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The new nurse-lead organization was the main factor responsible for the satisfactory function of the multi-disciplinary organization and acted in a more proactive manner than in previous systems because of clearly defined tasks and responsibility.
Focus in all learning sessions and action periods was to develop an effective multi-disciplinary organization which in a proactive manner could master the multi-modal interventions [ 6- 9].
An effectiveness study as a before-after trial was undertaken in which all elective primary total hip and total knee arthroplasty patients were divided into a before-implementation group receiving the current perioperative procedure, and an after-implementation group receiving the new accelerated perioperative care and rehabilitation procedures as provided by a new multi-disciplinary organization.
We believe that the observed reduction in adjusted LOS of 4.4 days between the preimplementation period and the postimplementation period was achieved by contribution from both parts of our accelerated intervention (i.e. changes in multi-disciplinary organization and multi-modal intervention).
After evaluation of the second activity period, which was performed as a RCT [ 19], the leading nurses who had developed the program handed over the new multi-disciplinary organization plan to new leading personnel, who were put in charge of the last full scale implementation in action period 3.
The observed difference in LOS therefore consisted of two elements, which we considered to be equally important parts of our accelerated intervention, namely a reduction in LOS due to changed admission procedures in the multi-disciplinary organization, and a reduction in LOS due to changed multi-modal intervention.
The care in general practice has become more multi-practitioner and multi-disciplinary organized [ 3].
Face - multi-disciplinary system comprising several assessment tools.
With UNICEF assistance, the organization offers multi disciplinary support, encompassing health, psychological and educational services for a group of HIV infected people, including 19 children.
Fractured Atlas, a New York City-based multi-disciplinary arts service organization, is finding that by creating information and data services for its members among the city's arts communities, it can also provide more effective advocacy for the arts to government.
The main implementation partner was Dignitas International, a Canadian-based non-governmental organization working in partnership with the MoH since 2004 to scale up HIV services in Zomba District, and the main evaluation partner was REACH Trust, a Malawian multi-disciplinary health research organization.
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