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Journal articles on the topic 'Physicians' Placement Service'

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1

Tseng, Joshua, Harry C. Sax, and Rodrigo F. Alban. "Variability in Critical Care–Related Charge Markups in Medicare Patients." American Surgeon 84, no. 10 (2018): 1622–25. http://dx.doi.org/10.1177/000313481808401017.

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Charge markups for health care are variable and inflated several times beyond cost. Using the 2015 Medicare Provider Fee-For-Service Utilization and Payment Data file, we identified providers who billed for critical care hours and related procedures, including CPR, EKG interpretation, central line placement, arterial line placement, chest tube/thoracentesis, and emergent endotracheal intubation. Markup ratios (MRs), defined as the amount charged divided by the amount allowable, were calculated and compared; 42.1 per cent of physicians billing for critical care–related services were specialized
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Jari, Irina, Alexandru G. Naum, Liliana Gheorghe, et al. "Granuloma of Silicone Breast Implants A case report and literature review." Revista de Chimie 70, no. 3 (2019): 940–42. http://dx.doi.org/10.37358/rc.19.3.7035.

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Silicone, a synthetic polymer containing the element silicon, has been used for breast implants. Complications resulting from the placement of silicone breast implants are becoming more frequent in clinical practice. Breast implant rupture is common and poses challenges for radiologists and physicians. Radiologists must be familiar with the normal and abnormal findings of common implants. Clinically apparent silicone granulomas are a relatively rare complication of breast implant placement and surgical resection is indicated when they are symptomatic or of diagnostic concern. The objective of
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Fok, Patrick T., David Teubner, Jeremy Purdell-Lewis, and Andrew Pearce. "Predictors of Prehospital On-Scene Time in an Australian Emergency Retrieval Service." Prehospital and Disaster Medicine 34, no. 03 (2019): 317–21. http://dx.doi.org/10.1017/s1049023x19004394.

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AbstractIntroduction:Prehospital physicians balance the need to stabilize patients prior to transport, minimizing the delay to transport patients to the appropriate level of care. Literature has focused on which interventions should be performed in the prehospital environment, with airway management, specifically prehospital intubation (PHI), being a commonly discussed topic. However, few studies have sought additional factors which influence scene time or quantify the impact of mission characteristics or therapeutic interventions on scene time.Hypothesis/Problem:The goal of this study was to
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Struck, Manuel Florian, Franziska Rost, Thomas Schwarz, et al. "Epidemiological Analysis of the Emergency Vascular Access in Pediatric Trauma Patients: Single-Center Experience of Intravenous, Intraosseous, Central Venous, and Arterial Line Placements." Children 10, no. 3 (2023): 515. http://dx.doi.org/10.3390/children10030515.

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Vascular access in severely injured pediatric trauma patients is associated with time-critical circumstances and low incidences, whereas only scarce literature on procedure performance is available. The purpose of this study was to analyze the performance of different vascular access procedures from the first contact at the scene until three hours after admission. Intubated pediatric trauma patients admitted from the scene to a single Level I trauma center between 2008 and 2019 were analyzed regarding intravenous (IV) and intraosseous (IO) accesses, central venous catheterization (CVC) and art
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Sunshine, Jonathan H., Rebecca S. Lewis, Barbara Schepps, and Howard P. Forman. "Data from a Professional Society Placement Service as a Measure of the Employment Market for Physicians." Radiology 224, no. 1 (2002): 193–98. http://dx.doi.org/10.1148/radiol.2241011150.

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Ng, Philip K., Mark J. Ault, and Lawrence S. Maldonado. "Peripherally Inserted Central Catheters in the Intensive Care Unit." Journal of Intensive Care Medicine 11, no. 1 (1996): 49–54. http://dx.doi.org/10.1177/088506669601100107.

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We report the success rate and complications of peripherally inserted central catheters (PICCs) in patients hospitalized in an intensive care unit (ICU). We performed a cohort study in the ICU of a large tertiary care, university-affiliated community hospital. All ICU patients for whom their attending physicians requested a PICC service consultation were included. Main outcome measurements included (1) the success rate for initial PICC placement, (2) the placement complication rate, and (3) the overall success and complication rate. Of the 91 consecutive attempts at PICC placement, 89 (97.8%)
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Baadh, Amanjit S., Stephen Rivoli, Jack Ansell, and Robert E. Graham. "Indications for Inferior Vena Cava (IVC) Filter Placement - Assessing Compliance with Accepted Standards Set by Two Professional Societies." Blood 116, no. 21 (2010): 2553. http://dx.doi.org/10.1182/blood.v116.21.2553.2553.

