Departmental Group Research Articles

Sometimes I just wish it was all over

In this article I reflect upon having recently been invited to join a new departmental group being set up to talk about Equality, Diversity and Inclusion; at the same time having been told to remember that my perspective is just one among equally valid others. I reflect upon what Drake (1999) has described as the ‘fundamentally opposed’ natures of the medical and social models, and upon the absurdity involved in a requirement to give assent to both. I consider the unfortunate dualism involved in claims that people ‘have disabilities’, and suggest that Sartre’s dictum ‘existence precedes essence’ offers a way of thinking about disability that the medical model can’t begin to make sense of. I draw upon statements by disabled people about how they feel about themselves to challenge conventional personal tragedy assumptions.

359 Assessment of Utilizing a Standardized Checklist on Length of Time for Resident Physician Sign Out and Attending Physician Grading Consistency

Transitions of patient care during physicians’ change of shift introduce the potential for critical information to be missed or distorted, resulting in possible morbidity. Since 2009, the Joint Commission has encouraged improving transitions of care as a national safety goal. Our study sought to determine if utilization of a sign out checklist during emergency medicine (EM) resident transition of care affected the consistency of attending physician overall assessment and if the checklist changed length of time to sign out. This prospective study assessed EM residents’ transition of care during departmental group sign out. After institutional review board (IRB) approval, residents of varying post-graduate years transferred their patients’ care to the incoming physician team. For two months, residents gave their typical sign out (pre-checklist cohort, PCL). For the next two months, residents utilized a standardized sign out checklist (post checklist cohort, CL). The incoming and outgoing attending physicians would assess each resident sign out, and give an overall assessment using a visual analogue scale. Intraclass correlation coefficients (ICC) using a two-way mixed model were calculated to determine the association between the two attending physician grades. ICCs were calculated for the PCL and CL cohorts. The time was also recorded from first patient sign out to last. Continuous data are reported as medians, with separate Wilcoxon signed rank tests conducted as appropriate. Assessment of transition of care was performed for 77 days (38 days of status quo, 39 days utilizing a checklist). There were 548 assessments in the PCL cohort and 697 in the CL cohort. The ICC for PCL was 0.11 (95% confidence interval -0.18 to 0.32), which demonstrates poor consistency between attending physician graders. The ICC for CL was 0.56 (95% confidence interval 0.45 to 0.65), demonstrating a moderate consistency among attending physicians. Length of time for sign out in PCL cohort was 13 minutes, and in the CL cohort was 9 minutes. This finding was statistically significant, p = 0.03. Our study concludes that a checklist utilized during emergency medicine resident sign out improves the consistency of attending physician assessments. A standardized checklist decreases length of time to sign out with the checklist.

Review of the A.А. Mikhailenko, M.M. Odinaka, N.N. Yakhno monography «The history of domestic neurology. Moscow neurological school»

Monograph by A.A. Mikhailenko, M.M. Odinaka, N.N. Yakhno “History of Russian neurology. Moscow Neurological School" (St. Petersburg: SpetsLit, 2015. - 511 p.) consists of a preface, eight chapters and an afterword. Already in the preface, the authors indicate that the monograph is presented not in the form of a detailed description of all types of activities of departmental groups, but in the form of essays, that is, the most important, remarkable and significant information and facts.

Exploring the identity and reputation of departmental groups: whose opinions matter most to their members?

This article focuses on perceptions of a collective's contribution identity (i.e. how its own members view the effectiveness of its contributions towards organisational goals) and contribution reputation (i.e. how the rest of an organisation views its contributions), and how they are associated with the job satisfaction of its members. Data from 187 employees across 10 organisational departments was used to test competing hypotheses developed from three different theoretical perspectives. Results suggest that satisfaction was positively linked to member beliefs about their department's contributions to organisational success. Reputation had a positive impact on satisfaction only when it is derived from individuals from other departments that a department interacted frequently with.

The organizational huddle process--optimum results through collaboration.

The St. Joseph's Regional Medical Center in Paterson, New Jersey, initiated a methodology called The Organizational Huddle Process in the fall of 1999. This communication vehicle enhances operational performance through a fast, focused, and highly collaborative process. The results of this initiative have been most impressive. Hundreds of problems have been resolved before escalating to crisis levels, with an increase in stakeholder satisfaction. This process is appropriate for all levels within an organization, is effective for both interdisciplinary and departmental groups, and has minimal associated implementation costs. This article reviews the rationale and benefits of The Organizational Huddle Process, a recommended implementation strategy, and a nurse manager's review on the application of this methodology.

