Background:  Outpatient clinics are struggling to deal with increasing workload and demand for services and hence to meet performance indicators and waiting time targets.  Outpatient services are trying to achieve effective and efficient health care in overcrowded, busy clinic settings.  Open access clinics have been advocated as a way of improving outpatient services. Methods:  A cluster randomised trial was undertaken of a guideline based open access urological investigation service for two common conditions - prostatism and microscopic haematuria.  The trial used a balanced incomplete block design.  The study involved sixty-six (73%) of general practices in the Grampian region of Scotland.  Data were collected before and after the intervention on general practitioners’ pre-referral and post-referral management, hospital management, patient outcome and costs.  Analysis was by intention-to-treat and multilevel modelling was adopted for analyses conducted at the individual patient level. Findings:  General practitioners’ compliance with referral guidelines increased (difference in means 0.5; 95% confidence interval 0.21 to 0.81, P>0.001).  Approximately 50% of patients were referred though the new system.  There were no changes in the number or casemix of referrals.  The intervention reduced waiting time from referral to initial outpatient appointment (ration of means 0.7; 0.55 to 0.89, prostatism patients only) and increased the number of patients who had a management decision reached at initial appointment (odds ratio 5.8; 2.9 to 11.5, P<0.00001, both conditions).  Patients were more likely to be discharged within 12 months (odds ratio 1.7; 0.9 to 3.8, P=0.11).  Overall the new service was probably cost saving to the NHS. Interpretation:  The guideline based open access investigation service streamlined the process of outpatient referral and resulted in a more efficient service with reduced outpatient waiting times.

Thesis (DR. P.H.)--University of Michigan.

Thesis (M.H.S.A.)--University of Michigan, 1982.

Thesis (M.H.S.A.)--University of Michigan, 1982.

Thesis (DR. P.H.)--University of Michigan.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1952. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves [214]-222).

Thesis (M.Public Health) -- University of the Western Cape, 2009. / Includes bibliographic references (leaves 118-126).

Thesis (M.A.)--University of Wisconsin--Madison. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 37-38).

In early December, 1971, I was one of eight people who met in a community center in Amherst, Massachusetts. We had all come in response to an ad, placed by one of those present, in a local newspaper. The ad called for anyone interested in setting up a free clinic to come to an organizational meeting that evening. This was to be the first meeting of a group that set itself the task of planning and opening a free clinic in the Pioneer Valley area. The term "free clinic" has no precise definition since it encompasses a wide range of different types of health care facilities. In general, these facilities provide medical services (although counseling, psychiatric and educational programs may also be involved), and they provide these services either at low cost or without cost to the person seeking help. Within these bounds however there is room for tremendous variation among free clinics in the range of services provided, the nature of the patient population (some clinics serve women or minority groups exclusively), the structure and organization of the facility, the relationship between professional and non-professional staff, and the political consciousness and activity of the staff as a body.

Thesis (M.S.)--Boston University / This is a study of 1) the ways in which family conferences are used in the Psychiatric Clinic of the Children's Medical Center; 2) the social worker's feelings and attitudes about these conferences; 3) team relationships in these conferences; and 4) implications of the family conference for the casework relationship. In order to describe the conferences and explore the social worker's feelings and attitudes, information was sought in six general areas: 1) how the conferences were used by the clinic and therapists; 2) social worker's general knowledge and experience with family conferences; 3) factors in team relationships; 4) the client's reactions to the family conference; 5) implications of the family conferences for the casework relationship, and 6) the social worker's evaluation of family conferences in general.