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Results for “Pilot Projects”

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At least 469 records · Page 26Linked to original sources

PubMed1993

[Antegrade puncture of the superficial femoral artery: a pilot project].

Antegrade puncture of the femoral artery is often the first step in angioplasty or thrombolysis of the lower limb. Because of presumed complications, mostly from anecdotal literature, the common femoral artery is the preferred site of entry. From there, selective catheterization of the superficial femoral artery can be performed. This two-step procedure is sometimes long and difficult for both the patient and the radiologist. To improve the ease and the rapidity of this procedure, the author performed direct antegrade puncture of the superficial femoral artery during 25 consecutive antegrade approaches. The only local complication was hematoma, which developed in two patients but disappeared spontaneously. Aggravating factors were the size of the catheters used and fibrinolytic therapy in one of the affected patients. The results of this pilot study suggest strongly that direct antegrade puncture of the superficial femoral artery is safer than might be expected from the literature, which deals primarily with retrograde puncture. This approach must now be systematically compared with the "classic" common femoral artery approach.

Aged↗

PubMed2004

Promoting transparency of long-term environmental decisions: the Hanford Decision Mapping System pilot project.

Nuclear waste cleanup is a challenging and complex problem that requires both scientific analysis and dialogue among a variety of stakeholders. This article describes an effort to develop an online information system that supports this analytic-deliberative dialogue by integrating cleanup information for the Hanford Site, and making it more "transparent." A framework for understanding and evaluating transparency guided system development. Working directly with stakeholders, we identified information needs and developed new ways to organize and present the information so that it would be more transparent to interested parties, with the ultimate aim of fostering greater participation in decision dialogues and processes. The complexity of the information needed for dialogue suggested that several types of communication devices ("information structures") were warranted. Five information structures were developed for the pilot Decision Mapping System (http://nalu.geog.washington.edu/dms). Decision maps hyperlinked decision information to maps of Hanford. Background Information provided context in a narrative format. Decision Paths organized decision process information on a timeline and provided direct hyperlinks to online documentation. The Geographic Library hyperlinked decision documents to maps. Finally, a Discussion Forum allowed users to make comments and view remarks from others. Early lessons from this work suggest that transparency is integral to long-term management, a participatory design process contributed greatly to its perceived success, and better data integration to support decision making is needed. This work has broad implications for risk communicators and risk managers because it speaks to the design of information systems to support "analytic-deliberative" decision processes (i.e., those that rely upon both risk science and public dialogue).

Communication↗

PubMed2003

Telemedicine in Western Africa: lessons learned from a pilot project in Mali, perspectives and recommendations.

OBJECTIVE: to evaluate the feasibility, potential and risks of an internet-based telemedicine network in developing countries of Western Africa. METHODS: a project for the development of a national telemedicine network in Mali was initiated in 2001, using internet-based technologies for distance learning and teleconsultations. RESULTS: the telemedicine network has been in productive use for 12 months and has enabled various collaboration channels, including North-South, South-South, and South-North distance learning and teleconsultations. It also unveiled a set of potential problems: a) limited pertinence of North-South collaborations when there are major differences in available resources or socio-cultural contexts between the collaborating parties; b) risk of induced digital divide if the periphery of the health system is not involved in the development of the network, and c) need for the development of local medical contents management skills. CONCLUSION: the identified risks must be taken into account when designing large-scale telemedicine projects in developing countries and can be mitigated by the fostering of South-South collaboration channels, the use of satellite-based internet connectivity in remote areas, and the valorization of local knowledge and its publication on-line.

Africa, Western↗

PubMedDate not supplied

Using nurse practitioners in home care. A report of two pilot projects.

Currently, nurse practitioners are not being employed by home care agencies due to problems related to reimbursement by third party payors, physician reluctance, and scope of practice concerns. This research describes client conditions and advanced practice services that home care nurses have identified as useful for the delivery of quality care.

Attitude of Health Personnel↗

PubMed2006

Using evidence and process improvement strategies to enhance healthcare outcomes for the critically ill: a pilot project.

BACKGROUND: Although the value of evidence-based practice may seem obvious, the process needed to produce more effective delivery of evidence-based healthcare is not obvious. Furthermore, the continuing escalation of healthcare costs fuels the desire of providers and consumers to undertake only those treatments that have benefit. One way to effect necessary changes in healthcare organizations is through focused, interdisciplinary, collaborative projects related to evidence-based practice. OBJECTIVES: To reduce rates of ventilator-associated pneumonia and catheter-related bloodstream infection in patients in the medical intensive care unit of a large, urban tertiary referral hospital in the Southwest. METHODS: The theory of planned behavior served as the basis for providing staff members with research-based, easily controllable strategies that "fit" with the usual methods of care delivery. Implementation of the strategies and data collection were accomplished through routine rounds on patients and regular reporting of objective information. RESULTS: During a 15-month period, use of the selected strategies resulted in a 54% reduction in ventilator-associated pneumonia, a 78% reduction in catheter-related bloodstream infections, and a 18% reduction in mean length of stay in the unit. Use of a multidisciplinary, environmentally tailored approach to concerns about patients' care resulted in estimated cost savings of 1.0 million US dollars to 2.3 million US dollars. CONCLUSIONS: Early, consistent communication about the project's rationale, expected behavior, and outcomes enhanced the manageability and effectiveness of this change in an adult intensive care unit.

