Organization and Response of Clinical Pathology to Ambulatory and Emergency Patient Care

1975 ◽  
Vol 6 (6) ◽  
pp. 41-45 ◽  
Author(s):  
John Bernard Henry ◽  
Bettina G. Martin ◽  
Allen L. Pusch
Keyword(s):  
Patient Care ◽  
Clinical Pathology ◽  
Emergency Patient

scholarly journals Indispensability of Clinical Bioinformatics for Effective Implementation of Genomic Medicine in Pathology Laboratories

ACI Open ◽  
2020 ◽  
Vol 04 (02) ◽  
pp. e167-e172
Author(s):  
Srikar Chamala ◽  
Siddardha Majety ◽  
Shesh Nath Mishra ◽  
Kimberly J. Newsom ◽  
Shaileshbhai Revabhai Gothi ◽  
...  
Keyword(s):  
Patient Care ◽  
Clinical Laboratory ◽  
Clinical Care ◽  
Genomic Medicine ◽  
Clinical Pathology ◽  
Genetic Mutation ◽  
Genomic Research ◽  
Pathology Laboratory ◽  
Clinical Bioinformatics ◽  
Effective Implementation

AbstractPatient care is rapidly evolving toward the inclusion of precision genomic medicine when genomic tests are used by clinicians to determine disease predisposition, prognosis, diagnosis, and improve therapeutic decision-making. However, unlike other clinical pathology laboratory tests, the development, deployment, and delivery of genomic tests and results are an intricate process. Genomic technologies are diverse, fast changing, and generate massive data. Implementation of these technologies in a Clinical Laboratory Improvement Amendments-certified and College of American Pathologists-accredited pathology laboratory often require custom clinical grade computational data analysis and management workflows. Additionally, accurate classification and reporting of clinically actionable genetic mutation requires well-curated disease/application-specific knowledgebases and expertise. Moreover, lack of “out of the box” technical features in electronic health record systems necessitates custom solutions for communicating genetic information to clinicians and patients. Genomic data generated as part of clinical care easily adds great value for translational research. In this article, we discuss current and future innovative clinical bioinformatics solutions and workflows developed at our institution for effective implementation of precision genomic medicine across molecular pathology, patient care, and translational genomic research.

scholarly journals Online Database for Documenting Clinical Pathology Resident Education

2007 ◽  
Vol 53 (1) ◽  
pp. 134-137 ◽  
Author(s):  
Andrew N Hoofnagle ◽  
David Chou ◽  
Michael L Astion
Keyword(s):  
Patient Care ◽  
Resident Education ◽  
Core Competencies ◽  
Clinical Pathology ◽  
Internet Access ◽  
Quality Service ◽  
Substantial Portion ◽  
Online Database ◽  
Educational Value ◽  
Microsoft Access

Abstract Background: Training of clinical pathologists is evolving and must now address the 6 core competencies described by the Accreditation Council for Graduate Medical Education (ACGME), which include patient care. A substantial portion of the patient care performed by the clinical pathology resident takes place while the resident is on call for the laboratory, a practice that provides the resident with clinical experience and assists the laboratory in providing quality service to clinicians in the hospital and surrounding community. Documenting the educational value of these on-call experiences and providing evidence of competence is difficult for residency directors. An online database of these calls, entered by residents and reviewed by faculty, would provide a mechanism for documenting and improving the education of clinical pathology residents. Methods: With Microsoft Access we developed an online database that uses active server pages and secure sockets layer encryption to document calls to the clinical pathology resident. Using the data collected, we evaluated the efficacy of 3 interventions aimed at improving resident education. Results: The database facilitated the documentation of more than 4 700 calls in the first 21 months it was online, provided archived resident-generated data to assist in serving clients, and demonstrated that 2 interventions aimed at improving resident education were successful. Conclusions: We have developed a secure online database, accessible from any computer with Internet access, that can be used to easily document clinical pathology resident education and competency.

