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Horkova, O. V., and Lyudmila A. Karasaeva. "UNRESOLVED ISSUES IN THE PROVISION OF MEDICAL-SOCIAL ASSISTANCE TO DISABLED ELDERLY PERSONS." Medical and Social Expert Evaluation and Rehabilitation 20, no. 4 (December 15, 2017): 172–75. http://dx.doi.org/10.18821/1560-9537-2017-20-4-172-175.
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The legislative provision of social services and rehabilitation of the disabled elderly was studied. There were determined special legislative, methodological and technical problems lying in the imperfection of the model of medical-social and rehabilitation services. Organizational problems of interagency cooperation authorities and institutions in the implementation of rehabilitation and social services to disabled elderly persons were revealed. Main directions of the improvement of the system of medical-social assistance and rehabilitation are proposed.
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Prizzia, PhD, Ross. "Emergency management and disaster response in Hawaii: The role of medical centers and the media." Journal of Emergency Management 2, no. 4 (October 1, 2004): 43. http://dx.doi.org/10.5055/jem.2004.0044.
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The research is an administrative case study based on an extensive review of Hawaii government documents and interviews with key personnel of the Hawaii Emergency Preparedness Committee (EPC), civil defense, and other relevant government officials. Interviews with key personnel at the major medical centers were also conducted as well as a survey of 80 percent of the local Hawaii-based TV news reporters. The study describes the interagency coordination at the federal, state, county, and community level to improve capability. Recommendations from the study included increased funding for family emergency preparedness and local community response teams and continuous training by emergency response coordinators to improve state and county disaster preparedness. The study also recommends collaboration with disaster-trained media reporters. The study concluded that, overall, Hawaii is adequately prepared in emergency response capability, particularly in the areas of medical services and interagency coordination, but coordination with the media reporting on disasters could be improved.
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Stack, Kathy. "The Office of Management and Budget: The Quarterback of Evidence-Based Policy in the Federal Government." ANNALS of the American Academy of Political and Social Science 678, no. 1 (June 18, 2018): 112–23. http://dx.doi.org/10.1177/0002716218768440.
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During the Obama administration, the White House Office of Management and Budget’s (OMB) leadership helped to initiate and cement evidence-based policymaking reforms across the federal government, particularly in social services programs. Notable accomplishments were in the design of outcome-focused programs that use and build evidence, the strengthening of agency evaluation capacity, and interagency data-linkage projects to harness administrative data. Here, I review those accomplishments and catalog the key assets and tactics that OMB used to help federal agencies increase their use of evidence and innovation. I also assess the shortcomings and limitations of the Obama-era OMB approach and draw conclusions about what could be done in the current or a future administration to further advance evidence-based policymaking in the executive branch. Specifically, I propose that Congress and the administration should work to improve agency evaluation capacity, assess and report on agencies’ progress in using and building evidence, and establish an Intergovernmental Evidence and Innovation Council.
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Yarrison, Gerald. "Physicians' Office Laboratories: Support Services and Revenue Options." Laboratory Medicine 19, no. 3 (March 1, 1988): 171–73. http://dx.doi.org/10.1093/labmed/19.3.171.
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Regnier, Fred E., Steven J. Skates, Mehdi Mesri, Henry Rodriguez, Živana Težak, Marina V. Kondratovich, Michail A. Alterman, et al. "Protein-Based Multiplex Assays: Mock Presubmissions to the US Food and Drug Administration." Clinical Chemistry 56, no. 2 (February 1, 2010): 165–71. http://dx.doi.org/10.1373/clinchem.2009.140087.
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Abstract As a part of ongoing efforts of the NCI-FDA Interagency Oncology Task Force subcommittee on molecular diagnostics, members of the Clinical Proteomic Technology Assessment for Cancer program of the National Cancer Institute have submitted 2 protein-based multiplex assay descriptions to the Office of In Vitro Diagnostic Device Evaluation and Safety, US Food and Drug Administration. The objective was to evaluate the analytical measurement criteria and studies needed to validate protein-based multiplex assays. Each submission described a different protein-based platform: a multiplex immunoaffinity mass spectrometry platform for protein quantification, and an immunological array platform quantifying glycoprotein isoforms. Submissions provided a mutually beneficial way for members of the proteomics and regulatory communities to identify the analytical issues that the field should address when developing protein-based multiplex clinical assays.
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Swor, Robert A., and Ronald L. Krome. "Administrative Support of Emergency Medical Services Medical Directors: A Profile." Prehospital and Disaster Medicine 5, no. 1 (March 1990): 25–30. http://dx.doi.org/10.1017/s1049023x00026479.
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AbstractPrehospital advanced life support (ALS) is provided by non-physicians under the supervision and the responsibility of a physician—the Emergency Medical Service Medical Director (EMSMD). In order to assess the time required of the EMSMD as well as the technical support provided and the medico-legal risks involved, a survey was distributed to physicians in attendance at the Annual Scientific Assemblies of the National Association of EMS Physicians in August 1986 and June 1987. The survey also was mailed to all EMSMDs in Michigan.Of the 66 EMS medical director respondents, 69% were compensated, 62% were provided with malpractice coverage, and 22% had been involved in legal actions. Clerical support was provided for 89%, office space for 58%, and 60% had access to a computerized record database system. The average time consumed per week was 17±13 hours.Differences were detected in the amount of support provided between services with an excess of 10,000 ALS responses per year and those with less than 10,000. The larger services more frequently provided office space and equipment (p<.02), malpractice coverage (p<.01), and access to a records database (p<.03) than did the smaller services. The EMSMDs for the larger services also were involved more frequently in legal actions (p<.03).Legal actions involved 14 of the EMSMDs: paramedic malpractice (6); system failures (3); dispatch errors (2); inappropriate receiving facility (2); and paramedic licensure, equipment failure, union grievance, withdrawal of medical control, and trauma center designation (1 each). Four of the 14 involved had not been provided with malpractice coverage.Medical direction of a prehospital EMS system requires a significant time commitment, incurs medico-legal risks, and in most communities receives clerical and data retrieval support, and the EMSMDs are compensated.
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McIlvenna, Kathleen, Douglas H. L. Brown, and David R. Green. "‘The Natural Foundation of Perfect Efficiency’1: Medical Services and the Victorian Post Office." Social History of Medicine 33, no. 2 (January 23, 2019): 539–58. http://dx.doi.org/10.1093/shm/hky123.
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Summary This article explores the creation of the Post Office medical service. Working for the Post Office was relatively well-paid and an increasing number of doctors were employed. Medical provision expanded with the introduction of non-contributory pensions from mid-century and developed into a comprehensive and nationwide service that was involved at all stages of employment, from initial recruitment through to receiving a pension. Post Office doctors assessed candidates’ fitness for work, checked on sick absences, provided free medicine and advice and visited workers’ homes. Doctors were responsible for determining whether or not a worker should be pensioned off on grounds of ill health. The career of the first Chief Medical Officer, Dr Waller Lewis, also illustrates the range of other areas in which the Post Office medical service became involved, including the clinical assessment and relief of sickness as well as identifying preventative measures to improve health outcomes.
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Holman, Josephine. "Functional Office Design: A Medical Record Department Perspective." Australian Medical Record Journal 18, no. 1 (March 1988): 15–17. http://dx.doi.org/10.1177/183335838801800107.
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The term ‘ergonomics' embodies the relationship of people to their total work environment. In this paper, medical record administrators are encouraged to explore the potential of ergonomics in its widest sense and, when evaluating the design of medical record departments, to keep in mind that office design is fundamental to productivity and staff morale. Medical record adminstrators need to press for changes in office design which not only improve the morale and performance of employees but also enhance the image of the medical record department as a vital and integral part of patient services.
