scholarly journals A Night Float System in Nephrology Fellowship: A Mixed Methods Evaluation

Kidney360 ◽  
2020 ◽  
Vol 1 (7) ◽  
pp. 631-639
Author(s):  
Jennifer B. Plotkin ◽  
Eric J. Xu ◽  
Derek M. Fine ◽  
Daphne H. Knicely ◽  
C. John Sperati ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Patient Care ◽  
Night Float ◽  
Mixed Methods Evaluation ◽  
Included Patient ◽  
Quality Of Patient Care ◽  
Positive Effect ◽  
Neutral Effect

BackgroundJohns Hopkins was an early adopter of an in-house nephrology fellowship night float to improve work-life balance. Our study aimed to elucidate attitudes to guide fellowship structuring.MethodsWe performed a mixed-methods study surveying Johns Hopkins fellows, alumni, and faculty and conducting one focus group of current fellows. Surveys were developed through literature review, queried on a five-point Likert scale, and analyzed with t and ANOVA tests. The focus group transcript was analyzed by two independent reviewers.ResultsSurvey response rates were 14 (100%) fellows, 32 (91%) alumni, and 17 (94%) faculty. All groups felt quality of patient care was good to excellent with no significant differences among groups (range of means [SD], 4.1 [0.7]–4.6 [0.7]; P=0.12), although fellows had a statistically significantly more positive view than faculty on autonomy (4.6 [0.5] versus 4.1 [0.3]; P=0.006). Fellows perceived a positive effect across all domains of night float on the day team experience (range, 4.2 [0.8]–4.6 [0.6]; P<0.001 compared with neutral effect). Focus group themes included patient care, care continuity, professional development, wellness, and structural components. One fellow said, “…my bias is that every program would switch to a night float system if they could.” All groups were satisfied with night float with 4.7 [0.5], 4.2 [0.8], and 4.0 [0.9] for fellows, faculty, and alumni, respectively; fellows were most enthusiastic (P=0.03). All three groups preferred night float, and fellows did so unanimously.ConclusionsNight float was well liked and enhanced the perceived daytime fellow experience. Alumni and faculty were positive about night float, although less so, possibly due to concerns for adequate preparation to handle overnight calls after graduation. Night float implementation at other nephrology programs should be considered based on program resources; such changes should be assessed by similar methods.

scholarly journals On-site Night Float by Attending Physicians: A Model to Improve Resident Education and Patient Care

2010 ◽  
Vol 2 (1) ◽  
pp. 57-61 ◽  
Author(s):  
Andrew Paul DeFilippis ◽  
Ildefonso Tellez ◽  
Neil Winawer ◽  
Lorenzo Di Francesco ◽  
Kimberly D. Manning ◽  
...  
Keyword(s):  
Patient Care ◽  
Resident Education ◽  
Treatment Plan ◽  
Diagnostic Procedures ◽  
Institute Of Medicine ◽  
Night Float ◽  
Quality Of Patient Care ◽  
Attending Physician ◽  
The Impact

Abstract Background In 2003, the Accreditation Council for Graduate Medical Education instituted common duty hour limits, and in 2008 the Institute of Medicine recommended additional limits on continuous duty hours. Using a night-float system is an accepted approach for adhering to duty hour mandates. Objective To determine the effect of an on-site night-float attending physician on resident education and patient care. Methods Night-float residents and daytime ward residents were surveyed at the end of their rotation about the impact of an on-site night-float attending physician on education and quality of patient care. Responses were provided on a 5-point Likert scale ranging from 1, strongly agree, to 5, strongly disagree. Results Overall, 92 of the 140 distributed surveys were completed (66% response rate). Night-float residents found the night-float attending physician to be helpful with cross-cover issues (mean  =  2.00), initial history and physical examination (mean  =  1.56), choosing appropriate diagnostic tests (mean  =  1.79), developing a treatment plan (mean  =  1.74), and improving overall patient care (mean  =  1.91). Daytime ward residents were very satisfied with the quality of the admission workups (mean  =  1.78), tests and diagnostic procedures (mean  =  1.76), and initial treatment plan (mean  =  1.62) provided by the night-float service. Conclusion A night-float system that includes on-site attending physician supervision can provide a valuable opportunity for resident education and may help improve the quality of patient care.

scholarly journals Nairobi Early Childcare in Slums (NECS) Study Protocol: a mixed-methods exploration of paid early childcare in Mukuru slum, Nairobi

2020 ◽  
Vol 4 (1) ◽  
pp. e000822
Author(s):  
Robert C Hughes ◽  
Patricia Kitsao-Wekulo ◽  
Sunil Bhopal ◽  
Elizabeth W Kimani-Murage ◽  
Zelee Hill ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Early Years ◽  
Epidemiological Methods ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Early Childcare ◽  
Depth Interviews ◽  
Childcare Providers

IntroductionThe early years are critical. Early nurturing care can lay the foundation for human capital accumulation with lifelong benefits. Conversely, early adversity undermines brain development, learning and future earning.Slums are among the most challenging places to spend those early years and are difficult places to care for a child. Shifting family and work structures mean that paid, largely informal, childcare seems to be becoming the ‘new normal’ for many preschool children growing up in rapidly urbanising Africa. However, little is known about the quality of this childcare.AimsTo build a rigorous understanding what childcare strategies are used and why in a typical Nairobi slum, with a particular focus on provision and quality of paid childcare. Through this, to inform evaluation of quality and design and implementation of interventions with the potential to reach some of the most vulnerable children at the most critical time in the life course.Methods and analysisMixed methods will be employed. Qualitative research (in-depth interviews and focus group discussions) with parents/carers will explore need for and decision-making about childcare. A household survey (of 480 households) will estimate the use of different childcare strategies by parents/carers and associated parent/carer characteristics. Subsequently, childcare providers will be mapped and surveyed to document and assess quality of current paid childcare. Semistructured observations will augment self-reported quality with observable characteristics/practices. Finally, in-depth interviews and focus group discussions with childcare providers will explore their behaviours and motivations. Qualitative data will be analysed through thematic analysis and triangulation across methods. Quantitative and spatial data will be analysed through epidemiological methods (random effects regression modelling and spatial statistics).Ethics and disseminationEthical approval has been granted in the UK and Kenya. Findings will be disseminated through journal publications, community and government stakeholder workshops, policy briefs and social media content.