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Abstract Abstract 2553 Background: Inferior Vena Cava (IVC) filter placement has increased significantly over the past few decades, due to expanding indications for filter placement. Indications for filter placement vary widely depending on which professional society recommendations are followed. Our objectives were to record the number of IVC filters placed in our medium sized metropolitan teaching hospital, assess the effect of medical specialty on placement and evaluate compliance with accepted standards as set by the American College of Chest Physicians (ACCP) and the Society of Interventi
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Teitelbaum, Louise, Dorothy Cotton, M. Lynne Ginsburg, and Yousery H. Nashed. "Psychogeriatric Consultation Services: Effect and Effectiveness." Canadian Journal of Psychiatry 41, no. 10 (1996): 638–44. http://dx.doi.org/10.1177/070674379604101006.

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Objectives: To determine the nature of referrals to a psychogeriatric consultation/outreach service, the types of interventions provided, and the effects and effectiveness of the service. Method: The study used a prospective approach in which 67 consecutive patients referred for psychogeriatric assessment were followed up 6 to 8 weeks after the initial assessment and then again 6 months after initial contact. Patients were rated at the time of referral and at follow-up on presence of psychiatric diagnosis, need for institutional care, and placement outcome. Results: Of the 67 patients initiall
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Chow, Courtney, and Richard Rosenquist. "Trends in spinal cord stimulation utilization: change, growth and implications for the future." Regional Anesthesia & Pain Medicine 48, no. 6 (2023): 296–301. http://dx.doi.org/10.1136/rapm-2023-104346.

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Chronic pain impacts more than 100 million Americans and has a significant impact on the economy and quality of life. Spinal cord stimulation (SCS) has demonstrated efficacy in managing a growing number of chronic pain conditions. This in combination with an increasing number of physicians trained in SCS placement has produced significant changes in utilization, expense and sites of service related to SCS. In particular, there has been a large increase in SCS placement by non-surgeons, use of percutaneous leads and performance in ambulatory surgery centers instead of inpatient settings. There
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McLean, Karen, Harriet Hiscock, Dorothy Scott, and Sharon Goldfeld. "What is the timeliness and extent of health service use of Victorian (Australia) children in the year after entry to out-of-home care? Protocol for a retrospective cohort study using linked administrative data." BMJ Paediatrics Open 3, no. 1 (2019): e000400. http://dx.doi.org/10.1136/bmjpo-2018-000400.

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IntroductionChildren entering out-of-home care have high rates of health needs across all domains of health. To identify these needs early and optimise long-term outcomes, routine health assessment on entry to care is recommended by child health experts and included in policy in many jurisdictions. If effective, this ought to lead to high rates of health service use as needs are addressed. Victoria (Australia) has no state-wide approach to deliver routine health assessments and no data to describe the timing and use of health service visits for children in out-of-home care. This retrospective
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Wood, Teresa, Valerie Sabol, Jill Engel, Deborah H. Allen, Julie A. Thompson, and Tracey L. Yap. "Using an Electromagnetic Guidance System for Placement of Small-Bowel Feeding Tubes to Reduce Feeding Start Times." Critical Care Nurse 43, no. 1 (2023): 52–58. http://dx.doi.org/10.4037/ccn2023847.

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Background Cardiothoracic surgery patients have an increased risk for aspiration and may require enteral access for nutrition. Local Problem In a cardiothoracic intensive care unit, feeding start times were delayed because of scheduling conflicts with support services. An electromagnetic device (Cortrak 2 Enteral Access System, Avanos Medical) was introduced to allow advanced practice providers (nurse practitioners and physician assistants) to independently establish postpyloric access and reduce dependence on ancillary services. Methods A quality improvement study was performed. Pre- and post
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Rajasekhar, Anita, Hany Elmariah, Darwin Ang, Lawrence Lottenberg, Rebecca Beyth, and Richard Lottenberg. "Inferior Vena Cava Filters in Trauma Patients: A National Practice Pattern Survey of U.S. Trauma Centers." Blood 120, no. 21 (2012): 4249. http://dx.doi.org/10.1182/blood.v120.21.4249.4249.

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Abstract Abstract 4249 Background: Despite the paucity of randomized controlled trials and strong observational studies supporting the efficacy of inferior vena cava filters (IVCFs) in venous thromboembolism (VTE) prevention, indications for placement of IVCFs have increased. Further, evidence-based guidelines for removal of retrievable filters do not exist. The purpose of this study was to characterize contemporary IVCF practices in the prevention and management of VTE, and clarify the stakeholders in IVCF placement and retrieval among trauma centers across the United States. Methods: In Sept
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Noor Sameh, Darwich, Ugur Umran, Anstadt Mark P, and Pedoto Michael J. "Cerebral arterial air embolism with anterior spinal cord syndrome after CT-guided hook-wire localization of Lung mass and pulmonary nodule." Journal of Neuroscience and Neurological Disorders 5, no. 1 (2021): 006–15. http://dx.doi.org/10.29328/journal.jnnd.1001044.

