PubMed · 3645935
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P L Kuhn. 1987. Standing ovation.. https://pubmed.ncbi.nlm.nih.gov/3645935/
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This paper describes recent reforms of quality assurance (QA) for the education of nurses, midwives and health visitors and reports qualitative findings from a study of how they are working out in practice. This study reported whether the stakeholders consider the system to be adequate for the principal aim of public protection. Using a postal survey and interviews, QA in nursing, midwifery and health visiting is compared and contrasted in the four countries of the United Kingdom. Issues of subjectivity versus objectivity in decision making over QA of nursing, midwifery and health visiting education and the extent to which these processes are rigorous arose. There is an inverse relationship between the number of higher education institutions in a country and the extent to which nursing, midwifery and health visiting QA personnel, responsible for conducting QA events, become involved with those institutions in offering advice and support. Generally speaking, where the changes have been greatest, satisfaction with the QA processes is lowest. Dissatisfaction was only expressed with processes and most likely arose from resistance to change but these are early days in the operation of the new QA procedures.
PURPOSE: To develop a questionnaire for measuring referring physician satisfaction and to conduct a pilot study in which this questionnaire is given to all physicians referring patients to the authors' radiology department. MATERIALS AND METHODS: After qualitative pre-testing and adjustment of the prototype questionnaire, data were collected using the finalized standardized questionnaire comprising 29 indicators rated on a 4-point ordinal scale mailed with a personalized cover letter to the total referring physician population of a radiology department (n = 727). The replies, rated 1 - 4, were entered into a data entry mask for statistical analysis. RESULTS: The response rate was 33.8 %. The indicators with the highest satisfaction rating were the range of examinations offered ("very satisfied": 79.3 % mean 3.79), the quality of the technical equipment used for MRI and CT (79.3 %, 3.79) and mammography (82.5 %, 3.82), and the quality of the images yielded by these procedures (74.5 %, 3.73 and 82.2 %, 3.83). Dissatisfaction was relatively high with the indicators "time to receipt of the written report" (28.3 % "not very satisfied" or "not at all satisfied", mean 2.97), "time to receipt of the X-ray images" (18.2 %, 3.07) and "availability of previous findings" (20.9 %, 3.05); satisfaction was higher among external referring physicians (p < 0.05). Physicians rated the importance of these three indicators as relatively high ("very important": 62.4 %, 54.3 % and 49.6 %). Other indicators showing a similar level of dissatisfaction were "car parking availability" (24.1 %, 3.01), "patient waiting time" (27.4 %, 2.87) and "patient environment" (21.2 %, 2.99), although these factors were rated as less important ("very important": 33.0 %, 33.7 % and 40.4 %). CONCLUSION: This questionnaire constitutes a standardized validated instrument for assessing referring physician satisfaction with a radiology department. The data from this pilot study highlight areas for potential improvement. Deployment of such a questionnaire in different radiology departments could serve to establish best practice benchmarks.
Bitterness and astringency are found in a variety of foods, including nuts, fruits, chocolate, tea, wine, and soymilk. In fruits and beverages, the taste of bitterness and the tactile sensation of astringency are elicited primarily by flavanol polymers (proanthocyanidins or condensed tannins). Variations in proanthocyanidin composition, such as polymer size, extent of galloylation, and formation of derivatives, affect both bitterness and astringency. In beverages, other factors also influence these sensations, including the pH and the levels of ethanol, sweetness, and viscosity. Similarly, foods eaten with beverages can influence astringency. For example, eating dark chocolate increases the astringency of red wine more than does milk chocolate. Individuals perceive astringency differently because of variations in salivary flow rates, and preferences for and acceptance of a product may vary tremendously among individuals; decreasing bitterness and/or astringency may not increase preference. Factors influencing bitterness, astringency, and individual preference decisions are discussed.