This study describes an Australian emergency department's (ED) experience with a quality improvement methodology from the USA. The Institute for Health Care Improvement (IHI) conducts collaboratives between clinical groups with similar interests, in this case ED. Their quality improvement model is described. Our involvement with the IHI showed the model to be transferable outside the USA. In applying the model to operational and clinical projects we were successful in meeting our goals to reduce clinical times: for time to analgesia (P= 0.34), time to thrombolysis (P= 0.30) and time to antibiotics in neutropenic patients (P= 0.015). We were unable to reach statistical significance in improvements due to the small sample sizes and sampling techniques. Changes in operational times were not clinically significant but almost reached statistical significance (e.g. median total length of stay in the ED fell 4 min (P= 0.06)). The near statistical significance of a small change was due to the large numbers of patients sampled.

Academies and Institutes↗

PubMedDate not supplied

Temporality across the life-span.

In seven studies, 7300 U.S., 891 Iranian, 534 Indian, and 216 Ghanaese persons aged four to ninety-nine were interviewed regarding their consciousness. For U.S. nationals: (a) at any given moment, persons were most apt to be thinking about the present and least apt to be thinking about the past, (b) frequency of future-orientation declined while, (c) frequency of present-orientation inclined with age, (d) in "typical thought" persons generally thought further into the future (a few months) than into the past (a few weeks), but (e) regarding those things that persons often think about that have or are yet to occur, they thought further into the past (5 years) than into the future (a year), (f) frequency of future-orientation did not vary as a function of social class, while degree of claimed planfulness was greater among the higher social class, and (g) claimed planfulness was curvilinearily related to age, with those aged eighteen through thirty-nine scoring highest. There were cross-national differences.

Adolescent↗