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Clinical performance and quality health care最新文献

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Evaluation of an orthopaedic screening service in primary care. 初级保健骨科筛查服务的评价。
Clinical performance and quality health care Pub Date : 1999-07-01
P Hattam, A Smeatham
{"title":"Evaluation of an orthopaedic screening service in primary care.","authors":"P Hattam,&nbsp;A Smeatham","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Historically, provision of orthopaedic services has been hospital based with GPs referring patients for specialist opinion. Growing demands on the service have led to new initiatives to reduce waiting times. One such initiative has been the introduction of orthopaedic assistants, usually physiotherapists, working with an extended scope of practice who see patients after referral to secondary care and determine the patients' ongoing management. Studies to date have examined the effect of an orthopaedic assistant working alongside a consultant in the hospital environment. This study describes the impact on the management of the orthopaedic caseload in one general practice resulting from \"screening\" prior to referral to secondary care by a physiotherapist with an extended scope of practice. It demonstrates the successful management of the majority of patients within primary care.</p>","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"7 3","pages":"121-4"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21691653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is day case tonsillectomy suitable for children in Cumbria? 在坎布里亚郡，儿童扁桃体切除术是否适用?
Clinical performance and quality health care Pub Date : 1999-06-01 DOI: 10.1108/14664109910306785
H. Kubba, R. Messersmith
{"title":"Is day case tonsillectomy suitable for children in Cumbria?","authors":"H. Kubba, R. Messersmith","doi":"10.1108/14664109910306785","DOIUrl":"https://doi.org/10.1108/14664109910306785","url":null,"abstract":"Day case tonsillectomy has been advocated as a means of reducing health-care costs associated with in-patient care. The authors studied 74 consecutive children undergoing conventional overnight stay tonsillectomy using a parental questionnaire and a retrospective case note review. Medical exclusion criteria for day surgery were present in 21 per cent, and social exclusion criteria in 82 per cent. Overall, only 16 per cent of children satisfied all the criteria for suitability. On the day of surgery, 29 per cent of children were reported as having poorly controlled pain and 31 per cent as having nausea and vomiting, such that unplanned admission would have been likely had they been done as day cases. In total 63 per cent of parents were unhappy or very unhappy with the possibility of same day discharge. The authors do not plan to introduce day case tonsillectomy in Cumbria.","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"113 5 Suppl 1 1","pages":"130-3"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88488342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
The care pathway: a tool to enhance clinical governance. 护理路径:加强临床治理的工具。
Clinical performance and quality health care Pub Date : 1999-06-01 DOI: 10.1108/14664109910306820
Brian W. Ellis, Sue Johnson
{"title":"The care pathway: a tool to enhance clinical governance.","authors":"Brian W. Ellis, Sue Johnson","doi":"10.1108/14664109910306820","DOIUrl":"https://doi.org/10.1108/14664109910306820","url":null,"abstract":"A care pathway defines in detail the individual components of treatment for a group of patients. A well-written pathway can lead to consistent care of the highest quality. There are both educational and audit advantages to the approach. The authors detail the means by which groups are selected and the care pathways written. An example of the benefits that can accrue comes from their experience at Ashford Hospital of running a pathway for patients having prostate surgery. The pathways are appreciated by patients, nurses, doctors and managers. Care is improved, costs contained and clinical governance enhanced.","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"17 1","pages":"134-44"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82174119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 32
Evaluation of an orthopaedic screening service in primary care. 初级保健骨科筛查服务的评价。
Clinical performance and quality health care Pub Date : 1999-06-01 DOI: 10.1108/14664109910306749
P. Hattam, A. Smeatham
{"title":"Evaluation of an orthopaedic screening service in primary care.","authors":"P. Hattam, A. Smeatham","doi":"10.1108/14664109910306749","DOIUrl":"https://doi.org/10.1108/14664109910306749","url":null,"abstract":"Historically, provision of orthopaedic services has been hospital based with GPs referring patients for specialist opinion. Growing demands on the service have led to new initiatives to reduce waiting times. One such initiative has been the introduction of orthopaedic assistants, usually physiotherapists, working with an extended scope of practice who see patients after referral to secondary care and determine the patients' ongoing management. Studies to date have examined the effect of an orthopaedic assistant working alongside a consultant in the hospital environment. This study describes the impact on the management of the orthopaedic caseload in one general practice resulting from \"screening\" prior to referral to secondary care by a physiotherapist with an extended scope of practice. It demonstrates the successful management of the majority of patients within primary care.","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"290 1","pages":"121-4"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86430693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 79
Systems are changing: where can they be improved? 系统在变化:哪里可以改进?
