scholarly journals Development of liaison psychiatry

1998 ◽  
Vol 22 (5) ◽  
pp. 291-293 ◽  
Author(s):  
E. Guthrie

A survey was undertaken to establish the current state of liaison psychiatry in England, Scotland and Wales. Eighty-six consultants were identified who carry out specific work in liaison psychiatry, 43 of these consultants hold either full-time or half-time posts in liaison. Sixteen new posts in liaison (full-time equivalent (FTE) or half-time equivalent (HTE)) have been created in the past two years. Half of these were entirely new posts and half have been created by consultants already in a general psychiatry post renegotiating their contracts. Some specialist registrar schemes have no training slots in liaison psychiatry and others have training slots in liaison psychiatry which are supervised by a trainer who is not in a FTE/HTE liaison post. A national database is required to track expansion in liaison psychiatry and training at specialist registrar level needs to be developed.

2003 ◽  
Vol 27 (9) ◽  
pp. 339-341 ◽  
Author(s):  
Geraldine Swift ◽  
Else Guthrie

Aims and MethodA postal survey of consultants in liaison psychiatry was carried out in the spring of 2002 to document the current state of liaison psychiatry in the UK and the Republic of Ireland. Information was collected on post specifications, clinical organisation and plans for further local development.ResultsNinety-three liaison consultants were identified. Seventy-seven posts were full-time or half-time, compared with 43 such posts in 1996. During the same time period, specialist registrar training posts have doubled from 30 to 61. A third of respondents anticipated further consultant posts in their region.Clinical ImplicationsDespite the increase in the number of liaison consultants since 1996, the numbers still fall below that recommended by the Royal College of Psychiatrists. Liaison consultants need to improve links with primary care and continue to develop specialised services to demonstrate the qualitative and financial benefits that liaison psychiatry has to offer to a wide range of patients.


2003 ◽  
Vol 27 (09) ◽  
pp. 339-341 ◽  
Author(s):  
Geraldine Swift ◽  
Else Guthrie

Aims and Method A postal survey of consultants in liaison psychiatry was carried out in the spring of 2002 to document the current state of liaison psychiatry in the UK and the Republic of Ireland. Information was collected on post specifications, clinical organisation and plans for further local development. Results Ninety-three liaison consultants were identified. Seventy-seven posts were full-time or half-time, compared with 43 such posts in 1996. During the same time period, specialist registrar training posts have doubled from 30 to 61. A third of respondents anticipated further consultant posts in their region. Clinical Implications Despite the increase in the number of liaison consultants since 1996, the numbers still fall below that recommended by the Royal College of Psychiatrists. Liaison consultants need to improve links with primary care and continue to develop specialised services to demonstrate the qualitative and financial benefits that liaison psychiatry has to offer to a wide range of patients.


CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S35-S36
Author(s):  
D. Savage ◽  
D. Petrie

Introduction: Planning for the future emergency physician (EP) workforce will be a significant challenge for decision makers given the rise in emergency department (ED) visits and no concurrent increase in resident positions. EP workforce planning must incorporate physician supply, as well as current and forecasted patient demand. Nova Scotia has undertaken the process of developing a planning model to support policy decision making. We hypothesize that Nova Scotia will require increased resident positions and recruitment from other provinces to meet future patient demand. Methods: We have developed an age structured population model that tracks the number of clinical full-time equivalent (FTE) EPs by their age and shows the “variance” (i.e., supply – demand = variance) over a 30 year planning horizon. This model represents all Level 1, 2, 3, and 4 EDs in Nova Scotia. Current physician supply was calculated based on FTE staffing levels. The current patient demand was based on historical volume and acuity of patients and converted to an FTE demand estimate. Forecasted demand was predicted to increase at an average rate of 0.5% per year. We varied the number of residents trained and the number of EPs recruited from outside the province to examine the effect on the EP workforce. Our initial model will reflect the current training environment and will be referred to as the “current state”. In our 3 scenarios, we increased the number of residents and recruited physicians by 50%, individually and then together. Our outcome measure will be the variance in FTE. Results: The current state showed that the province will have a deficit of 51 FTE EPs over the next 30 years. In scenario 1, a 50% increase in both resident training streams eliminated all variance, while in scenario 2, the increase in recruitment reduced the FTE variance to 34 FTE positions unfilled. In scenario 3, the variance was 0. Conclusion: We feel that this CTAS weighted volumes perspective is important for clinical services planning but the siting, sizing, and synergizing of EDs in a region will involve other inputs. Its important to recognize that we have made the assumption that all physicians starting to work in Nova Scotia will be a 1 FTE. Future iterations will examine the effect of more realistic FTE definitions that account for administrative, teaching and research activities.


