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Biomedical subjects

G Isouard

Publications and source records attributed to G Isouard.

11 recordsLinked to original sources
PubMed2006

Digital repeat analysis; setup and operation.

Since the emergence of digital imaging, there have been questions about the necessity of continuing reject analysis programs in imaging departments to evaluate performance and quality. As a marketing strategy, most suppliers of digital technology focus on the supremacy of the technology and its ability to reduce the number of repeats, resulting in less radiation doses given to patients and increased productivity in the department. On the other hand, quality assurance radiographers and radiologists believe that repeats are mainly related to positioning skills, and repeat analysis is the main tool to plan training needs to up-skill radiographers. A comparative study between conventional and digital imaging was undertaken to compare outcomes and evaluate the need for reject analysis. However, digital technology still being at its early development stages, setting a credible reject analysis program became the major task of the study. It took the department, with the help of the suppliers of the computed radiography reader and the picture archiving and communication system, over 2 years of software enhancement to build a reliable digital repeat analysis system. The results were supportive of both philosophies; the number of repeats as a result of exposure factors was reduced dramatically; however, the percentage of repeats as a result of positioning skills was slightly on the increase for the simple reason that some rejects in the conventional system qualifying for both exposure and positioning errors were classified as exposure error. The ability of digitally adjusting dark or light images reclassified some of those images as positioning errors.

Humans↗
PubMed2000

The introduction of the frontline management initiative in South Western Sydney Area Health Service.

This article provides an overview of the development and implementation of a management development strategy for the South Western Sydney Area Health Service (SWSAHS). The program, the Frontline Management Initiative (FMI), was introduced as a developmental tool which enabled managers to identify those competencies that they already possess and those which they need to develop. The FMI will be progressively implemented throughout the five sector health services of SWSAHS comprising approximately 1500 managers. This article outlines the introduction and experience of FMI in one sector health service, the development and assessment of a manager's portfolio, the pathway developed from FMI to university based health management courses, the lessons learnt and the future directions for management development.

Administrative Personnel↗
PubMed1999

A quality management intervention to improve clinical laboratory use in acute myocardial infarction.

OBJECTIVE: To assess the effect of a total quality management (TQM) approach on the appropriateness of clinical laboratory testing of patients with acute myocardial infarction. DESIGN: Retrospective, control-group, quasi-experimental study. SETTING: Two metropolitan teaching hospitals: one involved in the intervention (TQM experimental group); the other had no intervention (control group). INTERVENTION: A multidisciplinary team involved in the development of improvement strategies, including laboratory testing guidelines, education programs, data collection, monitoring and feedback. OUTCOME MEASURES: Total number of requested clinically indicated and non-clinically indicated tests. RESULTS: The proportion of clinically indicated tests that were requested increased from 77.5% to 88.2% (P < 0.01) and the number of non-clinically indicated tests was reduced by 81.7% with the introduction of the TQM strategies (P < 0.01). CONCLUSIONS: The introduction of a TQM approach has improved the appropriateness of test ordering in acute myocardial infarction. The reduction in non-clinically indicated tests could produce substantial savings in hospital pathology costs, and the increase in clinically indicated tests provides better patient care.

Aged↗
PubMed1999

The key elements in the development of a quality management environment for pathology services.

There is increasing recognition that many quality management initiatives in health care are undertaken without the appropriate development of a responsive and supportive organizational environment. In the present study, a multidisciplinary team was empowered to make appropriate changes in order to improve a variety of problem areas that affected the total pathology service of the hospital. Major changes were initially undertaken to develop a quality management environment. The four elements found to be important to the creation of the Total Quality Management (TQM) environment were change in management culture, development of teamwork, focus on customers, and continuous feedback to staff. The accomplishment of the TQM was assessed and confirmed using criteria developed by the Pathology Project TQM Team. As the TQM approach is process driven, it should be adaptable to other clinical situations and not just to pathology services. Potential barriers to achieving the required organizational environment are also explored.

Hospitals, Teaching↗
PubMed1998

Uncovering the causes of poor quality pathology laboratory services in acute myocardial infarction.

