The current paper addresses the complex issue of accountability by focusing on Italian public hospitals and teaching hospitals; it aims to analyze Italian health care organizations' strategies for responding to the pressure generated by regulations. In particular, in the last few years, Italian hospitals and teaching hospitals have been obliged to implement or improve their accountability instr...

At the time of publication of the first issue of the British Journal of Anaesthesia in July 1923, there were not many whole-time anaesthetists in this country, and these were confined to university teaching hospitals. Blomfield (1922) stated that there were 27 specialists at 12 teaching hospitals in London, and a similar situation existed in the provinces. In the peripheral hospitals, anaesthes...

Research that is integral into a 'learning healthcare system' can promote cost effective services and knowledge creation. As such, research is defined as a 'core function' in UK health service organisations, and is often planned through research and development (R&D) strategies that aim to promote research activity and research capacity development (RCD). The discussion focuses around the conte...

PROBLEM Medication management in the NHS has been highlighted by the UK Department of Health as an area for improvement. Pharmacist participation on post-take (post-admission) ward rounds was shown to reduce medication errors and reduced prescribing costs in the USA and in UK teaching hospitals, which can contribute to improved medication management. We sought to demonstrate the problem in our ...

Northern Ireland has one of the largest surgical training programmes in the United Kingdom. The surgical trainees' assessment of the quality of training provided has been collated prospectively since 1983, and provides a useful insight into the strengths and weaknesses of the programme, as well as the training value of individual posts. The overall quality of clinical training in surgery was co...

OBJECTIVES To determine the patterns of wheelchair use in terms of locations of use, whether wheelchair use in one location was related to wheelchair use in other locations, and factors associated with wheelchair use in different locations. DESIGN Longitudinal cohort study. SETTING Patients prescribed wheelchairs by clinicians at one of two teaching hospitals (one Veterans Affairs hospital ...

BACKGROUND Readmission rates are projected to serve as quality measures that have the potential to negatively impact hospital and physician reimbursement. Individual physicians and hospitals are developing plans to reduce readmission rates. Successful plans should be based on specific data obtained from each individual type of practice. OBJECTIVE To analyze the etiological factors responsible...

Becoming a physician is a lifelong journey, not merely the completion of medical school and postgraduate training. For those pedagogues that wish to train doctors as technicians the notion that there is something heroic and romantic in a physician's life is quaint, old fashioned, and out of date! In today's teaching hospitals virtual patients come via digital technology in computed x-ray and ma...

BACKGROUND To determine the impact of a dedicated trauma service on cost and quality of care in an urban teaching hospital, a before-and-after study was designed. The key elements of the trauma service were dedicated in-house trauma attending surgeons and residents, and continuity and integration of trauma care. METHODS Injury Severity Scores and probabilities of survival for each patient wer...

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...