Arizona↗

PubMed1987

Observations on community screening for alcohol problems: a pilot project to assess the feasibility of identifying heavy drinkers in a community setting.

Using a standard computerised alcohol screening questionnaire including the CAGE and SMAST instruments, 122 subjects in a suburban shopping centre in Perth, Western Australia, were screened in an attempt to estimate the prevalence of hazardous drinking and to investigate knowledge of and attitudes to safe and heavy alcohol consumption.

Alcohol Drinking↗

PubMed1991

Head and neck cancer localization with indium labelled carcinoembryonic antigen: a pilot project.

Antibodies reacting with cancer cells are playing an increasing role in cancer detection. Most antibodies under study are directed at onco-fetal proteins, principally carcino-embryonic antigen (CEA). In terms of imaging, most work has concentrated on the abdominal and pelvic regions. Although the majority of primary head and neck cancers are amiable to clinical identification, detection of regional metastases and recurrences following radiotherapy can be difficult. Antibody to CEA was radiolabelled with Indium-111 and used to identify proven head and neck tumors by external imaging. In seven patients with squamous cell tumors, five of five primary sites and two of three secondary sites were imaged satisfactory. Comparison with conventional scanning showed good correlation. There were no false positive scans, no consistent relationship between serum or tissue CEA levels and the success of imaging was evident. The success of this pilot study should encourage the search for more tumor-specific antigens, and further studies of external scintigraphic techniques in the localization of head and neck cancers.

Aged↗

PubMed2001

The application of telemedicine technology to a directly observed therapy program for tuberculosis: a pilot project.

We evaluated the use of videophone technology to provide directly observed therapy (DOT) to patients with active tuberculosis. During 304 treatment doses, adherence on videophone DOT was 95%, and patient acceptance of the technology was excellent. In selected cases, the use of videophone technology can maintain a high level of adherence to DOT in a cost-effective manner.

Centers for Disease Control and Prevention, U.S.↗

PubMed1995

Forensic DNA testing on skeletal remains from mass graves: a pilot project in Guatemala.

A reliable method for extracting DNA from teeth was developed and successfully applied to a set of 12 skeletons recovered from two 10-year-old Guatemalan mass graves. Attempts to identify the remains by mitochondrial DNA (mtDNA) testing were hampered by low sequence diversity. Our findings demonstrate the feasibility of using DNA typing to identify victims from mass graves.

Adolescent↗

PubMed2001

Systematic triage in the emergency department using the Australian National Triage Scale: a pilot project.

The objective of this study was to evaluate the validity in Belgium of the National Triage Scale for judgement of the urgency of a patient's condition and making a case-mix description of the patient profiles in the different urgency categories. The study is of a descriptive retrospective and descriptive correlational design and was carried out in the emergency department at the University Hospital Gasthuisberg in Leuven, Belgium. The urgency of patients arriving at the emergency department was evaluated during one randomly selected shift a day over 12 weeks in 1997 by one of the four triage-educated nurses, using an instrument based on the National Triage Scale. Patient identification and outcome parameters were retrieved from the existing computer system. The data were mainly analysed using the Ridit analysis. Overall 3650 patients were evaluated: Category 1, 4.19%; Category 2, 24.44%; Category 3, 39.32%; Category 4, 27.97%; Category 5, 4.08%. Any similarity between sentinel diagnoses as well as between the admission percentages in this pilot study and the reference from Australia (Z = 0.827; p > 0.05) was noted. Different aspects influenced the triage nurses while determining the degree of urgency. Urgency categories profiles revealed a significant effect of age (Kruskall-Wallis = 530.5; p = 0.000). Higher categories of urgency resulted in a higher degree of admission (t (df = 3640) = 643.45; p = 0.000). It is concluded that a resemblance between the pilot study and the reference confirms the predictive validity of the scale used. Patient profiles in the different urgency categories give a description of the emergency department population.

Adolescent↗

PubMed1997

[Continuing medical education via questionnaire studies. Three pilot projects for anesthesiology, cardiology and neurology].

