DOCSLIB.ORG

Strategies to Increase Health Facility Deliveries: Three Case Studies

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Strategies to Increase Health Facility Deliveries: Three Case Studies Strategies to increase health facility deliveries: Three case studies Strategies to increase health facility deliveries: Three case studies Copyright © 2014 UCSF Global Health Group The Global Health Group Global Health Sciences University of California, San Francisco 550 16th Street, 3rd Floor San Francisco, CA 94158 USA Email: [email protected] Website: globalhealthsciences.ucsf.edu/global-health-group Ordering information This publication is available for electronic download at globalhealthsciences.ucsf.edu/global-health-group/ ghg-publications Recommended citation Butrick, E., Diamond-Smith, N., Beyeler, N., Montagu, D., Sudhinaraset, M. (2014). Strategies to increase health facility deliveries: Three case studies. Global Health Group, Global Health Sciences, University of California, San Francisco. Cover photos courtesy of Photoshare. © 2006 Abhijit Dey (India) and © 2012 Akintunde Akinleye/NURHI (Nigeria). Produced in the United States of America. First Edition, December 2014 This is an open-access document distributed under the terms of the Creative Commons Attribution-Noncommercial License, which permits any noncommercial use, distribution, and repro- duction in any medium, provided the original authors and source are credited. Contents Introduction | 1 Methods | 2 Country selection process | 2 Interviews and recruitment | 2 Description of each case study | 3 Malawi | 3 Nigeria | 3 India | 3 Summary of themes | 4 Lesson learned #1: Political will | 4 Lesson learned #2: Balancing supply, demand and quality | 5 Lesson learned #3: Improving access to facility deliveries | 6 Lesson learned #4: Community engagement | 7 Lesson learned #5: Norm change | 8 Other policy implementation issues | 9 Transparency and accountability | 9 Conclusion | 10 Scale and sustainability | 10 Summary | 10 Appendix | 11 Malawi: TBA Ban | 11 Nigeria: Subsidy re-investment and empowerment program | 14 Uttar Pradesh, India: Janani Suraksha Yojana (JSY) program | 16 References | 18 Acknowledgements | 18 Introduction The past few decades have seen a growing number of Understanding the challenges and successes of these women delivering in facilities around the globe. Facility policy approaches, and the factors that facilitate success- deliveries are known, in more developed countries, to ful implementation, can inform decision makers interested be associated with improved maternal and child health in increasing the number of facility deliveries, and outcomes. Complications may arise with any birth, in ultimately improving maternal and child health outcomes. which case even a well-trained attendant at home cannot To this end, we conducted in-depth case studies in India, provide adequate care. In many rural areas distances to Malawi, and Nigeria, three countries that have implement- facilities are great and roads poor, making transfer after ed policies to increase facility deliveries. India and Malawi onset of delivery difficult and dangerous. have both experienced a large increase in the number of women delivering in facilities following the implementation According to the most recent Demographic and Health of their policies. Early findings also show that Nigeria’s Surveys (DHS) in Sub-Saharan Africa and Asia, more than policy is increasing facility deliveries, although it is still too 75% of women combined in both regions now deliver new for any country-level analysis. Through interviews with in facilities (Montagu et al., 2014). This change did not key informants, including policy makers, maternal health occur without impetus, as many countries, often with the experts, implementers and providers, we gathered infor- support and encouragement of the international communi- mation about the history, successes, challenges, changes, ty, have pursued strategies, programs and policies aiming and future of policies. to increase the number of women delivering in facilities, ranging from small scale interventions to national policies In this synthesis, we analyze the factors that contributed and laws. Many different approaches have been used. to the successful creation and implementation of maternal These approaches can be thought of as targeting differ- health policies, and assess the challenges faced in imple- ent determinants of why women fail to deliver in health menting and sustaining these policies. This report draws facilities, which have been characterized into four major out crosscutting