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Biomedical subjects

R Adelson

Publications and source records attributed to R Adelson.

At least 19 recordsLinked to original sources
PubMed1997

Total quality management: achieving service excellence.

Total Quality Management (TQM) provides a philosophy and a method for organizational renewal and redesign. It is based on the principle that productive work is accomplished through processes. Improving these processes requires the office team to objectively measure performance, discover root causes of problems, take corrective action, determine the effect of these actions, and secure achievements. TQM is a technique that provides a series of steps and set of tools. Through staff involvement and a desire for quality improvement, organizations involved in total quality note the accompanying satisfaction in taking constructive action, improving patient relations, and achieving service excellence. In today's competitive delivery environment, implementation of TQM can result in more satisfied patients, higher staff morale, and a more effective office team.

Dental Care↗
PubMed1995

Oral cavity and pharyngeal cancer among Department of Veterans Affairs hospital discharges.

OBJECTIVES: The purpose of this study is to determine the number of oral cavity and pharyngeal cancers among hospital discharges at Department of Veterans Affairs (VA) medical centers in one 12-month period. METHODS: A SAS file was created from the patient treatment file (PTF) with all discharges during fiscal 1990 having ICD-9-CM codes for oral cavity and pharyngeal cancer. Up to 10 discharge diagnoses from the most recent discharge summary were included in the data set. ICD-9-CM codes for alcohol dependence syndrome, drug dependence, and nondependent abuse of drugs also were included. ICD-9-CM codes for salivary and nasopharyngeal cancers were excluded. RESULTS: There were 3,733 unique individuals discharged with a diagnosis of oral cavity and pharyngeal cancer. The majority of cases (62%) were found in the oral cavity. The age distribution of oral cavity and pharyngeal cancer did not parallel the age distribution of veterans discharged during this year. Race and ethnicity of those discharged with the disease does not differ from that of all VA hospital discharges for 1990. CONCLUSIONS: VA data provide descriptive statistics of oral cavity and pharyngeal cancer among VA hospital discharges. VA data sets such as the PTF may offer the opportunity to examine hospital management issues, length of stay, and co-morbid diagnoses associated with oral cavity and pharyngeal cancer.

Adult↗
PubMed1994

Impact of HIV on VA dental services: report of a survey.

OBJECTIVES: This study assessed knowledge, attitudes, and behaviors related to the treatment of HIV-infected patients by Department of Veterans Affairs (VA) dental personnel. METHODS: A questionnaire was mailed to all VA dentists, hygienists, and EFDA assistants and completed anonymously in May 1991. Descriptive results are reported along with comparisons between the findings from this study and a similar VA survey conducted in 1988, as well as several national surveys of non-VA dentists. RESULTS: Nearly all VA respondents reported participation in some type of continuing education on HIV and infection control. They also reported high compliance with recommended infection control procedures. Furthermore, the findings suggest that VA dentists and hygienists have a high willingness to treat HIV-infected patients, far exceeding that expressed by non-VA dentists. However, a high level of anxiety related to occupational exposure to HIV seems to exist. Most respondents perceived a higher risk of HIV infection from commonly encountered occurrences in the workplace than actually exists based on current knowledge. CONCLUSIONS: While efforts to further reduce the risk of infection and improve care should continue, future efforts also should be directed toward reducing the anxiety of VA dental personnel in the treatment of infectious patients.

Adult↗
PubMed1993

Oral health status of a long-term-care, veteran population.

The Department of Veterans Affairs (VA) operates the largest, integrated health care system in the United States of America. The projected need for long-term-care in the VA health care system parallels an expected increase in need for care in the United States, but precedes the need for care in the general population by 25-30 yr. The VA's Office of Dentistry, in an effort to estimate the resource requirements of this swelling group of veterans, initiated in 1986-7 an oral health survey of long-term care patients. The overall goals were to describe the oral health status of VA nursing home care units (NHCU) residents and to develop a methodology for estimating future dental health services utilization. This study describes the oral health status of the study population. Demographic and oral health data were collected for 650 long-term care residents of six VA NHCUs between October 1986 and July 1987. Data were collected on sociodemographic status, medical history, dental caries, periodontal diseases, oral soft tissue pathology, and the presence of dental prostheses. Caries and periodontal disease were evaluated using the United States National Institute of Dental Research Survey of Employed Adults and Seniors protocols. The oral health status of the population is described using DMF and ESI indices, the prevalence of oral lesions, levels of tooth loss, oral hygiene scores, and the status of existing dentures. Findings show moderate levels of untreated dental caries and periodontal disease and significant tooth loss which increased with age. A need for preventive therapy, restorative dentistry, conservative periodontal therapy, and prosthodontic care was evident.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

Low rate of treatment of hypercholesterolemia by cardiologists in patients with suspected and proven coronary artery disease.