Clinical performance and quality health care Pub Date : 1999-04-01
D Birnbaum
{"title":"Systems are changing: where can they be improved?","authors":"D Birnbaum","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Wide-ranging changes of unprecedented scale throughout the delivery of healthcare services are producing consequences we cannot ignore. A need to collaborate to improve healthcare systems is evident. The Society for Healthcare Epidemiology of America (SHEA) and the Health Care Division of the American Society for Quality are responding in jointly sponsoring this symposium concerning problems with medical devices. This presentation and those that follow will explore the quality of management of managed-care corporations; the important threat to out primary source of innovation in medical technology posed by behaviors of consolidated corporations; the impact of these changes on roles of hospital epidemiologists; and measures to ensure proper design, production, delivery, and use of safe medical products. Our profession and SHEA have made significant research-based contributions that document their potential value, but we have not always done as well as we could to market epidemiology as an important asset for sound management decisions in this era of change. We should ally ourselves with related disciplines in order to succeed as we undertake new challenges on a broadening field.</p>","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"7 2","pages":"97-9"},"PeriodicalIF":0.0,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21597760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Results of a JCAHO accreditation survey in a university student health center. JCAHO对某高校学生健康中心的认可调查结果。
Clinical performance and quality health care Pub Date : 1999-04-01
B A Johnson, B Reppert
{"title":"Results of a JCAHO accreditation survey in a university student health center.","authors":"B A Johnson,&nbsp;B Reppert","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article describes the results of our initial accreditation survey by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). Strengths, as well as supplemental recommendations in our clinic and laboratory programs, were identified during the accreditation survey. Mechanisms for addressing the supplemental recommendations are described in this report. Direct and indirect costs of the accreditation process also are discussed.</p>","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"7 2","pages":"92-3"},"PeriodicalIF":0.0,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21597765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Institutional epidemiologists' roles in evaluating medical devices. 机构流行病学家在评估医疗器械中的作用。
Clinical performance and quality health care Pub Date : 1999-04-01
M D Nettleman
{"title":"Institutional epidemiologists' roles in evaluating medical devices.","authors":"M D Nettleman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As the prevalence and variety of medical devices have increased, so too has the need for active involvement by epidemiologists. Traditionally, epidemiologists enter the chain of events after devices are marketed. It is proposed that a more proactive approach should be taken and that epidemiologists should be involved at all stages of product development.</p>","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"7 2","pages":"104-6"},"PeriodicalIF":0.0,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21598429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Handwashing education practices: a descriptive survey. 洗手教育实践:一项描述性调查。
Clinical performance and quality health care Pub Date : 1999-04-01
M McGuckin, L L Porten
{"title":"Handwashing education practices: a descriptive survey.","authors":"M McGuckin,&nbsp;L L Porten","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hand washing is the single most important function in preventing the spread of infection. However, compliance by healthcare workers still remains under 50%. Intensive observational and interventional programs have been shown to increase compliance, but the increase in compliance is short-term. Therefore, in April 1998, we conducted a random survey of 500 members of the Association for Practitioners in Infection Control and the Society for Healthcare Epidemiology of America to determine the didactic educational practices (in-service lectures) of practitioners with regard to hand washing. Response rate was 18% (n = 90). Eighty-eight percent (73) conducted new employee orientation, 64% (73) conducted yearly in-service, whereas monthly, quarterly, and semiannual in-service were 11% (9), 11% (9), and 14% (12), respectively. Thirty-nine percent (35) of our respondents rated their compliance to hand washing as > 50%; 31% (19), < 50%; and, 39% (33) did not know. Only 5% (4) of our respondents determined the outcome measures and cost-effectiveness of their present handwashing program. Our survey had identified the lack of ongoing education for the healthcare worker about handwashing compliance. Continuous reinforcement through monthly in-service is labor-intensive and costly. An alternative model using the patient as ongoing reinforcement may be a solution for increasing compliance.</p>","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"7 2","pages":"94-6"},"PeriodicalIF":0.0,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21597758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Underreporting of percutaneous exposure accidents in a teaching hospital in Spain. 西班牙某教学医院经皮暴露事故的漏报。