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Systemic arterial air embolism (SAAE) is a rare but serious complication of CT-guided hook wire localization of pulmonary nodule usually with catastrophic and poor outcome. Hook wire needle localization is done pre-operatively by placing wire around or into the pulmonary nodule to provide the thoracic surgeon accurate location guidance of the target nodule for Video-Assisted Thoracoscopic Surgery (VATS) wedge resection with safety margins. Physicians should be aware of this possible complication during the procedure in order to rescue the patient promptly as it requires rapid diagnosis and man
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Atallah, Joseph. "Use of Eptifibatide as a Bridge Antiplatelet Agent for Intrathecal Drug Delivery System Placement." Pain Physician 6;15, no. 6;12 (2012): 479–83. http://dx.doi.org/10.36076/ppj.2012/15/479.

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Use of antiplatelet agents is becoming increasingly common, and their management may require new strategies if neuroaxial techniques are to be employed in patients who will not tolerate discontinuation of antiplatelet therapy. The patient was a 46-year-old man with a past medical history significant for coronary artery disease and who had undergone 14 stents. He developed stent thrombosis (ST) while on clopidogrel. Following the ST, he was subsequently placed on prasugrel. While on prasugrel, the patient presented for an intrathecal drug delivery system (IDDS) trial and placement due to severe
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Douglas-Ntagha, Pamela Bernice. "Redesigning the transfer center process to adapt to increasing demands for services." Journal of Clinical Oncology 30, no. 34_suppl (2012): 156. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.156.

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156 Background: Hospitals are faced with limited resources and a need to provide care to patients with the greatest needs. Methods: Develop a systematic approach for accepting external transfers to the appropriate setting of care based on clinical criteria Initiate communication between external physicians and accepting MDA (MD Anderson) physicians and ICU physicians as appropriate Identify a process for documenting clinical information to ensure appropriate and timely transfers to MDA Ensure policies and procedures align with EMTALA regulation. Results: MDA ICU physicians involved in the init
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Do, Thao Thi, Tri Minh Trinh, Thao Thi Phuong Tran, Van Thi Tuong Nguyen, and Lam Nguyen Le. "Clinical performance of computer-aided design/computer-aided manufacture lithium disilicate ceramic endocrown restorations: A 2-year study." Journal of Conservative Dentistry and Endodontics 27, no. 1 (2024): 51–56. http://dx.doi.org/10.4103/jcde.jcde_99_23.

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Abstract Context: Optimal restoration methods for endodontically treated teeth (ETTs) have always remained an ongoing discussion among physicians in this day and age. ETTs have a tendency to fracture when chewing, compared to initial teeth. From the perspective of biology, preserving and restoring tooth structure is critical to maintaining biomechanical, functional, and esthetic harmony. Dental bonding techniques have lessened the necessity for post-and-core restorations in ETTs with severe substance loss. A minimally invasive endodontic restoration technique called “endocrown” was initially i
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Kane, Kathleen E., Robert J. Tomsho, Karen Pheasant, et al. "The “ICE” Study: Feasibility of Inexpensive Commercial Coolers on Mobile EMS Units." Prehospital and Disaster Medicine 29, no. 3 (2014): 254–61. http://dx.doi.org/10.1017/s1049023x14000545.

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AbstractIntroductionPrehospital postresuscitation induced hypothermia (IH) has been shown to reduce neurological complications in comatose cardiac-arrest survivors. Retrofitting ambulances to include equipment appropriate to initiate hypothermia, such as refrigeration units for cooled saline, is expensive. The objective of this nonhuman subject research study was to determine if inexpensive, commercially available coolers could, in conjunction with five reusable ice packs, keep two 1 L bags of precooled 0.9% normal saline solution (NSS) at or below 4°C for an average shift of eight to 12 hours
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Nordyke, Robert J., Heidi Reichert, Lauren C. Bylsma, et al. "Costs Attributable to Arteriovenous Fistula and Arteriovenous Graft Placements in Hemodialysis Patients with Medicare coverage." American Journal of Nephrology 50, no. 4 (2019): 320–28. http://dx.doi.org/10.1159/000502507.

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Introduction: Hemodialysis (HD) in end-stage renal disease (ESRD) patients requires vascular access (VA) through an arteriovenous fistula (AVF), a prosthetic arteriovenous graft (AVG), or a central venous catheter. While AVF or AVG is commonly used for HD, the economic implications of AVF versus AVG use have not been fully established. We describe the healthcare resource utilization and costs of AVF and AVG use for incident ESRD patients in the United States. Methods: This observational cohort study of AVF and AVG placements used data from the United States Renal Data System to identify and fo
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Le, Aline, Le Kang, Andrew Noda, et al. "Effect of Meropenem Restriction on Time Between Order and Administration in a Medical Intensive Care Unit." Infection Control & Hospital Epidemiology 41, S1 (2020): s470. http://dx.doi.org/10.1017/ice.2020.1145.