themes and lessons learned from three categories by Gabrysch and Campbell (2009) (Gabrysch unique country experiences to provide insight relevant for and Campbell, 2009). Some strategies target sociocultural policy-makers and advocates on strategies and consider- determinants (for example, banning or integrating tradi- ations for policy and programmatic approaches to increas- tional birth attendants), some try to increase perceived ing facility deliveries. need (such as through pregnancy counseling), some tar- get economic barriers (such as conditional cash transfers, We identified five key lessons learned about effective fee removal, or vouchers), and others address physical policies to increase facility delivery, including: 1) the im- barriers (such as improving facility infrastructure and staff). portance of political will; 2) the need to balance supply, demand, and quality; 3) the importance of addressing ac- cess to the health system; 4) the important contribution of community engagement, and finally 5) the need to create changes in social norms. Introduction | 1 Methods Country selection process Interviews and recruitment To select the case study countries, we first conducted a Interviews were conducted with three broad groups of review of policies aimed to increase facility deliveries, with people: 1) maternal health experts including both in-coun- a focus on Asia and Sub-Saharan Africa. We focused on try and international representatives of donor and devel- countries where policies were accompanied by increases opment agencies, NGOs, and academic/research institu- in the percent of women delivering in facilities. From this, tions; 2) health officials and policy makers from case study we selected India, Malawi, and Nigeria to explore policies countries; and 3) people involved in policy implementation, across different developmental timelines. India and Malawi including program staff and high-level personnel at imple- both experienced large increases in the rates of facility menting health facilities. Interviews were conducted using delivery in the past 10 years using very different policy semi-structured guides that included questions about the approaches: India introduced a conditional cash transfer policy development and implementation processes, and program, while Malawi instituted a ban on traditional birth the outcomes and effects of the policy, including on-going attendants. Given the variation in implementation across and expected modifications to implementation plans. states in India, we focus our study specifically on Uttar Pradesh state, where maternal and neonatal mortality Respondents were recruited through directly contacting indicators lag behind other states in India. Nigeria recently government and other agencies involved in the creation initiated a maternal health program, which includes a con- and implementation of the policies of interest, as well ditional cash transfer program similar to that in India. Al- as research and program staff involved in supporting or though this is a new program, and the impacts on national evaluating implementation. Snowball sampling was then facility delivery rates are yet unknown, the policy provides used to expand our sample to other relevant individuals a useful comparison with India on effective finance-based and organizations. approaches. The study received exempt IRB approval from the Univer- sity of California, San Francisco. Consent was received from all respondents prior to their participation. Two personnel from UCSF conducted each case study, with a total of three UCSF staff involved in data collection, analy- sis, and write up. We conducted a total of 15 interviews in India, 16 in Nigeria and 16 in Malawi. The findings pre- sented below are based on analysis of these interviews. INDIA NIGERIA MALAWI Methods | 2 Description of each case study Each policy is described briefly below. For a more detailed following components: health facility staffing and renova- description, please see the Appendices. tions; supply chain for essential maternal health commod- ities; conditional cash transfers for ANC, facility-delivery, and post-natal care attendance; and community mobiliza- Malawi tion through village health workers and leadership commit- In the mid-2000s, deliveries by traditional birth attendants tees. The program focuses on rural and high need areas. (TBA) in Malawi were banned by the Malawian president, The SURE-P MCH program is dually managed by a with the support of the Ministry of Health (MOH). TBA’s federal-level implementing unit affiliated with the National roles were refocused from being birth attendants to being Primary Health Care Development Agency (NPHCDA), and community resources who would advise women and refer presidentially appointed oversight committee responsible them in to health facilities. The TBA ban was effective and for approving fund allocation and monitoring implemen- popular, however in 2010, the then-president of Malawi tation. States are engaged through state-level steering made a proclamation that effectively reversed the ban (due committees, and agreements