Clinical performance and quality health care Pub Date : 1999-04-01
E Benítez Rodríguez, A J Ruiz Moruno, J A Córdoba Doña, A Escolar Pujolar, F J López Fernández
{"title":"Underreporting of percutaneous exposure accidents in a teaching hospital in Spain.","authors":"E Benítez Rodríguez,&nbsp;A J Ruiz Moruno,&nbsp;J A Córdoba Doña,&nbsp;A Escolar Pujolar,&nbsp;F J López Fernández","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The study's objectives were to determine the frequency of biological-risk accidents involving percutaneous exposure and to identify factors associated with underreporting. Two hundred fifty healthcare professionals from inpatient services at high risk for exposure at the Puerta del Mar University Hospital of Cádiz, Spain, participated in the study. A questionnaire was used to measure personal and work variables, the number of accidents suffered and reported in the last year, and the circumstances motivating the reporting or nonreporting. Two hundred thirty-two persons (92.8%) completed the questionnaire. The accident rate was 12 per 100,000 hours worked. Physicians were the most frequent accident victims (rate 22/100,000 hours). The general surgery and emergency services had higher rates than other services (rates 19.82 and 14.17, respectively). Sixty-six percent of the accidents were not reported to the register. The main predictors of the underreporting were length of professional service greater than 19 years, working in the surgery service, and the perception that the accidents did not involve health risk. The true accident rate was higher than that reflected in the Accident Register. Underreporting was high. The main variables associated with underreporting were length of professional service, work area or department, and perception of risk from the accident.</p>","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"7 2","pages":"88-91"},"PeriodicalIF":0.0,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21597763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A comprehensive educational approach to improving patient isolation practice. 提高患者隔离实践的综合教育方法。
Clinical performance and quality health care Pub Date : 1999-04-01
F Kidd, P Heitkemper, A B Kressel
{"title":"A comprehensive educational approach to improving patient isolation practice.","authors":"F Kidd,&nbsp;P Heitkemper,&nbsp;A B Kressel","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To describe a workable plan for the successful education of a large, diverse group of healthcare workers in a university hospital setting.</p><p><strong>Design: </strong>A prospective, nonrandomized study of compliance with infection control isolation practice following various educational interventions.</p><p><strong>Setting: </strong>300-bed tertiary-care, academic medical center with out-patient clinics.</p><p><strong>Participants: </strong>Hospital employees and contract workers.</p><p><strong>Interventions: </strong>The infection control department introduced a plan to implement the Centers for Disease Control and Prevention's new isolation guidelines. A comprehensive proposal was presented to administration. It included a time line for institution and a comprehensive educational and performance-improvement plan, including standard lectures and a video that explained Standard and Transmission-Based Precautions. Follow-up consisted of customized in-services and one-on-one continued education tailored to the individual units.</p><p><strong>Results: </strong>Compliance with isolation procedure after standardized lectures and video alone was poor. Compliance improved after institution of smaller, more intensive in-services tailored to individual departments and given during all shifts.</p><p><strong>Conclusions: </strong>Intensive, individualized education is the key to compliance. This requires sufficient infection control staffing and administrative support.</p>","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"7 2","pages":"74-6"},"PeriodicalIF":0.0,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21598433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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