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At least 865 records · Page 48Linked to original sources
PubMed1975

Moving to a health centre--the effect on workload and patients.

A detailed study of the workload of an urban practice was made during a six-month period before and after moving into a health centre to see if the pattern changed after the move. It was found that the services provided enabled a much greater proportion of routine work to be done by the practice nurse so that the doctor could spend more time with the patients seen by him.A survey of the opinion of patients showed that the great majority was pleased with the services offered in the new premises and did not feel that they had lost contact with their own doctor.

Community Health Centers↗
PubMed2002

[Problems due to workload after surgical treatment of carpal tunnel syndrome].

The authors present a group of patients operated on account of the carpal tunnel syndrome in 1998-2000 at the Neurosurgical department in Pardubice. The group comprised 37 patients. 15 men and 22 women. The main objective of the retrospective investigation was to assess the period of work incapacity and asset of the operation from the aspect to proceed with the usual workload. The authors also tried to evaluate the effect of age, sex, occupation, preoperative clinical and electromyographic finding on the resulting effect of the operation. The period of work incapacity after one operation was 114 days. 84% patients returned to their original job. In 11% it was necessary to enlist in different work and a disability pension was granted to 5% patients. The discussion is focused on the period of work incapacity, enlistment in work, the effect of operation on the patients complaints and the objective finding as regards the lesion of fibres of the median nerve and also on the asset of EMG in the diagnosis and postoperative follow up.

Carpal Tunnel Syndrome↗
PubMed2003

Ireland in the World Cup: trauma orthopaedic workloads.

To determine if whether there were any changes in numbers of orthopaedic injuries at the emergency/ orthopaedic trauma department requiring treatment that could be related to televised home matches during World Cup 2002. Numbers of patients attending with musculoskeletal injuries directly attributable to world cup celebrations were collected during the four home matches. Attendances from midnight before the match until midday the day after the match were recorded. Control groups were matched from the previous month of May, and matched with the same day of the week for each of the four groups. Significantly more patients were admitted to the trauma service, referred to orthopaedic outpatients, and referred to the minor trauma clinic in the match versus control groups. 280 patients required onward referral during the match period compared with 233 during the control period. Televised Irish matches during the World Cup significantly increased the workload of the trauma orthopaedic service with musculoskeletal injuries. This should be taken into account when planning for such events in the future.

Adolescent↗
PubMed2004

[Acute physical workload and glucose serum concentration in subjects with different level of physical activity].

The aim of this study was to estimate glucose serum concentration during acute workload in the subjects with different level of physical activity. The study involved a group of healthy males, average 21 years of age, which, based on the level of their physical activity, were divided into two groups: trained and untrained subjects. Acute work load of 30 minutes duration was carried out on byciclergometer following the protocol of individually adjusted constant work load. The glucose serum concentration was measured in the rest and during exercise (6., 12. 18., 24. and 30. minutes). The standard glucose oxidase method was used to determine serum glucose concentration. The serum glucose concentration was in the mean refferal values in the rest period, and during exercise in both examined groups. In the trained group of subjects there was no statistically significant changes in glucose serum concentration during acute work load. In the untrained group of subjects we established decrease in glucose serum concentration during exercise (at 18th., 24th. and 30th) compared to the concentration at rest period. Level of physical activity does not cause significant changes in the glucose serum concentration during acute work load of moderate intensity. Trained subjects have better ability of serum glucose concentration maintenance during exercise compared with sedentary subjects.

Adult↗
PubMed2005

[Changes of EEG frequency-fluctuation characteristics during visual workloads].

OBJECTIVE: To observe the changes of alpha-band frequency-fluctuation characteristics of EEG under visual task. METHOD: Nineteen healthy right-handed male volunteers served as subjects, aged 24-32. EEG were recorded during rest (eyes-closed and eyes-open) and visual task, then analyzed using EEG frequency-fluctuation analysis system. RESULT: From eyes-closed to eyes-open, then to visual task state, the probability distribution characteristics of alpha-band frequency-fluctuation were significantly changed. The probability of 9 Hz and 10 Hz dominance decreased significantly, while the probability of 8 Hz and 11-13 Hz dominance increased significantly. The single component occupying absolute dominance was gradually transformed into the competition between these various components, and the lower frequency component in the front brain-areas gradually occupied dominance; meanwhile, the dominant fluctuation entropy increase significantly, the dominant fluctuation energy decreased significantly, and these processes showed obviously the brain-area related characteristics. CONCLUSION: These changes of alpha-band frequency-fluctuation characteristics reflect the further enhancement of brain activities in the areas related to visual task. This method may be helpful in the study of visual workloads.

Adult↗
PubMed1991

Rheumatoid arthritis: workload and outcome over 10 years.

