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At least 829 records · Page 46Linked to original sources
PubMed2005

Who's got what? A benchmarking exercise for tertiary neonatal units.

OBJECTIVES: To determine the current facilities available in level-3 neonatal units (NNU) in Australia and New Zealand to assist with establishment of standards for new NNU design. BACKGROUND: Many current NNU in Australia and New Zealand are planning new or redesigning existing facilities. There are no adequate local standards for NNU design available which reflect changing neonatal practices. METHODS: All level-3 neonatal units belonging to the Australia and New Zealand Neonatal Network (ANZNN) were invited to respond to a survey on NNU facilities. Questions were based around obtaining information on whether the NNU were planning to build or redesign the space and clinical facilities available in their existing facilities and what support and family spaces were provided. RESULTS: Twenty-six (six in New Zealand and 20 in Australia) of the 29 tertiary NNU in the ANZNN responded the survey. The oldest facility was built in 1960, with the most recent NNU being commissioned in 2003. Of the 26 responders, 18 indicated that they were planning to rebuild or renovate, with 13 anticipating completion within 6 years. The median floor area for existing level-3 cots was 11.1 m(2) (range 5.5-18.0 m(2)) and 5.8 m(2) (range 2.3-15.6 m(2)) for level-2 cots, respectively. Most units responded that storage space was insufficient (median 1.5 m(2) per cot, range 0.4-3.3 m(2) per cot). Most units had facilities for parents including a family lounge and parent overnight rooms, although 16 units indicated that they needed more overnight rooming in facilities. Noise levels in level-3 areas were described as being 'generally' or 'mostly noisy' in 14 of 25 responses, but noise levels in level-2 areas were less in the majority of responses. Privacy was cited as an issue for 80% of responding NNU with comments directed at either the layout or space constraints interfering with confidentiality or interactions with families. CONCLUSIONS: The majority of NNU have inadequate space and environmental control. The lack of space particularly impacts on infection control aspects, parental privacy and participation and staff satisfaction. Level-2 areas, where parent participation in the care of infants is often greater, should receive as much attention as higher technology level-3 areas. Furthermore, work should be undertaken to develop appropriate local recommendations for NNU design which are acknowledged by local government agencies and professional bodies and take into account the changes in neonatal care practices, integration of family in the care of infants and the needs of the staff.

Australia↗
PubMed2003

Benchmarking beam alignment for a clinical helical tomotherapy device.

A clinical helical tomotherapy treatment machine has been installed at the University of Wisconsin Comprehensive Cancer Center. Beam alignment has been finalized and accepted by UW staff. Helical tomotherapy will soon be clinically available to other sites. Clinical physicists who expect to work with this machine will need to be familiar with its unique dosimetric characteristics, and those related to the geometrical beam configuration and its verification are described here. A series of alignment tests and the results are presented. Helical tomotherapy utilizes an array of post-patient xenon-filled megavoltage radiation detectors. These detectors have proved capable of performing some alignment verification tests. That is particularly advantageous because those tests can then be automated and easily performed on an ongoing basis.

Benchmarking↗
PubMed2001

Benchmarking: the five year outcome of rheumatoid arthritis assessed using a pain score, the Health Assessment Questionnaire, and the Short Form-36 (SF-36) in a community and a clinic based sample.

BACKGROUND: Treatment, and therefore outcome, of rheumatoid arthritis (RA) will improve in the next few years. However, improvement in outcome can only be judged against the probability of certain outcomes with current conventional treatment. AIM: To document the five year outcome of RA in the late 1990s. SETTING: Norfolk Arthritis Register (NOAR). DESIGN: Longitudinal observational cohort study. METHODS: 318 patients with recent onset inflammatory polyarthritis recruited by NOAR in 1990-91 completed five years of follow up. Four groups were assessed: the whole cohort, all those referred to hospital, those who satisfied criteria for RA at baseline, and those referred to hospital who satisfied criteria for RA at baseline. Outcome was assessed with a visual analogue scale for pain, the Health Assessment Questionnaire (HAQ), and the Short Form-36 (SF-36). RESULTS: Of the RA hospital attenders, 50% had a visual analogue scale pain score of 5 cm or less and an HAQ score of 1.125 or less. SF-36 scores were reduced in all domains. Results are presented as cumulative percentages. CONCLUSIONS: These results can be used for comparison and to set targets for improvement.