A Call to Standardize Preanalytic Data Elements for Biospecimens, Part II

2015 ◽  
Vol 139 (9) ◽  
pp. 1125-1128 ◽  
Author(s):  
James A. Robb ◽  
Lynn Bry ◽  
Patrick M. Sluss ◽  
Elizabeth A. Wagar ◽  
Mary F. Kennedy ◽  
...  
Keyword(s):  
Patient Care ◽  
Working Group ◽  
Clinical Chemistry ◽  
Clinical Pathology ◽  
Biospecimen Collection ◽  
Clinical Annotation ◽  
Negative Impacts ◽  
The Many ◽  
Data Elements ◽  
Specific Implementation

Context Biospecimens must have appropriate clinical annotation (data) to ensure optimal quality for both patient care and research. Additional clinical preanalytic variables are the focus of this continuing study. Objective To complete the identification of the essential preanalytic variables (data fields) that can, and in some instances should, be attached to every collected biospecimen by adding the additional specific variables for clinical chemistry and microbiology to our original 170 variables. Design The College of American Pathologists Diagnostic Intelligence and Health Information Technology Committee sponsored a second Biorepository Working Group to complete the list of preanalytic variables for annotating biospecimens. Members of the second Biorepository Working Group are experts in clinical pathology and microbiology. Additional preanalytic area–specific variables were identified and ranked along with definitions and potential negative impacts if the variable is not attached to the biospecimen. The draft manuscript was reviewed by additional national and international stakeholders. Results Four additional required preanalytic variables were identified specifically for clinical chemistry and microbiology biospecimens that can be used as a guide for site-specific implementation into patient care and research biorepository processes. Conclusions In our collective experience, selecting which of the many preanalytic variables to attach to any specific set of biospecimens used for patient care and/or research is often difficult. The additional ranked list should be of practical benefit when selecting preanalytic variables for a given biospecimen collection.

scholarly journals Hospital Admission Location Prediction via Deep Interpretable Networks for the Year-Round Improvement of Emergency Patient Care

2021 ◽  
Vol 25 (1) ◽  
pp. 289-300 ◽  
Author(s):  
Rasheed El-Bouri ◽  
David W. Eyre ◽  
Peter Watkinson ◽  
Tingting Zhu ◽  
David A. Clifton
Keyword(s):  
Hospital Admission ◽  
Patient Care ◽  
Location Prediction ◽  
Emergency Patient

scholarly journals Opportunities for teaching ABCDE-based patient examination in health education

2021 ◽  
Author(s):  
Attila Pandur ◽  
Ferenc Jozsef Molnar ◽  
Luca Anna Ferkai ◽  
Gabor Furedi ◽  
Jozsef Betlehem ◽  
...  
Keyword(s):  
Patient Care ◽  
Practical Knowledge ◽  
Descriptive Analysis ◽  
Cross Sectional Study ◽  
Practical Implementation ◽  
Emergency Patient ◽  
Cross Sectional ◽  
Significant Difference ◽  
Threatening Condition ◽  
Keywords Education

Abstract Abstract: Background: The ABCDE-based Patient Examination is a systematic patient examination aimed at early detection of a critical condition and prevention of life-threatening condition. Its education in the field of emergency patient care is most frequently provided in theoretical and / or practical education, in the form of frontal work, with indirect and direct illustration, as well as simulation and situational practice. The aim of our research is to assess which educational environment and method best support the acquisition of practical knowledge, to examine students' physiological reactions to different situations, to assess how the personal presence of the instructor influences the student’s performance, and compare frontal education to the situation-simulation exercises. Methods: The research was carried out by non - random sampling by an expert using a cross - sectional study. The study included 3rd and 4th year paramedics (N = 47 persons) who at the time of the research were studying at the Faculty of Health Sciences of the University of Pécs and participated in the previous semester online ABCDE patient examination education. Students who did not show up at the time of the study or those who work in ambulance or hospital emergency patient care were excluded. Three sub-samples were formed: in the first the instructor was present during the education (n = 11 persons), in the second the instructor was not present during the education (n = 8 persons), and in the third a realistic simulator was used without the presence of their instructors. (n = 28 persons). A descriptive analysis of the sample statistics and Kruskall-Wallis test was used for data analysis and SPSS 24.0 and GraphPad Prism 8.4 were used for evaluation. Results: The results of the theoretical and practical tests did not correlate with each other (p = 0,14). During the practical test, the group using the realistic simulator achieved the worst result and the personal presence of the instructor did not improve the achieved result (p <0,001). When monitoring students’ heart rate, there was no significant difference between each group (p = 0,79; p = 0,48; p = 0,48). Conclusions: The presence of the instructor during the practical simulation did not affect the result, so in the current epidemiological situation, the practical simulation can be safely and efficiently taught from the camera room. Based on our results, the efficiency of realistic simulators in this situation is questionable. We did not find a clear relationship between theoretical knowledge and practical implementation, but it would be worthwhile to repeat the study with more and various equipments and a larger number of participants. Keywords: Education, Evaluation intervention, Evidence-Based Medicine, Complex intervention.