BACKGROUND: Although specific guidelines for the treatment of hypercholesterolemia have been published, it is not known whether physicians treating patients likely to have lipid disorders have adopted the recommendations. METHODS AND RESULTS: The approach of cardiologists to the treatment of hypercholesterolemia in a metropolitan teaching hospital was assessed by interviewing patients with chest pain who were admitted for coronary angiography in 1988-1989 and by measuring fasting blood lipid profiles. At 1 month and again 12-24 months later, patients were contacted by telephone to determine if there had been any changes in treatment. Of 95 patients evaluated, 81 had coronary artery disease. Only 17% of those with high levels of total cholesterol and/or low density lipoprotein cholesterol were being actively treated with diet and/or drugs. In the remaining patients, either lipid studies had not been done or abnormal results had not been addressed. There was little change in treatment approach during the month after the diagnostic procedure. Furthermore, the experience was similar in those patients subjected to coronary revascularization. One to 2 years after the initial intervention, 69 of the original study group could be contacted again. Although active dietary or pharmacological therapy was initiated in some individuals during this interval, it was stopped in others. Thirty-five percent of hypercholesterolemic patients were receiving targeted therapy. CONCLUSIONS: Thus, only a small proportion of patients with documented coronary artery disease and hypercholesterolemia were being actively treated for their lipid disorder, suggesting that the published treatment guidelines have not yet been fully accepted. However, an encouraging improvement in frequency of treatment of hypercholesterolemia was documented during the 1-2-year observation period.

Cardiology↗
PubMed1990

Issues in financing dental care for the elderly.

The elderly make up an increasingly larger segment of the patient population in dental practices. This article reviews recent epidemiologic, demographic, and health services research, and concludes that significant segments of the elderly are at high risk for oral disease and/or limited access to dental treatment, and consequently warrant classification as high-risk groups for policy considerations. It then proposes policy options to the dental community and public decision makers. Oral care can be viewed as having three components. Two basic components are the primary care component--which includes diagnostic, preventive restorative, and periodontal care--and the acute care component--i.e., the treatment of oral pain, trauma, and infection. The third, rehabilitative component, has to do with the restoration of oral function, including prosthodontics and cosmetic dentistry. Viewing dental care in this perspective may help link funding for dental primary care services with that for other primary health services, and link restoration of function and improvement of quality of life with similar health services, like hearing, vision, and social services. In addition, approaching dental care policy makers on several levels--i.e., federal, state, and local--will contribute to our ability as a profession, in the decades ahead, to meet the oral health needs of more elders: including the frail, those at high risk for oral disease, and those with limited access to care.

Adult↗
PubMed1988

Structuring policy options in geriatric oral health care.

Efforts to contain health care costs typically affect the elderly most. Comprehensive health care for the elderly includes dental services in addition to medical care. This article discusses the factors underlying the elderly's scant utilization of dental resources and suggests several strategies which may appreciably assist the elderly in procuring such necessary services.

Aged↗
PubMed1987

The library's role in the continuing education of health professionals.

Health sciences librarians have historically viewed disseminating information to health professionals as a major role. Typically, they have provided individualized services and are among the professions that help health professionals further their education after finishing formal education. Another group directly involved in health professional continuing education is continuing education (CE) providers who offer ongoing learning through group activities. These two professions often reached the same audiences in the past, and their different approaches--individual and group--were complementary. Health professionals who needed information immediately or who wished individual learning used the library while those who wanted to hear eminent colleagues tended to use CE meetings or seminars; some did both. The librarians and CE providers rarely interacted, but this is now changing. With the introduction of personal computers, medical librarians have expanded their responsibilities to include formalized classroom instruction. At the same time, CE providers have increased their scope beyond formalized group instruction into individualized education. Librarians and CE providers can either collaborate and share their expertise or they can compete against each other.

Education, Continuing↗
PubMed1984

Integrating library services and continuing education.

This paper presents an innovative integration of library services and continuing education (CE). While print material is an important continuing education information source for physicians, its volume is overwhelming. Librarians have developed the use of a variety of methods, including online data bases such as MEDLINE, to simplify and expedite access to printed information. Combining a library information delivery system with formal continuing education course activities can enhance the educational potential of two popular learning methods.

Data Collection↗