Neurology ◽  
2019 ◽  
Vol 93 (1) ◽  
pp. 30-34
Author(s):  
Daniel Weber ◽  
Harini Sarva ◽  
Joshua Weaver ◽  
Fei Wang ◽  
Jingyuan Chou ◽  
...  

In the current medical climate, medical education is at risk of being de-emphasized, leading to less financial support and compensation for faculty. A rise in compensation plans that reward clinical or research productivity fails to incentivize and threatens to erode the educational missions of our academic institutions. Aligning compensation with the all-encompassing mission of academic centers can lead to increased faculty well-being, clinical productivity, and scholarship. An anonymous survey developed by members of the A.B. Baker Section on Neurologic Education was sent to the 133 chairs of neurology to assess the type of compensation faculty receive for teaching efforts. Seventy responses were received, with 59 being from chairs. Key results include the following: 36% of departments offered direct compensation; 36% did not; residency program directors received the most salary support at 36.5% full-time equivalent; and administrative roles had greatest weight in determining academic compensation. We believe a more effective, transparent system of recording and rewarding faculty for their educational efforts would encourage faculty to teach, streamline promotions for clinical educators, and strengthen undergraduate and graduate education in neurology.


JAMIA Open ◽  
2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Amber Sieja ◽  
Melanie D Whittington ◽  
Vanessa Paul Patterson ◽  
Katie Markley ◽  
Heather Holmstrom ◽  
...  

Abstract Objective We report the influence of Sprint electronic health record (EHR) training and optimization on clinician time spent in the EHR. Materials and Methods We studied the Sprint process in one academic internal medicine practice with 26 providers. Program offerings included individualized training sessions, and the ability to clean up, fix, or build new EHR tools during the 2-week intervention. EHR usage log data were available for 24 clinicians, and the average clinical full-time equivalent was 0.44. We used a quasi-experimental study design with an interrupted time series specification, with 8 months of pre- and 12 months of post-intervention data to evaluate clinician time spent in the EHR. Results We discovered a greater than 6 h per day reduction in clinician time spent in the EHR at the clinic level. At the individual clinician level, we demonstrated a time savings of 20 min per clinician per day among those who attended at least 2 training sessions. Discussion We can promote EHR time savings for clinicians who engage in robust EHR training and optimization programs. To date, programs have shown a positive correlation between participation and subjective EHR satisfaction, efficiency, or time saved. The impact of EHR training and optimization on objective time savings remains elusive. By measuring time in the EHR, this study contributes to an ongoing conversation about the resources and programs needed to decrease clinician EHR time. Conclusions We have demonstrated that Sprint is associated with time savings for clinicians for up to 6 months. We suggest that an investment in EHR optimization and training can pay dividends in clinician time saved.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S325-S326
Author(s):  
Declan Hines ◽  
William Lee ◽  
Tamsin Ford ◽  
Sophie Westwood

