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Hospital caseload

Jason T Hotchkiss, Ruth Lesher
This study predicted Burnout from the self-care practices, compassion satisfaction, secondary traumatic stress, and organizational factors among chaplains who participated from all 50 states (N = 534). A hierarchical regression model indicated that the combined effect of compassion satisfaction, secondary traumatic stress, mindful self-care, demographic, and organizational factors explained 83.2% of the variance in Burnout. Chaplains serving in a hospital were slightly more at risk for Burnout than those in hospice or other settings...
June 2018: Journal of Pastoral Care & Counseling: JPCC
Taryn Orava, Christine Provvidenza, Ashleigh Townley, Shauna Kingsnorth
PURPOSE: Though high numbers of children with cerebral palsy experience chronic pain, it remains under-recognized. This paper describes an evaluation of implementation supports and adoption of the Chronic Pain Assessment Toolbox for Children with Disabilities (the Toolbox) to enhance pain screening and assessment practices within a pediatric rehabilitation and complex continuing care hospital. METHODS: A multicomponent knowledge translation strategy facilitated Toolbox adoption, inclusive of a clinical practice guideline, cerebral palsy practice points and assessment tools...
June 8, 2018: Disability and Rehabilitation
A McLoughlin, C Matthews, T M Hickey
BACKGROUND: Due to medical advances, growing numbers of adolescents with congenital heart disease (CHD) survive into adulthood and transferring from paediatric to adult healthcare. This transfer is significant step in a young person's life, and this study examines the views of Irish healthcare professionals' on how best to manage this transition. METHODS: Purposeful sampling was used to invite participation by healthcare professionals (HCPs) from a variety of disciplines whose caseloads include adolescents and young adults with CHD...
June 7, 2018: Child: Care, Health and Development
Shaneel Bappayya, Fiona Chen, Megan Alderuccio, Heinrich Schwalb
BACKGROUND: Rural and regional Australia presents a unique challenge in the delivery of surgical services by virtue of its geographical vastness and low population density. While up to 33% of Australians live in rural or regional areas, only 14.8% of surgeons work in a rural or regional area. Data regarding the caseload distribution of general surgeons working in a regional setting in Australia remain scarce. In order to better examine the training needs of rural general surgeons, this study aims to examine the caseload distribution of general surgeons working in regional Australia...
June 5, 2018: ANZ Journal of Surgery
Jacob M Shivley, Wilson C Brookshire, Philip A Bushby, Kimberly A Woodruff
Referral-level medicine is important in the veterinary curriculum, however veterinary students also need a solid base knowledge of clinically relevant, routine surgical and diagnostic skills to be clinically prepared after graduation. Exposure to a referral-only, or primarily referral caseload, does not always provide veterinary students with the routine hands-on experiences and competencies expected by the American Veterinary Medical Association Council on Education, the Royal College of Veterinary Surgeons, the Australian Veterinary Boards Council, or prospective employers...
2018: Frontiers in Veterinary Science
Theunis J van Zyl, Patrick B Murphy, Laura Allen, Neil G Parry, Ken Leslie, Kelly N Vogt
BACKGROUND: Most studies evaluating acute care surgery (ACS) models of care for patients with emergency general surgery (EGS) conditions have focused on patients who undergo surgery while admitted under the care of the ACS service. The purpose of this study was to prospectively examine the case-mix of admissions and consultations to an ACS service at a tertiary centre to identify the frequency and distribution of both operatively and nonoperatively managed EGS conditions. METHODS: In this prospective cohort study, we evaluated consecutive patients assessed by the ACS team between July 1 and Aug...
June 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Rikke Damkjær Maimburg
OBJECTIVE: To describe birth and neonatal outcome in women initiating a homebirth and cared for by a caseload midwifery teams with affiliation to a university hospital. Further, to describe the rate, time, and reasons for transfer between home and hospital. DESIGN: A descriptive study using prospectively collected registry data on initiated homebirths. RESULTS: A total of 268 women initiated a homebirth and 192 actually gave birth at home, equal to 1...
