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Hospital caseload

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https://www.readbyqxmd.com/read/29237604/stormy-weather-a-retrospective-analysis-of-demand-for-emergency-medical-services-during-epidemic-thunderstorm-asthma
#1
Emily Andrew, Ziad Nehme, Stephen Bernard, Michael J Abramson, Ed Newbigin, Ben Piper, Justin Dunlop, Paul Holman, Karen Smith
OBJECTIVES: To describe the demand for emergency medical assistance during the largest outbreak of thunderstorm asthma reported globally, which occurred on 21 November 2016. DESIGN: A time series analysis was conducted of emergency medical service caseload between 1 January 2015 and 31 December 2016. Demand during the thunderstorm asthma event was compared to historical trends for the overall population and across specific subgroups. SETTING: Victoria, Australia...
December 13, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29231287/using-secondments-in-tertiary-health-facilities-to-build-paediatric-expertise-in-allied-health-professionals-working-in-rural-new-south-wales
#2
Carmel Blayden, Sonia Hughes, Jennifer Nicol, Susan Sims, Isobel J Hubbard
OUTLINE OF PROBLEM: Allied health professionals working in rural settings have broad caseloads requiring advanced skills as general specialists. This can include children with specialised needs. DESIGN: Educational secondments were coordinated for allied health professionals to achieve self-nominated learning objectives. Learning objectives were assessed using pre and post evaluations to determine the effect of the educational secondment on knowledge and confidence specific to the nominated learning outcomes...
December 2017: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#3
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29204014/mental-healthcare-delivery-in-rural-greece-a-10-year-account-of-a-mobile-mental-health-unit
#4
Vaios Peritogiannis, Thiresia Manthopoulou, Afroditi Gogou, Venetsanos Mavreas
Introduction: Patients living in rural and remote areas may have limited access to mental healthcare due to lack of facilities and socioeconomic reasons, and this is the case of rural areas in Eastern Europe countries. In Greece, community mental health service delivery in rural areas has been implemented through the development of the Mobile Mental Health Units (MMHUs). Methods: We present a 10-year account of the operation of the MMHU of the prefectures of Ioannina and Thesprotia (MMHU I-T) and report on the impact of the service on mental health delivery in the catchment area...
October 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29175752/lack-of-generalizability-of-observational-studies-findings-for-turnover-time-reduction-and-growth-in-surgery-based-on-the-state-of-iowa-where-from-one-year-to-the-next-most-growth-was-attributable-to-surgeons-performing-only-a-few-cases-per-week
#5
Franklin Dexter, Craig Jarvie, Richard H Epstein
STUDY OBJECTIVE: Three observational studies at large teaching hospitals found that reducing turnover times resulted in the surgeons performing more cases. We sought to determine if these findings are generalizable to other hospitals, because, if so, reducing turnover times may be an important mechanism for hospitals to use for growing caseloads. DESIGN: Observational cohort study. SETTING: 116 hospitals in Iowa with inpatient or outpatient surgery from July 1, 2013 through June 30, 2015...
November 23, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29170304/7%C3%A2-mass-casualty-incidents-a-review-of-triage-severity-planning-assumptions
#6
Paul Hunt
BACKGROUND: Recent events involving a significant number of casualties have emphasised the importance of appropriate preparation for receiving hospitals, especially Emergency Departments, during the initial response phase of a major incident. Development of a mass casualty resilience and response framework in the Northern Trauma Network included a review of existing planning assumptions in order to ensure effective resource allocation, both in local receiving hospitals and system-wide...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29108324/age-adjusted-charlson-comorbidity-index-score-as-predictor-of-survival-of-patients-with-digestive-system-cancer-who-have-undergone-surgical-resection
#7
Yaohua Tian, Zhong Jian, Beibei Xu, Hui Liu
Comorbidities have considerable effects on survival outcomes. The primary objective of this retrospective study was to examine the association between age-adjusted Charlson comorbidity index (ACCI) score and postoperative in-hospital mortality in patients with digestive system cancer who have undergone surgical resection of their cancers. Using electronic hospitalization summary reports, we identified 315,464 patients who had undergone surgery for digestive system cancer in top-rank (Grade 3A) hospitals in China between 2013 and 2015...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29049412/measuring-facility-capability-to-provide-routine-and-emergency-childbirth-care-to-mothers-and-newborns-an-appeal-to-adjust-for-delivery-caseload-of-facilities
#8
Stephanie M Allen, Charles Opondo, Oona M R Campbell
BACKGROUND: Measurement of Emergency Obstetric Care capability is common, and measurement of newborn and overall routine childbirth care has begun in recent years. These assessments of facility capabilities can be used to identify geographic inequalities in access to functional health services and to monitor improvements over time. This paper develops an approach for monitoring the childbirth environment that accounts for the delivery caseload of the facility. METHODS: We used data from the Kenya Service Provision Assessment to examine facility capability to provide quality childbirth care, including infrastructure, routine maternal and newborn care, and emergency obstetric and newborn care...
