scholarly journals O7B.2 Pilot project for identifying psychosocial risk factors among senior physicians in the pediatric medical center of a university hospital center

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A62.3-A63
Author(s):  
Marie-Agnès Denis ◽  
Fabienne Dumetier ◽  
Ghislaine Poyard-Berger ◽  
Marie-Michèle Mantha-Belisle ◽  
Michel Vézina
Keyword(s):  
Occupational Health ◽  
Management Practices ◽  
Medical Center ◽  
Theoretical Models ◽  
Pilot Project ◽  
Working Environment ◽  
University Hospital ◽  
Junior Doctors ◽  
Warning Signals ◽  
Interview Guide

ContextAfter several warning signals coming from senior physicians working in a Department of pediatrics at a large university hospital, the Department of occupational health decided to assess objectively the psychosocial risks to which this personnel was exposed.MethodsA research team from the scientific unit of the Institut National de Santé Publique du Québec has developed an identification grid with markers that help understanding and limiting physical and psychological risks at work. This grid includes characteristics of the workplace environment and various aspects of management practices. It is based on theoretical models such as ‘Demand-Latitude-Support’ (Karasek & Theorell, 1990), ‘effort-reward imbalance’ (Siegrist, 1996), ‘organizational justice’ (Adams, 2000), and ‘prevention’ (Kristensen, 1999). The assessment involved an interview guide with a scoring system of data collected from credible persons familiar with the working environment.After adequate training in the use of the interview guide, an occupational physician and an occupational psychologist interviewed jointly each of 34 pediatricians and 3 managers and scored the 12 items of the guide according to specific recommendations. The data collected from the interviews were submitted to a thematic analysis.ResultsThe analysis showed that the working environment of the Department was not favorable to the return to work or work-life balance. Regarding management, the warning signals pointed to heavy workloads, lack of recognition, and communication problems. There were some protecting factors such as support from colleagues, some decision latitude (but limited possibilities of knowledge development) and, unevenly between wards, support from the hierarchy. The most negative indicators were reported by junior doctors and, as expected, by temporary personnel.DiscussionAccording to these results, group involving the assessment team, pediatricians, and ward managers will be formed to suggest improvements in the fields of human-resource management, communication, recognition, workloads, and occupational health.

scholarly journals 145 Point of care lung ultrasound in patient triage: integration of ultrasound into a streaming pathway for COVID-19

2020 ◽  
Vol 37 (12) ◽  
pp. 839.1-839
Author(s):  
Dominic Craver ◽  
Aminah Ahmad ◽  
Anna Colclough
Keyword(s):  
Point Of Care ◽  
District General Hospital ◽  
Training Programme ◽  
Service Evaluation ◽  
University Hospital ◽  
Junior Doctors ◽  
Point Of Care Ultrasound ◽  
Face To Face ◽  
Point Of Care Diagnostics ◽  
Audit Data

Aims/Objectives/BackgroundRapid risk stratification of patients is vital for Emergency Department (ED) streaming during the COVID-19 pandemic. Ideally, patients should be split into red (suspected/confirmed COVID-19) and green (non COVID-19) zones in order to minimise the risk of patient-to-patient and patient-to-staff transmission. A robust yet rapid streaming system combining clinician impression with point-of-care diagnostics is therefore necessary.Point of care ultrasound (POCUS) findings in COVID-19 have been shown to correlate well with computed tomography (CT) findings, and it therefore has value as a front-door diagnostic tool. At University Hospital Lewisham (a district general hospital in south London), we recognised the value of early POCUS and its potential for use in patient streaming.Methods/DesignWe developed a training programme, ‘POCUS for COVID’ and subsequently integrated POCUS into streaming of our ED patients. The training involved Zoom lectures, a face to face practical, a 10 scan sign off process followed by a final triggered assessment. Patient outcomes were reviewed in conjunction with their scan reports.Results/ConclusionsCurrently, we have 21 ED junior doctors performing ultrasound scans independently, and all patients presenting to our department are scanned either in triage or in the ambulance. A combination of clinical judgement and scan findings are used to stream the patient to an appropriate area.Service evaluation with analysis of audit data has found our streaming to be 94% sensitive and 79% specific as an indicator of COVID 19. Further analysis is ongoing.Here we present both the structure of our training programme and our integrated streaming pathway along with preliminary analysis results.

