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Heidi Frankel

Publications and source records attributed to Heidi Frankel.

7 recordsLinked to original sources
PubMed2006

Do not roll the videotape: effects of the health insurance portability and accountability act and the law on trauma videotaping practices.

BACKGROUND: We hypothesized that trauma video practices would be affected as a result of Health Insurance Portability and Accountabilty Act (HIPAA) enactment. METHODS: A survey was distributed electronically to coordinators and/or directors of level 1 trauma centers. Centers were queried on demographics, trauma video use, and reasons for changes, if any, in their video practice patterns. Descriptive statistics and chi-square analysis were employed. RESULTS: Survey response rate was 75%. Prior to HIPAA, 58% of responding trauma centers used video compared to 18% now. On a Likert scale of 1-5, video analysis rated 3.80. For those using video currently, the most common purposes are education (91%) and quality assurance (83%). HIPAA has affected the way video is used at one third of these centers. Ten percent receive institutional review board approval for videotaping, 35% get patient consent, and more than half report capturing a poor patient outcome on tape. The most commonly cited reasons for stopping video use were HIPAA and legal concerns about patient privacy, consent, and discoverability (79%). Scarce resources were, in part, to blame at 70% of centers, while video technology was found to be ineffective at only 32%. CONCLUSIONS: A minority of level I trauma centers currently use video, although it is effective according to users. HIPAA and medicolegal concerns have affected its use at some centers and contributed to its abandonment at others.

Data Collection↗
PubMed2002

The profile of level I trauma center directors.

BACKGROUND: No data are available regarding the characteristics of the trauma directors of Level I trauma centers. METHODS: Questionnaires were mailed to 102 directors of Level I trauma centers. Data were analyzed in a blinded fashion. RESULTS: Seventy-two directors responded. All were men, with a mean age of 48 +/- 6 years. Fifty-eight percent of directors were fellowship trained. Directorship was assumed 7.3 +/- 6.1 years after training and the average time on the job was 8.6 +/- 6.1 years. Directors work in urban (93%), university-affiliated (67%) institutions that admit 1,000 to 2,000 patients annually (50%). Practice time distribution is as follows: trauma clinical care, 33%; general surgery, 20%; administrative work, 18%; critical care delivery, 17%; and research, 11%. Directors take 6.6 +/- 2.2 night calls per month, with half of them taking in-house call. Eighty-eight percent of directors are involved in research. Seventy-eight percent of directors earn $200,000 to $325,000 per year, with the largest group making $225,000 to $250,000. Salary is derived from clinical revenues (42%) and hospital (37%) or university (20%) support. Compensation is higher in community hospitals and tends to be higher in the Midwest. CONCLUSION: The profile of the trauma director at a Level I trauma center was described. This may be important in trauma career and systems development.

Adult↗
PubMed2002

The role of positive examinations in training for the focused assessment sonogram in trauma (FAST) examination.

The purpose of this study is to determine whether the inclusion of known positive patients to the practical portion of a Focused Assessment Sonogram in Trauma (FAST) training course improves overall training and increases FAST accuracy. This is a prospective double-blind design. Original course participants (PRE) underwent a 2-hour didactic session and practicum with ten normal volunteers. Modified course participants (POST) additionally imaged five peritoneal dialysis (PD) patients to simulate positive examinations. The practitioners (six PRE and five POST) were compared as to their ability to detect and quantify intraperitoneal fluid (0-2000 cc) in nine PD patients during a double-blind prospective examination. Test results were reported as positive or negative. Positive results were further quantified by volume. Each practitioner performed ten examinations. Data for inexperienced clinicians are presented. Sensitivity for detecting < or = 750 cm3 was 45 per cent PRE and 87 per cent POST (P = 0.02). Accuracy in quantifying volume within 250 cm3 was 38 per cent PRE and 44 per cent POST (not significant). FAST accuracy for inexperienced sonographers--particularly in diagnosing smaller volumes--can be improved significantly by including positive studies in training. Exposure to positive FAST examinations during training improves the learning curve. With the growing dependency on FAST to accurately triage blunt abdominal trauma safe and effective FAST training should consist of didactic education and a practical portion that includes positive studies. When screened properly PD patients can be used effectively to demonstrate positive FAST studies.

Abdominal Injuries↗