DISCHARGE PLANNING: A PROCESS MODEL

As the requirements for health care hospitalization have become more demanding, so has the discharge planning process become a more important part of the health services system. A thorough understanding of hospital discharge planning can, then, contribute to our understanding of the health services system. This study involved the development of a process model of discharge planning from hospitals. Model building involved the identification of factors used by discharge planners to develop aftercare plans, and the specification of the roles of these factors in the development of the discharge plan. The factors in the model were concatenated in 16 discrete decision sequences, each of which produced an aftercare plan.^ The sample for this study comprised 407 inpatients admitted to the M. D. Anderson Hospital and Tumor Institution at Houston, Texas, who were discharged to any site within Texas during a 15 day period. Allogeneic bone marrow donors were excluded from the sample. The factors considered in the development of discharge plans were recorded by discharge planners and were used to develop the model. Data analysis consisted of sorting the discharge plans using the plan development factors until for some combination and sequence of factors all patients were discharged to a single site. The arrangement of factors that led to that aftercare plan became a decision sequence in the model.^ The model constructs the same discharge plans as those developed by hospital staff for every patient in the study. Tests of the validity of the model should be extended to other patients at the MDAH, to other cancer hospitals, and to other inpatient services. Revisions of the model based on these tests should be of value in the management of discharge planning services and in the design and development of comprehensive community health services.^

The Hospital Study of the City of Houston and Harris County

In 1941 the Texas Legislature appropriated $500,000 to the Board of Regents of the University of Texas to establish a cancer research hospital. The M. D. Anderson Foundation offered to match the appropriation with a grant of an equal sum and to provide a permanent site in Houston. In August, 1942 the Board of Regent of the University and the Trustees of the Foundation signed an agreement to embark on this project. This institution was to be the first one in the medical center, which was incorporated in October, 1945. The Board of Trustees of the Texas Medical Center commissioned a hospital survey to: - Define the needed hospital facilities in the area - Outline an integrated program to meet these needs - Define the facilities to be constructed - Prepare general recommendations for efficient progress The Hospital Study included information about population, hospitals, and other health care and education facilities in Houston and Harris County at that time. It included projected health care needs for future populations, education needs, and facility needs. It also included detailed information on needs for chronic illnesses, a school of public health, and nursing education. This study provides valuable information about the general population and the state of medicine in Houston and Harris County in the 1940s. It gives a unique perspective on the anticipated future as civic leaders looked forward in building the city and region. This document is critical to an understanding of the Texas Medical Center, Houston and medicine as they are today. SECTIONS INCLUDE: Abstract The Abstract was a summary of the 400 page document including general information about the survey area, community medical assets, and current and projected medical needs which the Texas Medical Center should meet. The 123 recommendations were both general (e.g., 12. “That in future planning, the present auxiliary department of the larger hospitals be considered inadequate to carry an added teaching research program of any sizable scope.”) and specific (e.g., 22. That 14.3% of the total acute bed requirement be allotted for obstetric care, reflecting a bed requirement of 522 by 1950, increasing to 1,173 by 1970.”) Section I: Survey Area This section basically addressed the first objective of the survey: “define the needed hospital facilities in the area.” Based on the admission statistics of hospitals, Harris County was included in the survey, with the recognition that growth from out-lying regional areas could occur. Population characteristics and vital statistics were included, with future trends discussed. Each of the hospitals in the area and government and private health organizations, such as the City-County Welfare Board, were documented. Statistics on the facilities use and capacity were given. Eighteen recommendations and observations on the survey area were given. Section II: Community Program This section basically addressed the second objective of the survey: “outline an integrated program to meet these needs.” The information from the Survey Area section formed the basis of the plans for development of the Texas Medical Center. In this section, specific needs, such as what medical specialties were needed, the location and general organization of a medical center, and the academic aspects were outlined. Seventy-four recommendations for these plans were provided. Section III: The Texas Medical Center The third and fourth objectives are addressed. The specific facilities were listed and recommendations were made. Section IV: Special Studies: Chronic Illness The five leading causes of death (heart disease, cancer, “apoplexy”, nephritis, and tuberculosis) were identified and statistics for morbidity and mortality provided. Diagnostic, prevention and care needs were discussed. Recommendations on facilities and other solutions were made. Section IV: Special Studies: School of Public Health An overview of the state of schools of public health in the US was provided. Information on the direction and need of this special school was also provided. Recommendations on development and organization of the proposed school were made. Section IV: Special Studies: Needs and Education Facilities for Nurses Nursing education was connected with hospitals, but the changes to academic nursing programs were discussed. The needs for well-trained nurses in an expanded medical environment were anticipated to result in significant increased demands of these professionals. An overview of the current situation in the survey area and recommendations were provided. Appendix A Maps, tables and charts provide background and statistical information for the previous sections. Appendix B Detailed census data for specific areas of the survey area in the report were included. Sketches of each of the fifteen hospitals and five other health institutions showed historical information, accreditations, staff, available facilities (beds, x-ray, etc.), academic capabilities and financial information.