CALL and Web training with teacher self-empowerment: a departmental and long-term approach

This paper examines the benefits of self-empowering, group in-service training (INSET). It incorporates evidence from several case studies. The training involves the teaching and practising of relevant skills, as a departmental group, in the evaluation, selection and use of various computer-assisted language learning (CALL) and Web materials. Prior assessment of the needs of individual teachers and those of the department as a whole inform subsequent targeting of the training content. These needs range from a self-confessed paucity of awareness of CALL materials among modern foreign language teachers to the effective use of multi-media authoring materials across the whole ability range. There is a description of a typical training session which reveals that there must be at least two facilitators offering expertise on the CALL materials being presented and practical teacher-training experience of the challenges teachers face within the classroom. The benefits of a model which supports team work and an educative process, and which holds a balance between theoretical issues and practical hands-on experience, is shown to be effective. The paper concludes with an evaluation of this form of INSET and proposes recommendations for further development and dissemination.

A case-control study of lung cancer at a foundry and two engine plants.

A nested case-control study of lung cancer was conducted among workers at an iron foundry and two engine manufacturing plants whose lung cancer mortality rates were slightly higher than expected. The study included 231 lung cancer cases and 408 controls for whom complete work histories were obtained. There was no association between usual plant of employment and lung cancer mortality. The odds ratio for persons employed for 20 or more years in the foundry compared with persons employed in the engine plants was 0.90 (95% confidence interval: 0.55, 1.5). Long-term employment as an engine plant worker was associated with odds ratios slightly, but not statistically significantly, below unity. In the foundry, only usual employment in the material handling departmental group and any employment in the quality control departmental group were statistically significantly directly related to lung cancer risk. However, the number of subjects so employed was small and there was no dose-response relation between length of employment in these departmental groups and lung cancer risk. Cases were less frequently employed than were controls in engine plant machining and assembly jobs and departments. It is concluded that employment in this facility was either unrelated, or only weakly related, to lung cancer risk.

Risk factors for a positive tuberculin skin test among employees of an urban, midwestern teaching hospital.

To determine the prevalence and incidence of and the relative risks for positive tuberculin skin tests among employees of a large, urban teaching hospital. Retrospective cohort study. Barnes Hospital, St. Louis, Missouri. Hospital personnel employed at any time between January 1989 and July 1991. 684 of 6070 employees screened (11.3% [95% CI, 10.4% to 12.1%]) had positive tuberculin skin tests. Factors associated with a positive result were age (odds ratio, 2.02 per decade [CI, 1.87 to 2.18]; P < 0.0001); black race (odds ratio, 1.58 [Cl, 1.26 to 2.00]; P < 0.0001); Asian race (odds ratio, 16.7 [CI, 9.33 to 29.9]; P < 0.0001); Hispanic ethnicity (odds ratio, 9.45 [CI, 3.58 to 25.0]; P < 0.0001); and percentage of low-income persons within the employee's residential postal zone (odds ratio, 1.14 per 10% [CI, 1.05 to 1.23]; P = 0.001). Twenty-nine of 3106 employees who had at least two tests had skin-test conversions (0.93% [CI, 0.60% to 1.3%]); 15 of these conversions (52%) occurred among employees who had no direct contact with patients. Only the percentage of low-income persons within the employee's residential postal zone (odds ratio 1.39 [CI, 1.09 to 1.78]; P = 0.0075) was independently associated with conversion. The most important associations with a positive tuberculin skin test were older age, minority group status, and the proportion of low-income persons within the employee's residential postal zone. Skin-test conversion was independently associated only with the percentage of low-income persons in the employee's postal zone. Stratifying employees according to degree of contact with patients or according to departmental group was not useful in determining risk for a positive tuberculin skin test or for skin-test conversion. For certain groups of employees, an exposure to tuberculosis in the community probably poses a greater risk than exposure in the hospital setting.

Results of a rubella screening program for hospital employees: a five-year review (1986-1990).

The Barnes Hospital Employee Health Service (St. Louis, Missouri) rubella screening program was evaluated over the 5-year period between January 1, 1986, and December 31, 1990. A total of 6,969 new employees were hired, and 6,115 (87.7%) were screened for evidence of rubella immunity by the Employee Health Service. Rubella serology was performed on 5,893 (96.4%) of the screened employees, while 222 (3.6%) had documentation of prior rubella vaccination or rubella infection. The absence of immunity was identified in 325 employees or 5.3% of all those screened. Women were more frequently screened by the Employee Health Service than were men (p < 0.0001), and blacks were more frequently screened than were non-Hispanic Caucasians (p < 0.0001). Physicians were less frequently screened than were other departmental groups (p < 0.0001). The rate of seronegativity for each year of hire varied from 4.45 to 6.76%, but these differences were not significant. Logistic regression analysis demonstrated that 5-year birth cohorts correlated significantly with serologic status. Employees born in 1960-1964 were least likely to be seronegative, and employees born in 1970 or later were most likely to be seronegative. Sex, race, and department group were not predictive of serologic status, although significant differences in results from different rubella assays were detected. Only 13.8% of seronegative employees were subsequently vaccinated by the Employee Health Service. This study demonstrates a lower seronegativity rate than did previous studies. It identifies groups of employees likely to escape rubella screening and low vaccination rates. It finds increasing seronegativity among employees born after 1964 that correlates with the reported increasing rates of rubella in the United States.

