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PubMed2005

Using project management methodology to plan and track inpatient care.

BACKGROUND: Effective care of each patient throughout a hospital admission involves executing a specific set of tasks to produce a favorable outcome within an appropriate time frame. The ProjectRounds methodology, which can be implemented using widely available software, incorporates the principles of project management in planning and control hospital inpatient care. It consists of four stages--clinical assessment, planning, scheduling, and tracking. OVERVIEW OF PROJECTROUNDS AND EXAMPLE: As an example, a 68-year-old-man is admitted with pneumonia. In clinical assessment, the admitting physician uses an assessment tool that prompts her to list all the patient's clinical issues, define the conditions that need to be met to discharge the patient, highlight special problems, and list any consultations, diagnostic tests, and procedures that are planned. In planning, the work breakdown structure--a tabulation of all the tasks in the "project" (the admission)--is created. In scheduling, a project schedule is generated, and in tracking, the clinical team evaluates and monitors the project's course. During interdisciplinary clinical rounds, the progress of the patient's hospital care can be tracked and quantified by employing the percent complete method. Tracking can be used as a "dashboard," providing a concise summary of the care that needs to be and has been rendered to the patient. SUMMARY AND NEXT STEPS: Applying the tenets of project management can optimize the process of providing health care to hospital inpatients.

Aged↗
PubMed2000

Electrochemical treatment of tumours.

The electrochemical treatment (EChT) of tumours implies that tumour tissue is treated with a continuous direct current through two or more electrodes placed in or near the tumour. The treatment offers considerable promise of a safe, simple and relatively noninvasive anti-tumour therapy for treatment of localised malignant as well as benign tumours. Although more than 10,000 patients have been treated in China during the past 10 years, EChT has not yet been universally accepted. The reason for this is the lack of essential preclinical studies and controlled clinical trials. Uncertainties regarding the destruction mechanism of EChT also hinder the development of an optimised and reliable dose-planning methodology. This article reviews the collected Chinese and occidental experiences of the electrochemical treatment of tumours, alone and in combination with other therapies. The current knowledge of the destruction mechanism underlying EChT is presented along with different approaches towards a dose planning methodology. In addition, we discuss our view of different important parameters that have to be accounted for, if clinical trials are to be initiated outside of China.

Animals↗
PubMed1999

Prediction of parental dominance combinations for planned matings, methodology, and simulation results.

Optimal use of dominance information requires a mating system and predictions of specific combining abilities for each set of prospective parents. Current evaluation procedures provide such predictions only for a limited number of parents. A procedure is described that predicts the specific combining ability for any parents. In this procedure, for each set of parents and their ancestors, the additive relationship matrix is created as a dense matrix. This matrix is then used to create a parental dominance matrix in a sparse matrix form, in which the rows of the matrix correspond to all parental combinations for which predictions are already available. Each new prediction requires a solution of the system of equations with the parental dominance matrix as the left-hand side. The efficiency of the mating system that accounts for dominance was evaluated in a simulation study. The simulated data files varied with respect to proportion of males and females selected, proportion of cattle born through embryo transfer, and additive and dominance variance. Sires and dams were preselected based on the additive merits only, but specific matings were arranged based on the combined additive plus dominance merit. The response to selection with consideration of dominance increased from 3.8 to 16.6% of the response from one generation of additive selection. The response was greater when the additive variance was smaller, the dominance variance was larger, the intensity of additive selection was lower, and the proportion of full sibs was greater. Use of dominance in the mating system is feasible and results in an additional genetic response to selection.

Animals↗
PubMed1993

Service management.

Superior service is the outcome of a dedicated planning methodology. Medical groups that plan and manage for patients' service needs will achieve market differentiation, enjoy enhanced levels of staff development and motivation and improve long-term financial performance. Medical groups that ignore the importance of service excellence will find themselves trailing those groups that provide superior service to their patients.

Consumer Behavior↗
PubMed1990

Surveillance methodology for planning, and evaluation of nutritional states.

In developing countries in general, malnutrition has been widely reported as a major public health problem. Most of morbidity and mortality in these countries especially in the under fives are attributed to nutritional deficiencies at least in part. However, documentation of malnutritional problems in these countries is inadequate for monitoring, planning and coordination of control programmes. The data that is collected in few instances where this is accomplished is insufficient for a meaningful analysis. This paper suggests some simple epidemiological techniques which could be routinely employed using the existing health personnel to monitor and document temporal trends and types of data required for useful understanding of the problem.

Adolescent↗