Howcanmedicalschoolsmakesure that their students will regularly encounter patients with common clinical conditions during their clinical training? This is a major challenge because patients who previously would have been hospitalized for the management of such conditions can now be cared for in ambulatory settings, thanks to advances in medical practice. As a result, most of the patients seen b...

OBJECTIVE Studies have shown that patients without a consistent primary care provider have inferior outcomes. However, little is known about the mechanisms for these effects. This study aims to determine whether primary care physicians (PCPs) provide more frequent medication intensification, lifestyle counseling, and patient encounters than other providers in the primary care setting. RESEARC...

Introduction Our prior work over 2005 and 2006 validated the feasibility of our method to identify retrospectively transferable cases using IR DRG in-patient groups and exclusion criteria based mainly on severity of illness for same encounters. Now, we want to implement a method to identify behavioral changes required from the clinicians. In order to do so, we needed to demonstrate the full tra...

OBJECTIVE To assess whether transferring knowledge from specialists at centres of excellence to referring doctors through online consultations can improve the management of patients requiring specialised care. DESIGN Retrospective case review of the first year of internet based patient initiated consultations between referring doctors and consulting specialists. SETTING US teaching hospital...

BACKGROUND Improvements in safety culture have been postulated as one of the mechanisms underlying the association between the introduction of the World Health Organisation (WHO) Surgical Safety Checklist with perioperative briefings and debriefings, and enhanced patient outcomes. The 5 Steps to Safer Surgery (5SSS) incorporates pre-list briefings, the three steps of the WHO Surgical Safety Che...

The concept and meaning of futile care depends on the existing culture, values, religion, beliefs, medical achievements and emotional status of a country. We aimed to define the concept of futile care in the viewpoints of nurses working in intensive care units (ICUs). In this phenomenological study, the experiences of 25 nurses were explored in 11 teaching hospitals affiliated to Social Securit...

In 2006, the Department of Health formed the National Institute of Health Research (NIHR) to create an environment for world class health research within the National Health Service (NHS). Historically, research occurred mainly in teaching hospitals, with a lack of equal opportunity for patients to participate in research and no overall nationwide framework to assist the conduct of research wit...

The use of restraints in contemporary healthcare represents an ethical problem to nurses and nursing. This paper describes a point prevalence study undertaken to examine the patterns of restraint use in an Australian teaching hospital. The objectives were: to clearly define restraint; establish its prevalence; the reasons for its use; and, to describe staffing levels in relation to restraint ra...

BACKGROUND The cooperation of patients and their consent to involve medical students in their care is vital to clinical education, but large numbers of students and lack of experience as well as loss of privacy may evoke negative attitudes of patients, which may sometimes adversely affect the clinical teaching environment. This study aimed to explore the attitudes of patients towards medical st...

Several reports have documented the prevalence and severity of emergency department (ED) overcrowding at specific hospitals or cities in Canada; however, no study has examined the issue at a national level. A 54-item, self-administered, postal and web-based questionnaire was distributed to 243 ED directors in Canada to collect data on the frequency, impact and factors associated with ED overcro...