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Hospital caseload

Catherine de Blacam, Sean Tierney, Odhran Shelley
BACKGROUND: Surgical training requires exposure to clinical decision-making and operative experience in a supervised environment. It is recognised that learning ability is compromised when fatigued. The European Working Time Directive requires a decrease in working hours, but compliance reduces trainees' clinical exposure, which has profound implications for plastic surgery training. The aim of this study was to evaluate plastic surgery registrars' experience of an EWTD-compliant rota, and to examine its impact on patient care, education, and logbook activity...
October 20, 2016: Journal of Plastic Surgery and Hand Surgery
Annelies Colliers, Roy Remmen, Marie-Luise Streffer, Barbara Michiels, Stefaan Bartholomeeusen, Koenraad G Monsieurs, Jef Goris, Samuel Coenen, Veronique Verhoeven, Hilde Philips
BACKGROUND: The implementation of general practitioner cooperatives (GPC) for out-of-hours (OOH) primary care, raises the question if the location of a GPC adjacent to a hospital reduces the OOH caseload of the emergency department (ED). METHODS: Two natural experiments were used in this before-after study, the effect of the implementation of two GPCs in two different regions on the out-of-hours caseload of the local EDs was compared. One GPC was located adjacent to the ED of a general hospital, the other was not...
October 17, 2016: Acta Clinica Belgica
Ana Martins, Susie Aldiss, Faith Gibson
PURPOSE: To describe the development and implementation of the specialist nurse key worker role across 18 children's cancer centres in the United Kingdom, and draw out significant factors for success to inform future development of the role across a range of specialities. METHOD: Data were obtained through 42 semi-structured interviews and a focus group with 12 key workers. Framework analysis revealed two main themes: models of care and key workers' perspectives of the role...
October 2016: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
Dhruv S Kazi, P Gregg Greenough, Rishi Madhok, Aaron Heerboth, Ahmed Shaikh, Jennifer Leaning, Satchit Balsari
BACKGROUND: Planning for mass gatherings often includes temporary healthcare systems to address the needs of attendees. However, paper-based record keeping has traditionally precluded the timely application of collected clinical data for epidemic surveillance or optimization of healthcare delivery. We evaluated the feasibility of harnessing ubiquitous mobile technologies for conducting disease surveillance and monitoring resource utilization at the Allahabad Kumbh Mela in India, a 55-day festival attended by over 70 million people...
September 21, 2016: Journal of Public Health
Ingrid Jepsen, Edith Mark, Maralyn Foureur, Ellen A Nøhr, Erik E Sørensen
BACKGROUND: Caseload midwifery is expanding in Denmark. There is a need for elaborating in-depth, how caseload midwifery influences the partner and the woman during childbirth and how this model of care influences the early phases of labour. AIM: To follow, explore and elaborate women's and their partner's experiences of caseload midwifery. METHODS: Phenomenology of practice was the analytical approach. The methodology was inspired by ethnography, and applied methods were field observations followed by interviews...
September 21, 2016: Women and Birth: Journal of the Australian College of Midwives
Anne Maree Kelly, Anna Holdgate, Gerben Keijzers, Sharon Klim, Colin A Graham, Simon Craig, Win Sen Kuan, Peter Jones, Charles Lawoko, Said Laribi
BACKGROUND: This study aimed to determine epidemiology and outcome for patients presenting to emergency departments (ED) with shortness of breath who were transported by ambulance. METHODS: This was a planned sub-study of a prospective, interrupted time series cohort study conducted at three time points in 2014 and which included consecutive adult patients presenting to the ED with dyspnoea as a main symptom. For this sub-study, additional inclusion criteria were presentation to an ED in Australia or New Zealand and transport by ambulance...
September 22, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
P Manchon-Walsh, L Aliste, J A Espinàs, J Prades, A Guarga, J Balart, S Biondo, A Castells, X Sanjuan, J Tabernero, J M Borras
BACKGROUND: Rectal cancer surgery in Catalonia has been involved in a process of centralisation. We assessed the impact of this health policy strategy on quality of care and clinical results. METHODS: We compared patterns of care and clinical outcomes of all rectal cancer patients receiving radical surgery for the first time in public hospitals in two time periods, before (2005 and 2007) and after (2011-2012) centralisation, analysing indicators of care quality according to the regional clinical practice guidelines...
