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At least 19 recordsLinked to original sources
PubMed1992

A patient transport pilot quality improvement team.

The transportation of inpatients within the hospital is a critical component of the patient care process. A quality improvement (QI) team at Massachusetts General Hospital (Boston) convened to improve this process and to pilot the QI approach there. Pilot QI projects have the burden of intense scrutiny by senior management at a point when the fundamentals needed for a successful QI project are scarce or not yet available. The authors, who were participants in this project, describe the methodology and outcomes of this pilot QI process as well as the lessons learned. The results confirm that, although difficult, it is possible to succeed in pilot projects and gain the support needed to move on to the next step in the QI journey.

Boston↗
PubMed1990

Mishaps during transport from the intensive care unit.

We undertook a prospective study of 125 intrahospital patient transports from the ICU in an attempt to identify any factors that could influence the occurrence of mishaps. One third of the transports sustained at least one mishap. Therapeutic intervention scoring system class IV transports had the highest rate of mishaps (35%). We found no relationship of occurrence of mishaps to severity of illness (Acute Physiology and Chronic Health Evaluation, APACHE II), number of lines, monitoring and support modalities, and time out of the ICU. Transports for elective procedures had more mishaps (60%) than occurred for emergencies (40%). Most mishaps occurred either during the procedure, on transports to CT scan, or while waiting at the destination. The numbers and types of escorts as defined by our ICU policy and physician attendance on transport did not clearly reduce mishap risk. Morbidity and mortality were not affected by mishaps. Although certain trends did emerge, no clearly defined predictive factor could be identified. Further study into transport mishaps is warranted.

Accidents↗
PubMed1992

Introducing a quality of service programme to hospital orderly staff.

Recent reshaping of health provision throughout New Zealand has brought many changes to virtually every area of the service. In some instances this has required a totally fresh approach with a different way of thinking. In others, it has meant the adaptation and remodelling of existing structures and approaches. This paper gives a brief overview of the West Auckland Health District Quality of Service Programme and, in particular, its introduction to the orderly service at Waitakere Hospital.

Job Description↗
PubMed1991

[The second report on Japanese abroad with psychiatric problems: air transportation of Japanese with mental disorders in western Europe].

This is to report on airline travel processes experienced with two Japanese psychotics (schizophrenic) abroad who were treated by the local consulates of Japan, and escorted by Japanese psychiatrists from April to May in 1989. A comparative analysis was made of the two cases from the following six points of view: psychopathology concerning travel, psychiatric evaluation at the time of travel, access to local psychiatric medical services, trust between the patient and escorting physician, method of administering drugs, and cooperation in strategy with the airline company. Results indicate that the following three points are crucial in the air transportation of Japanese psychotics: 1) Establishment of patient-escorting physician trust relationship, 2) Adequate sedation through sufficient administration of tranquilizers, 3) Establishment of communication and close cooperation with the airline company.

Adult↗
PubMedDate not supplied

Emergency department workload--a transatlantic comparison.

This paper compares the workload of the emergency department of a Level One trauma center in the United States and a large city hospital in the United Kingdom. The referral pattern and diagnostic classification of 5,000 patients presenting to both departments were compared, as were the transportation systems at the two sites. It was shown that similarities existed in many areas. Major trauma formed only a small proportion of the overall workload of both departments. The conclusion is that although the two emergency care systems have fundamental differences in terms of organization and finance, the workloads are remarkably similar. Interesting differences arose in areas such as use of helicopter transport, psychiatric and drug and alcohol related admissions, and in the number of patients brought to hospital under police escort.

Aircraft↗
PubMed1987

The impact of crime on home care services.

A telephone survey of 49 Veterans Administration Home Care Programs found 32 programs reporting dangerous areas in their territories. Twelve excluded patients based on safety of area of residence. Programs in the eastern United States and in cities with higher rates of crime were more likely to have paired visits, escorted visits, or to exclude patients. Programs providing paired or escorted visits were less likely to exclude patients, suggesting that such policies maximize access to home care.

Crime↗
PubMed1991

Aeromedical patient transfer.

Aeromedical evacuation involves the transfer of patients in a variety of aircraft types (both fixed-wing and helicopters). The patients' condition will hopefully be maintained or improved during the transfer. The escorting doctor should be aware of the differences between working in the airborne environment and working in the static ground-based facility.

Aircraft↗
PubMed1979

Using the resources of AA in treating alcoholics in a general hospital.

At Cleveland Metropolitan General Hospital a small number of staff and a large number of volunteers from Alcoholics Anonymous have collaborated to meet the treatment needs of the community's alcoholics. Recovered alcoholics serve as volunteers staffing a friendship room, located close to the emergency room and open weeknights between 6 and 10 p.m. They also provide counseling on AA, escort patients to AA meetings, help in postdischarge follow-up, and act as casefinders in the community. The hospital staff have become more aware of problems of alcoholism and are better able to treat alcoholics and to provide counseling and referral services.

Alcoholics Anonymous↗
PubMed1990

Interhospital transfer in the management of acute trauma.

During an 8-month period, 538 injured patients were transferred from primary hospitals to a referral hospital for further management of their injuries. Delay at the primary hospital was identified in 20% of all transfers and in 40% of patients transferred for management of head injury or multisystem injury. Delay at the primary hospital resulted in a median time from injury to arrival at the second hospital of 4 h. Defects in clinical management during transport included inexperienced escorts, inadequate airway control, ventilation, fluid resuscitation and stabilization of chest injuries. Nearly half of transfers were inappropriate because of the relatively minor nature of the injuries. Most of these had solitary musculoskeletal injuries to the extremities. These patients reflect the marked deficiency of specialist orthopaedic services in western Sydney during the study. Development of a metropolitan regional system of trauma care in western Sydney requires urgent action towards reducing the frequency of transfer, minimizing delays in transfer and maximizing basic resuscitation of seriously injured patients. Some designation of hospital roles is required and needs to be accompanied by a prehospital triage process. The population also has a right to expect adequate specialty services at suburban hospitals to enable treatment of minor and moderate single system injuries. Future trauma system developments should adequately reflect population growth and technological advances in clinical care.

Adolescent↗