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Chase, Philip N. "Gathering Evidence for Distance Education11The author wishes to acknowledge the following people for their assistance in developing the methods described in this article: Robert Collins, Chata Dickson, Charles Hamad, T.V. Joe Layng, Andrew Lightner, Harold Lobo, Kristin Mayfield, John Rochford, Janet Twyman, and Vennessa Walker. Support for developing these methods came from grant #10009793-1003772R from iLearn, Inc. to West Virginia University; and Interagency Service Agreement # CT EHS 8UMSCANSISA0000001CB between the University of Massachusetts Medical School and the Children’s Behavioral Health Initiative of the Executive Office of Health and Human Services, Commonwealth of Massachusetts." Acta de Investigación Psicológica 4, no. 3 (December 2014): 1657–72. http://dx.doi.org/10.1016/s2007-4719(14)70972-x.
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Martin, Thomas, Megan Ranney, James Dorroh, Nicholas Asselin, and Indra Sarkar. "Health Information Exchange in Emergency Medical Services." Applied Clinical Informatics 09, no. 04 (October 2018): 884–91. http://dx.doi.org/10.1055/s-0038-1676041.
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Background The Office of the National Coordinator for Health Information Technology has outlined the benefits of health information exchange in emergency medical services (EMSs) according to the SAFR model—search, alert, file, and reconcile—developed in collaboration with the California Emergency Medical Services Authority. Objective This scoping review aims to identify and characterize progress toward the adoption of prehospital health information exchange, as reported in the peer-reviewed literature. Methods A structured review of literature in MEDLINE-indexed journals was conducted using the “Electronic Health Records” topic-specific query, the “Emergency Medical Services” Medical Subject Headings descriptor, and a prehospital identifier. Results Our initial search yielded 368 nonduplicative, English-language articles; 131 articles underwent full-text review and 11 were selected for analysis according to pre-established inclusion criteria. Original research was thematically grouped according to the SAFR model. Conclusion Within isolated systems, there has been limited progress toward the adoption of prehospital health information exchange. Interoperability, accurate match algorithms, security, and wireless connectivity have been identified as potential barriers to adoption. Additional research is required to evaluate the role of health information exchange within EMSs.
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Snella, Kathleen A., Renee R. Trewyn, Laura B. Hansen, and J. Chris Bradberry. "Pharmacist Compensation for Cognitive Services: Focus on the Physician Office and Community Pharmacy." Pharmacotherapy 24, no. 3 (March 2004): 372–88. http://dx.doi.org/10.1592/phco.24.4.372.33179.
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Lea, Susan, Lynne Callaghan, Susan Eick, Margaret Heslin, John Morgan, Mark Bolt, Andrew Healey, et al. "The management of individuals with enduring moderate to severe mental health needs: a participatory evaluation of client journeys and the interface of mental health services with the criminal justice system in Cornwall." Health Services and Delivery Research 3, no. 15 (April 2015): 1–232. http://dx.doi.org/10.3310/hsdr03150.
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BackgroundExisting research identified substantial gaps between NHS mental health services and the criminal justice system for individuals with enduring moderate to severe mental health needs (EMHN). A pilot study in Cornwall echoed these findings, identifying deficiencies in provision at the interface of police and mental health services.AimTo explore the interagency management of individuals with EMHN as they come into contact with the police.DesignA mixed-methods approach within a community psychology framework to enhance the implementation of findings. Stage 1: policy review and clinical audit to identify a sample of mental health service users who were in contact with the police. Stage 2: case-linkage study of 80 service user journeys through services at the time of three types of police contact (Section 136 detention; arrest for criminal offence and contact that did not result in detention); and a health economics component including analysis of the actual cost of 55 service user journeys and enhanced service scenarios. Stage 3: local stakeholder consultation to validate and contextualise case-linkage findings, including a national event.SettingThe research site was the county of Cornwall within the organisational contexts of Cornwall Partnership NHS Foundation Trust and Devon & Cornwall Police.SampleProportionate stratified random sampling identified a sample of 80 cases examined in the case-linkage study from the 538 linked cases identified by the clinical audit.Data sourcesCase-linkage and health economics data involved individuals’ police and mental health records; stakeholder consultation data involved focus groups and interviews.ResultsOf the sample of 80 cases examined, 23 individuals had been detained under Section 136 of the Mental Health Act (1983: Great Britain.Mental Health Act 1983.Chapter 20. London: The Stationery Office; 1983) (accounting for 32 detentions), 52 had been detained in custody on suspicion of an offence (accounting for 126 arrests) and 15 had non-detention contact with the police. Findings showed that where police were aware of mental health needs and individuals were on caseload of a Mental Health Team, there was increased interaction and enhanced outcomes for service users and organisations. The health economics scenario modelling suggests that enhancing services has minimal effects on individual level costs compared with current practice.ConclusionsThe research revealed discrepancy in police and mental health professionals’ assessment of risk and interpretation of protocol and highlighted the need for joint interagency protocols and training to improve information sharing between agencies to enhance the management of individuals with enduring moderate to severe mental health needs.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Albanese, Nicole P., Alyssa M. Pignato, and Scott V. Monte. "Provider Perception of Pharmacy Services in the Patient-Centered Medical Home." Journal of Pharmacy Practice 30, no. 6 (November 25, 2016): 612–20. http://dx.doi.org/10.1177/0897190016679759.
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Background: Despite the positive data on clinical outcomes, cost savings, and provider experience, no study has surveyed providers to evaluate what pharmacy services they find to be worthwhile. Objective: To determine what clinical, cost/access, and educational pharmacy services providers in a patient-centered medical home (PCMH) consider worthwhile and the perceived barriers to successful pharmacist incorporation. Methods: A cross-sectional online survey was distributed to primary care physicians, nurse practitioners, and physician assistants in a PCMH physician group. Results: The survey response rate was 78%. Top-tier clinical services were identified as medication counseling, reconciliation, adherence assessment, polypharmacy assessment, and drug information. Formulary review was the only top-tier cost- or access-related service. Top-tier educational services included new black-boxed warnings, drug market withdrawals, and new drug reviews. Ninety-one percent of providers were comfortable referring to a pharmacist for diabetes medication selection and dose titration, but no other disease state eclipsed 75%. More than twice as many providers found the pharmacy service to be very or extremely valuable when the pharmacist is physically located in the office versus virtual interactions (70% vs 34%). Conclusion: Top-tier clinical, cost/access, and educational services considered worthwhile by providers in a PCMH have been identified. In addition to these services, when developing or evaluating a pharmacy service, special attention should be paid to provider preference for physical location in the office and perceived barriers to the pharmacist availability, concern over complex disease management competency and patient confusion as to the role of the pharmacist.
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Rayner, Clive, and Michael R. Ragan. "Are You Ready for Emergency Medical Services in Your Oral and Maxillofacial Surgery Office?" Oral and Maxillofacial Surgery Clinics of North America 30, no. 2 (May 2018): 123–35. http://dx.doi.org/10.1016/j.coms.2018.01.006.
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Collins, PhD, Matthew Lloyd. "A case study of the law enforcement/emergency medical services response to the Virginia Tech mass casualty incident on April 16, 2007." Journal of Emergency Management 5, no. 5 (September 1, 2007): 17. http://dx.doi.org/10.5055/jem.2007.0020.
