Cherokee tribal health evaluation report.

The purpose of this study was to develop and implement an evaluation program of all Eastern Band of Cherokee health care systems. First, the Eastern Band of Cherokee needs and demands, as identified by the Cherokee Health Board (CHB), the Tribal Council, and the participant voting townships (7), were discussed and listed. Next, existing health conditions data were collected, not only through the auspices of the IHS and the Communicable Disease Center (CDC), but also through state, local, and other resources. Through consultation with the CHB and other professional sources, standards for service delivery were established. Finally, a priorities formula was developed. The primary audience for this study was the Eastern Band of Cherokee tribal members. A combination of quantitative and qualitative research methods was used to evaluate all facets of the tribal health delivery system. To complete the evaluation, numerous interviews, conferences, and meetings were held. Health care providers were required to analyze their programs. On-site observations of patients, professional staff and facilities were conducted at each facility. The potential consequences of increased workloads were analyzed. Patient complaints were gathered and correlated with staff shortages. Archival records on the historic, educational, social, and economic aspects of the Cherokee Indians were examined and the pertinent material was presented as background. Data gleaned from this evaluation was presented in the form of charts, graphs, and maps along with appropriate narrative. A thorough evaluation of the tribal health care delivery system revealed several areas of concern. According to the authors, most of the concerns are of secondary consideration with the primary areas of concern falling into two major concepts: 1) survey materials that emphasize the inadequacies of the Cherokee Service Unit's physical facilities and 2) survey materials that verify the critical shortage in the staff, particularly in the hospital and in the clinic. An extensive data base has been established, to not only define the complexities of the entire health delivery system, but to also indicate the specific nature and degree of health need. Generally, health providers now have a much clearer perception of the total health care system; where and why more staff is necessary; and why the hospital has been deemed inefficient. It is hoped that through this report, a more complete understanding of the issues will produce long-awaited and substantial results. Because the findings of the study deemed some facets of the evaluation to be of secondary importance, two areas--physical facilities and staff shortages--will be addressed with appropriate recommendations. All elements of the health care industry providing services to the Eastern Band of Cherokee health delivery system should receive a copy of this evaluation. This report will enable health care providers and other pertinent officials to have a current and lucid, yet readily available comprehensive compendium referencing the total delivery system; complete with data to substantiate all findings and recommended changes.