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Biomedical subjects

T Pyne

Publications and source records attributed to T Pyne.

9 recordsLinked to original sources
PubMed1999

Meeting the information needs of clinicians for the practice of evidence-based healthcare.

This article reports on clinicians' use of library resources and the competencies they require to access information necessary for the practice of evidence-based healthcare. It is based on the results of a study commissioned by North Thames Region to identify the training needs of clinicians for the adoption and practice of evidence-based healthcare. Participants in this qualitative research study included librarians, clinicians (doctors, nurses and PAMs) and managers from four Acute and Community Trusts in and around London. The research indicates that the majority of clinicians recognize the need to keep up-to-date with changes in their specialty and many visit their libraries on a frequent basis, however, few appear to be searching for information with which to inform their immediate clinical decisions. Our sample acknowledged their low usage of journals such as Bandolier, the Health Effectiveness Bulletin and Journal of Evidence-Based Medicine. Similarly, low use of electronic databases, such as Cochrane and Cinahl, were reported. Examination of skill and self-efficacy levels in accessing and using information databases revealed wide variations across professions, specialities and Trusts. Qualitative research methods were employed to elicit the key competencies required to access clinically relevant research evidence, and a framework for integrating these competencies is presented.

Administrative Personnel↗
PubMed1998

Managing evidence-based health care: a diagnostic framework.

This paper proposes a diagnostic framework useful to Trust managers who are faced with the task of devising and implementing strategies for improvements in clinical effectiveness, and is based on a recent study incorporating clinicians, managers, and professional staff in four NHS Trusts in the North Thames Region. The gap framework is inspired by the gap model developed by Zeithaml, Parasuraman and Berry from their research into service quality and incorporates Dave Sackett's schema as well as a personal competency profile needed for the practice of evidence based health-care (EBHC). The paper highlights the four organisational and personal failures (gaps) which contribute to the fifth gap, namely the discrepancy between clinically relevant research evidence and its implementation in health care. To close the gaps, Trusts need to set the goal and tackle the cultural, organisational, attitudinal and more material aspects such as investment in the information infrastructure, education and training of doctors. Doctors need to go through a process from awareness to action facilitated through a combination of personal and organisational incentives and rewards as well as training in the requisite skills. Researchers should take steps to improve the quality of the evidence and its accessibility and purchasers should reinforce the use of EBHC by withdrawing funding for care which has proved to be ineffective, inappropriate or inferior.

Awareness↗
PubMed1996

Quality matters: junior doctors' perceptions.

Presents the results of an empirical study of junior doctors' views on quality and clinical audit in health care. Claims that the requirement for annual efficiency gains and rising patient expectations, together with the realization that the "costs of quality" can consume between 30 and 50 per cent of costs, has brought quality in health care to the forefront. In this context, and because much of the medical care is delivered by junior doctors, studies their perceptions on dimension of quality in health care, their knowledge of, and participation in, clinical audit and the obstacles to providing quality care. Makes a striking finding--the low priority given to patient satisfaction--a perspective which is out of alignment with the priorities of government policy, and the whole philosophy of "quality in service". Asserts that the role, significance and outcome of clinical audit as a quality improvement tool is cast into doubt by these consultants of tomorrow.

Attitude of Health Personnel↗
PubMed1996

Junior doctors and management: myth and reality.

Uses an empirical investigation based on a survey of junior doctors in five NHS trust hospitals, to examine their attitudes towards both the general principle of clinical involvement in hospital management and the particular prospect of exercising such a role themselves. Finds that junior doctors, with few exceptions and irrespective of grade, were very positive towards clinical management roles in NHS trusts and were almost universally keen to assume management responsibilities when they were more senior. At the same time, finds junior doctors to have little concept of the doctor manager role or the recognized and demanded specific preparation for assuming management responsibilities.

Attitude of Health Personnel↗
PubMed1994

The pre-registration year. It's time for job reprofiling.

The pre-registration house officers' year has a dual purpose. On the one hand, there is the basic service requirement for long hours of routine assistance to senior medical staff. On the other hand, there is the educational component of the job as seen in the GMC and post-graduate deans' objectives. Reports on a study which shows there is considerable tension between these two objectives. Examines the extent and nature of this divergence. Suggests that there are two problems to be addressed: how best to generate a sense of ownership and affinity to the trust hospital, and even more fundamental, requires a strategic audit and reappraisal of the purpose of the pre-registration year and strongly suggests the desirability of reprofiling it in order to provide a rich working experience and learning environment.

Data Collection↗
PubMedDate not supplied

AIDS: an update.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