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The April 16, 2007, shooting rampage on the Virginia Polytechnic Institute and State University (Virginia Tech) campus, carried out by Seung-Hui Cho, was the worst gun-related massacre in the history of the United States. The purpose of this article is twofold. First, it examines the emergency management literature on interagency communication, collaboration, and coordination as it relates to the Virginia Tech mass casualty incident (MCI). Second, the article presents a single instrumental case study that focuses on the bounded case of the Virginia Tech MCI. Through multiple sources of data collection to include observations, interviews, and document analysis, this study found that 14 law enforcement agencies and 13 emergency medical services agencies responded to the Virginia Tech MCI. With only two exceptions, the law enforcement agencies involved in the response to this MCI responded informally or self-deployed (arrived without being dispatched). However, all of the emergency medical services agencies that responded were formally dispatched. Lessons learned from the emergency management literature review and the case study will be discussed. In conclusion, policy recommendations, which will be generalizable to other rural university campuses and rural organizational settings, will be made.
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Viswanathan, Kristin P., Robert Bass, Gamunu Wijetunge, and Bruce M. Altevogt. "Rural Mass Casualty Preparedness and Response: The Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events." Disaster Medicine and Public Health Preparedness 6, no. 3 (October 2012): 297–302. http://dx.doi.org/10.1001/dmp.2012.38.
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ABSTRACTThe Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events hosted a workshop at the request of the Federal Interagency Committee on Emergency Medical Services (FICEMS) that brought together a range of stakeholders to broadly identify and confront gaps in rural infrastructure that challenge mass casualty incident (MCI) response and potential mechanisms to fill them. This report summarizes the presentations and discussions around 6 major issues specific to rural MCI preparedness and response: (1) improving rural response to MCI through improving daily capacity and capability, (2) leveraging current and emerging technology to overcome infrastructure deficits, (3) sustaining and strengthening relationships, (4) developing and sharing best practices across jurisdictions and sectors, (5) establishing metrics research and development, and (6) fostering the need for federal leadership to expand and integrate EMS into a broader rural response framework.(Disaster Med Public Health Preparedness. 2012;6:297–302)
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Limanto, Susana, and Andre Andre. "Information system to enhance medical services quality in Indonesia." International Journal of Electrical and Computer Engineering (IJECE) 9, no. 3 (June 1, 2019): 2049. http://dx.doi.org/10.11591/ijece.v9i3.pp2049-2056.
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The consequence of disproportionate distribution and placement of Doctor in Indonesia is affecting people who live in rural area. Patient have to travel to city to receive medical treatment and must encounter another different problem such as: patients often have to wait a long time in the doctor's office even sometimes do not get the service because of holiday or rejected because the queue is full. Medical record in some cases may lost due in Indonesia mostly medical record recorded manually (paper based). Therefore doctor treatment is not optimal because doctor can no longer inspect patient illness history and any treatment that have been conducted before. This research proposes a new concept to help people who live in rural area to get better medical treatment. People could register and monitor doctor service queue via smart phone. System expanded with medical record management facilities to improve service quality of patient. Research object was doctor service in Sulawesi, Indonesia. This research indicates system could increase time efficiency, energy, and cost efficiency for patient and also the doctor. Additionally current system will be optimal if supported with stable internet network.
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Hunter, Donna, Gerry McCartney, Susan Fleming, and Fiona Guy. "Improving the Health of Looked after Children in Scotland: 1. Using a Specialist Nursing Service to Improve the Health Care of Children in Residential Accommodation." Adoption & Fostering 32, no. 4 (December 2008): 51–56. http://dx.doi.org/10.1177/030857590803200407.
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The first of two studies reported here by Donna Hunter, Gerry McCartney, Susan Fleming and Fiona Guy investigated whether a specialist nursing service could improve the health care of 162 children in residential care in Renfrewshire, West Dunbartonshire and Argyll & Bute. It found that after the introduction of the service, the proportion of children with completed carer-held health records (BAAF health record booklets) increased from three per cent to 77 per cent; the proportion receiving a ‘pre-admission medical’ increased from 38 per cent to 48 per cent; the proportion adequately immunised increased from nine per cent to 56 per cent; the proportion with at least one outstanding medical referral decreased by at least four per cent; the number registered with a dentist increased from 14 per cent to 62 per cent and the proportion who received a ‘comprehensive health assessment’ increased from 17 per cent to 58 per cent. Thematic analysis of free text journals suggested that universal health services were much more accessible in Argyll & Bute due to well-developed interagency working, low numbers of children in residential care and low rates of staff turnover. In the more urban areas, the main advantage of the service was thought to be in the facilitation of interagency working. The service was received positively by residential care workers and children in residential establishments. This study suggests that the provision of a specialist nursing service can improve the health care of children in residential accommodation.
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Manchikanti, Laxmaiah. "Description of Documentation in the Management of Chronic Spinal Pain." Pain Physician 4;12, no. 4;7 (July 14, 2009): E199—E224. http://dx.doi.org/10.36076/ppj.2009/12/e199.
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Documentation assists health care professionals in providing appropriate services to patients by documenting indications and medical necessity, and reflects the competency and character of the physician. Documentation is considered a cornerstone of the quality of patient care. This is nowhere more true than in interventional pain management. Thus, documentation in physicians’ offices, hospital settings, ambulatory surgery centers, rehabilitation centers, and other settings must be accurate, complete, and reflect all of the services provided during each encounter. The Centers for Medicare and Medicaid Services (CMS) defines medical necessity in these terms: “no payment may be made under Part A or Part B for any expense incurred for items or services which are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a participant.” The American Medical Association (AMA) defines medical necessity as, “health care services or procedures that a prudent physician would provide to a patient for the purpose of preventing, diagnosing, or treating an illness, injury, disease, or its symptoms in a manner that is in accordance with generally accepted standards of medical practice, clinically appropriate in terms of type, frequency, extent, site, and duration, and not primarily for the convenience of the patient, physician, or other health care provider.” Documentation requirements include an appropriate medical record utilizing recognized and acceptable standards of documentation and an established process. However, the evolution of electronic medical records (EMRs) or electronic health records (EHRs) nullifies many of the issues faced in handwritten documentation. Multiple types of documentation include evaluation and management services and documentations in ambulatory surgery centers, hospital outpatient departments, and in office settings, specifically while performing interventional procedures. Evaluation and management services incorporate 5 levels of service for consultations and visits, with multiple key elements of service including history, physical examination, and medical decision making. Documentation of interventional procedures in general requires a history and physical, indication and medical necessity, intra-operative procedural description, post-operative monitoring and ambulation, discharge, and disposition. With minor variations, these requirements are similar for an in-office setting, hospital out patient department, and ambulatory surgery centers. Key words: Documentation, billing, coding, compliance, fraud and abuse, interventional techniques, evaluation and management services, office visit, consultation, new patient, established patient
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Maulina, Isra. "ANALISIS PERENCANAAN DAN PENGENDALIAN DALAM PENCAIRAN DANA PADA PENGADAAN ALAT-ALAT KEDOKTERAN PADA DINAS KESEHATAN KOTA LHOKSEUMAWE." J-ISCAN: Journal of Islamic Accounting Research 3, no. 1 (June 28, 2021): 44–58. http://dx.doi.org/10.52490/j-iscan.v3i1.1138.
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Good management will provide a reference or description of how the health office is managed in a transparent manner, there is independence, accountability, and there is responsibility and fairness so that financial performance at the lhokseumawe city health office can be achieved in accordance with the vision and mission of the health office. This study aims to determine how the process of implementing planning and control in the disbursement of funds for the procurement of medical equipment at the health office of lhokseumawe city. This research uses a qualitative approach with descriptive and analysis. Data collection in this study was carried out through interviews and documentation. Interviews were conducted with related parties and knew about the disbursement of funds for the procurement of goods / services at the lhokseumawe city health office in 2011. The results obtained indicate that the control planning process in disbursing funds for the procurement of medical devices in the lhokseumawe city health office in 2001 has not fully used the applicable rules so that the implementation of goods/ services is not in accordance with the reality and expectations of the community in general. This is evidenced by the delay in the distribution of medical devices at the puskesmas and the absence of an official report on the receipt of goods while the disbursement of funds was carried out 100%. This condition gave birth to a financial management system that was not transparent and accountable.