scholarly journals European List of Essential Medicines for Medical Education: a protocol for a modified Delphi study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045635
Author(s):  
Erik Donker ◽  
David Brinkman ◽  
Milan Richir ◽  
Paraskevi Papaioannidou ◽  
Robert Likic ◽  
...  
Keyword(s):  
Medical Education ◽  
Delphi Study ◽  
Medical Training ◽  
Medical Center ◽  
European Countries ◽  
Essential Medicines ◽  
Ethical Review ◽  
Junior Doctors ◽  
Direct Supervision ◽  
Modified Delphi

IntroductionJunior doctors are responsible for a substantial number of prescribing errors, and final-year medical students lack sufficient prescribing knowledge and skills just before they graduate. Various national and international projects have been initiated to reform the teaching of clinical pharmacology and therapeutics (CP&T) during undergraduate medical training. However, there is as yet no list of commonly prescribed and available medicines that European doctors should be able to independently prescribe safely and effectively without direct supervision. Such a list could form the basis for a European Prescribing Exam and would harmonise European CP&T education. Therefore, the aim of this study is to reach consensus on a list of widely prescribed medicines, available in most European countries, that European junior doctors should be able to independently prescribe safely and effectively without direct supervision: the European List of Essential Medicines for Medical Education.Methods and analysisThis modified Delphi study will recruit European CP&T teachers (expert group). Two Delphi rounds will be carried out to enable a list to be drawn up of medicines that are available in ≥80% of European countries, which are considered standard prescribing practice, and which junior doctors should be able to prescribe safely and effectively without supervision.Ethics and disseminationThe study has been approved by the Medical Ethics Review Committee of VU University Medical Center (no. 2020.335) and by the Ethical Review Board of the Netherlands Association for Medical Education (approved project no. NVMO‐ERB 2020.4.8). The European List of Essential Medicines for Medical Education will be presented at national and international conferences and will be submitted to international peer-reviewed journals. It will also be used to develop and implement the European Prescribing Exam.

scholarly journals Improvement of the module for occupational diseases in the structure of occupational health record

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Iancheva ◽  
T Kundurzhiev ◽  
N Tzacheva ◽  
L Hristova
Keyword(s):  
Public Health ◽  
Occupational Health ◽  
Health Services ◽  
Occupational Disease ◽  
Occupational Diseases ◽  
National Level ◽  
Working Environment ◽  
Occupational Health Services ◽  
Health Record ◽  
Disease Module

Abstract The study is based on the National Science Program 'eHealth in Bulgaria (e-Health)', funded by the Ministry of Education and Science. Partnership Contract No. D-01-200/16.11.2018 Issue Occupational health is closely linked to public health and health system. In Bulgaria there are many software products related to the registration and reporting of occupational health. Description of the Problem It is necessary to study all the determinants of occupational health, including the risks of diseases and accidents in the occupational environment, social and individual factors. The establishment of electronic systems for registering and monitoring both the health status of each worker and the possible hazards in the work environment is associated with the introduction and use of the occupational health record of each worker. Results The methodology for improving the module for occupational diseases in the structure of the occupational health record in Bulgaria has been developed. The classifications are in compliance with the legislation in the country and the requirements of the developing Eurostat methodology for European statistics on occupational diseases are applied. The occupational health record will serve both employers and physicians working in Occupational Health Services. Lessons The occupational disease module in the structure of the occupational health record will contribute to the statistical comparability of occupational disease data at regional and national level. Not only will the registration of the harmful factors of the working environment and the diseases related to the work process, but also the introduction of timely measures to ensure good occupational and public health. Key messages Through the occupational disease module, the structure of the occupational health record introduces the possibility of taking adequate measures to ensure good occupational health. The occupational health record will serve both employers and physicians working in Occupational Health Services.

scholarly journals Patient Clothing as a Healing Environment: A Qualitative Interview Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5357
Author(s):  
Seon-Ju Kam ◽  
Young-Sun Yoo
Keyword(s):  
Emotional Response ◽  
Positive Emotions ◽  
Design Method ◽  
Medical Center ◽  
Emotional Responses ◽  
University Hospital ◽  
Hospital Environment ◽  
University Hospitals ◽  
Pattern Design ◽  
Qualitative Interview Study