Load more

Recommended publications
  • Note on Health Facility and Types Larina Brooklyn * College of Medicine and Health Academy, Nigeria
    Health Econ Outcome Res Open Access 2021, Vol.7, Issue 5, e114. Editorial Note on Health Facility and Types Larina Brooklyn * College of Medicine and Health Academy, Nigeria Corresponding Author* clinics are these days staffed by expertly prepared specialists, attendants, paramedical clinicians, and so forth, though truly, this work was typically Larina Brooklyn done by the establishing strict orders or by volunteers. College of Medicine and Health Academy, Nigeria Medical Care Community E-mail: [email protected] Medical care habitats, including facilities, specialist's workplaces, earnest consideration communities and mobile medical procedure places, Copyright: © 2021 Larina Brooklyn . This is an open-access article distributed fill in as first resource with a health proficient and give outpatient clinical, under the terms of the Creative Commons Attribution License, which permits nursing, dental, and different sorts of care administrations. unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Clinical Nursing Homes Clinical nursing homes, including private therapy places and geriatric Received 18 May 2021; Accepted 20 May 2021; Published 27 May 2021 consideration offices, are medical services foundations which have convenience offices and which take part in giving present moment or long haul clinical therapy of a general or concentrated nature not performed by clinics to inpatients with any of a wide assortment of ailments Introduction Drug Stores and Pharmacies A health facility is, by and large, any area where medical services is Drug stores and pharmacies involve foundations occupied with given. Health offices range from little facilities and specialist's workplaces retailing remedy or nonprescription medications and prescriptions, to dire consideration places and enormous medical clinics with intricate and different kinds of clinical and muscular goods.[4] Regulated drug trauma centers and emergency rooms.
    [Show full text]
  • Operational Considerations for Case Management of COVID-19 in Health Facility and Community Interim Guidance 19 March 2020
    Operational considerations for case management of COVID-19 in health facility and community Interim guidance 19 March 2020 Background This document is intended for health ministers, health system administrators, and other decision-makers. It is meant to guide the care of COVID-19 patients as the response capacity of health systems is challenged; to ensure that COVID-19 patients can access life-saving treatment, without compromising public health objectives and safety of health workers. It promotes two key messages: 1. Key public health interventions regardless of transmission scenario; and 2. Key action steps to be taken by transmission scenario to enable timely surge of clinical operations. The public health objectives at all stages of the preparedness and response plan are to: • Prevent outbreaks, delay spread, slow and stop transmission. • Provide optimized care for all patients, especially the seriously ill. • Minimize the impact of the epidemic on health systems, social services, and economic activity. Based on the largest cohort of COVID-19 patients, about 40% of patients with COVID-19 may have mild disease, where treatment is mostly symptomatic and does not require inpatient care; about 40% of patients have moderate disease that may require inpatient care; 15% of patients will have severe disease that requires oxygen therapy or other inpatient interventions; and about 5% have critical disease that requires mechanical ventilation.1 However, the evolution of the outbreak in some countries has shown a higher proportion of severe and critical cases and the need to rapidly increase surge capacity to prevent rapid exhaustion of biomedical supplies and staff. In some countries, doubling rates of cases every 3 days has been observed.2 Scenarios of transmission Countries or subnational areas will have to respond rapidly to one or more epidemiological scenarios.
