scholarly journals 544 Allocation of Training Opportunities: Evaluation of a Rota Improvement Project

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Orchard ◽  
R Griggs
Keyword(s):  
Service Provision ◽  
Clinical Training ◽  
Working Relationships ◽  
Full Time ◽  
Improvement Project ◽  
Endoscopy Training ◽  
Innovative Method ◽  
Feedback Questionnaire ◽  
Training Opportunities ◽  
Fair Access

Abstract Aim Surgical registrars are under increasing pressure to achieve their competencies for ARCP under the constraints of EWTD, service provision and on call requirements. Less than full time (LTFT) and academic trainees can struggle to get fair allocation of training opportunities. These pressures can lead to competition between registrars for training opportunities and resentment can develop. We created a novel rota allocation method by which theatre, clinic and endoscopy training sessions were allocated based on percentage of elective days worked across the month, ensuring all trainees had the same opportunities. Method The system was implemented for 3 months in the colorectal departments at 2 hospitals. Full time, LTFT and academic trainees were treated equally with theatre, endoscopy and clinics allocated by percentage of elective days per month. The spreadsheet of allocations was viewable by all trainees to ensure transparency. All surgical registrars involved were invited to complete a feedback questionnaire on the new system. Results The rota was implemented for 3 months with full allocation of shifts during the study period. Trainees were successfully allocated training sessions proportionally to elective days. 7/ 10 registrars gave feedback, 85% of whom felt the system was fair and 71% thought it improved working relationships between trainees. Comments included “scrupulously fair”, “highly efficient” and gives “more transparency”. Conclusions Allocation of trainees to clinical training opportunities can be difficult. We present an innovative method by which trainees get equal and fair access to the training opportunities available and has consequently helped to improve working relationships between peers.

scholarly journals Challenges and solutions to returning to clinical training after research: a multidisciplinary survey of integrated academic trainees in West Yorkshire, United Kingdom

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
C. L. Downey ◽  
J. Bentley ◽  
H. Pandit
Keyword(s):  
United Kingdom ◽  
Clinical Training ◽  
Clinical Work ◽  
Survey Study ◽  
Full Time ◽  
Clinical Supervisors ◽  
Research Activities ◽  
Time Out ◽  
Rapid Transition ◽  
The University

Abstract Background Time out of clinical training can impact medical trainees’ skills, competence and confidence. Periods of Out of Programme for Research (OOPR) are often much longer than other approved mechanisms for time of out training. The aim of this survey study was to explore the challenges of returning to clinical training following OOPR, and determine potential solutions. Methods All current integrated academic training (IAT) doctors at the University of Leeds (United Kingdom) and previous IAT trainees undertaking OOPR in the local region (West Yorkshire, United Kingdom)(n = 53) were invited to complete a multidisciplinary survey. Results The survey was completed by 33 participants (62% response rate). The most relevant challenges identified were completing the thesis whilst transitioning back to clinical work, the rapid transition between full-time research and clinical practice, a diminished confidence in clinical abilities and isolation from colleagues. Potential solutions included dedicated funds allocated for the renewal of lapsed skills, adequate notice of the clinical rotation to which trainees return, informing clinical supervisors about the OOPR trainee returning to practice and a mandatory return to standard clinical days. Conclusions Addressing these issues has the potential to improve the trainee experience and encourage future trainees to take time out of training for research activities.

scholarly journals Creating a culture of quality: our experience with providing feedback to frontline hospitalists

2021 ◽  
Vol 10 (1) ◽  
pp. e001141
Author(s):  
Brittany Becker ◽  
Sneha Nagavally ◽  
Nicholas Wagner ◽  
Rebekah Walker ◽  
Yogita Segon ◽  
...  
Keyword(s):  
Performance Feedback ◽  
Rank Order ◽  
Quality Metrics ◽  
Faculty Members ◽  
Feedback Report ◽  
Full Time ◽  
Academic Medical Centre ◽  
Improvement Project ◽  
Tract Infections ◽  
Culture Of Quality

