Last data update: May 13, 2024. (Total: 46773 publications since 2009)
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Assessment of staffing, services, and partnerships of local health departments - United States, 2015
Newman SJ , Ye J , Leep CJ , Hasbrouck L , Zometa C . MMWR Morb Mortal Wkly Rep 2016 65 (25) 646-9 Beginning in 2008, the National Association of County and City Health Officials (NACCHO) periodically surveyed local health departments (LHDs) to assess the impact of the economic recession on jobs and budgets (1). In 2014, the survey was expanded to assess a wider range of factors affecting programs, services, and infrastructure in LHDs and renamed the Forces of Change survey (2). The survey was administered in to January-February 2015 to 948 LHDs across the United States to assess budget changes, job losses, changes in services, and collaboration with health care partners; 690 (73%) LHDs responded. Findings indicated a change in LHD infrastructure: compared with the previous fiscal year.* Overall, LHDs reported 3,400 jobs lost; 25% of LHDs reported budget decreases; 36% reported a reduction in at least one service area; and 35% reported serving fewer patients in clinics. In addition, up to 24% of LHDs reported expanding population-based prevention services, and LHDs reported exploring new collaborations with nonprofit hospitals and primary care providers (PCPs). |
The need for computerized tracking systems for resource-limited settings: the example of Georgetown, Guyana
Basavaraju SV , Pitman JP , Henry N , McEwan C , Harry C , Hasbrouck L , Marum L . Transfus Med 2009 19 (3) 149-51 Blood services in industrialized countries routinely use computerized tracking systems, the merits of which are described extensively in the literature. Such systems ease blood utilization review, enhance safety and improve tracking (Dohnalek et al., 2004; Davies et al., 2006; Dzik, 2007). Computerized blood-use modelling and prediction systems are typically used in developed nations to forecast demand (Katz et al., 1983; Sirelson & Brodheim, 1991; Nightingale et al., 2003). Because of financial and logistical challenges, such systems are uncommon in resource-limited settings, where blood services rely on manual, paper-based methods, or simple electronic tools (e.g., Microsoft Excel). Here we highlight the specific challenges faced by a blood service in a resource-limited setting and describe future options for low-cost, scalable computerized systems for developing countries. | In Guyana, blood is collected, screened and distributed by the National Blood Transfusion Service (NBTS), a branch of the Guyana Ministry of Health. Approximately 80% of all blood collected by NBTS is distributed to the Georgetown Public Hospital Corporation (GPHC), Guyana's only tertiary-care referral centre. For record keeping, NBTS collects daily information on blood (whole blood and blood products) units requested, cross-matched units issued and units returned unused in three paper-based registers. In October 2007, NBTS instituted an expanded paper-based Blood Request Form (BRF), which, for the first time, allowed NBTS to match patient data from the wards with blood centre data from the three registers. Properly completed BRFs, which are submitted by physicians, are now required for NBTS to dispense blood. NBTS files BRFs in three folders labelled as follows: (1) cancelled before preparation by NBTS; (2) prepared and retrieved by ward and (3) prepared but not retrieved by ward. In December 2007, NBTS conducted a preliminary internal review of November 2007 (the first complete month in which BRFs were used) records. This review suggested that nearly 60% of all blood units requested by GPHC were not delivered by NBTS. In January 2008, NBTS requested technical assistance from the U.S. Centers for Disease Control and Prevention (CDC) to conduct a rapid and focused assessment to investigate the extent of this apparent blood shortage. The investigation focused on the blood-ordering process at GPHC, the NBTS system to track GPHC requests and the distribution and flow of blood units. In conjunction with NBTS, CDC conducted a retrospective review and descriptive analysis of NBTS records for November 2007. The review tracked blood request information through the paper-based system of registers and folders. Data were extracted from the sources described above: BRFs filed in the three folders and entries in the three data registers. |
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