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Islas-Hernández, Iveth. "Quality of Care in Doctor's Office Adjacent to Pharmacies." Mexican Journal of Medical Research ICSA 9, no. 17 (January 5, 2021): 56–59. http://dx.doi.org/10.29057/mjmr.v9i17.5575.
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Introduction: In recent years, the use of private outpatient services, specifically Doctor’s Office Adjacent to Pharmacies (CAF) has had a remarkable growth, therefore, the objetive of the present study is to determine if they meet the requirements to provide quality service.
Methods: A systematic review was conducted on the Internet based on articles published in scientific journals. We included studies that provide information on the quality of care in CAF and comparing public and private services.
Results: Of the 15 articles selected, the 53.3% correspond to structure evaluation concluding that Medical personal of CAF faces a difficult employment situation, 60% of articles evaluate the process referring to the preference of usuarios is due to dissatisfactions produced in public services and 26.6% are evaluating the result mentioning that there is a conflict of interest that impact assessments.
Conclusion: The limit information on CAF highlights the need for more research to know the quality of care in its operation. It is therefore important to consider the CAF as part of the health system and create specific and standardized indicators that can measure
and evaluate objectively their care process.
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Pusateri, PhD, Anthony E., Mary J. Homer, PhD, Todd E. Rasmussen, MD, Kevin R. Kupferer, DHSc, and W. Keith Hoots, MD. "The interagency strategic plan for research and development of blood products and related technologies for trauma care and emergency preparedness 2015-2020." American Journal of Disaster Medicine 13, no. 3 (July 1, 2018): 181–94. http://dx.doi.org/10.5055/ajdm.2018.0299.
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Intensive blood use is expected to occur at levels, which will overwhelm blood supplies as they exist with current capabilities and technologies, both in civilian mass casualty events and military battlefield trauma. New technologies are needed for trauma care, and specifically to provide safer, more effective, and more logistically supportable blood products to treat patients with, or at risk of developing, acquired bleeding disorders resulting from trauma, acute radiation exposure, or other causes. Three of the primary agencies with major research and development programs related to blood products, the Biomedical Advanced Research and Development Authority (BARDA), the Department of Defense (DoD), and the National Heart, Lung, and Blood Institute are uniquely positioned to partner in addressing these issues, which have significant implications for each respective agency, as well as for the US population. Providing leadership, coordination, and oversight for the Food and Drug Administration’s national and global health security, counterterrorism, and emerging threats portfolios, the US Food and Drug Administration Office of Counterterrorism and Emerging Threats serves in a critical advisory and facilitative role regarding development and availability of blood products. This plan is informed by the 2012 PHEMCE Strategy (US Department of Health and Human Services, 2012), the 2007 “Shaping the Future of Research” Strategic Plan for the National Heart, Lung, and Blood Institute, the 2011 BARDA Strategic Plan, the DoD Combat Casualty Care Research Program: Policy Review, the 2015 DoD Hemorrhage and Resuscitation Research and Development Strategic Plan, and more than 30 participants from other agencies who participated in planning.
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Christensen, Bryan E., Mary Anne Duncan, Sallyann C. King, Candis Hunter, Perri Ruckart, and Maureen F. Orr. "Challenges During a Chlorine Gas Emergency Response." Disaster Medicine and Public Health Preparedness 10, no. 4 (March 29, 2016): 553–56. http://dx.doi.org/10.1017/dmp.2016.6.
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AbstractObjectiveA chlorine gas release occurred at a poultry processing plant as a result of an accidental mixing of sodium hypochlorite and an acidic antimicrobial treatment. We evaluated the public health and emergency medical services response and developed and disseminated public health recommendations to limit the impact of future incidents.MethodsWe conducted key informant interviews with the state health department; local fire, emergency medical services, and police departments; county emergency management; and representatives from area hospitals to understand the response mechanisms employed for this incident.ResultsAfter being exposed to an estimated 40-pound chlorine gas release, 170 workers were triaged on the scene and sent to 5 area hospitals. Each hospital redistributed staff or called in extra staff (eg, physicians, nurses, and respiratory therapists) in response to the event. Interviews with hospital staff emphasized the need for improved communication with responders at the scene of a chemical incident.ConclusionsWhile responding, hospitals handled the patient surge without outside assistance because of effective planning, training, and drilling. The investigation highlighted that greater interagency communication can play an important role in ensuring that chemical incident patients are managed and treated in a timely manner. (Disaster Med Public Health Preparedness. 2016;10:553–556)
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Teptin, S. E. "PECULIARITIES OF MEDICAL CARE FOR PATIENTS IN DEPARTMENT OF NURSING CARE." Medical Journal of the Russian Federation 25, no. 1 (February 15, 2019): 11–15. http://dx.doi.org/10.18821/0869-2106-2019-25-1-11-15.
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The purpose of the study is to study the peculiarities of organization of care for patients in the nursing Office. An analysis of case histories of 504 patients treated in the Nursing Department and 200 questionnaires of patients and their relatives about the quality of care and assistance. Considered the composition of the patients, the availability of diagnostic studies and consultation expertise, especially providing diagnostic assistance offices, nursing care, treatment outcomes, consumer opinion medical services.
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Schottinger, Joanne E., Kristen L. Andrews, Gail X. Lindsay, and Michael H. Kanter. "Use of electronic medical records on cancer screening rates: The proactive office encounter." Journal of Clinical Oncology 30, no. 34_suppl (December 1, 2012): 289. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.289.
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289 Background: The Southern California Permanente Medical Group cares for a diverse population of 3.5 million members. An electronic medical record supports the care of patients at each outpatient and inpatient encounter. In the US, only about 55% of Americans receive recommended preventive care services. Methods: The Proactive Office Encounter (POE) was developed to proactively address care gaps in preventive or chronic care needs at the point of service with every visit to either primary or specialty care. Prior to a visit, the staff identify missing labs or screening procedures and provides the patient with pre-visit instructions. With a standardized workflow and checklist used during any office visit, care gaps are identified from decision support tools in the electronic record and office staff pend necessary orders to the physician. The room is prepared for any procedures necessary (Pap), iFOBT kits are made ready for use if indicated, and on exiting, the patient receives an after visit summary that includes any necessary follow up instructions. Successful Completion Opportunity Reports are produced for every department to measure the improvement of closing care gaps. A small financial incentive is applied for specialists for these successful comp-letions (P4P). Back office work flow reports measure the elements of POE at the individual staff level. Performance on screening rates is reported bimonthly for feedback. Results: Within two years of implementation, pre and post POE cancer screening rates increased from 85.6 to 88.7 (3.1%) for breast cancer; 82.0 to 86.6 (4.6%) for cervical cancer; and 52.5 to 69.7 (17.4%) for colorectal cancer. Rates for advising smokers to quit smoking increased from 53 to 68 (15%). Conclusions: Use of evidence-based logic integrated in an electronic medical record combined with standard work flows deployed in primary and specialty care reliably ensures that patients receive needed services at every visit. This contributed to sharp rises in preventive care quality measures. Care shifts from being reactive to team-based and proactive and is no longer dependent on a physician remembering all the needed elements of care.