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Background: In this study, we assessed whether meropenem restriction led to delays in administration for patients in a medical intensive care unit (MICU) at a large tertiary-care urban teaching hospital. Methods: The antimicrobial stewardship program (ASP) at Virginia Commonwealth University Health System (VCUHS) requires approval for restricted antimicrobial orders placed between 8 a.m. and 9 p.m. Between 8 a.m. and 5 p.m. (daytime), authorized approvers include ASP and infectious diseases (ID) physicians. From 5 p.m. to 9 p.m. (evening) orders are approved by ID fellows. Orders were entered
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Mahadev, Srihari, Olga C. Aroniadis, Luis H. Barraza, et al. "Gastrointestinal endoscopy during the coronavirus pandemic in the New York area: results from a multi-institutional survey." Endoscopy International Open 08, no. 12 (2020): E1865—E1871. http://dx.doi.org/10.1055/a-1264-7599.

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Abstract Background and study aims The coronavirus disease 2019 (COVID-19), and measures taken to mitigate its impact, have profoundly affected the clinical care of gastroenterology patients and the work of endoscopy units. We aimed to describe the clinical care delivered by gastroenterologists and the type of procedures performed during the early to peak period of the pandemic. Methods Endoscopy leaders in the New York region were invited to participate in an electronic survey describing operations and clinical service. Surveys were distributed on April 7, 2020 and responses were collected ov
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Plymire, Christopher J., Elissa G. Miller, and Meg Frizzola. "Retrospective Review of Limitations of Care for Inpatients at a Free-Standing, Tertiary Care Children’s Hospital." Children 5, no. 12 (2018): 164. http://dx.doi.org/10.3390/children5120164.

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Limited studies exist regarding the timing, location, or physicians involved in do-not-resuscitate (DNR) order placement in pediatrics. Prior pediatric studies have noted great variations in practice during end-of-life (EOL) care. This study aims to analyze the timing, location, physician specialties, and demographic factors influencing EOL care in pediatrics. We examined the time preceding and following the implementation of a pediatric palliative care team (PCT) via a 5-year, retrospective chart review of all deceased patients previously admitted to inpatient services. Thirty-five percent (1
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Khramtsova, Natalia Anatolyevna. "CARDIOLOGICAL SERVICE OF THE IRKUTSK REGION - RESULTS OF 2022 AND DIRECTIONS OF DEVELOPMENT." Baikal Medical Journal 2, no. 3 (2023): 13–15. http://dx.doi.org/10.57256/2949-0715-2023-3-13-15.

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At the end of 2022, there were several positive trends in the performance of the cardiology service. Thus, mortality from circulatory system diseases (CVD) in the Irkutsk region, according to Rosstat, decreased by 4.3% compared to 2021 and amounted to 676.3 per 100,000 population. The mortality rate from MI also decreased and reached 52.9 per 100,000 population. According to the results of the year, a decrease in the total number of deaths from myocardial infarction by 145 people was noted. The proportion of hospitalizations in specialized departments of PSO and RSC increased by 6.2%, which le
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Drennan, Vari M., Melania Calestani, Francesca Taylor, Mary Halter, and Ros Levenson. "Perceived impact on efficiency and safety of experienced American physician assistants/associates in acute hospital care in England: findings from a multi-site case organisational study." JRSM Open 11, no. 10 (2020): 205427042096957. http://dx.doi.org/10.1177/2054270420969572.

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Summary Objectives To investigate the contribution, efficiency and safety of experienced physician associates included in the staffing of medical/surgical teams in acute hospitals in England, including facilitating and hindering factors. Design Mixed methods longitudinal, multi-site evaluation of a two-year programme employing 27 American physician associates: interviews and documentary analysis. Setting Eight acute hospitals, England. Participants 36 medical directors, consultants, junior doctors, nurses and manager, 198 documents. Results Over time, the experienced physician associates becam
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Borre, Ethan D., Suephy C. Chen, Matilda W. Nicholas, et al. "Early Implementation and Evaluation of a Teledermatology Virtual Clinic Within an Academic Medical Center." Iproceedings 6, no. 1 (2021): e35432. http://dx.doi.org/10.2196/35432.

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Background Teledermatology can increase patient access; however, its optimal implementation remains unknown. Objective This study aimed to describe and evaluate the implementation of a pilot virtual clinic teledermatology service at Duke University. Methods Leaders at Duke Dermatology and Duke Primary Care identified a teledermatology virtual clinic to meet patients’ access needs. Implementation was planned over the exploration, preparation, implementation, and sustainment phases. We evaluated the implementation success of teledermatology using the Reach, Effectiveness, Adoption, Implementatio
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deCastro, Maria Victoria A., Laura J. Eades, Sylvia A. Rineair, and Pamela J. Schoettker. "Proactive Planning for Vascular Access Therapy: One Hospital's Plan for Success." Journal of the Association for Vascular Access 19, no. 4 (2014): 238–43. http://dx.doi.org/10.1016/j.java.2014.07.005.

