The difficulties in delivering patient-care services in a pulmonary rehabilitation program (PRP), especially in a program with a multidisciplinary approach, can usually be overcome by first conceptualizing and then organizing the PRP within a human-service-agency framework. All human-service agencies have six service com-ponents in common. The following are the components and their applicability to the Harper Hospital (Detroit, Michigan) PRP: (1) Outreach and Referral local physi-cians are informed of the program and asked to send referrals; (2) Intake-initial information about the patient is gathered and his initial eligibility for the program is determined; (3) Assessment-more information about the patient is obtained, all data are organized for easy use and accessibility, and a final determination of eligibility is made; (4) Service Planning-needed service consultations are determined and obtained; (5) Service Delivery-during which a respiratory therapist serves as coordi-nator of the linkage of the various service subsystems and facilitates communication among them; (6) Follow-Up and Maintenance at 1-month, 3-month, 6-month, and 1-year intervals and after each rehospitalization. Through evaluation of the program process and the program outcomes, PRP administrators can modify PRP structure and staffing to enhance the effectiveness of service delivery. (MacDonell RJ Jr. The Pulmonary Rehabilitation Maze. Respir Care 1983:28:180-190,
Respiratory diseases. Task force report on prevention, control, education. Division of Lung Diseases, National Heart, Lung and Blood Institute. DHEW Publication No. 77-1248. Washington DC: U.S. Government Printing Office; 1977:83–91.
2.
Chronic respiratory disease control program. Public Health Service Publications Nos. 1529 and 1802. Arlington VA: National Center for Chronic Disease Control, 1968.
3.
National Center for Health Statistics. Vital statistics of the United States, Vol II. 1978.
4.
SahnS, NettL, PettyT.Ten year follow-up of a comprehensive rehabilitation program for COPD. Chest1980;77(2, Suppl):311–314.
5.
FishmanD, PettyT.Physical, symptomatic and psychological improvement in patients receiving comprehensive care for chronic airway obstruction. J Chronic Dis1971;24:775–785.
6.
HodgkinJ, BulchamO, KassI, et al. Chronic obstructive airway diseases: Current concepts in diagnosis and comprehensive treatment. JAMA1975;232:1243–1260.
7.
DudleyD, VerheyJ, MasudaM.Long term adjustment, prognosis and death in irreversible diffuse obstructive pulmonary syndromes. Psychosom Med1969;31:310–325.
8.
AgleD, BaumG.Psychological aspects of chronic obstructive pulmonary disease. Med Clin North Am1977;61:749–758.
9.
LertzmanM, CherniackR.Rehabilitation of patients with chronic obstructive pulmonary disease. Am Rev Respir Dis1976;114:1145–1162.
10.
MacDonellRJJr. Suggestions for establishment of pulmonary rehabilitation programs. Respir Care1981;26:966–977.
11.
McSweenyA, HeatonR, GrantI, CugellD, SollidayN, TimmsR.Chronic obstructive pulmonary disease: Socio-emotional adjustment and life quality. Chest1980;77(2, Suppl):309–311.
12.
LesterD.The psychological impact of chronic obstructive pulmonary disease. In: JohnsonR, ed. Pulmonary care. New York: Grune and Stratton, 1973:341–354.
13.
GrantI, HeatonR, McSweenyA, AdamK, TimmsR.Brain dysfunction in COPD. Chest1970;77(2, Suppl):308–309.
14.
KropH, BlockA, CohenE.Neuropsychologic effects of continuous oxygen therapy in chronic obstructive pulmonary disease. Chest1973;64:317–322.
