PubMed Health⌕ Search

PubMed · 10107071

Sampling clinicians' activities using electronic pagers.

Abstract

Pager-based activity sampling (PAS) is described as a cost-effective and unobtrusive method for sampling residents' activities in clinical settings. A sample program evaluation is presented using residents in an urban children's hospital resident-training program. The purposes of the program evaluation were: (a) to establish a behavioral baseline that would help clinical faculty understand how residents were using their time, and (b) to determine whether alterations in the way residents were assigned within the hospital resulted in desired changes to time spent. The primary rationale for changing resident-assignment policies were: (a) to decrease the time residents were spending in transit between various locations within the hospital, and (b) to increase the time spent by residents in educational activities and in direct contact with patients and their families. This PAS application demonstrates that the technique can produce statistically supportable conclusions, at minimal cost, without unduly disrupting either the residents or their patients. PAS is compared with other time-sampling methods, its limitations are discussed, and suggestions for future applications are provided.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

D M Brock, C S Scott, T W Pendergrass, S C MacDonald. 1990. Sampling clinicians' activities using electronic pagers.. https://doi.org/10.1177/016327879001300304

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Proportion estimation with confidence limits.

A common task in microbiology involves determining the composition of a mixed population of individuals by drawing a sample from the population and using some procedure to identify the individuals in the sample. There may be a significant probability that the identification procedure misidentifies some members of the sample (for example, because the available data are insufficient unambiguously to identify an individual) which makes finding the proportions in the underlying population non-trivial. A further complication arises where individuals are present in the population that do not belong to any of the subpopulations recognised by use of the identification procedure. A simple algorithm is presented to address these problems and construct a maximum likelihood estimate of the proportions, together with confidence limits. The technique is illustrated using an example drawn from flow cytometry in which phytoplankton cells are identified from flow cytometry data by an RBF neural network, and the limitations of the approach are discussed.

Confidence Intervals↗

A small sample confidence interval approach to assess individual bioequivalence.

The concept of interchangeable pharmaceutical products has been examined in great detail in the literature. Anderson and Hauck proposed a statistical random coefficient model to study 'switchability', and coined the phrase 'individual bioequivalence' which they defined with a probability-based inequality. Since that paper there has been considerable work and discussion. The Food and Drug Administration has recommended the introduction of individual bioequivalence (IBE) and population bioequivalence (PBE) methods in a draft guidance document. The proposal in the draft guidance includes criteria for IBE and PBE and recommends the use of non-parametric bootstrap 95 per cent upper confidence intervals for the conclusion of either IBE or PBE. However, this method requires intensive computations. We have developed an alternative confidence interval procedure to assess IBE by the FDA recommended criteria. This method utilizes Howe's approximation I to a Cornish-Fisher expansion. Our proposed method is applicable to balanced or unbalanced data in a broad class of extended cross-over designs, and can be easily programmed using readily available software.

Confidence Intervals↗

Effect of needle length on incidence of local reactions to routine immunisation in infants aged 4 months: randomised controlled trial.

OBJECTIVE: To compare rates of local reactions associated with two needle sizes used to administer routine immunisations to infants. DESIGN: Randomised controlled trial. SETTING: Routine immunisation clinics in eight general practices in Buckinghamshire. PARTICIPANTS: Healthy infants attending for third primary immunisation due at 16 weeks of age: 119 infants were recruited, and 110 diary cards were analysed. INTERVENTIONS: Immunisation with 25 gauge, 16 mm, orange hub needle or 23 gauge, 25 mm, blue hub needle. MAIN OUTCOME MEASURES: Parental recordings of redness, swelling, and tenderness for three days after immunisation. RESULTS: Rate of redness with the longer needle was initially two thirds the rate with the smaller needle (relative risk 0.66 (95% confidence interval 0.45 to 0.99), P=0.04), and by the third day this had decreased to a seventh (relative risk 0.13 (0.03 to 0.56), P=0.0006). Rate of swelling with the longer needle was initially about a third that with the smaller needle (relative risk 0.39 (0.23 to 0.67), P=0.0002), and this difference remained for all three days. Rates of tenderness were also lower with the longer needle throughout follow up, but not significantly (relative risk 0.60 (0.29 to 1.25), P=0.17). CONCLUSIONS: Use of 25 mm needles significantly reduced rates of local reaction to routine infant immunisation. On average, for every five infants vaccinated, use of the longer needle instead of the shorter needle would prevent one infant from experiencing any local reaction. Vaccine manufacturers should review their policy of supplying the shorter needle in vaccine packs.

Confidence Intervals↗