scholarly journals Advancing Fellowship Training in Selective Pathology: Design and Implementation of the Milestones 2.0

2021 ◽  
Author(s):  
Ian S. Hagemann ◽  
Robin Elliott ◽  
Alexandra Kalof ◽  
Elaine S. Keung ◽  
Ninad Patil ◽  
...  
Keyword(s):  
Patient Care ◽  
Work Group ◽  
Core Competencies ◽  
Medical Knowledge ◽  
Clinical Pathology ◽  
The United States ◽  
Fellowship Training ◽  
Assessment Tools ◽  
Anatomic Pathology ◽  
Knowledge Competencies

Context.— Program requirements for Selective Pathology fellowships in the United States were established by the Accreditation Council for Graduate Medical Education (ACGME) in 2011 to govern fellowships providing advanced training in surgical pathology, focused anatomic pathology, or focused clinical pathology. Selective Pathology entered the ACGME's Next Accreditation System in 2015 with the introduction of the Selective Pathology Milestones 1.0, a set of benchmarks for evaluating fellow progress in each of the 6 ACGME core competencies. In 2019, the ACGME convened a work group for a planned periodic update to these milestones. Objective.— To summarize changes to the Selective Pathology milestones. Design.— The study design featured expert opinion and survey. Results.— The Patient Care milestones for anatomic pathology–focused fellowships contain a renewed emphasis on both gross and microscopic examination, whereas for clinical pathology–focused fellowships, the emphasis is on interpretation of laboratory assays. The milestones for the non–Patient Care, non–Medical Knowledge competencies have been updated to a harmonized set of milestones designed to extend across all specialties and subspecialties. New to the milestones program is a supplemental guide that provides examples, suggested assessment tools, and references to aid in implementation. Public comments were supportive of the changes. Conclusions.— The Milestones 2.0 are set for implementation in July 2021. Updates in the new milestones are aimed at facilitating training and harmonizing evaluation across subspecialties.

Measuring the Clinical Impact of Pathologist Reviews of Blood and Body Fluid Smears

2007 ◽  
Vol 131 (3) ◽  
pp. 468-472
Author(s):  
Linda M. Sandhaus ◽  
David N. Wald ◽  
Kenan J. Sauder ◽  
Erica L. Steele ◽  
Howard J. Meyerson
Keyword(s):  
Patient Care ◽  
Clinical Diagnosis ◽  
Body Fluid ◽  
Patient Management ◽  
Clinical Pathology ◽  
Clinical Impact ◽  
Survey Study ◽  
Physician Awareness ◽  
Improving Patient Care ◽  
Study Inclusion

Abstract Context.—Despite the widespread practice of pathologist review of blood and body fluid smears, little is known about its impact on improving patient care. Objective.—To assess the clinical usefulness of pathologist review of blood and body fluid smears. Design.—Survey study. Pathology residents contacted the ordering physician after pathologist reviews were reported to assess their clinical impact. Results.—Ninety-six pathologist reviews met criteria for study inclusion, and 64 ordering physicians were successfully contacted during the 2-month study period. Of the 64 cases, 19 reviews (30%) had been seen by the physician within 24 to 48 hours after the report was issued and 33 (51%) had not been seen; in 4 (6%) instances, physicians did not remember whether they had seen the review. Eight reviews (13%) were considered urgent enough to warrant immediate communication by the pathologist. Of the 27 reviews that were seen or directly communicated, 23 (85%) contributed to clinical diagnosis and/or patient management. Conclusions.—This study demonstrates the contribution of pathologist reviews of blood and body fluids to clinical diagnosis and patient management. The results also highlight the problem of a lack of physician awareness of clinical pathology results.

Communications problems affecting patient care in hospitals

JAMA ◽  
1966 ◽  
Vol 195 (1) ◽  
pp. 36-37 ◽  
Author(s):  
J. C. Quint
Keyword(s):  
Patient Care
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