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S F Isenberg

Publications and source records attributed to S F Isenberg.

At least 19 recordsLinked to original sources
PubMed1998

Utilizing patient satisfaction data to assess quality improvement in community-based medical practices.

Our objective was to quantitatively measure the effect of quality improvement-based intervention on the improvement in patient satisfaction with physicians, office visits. A prospective nonrandomized case-control protocol was used at a multiple-site community-based medical and surgical office practices of members of Project Solo/Physicians Information Exchange. The study subjects were convenience samples of new and return patients seen between July 1996 and July 1997. One group of physicians (control group) surveyed patient satisfaction with office visits on two separate occasions with no intervention between the two occasions, except for seeing their own results after the first survey. A second group of physicians (intervention group) also surveyed patient satisfaction with office visits on two separate occasions, but were provided with a quality improvement poster between surveys. Changes in patient satisfaction between the two surveys were measured. The visit rating questionnaire, a nine-item patient-based questionnaire, was used to measure patient satisfaction; percentage excellent responses in the summary categories of patient access, physician attributes, and overall visit were used. Overall, 6088 patients from 59 physicians' offices participated; 3815 patients from 29 physicians in the control group, and 2273 patients from 30 physicians in the intervention group. The control group demonstrated small and nonsignificant changes in patient satisfaction between the two survey periods (0.6-1.4% increase, P = NS), and the intervention group demonstrated statistically significant improvements in patient satisfaction between the two survey periods (4.2-5.7% increase, P = 0.05-0.001). In addition, the two groups were compared directly using a stratified chi 2 analysis, and the differences were also statistically significant (chi 2 = 3.7-8.3, P = 0.05-0.004). We conclude that the use of a quality improvement-based intervention had a significant positive effect on patient satisfaction with office visits, when compared to a group of physicians who did not use any intervention.

Adolescent↗
PubMed1997

Problems and pitfalls in community-based outcomes research.

OBJECTIVE: To assess the feasibility of multisite community-based outcomes research. DESIGN: Prospective observational study of variations in treating acute external otitis by otolaryngologists and primary care practitioners. SETTING: Community-based independent otolaryngology practices. PARTICIPANTS: Patients with external otitis treated by otolaryngologists in Project Solo, a nonprofit, grassroots organization of independent physicians united for quality, patient advocacy, and cost containment. METHODS: Confidential (bar-coded), disease-specific outcomes questionnaires completed by patients (12 items) and by participating physicians (15 items). Response to treatment was measured with a follow-up patient questionnaire (3 items). RESULTS: Nine patients were recruited from 5 of 29 enrolled otolaryngologists. Primary care practitioners were more likely to prescribe oral antimicrobials than otolaryngologists (100% vs. 44%, p = 0.03), but less likely to insert a wick in the external auditory canal (11% vs. 78%, p = 0.02). Poor recruitment was caused by an overly long and complex survey, data collection at multiple time points, lack of time during office hours, cumbersome data collection requirements, inadequate ongoing communication, and a lack of enthusiasm for the project. CONCLUSIONS: Future efforts at implementing a multisite outcomes study will require shorter questionnaires, smoother integration of the survey process with regular office flow, simplified procedures for data exchange, frequent communication with data collection sites, and motivational programs for participating physicians and their office staff.

Epidemiologic Methods↗
PubMed1996

Project Solo: an independent practitioner initiative for confidential self-assessment of quality.

Project Solo, a grassroots organization of independent physicians, has developed a unique method of confidential self-assessment of quality. Participating physicians can use the data to improve their own practices and to have a strong, credible voice for retaining and promoting the strengths of independent practices in providing medical care. In a pilot project, 56 independent physicians in Project Solo were given bar-coded, postage-paid survey forms of patient satisfaction to distribute to 100 patients. The population for this pilot study was the 35 physicians with patients returning at least one survey. A total of 1858 surveys (53% of surveys given to physicians) were returned, representing a variety of rural and urban practices in 19 states. The mean percentage of responses rated "excellent" to survey items from Project Solo physicians is similar to the percentages reported for this survey in other studies. We conclude that Project Solo serves as an effective and efficient model for gathering patient satisfaction data and can be further developed as a tool for gathering clinical outcome and other quality measurement data in the solo and small group practice setting.

Demography↗
PubMed1996

Seed corn???

Explore the source record for details and available documents.

Cost Control↗
PubMed1980

An unusual congenital middle ear ossicular anomaly.

Unilateral congenital absence of the stapes suprastructure occurred in association with displaced attachment of the stapedial tendon on an abbreviated incudal lenticular process. The stapes footplate was intact and mobile, and the middle ear was otherwise normal. This is interpreted to be a developmental aberration involving partial absence of a second branchial arch derivative. The preoperative history of no trauma or surgery and the audiologic analysis correlated with the occurrence of this anomaly. This appears to be the first reported case of this unusual congenital anomaly. In addition, it adds a unique item to the differential diagnosis of the pathologic features implicated in an ear with a conductive deficit, intact stapedius reflex, and tympanogram consistent with ossicular discontinuity.

Adult↗
PubMed1980

Isolated intralabyrinthine schwannoma.

Although most vestibular schwannomas arise in the internal auditory canal, a more peripheral site of origin is possible. We report a case of isolated schwannoma limited to the labyrinthine vestibule. Our description of the location of this tumor is further documentation that schwannomas can arise from the terminal vestibular nerve fibers to the cristae or maculae. Either the nerve roots of the superior vestibular nerve to the utricle and horizontal and superior semicircular canal cristae, or the nerve roots of the inferior vestibular nerve to the saccule and posterior semicircular canal crista may have been the locus of origin of this unusual tumor. Intralabyrinthine schwannoma should be included in the differential diagnosis in the face of progressive auditory and vestibular dysfunction. Because conventional roentgenographic studies usually fail to demonstrate the presence of schwannoma in this location surgical exploration of the labyrinthine vestibule in the presence of unserviceable hearing and incapacitating vertigo is indicated.

Diagnosis, Differential↗
PubMedDate not supplied

Endoscopic removal of chondromyxoid fibroma of the ethmoid sinus.

The first case of the endoscopic intranasal excision of chondromyxoid fibroma as an outgrowth of the ethmoid bone is reported. This case appears to represent the second reported type of recurrence of CMF in the head and neck area and the second type of CMF originating in the ethmoid.

Adult↗