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Biomedical subjects

I J Benett

Publications and source records attributed to I J Benett.

9 recordsLinked to original sources
PubMed1995

Audit as part of summative assessment of vocational training.

Written evidence of the ability to carry out audit and performance review looks likely to be one of the four components of a summative assessment package for the end of vocational training. This paper seeks to raise the issues involved in this process. The features of audit which lend themselves to assessment of the attributes of a general practitioner are discussed. The criteria which might be used to assess a written submission are presented. A possible mechanism for marking and grading is suggested, and strategies for optimizing the validity and reliability of that assessment discussed. A timescale for implementation is also suggested. These issues need to be discussed and a process piloted if a credible mechanism is to be in place by August 1996.

Education, Medical, Graduate↗
PubMed1994

Terminal care: improving teamwork in primary care using Significant Event Analysis.

Significant Event Analysis can be used to improve the effectiveness of a Primary Health Care Team caring for terminally ill patients. A method of doing this is described in detail. Positive team qualities were confirmed and enhanced. Significant areas for improvement were identified: insufficient information had been given to some key workers, changes in medication had been poorly planned, continuity of care, and emotional and professional support of team members were inadequate. A strategy for change was developed and implemented. Performance was reviewed a year later. It was found that the Significant Event Analysis had caused changes in team practices, and was valid and reliable enough to be used as a tool for improving teamwork in primary care in future.

Humans↗
PubMed1994

Emerging standards for diabetes care from a city-wide primary care audit.

Aggregated data from Manchester practices participating in the Diabetes 2000 project were used to develop peer group standards of mean performance and of excellence. The crude prevalence of known diabetes mellitus was 1.21% of which 20.2% had Type 1 diabetes. The aggregated mean of patients who had the following examinations performed in the preceding year were: glycated haemoglobin 56.8%; weight or body mass index 67.8%; foot pulses 37.3%; ankle reflexes 31.3%; proteinuria 60%; fundoscopy 48.2%; blood pressure 81.1%; serum cholesterol or lipids 34%. The percentage of patients referred to or seen by health care professionals in the preceding year were 14.4% to diabetes specialist nurses; 22.1% to opticians or ophthalmologists; 25% to chiropodists; and 21.5% to dietitians. The best performing practices examined 79% of patients fundi in the preceding year, 84% of their foot pulses, 74% of their ankle reflexes, and gave appropriate smoking advice in 65% of cases. These standards were fed back to the participating practices so that they could compare their own performance with that of the city-wide mean, and with the best performing practices. From these data practices have then been able to set themselves realistic targets for improved performance in the following year.

Diabetes Mellitus↗
PubMed1994

Do doctors address the concerns of patients with diabetes?

Diabetes has an impact on people at both a biomedical and a holistic level. Furthermore there is a legitimate and substantial 'medical agenda' which doctors must address. But does this mean that they fail to deal with the concerns of their patients? A questionnaire study of diabetic patients attending the Manchester Diabetes Centre found that not all the patients' concerns were addressed in 25.5% of consultations. 220 (98%) patients were recruited from 225 approached. Not surprisingly, those who expressed three or more concerns were significantly less likely to have all their concerns addressed compared with those who had only one or two concerns (p = 0.001). The probability of having an individual concern addressed was 0.82. It was also found that Black-Caribbeans were significantly less likely to have their concerns addressed than Whites especially if they were over 60 years old (p = 0.03). This study concludes that doctors should be particularly aware of the needs of patients who express many concerns, and especially if they are Black-Caribbeans. Further research should develop strategies for improving the ability of doctors to identify and address the concerns of their patients.

Black or African American↗
PubMed1993

What do people with diabetes want to talk about with their doctors?

A survey was conducted to establish the concerns of people with diabetes when they consult their doctors. A total of 225 people attending consecutively at the Manchester Diabetes Centre were invited to take part. Their concerns were assessed by a questionnaire administered immediately before consulting a doctor. Of the 220 (98%) respondents 53.6% had concerns about metabolic control; 31.8% had concerns which suggested cognitive or emotional problems in coming to terms with their diabetes; 20.5% and 22.7% had concerns related to organ involvement and medication, respectively; 11.8% expressed no concerns. Women who were concerned about metabolic control and organ involvement were younger than women who were not (p < 0.001, and p = 0.004, respectively). Men who were concerned about medication were younger than men who were not (p = 0.002). The concerns of men diagnosed for < or = 10 years were more likely to suggest difficulty in adjusting to the disease than those who had been diagnosed for longer (p = 0.007). Women diagnosed for < or = 10 years were more likely to be concerned about metabolic control than those diagnosed for longer (p = 0.018). Both men and women diagnosed for > 10 years, were more likely to be concerned about medication than those diagnosed for a shorter time (p = 0.025). Ethnicity did not seem to influence the outcomes. The significant proportion of people who have concerns which suggest difficulty in adjusting to the disease, the gender differences, and the changes over time suggest the need for more detailed research into those concerns.

Communication↗
PubMed1992

Pre-recorded answerphone messages: influence on patients' feelings and behaviour in out of hours requests for visits.

The aim of this qualitative study was to investigate the feelings and behaviour of patients requesting out of hours visits on hearing pre-recorded answerphone messages. Actual messages which had been recorded were classified by a group of four people. Examples of each type of message were then played to a second group, of six people, who expressed their feelings about the varying messages. A third group, of 10 people, was asked to invent hypothetical emergency situations of increasing severity. For each of the emergency situations their proposed actions on hearing the different types of answerphone message were recorded. The results showed that people preferred short messages telling them what to do in an emergency and the time of the next surgery. They also felt that the message should be recorded by a doctor and not a receptionist and be delivered in a 'neutral' tone. Proposed actions were not influenced by the content of the message or the person recording the message. The most important factor in deciding which action to take was the tone of the message. A 'strict' rather than a 'neutral' tone tended to discourage patients from calling out their doctor and was more likely to lead to inappropriate responses. It is suggested that answerphone messages recorded by the doctor, stating what to do in an emergency and the time of the next surgery, delivered in a neutral rather than a strict tone, will lead to the most appropriate responses from patients.

Communication↗