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Abstract Background: Vascular access is a critical component of care for patients in neonatal intensive care units (NICUs). Our NICU had only a small number of nurses cross-trained to perform peripherally inserted central catheter (PICC) insertions and was not able to provide coverage 24 hours a day, 7 days a week. We combined the vascular access team (VAT) and NICU PICC team to improve the timeliness of NICU PICC insertions, standardize care, and use ultrasound for all PICC placements. Methods: A paper guide tool was developed to prioritize PICC placements as emergent, same-day, or nonemergen
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Campbell, John Charles, Majid Taghavi, and Peter T. VanBerkel. "Day and Night: Locating the General Practitioner’s Panel after Hours." Applied Sciences 13, no. 10 (2023): 6273. http://dx.doi.org/10.3390/app13106273.

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Location science is used to determine the optimal geographical placement of primary care resources with operations research models. In determining the optimal placement, we account for the objectives of both patients and physicians. These objectives and the methods used to address them differ between daytime and after-hours settings. These time settings are treated separately since primary care services are typically limited during after-hours operations. Three solution approaches are considered to address both time settings: independent, sequential, and simultaneous. The independent approach
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Sekhon, Harmehr, Kerman Sekhon, Sasha Elbax, et al. "Promoting Aging in the Community Through the Community Care Access Centre Reform in Ontario, the Weaknesses and Strengths." International Journal of Integrated Care 25 (April 9, 2025): 167. https://doi.org/10.5334/ijic.icic24397.

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Background: The Community Care Access Corporations (CCAC) Act (2001) in Ontario, Canada, addressed an emerging need to support aging in the community, decrease informal caregiver burden, decrease time spent in hospitals and to provide one point of entry for various services (1). Prior to the establishment of CCAC services, provincial acute in-home care services (established in 1972), provincial chronic home care service (implemented 1975-1984), and co-ordination services for long-term care facilities (implemented 1978-1984), each provided in-home care and long-term-care facility placement supp
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Patel, Milesh M., Lee Eisenberg, David Witsell, and Kristine A. Schulz. "Assessment of acute otitis externa and otitis media with effusion performance measures in otolaryngology practices." Otolaryngology–Head and Neck Surgery 139, no. 4 (2008): 490–94. http://dx.doi.org/10.1016/j.otohns.2008.07.030.

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Objective To evaluate the acute otitis externa and otitis media with effusion performance measure sets in a clinical setting and provide preliminary data on measure compliance. Study Design and Setting Quality improvement study. Subjects and Methods Convenience sampling (N = 84) was performed at five sites of ENT and Allergy Associates, LLC. Results Physicians reported prescribing topical antibiotic preparations and assessing for auricular or periauricular pain in 98% of acute otitis externa cases (N = 55). In addition, 87% did not prescribe systemic antimicrobials. Pneumatic otoscopy was used
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Obasi, Jennifer U., and Adrian P. Umpierrez De Reguero. "Safety Profile of Bone Marrow Aspiration and Biopsies Performed By the Hospitalist Procedure Service at an Academic Center: An Observational Study." Blood 134, Supplement_1 (2019): 5848. http://dx.doi.org/10.1182/blood-2019-121444.

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Background: Bone marrow sampling is an invasive procedure that can be obtained by aspiration and biopsy(also called trephine biopsy) and as such, requires good technical skills to avoid complications and increase diagnostic yield. Aspirate and biopsy samples are complementary and when obtained together, are an invaluable tool toward obtaining an accurate and comprehensive profile for cellular, cytogenetic, immunophenotypic and cytological assessments. Bone marrow aspiration and trephine biopsy are generally regarded as relatively low risk procedures, however, factors that should be taken into
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Hongkan, Wasana, Roungtiva Muenpa, and Parinya Chamnan. "Rural physician recruitment program in Thailand: factors associated with medical student enrollment and post-graduation intentions." Education for Health 37, no. 2 (2024): 101–9. http://dx.doi.org/10.62694/efh.2024.8.

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Objectives: Thailand’s Collaborative Project to Increase Production of Rural Doctor (CPIRD) recruits students with a rural background and provides clinical year training in provincial teaching hospitals. We studied the main reasons for students attending this rural recruitment project and their intention to work in rural areas. Methods: In 2018, 2,870 4th–6th year medical students from 34 teaching hospitals under the CPIRD were sent a questionnaire surveying the following factors: their gender; year of study; size of the teaching hospital in which they were training; a domicile of origin and t
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Antonio, CT, JP Guevarra, PN Medina, et al. "Components of compulsory service program for health professionals in low- and middle-income countries: a scoping review." Perspectives in Public Health 140, no. 1 (2019): 54–61. http://dx.doi.org/10.1177/1757913919839432.

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Aims:The global health landscape has been characterized by shortfalls and imbalances in human resources for health (HRH), with more health workers concentrated in urban than rural areas. To address this maldistribution, some countries resorted to the implementation of a compulsory service policy for HRH. However, there is no comprehensive documentation describing the different components of such policies. This scoping review aims to determine the components for compulsory service for selected health professionals in low- and middle-income countries (LMICs).Methods:A search was conducted in MED
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Dittmar, Esther. "Reforming the paramedic profession? Two weeks with paramedics in Germany." International Paramedic Practice 11, no. 1 (2021): 19–26. http://dx.doi.org/10.12968/ippr.2021.11.1.19.