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LaBeau, Kathleen M., Marianne Simon, and Steven J. Steindel. "Clinical laboratory test menu changes in the Pacific Northwest: 1994 to 1996." Clinical Chemistry 44, no. 4 (April 1, 1998): 833–38. http://dx.doi.org/10.1093/clinchem/44.4.833.
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Abstract Laboratory testing services are presently undergoing dynamic changes in response to a wide range of external factors. Government regulations, reimbursement, and managed care are only a few of the influences affecting the availability of testing services and on-site testing capabilities in hospital, independent, and physician office laboratories. Medical practice changes, marketplace influences, test technologies, and costs also play a role in determining where testing is being performed. To better understand the factors influencing clinical laboratory test volumes and menus and to identify on-site testing deemed essential in physician office laboratories, we gathered information from a network of clinical laboratories in the Pacific Northwest. Questionnaires were sent to 257 Laboratory Medicine Sentinel Monitoring Network participants in March 1996. In the past 2 years, changes in on-site test volumes and test menus have been primarily due to medical practice changes and marketplace influences. When laboratories had a decrease in test volumes or test menu choices, the size of the patient workload and the volumes of test orders have had the greatest impact. Laboratory regulations and managed care contracts have played a role in shifting on-site testing to outside sources; however, these factors did not appear to be primary influences. Only 5% of physician office laboratories identified tests that they believed were essential for optimal patient care but did not perform on-site.
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Shah, Ram Kishor. "Historical aspects of cardiovascular services in Nepal." Nepalese Heart Journal 1 (December 31, 2000): 2–5. http://dx.doi.org/10.3126/njh.v1i0.26014.
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Himalayan Kingdom Nepal, birth place of Devi Sita, Lord Ram and Buddha is situated between two giant countries. The heart of Nepal is the beautiful flora and mighty Himalayas. Ayurveda was the main modality of therapy for most ancient Nepalese people. After the treaty of Sugauli in 1816 AD, a Residency office of British India was established in Kathmandu. Allopathic medical service was provided by the doctors posted in the residency. It was from that period the people in Kathmandu came to know about a system of medicine other than Ayurveda. After many years of this type of arrangement, Bir Hospital actually came into existence in 1889 AD, more than one hundred years ago.
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Fichtenbaum, Rudy, and Kwabena Gyimah-Brempong. "The Effects of Race on the Use of Physicians' Services." International Journal of Health Services 27, no. 1 (January 1997): 139–56. http://dx.doi.org/10.2190/gqhj-cuqt-n63h-cg0h.
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In recent years several studies have examined the role of race in determining both health care status and access to care. Most studies in this area have focused primarily on health care status, although the issue of access is often mentioned. While there are many reasons for differences in health status, access to resources may play an important role. Using a Poisson regression, a decomposition analysis, and data from the 1987 National Medical Expenditure Survey, the authors of this article show that significant differences remain in the number of physician office visits for whites and African-Americans. The proportion of the racial differences in the number of office visits not explained by differences in objective factors is relatively large. In fact, the results show that a considerable part of the racial differential can be explained by differential responses to these objective factors. This implies that, even if all the objective factors that affect the demand for visits are equalized across race, significant differences in the utilization of health care services will remain.
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Piórkowski, Adam. "Construction of a dynamic arrival time coverage map for emergency medical services." Open Geosciences 10, no. 1 (June 11, 2018): 167–73. http://dx.doi.org/10.1515/geo-2018-0013.
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Abstract This article presents a design of coverage maps for emergency journeys made by emergency medical services. The system was designed for the Malopolskie Voivodeship Office in Cracow, Poland. The proposed solution displays maps of the ambulance coverage of areas and ambulance’s potential journey times. There are two versions of the map: static and dynamic. The static version is used to appropriately allocate ambulances to cover an area with the ability to reach locations in less than 15 or 20 minutes; the dynamic version allows monitoring of ambulance fleets under normal conditions or in the event of a crisis. The article also presents the results of archival data related to the movement of ambulances on the roads of Malopolskie Voivodship. Particular attention was paid to the relation between the speed of vehicles and the traffic on the road, the day of the week or month, and long-term trends. The collected observations made it possible to assume a general model of ambulance movement in the voivodeship to calculate arrival time coverage maps.
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Smith, Jason W., and Sherry L. Weber. "Multi-Agency Permitting Teams." Transportation Research Record: Journal of the Transportation Research Board 1941, no. 1 (January 2005): 129–35. http://dx.doi.org/10.1177/0361198105194100116.
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Over the past several years, the State of Washington has invested substantial time and energy to streamline the environmental regulatory and permit process. The creation of the Multi-Agency Permitting Team (MAP team) pilot is one such strategic investment. The concept is based on the idea that an interagency team composed of diverse disciplines, located within one office, will experience enhanced communication, coordination, and higher-quality, more timely permit decisions. Currently, the MAP team consists of staff from five government agencies: the U.S. Army Corps of Engineers, Washington State Department of Ecology, Washington State Department of Fish and Wildlife, Washington State Department of Transportation, and King County Department of Development and Environmental Services. Fifty-two transportation projects are assigned to the team. After initially defining how to work together, the team began communications with their customer base in an attempt to make permitting processes more consistent and predictable. The team has been using this feedback to initiate streamlining opportunities to define complete applications, to create early project coordination and MAP team permit processes, to identify improvement opportunities within each agency, and to create model business practices that will use existing project experiences to deliver future projects. These investments in early project coordination are being tracked through eight performance measures. The MAP team pilot sunsets on June 30, 2005, and, if successful, Washington State may institute the MAP team concept as a permanent business practice with the potential for growth in other transportation, intergovernmental, and private venture applications.
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Roxana, Oancea, Sfeatcu Ruxandra, Gheorghiu Irina Maria, Mihai Mitran, Loredana Mitran, Iliescu Alexandru-Andrei, and Paula Perlea. "Healthcare Services Use Among Dental Patients." ARS Medica Tomitana 25, no. 2 (May 1, 2019): 49–52. http://dx.doi.org/10.2478/arsm-2019-0011.
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Abstract Regular medical attendance proved to have a positive impact on health, therefore the aim of the study is to detect the reasons and frequency for health care use among a group of 110 urban dental patients aged between 33 and 75 years, 50% males. The subjects completed an anonymous questionnaire with items related to their medical visits patterns: reason (treatment/control and emergency) and frequency of healthcare services use; self-assessed oral and general health and socio-demographic data. Most of the patients were adults (81.8%) and with more than 12 years of study (50%). In terms of reason for attending the dental office, 72% visited the dentist for emergency reasons, mainly men, elderly, patients with low level of education, and those who self-rated their oral health as satisfying or poor. Regarding medical visits, 54% from all patients attended healthcare for emergency reasons, regardless age, gender, education level and self-perceived general health. The results showed that worse healthcare services use is associated with low education level and gender, especially men visited the dentist when there is pain only. There is need to increase the number of individuals who use regular health care, for prevention and early detection of diseases.
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Halpern, Michael T., Brenda Vincent, and Dana Wollins. "Physician office visits for cancer survivors: Results from a national survey." Journal of Clinical Oncology 34, no. 3_suppl (January 20, 2016): 33. http://dx.doi.org/10.1200/jco.2016.34.3_suppl.33.