June 2018: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
Ingegerd Hildingsson, Christine Rubertsson, Annika Karlström, Helen Haines
OBJECTIVE: Continuity with a known midwife might benefit women with fear of birth, but is rare in Sweden. The aim was to test a modified caseload midwifery model of care to provide continuity of caregiver to women with fear of birth. METHODS: A feasibility study where women received antenatal and intrapartum care from a known midwife who focused on women's fear during all antenatal visits. The study was performed in one antenatal clinic in central Sweden and one university hospital labor ward...
June 2018: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
Kate Dawson, Michelle Newton, Della Forster, Helen McLachlan
BACKGROUND: Caseload midwifery has many benefits for women and their babies, however only around 8% of women receive caseload care in the public maternity system in Australia. Midwives working within caseload models are required to provide activity-based care (working on-call, responsively to the needs of their caseload of women) rather than undertaking shift work. There has been debate regarding the impact of caseload work on midwives, but recently caseload work has been associated with higher professional satisfaction and lower burnout when compared to midwives working in traditional models...
May 7, 2018: Midwifery
Thomas Ahn, Robert J Ellis, Victoria M White, Damien M Bolton, Michael D Coory, Ian D Davis, Ross S Francis, Graham G Giles, Glenda C Gobe, Carmel M Hawley, David W Johnson, David J T Marco, Megan McStea, Rachel E Neale, Elaine M Pascoe, Simon T Wood, Susan J Jordan
BACKGROUND: New-onset chronic kidney disease (CKD) following surgical management of kidney tumors is common. This study evaluated risk factors for new-onset CKD after nephrectomy for T1a renal cell carcinoma (RCC) in an Australian population-based cohort. METHODS: There were 551 RCC patients from the Australian states of Queensland and Victoria included in this study. The primary outcome was new-onset CKD (eGFR <60 mL/min per 1.73 m2 ) and the secondary outcome was new-onset moderate-severe CKD (<45 mL/min per 1...
May 22, 2018: Journal of Surgical Oncology
Franklin Dexter, Richard H Epstein, Johannes Ledolter, Jonathan P Wanderer
STUDY OBJECTIVE: Recent studies have made longitudinal assessments of case counts using State (e.g., United States) and Provincial (e.g., Canada) databases. Such databases rarely include either operating room (OR) or anesthesia times and, even when duration data are available, there are major statistical limitations to their use. We evaluated how to forecast short-term changes in OR caseload and workload (hours) and how to decide whether changes are outliers (e.g., significant, abrupt decline in anesthetics)...
May 16, 2018: Journal of Clinical Anesthesia
David A Smelson, Matthew Chinman, Gordon Hannah, Thomas Byrne, Sharon McCarthy
BACKGROUND: Evidence-based treatment for co-occurring disorders is needed within programs that serve homeless Veterans to assist with increasing engagement in care and to prevent future housing loss. A specialized co-occurring disorders treatment engagement intervention called Maintaining Independence and Sobriety Through Systems Integration, Outreach and Networking - Veterans Edition (MISSION-Vet) was implemented within the Housing and Urban Development - Veterans Affairs Supportive Housing (HUD-VASH) Programs with and without an implementation strategy called Getting To Outcomes (GTO)...
May 5, 2018: BMC Health Services Research
Line Ryberg Rasmussen, Jan Mainz, Mette Jørgensen, Poul Videbech, Søren Paaske Johnsen
OBJECTIVE: The relationship between inpatient volume and the quality of mental health care remains unclear. This study examined the association between inpatient volume in psychiatric hospital wards and quality of mental health care among patients with depression admitted to wards in Denmark. METHODS: In a nationwide, population-based cohort study, 17,971 patients (N=21,120 admissions) admitted to psychiatric hospital wards between 2011 and 2016 were identified from the Danish Depression Database...