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While paramedics in Anglo-American emergency medical services enjoy relative autonomy, paramedic practice in the Franco-German model deployed in Germany depends heavily on emergency physician input. Increasing demand, especially from low-acuity incidents, causes challenges in these countries. To address this, German politicians plan to implement extensive emergency care reforms and consider an update of regulations around paramedic practice. A 2-week placement allowed for practice observation, discussions with stakeholders and a review of various resources to identify current issues in Germany
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Lim, Ming Yeong, Caroline Dupre Vaughn, Lauren T. Shane, and Charles S. Greenberg. "Strategies to Improve Safety and Outcomes Utilizing Systems-Based Hematologists in IVC Filter Placement and Management in an Academic Medical Center." Blood 128, no. 22 (2016): 4739. http://dx.doi.org/10.1182/blood.v128.22.4739.4739.

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Abstract In large academic institutions, there are multiple disciplines and clinical scenarios that may require placement of inferior vena cava filters (IVCF). Both the Society of Interventional Radiology (SIR) and the American College of Chest Physicians (ACCP) have released guidelines for IVCF use, with the ACCP guidelines being more stringent due to the lack of survival benefit supported by level I data. Several publications have reported high rates of retrievable IVCF complications. In response to these risks and low retrieval rates, the U.S. FDA issued an updated safety alert in 2014 reco
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Moureau, Nancy L., and Ann Zonderman. "Complications of Vascular Access Device Terminal Tip Placement: A Case Study and Review of Subsequent Legal Action." Journal of the Association for Vascular Access 12, no. 1 (2007): 33–37. http://dx.doi.org/10.2309/java.12-1-9.

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Abstract A patient experienced complications following insertion and use of 2 similar vascular access devices with tip termination apparently in the subclavian veins. The thrombotic complications that developed were identified and reported in the first incident (a) as an occluded catheter, and then (b) as bleeding complications with delayed reporting for 8 days with the second catheter. The result was symptomatic deep vein thrombosis, thoracic outlet syndrome, and permanent nerve damage in both right and left extremities used for the venous catheter. The patient brought charges of malpractice
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Jefford, Michael, Judy Evans, Linda Nolte, Amanda Piper, Liz Simkiss, and Kathryn Whitfield. "A clinical placement program for primary care professionals at a comprehensive cancer centre." Journal of Clinical Oncology 34, no. 3_suppl (2016): 44. http://dx.doi.org/10.1200/jco.2016.34.3_suppl.44.

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44 Background: Primary care physicians (PCPs) and primary care nurses (PCNs) are likely to have a critical role in providing care for cancer survivors, especially following the end of cancer treatments. Generalists (PCPs and PCNs) express a need for information and training in post-treatment care. Based on models in other contexts a clinical placement program was developed at a comprehensive cancer centre to determine (1) its feasibility and acceptability, and (2) whether learning needs were met. Methods: Five clinical services (breast, lower gastro-intestinal, urology, skin and melanoma, late
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Murray-Davis, Beth, Elizabeth Shaw, Brian Kerley, and Sandy Knight. "A Pilot Project of Collaborative Maternity Education: Understanding Perspectives from Family Medicine and Midwifery." Canadian Journal of Midwifery Research and Practice 12, no. 3 (2024): 22–29. http://dx.doi.org/10.22374/cjmrp.v12i3.102.

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Background: In Canada, the decreasing numbers of family physicians and the small number of midwives providing obstetric care have been associated with a decline in access to maternity services. Several studies and policy documents support the development of models to enhance collaboration between midwives and physicians and to expose trainees to these models. A pilot project was undertaken to implement and evaluate an interprofessional learning opportunity involving midwifery students (MWSs) and family medicine residents (FMRs). Methods: The aim was to describe how FMRs and MWSs develop skills
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Paul, Charles J., Bradley A. Erickson, Kenneth G. Nepple, and Chad R. Tracy. "Does Rounding Order Bias Discharge Efficiency? Predictors of Discharge Timing on an Academic Urology Service." Journal for Healthcare Quality 46, no. 1 (2024): 12–21. http://dx.doi.org/10.1097/jhq.0000000000000415.

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ABSTRACT No previous works have analyzed whether the order in which surgical teams see patients on morning rounds affects discharge efficiency at teaching hospitals. We obtained perioperative urologic surgery timing data at our academic institution from 2014 to 2019. We limited the analysis to routine postoperative day 1 discharges. Univariate and multivariate analyses were performed to determine whether various hospital and patient factors were associated with discharge timing. We analyzed 1,494 patients. Average discharge order time was 11:22 a.m. and hospital discharge 1:24 p.m. Univariate
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Endres, Kaitlin. "Early exposure to community service learning in the medical curriculum: A model for orientation week introduction." McMaster University Medical Journal 16, no. 1 (2019): 19–25. http://dx.doi.org/10.15173/mumj.v16i1.2017.

