We all negotiate every day, professionally and socially, yet few of us have had any training in how to do so more effectively. For professionals in health, social care and children's services, an ability to negotiate successfully is vital. Commissioning, contracting and negotiating new partnerships for delivering better services are now part of everyday life. Arguing that in the health and social services a different, less aggressive approach is required to that advocated by negotiators in the commercial sectors, Keith Fletcher explains how to prepare for and deal with negotiation situations more confidently so that settlements can be reached which satisfy all parties.

Clinical Audit in Mental Health Towards a Multidisciplinary Approach John Riordan Central Psychology Service, Thorpe Combe Hospital, Walthamstow, UK and Darren Mockler Neuropsychology Department, King's College Hospital, London, UK Clinical audit is central to current health care reforms. Although the concept of audit is now well accepted, the key challenge is its implementation in different specialities. In the field of mental health care a highly collaborative, team-based approach is essential, and audit practice must take into account the activities of the full range of multidisciplinary professional groups in hospital and community settings. The content of this book reflects the growing need to extend the principles of medical audit to encompass clinical audit in order to meet the demands of purchasers, providers, clinicians, carers and patients. An evaluation of key areas of care such as delivery, timeliness and outcome, with an emphasis on quality, is provided. The approach to clinical audit, here, is essentially practical and case-oriented and this book will appeal to a wide audience including psychiatric services managers, consultant psychiatrists, social services care managers and community care teams, and quality assurance professionals.

A COMPLETE, STEP-BY-STEP GUIDE TO PREPARING YOURSELF AND YOUR COMMUNITY TO AID FIRST RESPONDERS DURING A DISASTER SITUATION Nothing brings out the best in neighbors more than facing a catastrophe together. But don't wait till the disaster is upon you. This book shows how you can work together today to protect the lives and homes of all the families in your neighborhood tomorrow. With guidance on how you can take a leadership role, this helpful handbook details everything your community needs to be fully prepared for any natural disaster. * Creating event-specific disaster kits for yourself and your family * Learning about basic fire safety and fire fighting * Establishing triage centers in the event that first responders can't reach you * Stabilizing disaster victims through need-to-know first aid * Creating your own neighborhood emergency response team to keep your neighborhood safe and save lives should the worst occur

In the event of a disaster or public health emergency, individual agencies and hospitals cannot always effectively act alone. In order to provide a collaborative, comprehensive system of planning and response a Healthcare Emergency Response Coalition (HERC) is needed. This book introduces the concept of a HERC and demonstrates why and how a HERC is among the most effective tools for health emergency response and preparedness. Establishing a Healthcare Emergency Response Coalition addresses all matters related to instituting and developing a successful HERC. This Guide is based on Palm Beach County's experiences during the formation and implementation of their tried and tested HERC now a national model and can serve to direct your community in establishing its own HERC. It addresses the most fundamental questions of starting a HERC, such as - What is a HERC? - Why do we need a HERC? - How do we start a HERC - How should a HERC be structured? It also provides guidance for developing and sustaining a successful HERC by outlining the steps and activities needed to begin and providing a list of policies and procedures that can be implemented and resources that can be consulted. This information can be applied and customized to any community's specific needs and resources to implement a program that will address any size disaster or healthcare emergency that presents itself. This book provides myriad benefits to everyone invested in emergency preparedness for a community, from health officials and emergency response teams to government officials and fire and police departments, along with anyone else involved with preparing his or her community for disasters and public health emergencies.

The three basic elements in preparing for, responding to and recovering from any catastrophic disaster are (1) leadership; (2) capabilities; and (3) accountability. Leadership in the form of legal authorities, roles and responsibilities, and lines of authority at all levels of government must be clearly defined, effectively communicated, and well understood in order to facilitate rapid and effective decision making. Developing the capabilities needed for catastrophic disasters should be part of an overall national effort designed to integrate and define what needs to be done, where, by whom, and how well. Ensuring needed capabilities are ready requires effective planning and coordination, plus robust training and exercises in which the capabilities are realistically tested, problems identified, and subsequently addressed in partnership with federal, state, local, and non-governmental stakeholders.

