We examined the effects of extreme drought events on benthic macroinvertebrate (BMI) community structure in six forested upland streams in south-central Ontario, Canada, during a 9-year period. Variation in the mean winter El Niño – Southern Oscillation Index was strongly correlated with drought conditions (zero flow days) in the study streams. Drought onset and duration varied among study streams and among years. Below-average precipitation coincided with the occurrence of drought, although it remains unclear if snowfall and rainfall contributed equally to the impact of decreased precipitation. Increased relative abundance of Ephemeroptera, Plecoptera, and Trichoptera (EPT) one year following drought and decreased relative abundance two years after drought indicated high resistance but poor resilience. In contrast, chironomids showed poor resistance and high resilience. Although these patterns were not consistent across all streams, temporal coherence among streams was found in percent EPT, percent chironomids, and percent dipterans, suggesting that drought acts as a disturbance mechanism that simplifies benthos community assemblages. Biocriteria developed from 22 nearby reference streams indicated that abnormal BMI communities occurred only after recurring episodes of drought, indicating that the effects of drought are cumulative. Headwater streams may prove to be sentinel ecosystems for monitoring the impacts of climate change.

While Quality of Working Life (Q WL) has received a great deal of attention over the past years, somewhat less attention has been given to the role and impact of unions on QWL programs. The role that unions play is controversial. In order to examine the effect of union involvement, this paper uses the case survey method to analyze nine union and nine non-union organizations which implemented QWL programs. The union leadership appeared to play a positive role in improving the design and implementation of the QWL program, but there appeared to be an inability of the union leadership to transmit the program to the rank-and-file members. Recommendations are made to increase rank-and-file involvement in the QWL program.

137 Background: As the majority of oncology care is delivered in the ambulatory setting, patients and families require reliable and efficient ways to contact the care team with clinical concerns. The Abramson Cancer Center is comprised of 40 medical oncologists seeing over 100,000 annual outpatient visits. Press Ganey phone access satisfaction scores in the 12th percentile reflect patient dissatisfaction with phone communication. We initiated a pilot project to improve phone access. Methods: Baseline data was collected from 3 main sources of patient calls: intake office, administrative assistants, and triage RN’s. Over 2,000 patient calls were tallied during a one week period documenting: time of call; live answer vs voice mail; reason for call; whether and to whom the call was transferred. A subset analysis of calls related to symptom/medication management (SM) was performed via EMR audit to determine: time to call resolution (TTR), % resolved within 2 hours, % documented in the EMR, and % answered live. The TTR of patient SM calls and % resolved in < 2hrs were calculated by comparing the time of call receipt per log to the time of closed phone encounter in the EMR. The percent of calls documented was determined by comparing the call log to corresponding EMR encounters. The percent answered live was determined by review of the call log. As a pilot test of change, all calls in one of the practices were forwarded to a single source (intake office) to ensure live answer. The staff was educated to create an EMR encounter for each SM call and then route the encounter to a clinical pool (RN, APP and MD). An automated report enabled monitoring of key metrics. Results: The goals set for the pilot project were exceeded for 2 of the 3 performance metrics (Table). Conclusions: Within a complicated academic health system, we utilized our EMR and modified our phone triage system to streamline and reduce variation for management of SM calls. 62% of these calls were resolved within 2 hours, and the mean time to resolution of SM calls was reduced from 127 to 87 minutes. [Table: see text]

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To keep the ASTA membership apprised of the activities of the School Task Force, the next issues of the journal will present current activities, current concerns, past achievements, and future plans. We hope the ASTA membership will communicate with us—questions, suggestions, and particularly, responses to help achieve the goals of the task force. The Hotline is always open.