BackgroundOne way to provide performance feedback to hospitalists is through the use of dashboards, which deliver data based on agreed-upon standards. Despite the growing trend on feedback performance on quality metrics, there remain limited data on the means, frequency and content of feedback that should be provided to frontline hospitalists.ObjectiveThe objective of our research is to report our experience with a comprehensive feedback system for frontline hospitalists, as well as report the change in our quality metrics after implementation.Design, setting and participantsThis quality improvement project was conducted at a tertiary academic medical centre among our hospitalist group consisting of 46 full-time faculty members.Intervention or exposureA monthly performance feedback report was distributed to provide ongoing feedback to our hospitalist faculty, including an individual dashboard and a peer comparison report, complemented by coaching to incorporate process improvement tactics into providers’ daily workflow.Main outcomes and measuresThe main outcome of our study is the change in quality metrics after implementation of the monthly performance feedback reportResultsThe dashboard and rank order list were sent to all faculty members every month. An improvement was seen in the following quality metrics: length of stay index, 30-day readmission rate, catheter-associated urinary tract infections, central line-associated bloodstream infections, provider component of Healthcare Consumer Assessment of Healthcare Providers and Systems scores, attendance at care coordination rounds and percentage of discharge orders placed by 10:00.ConclusionsImplementation of a monthly performance feedback report for hospitalists, complemented by peer comparison and guidance on tactics to achieve these metrics, created a culture of quality and improvement in the quality of care delivered.

scholarly journals Reasonable adjustments for people with intellectual disability in acute care: a scoping review of the evidence

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e039647
Author(s):  
Mairead Moloney ◽  
Therese Hennessy ◽  
Owen Doody
Keyword(s):  
Intellectual Disability ◽  
Acute Care ◽  
Scoping Review ◽  
Service Provision ◽  
Care Setting ◽  
Acute Care Setting ◽  
Inclusion Criteria ◽  
Health Service Provision ◽  
Acute Care Settings ◽  
Fair Access

ObjectivesPeople with intellectual disability are vulnerable in terms of health service provision due to increased comorbidity, higher dependency and cognitive impairment. This review explored the literature to ascertain what reasonable adjustments are evident in acute care to support people with intellectual disability, ensuring they have fair access and utilisation of health services.DesignScoping review.SettingAcute care settings.MethodsFive databases were systematically searched to identify studies that reported on the implementation of reasonable adjustments. Authors worked in pairs to screen studies for inclusion, data were extracted and charted and findings were synthesised according to content and themes.ResultsOf the 7770 records identified, six studies were included in the review. The volume of evidence was influenced by specific inclusion criteria, and only papers that reported on the actual implementation of a reasonable adjustment within an acute care setting were included. Many papers reported on the concept of reasonable adjustment; however, few identified its applications in practice.ConclusionsThe scoping review highlights a lack of research on the practice and implementation of reasonable adjustments within acute care settings. There is a need for increased support, education and the provision of intellectual disability specialists across acute care settings.

Improving Psychosocial Risk Assessment and Service Provision for Craniofacial Team Patients: A Quality Improvement Project

2021 ◽  
pp. 105566562110430
Author(s):  
Canice E. Crerand ◽  
Meghan O’Brien ◽  
Hillary M. Kapa ◽  
Ari N. Rabkin ◽  
Amanda Smith ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Quality Improvement ◽  
Service Provision ◽  
Academic Medical Center ◽  
Psychosocial Risk ◽  
Secondary Outcome ◽  
Risk Screening ◽  
Improvement Project ◽  
Psychosocial Services ◽  
Psychosocial Risk Assessment

To improve psychosocial risk assessment and service provision for children with craniofacial conditions presenting for annual interdisciplinary team visits. Institute for Healthcare quality improvement model. U.S. pediatric academic medical center. Caregivers of children ages 0-17 years with craniofacial conditions presenting for 1692 team visits between August 2017 and July 2019. Key drivers included: (1) standardizing pre-visit triage processes; (2) administering the Psychosocial Assessment Tool-Craniofacial Version (PAT-CV); (3) utilizing PAT-CV scores in real time to add patients to psychosocial provider schedules; and (4) family education. Interventions included improving patient screening, increasing PAT-CV completion rate, altering clinic flow, providing patient and parent education about psychosocial services, and altering team member roles to fully integrate PAT-CV administration and scoring in the clinic. The primary outcome was the percentage of patients identified for psychosocial consultations via nurse triage, PAT-CV score, family or provider request who completed consultations. The secondary outcome was the percentage of patients completing needed psychosocial consultations based on elevated PAT-CV scores. Use of the PAT-CV resulted in an increase in the percentage of patients with elevated psychosocial risk who received a psychosocial consultation from 86.7% to 93.4%. The percentage of children receiving psychosocial consultation at their annual team visit due to elevated PAT-CV scores increased from 72% to 90%. Integrating a validated psychosocial risk screening instrument can improve risk identification and psychosocial consultation completion. A combination of risk screening approaches may be indicated to identify patients in need of psychosocial services.

