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PubMed2002

The OECD pilot project of mutual joint visits: state of the art and need for further action.

This paper describes the ongoing pilot project to examine the organisation and procedures of the 33 national good laboratory practice (GLP) compliance monitoring programmes in OECD to determine the extent to which they comply with the recommendations of the 1989 Council Decision-Recommendation on compliance with GLP. The project is based on mutual joint visits (MJV) of peer review teams representing other monitoring authorities. At the time of this paper all 33 MJV had been completed and the reports were being reviewed by the OECD Working group on GLP. A full evaluation of the pilot project will take place in 2002, after which a policy decision will be made regarding the need to continue such a programme and in what form.

Clinical Laboratory Techniques↗

PubMed1998

Challenges of developing a cervical screening information system: the Ontario pilot project.

OBJECTIVE: To create a cervical screening information and reporting system in 2 geographic areas of Ontario. DESIGN: A pilot project involving access to, and linkage of, cervical screening-related cytology, colposcopy and histopathology records for women in the study areas, followed by development and production of woman-specific and aggregate reports. SETTING: Hospital cytology and pathology departments, colposcopy clinics, private cytology laboratories, and the provincial cancer agency (Cancer Care Ontario, formerly the Ontario Cancer Treatment and Research Foundation). MAIN OUTCOME MEASURES: Access to required records; data quality (i.e., standardization, completeness, accuracy); quality of record linkage; utility of reports to evaluators, data sources and physicians. RESULTS: The pilot project was not completed because of a number of major challenges, including multiple data sources requiring separate investigation and negotiations for access; variations in reporting terminology and coding; incompatibility or lack of computer systems; incompleteness of identifiers for record linkage; variation in legislation permitting data access and sharing and in its interpretation; and major financial, resource and time requirements. CONCLUSIONS: Although sufficient will and resources can overcome technical obstacles, changes in legislation will be required to overcome other challenges. Strong links with all sectors involved in cervical screening and attention to changes in the health care system are essential.

Colposcopy↗

PubMedDate not supplied

Geophysical monitoring of a field-scale biostimulation pilot project.

The USGS conducted a geophysical investigation in support of a U.S. Naval Facilities Engineering Command, Southern Division field-scale biostimulation pilot project at Anoka County Riverfront Park (ACP), down-gradient of the Naval Industrial Reserve Ordnance Plant, Fridley, Minnesota. The goal of the pilot project is to evaluate subsurface injection of vegetable oil emulsion (VOE) to stimulate microbial degradation of chlorinated hydrocarbons. To monitor the emplacement and movement of the VOE and changes in water chemistry resulting from VOE dissolution and/or enhanced biological activity, the USGS acquired cross-hole radar zero-offset profiles, travel-time tomograms, and borehole geophysical logs during five site visits over 1.5 years. Analysis of pre- and postinjection data sets using petrophysical models developed to estimate VOE saturation and changes in total dissolved solids provides insights into the spatial and temporal distribution of VOE and ground water with altered chemistry. Radar slowness-difference tomograms and zero-offset slowness profiles indicate that the VOE remained close to the injection wells, whereas radar attenuation profiles and electromagnetic induction logs indicate that bulk electrical conductivity increased down-gradient of the injection zone, diagnostic of changing water chemistry. Geophysical logs indicate that some screened intervals were located above or below zones of elevated dissolved solids; hence, the geophysical data provide a broader context for interpretation of water samples and evaluation of the biostimulation effort. Our results include (1) demonstration of field and data analysis methods for geophysical monitoring of VOE biostimulation and (2) site-specific insights into the spatial and temporal distributions of VOE at the ACP.

Environmental Monitoring↗

PubMed2000

Public library consumer health information pilot project: results of a National Library of Medicine evaluation.

In October 1998, the National Library of Medicine (NLM) launched a pilot project to learn about the role of public libraries in providing health information to the public and to generate information that would assist NLM and the National Network of Libraries of Medicine (NN/LM) in learning how best to work with public libraries in the future. Three regional medical libraries (RMLs), eight resource libraries, and forty-one public libraries or library systems from nine states and the District of Columbia were selected for participation. The pilot project included an evaluation component that was carried out in parallel with project implementation. The evaluation ran through September 1999. The results of the evaluation indicated that participating public librarians were enthusiastic about the training and information materials provided as part of the project and that many public libraries used the materials and conducted their own outreach to local communities and groups. Most libraries applied the modest funds to purchase additional Internet-accessible computers and/or upgrade their health-reference materials. However, few of the participating public libraries had health information centers (although health information was perceived as a top-ten or top-five topic of interest to patrons). Also, the project generated only minimal usage of NLM's consumer health database, known as MEDLINEplus, from the premises of the monitored libraries (patron usage from home or office locations was not tracked). The evaluation results suggested a balanced follow-up by NLM and the NN/LM, with a few carefully selected national activities, complemented by a package of targeted activities that, as of January 2000, are being planned, developed, or implemented. The results also highlighted the importance of building an evaluation component into projects like this one from the outset, to assure that objectives were met and that evaluative information was available on a timely basis, as was the case here.