Texas Medical Center --- Its Origins

This document details the people and institutions who were instrumental in the establishment and development of the Texas Medical Center (TMC). Biographical information about the founders, role the M. D. Anderson Foundation, and opening of the main institutions in the early 1950s is detailed. A copy of a speech given in 1958 by W. B. Bates, one of the trustees of the M. D. Anderson Foundation, on the history and development of the TMC is significant because he was one of the founders of the TMC. This document was commissioned by the Houston Chamber of Commerce in 1971 as the Texas Medical Center began a new phase of expansion with the pending addition of The University of Texas Medical School at Houston. It includes information about each of the 21 institutions which comprised the TMC at that time.

End -of -life planning and decision -making: Implications for adults with mental retardation

This research focused on the topic of end-of-life planning and decision-making for adults affected by mental retardation. Adults with mental retardation have unique challenges in this regard, including difficulty communicating their wishes without assistance and diminished decision-making skills. The primary research objective was to identify factors that can affect opportunities for adults with mental retardation in community-based services settings (and their advocates) to be involved in planning and deciding about their own end-of-life experience. ^ A descriptive qualitative inquiry was designed to explore issues related to death and dying, and the notion of end-of-life planning, from the perspective of adults with mental retardation who receive publicly-funded community services ("clients") and family members of individuals who receive such services. Study participants were recruited from a single mental retardation service provider in a large urban setting (the "Agency"). Sixteen clients and 14 families of Agency clients took part. Client data collection was accomplished through face-to-face interviews, focus group meetings, and record reviews; family members were involved in a face-to-face interview only. ^ An initial coding scheme was developed based upon literature and policy reviews, and themes related to the research questions. Analysis involved extracting data from transcripts and records and placing it into appropriate thematic categories, building support for each theme with the accumulated data. Coding themes were modified to accommodate new data when it challenged existing themes. ^ Findings suggest that adults with mental retardation do have the requisite knowledge, interest, and ability to participate in decisions about their end-of-life experience and handling of affairs. Siblings are overwhelmingly the chosen future surrogates and they (or their children) will likely be the end-of-life advocates for their brothers and sisters affected by mental retardation. Findings further point to a need for increased awareness, accurate information, and improved communication about end-of-life issues, both in general and particular to adults affected by mental retardation. Also suggested by the findings is a need to focus on creating accommodations and adaptations that can best uncover a person's authentic views on life and death and related end-of-life preferences. Practical implications and suggestions for further research are also discussed. ^

Pro Scientia et Patria : Universidad, ciencia y sociedad. El caso de la Universidad Nacional de La Plata durante el período gonzaliano (1905-1918)

La presente tesis trata sobre el modelo gonzaliano de universidad científica que se adopta en la Universidad Nacional de La Plata a partir de 1905. El análisis del caso particular plantea el tema de la relación ciencia-universidad en la Argentina en el momento inicial de esta vinculación, situado históricamente entre fines de siglo XIX y principios de siglo XX. Se hace particular referencia a la tensión estructural de la universidad argentina constituida alrededor del eje ciencia - profesión y a la articulación que se da entre ciencia y universidad con la emergencia de la profesión académica. En el trabajo nos proponemos mostrar, en primer lugar, en qué medida y mediante qué dispositivos el carácter científico constituyó el eje vertebrador de todas las prácticas universitarias en el período comprendido entre 1905 y 1918, etapa durante la cual J. V. González ejerció la presidencia de la UNLP: la formación científica de los estudiantes, la investigación y la extensión a la sociedad. En segundo lugar, nos interesa indagar acerca de sus límites para lo cual se aborda la discusión entre la dinámica institucional y los condicionamientos estructurales de la sociedad argentina. Finalmente, se discuten las tendencias -científicas o profesionales- que se consolidan al final del período considerado

Pro Scientia et Patria : Universidad, ciencia y sociedad. El caso de la Universidad Nacional de La Plata durante el período gonzaliano (1905-1918)