2017: PloS One
https://www.readbyqxmd.com/read/29025099/dutch-surgeons-views-on-the-volume-outcome-mechanism-in-surgery-a-qualitative-interview-study
#9
R Mesman, M J Faber, G P Westert, H J J M Berden
Objective: To contribute to a better understanding of volume-outcome relationships in surgery by exploring Dutch surgeons' views on the underlying mechanism. Design: A qualitative study based on face-to-face semi structured interviews and an inductive content analysis approach. Setting: Interviews were conducted in eight hospitals in the Netherlands (2 university, 4 teaching and 2 general). Participants: Twenty surgeons (gastrointestinal, vascular and trauma)...
August 9, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28981491/the-new-zealand-major-trauma-registry-the-foundation-for-a-data-driven-approach-in-a-contemporary-trauma-system
#10
Siobhan Isles, Grant Christey, Ian Civil, Peter Hicks
AIM: To describe the development of the New Zealand Major Trauma Registry (NZ-MTR) and the initial experiences of its use. METHOD: The background to the development of the NZ-MTR was reviewed and the processes undertaken to implement a single-instance of a web-based national registry described. A national minimum dataset was defined and utilised. Key structures to support the Registry such as a data governance group were established. RESULTS: The NZ-MTR was successfully implemented and is the foundation for a new, data-driven model of quality improvement...
October 6, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28974070/hypotension-during-induction-of-anaesthesia-is-neither-a-reliable-nor-a-useful-quality-measure-for-comparison-of-anaesthetists-performance
#11
R H Epstein, F Dexter, E S Schwenk
Background: Identification of statistically reliable outcomes for comparison among anaesthetists is challenging. Time-weighted intraoperative mean arterial pressure <65 mm Hg (AUC 65 ) is associated with increased odds for myocardial damage. We explored retrospectively whether such hypotension before incision was statistically reliable for peer comparison. Methods: We retrieved electronic data between 2006 and 2015 at a tertiary care, academic hospital in the USA for patients at risk for myocardial damage (inpatient after surgery, ASA physical status ≥III, ≥50 yr of age, and case duration ≥60 min)...
July 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28973498/failure-to-rescue-and-mortality-following-resection-of-intracranial-neoplasms
#12
Hani Malone, Michael Cloney, Jingyan Yang, Dawn L Hershman, Jason D Wright, Alfred I Neugut, Jeffrey N Bruce
BACKGROUND: There is growing recognition that perioperative complication rates are similar between hospitals, but mortality rates are lower at high-volume centers. This may be due to differences in the ability to rescue patients from major complications. OBJECTIVE: To examine the relationship between hospital caseload and failure to rescue from complications following resection of intracranial neoplasms. METHODS: We identified adults in the Nationwide Inpatient Sample diagnosed with glioma, meningioma, brain metastasis, or acoustic neuroma, who underwent surgical resection between 1998 and 2010...
August 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28964707/operationalising-caseload-midwifery-in-the-australian-public-maternity-system-findings-from-a-national-cross-sectional-survey-of-maternity-managers
#13
Kate Dawson, Della A Forster, Helen L McLachlan, Michelle S Newton
BACKGROUND: Despite high-level evidence of the benefits of caseload midwifery for women and babies, little is known about specific practice arrangements, organisational barriers and facilitators, nor about workforce requirements of caseload. This paper explores how caseload models across Australia operate. METHODS: A national cross-sectional, online survey of maternity managers in public maternity hospitals with birthing services was undertaken. Only services with a caseload model are included in the analysis...
September 27, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/28949100/cancer-multidisciplinary-team-meetings-in-practice-results-from-a-multi-institutional-quantitative-survey-and-implications-for-policy-change
#14
Nicole M Rankin, Michelle Lai, Danielle Miller, Philip Beale, Allan Spigelman, Gabrielle Prest, Kim Turley, John Simes
AIM: Multidisciplinary care is advocated as best practice in cancer care. Relatively little is documented about multidisciplinary team (MDT) meeting functioning, decision making and the use of evidence to support decision making in Australia. This descriptive study aimed to examine team functioning, the role of team meetings and evidence use in MDTs whose institutions are members of Sydney Catalyst Translational Cancer Research Centre. METHODS: We designed a structured 40-item survey instrument about topics that included meeting purpose, organization, resources and documentation; caseload estimates; use of evidence and quality assurance; patient involvement and supportive care needs; and open-ended items about the MDTs strengths and weaknesses...
