PubMed Health⌕ Search

Biomedical subjects

S C McDonald

Publications and source records attributed to S C McDonald.

7 recordsLinked to original sources

A study of the workforce in emergency medicine.

STUDY OBJECTIVE: Emergency medicine has progressed significantly since its initial recognition as a medical specialty. Relatively little factual information is known, however, regarding who or how many physicians practice emergency medicine. The purpose of this study is to determine the total number of physicians practicing clinical emergency medicine during a specified period, to describe certain characteristics of those individuals, and to estimate the total number of full-time equivalents (FTEs), as well as the total number of individuals needed to staff those FTEs. METHODS: Data were gathered from a survey of a random sample of 2,062 hospitals drawn from a population of 5,220 hospitals reported by the American Hospital Association as having, or potentially having, an emergency department. The survey instrument addressed items such as descriptive data on the institution, enumeration of physicians in the ED, as well as the total number working during the period June 1, 1997, through June 14, 1997. Demographic data on the individuals were also collected. RESULTS: A total of 942 hospitals responded (a 45.7% return rate). These hospitals reported a total of 5,872 physicians were working during the specified period, or an average of 7.48 persons scheduled per institution. The physicians were scheduled for a total of 297,062 hours. The average standard for FTE was 40 clinical hours per week. This equates to 3,713 FTEs or 4.96 FTEs per institution. The ratio of persons to FTEs was 1.51:1. With regard to demographics, 83% of the physicians were men and 81% were white. Their average age was 42 years. As to professional credentials, 58% were emergency medicine-residency trained and 53% were board certified in emergency medicine; 46% were certified by the American Board of Emergency Medicine. CONCLUSION: Given that there are 4,945 hospitals with EDs and given that the data indicate there are 4.96 FTEs per ED, the total number of FTEs is projected to be 24,548 (standard error = 437). Given further that the data indicate a physician/FTE ratio of 1.51:1, we conclude that there are 36,990 persons (standard error = 683) needed to staff those FTEs. When adjusted for persons working at more than one ED, that number is reduced to 32,026.

Adult↗

Total quality management in health care.

Total quality management (TQM), continuous quality improvement (CQI) and quality control are terms that are becoming very familiar to workers in the health care environment. The purpose of this article is to discuss these terms and the concepts they describe. The origins of TQM and the keen interest in its application to the health care environment today are addressed. In other environments, TQM has shown significant increases in productivity while increasing effectiveness. Its application to the health care environment is the provision of the best possible care through continuously improving service to meet or exceed the needs and expectations of the customer. The customer in the health care environment could be the patient, staff, physician and community serviced by the hospital. Characteristics of the new organizational structure are reviewed. Established techniques and processes are commonly used to identify process-improvement opportunities to assist the manager in continuously evaluating quality trends.

Canada↗

Fluphenazine decanoate: a clinical problem?

The authors compared the medical records of 20 randomly selected schizophrenic patients who were receiving fluphenazine decanoate with the records of 20 other randomly selected schizophrenic patients who were receiving oral medications only. The fluphenazine decanoate group had a significantly higher mean chlorpromazine equivalent dose (2010 +/- 836) than the oral medication group (373 +/- 384). The two groups did not, however, differ on any of the other variables studied. The findings, in addition to reports in the literature, suggest that the use of fluphenazine decanoate may come at the inadvertent cost of a significantly higher dose of antipsychotic medications in a subgroup of patients.

Antipsychotic Agents↗

Method for calculating dose when lung tissue lies in the treatment field.

The absorbed dose in lung and beyond lung as a result of increased lung transmission of x and gamma irradiation is described. The correction factor used to calculate the absorbed dose is a function of beam energy, field area, lung density, and lung and soft tissue depth. Agreement between measurements and calculations in the Alderson phantom is within 3%. An example of how this technique can be used is described.

Cobalt Radioisotopes↗