    [Show full text]
  • A Model Policy for SMART Health Facilities the Model Policy for SMART Health Facilities Was Prepared by Dr
    A Model Policy for SMART Health Facilities The Model Policy for SMART Health Facilities was prepared by Dr. Vasantha Chase, et al, (Castries, Saint Lucia), on behalf of the Pan American Health Organization (2013). TABLE OF CONTENTS Foreword . 3 Section I – Defining the Problem . 5 • The vulnerability of health facilities to natural hazards . 5 • The vulnerability of health facilities to climate change and variability . 6 • Damage to health facilities from disasters . 7 • The cost of damage to health facilities in the Caribbean . 8 • Costs related to climate change and variability . 9 • Progress is being made . 10 Section II –Conceptual Framework for a Policy on SMART Health Facilities . 13 Section III – A Model for Developing a SMART Health Facilities Policy . 17 • Purpose of the policy . 17 • Policy guidelines . 17 • Components of the policy . 18 • Policy strategy . 21 • Implementing the policy . 22 • Monitoring, evaluation and reporting . 23 Conclusion . 25 Acronyms . 26 Glossary . 27 List of Tables • Table 1: Impact of Hurricane Tomas (2010) on health facilities in Saint Lucia . 7 • Table 2: Categorization of Energy Supply in Health Facilities in Guyana . 10 List of Figures • Figure 1: SMART Health Facilities Policy: The conceptual framework . 14 • Figure 2: Operationalising the SMART Health Facilities Policy . 16 • Figure 3: Mapping the Policy on SMART Health Facilities . 19 1 FOREWORD he Caribbean is a highly hazard-prone region. Hurricanes Gilbert, Ivan and Tomas are stark reminders of how the direct and indirect impact of weather-related disasters can significantly Tdisrupt access to health services and the sector’s ability to provide care. However, today it also is becoming increasingly clear that the health sector itself is one of many contributors to the impact of climate change, making it imperative to step up efforts to reduce the environmental footprint and increase the resiliency of its health facilities.
    [Show full text]
  • Choosing Hospice Consumer's Guide
    Choosing Hospice a consumer’s guide Table of Contents Introduction ............................................................2 What makes hospice care special? .........................4 Minnesota Network of Hospice & Palliative Care (MNHPC) promotes quality of life in Minnesota How will hospice care provide support communities through education and access to resources in advance care planning, palliative for me and my family? ...........................................6 care and hospice care. What if I live alone or don’t have Our vision is that all individuals, families and family nearby? .......................................................7 providers will understand the value of and have access to these resources. Who is eligible for hospice care? ...........................8 With provider members across Minnesota, the work of MNHPC touches communities through- How is my care paid for? .......................................8 out the entire state. How do I find a hospice program? .......................10 Glossary ...............................................................12 Originally written in 1997 with a grant from the Allina Foundation as part of its Project DECIDE Program. © 1997 Minnesota Hospice Organization. All rights reserved. © 2nd Edition, Revised 1998. All rights reserved. © 3rd Edition, Revised 2000. All rights reserved. © 4th Edition, Revised 2009. All rights reserved. © 5th Edition, Revised 2010. All rights reserved. Made accessible in 2016 by funding from a Live Well at Home Grant from Minnesota Department of Human Services. 1 INTRODUCTION The thought that you or someone you love According to the wife of a hospice patient, is dying can be overwhelming. It may seem “Thank you for being “We knew that Mark’s prognosis wasn’t that all is hopeless, that there is nothing honest with me, for good, but we also knew that we had today more you can do.
    [Show full text]
  • 4 Isolation Rooms
    4 Isolation Rooms 4 Isolation Rooms 4.1 General An isolation facility aims to control the airflow in the room so that the number of airborne infectious particles is reduced to a level that ensures cross-infection of other people within a healthcare facility is highly unlikely. This may be achieved by: . Control of the quantity and quality of intake or exhaust air. Maintain different air pressures between adjacent areas. Designing airflow patterns for specific clinical procedures. Diluting infectious particles with large air volumes. Air filtration – HEPA filters, etc. Isolation facilities include the following types: . Neutral or standard room air pressure, for example standard air conditioning, also known as Class S . Positive room air pressure where an immune-compromised patient is protected from airborne transmission of any infection, Class P . Negative room air pressure, where others are protected from any airborne transmission from a patient who may be an infection risk, Class N . Negative room air pressure with additional barriers including an Anteroom, also known as Class Q for quarantine isolation. Isolation rooms have fairly high rates of air exchange relative to other patient areas. This applies to both ventilation air supply and exhaust flow rates. Potential draughts within the patient room can result, therefore thermal comfort of the patient needs special attention. Consideration should be given to installing individual thermostats in each room so that air temperature and relative humidity can be controlled from within the room. Isolation rooms do not necessarily always require the provision of an Anteroom. This should be determined by the proposed operational policy and be included at an early stage of the design process.
