Training According to the Needs and Responsibilities

Most European centers supervise less than 50 patients. This limits the ventilator experience of the staff. But these small centers can provide the patient greater accessibility. The solution to the dilemma between accessibility and expertise is the creation of networks of centers. The centers with more expertise, technology, and specialists can give support to local centers with less technological resources but who are able to provide closer attention to the patient. Eventually the patient may be transferred from the local center to the center with more technological support for a more complex evaluation, but the routine care is given in the most accessible place. Moreover, in the context of a network the introduction of innovations is easier and permits a more homogeneous dissemination. 

In this context, the role of the healthcare coordinator is very important (26), as for each individual, issues such as supervision of the home equipment, or planning of the visits for education, or continued training will improve the quality of life for those receiving PMV. 

DeBusk RF, West JA, Houston Miller N, et al. Chronic disease management. Arch Intern Med 1999 159 2739-2742. 

World Health Organization. Innovative care for chronic conditions building blocks for action. Geneva World Health Organization, 2002. 

Wagner EH. The role of patient care teams in chronic disease management. BMJ 2000 320 569-571. 

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