scholarly journals A Clinical Training Program for Hybrid Closed Loop Therapy in a Pediatric Diabetes Clinic

2019 ◽  
Vol 14 (2) ◽  
pp. 290-296 ◽  
Author(s):  
Cari Berget ◽  
Sarah E. Thomas ◽  
Laurel H. Messer ◽  
Katelin Thivener ◽  
Robert H. Slover ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Training Program ◽  
Clinical Training ◽  
Insulin Pump ◽  
Improvement Project ◽  
Quality Improvement Process ◽  
Pediatric Diabetes ◽  
Clinical Training Program

Background: Hybrid closed loop (HCL) therapy is now available in clinical practice for treatment of type 1 diabetes; however, there is limited research on how to educate patients on this new therapy. The purpose of this quality improvement project was to optimize a HCL education program for pediatric patients with type 1 diabetes (T1D). Methods: Our multidisciplinary team developed a novel HCL clinical training program for current insulin pump users, using a quality improvement process called the Plan-Do-Study-Act model. Seventy-two patients participated in the HCL training program, which included (1) an in-person group class to reinforce conventional insulin pump and CGM use on the new system, (2) a live video conference class to teach HCL use, and (3) three follow-up phone calls in the first 4 weeks after HCL training to assess system use, make insulin adjustments, and provide targeted reeducation. Diabetes educators collected data during follow-up calls, and patients completed a training satisfaction survey. Results: The quality improvement process resulted in a training program that emphasized education on HCL exits, CGM use, and optimizing insulin to carbohydrate ratio settings. Patients successfully sustained time in HCL in the initial weeks of use and rated the trainings and follow-up calls highly. Conclusions: Ongoing educational support is vital in the early weeks of HCL use. This quality improvement project is the first to examine strategies for implementation of HCL therapy into a large pediatric diabetes center, and may inform best practices for implementation of new diabetes technologies into other diabetes clinics.

scholarly journals New Innovative Peripheral Insertion Method of I.V. Cannula

2020 ◽  
Vol 8 (2) ◽  
pp. 32
Author(s):  
Gabriela Stefkova ◽  
Maria Zamboriva
Keyword(s):  
Critical Thinking ◽  
Student Performance ◽  
Clinical Training ◽  
Healthcare Professionals ◽  
Healthcare Providers ◽  
General Medicine ◽  
Critical Dimension ◽  
Venous Access ◽  
University Education ◽  
Innovative Method

AbstractObjective: Effective practice is increasingly seen as a critical dimension of the professional development of healthcare professionals. Reducing the number of punctures when placing an intravenous (I.V.) cannula reduces pain and further suffering for the patient. At the same time, the proper technique of I.V. cannulas save time for healthcare providers. Background: The method of securing venous access by intravenous cannula is part of the teaching of medical and nursing study programs. Critical thinking is the basic skill necessary to assess any information, explain the causes and the ability to solve problems. University education develops this skill through strategic teaching of simulation methods. Methods: In connection with new information of the method of I.V. cannulas by “magic movement”, we decided to use the Core model for critical reflection designed by Cottrell (2010), to evaluate new techniques in preclinical education of students from general medicine and nursing on I.V. cannulation in simulation laboratories. Results: The results have shown that student performance levels will be increased by applying critical thinking and simulation as an option for integrated pre-clinical training for future healthcare professionals. Conclusion: Innovative method of introducing peripheral I.V. cannula provides a framework to guide curriculum development and teaching strategies as well as to support the advance of cognitive and empirical skills of healthcare professionals. A new technique for applying “magic movement” of I.V. cannula we innovate the curriculum of basic nursing practices while contributing to the development of evidence-based practice.Key words: Intravenous catheter, Innovative method “magic movement”, Critical thinking, Simulation laboratories.

scholarly journals Situational antecedents to organizational identification and the role of supervisor support