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33 Background: Cancer survivors may require specialized medical care to address their unique needs. However, there are few reports of nationally-representative outpatient-care patterns among survivors. Methods: We examined adult cancer survivors’ outpatient medical visits using data from the 2010 & 2012 National Ambulatory Medical Care Survey (NAMCS), a survey of U.S. physician office-based visits. Survivors were identified as individuals with medical visits related to cancer (based on physician diagnosis codes or patient-supplied reasons for visit) but who did not currently have cancer. Weights from the NAMCS were used to produce results corresponding to the overall U.S. population. Results: The NAMCS data included 477 survivor visits, corresponding to a two-year nationally-representative weighted total of 7,435,753 visits. Most survivors were White (75%); 13% were Black and 8% Hispanic. Most survivors had private insurance (49%) or Medicare (40%); 4% had Medicaid. Almost all (99%) saw a physician during the recorded visit. Only 20% of survivor’s outpatient visits were with oncologists; 20% were with primary care physicians, 12% with OB/GYN physicians, 5% with general surgeons, and more than one-third (35%) with other physician specialties. The most common services received during survivors' visits include general physical exams (57%) and imaging studies (20%). Visits with oncologists were less likely to include depression screening or counseling regarding nutrition, exercise, stress management, tobacco use, or weight reduction than were visits with other types of physicians. Conclusions: Cancer survivors experience diverse outpatient medical care interactions; only a minority of these are with oncologists. Oncologist visits are less likely to involve important counseling services. The NAMCS represents an important data source for examining outpatient care patterns among survivors.
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Gerzon, M.D., Rowel A., and John Clifford P. Salugsugan. "Patient Satisfaction and Challenges of the Health Care Services of Negros Occidental Provincial Medical Clinic." Philippine Social Science Journal 3, no. 1 (June 22, 2020): 70–81. http://dx.doi.org/10.52006/main.v3i1.122.
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The Medical Clinic provides outpatient health services to the employees of the Provincial Government of Negros Occidental. Patient satisfaction gauges the quality of health care services. This study assessed the level of patient satisfaction on the health services and identified the challenges encountered by patients. Also, it compared the level of patient satisfaction in terms of their demographic profile. This descriptive-comparative design used a researcher-made survey questionnaire which was administered to 307 employees. The study revealed that the overall level of satisfaction was very high. A significant difference was found in the level of patient satisfaction when respondents were categorized according to sex and age. The most significant challenge encountered by patients was insufficient medicines and medical supplies. The findings were used as baseline data in designing a Clinic Manual of Procedures and Holistic Health Program for the Provincial Health Office.
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Alhazmi, Riyadh A., R. David Parker, and Sijin Wen. "Standard Precautions Among Emergency Medical Services in Urban and Rural Areas." Workplace Health & Safety 68, no. 2 (October 25, 2019): 73–80. http://dx.doi.org/10.1177/2165079919864118.
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Backround: Emergency medical services (EMS) workers are at risk of exposure to bloodborne pathogens and frequently exposed to blood and bodily fluids through percutaneous injuries. This study aimed to assess the consistency with which standard precautions (SPs) among rural and urban EMS providers were used. Methods: This study consisted of a cross-sectional survey conducted with a sample of certified EMS providers in West Virginia in which we ascertained details about sociodemographic characteristics, and the frequency of consistent SP. An email invitation was sent to a comprehensive list of agencies obtained from the Office of West Virginia EMS. Findings: A total of 248 out of 522 (47%) EMS providers completed the survey. The majority of the EMS providers (76%) consistently complied with SPs; however, more than one third (38%) of urban EMS providers indicated inconsistent use compared with 19% of rural EMS providers ( p = .002). Most EMS providers reported low prevention practices to exposure of blood and body fluids in both areas. Conclusion/Application to Practice: The results emphasize the need to enhanced safe work practices among EMS providers in both rural and urban areas through education and increasing self-awareness. Occupational health professional in municipalities that serve these workers are instrumental in ensuring these workers are trained and evaluated for their compliance with SPs while in the field.
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Alekhina, S. V., and L. P. Falkovskaya. "Interdepartmental Interaction as a Mechanism for the Development of Psychological Service in Education." Psychological-Educational Studies 9, no. 3 (2017): 116–28. http://dx.doi.org/10.17759/psyedu.2017090312.
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The article considers the interdepartmental approach as an important methodological principle of ensuring the quality and effectiveness of social and educational services. The authors study the problems of organization of interdepartmental interaction within the framework of the development of regulatory legal regulation; on the basis of legislative acts, the most important structural elements of the psychological service of education have been determined. Various institutional forms of the development of the psychological service in the context of interdepartmental interaction are presented. As a result of the Institute's problems of inclusive education, monitoring revealed indicators of the formation of interagency cooperation in the work of the central psychological-medical and pedagogical commissions, models of early care for children with developmental difficulties. The authors emphasize the need for psychological work in educational organizations, the resolution of questions about the organization of the psychological service of education, the destination of the teacher-psychologist.
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Klein, Roger D., and Sheldon Campbell. "Health Care Fraud and Abuse Laws." Archives of Pathology & Laboratory Medicine 130, no. 8 (August 1, 2006): 1169–77. http://dx.doi.org/10.5858/2006-130-1169-hcfaal.
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Abstract Context.—Health care fraud and abuse enforcement actions have significantly expanded in number and scope during the past several years. The Department of Health and Human Services Office of Inspector General named review of in-office pathology services a critical priority in its 2005 Work Plan. As providers of pathology and laboratory medicine services, pathologists need to be aware of the potential impact of these laws on their practices. Objectives.—To review the major statutes and regulations underlying most federal investigations and prosecutions of health care fraud, with a special emphasis on their relationships to pathology practice. Design.—The authors reviewed pertinent federal statutes, regulations, and other documents, along with relevant legal literature. Results.—The health care fraud and abuse laws are complicated and potentially impact pathology practice in unforeseen ways. Conclusions.—The health care fraud and abuse laws are complex and often counterintuitive. The penalties for violation of these laws are severe. Because they may impact many areas of pathology and laboratory medicine practice, pathologists are advised to consult experienced legal counsel prior to embarking on potentially suspect health care arrangements.
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Inozemtseva, Svetlana, and Larisa Karaseva. "Recommendations for nursing staff on the organization activity of the methodical office." Medsestra (Nurse), no. 5 (May 1, 2020): 72–76. http://dx.doi.org/10.33920/med-05-2005-12.
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In modern conditions, nursing is seen as an essential part of the health care system. The range of functions of nursing personnel is now significantly expanded, the degree of responsibility of nurses for the patient and the quality of services provided has increased. In this situation, the need for the creation of teaching rooms for nursing staff of medical organizations is growing.
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Stašys, Rimantas. "E-HEALTH SERVICES AND THEIR REQUIREMENTS EVALUATION." Business, Management and Education 8, no. 1 (December 20, 2010): 246–60. http://dx.doi.org/10.3846/bme.2010.17.
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E-health could be defined as the use of modern information technologies within the health care facilities in order to better satisfy expectations and needs of the patients, medical staff and administration. As the research shows economic profits exceed investments in the e-health three times. Studies in Lithuania in December of 2008 show that only 38 % of the country hospitals have online WebPages. Only large hospitals located in the major Lithuanian cities have internet sites. Situation within the outpatient facilities is even worse. Only 12 % of these health care facilities had online services offered to the public according to the survey completed at the end of 2008. There is insufficient focus for doctors’ advices and not enough links to other websites. Additionally, many sites do not contain information about career opportunities within a facility. Finally, online sites lack such information as the institution’s service charges or their implementation for various projects. Only a few hospitals have an online registra-tion feature and very few provide work hours. Outpatient service facilities do not reflect the institution’s activities adequately. None of the outpatient service facilities provide business reports; there is no information about their participation in the international projects. Only four WebPages contain sections providing the career opportunities for the office and a list of new doctor positions available. By the comparison of the Webpages of polyclinics and health care facilities one can indicate that polyclinic facilities have better online pages. Most of the health care consumers would use the Internet to find out such information as the doctor’s qualifications and work experience, information about main diseases and their symptoms, the medications and their side effects, tips on healthy lifestyle, as well as utilize registration to a specialist feature. Most of the respondents surveyed also indicated that there should be more information about health care services and their prices, institution’s medical equipment and devices as well as their methods of treatment. The best practice for the e-Health website is classifying it into four groups: information on the health care institution, information relating to the services provided, information on the medical staff working in the office, other information. 48 % of the respondents were not familiar with the online registration possibility, and 74 % of survey participants would like to use the feature. Only 13 % of the respondents knew that they could fill prescription online and only 10 % were aware of the electronic medical record. All of this leads to the conclusion that Lithuanian consumers lack information about the e-health.