September 26, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28943420/impact-of-hospital-caseload-and-elective-admission-on-outcomes-following-extracranial-intracranial-bypass-surgery
#15
Hesam Akbarian-Tefaghi, Piyush Kalakoti, Hai Sun, Kanika Sharma, Jai Deep Thakur, Devi Prasad Patra, Rimal H Dossani, Amey Savardekar, Christina Notarianni, Gregory J Zipfel, Anil Nanda
BACKGROUND: Limited information exists evaluating the impact of hospital caseload and elective admission on outcomes following patients undergoing extracranial-intracranial (ECIC) bypass surgery. Using the Nationwide Inpatient Sample (NIS) for the years 2001 through 2014, we evaluated the impact of hospital caseload and elective admission on outcomes following bypass. METHODS: In an observational cohort study, weighted estimates were used to investigate the association of hospital caseload and elective admission on short-term outcomes following bypass surgery using multivariable regression techniques...
September 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28913493/an-evaluation-of-operating-room-throughput-in-a-stand-alone-soft-tissue-trauma-operating-theatre
#16
Brian D O'Donnell, Ken Walsh, Aileen Murphy, Brendan McElroy, Gabriella Iohom, George D Shorten
BACKGROUND: Operating room time is a limited, expensive commodity in acute hospitals. Strategies aimed at reduction of non-operative time improve operating room throughput and capacity. We conducted a prospective study to evaluate and augment operating room throughput and capacity using context-specific work practice changes. METHODS: Following institutional and ethical approval, an interdisciplinary group designed and introduced a series of work practice changes specific to a stand-alone soft tissue trauma theatre, comprising modifications to patient processing, staff behaviours and additional anaesthesiologist hours...
April 2017: Romanian journal of anaesthesia and intensive care
https://www.readbyqxmd.com/read/28911286/the-effect-of-a-surgery-specific-cardiac-output-guided-haemodynamic-algorithm-on-outcomes-in-patients-undergoing-pancreaticoduodenectomy-in-a-high-volume-centre-a-retrospective-comparative-study
#17
COMPARATIVE STUDY
L Weinberg, J Banting, L Churilov, R L McLeod, K Fernandes, I Chao, T Ho, D Ianno, V Liang, V Muralidharan, C Christophi, M Nikfarjam
In this retrospective observational study performed in a high-volume hepatobiliary-pancreatic unit, we evaluated the effect of a surgery-specific goal-directed therapy (GDT) physiologic algorithm on complications and length of hospital stay. We compared patients who underwent pancreaticoduodenectomy with either a standardised Enhanced Recovery After Surgery program (usual care group), or a standardised Enhanced Recovery After Surgery program in combination with a surgery-specific cardiac output-guided algorithm (GDT group)...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28885506/the-theory-and-practice-of-pancreatic-surgery-in-france
#18
Olivier Farges, Noelle Bendersky, Stéphanie Truant, Jean Robert Delpero, François René Pruvot, Alain Sauvanet
OBJECTIVE: Measure the caseload of pancreatectomies that influences their short-term outcome, at a national level, and assess the applicability of a centralization policy. BACKGROUND: There is agreement that pancreatectomies should be centralized. However, previous studies have failed to accurately define a "high-volume" center. METHODS: French healthcare databases were screened to identify all adult patients who had elective pancreatectomies between 2007 and 2012...
November 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28876672/civilian-gunshot-wounds-to-the-chest-a-clinicopathological-analysis-of-an-annual-caseload-at-a-level-1-trauma-centre
#19
V M Meijering, A T Hattam, P H Navsaria, A J Nicol, S Edu
BACKGROUND: Gunshot wounds (GSW) to the chest are common presentations to trauma centres in South Africa. The clinical management and outcome of GSW to the chest are significantly altered by missile trajectory and the associated anatomical structures injured making them challenging injuries to treat. Currently, the management of GSW chest is based on scant evidence and treatment is typically according to algorithms based largely on the anecdotal experience of high volume institutions and experienced clinicians...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876666/civilian-gunshot-wounds-to-the-chest-a-clinicopathological-analysis-of-an-annual-caseload-at-a-level-1-trauma-centre
#20
V M Meijering, A T Hattam
BACKGROUND: Gunshot wounds (GSW) to the chest are common presentations to trauma centres both in South Africa and internationally. The clinical management and outcome of GSW to the chest are significantly altered by missile trajectory and the associated anatomical structures injured making them challenging injuries to treat. Currently, the management of GSW chest is based on scant evidence and treatment is typically according to algorithms based largely on the anecdotal experience of high volume institutions and experienced clinicians...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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