Rheumatoid arthritis remains a chronic disabling disorder in which medical and surgical intervention may provide amelioration but not cure. In this study a cohort of 123 rheumatoid patients were followed for a period of 10 years from the time of prescription of their initial second-line agent. The workload involved in managing articular, extra-articular and intercurrent disease in these patients has been documented and outcome in relation to continued use of 'disease modifying' therapy evaluated. At 10 years 24 patients (20 per cent) had died and 7 (5 per cent) were not traced; of the 92 (75 per cent) who were assessed, three had become wheelchairbound, two for reasons other than rheumatoid arthritis. Seventy-one per cent of patients required joint surgery, 36 per cent management of peptic ulcer and 45 per cent experienced major episodes of sepsis. Analysis of the results in the 92 patients who were evaluated at 10 years showed significant improvement in Ritchie articular index, pain score, morning stiffness, haemoglobin, platelets, ESR, total globulins, IgG and IgM. Grip strength and Lee functional index showed a trend towards deterioration which did not reach significance. Sixty-seven (73 per cent) of the 92 patients remained on a second- or third-line agent at 10 years (median duration of treatment 107 months); 25 (27 per cent) were not receiving such therapy (median duration of second- and third-line therapy 13 months). The group remaining on treatment showed significant improvement similar to that of the total study group. Those not on treatment improved only for articular index; Lee functional index deteriorated significantly. There was a correlation between area under the curve for ESR over 10 years and radiological progression of disease in hands (r = 0.29, p = 0.026) and in knees and hips (r = 0.3748, p = 0.012) over the 10 year period. Radiographic score correlated well with Lee functional index at the outset and at 10 years and also with the change in the radiographic score over the 10-year period. Unlike the results of previous studies, there was no morbidity from vertebral collapse; this may be related to the low dose of corticosteroids in this cohort (seven patients received systemic corticosteroids). Thus while the aim of treating patients for prolonged periods with second- or third-line therapy was achieved in the majority with no overt evidence of cumulative toxicity, sustained medical and surgical intervention was and will be needed in order to minimize disability in these and other patients with rheumatoid arthritis.

Adult↗
PubMed1991

Preferences of healthy and ill patients for style of general practitioner care: implications for workload and financial incentives under the new contract.

Seven hundred and sixty patients from four general practices in an urban health centre were asked to evaluate the relative importance of 20 statements describing different aspects of general practice. Significant differences were observed between sub-groups of the patients, in particular those who would be likely to make greater use of the general practitioner--the elderly and the ill. Patients who reported not good or poor health status were more likely to value second opinions and, conversely, undervalue efficient prescribing, and an emphasis on vaccinations, cervical smears and check ups. Elderly patients placed greater emphasis on second opinions, protection in their relationship with the hospital, routine visits to the elderly and friendly staff, and similarly undervalued an emphasis on vaccinations, cervical smears and check ups. This means that practices which increase their list size to benefit from higher capacitation payments might, depending on their characteristics, attract predominantly healthy people and increase patient numbers without a commensurate increase in workload. Other facets of the payment system, in particular fees for health promotion work, further support this bias against ill patients.

Adolescent↗
PubMedDate not supplied

Low positive end expiratory pressures improve the left ventricular workload versus coronary blood flow relationship.

Positive end expiratory pressure (PEEP) has desirable effects on blood oxygenation. Nonetheless, PEEP ventilation has an adverse cardiovascular response which limits its utilization. We have studied the effect of PEEP ventilation on the relationship between coronary flow (CBF) to left ventricular workload. In the closed chest of surgically instrumented dogs, increasing PEEP caused a significant decrease in aortic, left ventricular pressures and aortic flow. The coronary blood flow decreased by 5% for PEEP values of 4 cm of H2O and by 25% for 14 cm of H2O of PEEP. The left ventricular (dP/dt)max was markedly decreased. Following the application of 16 cm H2O of PEEP, the predicted myocardial oxygen consumption using Kreb's equation decreased by 42% of base line values, p less than 0.001. The ratio of CBF to predicted oxygen consumption increased with higher PEEP values, a 84% increment at 16 cm H2O of PEEP relative to zero PEEP (p less than 0.001). Our results suggest that PEEP may have beneficial effects on the relationship between CBF and the predicted myocardial oxygen consumption, and therefore may minimize hypoxic myocardial situations. Further studies that will directly measure the myocardial oxygen consumption are essential before clinical conclusions can be drawn from our results.

Animals↗
PubMed1990

The impact of the 23-hour patient on nursing workload.

Decreasing length of in-patient stay and increasing the number of outpatient procedures being performed has led to the creation of the 23/24-hour observation patient. In this study, the authors show that the addition of observation patients to aggregate workload data causes a meaningful staffing deficit 60-90% of the time in three out of four clinical areas studied. The authors explore the statistical impact on staffing of the addition of observation patients to aggregate inpatient data and provide several strategies for staffing.

Ambulatory Care↗
PubMedDate not supplied

A comparison of workload estimates using three methods of patient classification.

This research examined the equivalence of the workload estimates of three commonly used patient classification systems in nursing (GRASP, PRN and Medicus). Patient classification systems are used for program costing and formulation of the nursing budgets. The findings suggest that the estimates of absolute hours of care provided by the three systems differ significantly when all three tools are used on the same patient population, particularly in the Intensive Care Units (ICUs). The data suggest that these differences result from the weights assigned to individual indicators within each system. Although hours of care estimates are significantly different, they are highly correlated. This research suggests that the estimates of hours and costs provided by different patient classification systems may involve clinically important differences. These discrepancies could result in inequitable funding practices unless mechanisms are developed for showing the relationships between systems.