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Deppe, Janet, and Marie Ireland. "Medicaid 101: A Primer for Speech-Language Pathologists in Education Settings." Perspectives on School-Based Issues 12, no. 1 (March 2011): 3–11. http://dx.doi.org/10.1044/sbi12.1.3.
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This paper will provide the school-based speech-language pathologist (SLP) with an overview of the federal requirements for Medicaid, including provider qualifications, “under the direction of” rule, medical necessity, and covered services. Billing, documentation, and reimbursement issues at the state level will be examined. A summary of the findings of the Office of Inspector General audits of state Medicaid plans is included as well as what SLPs need to do in order to ensure that services are delivered appropriately. Emerging trends and advocacy tools will complete the primer on Medicaid services in school settings.
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Shrestha, Anjupa, and S. Sharma. "Status of Abortion Services in Jumla." Journal of Karnali Academy of Health Sciences 1, no. 2 (October 6, 2018): 47–49. http://dx.doi.org/10.3126/jkahs.v1i2.24138.
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Introduction: Abortion was legalized in Nepal in September 2002. Only a trained and listed provider can provide abortion services at a health. For many women, especially in developing countries like Nepal, safe abortion may not be available, affordable or accessible despite the liberalization of abortion law. The aim of this study was to determine the status of abortion in Jumla.
Methods: This retrospective study was conducted from the record of District Health Office; Jumla from the month of Ashad 2074 to Jestha 2075. Total Enumerative sampling technique was used. Data of public health sector and Marie Stopes Center, Jumla were retrieved and analyzed in terms of frequency, rate, and percentage.
Results: Total 1196 women have received abortion services and abortion rate was 36.077 per 1000 (15-49 Years women). Most of the women(90%) were more than 20 years of age and majority of women (82%) chose medical method for abortion service. Majority (88.62%) have used Post abortion family Planning services.
Conclusions: The abortion rate of Jumla was still high. Nine out of ten women who received abortion services were more than 20 years of age. Women preferred medical method rather than surgical method for abortion service. Nearly one tenth women had not used any post abortion family planning method.
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Federiuk, Carol S., and Kerth O'Brien. "Sources of Disagreement Among Public and Private Agency Paramedics." Prehospital and Disaster Medicine 10, no. 2 (June 1995): 92–95. http://dx.doi.org/10.1017/s1049023x00041789.
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AbstractIntroduction:The purpose of the study was to document the occurrence and causes of disagreements between paramedics in a tiered-response emergency medical services (EMS) system.Methods:This cohort analysis of disagreements between paramedics sampled 63 male public agency, 90 male private agency, and 41 female private agency paramedics. Paramedics responded to Likert-type items and one open-ended item concerning the occurrence of conflict between paramedics.Results:On-scene conflict between EMS personnel from public and private agencies was reported by 70% of the respondents. Conflicts that interfered with patient care were reported to occur more frequently between paramedics from different types of agencies. The most commonly mentioned subject of disagreement was patient treatment, followed by patient transport, interpersonal and interagency conflicts, and patient assessment.Conclusion:A majority of paramedics have experienced on-scene disagreements with other paramedics. Disagreements occur more frequently between paramedics from different agencies and encompass a wide range of issues concerning patient care and interpersonal relationships.
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Phelps, Scot. "Mission Failure: Emergency Medical Services Response to Chemical, Biological, Radiological, Nuclear, and Explosive Events." Prehospital and Disaster Medicine 22, no. 4 (August 2007): 293–96. http://dx.doi.org/10.1017/s1049023x00004891.
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AbstractIntroduction:Only 4% of the United States Homeland Security funding for public safety terrorism preparedness is allotted to emergency medical services (EMS), despite the primary threat from a mass-terrorism chemical weapons attack (MTCWA) being personal injury. This study examines the preparedness of the EMS torespond to, treat, and transport victims of such attacks.Hypothesis:It was hypothesized that US EMS agencies lack the necessary equipment to mitigate large-scalemorbidity and mortality from a MTCWA.Methods:Seventy after-action reports from full-scale, chemical weapons exercises conducted in large cities across the US were examined by the Office of Domestic Preparedness, Chemical Weapons Improved Response Program to ascertain if EMS responders had personal protective equipment sufficient to operate at the scene of aMTCWA.Results:Of the 50 after action reports that mentioned EMS personal protective equipment, only six (12%) EMS agencies equipped their staff with personal protective equipment.Conclusions:Results indicate that EMS responders are not prepared to safely respond to MTCWAs, which mayresult in a significant loss of life of victims and responders.
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Chrischilles, Elizabeth A., Dennis K. Helling, and Carl R. Aschoff. "Effect of Clinical Pharmacy Services on the Quality of Family Practice Physician Prescribing and Medication Costs." DICP 23, no. 5 (May 1989): 417–21. http://dx.doi.org/10.1177/106002808902300511.
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This study assessed the impact of physician exposure to clinical pharmacy services on the appropriateness of physician prescribing and on medication costs. Two study sites were used: FPC (primary resident training office without clinical pharmacist) and PMC (satellite office with clinical pharmacist). The same physicians provided care at both study sites. Exposed patient encounters were selected from encounters during each resident's rotation at the PMC satellite. Unexposed patient encounters were selected from encounters at the FPC immediately prior to each resident's exposure to clinical pharmacy services. A blind review panel evaluated case abstracts of the patient encounters for appropriateness of drug choice, daily dosage, dosing interval, duration of treatment, clarity of instructions, and monitoring data; potential severity of the patient problem; and difficulty of the clinical decision. After adjusting for covariables (potential severity, difficulty, patient age, sex, Medicaid status, therapeutic category, and type of medical problem), physician-patient encounters in which family practice residents were exposed to clinical pharmacy services were rated significantly more appropriate for choice of drug prescribed, daily dosage chosen, dosing interval selected, clarity of prescription instructions, and monitoring data. Costs of acute medications, as measured by average wholesale price per day, per dose, and per treatment course, were also significantly lower for clinical pharmacy-exposed physician-patient encounters.
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Ross, Elisabeth J. "Pharmacy College Application Service." Journal of Pharmacy Practice 13, no. 5 (October 2000): 331–37. http://dx.doi.org/10.1106/eyu2-ynht-cx4f-c6dm.
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The American Association of Colleges of Pharmacy (AACP) is developing a centralized application service for U.S. colleges and schools of pharmacy. The Pharmacy College Application Service, known as PharmCAS, will allow applicants to use a single application and one set of materials to apply to multiple Pharm.D. programs. The purpose of PharmCAS is to benefit AACP member institutions, applicants, and the AACP office in terms of facilitation of the admissions process, student recruitment, and data collection. Other health professions’ education associations have established centralized application services with proven success.