Patients’ emotional responses to the hospital environment can be considered as important as medical technology and equipment. Therefore, this study investigated their experiences to determine whether the pattern using hospital identity (HI) elements, a widely used design method for patient clothing in university hospitals, can affect their emotional response and contribute to healing. It aimed to identify whether controlling the motif characteristics, arrangement, and spacing in this pattern design, and the direction between motifs, could be a method to design patient clothing for healing. To investigate patients’ emotional response and suggestions for patient clothing design, an interview-based qualitative approach was used. In-depth interviews were conducted with 12 patients discharged from Kyung Hee University Hospital Medical Center (KHUMC), Seoul. The interview questions consisted of two parts. One part featured questions about participants’ emotional responses to the medical environment and their latest patient clothing experience, and the other featured questions about their emotional response to, and suggestions for, the healing expression of pattern design using HI. The results confirmed that the motif characteristics, arrangement, and spacing, and the direction between motifs, influenced patients’ positive emotions and contributed to the healing effect. Therefore, when the HI elements of a medical institution are applied in the design of patient clothing with the characteristics of a healing design, patients perceive this as providing stability and comfort. The design of patient clothing becomes a medium that not only builds the brand image of medical institutions, but also enhances the quality of medical services centered on patient healing.

scholarly journals Couples’ experiences with expanded carrier screening: evaluation of a university hospital screening offer

2021 ◽  
Author(s):  
Ivy van Dijke ◽  
Phillis Lakeman ◽  
Naoual Sabiri ◽  
Hanna Rusticus ◽  
Cecile P. E. Ottenheim ◽  
...  
Keyword(s):  
High Risk ◽  
Medical Center ◽  
Informed Choice ◽  
Carrier Screening ◽  
University Hospital ◽  
Structured Interviews ◽  
Expanded Carrier Screening ◽  
Post Test ◽  
Future Child ◽  
Clinically Significant

AbstractPreconception carrier screening offers couples the possibility to receive information about the risk of having a child with a recessive disorder. Since 2016, an expanded carrier screening (ECS) test for 50 severe autosomal recessive disorders has been available at Amsterdam Medical Center, a Dutch university hospital. This mixed-methods study evaluated the experiences of couples that participated in the carrier screening offer, including high-risk participants, as well as participants with a general population risk. All participants received genetic counselling, and pre- (n = 132) and post-test (n = 86) questionnaires and semi-structured interviews (n = 16) were administered. The most important reason to have ECS was to spare a future child a life with a severe disorder (47%). The majority of survey respondents made an informed decision (86%), as assessed by the Multidimensional Measure of Informed Choice. Among the 86 respondents, 27 individual carriers and no new carrier couples were identified. Turn-around time of the test results was considered too long and costs were perceived as too high. Overall, mean levels of anxiety were not clinically elevated. High-risk respondents (n = 89) and pregnant respondents (n = 13) experienced higher levels of anxiety before testing, which decreased after receiving the test result. Although not clinically significant, distress was on average higher for carriers compared to non-carriers (p < 0.0001). All respondents would opt for the test again, and 80.2% would recommend it to others. The results suggest that ECS should ideally be offered before pregnancy, to minimise anxiety. This study could inform current and future implementation initiatives of preconception ECS.

scholarly journals How does participation in a voluntary prize exam affect medical students’ knowledge and interest in ENT, plastic surgery, ophthalmology and dermatology?

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Razan Nour ◽  
Kerry Jobling ◽  
Alasdair Mayer ◽  
Salma Babikir
Keyword(s):  
Medical Students ◽  
Plastic Surgery ◽  
Pilot Project ◽  
Junior Doctors ◽  
Free Text ◽  
Medical Specialties ◽  
Spare Time ◽  
Before And After ◽  
To Receive ◽  
Interest And Knowledge

Abstract Background Otolaryngology (ENT), plastic surgery, ophthalmology and dermatology are medical specialties which tend to receive less coverage in UK medical school curricula compared to larger, generalist specialties. As a result, there are fewer opportunities for medical students to learn and to cultivate an interest. There are numerous papers that report concerns about junior doctors’ ability to manage conditions within these specialties, which may jeopardise patient safety. The aim of our pilot project was to increase medical students’ interest and knowledge of ENT, plastic surgery, ophthalmology and dermatology. In addition to describing our project, we present and discuss literature on UK undergraduate education in these specialties and its impact on preparedness of junior doctors and future career choices. Methods One hundred twelve final year medical students at Newcastle University were invited to take part in a voluntary two-part (written and clinical) exam, in which prizes could be won and all participants would receive a certificate of participation. We distributed two online surveys to the students, one administered before the exam and one afterwards. Data was collected regarding the students’ motivation for entering the prize exam and the students’ baseline interest and knowledge in these specialties before and after the prize exam. Free-text responses were collected about the students’ opinion of the project and whether participation was beneficial. Results Sixteen students participated in the exam. There was a statistically significant increase in the students’ knowledge in ENT (p < 0.000), plastic surgery (p < 0.000), ophthalmology (p < 0.028) and dermatology (p < 0.012) after participation in the exam, but not in their interest levels. ENT was the preferred specialty of our cohort. The students reported that they found participation beneficial to their learning, particularly receiving exam feedback and explanations to exam questions. Conclusions This pilot project was a useful intervention in increasing medical students’ knowledge in these specialties, but not in their levels of interest. It also demonstrates that medical students are willing to participate in voluntary initiatives (in their spare time) to gain more learning opportunities and that medical students value timely exam feedback to guide their revision.

