The article describes an evaluation of a palliative care service in a regional and tertiary care facility. The service components are described. The four outcomes chosen for evaluation were: (a) symptom relief; (b) satisfaction with care for patients/families; (c) utilization of community resources; (d) good nursing morale and low staff stress. Quality of life was measured using a symptom distress scale; satisfaction using an adapted Kristjanson FAMCARE scale; community resources with opinion and satisfaction surveys; and staff morale and stress with the Maslach Burnout Inventory and Latack's Coping Questionnaire. Results showed that overall symptom distress was reduced. Patients/families were generally satisfied, with some areas needing attention. Physicians were generally satisfied and believed patients/families benefited from the psychosocial support, respite, and education/information. Nurses felt they had the time, energy, resources and support to give quality care.
This article explores the similarities, differences and overlaps among research, evaluation and quality measurement. Criteria for determining the differences are offered as a quick guide to differentiating among them. These criteria are the purpose of the project, generalizability, intended use of the findings, intended subjects and intent to prove causation. Determining the key differences among research, evaluation and quality measurement facilitates the choice of restrictions, supports and reporting process that should be applied to each.
This paper will attempt to clarify the meaning of negligence. The difference between the negligent acts of a layman and a professional are defined and compared, as well as professional and non-professional occupations. The method of determining the standard by which occupational therapists are measured is discussed as well as the points the Courts consider when the standard is breached and harm to the patient results. Consideration is given to the gradual shift of responsibility from the physician to the health care professional, the ensuing legal implications, and the division of responsibility for negligence. The position of occupational therapists employed by health care facilities, in relation to the liability of the employer and the practitioner are outlined. The points discussed are illustrated by cases from the British, Canadian and American Courts.
This article illustrates how the logic model and a course on program evaluation at a large health sciences centre were instrumental in preparing staff to evaluate their own programs. Staff and physicians need basic skills in program evaluation. The logic model is a simple yet useful tool in helping to identify key measurables. A short course to teach the theory and practice of logic models, evaluation design, choice and design of measures, and data analysis has been shown to be a practical solution in preparing staff and physicians to evaluate their own programs.
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