(Contact Info: larry at larryblakeley.com)

Important Note: You will need to click this icon to download the free needed to view most of the images on this Web site - just a couple of clicks and you're "good to go." For reasons why - go here.

A listing and access link to all:
song lyrics and mp3 audio files http://www.royblakeley.name/larry_blakeley/songs/ (all of which are a part of this Web site) can be accessed simply by selecting the "htm" file for the song you want;

poetry http://www.royblakeley.name/larry_blakeley/poetry.htm;

quotations http://www.royblakeley.name/larry_blakeley/quotations.htm; and

essays written by Larry Blakeley http://www.royblakeley.name/larry_blakeley/articles/articles_larry_blakeley.htm,

all of which are used to tell the story in this Web site, can be accessed by going to each respective link set out above.

My son, Larry Blakeley http://www.royblakeley.name/larry_blakeley/larryblakeley_photos_jpeg.htm manages this Web site.

Major Roy James Blakeley (December 10, 1928 - July 22, 1965) - USAF (KIA)

When I was young my dad would say
Come on son let's go out and play

No matter how hard I try
No matter how many tears I cry
No matter how many years go by
I still can't say goodbye

- "I Still Can't Say Goodbye," Performer: Chet Atkins

MP3 audio file/lyrics http://www.royblakeley.name/larry_blakeley/songs/still_cant_say_goodbye.htm

For a larger image click on the photograph.

Rural communities likely face the same quality challenge as urban communities. Although the evidence pertaining specifically to rural areas is sparse, what does exist corroborates the general finding that, as documented for the nation overall in the "Quality Chasm" report, the level of quality falls far short of what it should be.

Some of the quality shortcomings in rural areas stem from the lack of access to "core health care services," defined for purposes of this report as primary care in the community, emergency medical services, oral health care, and public health services. For some core health care services, most notably emergency medical services, mental health and substance abuse services, and oral health care, access is severly constrained in many if not most rural communities by long-standing shortages of qualified health professionals. Many rural communities have difficulty attracting and retaining clinicians because of concerns about isolation, limited health facilities, or a lack of employment and education opportunities for their families. Although steps have been taken in recent years to introduce a more favorable financial climate for rural health care providers, an underresourced health care delivery infrastructure persists.

Rural communities also confront a different mix of health and health care needs than do urban areas. Rural populations tend to be older than urban populations and to experience higher rates of limitations in daily activities as a result of chronic conditions. Rural populations exhibit poorer health behaviors (i.e., higher rates of smoking and obesity and lower rates of exercise) relative to most urban populations, although there is variability in health bahaviors among rural communities. Unless action is taken now, the future burden of chronic disease in many rural communities will be enormous.

The IOM committee developed a five-pronged strategy to address the quality challenges in rural communities:

- Adopt an integrated, prioritized approach to addressing both personal and population health needs at the community level.

- Establish a stronger quality improvement support structure to assist rural health systems and professionals in acquiring knowledge and tools to improve quality.

- Enhance the human resource capacity of rural communities, including the education, training, and deployment of health care professionals, and the preparedness of rural residents to engage actively in improving their health and health care.

- Monitor rural health care systems to ensure that they are financially stable and provide assistance in securing the necessary capital for system redesign.

- Invest in building an ICT (information and communications technology) infrastructure, which has enormous potential to enhance health and health care over the coming decades.

- "Quality Through Collaboration: The Future of Rural Health Care (2004)," Committee on The Future of Rural Health Care, Board on Health Care Services http://www.iom.edu/board.asp?id=3809, ISBN: 0-309-09439-9, http://www.iom.edu/board.asp?id=3809, http://www.nap.edu/catalog/11140.html

Directory: http://www.royblakeley.name/larry_blakeley/articles/monthly_articles/

File Name: quality_collaboration_rural_healthcare2004.pdf

Post Date: March 5, 2005 at 7:50 AM CST; 1350 GMT