A study was undertaken to identify the causes that contributed to poor quality pathology services for hospitalized patients with acute myocardial infarction. Through the use of continuous quality improvement (CQI) strategies, the procedure involved a systematic process analysis which assessed the types and sources of variation, and possible causal factors for changes in performance. Thirteen suspected causes of poor quality were identified and data collected to confirm or reject their involvement. The study demonstrated that even strongly suspected causes of poor quality need to be confirmed by data. We found that 23% of the suspected root causes were not substantiated by the data collected. The CQI approach was process driven and should be adaptable to other clinical situations and not just pathology services.

Computer Terminals↗
PubMed1988

Biosafety practices in pathology laboratories.

A study was undertaken of the biosafety status of all public sector based pathology laboratories in N.S.W. Questionnaires were sent to all 85 departments. A total of 71 completed questionnaires were returned from the laboratory managers, representing a response rate of 84%. The study showed that many departments have not yet implemented the recent AIDS Task Force code of biosafety practice for laboratories. Relatively poor practices were identified in the handling and transport of patient samples, the disposal of infected waste and the use of equipment not designed for aerosol containment. Continuous safety training for staff and regular external assessments of laboratories were recommended as possible measures to improve the biosafety standards of pathology departments.

Accident Prevention↗
PubMed1988

Impact of new technology on employment prospects in clinical pathology.

Technological advances have changed the face of the clinical pathology laboratory. The introduction of automated instrumentation, computerisation and commercially prepared reagents has had a significant impact on the role, skills and employment prospect of laboratory scientists. The present study assessed the impact that technology has had amongst laboratory scientists employed in hospital biochemistry departments in N.S.W. The study showed that many traditional skills had been lost due to technological change. Very little growth is expected in the workforce over the next few years. New graduates should have difficulties in finding employment, especially in the routine areas of testing.

Clinical Competence↗
PubMed1987

Occupational health and safety: a NSW hospital experience.

This paper outlines the experience of the establishment of an Occupational Health and Safety Committee at the Canterbury Hospital and Area Health Service and its achievements over the past two years. As a priority the committee members reviewed and refined safety reporting systems. The committee also considered the need to complement retrospective reporting with a proactive hazard prevention program. A system of departmental inspections was introduced in order to meet this perceived need. Following identification of hazards, education programmes and control strategies were developed to minimise risks. These strategies included some very innovative approaches to perennial problems.

Accident Prevention↗
PubMed1979

Measurement of serum levels of oestriol and human placental lactogen in the management of pre-eclamptic pregnancies.

Maternal serum levels of total oestriol and human placental lactogen (HPL) were measured in 280 normal and 87 pre-eclamptic pregnancies. Normal levels of HPL, but significantly reduced total oestriol values were obtained when pre-eclampsia was present. However, when fetal complications developed, both hormone levels were further significantly reduced. The severity of pre-eclampsia had no effect on the serum levels of oestriol and HPL. An analysis of the 18 pregnancies with significant fetal-placental dysfunction showed that 13 (72%) were predicted by unfavourable levels of total oestriol, nine (50%) by unfavourable levels of HPL, and 14 (78%) by the use of both assays. The present study supports the value of antenatal measurement both of serum total oestriol and of HPL in the management of pre-eclamptic pregnancies.

Estriol↗
PubMed1979

Value of total serum oestriol and human placental lactogen in the assessment of fetal-placental function.

Serum levels of total oestriol and human placental lactogen (HPL) were measured in 360 pregnancies; in 182 there were abnormalities likely to be associated with increased fetal risk. A total of 217 estimations of oestriol and HPL were performed in 163 normal pregnancies to define the normal ranges. The value of both tests in the management of complicated pregnancies was assessed. Serum oestriol was found to be very efficient in the diagnosis of intrauterine growth retardation. In such cases, 76% of patients had unfavourable oestriol levels. Patients with mild pre-eclampsia had HPL levels similar to normal, but values decreased significantly in the presence of fetal distress. The mean serum oestriol level in patients with pre-eclampsia were lower than normal, and were further reduced in the presence of fetal distress. The importance of measuring serum oestriol levels at each antenatal visit is stressed in the detection of developing fetal complications; in such cases, 73% of patients had subnormal values. Both tests provided accurate assessments in the 8 patients with intrauterine death. Significant fetal-placental dysfunction was present in 55 patients, and 41 (75%) were predicted by serum oestriol, 23 (42%) by HPL, and 45 (82%) by the use of both tests. In the 142 complicated pregnancies that resulted in a favourable outcome, confirmation was obtained in 102 (72%) by serum oestriol and in 121 (86%) by HPL.

Adult↗