Bmc Health Serv Res
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Bmc Health Serv Res · Jan 2008
Conceptualizing handover strategies at change of shift in the emergency department: a grounded theory study.
The importance and complexity of handovers is well-established. Progress for intervening in the emergency department change of shift handovers may be hampered by lack of a conceptual framework. The objectives were to gain a better understanding of strategies used for change of shift handovers in an emergency care setting and to further expand current understanding and conceptualizations. ⋯ Including phases and agents in conceptualizations of handovers can help target interventions to improve patient safety. The conceptual model also clarifies unique handover considerations for the emergency department setting.
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Bmc Health Serv Res · Jan 2008
Prevalence and associated factors in burnout and psychological morbidity among substance misuse professionals.
Studies of psychological stress among substance misuse professionals rarely describe the nature of burnout and psychological morbidity. The main aim of this study was to determine the extent, pattern and predictors of psychological morbidity and burnout among substance misuse professionals. ⋯ In the sample of substance misuse professionals studied, rates of psychological morbidity and burnout were high, suggesting a higher level of vulnerability than in other health professionals. Furthermore, pathways to psychological morbidity and burnout are partially related. Therefore, targeted response is required to manage stress, burnout and psychological morbidity among substance misuse professionals. Such a response should be integral to workforce development.
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Bmc Health Serv Res · Jan 2008
Unmeasured improvement work: the lack of routinely collected, service-related data in NHS endoscopy units in England involved in "modernisation".
The availability of routinely collected service-related endoscopy data from NHS endoscopy units has never been quantified. ⋯ There was a lack of service-related endoscopy data routinely collected by the study sites, especially those who had participated in the MES project. Without this data, NHS endoscopy services cannot have a true understanding of their services, cannot identify problems and cannot measure the impact of any changes. With the increasing pressures placed on NHS endoscopy services, the need to effectively inform redesign plans is paramount. We recommend the compulsory collection of service-related endoscopy data by all NHS endoscopy units using a standardised format with rigorous guidelines.
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Bmc Health Serv Res · Jan 2008
Towards integration of general practitioner posts and accident and emergency departments: a case study of two integrated emergency posts in the Netherlands.
Accident and emergency (A&E) departments and general practitioner (GP) posts are often used inappropriately, leading to overcrowding. In the Netherlands, increasingly more integrated emergency posts (IEPs) are being created, integrating the care provided by GP posts and A&E departments, in order to improve the provision of the emergency care. ⋯ IEPs could be a promising innovation to organize emergency care more efficiently; however, it might take time to convince professionals of the possible advantages. Studies involving more IEPs and longer follow-up times are needed to determine whether such integration should be stimulated.
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Bmc Health Serv Res · Jan 2008
A proposed approach in defining population-based rates of major injury from a trauma registry dataset: delineation of hospital catchment areas (I).
Determining population-based rates for major injury poses methodological challenges. We used hospital discharge data over a 10-year period (1996-2005) from a national trauma registry, the Trauma Audit and Research Network (TARN) Manchester, to construct valid numerators and denominators so that we can calculate population-based rates of major injury in the future. ⋯ Large national trauma registries, including TARN, hold suitable data for determining population-based injury rates. Patient postcodes from hospital discharge allow identification of denominator populations using a market area approach.