August 25, 2016: European Journal of Surgical Oncology
Tae Youn Kim, Karen D Marek
The purpose of this study was to identify characteristics of chronically ill community-dwelling older adults that differentiate the intensity of care provided by nurse care coordinators. We performed data mining on electronic health records, nurses' activity logs, and health status measures from 784 care episodes provided to 196 older adults. An inductively created decision tree identified nine groups from a combination of the six participant characteristics including medication regimen complexity, cognition, physical and mental health, hospital admission, and physical functioning...
August 26, 2016: Western Journal of Nursing Research
David L S Morales, Muhammad S Khan, Joseph W Turek, Reshma Biniwale, Christo I Tchervenkov, Michele Rush, Jeffrey P Jacobs, James S Tweddell, Marshall L Jacobs
BACKGROUND: The Society of Thoracic Surgeons Workforce on Congenital Heart Surgery (CHS) undertook a third subspecialty Practice Survey (2005, 2010, 2015) to obtain contemporary data. METHODS: A search for potential participants was conducted using multiple directories and websites. The survey instrument was widely distributed electronically. All surgeons listing congenital or pediatric cardiac surgery among interests were targeted. RESULTS: There were a total of 213 respondents: 177 (83%) were practicing congenital heart surgeons (median age 50 years; range, 34 to 80 years; 93% men), 9 (4%) were CHS trainees, 17 (8%) were retired congenital heart surgeons, and 10 (5%) were others...
August 20, 2016: Annals of Thoracic Surgery
C Groeben, R Koch, M Baunacke, M P Wirth, J Huber
BACKGROUND: To assess trends in the distribution of patients for radical prostatectomy in Germany from 2006 to 2013 and the impact of robotic surgery on annual caseloads. We hypothesized that the advent of robotics and the establishment of certified prostate cancer centers caused centralization in the German radical prostatectomy market. METHODS: Using remote data processing we analyzed the nationwide German billing data from 2006 to 2013. We supplemented this database with additional hospital characteristics like the prostate cancer center certification status...
August 23, 2016: Prostate Cancer and Prostatic Diseases
Mihaela S Stefan, Penelope S Pekow, Meng-Shiou Shieh, Nicholas S Hill, Michael B Rothberg, Kimberly A Fisher, Peter K Lindenauer
OBJECTIVE: To determine the relationship between hospital noninvasive ventilation caseload and outcomes among patients with an acute chronic obstructive pulmonary disease exacerbation. DESIGN: Cross-sectional study of 13,893 patients with chronic obstructive pulmonary disease treated with noninvasive ventilation. SETTING: A total of 243 U.S. hospitals participating in the Premier Inpatient Database. PATIENTS: A total of 13,893 patients admitted between July 2009 and June 2011...
August 9, 2016: Critical Care Medicine
J Allen, S Kildea, H Stapleton
OBJECTIVE: to identify possible mechanisms by which caseload midwifery reduces preterm birth for young childbearing women. DESIGN: a mixed methods triangulation, convergence design was used to answer the research question 'How does the way maternity care is provided affect the health and well-being of young women and their babies?' The project generated quantitative and qualitative findings which were collected and analysed concurrently then separately analysed and published...
October 2016: Midwifery
Héctor Ortiz, Antonio Codina, Miguel Á Ciga, Sebastiano Biondo, José M Enríquez-Navascués, Eloy Espín, Eduardo García-Granero, José V Roig
UNLABELLED: INTRODUCCIóN: The purpose of this prospective multicentre multilevel study was to investigate the influence of hospital caseload on long-term outcomes following standardization of rectal cancer surgery in the Rectal Cancer Project of the Spanish Society of Surgeons. METHODS: Data relating to 2910 consecutive patients with rectal cancer treated for cure between March 2006 and March 2010 were recorded in a prospective database. Hospitals were classified according to number of patients treated per year as low-volume, intermediate-volume, or high volume hospitals (12-23, 24-35, or ≥36 procedures per year)...
October 2016: Cirugía Española
Giovanni Marchegiani, Stefano Andrianello, Marta Massignani, Giuseppe Malleo, Laura Maggino, Salvatore Paiella, Cristina R Ferrone, Claudio Luchini, Aldo Scarpa, Paola Capelli, Mari Mino-Kenudson, Keith D Lillemoe, Claudio Bassi, Carlos Fernàndez-Del Castillo, Roberto Salvia
BACKGROUND: Since their introduction in the WHO classification, the incidence of solid pseudopapillary tumors (SPTs) of the pancreas has progressively increased, mainly because of the widespread use of cross-sectional imaging. Few recent studies have analyzed the biological behavior of SPTs, but reliable data on long-term follow-up are needed. METHODS: Retrospective analysis of two Institutions with high caseload, The Department of General Surgery-Pancreas Institute, University of Verona Hospital Trust and the Department of General Surgery, Massachusetts General Hospital, Harvard Medical School, was carried out...