AimsLiaison psychiatry services (LPSs) provide psychiatric care to general medical patients. This paper aims to evaluate LPS provision for children and young people In England.MethodThe annual Liaison Psychiatry Surveys of England (LPSEs) included questions on paediatric services from 2015 (LPSE-2). Questions were developed in consultation with NHS England and the Liaison Faculty of the Royal College of Psychiatrists. We analysed data from LPSE-2 and three subsequent surveys.LPSs were systematically identified by contacting all acute hospitals with Type 1 emergency departments listed by NHS England. All identified LPSs were emailed a copy of the questionnaire, with follow-up emails and telephone contact for non-responders. Responses by email, post or telephone were accepted.ResultThe number of acute hospitals with access to paediatric LPSs increased from 29 (16%) in 2015 to 46 (27%) in 2019; all of these hospitals had access to adult LPSs. The number of paediatric LPSs with at least 11 full time equivalent (FTE) mental health practitioners (MHPs) has increased from 6% to 24% and from none to 16% with 13 FTE or more MHPs. For both LPSE-4 and LPSE-5, there were only two acute hospitals where both 8 FTE MHPs and 1.5 FTE consultants were present. For LPSE-4, only one site met the Core 24 criteria (for adults - there are no criteria for paediatric LPSs) of 11 FTE MHPs and 1.5 FTE consultants, and for LPSE-5, both these sites exceeded them. Other paediatric services did not meet the adult core 24 criteria for a LPS.Acute hospitals with access to 24/7 paediatric LPSs increased from 12% to 19% between LPSE-4 and LPSE-5. In LPSE-5 68% of paediatric LPS worked to a one-hour response time target to the ED. This is an increase from 42% (14/33) in LPSE-4.ConclusionThere are still far fewer paediatric than adult LPSs, but the provision of paediatric LPSs improved from 2015 to 2019, with more services, more staffing, and faster response times. Services need to continue to improve as few services match the adult core 24 criteria for an LPS.


2020 ◽  
Vol 10 (2) ◽  
pp. 55-59
Author(s):  
Irgi Achmad Fahrezy ◽  
ST. Salmia L. A ◽  
Soemanto Soemanto

Pertumbuhanydan permintaan akan sandang yangysemakin meningkat menuntutbperusahan konveksi untuk memiliki tingkat produktifitas yang tinggi, dimana proses ini dapat dilakukan dengan cara meningkatkanbproduktifitas karyawannya. Erlangga Konveksi adalah salah satu perusahaan konveksi yang berdiri tahun 2010. Masalah yang terjadi di Erlangga Konveksi adalah tidak seimbangnya waktu proses produksi pada tiap stasiun kerja yang menyebabkan terjadinya penambahan jumlahpwaktu kerja dan menyebabkan penumpukanfdan banyak kegiatan dari operator yang menghabiskantwaktu dimana operator banyak melakukan kegiatan di luar dari stasiun kerja mereka sendiri untuk membantu operator di stasiun kerja lainya. Untuk itu perlu dilakukan pengukuran beban kerja sebagai dasar perhitungan kebutuhan tenaga kerja yang sesuai pada bagian produksi. Metode yang digunakan dalam penelitian ini adalah metode Full Time Equivalent. Hasil pengukuran menunjukkan beban kerja adalah sebesar 0,33 pada operator gambar pola; 0,29 pada operator  pemotongan 1; 0,31 pada operator pemotongan 2; 0,21 pada operator sablon 1 dan 2; 0,22 pada operator press sablon; 1,24 pada operator jahit obras 1; 1,27 padaooperator jahit obras 2; 0,34 pada operator jahit rantai; 0,25 pada operator cutting sebelumnoverdeck; 0,55 pada operator overdeck 1 dan 2; 0,57 pada operator overdeck 3; 0,18 pada operator quality control 1 dan 2; 0,14 pada operator steam; 0,42 pada operatorpsetrika dan 0,20 pada operator packaging. Berdasarkan beban kerja yang telah dihitung pada masing-masing operatorybagian produksi Erlangga Konveksi, Malang, jumlah tenaga optimal pada bagian produksi adalah sebanyak 7 orang yang terbagi ke dalam 7 stasiun kerja.


i-Perception ◽  
2021 ◽  
Vol 12 (3) ◽  
pp. 204166952110203
Author(s):  
Jonas K. Olofsson ◽  
Ingrid Ekström ◽  
Maria Larsson ◽  
Steven Nordin