La presente tesis trata sobre el modelo gonzaliano de universidad científica que se adopta en la Universidad Nacional de La Plata a partir de 1905. El análisis del caso particular plantea el tema de la relación ciencia-universidad en la Argentina en el momento inicial de esta vinculación, situado históricamente entre fines de siglo XIX y principios de siglo XX. Se hace particular referencia a la tensión estructural de la universidad argentina constituida alrededor del eje ciencia - profesión y a la articulación que se da entre ciencia y universidad con la emergencia de la profesión académica. En el trabajo nos proponemos mostrar, en primer lugar, en qué medida y mediante qué dispositivos el carácter científico constituyó el eje vertebrador de todas las prácticas universitarias en el período comprendido entre 1905 y 1918, etapa durante la cual J. V. González ejerció la presidencia de la UNLP: la formación científica de los estudiantes, la investigación y la extensión a la sociedad. En segundo lugar, nos interesa indagar acerca de sus límites para lo cual se aborda la discusión entre la dinámica institucional y los condicionamientos estructurales de la sociedad argentina. Finalmente, se discuten las tendencias -científicas o profesionales- que se consolidan al final del período considerado

Pro Scientia et Patria : Universidad, ciencia y sociedad. El caso de la Universidad Nacional de La Plata durante el período gonzaliano (1905-1918)

La presente tesis trata sobre el modelo gonzaliano de universidad científica que se adopta en la Universidad Nacional de La Plata a partir de 1905. El análisis del caso particular plantea el tema de la relación ciencia-universidad en la Argentina en el momento inicial de esta vinculación, situado históricamente entre fines de siglo XIX y principios de siglo XX. Se hace particular referencia a la tensión estructural de la universidad argentina constituida alrededor del eje ciencia - profesión y a la articulación que se da entre ciencia y universidad con la emergencia de la profesión académica. En el trabajo nos proponemos mostrar, en primer lugar, en qué medida y mediante qué dispositivos el carácter científico constituyó el eje vertebrador de todas las prácticas universitarias en el período comprendido entre 1905 y 1918, etapa durante la cual J. V. González ejerció la presidencia de la UNLP: la formación científica de los estudiantes, la investigación y la extensión a la sociedad. En segundo lugar, nos interesa indagar acerca de sus límites para lo cual se aborda la discusión entre la dinámica institucional y los condicionamientos estructurales de la sociedad argentina. Finalmente, se discuten las tendencias -científicas o profesionales- que se consolidan al final del período considerado

De la reflexión a la acción. Relato de la experiencia RoadsMOOC, como viaje educomunicativo de transformación personal y social

Con la intención de experimentar con nuevas formas de aprendizaje a través de la Educomunicación y de los MOOCs sociales o sMOOC, creamos una experiencia de aprendizaje colaborativo y de empoderamiento individual y social, a través de nuestra propuesta “Road sMOOC: Un viaje Eduktransformador”, llevado a cabo en la Plataforma ECOLearning. La finalidad de este sMOOC ha sido emprender un viaje de descubrimiento personal y de alfabetización digital crítica, motivando a los participantes a que dejen aflorar su potencial transformador y que participen activamente en las redes sociales, generando así un aprendizaje colectivo y aumentando el impacto social de nuestras acciones. Se reflexiona sobre los autores que nos inspiraron, sobre lo que entendemos por Educomunicación transformadora y las posibilidades que ofrecen los sMOOC. Finalmente resumimos los objetivos, recursos creados, aprendizajes compartidos y conclusiones que surgen al co-crear una identidad colectiva y un espíritu de trabajo en comunidad como “Eduktransformers”.

The New York City infant day care study : a comparative study of licensed group and family infant day care programs and the effects of these programs on children and their families /

"Final report, grant MC-R-360011."

Practice management considerations /

Mode of access: Internet.

Mental health issues in grief counseling : summary of proceedings : National Conference on Mental Health Issues Related to Sudden Infant Death Syndrome, February 23-25, 1977, Friendship International Hotel, Baltimore, Md. /

Includes bibliographical references.

Prevention of hemolytic disease of the fetus and newborn due to rh isoimmunization /

Mode of access: Internet.

Smoking cessation in pregnancy : abbreviated prenatal counseling protocols for WIC educators and/or health care professionals /

"Reprint December 1994"--P. [2] of cover.

Mental health and aging [microform] : call for federal action : hearing before the Select Committee on Aging, House of Representatives, One Hundredth Congress, second session, March 2, 1988.

"Comm. pub. no. 100-678."

The National Health Service Corps practice management guide book.

Prepared under a contract for the National Health Service Corps by Family Health Care, Inc.