The Workforce Investment Act of 1998: Performance Management and People With Disabilities

The primer outlines the various components of the Workforce Investment Act of 1998 (WIA). It also suggests ways that people with disabilities can fully access WIA systems and services.The report was prepared for the Rehabilitation Research and Training Center on Employment Policy for Persons with Disabilities and funded by the United States Department of Education, National Institute on Disability and Rehabilitation Research

Perspectives on screening strategies for early detection of childhood hearing impairment

The aims of this thesis were to assess the status of childhood hearing screening programmes, primarily in Europe, and to evaluate their performance against the parameters that make up a childhood hearing screening programme, such as test method, protocol, location, screening professional, and age of the infant at screening. Studies I, III and III were ecological studies within the EUSCREEN project. The purpose of the EUSCREEN project was to develop a cost-effectiveness model and toolkit for implementation and modification of childhood hearing and vision screening programmes. Studies I, II and III made up an independent line of research that assessed existing childhood hearing screening programmes. A comprehensive questionnaire was delivered to professionals representing their local hearing screening programme. Questions included the provision, protocols, factors, and performance of newborn and childhood hearing screening. Study IV was a systematic review of literature. Studies were aggregated that compared referral or follow-up rate between parameters in a newborn hearing screening (NHS) programme. Study V investigated the presence of false negatives in the NHS programme in Region Stockholm. A retrospective analysis of the otoacoustic emission (OAE) results was performed among children with hearing impairment who had previously passed NHS. Universal nationwide NHS existed in 25 of 30 high-income countries surveyed and 3 of 15 low- to middle-income countries. Universal preschool or school-entry screening existed in 17 out of 47 countries or regions. For NHS, countries that only used OAE for the test method had lower health spending compared to those that used automated auditory brainstem response (aABR). However, using aABR resulted in lower referral rates compared to OAE. Other factors that influenced referral rate were the number of rescreens, the age of the infant, the experience of the screening professional and the organization of the screening programme. Out of the 12 programmes with a valid follow-up rate to diagnostic assessment, eight had rates below 90%. Factors such as personnel experience and knowledge and the location of follow-up can improve rates; however, few high-quality studies investigated this issue. There are other reasons why children with hearing impairment are not detected by NHS. Out of 1244 children with hearing impairment in study V, 24 were lost due to errors in documentation. Additionally, two OAE variables predicted hearing impairment among infants who previously met passing criteria (p<0.001). Increasing the stringency of passing criteria will increase the number of children with hearing impairment detected by screening. The findings from this thesis may be used for implementing new programmes or improving existing ones. However, the results also suggest a significant deficiency in the process for monitoring and evaluation of hearing screening programmes. Out of 42 NHS programmes surveyed, 23 had valid referral rates and 12 had a valid follow-up rate. Out of 17 preschool or school-entry programmes, only two provided these data. Developing a process for collecting and reporting on existing outcomes is the necessary first step to quality improvement

States' Roles in Shaping High Performance Health Systems

Analyzes results from the State Health Policies Aimed at Promoting Excellent Systems survey and a review of current research on efforts to improve state healthcare systems, with a focus on coverage; quality, safety, and value; and infrastructure

Embedding accessibility and usability: considerations for e-learning research and development projects

This paper makes the case that if e‐learning research and development projects are to be successfully adopted in real‐world teaching and learning contexts, then they must effectively address accessibility and usability issues; and that these need to be integrated throughout the project. As such, accessibility and usability issues need to be made explicit in project documentation, along with allocation of appropriate resources and time. We argue that accessibility and usability are intrinsically inter‐linked. An integrated accessibility and usability evaluation methodology that we have developed is presented and discussed. The paper draws on a series of mini‐case studies from e‐learning projects undertaken over the past 10 years at the Open University

Improving the Lives of Young Children: The Role of Developmental Screenings in Medicaid and CHIP

Outlines barriers to early identification of health, developmental, or behavioral problems. Recommends policies to increase Medicaid and Children's Health Insurance Program enrollment, Well-Child Visits and screenings, and use of data to improve policies

Implementing means-tested welfare systems in the United States

While targeting can effectively channel resources to the poor, implementation details matter tremendously to distributive outcomes. Several key factors affect performance, including: data collection processes; information management; household assessment mechanisms; institutional arrangements; and monitoring and oversight mechanisms. This report conducts an in-depth assessment of key design and implementation factors and their potential impact on outcomes for the household targeting system used in the United States to target social programs to the poor and vulnerable.

Committed to Safety: Ten Case Studies on Reducing Harm to Patients

Presents case studies of healthcare organizations, clinical teams, and learning collaborations to illustrate successful innovations for improving patient safety nationwide. Includes actions taken, results achieved, lessons learned, and recommendations