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Biomedical subjects

L Ronan

Publications and source records attributed to L Ronan.

5 recordsLinked to original sources
PubMed2004

Needs analysis for tele-neurophysiology in the Irish North-Western Health Board.

No clinical neurophysiology (CN) service is currently provided by the North-Western Health Board (NWHB) region in Ireland. Digital technology associated with CN is compatible with tele-neurophysiology service development and may increase the efficiency of patient care in remote areas. This study was conducted to assess the need for CN in the NWHB with a view to implementing a tele-neurophysiology service for the region. A retrospective audit of investigations performed at six CN departments in Dublin compared patient groups from regions with (Eastern Regional Health Authority--ERHA) and without (NWHB) local CN departments. 4954 records were audited. CN activity was lower than internationally expected (ERHA group 52% of expected, NWHB group 23% of expected). The 2 groups differ in the specialty of referring clinician (p < 0.0001). NWHB patients are more likely to be referred by clinicians outside their region (p < 0.0001) and wait longer for appointment (p < 0.0001). While there is an unmet demand for CN services in Ireland generally, the population of the NWHB is further disadvantaged. Tele-neurophysiology has the potential to provide fairer access to CN services across the country. The data from this study provide a baseline against which the outcome of investment in CN can be monitored and evaluated.

Chi-Square Distribution↗
PubMed1998

When the patient dies: a survey of medical housestaff about care after death.

Our objectives were to determine medical housestaff exposure to the tasks of care after a death in the hospital and to characterize their practices, training, and attitudes toward this care. The study design was a review of hospital records and survey of housestaff at two academic medical centers. Forty-seven of 239 medical housestaff were surveyed. In one of the two hospitals studied, the number of death certificates completed by interns during 1 year was determined, and an estimate of exposure to hospital deaths and three other common discharge diagnoses during the same period was calculated. Housestaff were surveyed about the tasks of care after a death, including the determination of death, preparation of the body, notification of family, documentation, review of death with staff, and follow-up with family. Interns at one hospital completed a death certificate an average of 7 (range 1 to 13) times a year and were involved annually with approximately 30 inpatient deaths on ward teams. Exposure to a hospital death was comparable in frequency to that for pneumonia (48 cases/yr), congestive heart failure (32 cases/yr), or AIDS (24 cases/hr). Housestaff reported little or no formal training for the tasks of care after a death. Considerable variation among housestaff was noted in such routine tasks as how death was determined, discussions with the family, and providing bereavement care. Only 12% of respondents regularly reviewed personal reactions to a death with the medical team. In response to open-ended questioning, housestaff described significant distress and uncertainty regarding their roles in completing the tasks of care after a patient death. Medical housestaff are regularly exposed to hospital deaths, yet report minimal training, wide variations in practice, and significant distress with the performance of tasks after a death. We encourage greater attention to teaching about this important area of medical practice.

Journal Article↗
PubMed1992

An experimental ward. Improving care and learning.

The rapidly changing health care system is still largely organized according to old, and increasingly outdated models. The contemporary demands of patient care and residency training call for an experimental ward, which can develop and test new techniques in hospital organization and the delivery of care in a comprehensive way.

Health Services Research↗
PubMedDate not supplied

Customer needs, expectations, and satisfaction with clinical neurophysiology services in Ireland: a case for tele-neurophysiology development.

Although equitable access to services should be based on need, geographical location of patients and their clinicians can give rise to inequalities in healthcare delivery. Development of tele-medicine services can improve equity of access. The specialty of Clinical Neurophysiology (CN), currently under-developed in Ireland provides an example of such potential. This study aimed to determine the needs, expectations, and satisfaction of CN customers, namely patients and referring clinicians. The goal was to examine geographical impediments to access that might be addressed by the introduction of tele-neurophysiology. Two customer surveys were conducted: CN referring clinicians and CN patients. Thirty-one North Western Health Board (NWHB) consultant clinicians responded to a postal survey. Distance and delays caused by long waiting lists were felt to deter or make CN referral irrelevant. Ninety-seven percent believed the lack of a local service negatively impacts on patient management and 93% would welcome the introduction of a tele-neurophysiology service. The geographical location of patient's residence and/or the location of the referring clinician's practice influenced waiting lists for CN. Fifty-eight (105/182) percent of patients living in a region with a CN service compared to 39% (50/128) of those living in a region with no service received an appointment within one month. In addition to the current insufficient CN service capacity in Ireland, these surveys highlighted geographical inequities. Tele-neurophysiology has the potential to speed-up diagnosis, result in more patients being appropriately investigated and be fairer to patients.

Consumer Behavior↗