Computers↗

PubMed1998

Teleradiology in KwaZulu-Natal. A pilot project.

OBJECTIVE: This was a pilot teleradiology project connecting two secondary KwaZulu-Natal hospitals' radiography departments to a central Durban teaching hospital. The purpose of the study was to assess the usefulness of same-day teleradiology reports to the medical staff and whether such a service changed patient management. DESIGN: After 1 month's service at each hospital, the first 200 teleradiology reports, original radiographs and patients' case notes were reviewed to determine whether any errors in interpretation of the radiographs had been made and whether the reports had changed patient management. RESULTS: The service changed patient management in 10% of cases. Undetected pathology was recognised by the radiologist in 20 patients--pulmonary tuberculosis in 10, spinal tuberculosis in 3, miliary tuberculosis in 2 and fractures in 5. Problems were encountered with transmission of data using the current telephone network, loss of data at the receiving station and the increased workload of the radiographer transmitting the data. CONCLUSIONS: Teleradiology services do make a positive impact on patient management in rural hospitals. However, there are many technical pitfalls that must be avoided in order to establish an effective service.

Hospitals, Rural↗

PubMed2005

Telegenetics in Maine: Successful clinical and educational service delivery model developed from a 3-year pilot project.

PURPOSE: The goal of this 3-year pilot project was to increase accessibility to genetics educational and clinical services in Maine. METHODS: Southern Maine Genetics Services, Foundation for Blood Research in collaboration with Maine Telemedicine Services established telemedicine capacity to link with rural health care centers located in Northern, Central, and Southern Maine and public health nursing statewide for the provision of genetics clinical and educational services. Core partners included a rural family practice residency program, a rural pediatric practice in northern Maine, and public health nurses statewide. The telegenetics model created was based on development and implementation of a preventive and medical management technology solution, conducting a pilot study to collect data, and approaching insurance companies for reimbursement. Evaluation included surveys on the quality, acceptability, and usefulness of genetics services delivered via telemedicine, telephone interviews, and decision-making confidence evaluations. RESULTS: During the project period, 24 rural clinical sites participated. In total, 93 presentations were given, and 125 patients were evaluated. Sixty-four percent of patients evaluated were pediatric. Despite site coordinator efforts to complete satisfaction surveys, the provider and patient response level was low (18% and 25%, respectively). Of those evaluations received, provider and patient response to telegenetics was positive. Decision-making confidence for genetics and neurology consultants was high. Our experience contributes to the development of telegenetics models that can be used in other rural states.

Genetic Counseling↗

PubMed1993

An appliance based approach to the management of palatopharyngeal incompetency: a clinical pilot project.

The palatal lift appliance has been described in the dental literature for more than 30 years, yet its efficacy remains controversial in the management of palatopharyngeal incompetency during speech. A pilot project was undertaken to develop a clinical research protocol. In the pilot project, 32 patients had palatopharyngeal incompetency managed with a palatal lift appliance. The results of the treatment were that 21 of the 32 patients experienced reduction programs but, of these, seven still required surgery. Before firm conclusions on the use of the palatal lift appliance can be made, objective, measurable assessment of speech through well-designed clinical protocols is required.

Acrylic Resins↗

PubMed2006

[Infection control and compliance with national recommendations among dentists in Frankfurt/M, Germany: results of a pilot project, 2005].

Recommendations for prevention of infection in dentistry have been published in many countries and in Germany as well. In a pilot project in collaboration with the Public Health Service of the City of Frankfurt and the chamber of dentists in Hesse, compliance with these recommendations was studied in dental practices in Frankfurt/M in 2005. After being informed about the recommendations, more than 50% of the 560 Frankfurt dentists agreed to participate in this project, and 127 of these practitioners were visited by experts of the dentist chamber. Hygienic standards in the practices were examined using a checklist. A proper hygiene schedule was observed in 84% of the practices. Facilities for hand hygiene such as dispensers for soap, disinfectant and towels were available in 98, 93 and 92% of the practices, and personal protective equipment such as gloves, masks, eye wear and gowns was found in 98, 100, 98 and 88% of the practices, respectively. Reprocessing of dental instruments was done either manually (52%), manually in combination with ultrasonic cleaning (48%) or by using special reprocessing machines (32%). Steam sterilization was used in all practices; in some practices gravity displacement sterilizers were used (14%), whereas in most of the practices (61%) a high-speed prevacuum sterilizer was available -- especially in dental surgeon practices (77%). Monitoring and documentation of the sterilization process was done automatically (33%) or by hand (55%). In 80% of the practices, pressure, temperature, time and person responsible were documented. Documents of routine maintenance and regular biological testing of the sterilizers could be shown in 93 and 84% of the practices. The Frankfurt pilot project based on information and advice in combination with control has proven to be successful in the majority of practices enrolled. Encouraged by this experience, the chamber of dentists wants to implement this project all over the state of Hesse. The intention is to inform and to visit all 4,500 dental practices in agreement with the local public health services, which in turn could reduce their own control visits in dental practices. Thus, hygiene control visits of the public health services could focus on other practices such as ambulatory surgery or endoscopy.