This text examines actual attempts to "prepare" for catastrophes and finds that the policies adopted by corporations and government agencies are fundamentally rhetorical: the plans have no chance to succeed, yet they serve both the organizations and the public as symbols of control, order and stability. These "fantasy documents" attempt to inspire confidence in organizations, but Lee Clarke suggests that they are disturbing persuasions, soothing the perception that ultimately one cannot control technological advances. For example, Clarke studies corporations' plans for cleaning up oil spills in Prince William Sound prior to the "Exxon Valdez" debacle, and he finds that the accepted strategies were not just unrealistic but completely untenable. Although different organizations were required to have a cleanup plan for huge spills in the sound, a really massive spill was unprecedented, and the accepted policy was little more than a patchwork of guesses based on (mostly unsuccessful) cleanups after smaller accidents. Clarke points out that reassuring rhetoric (under the guise of expert prediction) may have no basis in fact or truth because no such basis is attainable. In uncovering the dangers of planning when implementation is a fantasy, Clark concludes that society would be safer, smarter, and fairer if organizations could admit their limitations.

What does it mean to be a good doctor in America today? How do such challenges as new biotechnologies, the threat of malpractice suits, and proposed health-care reform affect physicians' ability to provide quality care?
These and many other crucial questions are examined in this book, the first to fully explore the meaning and politics of competence in modern American medicine. Based on Mary-Jo DelVecchio Good's recent ethnographic studies of three distinct medical communities--physicians in rural California, academics and students involved in Harvard Medical School's innovative "New Pathway" curriculum, and oncologists working on breast cancer treatment--the book demonstrates the centrality of the issue of competence throughout the medical world. Competence, it shows, provides the framework for discussing the power struggles between rural general practitioners and specialists, organizational changes in medical education, and the clinical narratives of high-technology oncologists. In their own words, practitioners, students, and academics describe what competence means to them and reveal their frustration with medical-legal institutions, malpractice, and the limitations of peer review and medical training.
Timely and provocative, this study is essential reading for medical professionals, academics, anthropologists, and sociologists, as well as health-care policymakers.

In the current atmosphere of closer scrutiny of healthcare practices and procedures, front-line managers and health care providers must investigate potential problems in their work environment, whether at the behest of upper management, in order to meet Joint Commission on Accreditation of Health Care Organizations (JCAHO) standards, or through their own sense that "weÆre doing something wrong." For the investigator with limited previous experience in evaluation or research, the prospect of undertaking this kind of investigation can appear daunting, to say the least. Quality Improvement Projects in Health Care was written just for this individual. Author Eleanor Gilpatrick, a seasoned investigator and professor of health services administration, provides a review of the basic terminology and guidelines for carrying out "nuts-and-bolts" quality improvement research. She then demonstrates how such a research project can be implemented through 14 case studies involving actual health care situations. Altogether, the cases speak to a broad array of issues and potential pitfalls for the unwary investigatorùand they show that progress can be made in even the most difficult circumstances. Quality Improvement Projects in Health Care will be of interest to students and professionals in health sciences administration, nursing, allied health, and public health.

In the current atmosphere of closer scrutiny of healthcare practices and procedures, front-line managers and health care providers must investigate potential problems in their work environment, whether at the behest of upper management, in order to meet Joint Commission on Accreditation of Health Care Organizations (JCAHO) standards, or through their own sense that "weAEre doing something wrong." For the investigator with limited previous experience in evaluation or research, the prospect of undertaking this kind of investigation can appear daunting, to say the least. Quality Improvement Projects in Health Care was written just for this individual. Author Eleanor Gilpatrick, a seasoned investigator and professor of health services administration, provides a review of the basic terminology and guidelines for carrying out "nuts-and-bolts" quality improvement research. She then demonstrates how such a research project can be implemented through 14 case studies involving actual health care situations. Altogether, the cases speak to a broad array of issues and potential pitfalls for the unwary investigatoruand they show that progress can be made in even the most difficult circumstances. Quality Improvement Projects in Health Care will be of interest to students and professionals in health sciences administration, nursing, allied health, and public health.

This book presents a comparative analysis of mental health policy in Western Europe and North America. It also considers how and why different policies have developed.

Simon Goodwin examines the transition from institutional to community-based models of care for people with mental health problems, identifying variations in the inception, pace and style in which community-based service provision has emerged in different countries. Goodwin also assesses the problems and issues that have arisen as a result of the shift towards more community-based systems of care and treatment, and argues that it is a policy made up of conflicting aims and purposes, which is reflected in its implementation.