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Community service learning programs in pre-clerkship medical education are increasingly recognized as important in creating physicians who recognize the effects of one’s environment on their health and further strive to advocate for these patients to receive access to social programs that can improve their outcomes. The University of Ottawa Aesculapian Society recognized that an excellent method for providing early exposure to service opportunities in one’s new community is through Orientation Weeks. Prior to this year, no Orientation Week across Ontario had a philanthropy focus. Philanthropy
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Musuuza, Jackson S., Ann Schoofs Hundt, Pascale Carayon, et al. "Implementation of a Clostridioides difficile prevention bundle: Understanding common, unique, and conflicting work system barriers and facilitators for subprocess design." Infection Control & Hospital Epidemiology 40, no. 8 (2019): 880–88. http://dx.doi.org/10.1017/ice.2019.150.

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AbstractObjective:Clostridioides difficile (C. difficile) poses a major challenge to the healthcare system. We assessed factors that should be considered when designing subprocesses of a C. difficile infection (CDI) prevention bundle.Design:Phenomenological qualitative study.Methods:We conducted 3 focus groups of environmental services (EVS) staff, physicians, and nurses to assess their perspectives on a CDI prevention bundle. We used the Systems Engineering Initiative for Patient Safety (SEIPS) model to examine 5 subprocesses of the CDI bundle: diagnostic testing, empiric isolation, contact i
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Taher, A. Khaled, J. Lockwood, C. Spearen, et al. "LO11: Improving patient access, care and transportation by paramedics (IMPACT): a novel curriculum toward redefining paramedic services in Ontario." CJEM 20, S1 (2018): S10. http://dx.doi.org/10.1017/cem.2018.73.

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Introduction: A proportion of Emergency Department (ED) visits may be treated in out-of-hospital settings. The objective of this curriculum was to expand paramedic competencies to safely risk stratify patients and divert low risk, low acuity patients from EDs with and without physician oversight. Methods: We followed Kerns 6-step Curriculum Development Framework . (a) We identified a problem, and (b) completed a needs assessment by retrospectively reviewing the clinical pathways of 3000 patients were cared for and transported by paramedics and received care at an EDs. We used this data to iden
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Dettenmeier, Patricia A. "Planning for Successful Home Mechanical Ventilation." AACN Advanced Critical Care 1, no. 2 (1990): 267–79. http://dx.doi.org/10.4037/15597768-1990-2005.

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Home mechanical ventilation has evolved to permit discharge of patients on portable negative or positive pressure mechanical ventilators. Assessment of the patient for home discharge is initiated by a multidisciplinary team. The nurse, physician, social worker, respiratory therapist, speech therapist, occupational therapist, home health nursing agency, durable medical equipment supplier, and caregivers constitute the team. The crucial links to a successful patient discharge are an involved family and a well-developed plan of care, although patient finances also are important. The nurse develop
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Kisor, David F., David R. Bright, Megan Conaway, Bruce A. Bouts, and Gregory P. Gerschutz. "Pharmacogenetics in the Community Pharmacy." Journal of Pharmacy Practice 27, no. 4 (2014): 416–19. http://dx.doi.org/10.1177/0897190014522496.

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Introduction: Although antiplatelet therapy is a mainstay of post–percutaneous coronary intervention therapy, pharmacogenetic (PGt) considerations of therapy are often ignored despite related Food and Drug Administration warnings. Pharmacists are well situated to provide PGt guidance, and the community pharmacy is one setting where PGt testing, interpretation, and recommendations can take place to ensure optimal therapeutic outcomes. Case Report: A 65-year-old man who had a myocardial infarction that was treated with PCI and stent placement was determined by a community pharmacist to be a cand
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Schaller, Richard J., J. Stephen Huff, and Allan Zahn. "Comparison of a Colorimetric End-Tidal CO2 Detector and an Esophageal Aspiration Device for Verifying Endotracheal Tube Placement in the Prehospital Setting: A Six-Month Experience." Prehospital and Disaster Medicine 12, no. 1 (1997): 57–63. http://dx.doi.org/10.1017/s1049023x00037237.

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AbstractIntroduction:Hand held, colorimetric, end-tidal CO2 detector devices are being used to verify correct endotracheal tube (ETT) placement. The accuracy of these devices has been questioned in situations of cardiac arrest. The use of the esophageal detector device (EDD) is an easy alternative for detection of ETT placement, and may be more accurate in situations of cardiac arrest.Hypothesis:The use of the esophageal aspiration device in comparison with a colorimetric end-tidal CO2 detector is more accurate in detecting proper ETT placement and easier to use in the prehospital setting than
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Heintz, Brett H., Jenana Halilovic, and Cinda L. Christensen. "Impact of a Multidisciplinary Team Review of Potential Outpatient Parenteral Antimicrobial Therapy Prior to Discharge from an Academic Medical Center." Annals of Pharmacotherapy 45, no. 11 (2011): 1329–37. http://dx.doi.org/10.1345/aph.1q240.

