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Biomedical subjects

R Eldar

Publications and source records attributed to R Eldar.

At least 19 recordsLinked to original sources

[Concerted action program for quality assurance of European community hospitals as applied in Israel].

The concerted action program on quality assurance (QA) of the European Community (COMAC) was implemented in 14 hospitals in Israel. It was focused on prevention of pressure sores, preoperative assessment, prophylactic use of antibiotics in elective surgery and proper keeping of medical and nursing records. Mechanisms for quality assessment and interventions for improvement and monitoring were implemented. Improvement in QA infrastructure, processes of care in the project topics, and in QA awareness were found. Management involvement, previous motivation for professional improvement, behavioral strategies for change and having highly respected QA leaders were found to contribute to the development of effective QA. Professional associations and national authorities should be responsible for establishing support systems as well as promoting legislation, formulating guidelines, recommending allotment of resources, and developing educational programs.

Europe

Assessment chart for inpatient rehabilitation following stroke.

In order to enable comparison of the post-stroke patient's functional status between different points during the rehabilitation process, an assessment chart was developed; this covered cognitive, basic and integrated functions. The chart was applied by two independent examiners on 36 patients, with a mean age of 60, admitted consecutively for rehabilitation following stroke. The results of the assessment using the chart were compared with those measured with the Kenny Self Evaluation System. There was a positive correlation both between the Kenny System and the developed chart and the two examiners. It is felt that the chart meets the demands of easy applicability, numerical scoring and comprehensiveness. It is sufficiently sensitive to reflect the progress of patients during rehabilitation and enables re-evaluation of initial treatment plans focusing on the needs of the individual patient. The developed chart may serve as a useful tool in the evaluation of stroke inpatients during their rehabilitation.

Activities of Daily Living

[The road accident epidemic].

Nearly 23,000 persons were injured in 1988 on our country's roads. Of these, some 500 were killed and 3600 severely injured. Despite the magnitude of the problem, the health care system is not sufficiently effective in the field of road accident prevention and mitigation of the human damage, nor is it sufficiently involved in the work of organizations active in these fields. There is an urgent need to establish a health authority in this area, linked to the Ministry of Health, consisting of experts from clinical and academic institutions and representatives of the medical profession. This authority should be responsible for the coordination, initiation and implementation of all health and medical activities in the field of road accident prevention and in improving the care rendered the victims.

Accidents, Traffic

The quality of antihypertensive care.

The study involved 82 hypertensive patients under 65 years of age who suffered a stroke and did not have other risk factors for stroke but high blood pressure. The purpose of the study was to disclose possible deficiencies and to indicate areas for improvement in providers' practices. The process and intermediate outcome of care were judged to be satisfactory in only 4 patients out of the 75 known as hypertensives prior to the stroke (5.2%). There was no association between the structure of care and its process or outcome. The findings of the study are being used in the efforts to improve practices. It is suggested that the described approach could be applied by rehabilitation medicine to assessments of quality of care of conditions known to be risk factors of impairments that lead to disabilities, thereby contributing to quality assurance and disability prevention.

Adult

Patient assessment of care in a pain management unit.

Seventy individuals, 40 females and 30 males with a mean age of 58.5, suffering from protracted pain and associated incapacitation (due, mainly, to rheumatoid or osteoarthrotic conditions) were treated as outpatients with the purpose of relieving their pain and improving their function. The quality of care provided was evaluated based on the outcome approach, using patient assessment of the reduction of their pain and improvement of their limitations--complemented by the assessment of the physician who treated them--and their satisfaction with the care as the measurements of their assessments. The results of the assessment indicate that on completion of treatment 23% of patients had no pain, while the pain level of the rest decreased by 64% with only three still suffering from severe pain and none from very severe pain. In the majority of patients considerable improvement of the associated functional limitation was achieved. There was a high degree of satisfaction with care received in 90% of patients.

Adult

Diagnostic radiology in disaster medicine: implications for design, planning and organization of X-ray departments.

Diagnostic radiology plays an important role in the evaluation of disaster casualties; these are referred to X-ray departments, shortly after their arrival at hospital, in large numbers, frequently overwhelming facilities and resources of the department. The study of relevant literature and the experience of the authors suggest that there are implications for design, planning and organization of X-ray departments to be considered in disaster-prone areas. Departments should be sited as near as possible to triage areas, on the same floor, with broad, unobstructed passages. There should be provision for easy passage of equipment and trolleys through doors and corridors and large circulation areas, working rooms and waiting spaces with plugs, for electricity, piped oxygen and suction and devices for hanging infusion sets. Two entrances to the department would enable one-way flow through the department. All work should be done in the department and examinations performed with mobile units avoided. A radiologist at the entrance to the department and a control post at the exit ensure adequate processing of casualties. Interpretation and reporting should be done by assigned radiologists dictating directly to typists; films and reports should accompany casualties.

Disaster Planning

Preference of hospital employees for work-related outcomes.

A list of five possible work-related outcomes was compiled and included in a questionnaire. This was administered to 490 employees, categorized into seven occupational groups, in three different hospitals in Manila, The Philippines. Responses were compared among work outcomes, identical occupational groups and three hospitals; the most valued outcome was established for all respondents. Findings indicate that variables apt to motivate employees depend on the occupational group to which they belong, the kind of work they perform and the type of hospital in which they work. These findings have implications for the ability of hospital administrators to motivate their employees to perform in a manner that meets expected standards.

Career Mobility

Reuben Eldar.

Explore the source record for details and available documents.

Climate

The medical severity index of disasters.

In 1980 an international working party postulated a definition for a disaster. Later this concept was formulated into a classification and scoring system. This system has now been refined to be used prospectively during the management stage of a calamity. By calculating the medical severity index, which is the product of the casualty load and the severity of the incident, and comparing this figure with the available total capacity of the medical services, which is the medical rescue capacity, the medical transport capacity and the hospital treatment capacity, the dispatcher at the control center can fairly quickly and precisely identify if a calamity is to be regarded as a disaster or not and if the region can cope with the situation. Moreover a calculation of the hospital treatment capacity in the region could serve as a guideline for estimation of the dimensions needed for the medical rescue capacity and medical transport capacity when planning how to deal with a disaster.

Disaster Planning

Preparation of a hospital rehabilitation system for war and other disasters.

A large number of casualties caused by war are in need of medical rehabilitation. Rehabilitation facilities are unable to cope adequately with them without advance planning and preparedness. Guidelines are suggested for the planning and preparation of a hospital rehabilitation system for war, including the formulation of policies, expanding and strengthening of existing rehabilitation facilities, and converting institutions, as well as securing the necessary human and material resources. It is also suggested that such plans and preparations should be adapted to form a basis for meeting rehabilitation needs caused by natural and civil disasters.

Disaster Planning