Attitude of Health Personnel↗

PubMed2003

Red palm oil as a source of vitamin A for mothers and children: impact of a pilot project in Burkina Faso.

OBJECTIVE: To demonstrate the effectiveness of the commercial introduction of red palm oil (RPO) as a source of vitamin A (VA) for mothers and children in a non-consuming area, as a dietary diversification strategy. DESIGN: A pre-post intervention design (no control area) was used to assess changes in VA intake and status over a 24-month pilot project. SETTING AND SUBJECTS: The pilot project involved RPO promotion in 10 villages and an urban area in east-central Burkina Faso, targeting approximately 10 000 women and children aged <5 years. A random sample of 210 mother-child (12-36-months-old) pairs was selected in seven out of the 11 pilot sites for the evaluation. RESULTS: After 24 months, RPO was reportedly consumed by nearly 45% of mothers and children in the previous week. VA intake increased from 235+/-23 microg retinol activity equivalents (RAE) to 655+/-144 microg RAE in mothers (41 to 120% of safe intake level), and from 164+/-14 microg RAE to 514+/-77 microg RAE in children (36 to 97%). Rates of serum retinol <0.70 micromol l(-1) decreased from 61.8+/-8.0% to 28.2+/-11.0% in mothers, and from 84.5+/-6.4% to 66.9+/-11.2% in children. Those with a lower initial concentration of serum retinol showed a higher serum retinol response adjusted for VA intake. CONCLUSIONS: Commercial distribution of RPO was effective in reducing VA deficiency in the pilot sites. While it is promising as part of a national strategy, additional public health and food-based measures are needed to control VA malnutrition, which remained high in the RPO project area.

Breast Feeding↗

PubMed2001

Early screening for dyslexia--a collaborative pilot project.

An ongoing collaborative project, currently being piloted in 12 Wiltshire primary schools, is described. The aim is to provide a means of identifying potentially dyslexic children by the end of Key Stage 1 (Year 2) with a view to early intervention. The causal links identified by research between phonological skills and literacy development are taken as the theoretical basis of an initial screening procedure, and an intervention package is implemented for identified children. Those demonstrating persistent difficulties one year later are further assessed over a school term using an assessment package designed to identify those children showing a dyslexic profile. Further intervention is then planned and implemented.

Child, Preschool↗

PubMed2002

Videoconferencing for continuing medical education: from pilot project to sustained programme.

Videoconferencing has been used to provide distance education for medical students, physicians and other health-care professionals, such as nurses, physiotherapists and pharmacists. The Dalhousie University Office of Continuing Medical Education (CME) has used videoconferencing for CME since a pilot project with four sites in 1995-6. Since that pilot project, videoconferencing activity has steadily increased; in the year 1999-2000, a total of 64 videoconferences were provided for 1059 learners in 37 sites. Videoconferencing has been well accepted by faculty staff and by learners, as it enables them to provide and receive CME without travelling long distances. The key components of the development of the videoconferencing programme include planning, scheduling, faculty support, technical support and evaluation. Evaluation enables the effect of videoconferencing on other CME activities, and costs, to be measured.

Attitude of Health Personnel↗

PubMed1996

Pilot project on functional outcome in stroke.

The purpose of this pilot project was to compare the outcome of stroke survivors cared for on an Acute Stroke Unit (ASU) to those who received care on a routine medical-surgical unit. The sample included a total of 88 patients, 68 admitted to an acute stroke unit and 20 admitted to a medical-surgical unit. The Functional Index Measure was used to assess in-hospital functional gains in the two groups. There appeared to be a trend toward increased functional gains in the group of stroke patients cared for on the Acute Strike Unit as compared to the group of patients cared for on medical-surgical units. These findings provide a foundation for neuroscience nurses and other health care professionals to study functional gains after stroke.

Activities of Daily Living↗

PubMed1988

An interdisciplinary clinic for neurogenically impaired adults: a pilot project for educating students.