What are the political forces which drive the process of change in the health service? How do these forces impact on existing structures of power, policy and organisation? In addressing these questions, Brian Salter applies an original theory of political change to key areas of NHS activity. He shows how the escalating demand for health care combined with recent radical policy initiatives has posed different problems for politicians, doctors, bureaucrats and managers. Out of the accommodations reached, a new shape has emerged for the NHS.

Americans have benefited from substantial improvements in health since the end of World War II. They live longer and grow taller; they have the safest and cheapest food supply on the planet; they have seen virtually all childhood diseases brought under control. Yet concerns about health remain widespread today. Cancer seems to be everywhere; autoimmune, nervous, and environmental diseases have reached pandemic proportions; medical malpractice suits have proliferated.

How can we have received so many benefits while still being as worried as ever about our health and the health care system established to ensure and extend those benefits? The historical perspective provided by the essays in this volume helps answer this question by identifying two points of significant change in health care policy. Beginning in the 1950s there emerged a subtle yet critical reconceptualization as the individual rather than the group came to figure prominently as the central policy-making unit. Then in the late 1960s a palpable sense of limits rendered the individualism of the previous decade into a Malthusian formulation: the greater the access or benefits that any one person received, the less others could get. Besides tracing these patterns in health care development, the essays also show how traditional notions of expertise have been affected by the changes. Contributors are Amy Sue Bix, Hamilton Cravens, Gerald N. Grob, Alan I Marcus, Diane Paul, David Rosner and Gerald Markowitz, and James Harvey Young.

New ideas on the role of the state in developing countries have considerable implications for the social sectors, especially health. Certain international organizations have advocated a larger role for private sector health care providers and many developing country governments have adopted this approach. Yet, until now, very little evidence has existed about how shifting the balance between public and private roles might affect equity, and the quality and efficiency of health care. This book presents the results from a coordinated programme of research on the private health care sector including studies carried out by Asian, African and Latin American researchers. The conceptual chapters draw upon both industrialized and developing country literature to describe the intellectual terrain, analyse the key issues and summarize experience to date. This book will help increase understanding of the private sector, as well as illustrating the contentious issues involved in privatization. It will be useful to students and academics involved in international public health courses, and to health policy makers in developing countries.

Can the United States provide a health care program that offers a comprehensive package of the highest-quality health benefits to all Americans while containing health care costs? In this important book, Dr. William L. Kissick says that it cannot: no society in the world has sufficient resources to provide all the health services its population is capable of utilizing. Dr. Kissick was an active participant in the drafting of Medicare legislation in the 1960s and for the past twenty-five years has held joint positions in a medical school and a business school where he has specialized in health care management. Drawing on his long experience in the field, he discusses the dimensions of the current crisis, the financial and medical implications of alternative proposals--including the program put forth by the Clinton administration--and the requirements for long-term strategies. He argues that although there are no ideal solutions to health care reform, there are many significant programs at the regional, state, and local level that can serve as prototypes for the restructuring of the organization, financing, and delivery of health services. Dr. Kissick discusses some of these alternatives and suggests that after the federal government legislates a health care policy, it should be implemented through collaboration with state and local initiatives, for such programs have been built on an understanding of regional needs, expectations, and cultural diversity.

Experts agree--the U.S. has achieved the most technologically advanced medical care system in the world and it provides the highest quality, most comprehensive medical education available. Can we conclude that our health care system is one of America's success stories? It appears--we cannot. However, amid growing concern over our health care system, there is far less agreement on what to do about it. Jennie Kronenfeld addresses major health care controversies confronting American society, health care professionals, and policymakers. This intriguing book focuses on the overlapping area between policy sciences and health care studies, particularly the cost, access, and quality of health care. Kronenfeld discusses whether our system can solve its problems, or whether we have a health care "system" at all. Do we have a national health care "policy," or a web of state, county, and city policies? And, what of fundamental changes being adopted in the midst of the controversies surrounding reproductive health and abortion, mental health and behavioral health, disease patterns/physical health/AIDS, aging and long-term care, as well as the professions and facilities who provide care? A provocative examination of these important issues, Controversial Issues in Health Care Policy is essential reading for students of policy studies, health services, and sociology, as well as for policymakers, and health care professionals.