Evaluation of an Intervention to Change Benzodiazepine-Prescribing Behavior in a Prepaid Group Practice Setting

To determine the effect of two levels of educational intervention on benzodiazepine-prescribing behavior in an elderly population in a controlled prepaid group practice (PPGP) setting, we designed a prospective controlled trial, with six-month follow-up. Our setting was a 270,000 member group-model PPGP in Colorado, from 1990 to 1991. Participants included 91 physicians, 62 men and 29 women; median age was 38.7 years. Group 1 received a one-on-one educational presentation by a clinical pharmacist, written educational materials, a brief follow-up visit, and feedback with recommendations. Group 2 received only a face-to-face presentation, given to departmental groups, as well as the same written educational materials used in group 1. Controls received no intervention. Our primary outcome measure was the benzodiazepine "on/off" status of the elderly PPGP members. The secondary outcome measure was the median change (preintervention minus postintervention) in a standardized amount of benzodiazepines prescribed per physician. Logistic regression analysis failed to show a significant effect on postintervention benzodiazepine on/off status between study groups, when controlling for preintervention on/off status, PPGP-member age, PPGP-member gender, and all possible interactions. Analysis of variance failed to demonstrate an effect of either intervention on the median change in standardized amount of benzodiazepines prescribed per physician, with groups 1, 2, and controls yielding values of -278 (range: -4,137, 2,844), -330 (-1,531, 1,358), and -541 (range: -3,716, 2,185), respectively. We conclude that strategies effective in changing physician prescribing behavior in other settings may not be effective in a PPGP setting with benzodiazepines in the elderly as the target for change.

An Occupational Hazard for Pathologists and Pathology Technicians in Japan

The incidence of pulmonary tuberculosis among pathology workers in Japan is elevated, presumably due to frequent exposure to tubercle bacilli in the work place. To demonstrate the etiological significance of the association between this disease and occupation epidemiologically, a questionnaire survey was performed to assess the incidence of pulmonary tuberculosis among 1,201 pathologists and 1,187 pathology technicians throughout Japan. Pathology department workers other than pathologists and technicians, such as secretaries (n = 207), and workers in university departments of preventive medicine and public health (n = 732) served as control groups. While non-occupation-related tuberculosis was found in both departmental groups with nearly equal incidence, the incidence of pulmonary tuberculosis among pathologists and pathology technicians after engagement in their current specialist work was significantly higher than that in the control groups (odds ratio = 6.08-10.98). The incidence of disease among pathology technicians who assisted in autopsies was markedly higher than among those not involved in autopsies (odds ratio = 6.65). This elevated incidence was significantly related to the duration of work in pathology activities, and showed little change over the last decade. These findings indicate that specific environmental conditions in pathology departments, particularly autopsy of cadavers harboring active tuberculosis, constitute a serious occupational hazard.

The Postaudit Review of Equipment Replacement Decisions in Capital Intensive Companies

Abstract In spite of the universal agreement that capital expenditure postaudit reviews provide valuable feedback, postaudit reviews of equipment replacement decisions are rarely performed in practice. The lack of a precise and reliable accounting system is probably a primary reason that such decisions are not often subjected to a postaudit review. The accounting information related to an equipment replacement is usually aggregated with accounting information related to a cost center; and the cost center often contains many equipment items. This paper describes an approach to cost center accounting that focuses on major items of equipment instead of departmental groups of production workers. By focusing cost center control on major items of equipment, the accounting information would be sufficiently disaggregated in capital intensive industries to permit greatly enhanced analysis, including a meaningful postaudit review of equipment replacement capital expenditures.

Use of Computer-Assisted Instruction in Introductory Management Science

This study investigated the effects of computerassisted instruction on student problem-solving ability and student attitude toward computers and quantitative methods. This was done in conjunction with a traditional introductory management science course. Scores on a departmental group final and responses to pre- and post-course questionnaires were analyzed. The findings indicate that the use of computer-assisted instruction did affect student attitudes. The students who used the computer materials showed an overall increase in their appreciation of computers and quantitative methods. The students who did not use the computer-assisted instruction showed no overall change in their attitudes.

Personal characteristics of house staff candidates: a quantitative analysis of relative weights.

We surveyed the faculty, fellows, and residents of a department of medicine to determine the relative importance of each of eight personal characteristics evaluated during the interview of house staff candidates. A booklet containing all possible pairings of the eight characteristics was distributed to 219 participants who were asked which member of each pair should have greater weight for assigning an overall interview grade. Usable data were returned by 172 persons (79%) and analyzed by the psychometric scaling method of paired comparisons. The four characteristics with the greatest relative weights were professional attitude, maturity, enthusiasm and energy, and knowledge. The faculty, fellows, and residents were highly consistent in their judgments. However, three of the characteristics (motivation for clinical practice, knowledge, and verbal skill) significantly distinguished the three departmental groups. These results show that utility of the paired comparison method for identifying a department's weighting of variables for selection of house staff.