Adult↗
PubMed2001

A simple benchmark for evaluating quality of care of patients following acute myocardial infarction.

OBJECTIVE: To develop a simple risk model as a basis for evaluating care of patients admitted with acute myocardial infarction. METHODS: From coronary care registers, biochemistry records and hospital management systems, 2153 consecutive patients with confirmed acute myocardial infarction were identified. With 30 day all cause mortality as the end point, a multivariable logistic regression model of risk was constructed and validated in independent patient cohorts. The areas under receiver operating characteristic curves were calculated as an assessment of sensitivity and specificity. The model was reapplied to a number of commonly studied subgroups for further assessment of robustness. RESULTS: A three variable model was developed based on age, heart rate, and systolic blood pressure on admission. This produced an individual probability of death by 30 days (P(30)) where P(30) = 1/(1 + exp(-L(30))) and L(30) = -5.624 + (0.085 x age) + (0.014 x heart rate) - (0.022 x systolic blood pressure). The areas under the receiver operating characteristic curves for the reference and test cohorts were 0.79 (95% CI 0.76 to 0.82) and 0.76 (95% CI 0.72 to 0.79), respectively. To aid application of the model to routine clinical audit, a normogram relating observed mortality and sample size to the likelihood of a significant deviation from the expected 30 day mortality rate was constructed. CONCLUSIONS: This risk model is simple, reproducible, and permits quality of care of acute myocardial infarction patients to be reliably evaluated both within and between centres.

Adult↗
PubMed2000

Benchmarking general practice use of pathology services: a model for monitoring change.

AIMS: To identify a model to assess general practitioner use of pathology services that could be applied to assess specific interventions designed to promote best practice. METHODS: A database containing standardised requesting data for 22 general practices was constructed. The database contained 28 tests covering 95% of general practitioner activity, distributed across pathology, and it was evaluated during two sequential six month periods. A comparison of ranks of requesting activity between different time periods was undertaken by calculating Pearson rank correlation coefficients. Requesting numbers were also adjusted for patients' age and sex distributions within the 22 practices for a sample of three high volume tests. The effects of distributing requesting guidelines and details of requesting activity were assessed during two sequential three month periods. RESULTS: Requesting activity was extremely stable during the two baseline periods for most test (r > 0.80 for 20 of the 28 tests). Several less discriminatory tests were identified. Age and sex adjustment had minimal impact on the ranks of requesting activity. Requesting activity during the two three month periods after distributing guidelines and comparative details of individual requesting activity showed little change (overall correlation coefficient, 0.844 between baseline and intervention periods). CONCLUSIONS: Ranking general practitioners requesting activity adjusted for practice list size provides a reproducible means of measuring requesting activity for most pathology tests performed in general practice. Activity was not influenced by age or sex of patients on the practice list. Distributing requesting guidelines and individual requesting activity on their own do not have any measurable impact on requesting activity. More innovative (possibly multiple) interventions might be required to influence general practitioner requesting practice.

Age Factors↗
PubMed2001

How many chaplains per 100 inpatients? Benchmarks of health care chaplaincy departments.

Reports the results of a questionnaire survey of a sample of chaplaincy departments directors (N = 370) designed to answer the following questions: How many chaplains do various types of hospitals employ per 100 inpatients? What is the relationship between the number of employed chaplains and departmental Clinical Pastoral Education (CPE) programs? How much effort do departments give to outpatient ministry? What percentage of ministry do volunteer chaplains provide? Provides tentative answers to inform the strategic planning processes of chaplains and administrators.

Benchmarking↗
PubMed2001

Benchmarking to the world's best in mathematics. Quality control in curriculum and instruction among the top performers in the TIMSS.

UNLABELLED: This article describes the education quality control systems (for mathematics) used by those countries that performed best on the Third International Mathematics and Science Study (TIMSS). Enforced quality control measures are defined as "decision points"--where adherence to the curriculum and instruction system can be reinforced. Most decision points involve stakes for the student, teacher, or school. They involve potential consequences for failure to adhere to the system and to follow the program at a reasonable pace. Generally, countries with more decision points perform better on the TIMSS. When the number of decision points and TIMSS test scores are adjusted for country wealth, the relationship between the degree of (enforced) quality control and student achievement appears to be positive and exponential. CONCLUSION: The more (enforced) quality control measures employed in an education system, the greater is students' academic achievement.

Benchmarking↗