    [Show full text]
  • Checklist to Prepare Physician Offices for COVID-19
    Checklist to Prepare Physician Offices for COVID-19 ASSUMPTION: Transmission will be primarily through exposure to respiratory droplets and direct contact with patients and their contaminated environments. Universal Early Preparation within six feet of patients with suspected COVID-19 infection. (See approved respirators). Provide training ☐ Educate staff and patients about changes they for staff on respirators to ensure fit and appropriate can expect to be implemented in the office use. during an outbreak or pandemic, and about ways to prepare themselves and their families. • Ensure adherence to standard precautions, including airborne precautions and use of eye protection. Assume that every patient is potentially infected or COVID-19 Education colonized with a pathogen that could be transmitted in • Educate staff about coronavirus disease 2019 a health care setting. (COVID-19), and why it is important to contain the • Implement mechanisms and policies that promptly outbreak. alert key facility staff including infection control, health • Educate staff on facility policies and practices care epidemiology, facility leadership, occupational to minimize chance of exposure to respiratory health, clinical laboratory, and frontline staff about pathogens including SARS-CoV-2, the virus that known suspected COVID-19 patients (i.e. PUI). Keep causes COVID-19. updated lists of staff and patients to identify those at risk in the event of an exposure. • Train and educate staff with job-or task-specific information on preventing transmission of infectious • Staff should follow the CDC guidelines collecting, agents, including refresher training. handling and testing clinical specimens from (PUIs for COVID-19. • Educate staff about COVID-19 evaluation and treatment. • Prepare for office staff illness, absences, and/or quarantine.
    [Show full text]
  • Health Facility Checklist Section 1226 [Oshpd 3] Clinics 1226.6 Primary
    Compliance Checklist: [OSHPD 3] Primary Care Clinics Page 1 of 11 HEALTH FACILITY CHECKLIST SECTION 1226 [OSHPD 3] CLINICS 1226.6 PRIMARY CARE CLINICS Primary Care Clinics are Health Facilities licensed under Section 1200 of the California Health & Safety Code that provide services limited to those listed in California Building Code Section 1226.6. Outpatient clinical services of a hospital providing services, licensed under Section 1250 of the California Health & Safety Code, which are equivalent to a primary care clinic, shall also comply with California Building Code Section 1226.6 and be considered a primary care clinic. Primary care clinics are subject to the provisions of Section 1226 [OSHPD 3] CLINICS, of the California Building Code and all amendments to the California Building Standards Code (CBSC) under the banner [OSHPD 3]. OSHPD requirements apply to all facilities described above and are not dependent upon Occupancy Group designations. While Examination Rooms are required in Primary Care Clinics, the provision of Treatment Rooms is optional and dependent upon the intended delivery of care. Examination Rooms are intended for diagnostic examinations, where Treatment Rooms are intended for clinical/interventional procedures and include appropriate size and finish requirements to accommodate treatment/procedures that do not require a restricted (sterile) environment but may use sterile instruments or equipment. All new buildings and additions, alterations or repairs to existing buildings, and conversion of space to a clinic use within existing buildings, subject to Licensing and Certification, California Department of Public Health, shall comply with applicable provisions of the California Building Code (CBC), California Electrical Code (CEC), California Mechanical Code (CMC), California Plumbing Code (CPC), California Energy Code, California Green Building Standards Code and California Fire Code (Parts 2, 3, 4, 5, 6, 9, and 11 of Title 24).