2020 ◽  
Vol 17 (3) ◽  
pp. 153-166 ◽  
Author(s):  
Matthew Valle ◽  
Martha C. Andrews ◽  
K. Michele Kacmar
Keyword(s):  
Procedural Justice ◽  
Undergraduate Students ◽  
Organizational Identification ◽  
Structural Equation ◽  
Mediating Effect ◽  
Equation Modeling ◽  
Full Time ◽  
Content Type ◽  
Training Opportunities

Purpose The purpose of this paper is to examine the effects of procedural justice, training opportunities and innovation on job satisfaction and affiliation commitment via the mediating effect of organizational identification. The authors also explored the moderating role of satisfaction with supervisor on the relationship between the antecedents and organizational identification as well as its moderating effect on the mediational chain. Design/methodology/approach The authors used structural equation modeling techniques, using MPLUS 7.4, to analyze data collected from 247 full-time employees who were recruited by undergraduate students attending a private university in the Southeast region of the USA. Findings Results demonstrated that the indirect effects for procedural justice and training opportunities as predictors were significant, while none of the paths for innovation as a predictor were significant. Satisfaction with supervisor moderated the relationships between procedural justice and organizational identification and innovation and organizational identification. Originality/value This research expands the nomological network concerning antecedents and consequences of organizational identification. It also explores the role of satisfaction with one’s supervisor, as this can affect identification with the organization. This research provides support for the notion that stronger employee–organization relationships lead to positive individual and organizational outcomes.

A Psychiatrist's Experience in a Primary Health Care Setting

1977 ◽  
Vol 7 (3) ◽  
pp. 229-240 ◽  
Author(s):  
Henry E. Schniewind
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Care Setting ◽  
Health Care Team ◽  
Health Care Setting ◽  
Working Relationships ◽  
Full Time ◽  
Primary Health Care Setting ◽  
Primary Health ◽  
Challenges And Opportunities

Psychiatrists have, for years, offered consultation to their nonpsychiatrist colleagues in many settings and have worked with them in a variety of ways. The development of new programs in primary medical care offers new challenges and opportunities to the liaison psychiatrist. This paper describes the experience of a full-time psychiatrist in a hospital-based primary health care setting. Special problems are encountered in developing working relationships with patients, physicians, nurses, social workers, administrators, and other members of the health care team. Effective resolution of these problems makes it possible to offer comprehensive mental health services as an integral part of primary health care. This psychiatrist's role differs from other consultation-liaison functions by virtue of full-time economic, patient care, academic, geographic and administrative assimilation into the primary health care setting itself. It is suggested that this role is an effective way to bring supportive and educational psychiatric services to patients and providers of all levels of sophistication and need.

Psychiatric Care of Adults with Intellectual Disabilities: Changing Perceptions Over a Decade

2008 ◽  
Vol 42 (10) ◽  
pp. 890-897 ◽  
Author(s):  
Jennifer Torr ◽  
Nicholas Lennox ◽  
Sally-Ann Cooper ◽  
Therese Rey-Conde ◽  
Robert S. Ware ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disabilities ◽  
Clinical Training ◽  
Psychiatric Treatment ◽  
Health Needs ◽  
Mental Health Needs ◽  
Problem Behaviours ◽  
Adults With Intellectual Disabilities ◽  
Training Opportunities

Objective: In light of developments in training and service provision, the aim of the present study was to compare two state-wide surveys, undertaken in 1994 and in 2004, of psychiatrists about their perceptions of their training and psychiatric treatment of adults with intellectual disabilities who also have mental health needs. Methods: A 50-item self-administered questionnaire was developed for the 2004 survey, based on the 1994 study. This was sent to all 624 Fellows of the Royal Australian and New Zealand College of Psychiatry registered in Victoria at the time. A series of questions was asked based on workload, training, the role of psychiatry in intellectual disabilities, opinions on assessment and management, improving services, and the demographics of participant psychiatrists. Results of the 2004 survey are compared with the 1994 study. Results: There has been some change in psychiatrists’ opinions about acute admission wards, believing strongly that they do not meet the needs of the adults with severe intellectual disabilities, leaving them vulnerable to exploitation. There has been some improvement in their ability to adequately manage adults with intellectual disabilities who have mental health needs and/or problem behaviours. Conclusions: Mainstream mental health services fail to meet the needs of adults with intellectual disabilities. Improved specialist clinical services and more clinical training opportunities are required.

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