Olfaction, the sense of smell, is characterized by a notable age-dependency such that aging individuals are more likely to have poor olfactory abilities. These impairments are considered to be mostly irreversible and as having potentially profound effects on quality of life and food behavior, as well as constituting warning signs of mortality, cognitive dysfunction, and dementia. Here, we review the current state of research on aging and olfaction, focusing on five topics which we regard to be of particular relevance for the field: nutrition and health, cognition and dementia, mortality, environment and genetics, and training-based enhancement. Under each of these headlines, we provide a state-of-the-art overview and discuss gaps in our knowledge which might be filled by further research. Understanding how olfactory abilities are diminished in aging, and how they may be alleviated or recovered, involves a set of challenging tasks for researchers in the years to come.


Author(s):  
Tat Ming Ng ◽  
Sock Hoon Tan ◽  
Shi Thong Heng ◽  
Hui Lin Tay ◽  
Min Yi Yap ◽  
...  

Abstract Background The deployment of antimicrobial stewardship (AMS) teams to deal with the COVID-19 pandemic can lead to a loss of developed frameworks, best practices and leadership resulting in adverse impact on antimicrobial prescribing and resistance. We aim to investigate effects of reduction in AMS resources during the COVID-19 pandemic on antimicrobial prescribing. Methods One of 5 full-time equivalent AMS pharmacists was deployed to support pandemic work and AMS rounds with infectious disease physicians were reduced from 5 to 2 times a week. A survey in acute inpatients was conducted using the Global Point Prevalence Survey methodology in July 2020 and compared with those in 2015 and 2017–2019. Results The prevalence of antimicrobial prescribing (55% in 2015 to 49% in 2019 and 47% in 2020, p = 0.02) and antibacterials (54% in 2015 to 45% in 2019 and 42% in 2020, p < 0.01) have been reducing despite the pandemic. Antimicrobial prescribing in infectious disease wards with suspected or confirmed COVID-19 cases was 29% in 2020. Overall, antimicrobial prescribing quality indicators continued to improve (e.g. reasons in notes, 91% in 2015 to 94% in 2019 and 97% in 2020, p < 0.01) or remained stable (compliance to guideline, 71% in 2015 to 62% in 2019 and 73% in 2020, p = 0.08). Conclusion During the COVID-19 pandemic, there was no increase in antimicrobial prescribing and no significant differences in antimicrobial prescribing quality indicators.


Author(s):  
Belinda Jessup ◽  
Tony Barnett ◽  
Kehinde Obamiro ◽  
Merylin Cross ◽  
Edwin Mseke

Background: On a per capita basis, rural communities are underserviced by health professionals when compared to metropolitan areas of Australia. However, most studies evaluating health workforce focus on discrete professional groups rather than the collective contribution of the range of health, care and welfare workers within communities. The objective of this study was therefore to illustrate a novel approach for evaluating the broader composition of the health, welfare and care (HWC) workforce in Tasmania, Australia, and its potential to inform the delivery of healthcare services within rural communities. Methods: Census data (2011 and 2016) were obtained for all workers involved in health, welfare and care service provision in Tasmania and in each statistical level 4 area (SA4) of the state. Workers were grouped into seven categories: medicine, nursing, allied health, dentistry and oral health, health-other, welfare and carers. Data were aggregated for each category to obtain total headcount, total full time equivalent (FTE) positions and total annual hours of service per capita, with changes observed over the five-year period. Results: All categories of the Tasmanian HWC workforce except welfare grew between 2011 and 2016. While this growth occurred in all SA4 regions across the state, the HWC workforce remained maldistributed, with more annual hours of service per capita provided in the Hobart area. Although the HWC workforce remained highly feminised, a move toward gender balance was observed in some categories, including medicine, dentistry and oral health, and carers. The HWC workforce also saw an increase in part-time workers across all categories. Conclusions: Adopting a broad approach to health workforce planning can better reflect the reality of healthcare service delivery. For underserviced rural communities, recognising the diverse range of workers who can contribute to the provision of health, welfare and care services offers the opportunity to realise existing workforce capacity and explore how ‘total care’ may be delivered by different combinations of health, welfare and care workers.


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