    [Show full text]
  • Operational Considerations for Community Isolation Centers for COVID-19 in Low-Resource Settings
    Operational Considerations for Community Isolation Centers for COVID-19 in Low-Resource Settings Accessible version: https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/operational-considerations-isolation-centers.html Background The coronavirus disease 2019 (COVID-19) pandemic has presented numerous challenges to health systems, including large numbers of patients that can overwhelm health facilities and staff. Community isolation centers (CICs) can give people experiencing mild to moderate symptoms (e.g. fever, fatigue, cough, muscle pain, sore threat, new loss of smell or taste, nasal congestion, shortness of breath or headache) a safe place to voluntarily isolate, while conserving healthcare facility resources. Guiding principles: • Community isolation centers generally do not care for severely ill patients or those with increased risk for severe disease. These patients should seek care at a health facility or hospital where advanced care, treatment and constant monitoring can be provided. However, in cases where no hospital beds are available, CICs can accept such people when feasible to prevent household transmission that could occur if they stayed home. CICs also support linkage to higher level care. • People with mild or moderate illness who have been tested and are waiting for their results should isolate at home until they know their status to avoid becoming infected by other patients at a CIC. In cases where safely isolating at home is not possible, people waiting for results may isolate in a CIC. This document gives operational considerations for CDC country offices, ministries of health, and other partners about establishing and operating CICs for people with suspected or laboratory-confirmed COVID-19.
    [Show full text]
  • STAR LRP-Approved Site and Facility Type Definitions
    Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP) Facility Type Definitions A C D E F H I L M N O P R S V Y Eligible STAR LRP-Approved Definition Facility Types American Indian Indian Health Service, Tribal or Urban Indian Health Clinic (ITU) – A health care facility Health facilities, (whether operated directly by the IHS; or by a tribe or tribal organization contracting with the IHS including Indian pursuant to the Indian Self-Determination and Education Assistance Act, codified at 25 U.S.C. 450 et Health Service seq.; or by an urban Indian organization receiving funds under Subchapter IV of the Indian Heath Care Improvement Act, codified at 25 U.S.C. 1651 et seq.), which provides clinical substance use (IHS) Hospitals disorder (SUD) treatment services to eligible American Indians and Alaska Natives on an outpatient basis. For more information, please read the Urban Indian Health Program Fact Sheet or view the IHS Profile Fact Sheet. IHS Hospitals – A collective term that includes hospitals that are both IHS-owned and IHS- operated, or IHS-owned and tribally-operated. That is, a federal facility operated by a tribe or tribal organization contracting with the IHS pursuant to the Indian Self-Determination and Education Assistance Act. These hospitals provide both inpatient and outpatient clinical Substance Use Disorder (SUD) treatment services to eligible American Indians and Alaska Natives. This term does not include hospitals that are both tribally-owned and tribally-operated. Community Health Nonprofit entities that provide primary health services and other related services to a medically Centers underserved population.
    [Show full text]
  • Health Professions Regulatory Bodies Act, 2013 Act 857
    Health HealthProfessions Professions Regulatory Regulatory Bodies Bodies Act,Act, 2013 2013 Act 857 ARRANGEMENT OF SECTIONS Section PART ONE —ALLIED HEALTH PROFESSIONS COUNCIL Establishment of the Council 1. Establishment of the Allied Health Professions Council 2. Object of the Council 3. Functions of the Council 4. Governing body of the Council Registration 5. Registration of allied health professionals and other allied health care providers 6. Qualification for registration 7. Registration of a foreign trained person 8. Types of registers 9. Temporary registration 10. Provisional registration 11. Permanent registration 12. Suspension of registration 13. Cancellation of registration 14. Annual list of allied health professionals and allied health care providers 15. Removal and restoration of names from the register 16. Representation to the Board and appeal Miscellaneous provisions 17. Entry of premises 18. Investigation by inspector 19. Power of closure 20. Notice of change of name or address 21. Offences 22. Regulations 23. Interpretation 24. Transitional provisions 1 Act 857 HealthHealth Professions Professions Regulatory Regulatory Bodies Bodies Act, 2013 Act, 2013 PART TWO—MEDICAL AND DENTAL COUNCIL Establishment of the Council 25. Establishment of the Medical and Dental Council 26. Object of the Council 27. Functions of the Council 28. Governing body of the Council Registration 29. Registration procedure 30. Qualification for registration 31. Registration of foreign trained practitioners 32. Types of registers 33. Temporary registration 34. Provisional registration 35. Permanent registration 36. Suspension of registration 37. Cancellation of registration 38. Representation to the Board and appeal 39. Annual list of registered practitioners 40. Removal and restoration of names from register 41.