The second revised edition of a popular training guide designed to help health workers, including nurses, midwives, and medical assistants, improve their managerial skills. Acknowledging the close link between good management and good health care, the manual shows how a wide range of simple managerial tools can be used to stretch scarce resources, whether through more efficient use of time or less wastage of drugs. Throughout the book, numerous exercises, practical examples, case studies, cartoons, charts, and sample forms are used to help readers adopt a problem-solving attitude and relate advice and suggestions to their own daily problems. The guide features 14 chapters presented in four main parts, any one of which can be studied separately or as part of the whole, according to individual learning needs. The first part explains the general principles and functions of management. Part two, on personal relations, offers advice on how to motivate a health team, delegate authority, supervise, conduct meetings, and encourage high standards of work. The third and most extensive part describes problem-solving methods for the management of common problems involving equipment, drug supply, money, time, and space. The final part shows how the principles of good management can be applied to health care in a community.

Red Adair is now a multimillionaire, but he has worked his way up from a poor childhood in Houston where he spent years on the railways and on bomb-disposal before becoming an expert on oil-well firefighting. This is an account of his heroic life fighting fires all over the world - the 800-foot Devil's Cigarette Lighter in Algeria, fires in the giant wells of the Awaz Field in Iran, the sabotaged wells of Sumatra and Libya, and most recently, the Piper Alpha explosion in the North Sea.

Using the authors many years of experience in emergency services and his skills as a hazardous materials consultant, prepares the first responder to handle everything from re-establishing control and on-scene triage to investigating the crime. Including information on pre-incident and avoidance tactics, the author also discusses monitoring and detection techniques, protective equipment and decontamination, and an extensive list of resource organizations and training opportunities. This up-to-date 3rd edition is written to provide concise information for emergency responders who might be called upon to confront explosive, chemical, nuclear, biological, or incendiary acts of terrorism.

Radioactive sources such as nuclear power installations can pose a great threat to both humans and our environment. How do we measure, model and regulate such threats? Environmental Radioactivity and Emergency Preparedness addresses these topical questions and aims to plug the gap in the lack of comprehensive literature in this field. The book explores how to deal with the threats posed by different radiological sources, including those that are lost or hidden, and the issues posed by the use of such sources. It presents measurement methods and approaches to model and quantify the extent of threat, and also presents strategies for emergency preparedness, such as strategies for first-responders and radiological triage in case an accident should happen. Containing the latest recommendations and procedures from bodies such as the IAEA, this book is an essential reference for both students and academicians studying radiation safety, as well as for radiation protection experts in public bodies or in the industry.

While professional courses and how-to manuals can prepare us for expected events that will occur in the course of our careers, there remains an untapped reservoir of life experience that cannot be prepared for in training or study. These events and experiences give texture and meaning to our work and shape our character. Filled with stories of courage and inspiration, What They Didn't Teach at the Academy: Topics, Stories, and Reality Beyond the Classroom looks at experiences encountered by public safety and military professionals that were not necessarily encompassed in their training or realistically portrayed in simulations. Topics raised in the stories include: A doctor confronting her own debilitating and potentially fatal disease Cultural awareness and safe travel Suicide among law enforcement officers Departmental harassment of a new police recruit Coping with an addicted spouse Posttraumatic stress disorder Life as a K-9 handler The effect of work obligations on marriage and family Conflicts between moral beliefs and professional principles Debunking myths about Islam The book also examines coping mechanisms for stress and discusses the importance of observation, perception, and communication in facing challenging encounters. Through this collection of vignettes and philosophies, the contributors demonstrate that the lessons of life are not taught in colleges, universities, and academies but through hard experience.

"Cop Doc's Guide to Public Safety Complex Trauma Syndrome" is written in response to the need for an advanced, specialized guide for clinicians to operationally define, understand, and responsibly treat complex post-traumatic stress and grief syndromes in the context of the unique varieties of police personality styles. The book continues where Rudofossi's first book, "Working with Traumatized Police Officer Patients", left off. Theory is wed to practice and practice to effective interventions with police officer-patients. The 'how' and 'why' of a clinician's approach is made highly effective by understanding the distinct personality styles of officer-patients. Rudofossi's theoretical approach segues into difficult examples that highlight each officer-patient's eco-ethological field experience of loss in trauma, with a focus on enhancing resilience and motivation to - otherwise left disenfranchised. Thus, this original work expands the ecological-ethological existential analysis of complex PTSD into the context of personality styles, with an emphasis on resilience - without ignoring the pathological aspects of loss that often envelop officer-patient trauma syndromes.