The Danish Medical Association and the scientific societies have initiated three studies to evaluate the use of questionnaires for continuous medical education. One study was a questionnaire in anaesthesiology with 30 questions with answers yes/no/no answer, which was sent to 600 specialists in anaesthesiology. One study was in cardiology with a multiple choice questionnaire, sent to 300 general practitioners and 75 specialists in internal medicine outside cardiology. One study concerned the educational value of State-of-the-Art articles about neurology in Ugeskrift for Laeger (Journal of the Danish Medical Association) sent to 500 doctors outside neurology. All questionnaires were sent anonymously, with one general reminder. For the anaesthesiology study 234 questionnaires were returned (40.5%). In the cardiology study 195 questionnaires were returned (52%). For the study on neurology 278 answered (56%). Only about half of the questionnaires were returned for the three studies, and a lot of effort and resources were put into the studies. An extension from these small pilot studies to a general systematic continuous methodology with updated questionnaires in the postgraduate medical education seems troublesome. An optional self-registration for medical education such as The Canadian "Mocomp concept" might be a more realistic suggestion.

Anesthesiology↗

PubMed2001

EMR to the rescue. An ambulatory care pilot project shows that data sharing equals cost shaving.

PROBLEM: Inefficiencies in managing office practices and costs. SOLUTION: Installation of an EMR in ambulatory practices to integrate clinical data from patient visits and use it to improve efficiencies "downstream". RESULTS: Marked reduction in costs of ambulatory practice management and major improvements in revenue capture, improved patient satisfaction. KEYS TO SUCCESS: Analysis of workflow, documentation of progress with benchmarking.

Academic Medical Centers↗

PubMedDate not supplied

African American community breast health education: a pilot project.

This paper reports the results of a project designed to examine the effectiveness of a Train the Trainer breast health education and screening program for African American, elderly and underserved women residing in the greater Nashville area. The project aimed to identify a cadre of women from the community willing to serve as leaders advocated and peer breast health educators. Data collected from the community leaders and the women from the local community during the course of the project suggest that the Train the Trainer model was well suited to provide education, support and breast cancer resource referral to women residing within this rural Tennessee community.

Black or African American↗

PubMed1998

'Partnership with parents' a pilot project.

This paper looks at a controlled study which aimed to measure the efficacy of a parent programme. The parents involved were all parents of pre-school children with specific expressive language delay (SELD). A number of measures were used to identify changes in mother-child interaction and language development. Significant differences were noted in the experimental group while the control group remained stable over time. The results indicate the potential effectiveness of this type of intervention for children identified as having SELD.

Child, Preschool↗

PubMedDate not supplied

Enhancing early discharge with home follow-up: a pilot project.

Although early hospital discharge of mothers and infants reduces health care costs, it also decreases the opportunities for women to learn the mothering role with the help of health care providers. This article describes the development of a program in which hospital staff nurses provide follow-up care to new mothers and their infants in the home. In addition, it compares the nonroutine health care expenditures in the postpartum period of mother-infant dyads receiving this service and of dyads who did not.

Adolescent↗

PubMed1992

Integrating providers into quality improvement: a pilot project at one hospital.

Brigham and Women's Hospital initiated a study of the quality of care centering on self-reporting of potential medical injuries by providers. The goal of the study is to decrease the incidence of such injuries through a continuous quality methodology that integrates providers into the identification phase and incorporates all hospital employees in the development of new practices. This article provides an overview of the investigation methodology and discusses the conceptual relationships between clinical epidemiological analyses and industrial quality improvement.

Boston↗

PubMed1976

Arbitration of malpractice claims: a hospital-based pilot project.

In summary, the findings of this study indicate that the "simple existence" of an arbitration option and the logistical systems supporting it have produced positive results and have established significant trends in a group of hospitals participating in the Southern California Arbitration Project when compared to a group of Southern California hospitals that have not participated. Albeit inconclusive at this time, the concept may well be a feasible alternative to litigation in securing an expeditious and inexpensive resolution for malpractice cases. Arbitration, in and of itself, is most assuredly no panacea for the critical malpractice problem currently experienced throughout the country; however, its potential substantive contribution toward the resolution of malpractice claims is certainly one worthy of extensive experimentation and evaluation.

California↗

PubMed2001

Treatment of sexual offenders who are in categorical denial: a pilot project.

This paper describes an approach to treatment for sexual offenders who are in categorical denial. Other efforts to have them, at least partially, admit responsibility had failed and they were to be released from prison without any treatment. Evidence that suggests denial is not predictive of risk and that treatment may reduce the risk of these offenders is reviewed. Essentially, this paper offers a possible approach to dealing with these intractable deniers which, it is suggested, is better than not trying to modify their risk, and that may prove to be effective.

Adaptation, Psychological↗