Effect of Occupational Health and Safety, and Work Environment on Employee Performance with Working Satisfaction as Mediation Variable

2021 ◽  
Vol 6 (2) ◽  
pp. 117-124
Author(s):  
Setyani Dwi Lestari ◽  
Nafiana Putri ◽  
Yuwono Yuwono ◽  
Indrabudiman Amir
Keyword(s):  
Job Satisfaction ◽  
Occupational Health ◽  
Work Environment ◽  
Structural Equation ◽  
Employee Performance ◽  
Health And Safety ◽  
Occupational Health And Safety ◽  
Working Environment ◽  
Coefficient Of Determination ◽  
Safety Work

Objective - This study aims to determine and analyze the influence of Occupational Health and Safety, and the Working Environment on Employee Performance with Job Satisfaction as a mediating variable in PT. Kereta Api Indonesia (Persero) with sample on DAOP I Jakarta. Methodology/Technique - The study population numbered 292 employees and 75 respondents be adopted as a sample of the study. Techniques of analysis using a statistical test structural equation model-based variance (SmartPLS). Findings – The results showed that, (1) Occupational Health and Safety had no effect on Job Satisfaction and Employee Performance, (2) the Work Environment had a positive and significant effect on Job Satisfaction and Employee Performance (3) Job Satisfaction has a positive and significant effect on Employee Performance, (4) Occupational Health and Safety has no effect on Employee Performance even though through Job Satisfaction mediation, (5) the Work Environment has a positive and significant effect on Employee Performance through mediation of Job Satisfaction, (6) Occupational Health and Safety, and the Work Environment simultaneously have a positive and significant effect on Job Satisfaction with the coefficient of determination, which is equal to 0,533, (7) Occupational Health and Safety, Work Environment, and Job Satisfaction simultaneously have a positive effect and significant to Employee Performance with coefficient of determination, which is equal to 0,890. Novelty - The company is expected to provide adequate rest periods, maintain the nutritional intake of its employees by providing healthy food, provide educational scholarships for further levels for employees, safeguard the work environment from chemical hazards and other hazards, and give positive motivation to the employees. Type of Paper: Empirical. JEL Classification: J20, J24, J28. Keywords: Occupational Health and Safety, Work Environment, Job Satisfaction, Employee Performance Reference to this paper should be made as follows: Dwi, L.S; Putri, N; Yuwono; Amir, I. (2021). Effect of Occupational Health and Safety, and Work Environment on Employee Performance with Working Satisfaction as Mediation Variable, Journal of Management and Marketing Review, 6(2) 117 – 124. https://doi.org/10.35609/jmmr.2021.6.2(3)

Utility of Anakinra in Acute Crystalline Diseases: A Retrospective Study Comparing a University Hospital with a Veterans Affairs Medical Center

2018 ◽  
Vol 46 (7) ◽  
pp. 748-750 ◽  
Author(s):  
Julianna Desmarais ◽  
Cong-Qiu Chu
Keyword(s):  
Retrospective Study ◽  
Adverse Effects ◽  
Medical Center ◽  
Veterans Affairs ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Acute Gout ◽  
Efficacy And Safety ◽  
Inpatient Management ◽  
Gout Flares

Objective.To evaluate the efficacy and safety of anakinra in inpatient management of acute gout and pseudogout.Methods.Hospitalized patients with acute gout (n = 77) or pseudogout (n = 11) or both (n = 3) were analyzed for response to anakinra and adverse effects.Results.Half of all patients had comorbidities limiting the treatment choice. Anakinra was well tolerated, and 92% of gout flares and 79% of pseudogout flares responded to treatment.Conclusion.Anakinra is an effective and safe treatment for acute gout and pseudogout in hospitalized patients, particularly in those with comorbidities.

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