Annually, a small but significant portion of motor-vehicle collisions, costs, and deaths are related to OSAS. With CPAP treatment, most of these collisions, costs, and deaths can be prevented. Treatment of OSAS benefits both the patient and the public.
Infarct size after middle cerebral artery occlusion in the rat can be rapidly and reproducibly assessed with inexpensive scanning equipment and automated image analysis of TTC-stained brains.
Objective:The objective of the study was to assess whether a targeted intervention improved the satisfaction of neonatal parents with primary medical provider communication.Study Design:The study design was a survey assessment of parents in a neonatal intensive care unit regarding their satisfaction with physician and nurse practitioner communication. Serial cohorts were surveyed before and after an intervention, including educating providers about family communication, distributing contact cards to families and showing a poster of providers in the unit.Result:More subjects in the post-intervention cohort (n=33) were satisfied (95%) with provider communication than in the pre-intervention cohort (n=50, 74% P<0.01). Parents who reported talking with a provider in the previous 7 days were more satisfied than parents who did not (P<0.001). After the intervention, fewer families (36 versus 65%) reported a desire for more frequent provider contact (P<0.01).Conclusion:A targeted intervention improved parent satisfaction with provider communication. Improving the quality and quantity of parent–provider communication increased parent satisfaction with communication with their baby's medical providers.
Objective(1) To determine the effects of adding a provider in triage on average length of stay (LOS) and proportion of patients with >6 h LOS. (2) To assess the accuracy of computer simulation in predicting the magnitude of such effects on these metrics.MethodsA group-level quasi-experimental trial comparing the St. Louis Veterans Affairs Medical Center emergency department (1) before intervention, (2) after institution of provider in triage, and discrete event simulation (DES) models of similar (3) ‘before’ and (4) ‘after’ conditions. The outcome measures were daily mean LOS and percentage of patients with LOS >6 h.ResultsThe DES-modelled intervention predicted a decrease in the %6-hour LOS from 19.0% to 13.1%, and a drop in the daily mean LOS from 249 to 200 min (p<0.0001). Following (actual) intervention, the number of patients with LOS >6 h decreased from 19.9% to 14.3% (p<0.0001), with the daily mean LOS decreasing from 247 to 210 min (p<0.0001).ConclusionPhysician and mid-level provider coverage at triage significantly reduced emergency department LOS in this setting. DES accurately predicted the magnitude of this effect. These results suggest further work in the generalisability of triage providers and in the utility of DES for predicting quantitative effects of process changes.
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