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The remainder of the money goes to a city-administered fund which is used to pay for outreach, implementation and a waste reduction program which supplies free reusable bags at Aspen's airport, car rental facilities, hotels and the city's Department of Environmental Health.
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The PL intervention condition was supported by three key efforts: (1) Peer Leaders (PLs) (outreach, intervention implementation); (2) Resident Working Group (tailoring activities to the housing community, planning and implementation; reach); and (3) ODH staff/technical assistance.
In the findings section which follows, we provide a descriptive account of early PHC outreach team implementation.
Table 2 summarises the strengths and weaknesses of the PHC outreach team implementation in the North West Province.
Entry was certainly facilitated by the fact that two of our organizations (Health Systems Trust and University of the Western Cape) were in a partnership with the Province supporting PHC outreach team implementation at the time of the evaluation.
Such reduction can be attributed to changes in the delivery of critical care, including increased capacity, establishment of clinical networks and outreach services, implementation of ventilator care bundles [ 1], and enhancement of strategies to improve decision-making [ 2- 4] and communication among staff, patients, and family members [ 3, 5- 7].
The original PALSA approach, on which the PALM PLUS package was based, was one of the first attempts at combining educational outreach with guideline implementation in sub-Saharan Africa [ 11].
The question we face now is how to improve implementation and outreach efforts.
We observed improvement in clinical outcome of critically ill patients after the implementation of outreach intensive care support delivered by a RRT in a teaching hospital.
Gender roles in transition and ethnic and cultural diversity may further add to the complexity of modern family arrangements and challenge implementation of outreach strategies.
We report a reduction in the cardiac arrest rate post implementation of outreach, although this may be due to other external factors.
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