494 Streamlining the Minor Operations Process - The Effect of Better Documentation

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
T Schrire ◽  
C Estela
Keyword(s):  
Patient Care ◽  
Plastic Surgery ◽  
Patient Experience ◽  
Patient Flow ◽  
Vital Part ◽  
Rapid Turnover ◽  
Quality Of Patient Care ◽  
New Form ◽  
Minor Operations

Abstract Introduction Plastic Surgery Minor Operations is a fast paced, rapid turnover operative environment. It is reliant on effective communication, accurate surgery, and time efficiency. It was noticed in our department that there was confusion regarding booking and operative intentions leading to delays in surgery and over-running lists. This was worsening patient experience and leading to delays in patient care. Method In response to the delays and confusion in booking, a new booking form was created, so all patients have a standardised booking containing the necessary information. This form was disseminated across all the booking clinics and formed a vital part of the pre-operative check in process. Results The audit was carried out at the time of introduction, and then re-audited a year later to see if the form has improved care for patients. Results showed that with the new booking form, people were not having to cancel or rearrange patients. Patient booking forms were sufficient, and a copy of the clinic letter no longer required for the operation to proceed or for clarity. It was noted that more senior advice was sought. Conclusions The new form has improved patient flow and quality of patient care, whilst streamlining the booking process.

scholarly journals Pediatric Endocrinology in the Time of COVID-19: Considerations for the Rapid Implementation of Telemedicine and Management of Pediatric Endocrine Conditions

2020 ◽  
Vol 93 (6) ◽  
pp. 343-350
Author(s):  
Molly O. Regelmann ◽  
Rushika Conroy ◽  
Evgenia Gourgari ◽  
Anshu Gupta ◽  
Ines Guttmann-Bauman ◽  
...  
Keyword(s):  
Patient Care ◽  
Care Patient ◽  
The Novel ◽  
Patient Privacy ◽  
Pediatric Endocrinology ◽  
Quality Of Patient Care ◽  
Care Outcomes ◽  
Novel Coronavirus ◽  
The Impact

<b><i>Background:</i></b> Pediatric endocrine practices had to rapidly transition to telemedicine care at the onset of the novel coronavirus disease 2019 (COVID-19) pandemic. For many, it was an abrupt introduction to providing virtual healthcare, with concerns related to quality of patient care, patient privacy, productivity, and compensation, as workflows had to change. <b><i>Summary:</i></b> The review summarizes the common adaptations for telemedicine during the pandemic with respect to the practice of pediatric endocrinology and discusses the benefits and potential barriers to telemedicine. <b><i>Key Messages:</i></b> With adjustments to practice, telemedicine has allowed providers to deliver care to their patients during the COVID-19 pandemic. The broader implementation of telemedicine in pediatric endocrinology practice has the potential for expanding patient access. Research assessing the impact of telemedicine on patient care outcomes in those with pediatric endocrinology conditions will be necessary to justify its continued use beyond the COVID-19 pandemic.

scholarly journals A mixed methods approach to determine the climate of interprofessional education among medical and health sciences students

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nabil Sulaiman ◽  
Youssef Rishmawy ◽  
Amal Hussein ◽  
Maha Saber-Ayad ◽  
Hamzah Alzubaidi ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Patient Care ◽  
Interprofessional Education ◽  
Health Sciences ◽  
Study Cohort ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Positive Attitudes ◽  
Health Sciences Students

Abstract Background High-quality patient care is a complex phenomenon that requires collaboration among healthcare professionals. Research has shown that Interprofessional Education (IPE) carries promise to improve collaborative work and patient care. So far, collaboration among various health professionals remains a challenge. Very few focus group discussions to determine the medical students’ readiness and positive attitudes towards IPE have been reported from the Arabian context. Methods A two-staged sequential mixed methods study was conducted among medical, dental, pharmacy, and health sciences students of the University of Sharjah United Arab Emirates. The perspectives of students toward IPE and collaborative practice were first gathered by administering a validated instrument, Readiness for Interprofessional Learning Scale (RIPLS). This was followed by focused group discussions. A quantitative as well as a qualitative data analysis was performed. Results This study cohort included 282 students. All respondents showed readiness to adopt IPE as all statements of the RIPLS inventory scored high median scores. All participants showed positive attitudes and readiness towards IPE. Three main domains of themes were generated from focus group discussions; prior knowledge, need for IPE framework and its implementation. Information workload, lack of clarity and less focused teaching pedagogies of IPE were considered as perceived barriers. Conclusion This study demonstrated a substantial agreement of medical and health sciences students towards readiness and perceived effectiveness of IPE. Educators are urged to embed new IPE programs into existing curricular frameworks, which can potentially enhance collaborative learning and improve quality of patient care.

Medical Audit to Improve the Quality of Patient Care in Thoracic Surgery

2021 ◽  
Vol 31 (4) ◽  
pp. 497-508
Author(s):  
Farid M. Shamji ◽  
Joel Cooper ◽  
Gilles Beauchamp
Keyword(s):  
Thoracic Surgery ◽  
Patient Care ◽  
Medical Audit ◽  
Quality Of Patient Care
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