the system of healthcare delivery must be integrated so that healthcare provision is both cost-effective and safe.

Balance Sheets—Tools for Translating Evidence into Practice Integrated care delivery systems have two inherent advantages over other health care organizations. First, we integrate the financing of care with care delivery. Second, our integrated care delivery systems position us to be able to collaboratively recommend and carry out changes in practice more effectively than other delivery systems...

A number of trends, pressures and policy shifts are promoting greater patient involvement in health care delivery through consultations, treatments and continuing care. However, while the literature on different methods of involvement is growing fast, little attention has been given so far to the role which patients themselves wish to play, or to the conceptual meanings behind involvement or pa...

This issue brief explores the continuing evolution of the Medicaid program on several fronts. It discusses the benefits and cost-sharing flexibility that is included in the Deficit Reduction Act of 2005 (DRA) and examines the implications of these provisions for states, beneficiaries, and providers. The paper also explores recent trends in section 1115 waiver development and considers the use o...

With the recognition of the inadequacy of psychiatric services in India, maximinig health care delivery has become apriority. Tliere is therefore need to concentrate upon undergraduate psychiatric training as means to increase the availabe numbers of professionals equipped to treat psychiatric disorders (Channabasavanna, 1986). Towards this end the present M.B.B.S. Psychiatric Training Programm...