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Sheinberg, Dallas, Neil Mohile, Jeremy Ramdial, Farooq Faheem, Jorge Antunez de Mayolo, Eugene Ahn, Rakesh Singal, and Damien Mikael Hansra. "Evaluation of hematology/oncology patient and physician opinions on medical office outpatient services in an ethnically diverse population." Journal of Clinical Oncology 34, no. 15_suppl (May 20, 2016): e18182-e18182. http://dx.doi.org/10.1200/jco.2016.34.15_suppl.e18182.
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Schoenhoff, Deborah D., Timothy W. Lane, and Charles J. Hansen. "Primary Prevention and Rubella Immunity: Overlooked Issues in the Outpatient Obstetric Setting." Infection Control & Hospital Epidemiology 18, no. 09 (September 1997): 633–36. http://dx.doi.org/10.1086/647688.
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AbstractObjective:To determine the knowledge of rubella immune status among practicing obstetrician-gynecologists in the United States and of rubella immunity policies covering healthcare workers in the obstetric-care office setting.Design:Mailed survey questionnaire, August through December 1994.Setting:Physicians from multiple-practice sites including private office, public institution, university or teaching hospital, and closed panel health maintenance organization settings.Participants:3,302 practicing obstetrician-gynecologists, chosen by a systematic random sample from the AMA national physician database.Main Outcome Measures:Participants were defined as rubella immune if they reported knowledge of prior rubella vaccination or positive antibody titer. Knowledge of a policy for documenting rubella immunity among employees in the office-based practice setting also was assessed.Results:Questionnaires were returned from 50% (1,666) of the 3,302 surveyed, and 96% (1,599) were evaluable. Approximately 20% (304/1,599) of the responding obstetrician-gynecologists did not have knowledge of documented rubella immunity, and the majority of office-based practices did not require documentation of rubella immunity in the following groups: physicians, 66% (723/1,094); office nurses, 62% (666/1,070); and other office staff, 69% (728/1,063). Sixty-two percent (993/1,599) of responding physicians had individual rubella serologies performed, with 916 known to be positive, 53 reported negative, and 24 reported unknown. Fifty-seven percent (918/1,599) reported receiving monovalent rubella vaccine or trivalent measles-mumps-rubella vaccine. Multiple logistic regression analysis revealed the following to be independent predictors of positive immune status among respondents: female gender (odds ratio [OR], 2.4; 95% confidence interval [CI95], 1.8-3.1), medical school graduation since 1980 (OR, 2.6; CI95, 2.0-3.3), providing obstetric or fertility services (OR, 1.5; CI95, 1.2-1.9), and group practice setting ≥5 physicians; OR, 1.2; CI95, 1.1-14).Conclusions:Nationally, nearly one of every five practicing obstetricians may not have documented rubella immunity, and the majority of office-based practices have no system for assuring such immunity. Rubella immunity should extend beyond the hospital setting, with consideration for requiring rubella immunity as a condition for employment. Methods for effective implementation and documentation of current guidelines need to be addressed, particularly in the office setting.
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Soloway, H. B. "Establishing a direct laboratory access program." Clinical Chemistry 41, no. 5 (May 1, 1995): 809–12. http://dx.doi.org/10.1093/clinchem/41.5.809.
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Abstract Direct Laboratory Access (DLA) refers to a program whereby individuals who wish to have laboratory testing performed can avail themselves of such testing independently of a physician referral. DLA benefits both physicians and consumers. Physicians benefit by not having to invest time and office resources for consumers who do not seek medical intervention but rather who visit physicians for the sole purpose of obtaining permission to have laboratory tests performed. Consumers benefit by avoiding physician encounters they do not want, by receiving state-of-the-art laboratory testing they do want, and by avoiding the added expense and inconvenience of a physician office visit. DLA appeals to an anxious, educated, and somewhat affluent niche market. The program fills a void in the provision of health services while providing a small stream of revenue for laboratories.
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Tyszko, Piotr, Waldemar Wierzba, Krzysztof Kanecki, and Anna Ziółkowska. "Transformation of the ownership structure in Polish healthcare and its effects." Open Medicine 2, no. 4 (December 1, 2007): 528–38. http://dx.doi.org/10.2478/s11536-007-0045-z.
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AbstractPoland, like other countries with previously dominant state healthcare systems, has introduced ownership transformation in the healthcare structure. These changes, however, are being accomplished without a clearly defined state policy in this area. The aim of the present study was to assess the course and effects of ownership transformation in outpatient healthcare and hospitals. Data were collected from publications of the Central Statistical Office, which provided information on the numbers of outpatient healthcare institutions, medical practices, general hospitals, and services they provided. The healthcare ownership transformation has divided the medical services market into public and nonpublic providers. In addition, privatization of outpatient healthcare facilities precedes privatization of hospitals, outpatient institutions providing primary healthcare were privatized first; the subsequent stage included those providing specialized services, at first privatization of ambulatory medical infrastructure preceded privatization of services in urban areas, whereas in rural areas, privatization of services preceded structural privatization, privatization provides favorable conditions to improve territorial availability of outpatient healthcare in urban areas, medical practices, although numerous, are of little importance in providing services, the hospital ownership transformation is at its initial stage, and structural ownership transformation in the Polish healthcare system is subject to market rules.
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Schuh, Michael J., and Sheena Crosby. "Description of an Established, Fee-for-Service, Office-Based, Pharmacist-Managed Pharmacogenomics Practice." Senior Care Pharmacist 34, no. 10 (December 1, 2019): 660–68. http://dx.doi.org/10.4140/tcp.n.2019.660.
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OBJECTIVE: To describe an established, pharmacist-managed, fee-for-service, office-based pharmacogenomics (PGx) practice.<br/> SETTING: Multi-specialty, academic, tertiary care medical clinic and hospital.<br/> PRACTICE DESCRIPTION: Physician office-based PGx fee-for-service (FFS) pharmacist practice. Patients seen are complex and most are older adults.<br/> INNOVATION: Established service in a new area of ambulatory practice that is financially self-sustaining. Patients who received PGx testing were seen within the medication therapy management polypharmacy practice since 2015, with the PGx practice becoming official in 2018.<br/> MAIN OUTCOME MEASUREMENTS: Growth of practice, evaluated by referred patient consults ordered per month by providers.<br/> RESULTS: Because of insufficient third-party payment for PGx services, the practice was developed as a selfpay, FFS practice and growing because of patient and provider demand.<br/> CONCLUSION: It is quite possible pharmacists in greater numbers can expand PGx services into ambulatory and inpatient areas they may have never otherwise entered now that PGx has grown in use and relevance. PGx presents additional opportunities and service lines for pharmacists to practice how they were trained and assist them in collaborative integration onto the medical team.
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Condos, S. G., J. M. Selles, R. C. Merrell, and T. Stamkopoulos. "Tele-Affiliation in Medical Education: Experience from the International Program at Yale Office of Telemedicine." Methods of Information in Medicine 41, no. 05 (2002): 382–86. http://dx.doi.org/10.1055/s-0038-1634366.
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Summary Objectives: Telemedicine is developed in response to the needs of users that results in a more viable model. Yale has developed a process called tele-affiliation to combine services that are customized to the international client’s needs. Methods: Several defined steps compose the tele-affiliation process. The Yale-Greece telemedicine program is used as an illustration of this process. Some of the programs developed in response to Greek needs include breast cancer clinics, women’s health clinics and tele-homecare monitoring for post-operative and chronically ill patients. Results: Tele-affiliation creates an infrastructure that has the potential to change the method of health care delivery. By using the infrastructure created by the tele-affiliation process, templates for disease management, as well as health promotion and education can be delivered to a global audience. Conclusions: A tele-affiliation education environment has been developed and tested between Yale University School of Medicine and Greece resulting in an improved infrastructure for health education and management.