The use of hypnosis in audiologic assessment.
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Biomedical subjects
Publications and source records attributed to M L Allen.
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Esophageal motility testing is the method of choice in evaluating esophageal motor disorders. Some physicians, however, question the clinical utility of esophageal motility testing, since the results are often normal in symptomatic patients. The clinical utility of esophageal motility testing is reviewed for patients with a complaint of noncardiac chest pain, dysphagia or symptoms of gastroesophageal reflux disease. Esophageal motility testing is particularly useful for evaluating patients with dysphagia, but less so for gastroesophageal reflux disease patients, and has little clinical utility in patients with noncardiac chest pain.
The Internet links together millions of computers to share a wide variety of information--words, sounds and images--which makes it ideally suited for applications in diagnostic imaging departments. Timely availability of patient information is critical to patient care. In the form of a report, image or both, information is the final product of every imaging department. Internet applications can allow physicians easy access to and review of patient information. Many imaging departments already have the basic components of Internet technology in place, which may include an existing image distribution network. At the University of Kansas Medical Center (UKMC), we had a good network base and digital digitation and distribution system, but had not found an appropriate PACS for image distribution and display. When a home page was designed for the radiology department at UKMC, it was intended for report distribution. However, we quickly discovered that it could also function as a low-cost/low-resolution image distribution system. Before making confidential patient information accessible on the Internet, appropriate information security requirements must be in place. At UKMC, access is strictly controlled through the medical records department. Programmers in the radiology department at UKMC are also using the Internet to develop applications for on-line review, editing and electronic signature. Early experience with the Internet as a basis for radiology image and report distribution has been extremely successful and popular with referring physicians at UKMC.
In healthcare, competency assessment continues to be a concern. Even the JCAHO stresses its importance, along with ongoing education for employees. Many healthcare facilities have developed specific technical-competency requirements to ensure quality of service. The leadership at the University of Kansas Hospital (UKMC) wanted to develop a value-driven performance review process that focused on values and interpersonal skills for its employees. The current set of values lacked focus on key quality, behavior and service values, and it was felt employees had not committed to these values. A task force, made up of representatives from key hospital groups, was formed to create a process that would emphasize and assess key leadership skills and values. This team discussed various review mechanisms, including Micheli's 360-degree review process, which uses various sources (supervisors, colleagues and peers, for example) to give input that will be broader and more comprehensive of employee performance. The team incorporated such key leadership expectations as visioning, empowering, modeling, communication, stewardship and self-development into the tool. Called Leadership Enhancement And Development (LEAD), the tool could be completed by a peer, supervisor, direct report or even used for self-review. Results were kept confidential through the use of numbers and letters yet could be incorporated into a spreadsheet for analysis. Starting with managers and supervisors, the process has been piloted in a few larger departments at UKMC where it has been well received. Over time, the process will be used for all employees where it will continue to stress the importance of hospital values and commitment to patients and other employees.
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