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Background:: Outpatient parenteral antimicrobial therapy (OPAT) is frequently prescribed at hospital discharge, often without infectious diseases (ID) clinician oversight. We developed a multidisciplinary team, including an ID pharmacist, to review OPAT care plans at hospital discharge to improve safety, clinical efficacy, practicality, and appropriateness of the proposed antimicrobial regimen. Objective: To evaluate the impact of the OPAT team on regimen safety, efficacy, and complexity; calculate the economic benefits of the service by avoiding hospital discharge delay, central venous cathet
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Mahajan, Pranav, Helen Crimlisk, and Chris Kenworthy. "The Royal College of Psychiatrists Physician Associate Inceptorship Programme: Developing Educational Programmes to Support the Integration of This New Role in Psychiatric Services." BJPsych Open 8, S1 (2022): S27—S28. http://dx.doi.org/10.1192/bjo.2022.136.

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AimsPhysician associates (PAs) are becoming more commonplace in psychiatric services in the UK to help address long term workforce difficulties. In 2019, the NHS Long Term Plan detailed a commitment to transforming mental health care in England recognising that services were not meeting current or future increase in demand. Health Education England's (HEE) report, Stepping Forward to 2020/21: The Mental Health Workforce Plan for England, described a longer-term strategy to expand the mental health workforce, including recruiting 5,000 people into ‘new roles’ including physician associates. The
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Chakraborty, Samyadip, and Santanu Mandal. "Enablers of clinician involvement inclination, care delivery agility and clinical productivity." Benchmarking: An International Journal 26, no. 3 (2019): 753–72. http://dx.doi.org/10.1108/bij-06-2017-0144.

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PurposeHealthcare services have enormous potential for growth in the country. However, the drivers of clinical productivity are yet to be explored. The purpose of this paper is to examine the effect of clinician buy-in, clinician ease of use, clinician work stream flexibility and device placement comfort on clinician’ s involvement. The study further examines the effect of converged devices implementation and wireless portable devices adoption on care delivery agility. Lastly, the authors examine the influence of clinician’s involvement and care delivery agility on clinical productivity.Design
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Stewart, Ronald D. "Analgesia in the Field." Prehospital and Disaster Medicine 4, no. 1 (1989): 31–34. http://dx.doi.org/10.1017/s1049023x00038504.

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Emergency Medical Services and the care of patients in the field have taken giant steps forward over the past decade. Born of the desire of physicians to influence the mortality rates of sudden cardiac death in the community, systems of advanced life support have taken root in the urban centers in the United Kingdom, Australia, the United States, and other countries (1-3). Although originally largely designed around the concept of “mobile coronary care,” these systems soon were deluged with calls for help from all sectors of the community, and faced a variety of medical problems. As trauma gra
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Tolia, Vaishal, Eddie Castillo, and David Guss. "EDTITRATE (Emergency Department Telemedicine Initiative to Rapidly Accommodate in Times of Emergency)." Journal of Telemedicine and Telecare 23, no. 4 (2016): 484–88. http://dx.doi.org/10.1177/1357633x16648535.

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Objective Emergency Department (ED) patient volumes are unpredictable, which can result in service delays and patients leaving without care. We initiated a programme of emergency physician (EP) telepresence in the ED with the objectives of assessing feasibility, safety, patient and provider acceptance, and throughput time. Methods This was a prospective convenience study. Patients presenting to the ED during operation of the study who were planned for placement in the waiting room were considered for enrolment. A faculty EP conducted patient evaluations via telepresence with confirmatory evalu
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Craig, Elise, Erica Brotzman, Benjamin Farthing, Rachel Giesey, and Jenifer Lloyd. "Poor match rates of osteopathic applicants into ACGME dermatology and other competitive specialties." Journal of Osteopathic Medicine 121, no. 3 (2021): 281–86. http://dx.doi.org/10.1515/jom-2020-0202.

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Abstract Context There has been a steady increase in the number of osteopathic (DO) medical students in the United States without a corresponding increase in DO representation in competitive specialties. Objectives To investigate the trends and impact of the Accreditation Council for Graduate Medical Education (ACGME) single accreditation system on DO match rates into dermatology and other competitive specialty programs. Methods Information was collected through public databases (Electronic Residency Application Service [ERAS]; National Resident Matching Program [NRMP]; Association of American
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Landoll, Ryan R., Ronald M. Cervero, Jeffrey D. Quinlan, and Lauren A. Maggio. "Primary Care Behavioral Health Training in Family Medicine Residencies:." Family Medicine 52, no. 3 (2020): 174–81. http://dx.doi.org/10.22454/fammed.2020.681872.

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Background and Objectives: Primary care behavioral health (PCBH) is a service delivery model of integrated care linked to a wide variety of positive patient and system outcomes. However, considerable challenges with provider training and attrition exist. While training for nonphysician behavioral scientists is well established, little is known about how to train physicians to work efficiently within integrated teams. Methods: We conducted a case study analysis of family medicine residencies in the military health system using a series of 30 to 45-minute semistructured interviews. We conducted
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