The Journal of ambulatory care management
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J Ambul Care Manage · Oct 2008
Integrating disaster preparedness and surge capacity in emergency facility planning.
The ability to adapt and utilize emergency facilities is a critical element in responding to surges resulting from man-made and natural events. The current stresses on emergency services throughout the country find few adequately prepared to effectively absorb a sudden increase in patients along with some of the potential special requirements, such as quarantining of epidemic patients and mass decontamination. This article reviews major findings of the federally funded ER One project, a research initiative that has described a number of facility strategies, which should be considered in planning new emergency facilities. An early case study in the application of these principles at the recently completed Tampa General Hospital emergency service is provided, illustrating how, when integrated into the early planning and design, many of the ER One recommendations can be implemented at modest capital cost increases.
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J Ambul Care Manage · Jul 2008
Involvement of general practice (family medicine) in undergraduate medical education in the United Kingdom.
We describe the changes in the development and delivery of undergraduate medical education in the United Kingdom as it moved from being exclusively hospital based to one that is increasingly led and delivered by academic departments of general practice (GP), GP teachers, and hospitalists guided by the General Medical Council. We describe the impact of this change on GP teachers, medical students, and patients. The Kings Medical Firm in the Community and The Cambridge Community-based clinical course have been examples of innovation in undergraduate GP teaching and illustrate some of the strengths and challenges of delivering undergraduate medical teaching in the community.
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J Ambul Care Manage · Apr 2008
The ecology of the patient visit: physical attractiveness, waiting times, and perceived quality of care.
This study examined the relationship between the attractiveness of the physical environment of healthcare facilities and patient perceptions of quality, service, and waiting time through systematic observations and patient satisfaction surveys at 7 outpatient practices at Weill Cornell Medical Center. Findings indicate positive correlations between more attractive environments and higher levels of perceived quality, satisfaction, staff interaction, and reduction of patient anxiety. The comparison of actual observed time and patients' perception of time showed that patients tend to overestimate shorter waiting times and underestimate longer waiting times in both the waiting area and the examination room. Further examinations of the way outpatient-practice environments impact patient and staff perceptions and how those perceptions impact behavior and medical outcomes are suggested.