    [Show full text]
  • Pharmacists' Impact on Patient Safety
    AMERICAN PHARMACISTS ASSOCIATION Pharmacists’ Impact on Patient Safety A Joint Project of the American Pharmacists Association Academy of Pharmacy Practice and Management and Academy of Pharmaceutical Research and Science This publication was developed by the American Pharmacists Association. © American Pharmacists Association. All rights reserved. Printed in the U.S.A. Expert Panel Members Chelsea M. Anderson, PharmD, MBA, BCPS—Chair Dorothy L. Smith, PharmD Project Manager CEO and President Center for Medication Safety Advancement Consumer Health Information Corporation Purdue University College of Pharmacy McLean, Virginia West Lafayette, Indiana Terri Warholak, PhD, FAPhA Kimberly Sasser Croley, PharmD, CGP, Associate Professor FASCP, FAPhA The University of Arizona College of Pharmacy Clinical Pharmacist Tucson, Arizona Laurel Senior Living Communities London, Kentucky Daniel A. Zlott, PharmD, BCOP Oncology Pharmacy Specialist Calvin “Clay” Daniels, PharmD, PhD—Observer National Institutes of Health PGY2 Medication Use Safety Resident Bethesda, Maryland St. Jude Children’s Research Hospital Memphis, Tennessee Stefanie P. Ferreri, PharmD, CDE, BCACP, FAPhA Project Coordinator and Director, PGY1 Community Residency Program Contributing Author Clinical Associate Professor and Executive Vice Chair Angela T. Cassano, PharmD, BCPS, FASHP University of North Carolina Eshelman Pharmfusion Consulting, LLC School of Pharmacy Midlothian, Virginia Chapel Hill, North Carolina Elizabeth Flynn, PhD Clinical Associate Affiliate Professor APhA Staff Contributors University of Florida College of Pharmacy Ryan M. Burke, PharmD Artesia, New Mexico Associate Director, Practice Initiatives John A. Galdo, PharmD, BCPS, CGP Anne Burns, BSPharm Assistant Professor Vice President, Professional Affairs Samford University McWhorter School of Pharmacy Birmingham, Alabama Lindsay Kunkle, PharmD Director, Practice and Science Affairs Ashley Lorenzen, PharmD, BCPS Assistant Professor James A.
    [Show full text]
  • Transfer Agreement
    Transfer Agreement between a Hospital and a Related Health Facility in Minnesota The ______________________________________________________ hospitals and the ________________________________________________________________________ related health facility do hereby join together in the following transfer agreement. The purpose of this agreement is to provide health care most suited to the individual (patients/residents) needs. This agreement shall operate to promote optimum use of the acute care facilities of general hospital and of the post-acute care services of the related health facility. This agreement shall comply with appropriate requirements of the Federal Government and the state licensing agencies. Now, therefore, the hospital and related health facility which are signatory below, in consideration of the mutual advantages occurring to both do hereby covenant and agree each with the other as follows: 1. The governing body of the hospital signatory below and the governing body of the related health facility signatory below shall have exclusive control of the management, assets, and affairs of their respective facilities. No party by virtue of this agreement assumes any liability of any debts or obligations of a financial or legal nature incurred by the other party of this agreement. It is not the intention of either party to create a joint venture with any other party but instead that each party shall operate independent of any other party in the discharge of any obligations assumed by it and the receipt of any agreed compensation to be paid by it. 2. No clause of this agreement shall be interpreted as authorizing either signatory facility to look to the other signatory facility to pay for services rendered to an individual transferred by virtue of this agreement, except to the extent that such liability would exist separate and apart from this agreement.
    [Show full text]