April 26, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Franklin Dexter, Craig Jarvie, Richard H Epstein
STUDY OBJECTIVE: Suppose that it were a generalizable finding, in both densely populated and rural states, that there is marked heterogeneity among hospitals in the percentage change in surgical caseload and/or in the total change in caseload. Then, individual hospitals should not simply rely on federal and state forecasts to infer their expected growth. Likewise, individual hospitals and their anesthesiology groups would best not rely on national or US regional surgical trends as causal reasons for local trends in caseload...
April 18, 2018: Journal of Clinical Anesthesia
Joseph Piatt
OBJECTIVE An implicit expectation of the pioneers of trauma system design was that high clinical volume at select centers could lead to superior outcomes. There has been little study of the regionalization of pediatric craniospinal trauma care, and whether it continues to trend in the direction of regionalization is unknown. The motivating hypothesis for this study was that trauma system design in the United States is proceeding on a rational basis, producing hospital caseloads that are increasing over time and, because of geographic siting appropriate to the needs of catchment areas, in an increasingly uniform manner...
April 20, 2018: Journal of Neurosurgery. Pediatrics
Li Wang, Michel Grignon, Sheril Perry, Xi-Kuan Chen, Alison Ytsma, Sara Allin, Katerina Gapanenko
OBJECTIVE: To evaluate the technical efficiency of acute inpatient care at the pan-Canadian level and to explore the factors associated with inefficiency-why hospitals are not on their production frontier. DATA SOURCES/STUDY SETTING: Canadian Management Information System (MIS) database (CMDB) and Discharge Abstract Database (DAD) for the fiscal year of 2012-2013. STUDY DESIGN: We use a nonparametric approach (data envelopment analysis) applied to three peer groups (teaching, large, and medium hospitals, focusing on their acute inpatient care only)...
April 17, 2018: Health Services Research
Dan L Crouse, Philip S J Leonard, Jonathan Boudreau, James T McDonald
BACKGROUND: Several international studies have reported negative associations between hospital and/or provider volume and risk of postoperative death following total hip arthroplasty (THA). The only Canadian studies to report on this have been based in Ontario and have found no such association. We describe associations between postoperative deaths following THA and provider caseload volume, also adjusted for hospital volume, in a population-based cohort in New Brunswick. METHODS: Our analyses are based on hospital discharge abstract data linked to vital statistics and to patient registry data...
April 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Roos Mesman, Marjan J Faber, Gert P Westert, Bart Berden
Objective In many countries, the evidence for volume-outcome associations in surgery has been transferred into policy. Despite the large body of research that exists on the topic, qualitative studies aimed at surgeons' views on, and experiences with, these volume-based policies are lacking. We interviewed Dutch surgeons to gain more insight into the implications of volume-outcome policies for daily clinical practice, as input for effective surgical quality improvement. Methods Semi-structured interviews were conducted with 20 purposively selected surgeons from a stratified sample for hospital type and speciality...
January 1, 2018: Journal of Health Services Research & Policy
Susanne Lohmann, Elke Mattern, Gertrud M Ayerle
OBJECTIVE: To explore how midwives perceive patient preferences related to midwifery care in Germany. DESIGN: This qualitative study, which was part of a larger study, used a hermeneutic-interpretive approach and involved focus group interviews with midwives. Data collection and analysis were done in a conjoined fashion between April 2015 and September 2016. SETTING: Four focus group interviews were conducted in four different federal states of Germany...
June 2018: Midwifery
Robert Micieli, Raed Alhusayen
BACKGROUND: Changes in the practice patterns and demographics of Canadian dermatologists remain largely unknown and would be helpful in assessing the future practice of dermatology across Canada. OBJECTIVE: To assess changes in the population of Ontario dermatologists over time and the factors that influence their practice patterns, caseload, and the procedures they perform. METHODS: A retrospective population-based analysis was performed using comprehensive administrative data on Ontario Health Insurance Plan insured dermatology visits and procedures from April 1, 2009, to March 31, 2015...
March 1, 2018: Journal of Cutaneous Medicine and Surgery
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