October 2016: Journal of Surgical Oncology
Luis Sagaon-Teyssier, Lisa Fressard, Marion Mora, Gwenaëlle Maradan, Valérie Guagliardo, Marie Suzan-Monti, Rosemary Dray-Spira, Bruno Spire
OBJECTIVES: To determine the impact of hospital caseload size on HIV virological success when taking into account individual patient characteristics. METHODS: Data from the ANRS-VESPA2 survey representative of people living with HIV in France was used. Analyses were carried out on the 2612 (86.4% out of 3022) individuals receiving antiretroviral (ARV) treatment for at least one year. Outcomes correspond to two definitions of virological success (VS1 and VS2 respectively) and were analyzed under a multi-level modeling framework with a special focus on the effect of the caseload size on VS...
August 2016: Health Policy
Elaine Wittenberg, Betty Ferrell, Joy Goldsmith, Sandra L Ragan, Judith Paice
BACKGROUND: Despite increased attention to communication skill training in palliative care, few interprofessional training programs are available and little is known about the impact of such training. OBJECTIVE: This study evaluated a communication curriculum offered to interprofessional palliative care teams and examined the longitudinal impact of training. METHODS: Interprofessional, hospital-based palliative care team members were competitively selected to participate in a two-day training using the COMFORT(TM SM) (Communication, Orientation and options, Mindful communication, Family, Openings, Relating, Team) Communication for Palliative Care Teams curriculum...
July 2016: Journal of Palliative Medicine
Raymond Yap, Mark Cullinan
BACKGROUND: Training in medicine and surgery has been a public hospital responsibility in Australia. Increasing specialist training needs has led to pressure on speciality societies to find additional training posts, with one utilized solution being the establishment of private hospital training. This growing use has been despite no previously published evaluations of private hospital training in Australia. This article seeks to evaluate the feasibility of surgical training in private hospitals in appendicectomy...
June 9, 2016: ANZ Journal of Surgery
Elhanan Bar-On, Nehemia Blumberg, Amit Joshi, Arnon Gam, Amos Peyser, Evgeny Lee, Shree Krishna Kashichawa, Alexander Morose, Ophir Schein, Amit Lehavi, Yitshak Kreiss, Tarif Bader
BACKGROUND: Field hospitals have been deployed by the Israel Defense Forces (IDF) Medical Corps in numerous disaster events. Two recent deployments were following earthquakes in Haiti in 2010 and in Nepal in 2015. Despite arrival in similar timetables, the mode of operation was different-independently in Haiti and in collaboration with a local hospital in Nepal. The pathology encountered in the two hospitals and the resultant treatment requirements were significantly different between the two events...
September 2016: World Journal of Surgery
Alexander H Jones, William Ampofo, Richard Akuffo, Brooke Doman, Christopher Duplessis, Joseph A Amankwa, Charity Sarpong, Ken Sagoe, Prince Agbenohevi, Naiki Puplampu, George Armah, Kwadwo A Koram, Edward O Nyarko, Samuel Bel-Nono, Erica L Dueger
BACKGROUND: Influenza epidemiology in Africa is generally not well understood. Using syndrome definitions to screen patients for laboratory confirmation of infection is an established means to effectively conduct influenza surveillance. METHODS: To compare influenza-related epidemiologic data, from October 2010 through March 2013, we enrolled hospitalized severe acute respiratory infection (SARI; fever with respiratory symptoms) and acute febrile illness (AFI; fever without respiratory or other localizing symptoms) patients from three referral hospitals in Ghana...
September 2016: Influenza and Other Respiratory Viruses
Elisa B Kepner, Rachel Spencer
Determining staff and space requirements for military medical centers can be challenging. Changing patient populations change the caseload requirements. Deployment and assignment rotations change the experience and education of clinicians and support staff, thereby changing the caseload capacity of a facility. During wartime, planning becomes increasingly more complex. What will the patient mix and caseload volume be by location? What type of clinicians will be available and when? How many beds are needed at each facility to meet caseload demand and match clinician supply? As soon as these factors are known, operations are likely to change and planning factors quickly become inaccurate...
April 2016: U.S. Army Medical Department Journal
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