• Understand the different types of managed care organizations. • Understand key differences between managed care organizations. • Understand the inherent strengths and weaknesses of each model type. • Understand the basic forms of Integrated Delivery Systems (IDSs) and how they are evolving. • Understand the major strengths and weakness of each type of IDS, initially, and how they have played ...

The health care delivery system is changing rapidly, with providers forming patient-centered medical homes and exploring the creation of accountable care organizations. Enactment of the Affordable Care Act will likely accelerate these changes. Significant delivery system reforms will simultaneously affect the structures, capabilities, incentives, and outcomes of the delivery system. With so man...

BACKGROUND Childbirth is a demanding event in a woman's life. The aim of this study was to explore whether a brief intervention in the form of an antenatal course in self-hypnosis to ease childbirth could improve the childbirth experience. METHOD In a randomized, controlled, single-blinded trial, 1,222 healthy nulliparous women were allocated to one of three groups during pregnancy: A hypnosi...

PURPOSE The purpose of this article is to examine the Institute of Medicine's recommendations, the National Prevention Council Action Plan, the medical home model, and the nursing standards that drive quality for telephone nursing triage. FINDINGS These guidelines require reconceptualizing nursing roles, a commitment to lifelong learning, continued competence, and transformational leadership ...

Recognizing changes are coming to the healthcare delivery system, pastoral care departments are developing a new vision of spiritual care. As they educate and hire staff, many directors are finding that alternative staffing approaches can help them make the transition. Flexible schedules for pastoral care professionals improve the care they deliver and enhance morale. Restructuring responsibili...

To assess the feasibility and quality of general practitioner obstetrics an audit of 1223 consecutive obstetric deliveries over 26 years was carried out with standard clinical records. The perinatal mortality of 9.0 per 1000 births was significantly better than the national average of about 19.0 per 1000 for the overall period. During the audit home deliveries virtually stopped. The proportion ...

The notion of preconception care aims to target the existing risks before pregnancy, whereby resources may be used to improve reproductive health and optimize knowledge before conceiving. The preconception period provides an opportunity to intervene earlier to optimize the health of potential mothers (and fathers) and to prevent harmful exposures from affecting the developing fetus. These inter...

Background In Ethiopia, majority (62%) of pregnant women attend antenatal care at least once, yet only 26% deliver with skilled birth attendants in the available health units. Thus, this study explored beliefs and behaviors related to labour and skilled attendance among the women, their perspectives on health care providers, and traditional birth attendants. Methods Sixteen key informant inte...

PURPOSE OF REVIEW The purpose of the present article is to review recent national guidelines regarding healthcare transition (HCT) planning for adolescents with special healthcare needs (SHCN) and to describe practical tools for use by the primary care pediatrician to implement these guidelines. RECENT FINDINGS Approximately one in five adolescents in the United States has SHCN. Achieving suc...

This study explored how direct care workers in nursing homes conceptualize good care and how their conceptualizations are influenced by external factors surrounding their work environment and the relational dynamics between them and residents. Study participants were drawn from a local service employees' union, and in-depth interviews were conducted. Data were analyzed using a grounded theory a...