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Biomedical subjects

W Donnelly

Publications and source records attributed to W Donnelly.

8 recordsLinked to original sources
PubMed1993

The cost of accreditation: one hospital's experience.

OBJECTIVE: The 1989 survey conducted by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) at the UCLA Neuropsychiatric Hospital was the hospital's first using standards outlined in the 1989 edition of JCAHO's Accreditation Manual for Hospitals. The authors' goal was to calculate the cost of preparing for and undergoing the 1989 survey. METHODS: Costs associated with planning for the survey and conducting a mock survey and the actual survey were based on records of staff time spent on those activities, fees for consultant services, and fees for the actual survey. Costs associated with follow-up of the mock survey, preparation for the actual survey, and additional staff time spent in record keeping and treatment planning to meet accreditation standards were based on staff estimates of time spent in these activities. RESULTS: Documented and estimated costs for the survey process totaled $326,784, which represented about 1 percent of the hospital's operating budget for 1989. CONCLUSIONS: Although the hospital had a successful survey outcome and received accreditation with few contingencies, the authors question whether quality of care was improved by the survey process and whether the high cost of the survey constitutes an appropriate use of resources.

Accreditation↗
PubMed1990

Membranoproliferative glomerulonephritis in a fifteen-month-old boy.

A 15-month-old boy presented with hypertension, edema, heavy proteinuria, gross hematuria and renal insufficiency. A renal biopsy was consistent with classical membranoproliferative glomerulonephritis type I. Although usually thought of as a disease in older children and young adults, membranoproliferative glomerulonephritis can occur as early as the second year of life.

Basement Membrane↗
PubMed1985

Correlates of biopsy-studied nephropathy in young patients with insulin-dependent diabetes mellitus.

We have correlated pathologic findings in kidney biopsies from 12 adolescents with proteinuria or hypertension with severity of limited joint mobility (LJM) and retinopathy. We compared mean glucosylated hemoglobin (GHB) and clinical findings in these patients with those in patients without proteinuria or hypertension. Severity of LJM correlated with basement membrane thickening. Protein excretion correlated with degree of mesangial matrix increase and basement membrane changes. Retinal changes were related to basement membrane thickness and duplication. Despite treatment, blood pressures were significantly higher in patients with nephropathy than in the comparison group. Glycemic control status was generally poor and did not correlate with pathologic changes. The narrow spectrum of control did not permit assessment of possible effects of milder metabolic derangement. However, the similarity of GHB values in the groups with and without nephropathy implicates other factors. The group with clinical nephropathy had more LJM than did the comparison group, reaffirming LJM as a risk factor for early microvascular disease. Biopsy changes of nephropathy may begin relatively early in the course of diabetes (less than 7 years in three of our patients) and is already advanced when proteinuria appears.

Adolescent↗
PubMed1982

On stillbirth.

Explore the source record for details and available documents.

Clergy↗
PubMed1981

Perinatal mortality counseling program for families who experience a stillbirth.

The emotional impact of a stillbirth on a family has only recently begun to be appreciated. Literature regarding the grieving process in these families has been relatively scant and does not often facilitate applied approaches. The Perinatal Mortality Counseling Program (PMCP) at Shands Teaching Hospital, Gainesville, Florida, provides crisis intervention and support for these families as well as serving a research function. This article outlines the program, including its history, composition, procedures, and research.

Counseling↗