The Interdisciplinary Rehabilitation Clinic was a pilot project to assess the feasibility and efficacy of providing university-based clinical practicum experiences for students in the Schools of Allied Health Professions and Social Welfare at the University of Wisconsin--Milwaukee. It was designed according to the medical model and was based on the Joint Commission on the Accreditation of Hospitals Standards for Rehabilitative Services. This program was based on the professional conviction that people who are expected to function in an interdisciplinary environment would be better able to do so if educated according to an interdisciplinary model. The Interdisciplinary Rehabilitation Clinic addressed the university mission of education, research, and service. It provided an opportunity to integrate theory with practice for students in a clinical setting; demonstrated to health professions students that both basic and applied research evolves from and contributes to clinical practice; and provided care for individuals deprived of needed rehabilitative services because of funding cuts and other changes in current health care service delivery systems. The clinic provided rehabilitative service in the form of speech, and occupational therapy, therapeutic recreation, and social work services to neurogenically impaired adults from the greater Milwaukee area. Student clinicians evaluated the patient's abilities/disabilities, were observed during the evaluation process by their fellow students, met in joint treatment planning teams, treated the patients, and performed hospital-simulated staffings. Medical record administration (MRA) students assessed and provided in-service on documentation practices, developed a record-keeping system, and designed forms.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2000

Evaluation of a pilot project to use computers in a rural general practice term.

In 1998, the Department of General Practice (Faculty of Medicine and Dentistry, University of Western Australia) ran a pilot project to use computers in a sixth year rural general practice term. Students were provided with a laptop computer to take into rural and remote areas throughout Western Australia during their 4-week clinical attachment. An email mailing list was set up for course participants to share experiences and complete set learning activities specifically related to rural general practice. An evaluation of this pilot project found that students felt less isolated on rural attachments, course outcomes were improved and rural preceptors were more involved in the programme. The development of a teaching and learning programme that involves the use of computers in rural general practice for undergraduate students has the potential to improve the quality of their medical education.

Education, Distance↗

PubMed1991

HCFA pilot project may bolster hospital-physician collaboration.

A new HCFA pilot project will probe the feasibility and cost-effectiveness of paying hospitals and physicians one negotiated package fee for coronary artery bypass surgery. If successful, the pilot may be expanded to other procedures, ultimately forcing hospitals and physicians to seek new avenues of negotiation to determine how to split the lump-sum payments. Find out how the hospital executives in this project negotiated with their physicians.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed2003

Claimant identification pilot projects. Final rules.

We are revising our regulations that pertain to the processing of initial claims for disability benefits under title II (Social Security Disability Insurance) and title XVI (Supplemental Security Income) of the Social Security Act (the Act). We will be conducting pilot projects wherein we will request photographic identification from individuals filing for title II and title XVI disability and blindness benefits in specified geographic areas covered by the pilot projects. In addition, we will require individuals to allow us to take their photograph and we will make these photographs a part of the claims folder. We will permit an exception to the photograph requirement when an individual has a sincere religious objection. This process will strengthen the integrity of the disability claims process by helping to ensure that the individual filing the application is the same individual examined by the consultative examination (CE) physician.

Confidentiality↗

PubMed1987

A clinical pharmacy-oriented drug surveillance network: II. Results of a pilot project.

A nationwide network of clinical pharmacists has been organized for the purpose of collecting drug experience data generated during the routine clinical care of patients. In order to assess the utility of this network a pilot project was performed to obtain a cross-sectional view of antibiotic utilization in the U.S. and to identify potential problems with a more widespread implementation of this program. One hundred eleven pharmacists enrolled in the drug surveillance network participated in this survey and collected information on more than 2000 patients treated with antimicrobial agents over approximately a three-month period (February-April 1987). The most common sites of infection were the lung, genitourinary tract, skin and soft tissue, and the abdomen, and accounted for approximately 75 percent of infections. Overall, the aminoglycosides, the first-generation cephalosporins, and the aminopenicillins remain the most commonly used antibiotics and represent approximately 50 percent of antimicrobials used in the surveyed population. The results of this pilot project suggest that the use of a nationwide network of clinical pharmacists is a promising source of clinically relevant drug experience data. The ability to concurrently evaluate patients and link information regarding patient demographics, drug therapy regimens, diagnosis, and clinical outcomes fills an important gap in our knowledge of clinical drug utilization.

Adult↗

PubMed1989

A pilot project of glaucoma in Barbados.

The prevalence of open-angle glaucoma is believed to be very high among West Indian blacks. To begin investigating the prevalence and risk factors for glaucoma and other eye diseases in Barbados, WI, a pilot study was conducted. The pilot project identified a stratified, random national sample of 300 persons over 35 years of age who were invited to participate in an ophthalmic examination and an interview. Of those contacted 89% were eligible and 95% of these agreed to participate. The overall glaucoma prevalence in the participants was 6%; it was 13% among black and mixed persons over 54 years. Age related cataract, hypertension, and diabetes were frequent findings. Although the sample size of the pilot project is small, the results suggest a high prevalence of glaucoma in Barbados, a finding that merits further study.

Adult↗