Evaluation Studies as Topic↗
PubMed1989

Relationship between perceived psychic workload and heart rate reactivity in industrial women managers.

The paper presents the results of an investigation into the physiological cost of psychic load in the profession of industrial managers. The psychic workload was estimated on the basis of an evaluation of work requirements and the ability to meet them in terms of mental difficulty, monotony, risk, responsibility, interpersonal conflicts and time pressure. The physiological cost was estimated on the basis of heart rate at work, during leisure time and sleep. Heart rate at work indicated that occupational tasks carried significant psychic load. Notably, the analysis of requirements involving risk showed them to be the most important factor affecting heart rate. Physiological effects of psychic load at work persisted round the clock, which is reflected by a correlation between heart rate during leisure time and sleep and some measures of load and/or working time.

Electrocardiography↗
PubMed1989

Does smog increase the general practitioner's workload?

Dublin city experienced a week-long episode of intense smog in November 1988. A retrospective analysis was carried out in ten general practices of the numbers of patients seen during November. Each practice was situated in an area affected by high smog levels. The numbers of patients seen in surgery and on house-calls showed no differences during the weeks preceding the smog outbreak, during the period of high smog levels or during the week after this period. No qualitative data on the reasons for patients' visits were collected and no comments can be made on the nature of patients' illnesses during this period. There was no evidence for an increased workload in general practice caused by this episode of intense smog but a prospective study is necessary to confirm this finding and to examine the nature of patients' problems during such an episode.

Humans↗
PubMed1989

Changes in emergency surgery between 1973 and 1982: audit of the workload of one surgical team.

The emergency surgical workload of a consultant in general surgery has been studied by comparing two prospectively collected audits of 6-month periods 9 years apart. There have been a number of changes in the pattern and intensity of general surgical admissions (excluding trauma) with a decline in the total number per day from 14.1 to 12.4 and a reduction in the number of days on call for general surgery from 30 to 14 over the 6-month period. There was a similar fall in days on call for trauma from 60 to 23 days and a decline in total emergency surgical operations from 6.6 to 5.2 operations per night on call. These changes have mainly been produced by an increase in the number of consultants in the hospital from five to eight and specialisation with the establishment of an area urology unit. The results of this study suggest that as consultant numbers increase in a particular area there will be diminished exposure of surgical trainees to emergency cases both in quantity and in quality, and this loss of experience will prove deleterious to the trainee surgeon.

Emergencies↗
PubMed1989

Surgical audit--workload, utilisation of manpower and beds, pattern of admission and operations in a community teaching hospital.

The first surgical audit from a South African teaching hospital is presented. During a 1-year period (1987) 1,725 patients were treated in a 60-bed unit (29 patients/bed/yr). Eighty per cent of admissions were emergencies; 1036 operative procedures were performed (45% emergency operations). Aspects of workload, utilisation of beds, pattern of admission and operations are discussed. The audit indicated that a surgical unit in an urban teaching hospital for white patients serves mainly as an acute surgical facility.

Hospital Departments↗
PubMed1989

The workload of a surgical unit in a district general hospital.

A 3-month prospective study of the workload of a surgical unit in a district general hospital was performed to identify the relationship between outpatient work, admissions to hospital, and scheduled operating lists. We have shown that under 60% of all new cases seen in the outpatient clinic had admissions arranged after initial consultation. Over two-thirds of inpatient admissions were for emergencies or urgent cases, and thus not able to be controlled by the surgical team. One-third of emergency admissions had an operation within 24 h of admission. One third of the total number of cases on scheduled lists were emergency or urgent cases (taking up approximately 50% of the operating time). Of all admissions, 32% were as day cases. Of all routine operations, 35% were performed at a community hospital taking only 18% of all our admissions.

Ambulatory Surgical Procedures↗
PubMed1989

House officers' workload--little changes in 20 years.

Studies undertaken in the late 1960s and early 1970s identified areas of the junior hospital doctors' workload that merited attention. Some 20 years later the same key areas continue to raise criticism from house officers in Edinburgh.

Humans↗
PubMed1986

Workload measurement system analyses out-patient costs.

The in-patient and one-day-care analyses focus on hospital patients and patient categories and the impact of these categories on each department and on the hospital, whereas the out-patient analyses use the requesting clinical service as the patient category. The approach taken to the analyses of out-patient workload is much simpler that the approach to the categorization and analysis of in-patient and one-day-care stays. The simpler approach to the analysis of out-patient services provides meaningful yet easy-to-use information for a relatively low investment of time and effort. Future endeavors to analyse the costs of out-patient services should link together all visits to hospital departments associated with a particular "out-patient case" (which may take place over several days). To accommodate such analyses of hospital out-patient products, complete hospital out-patient products (that is, categories of cases) that are more analogous to in-patient categories must be defined.

Costs and Cost Analysis↗