Department Evaluation Research Articles

Performance evaluation in operations department

Performance evaluation in operations department

Occurrence Patterns of Traumatic Brain Injury Within the Emergency Department and Internal Screening Process Efficacy During the COVID-19 Pandemic: Retrospective Analysis.

BackgroundTraumatic brain injury (TBI) is one of the leading causes of death in pediatric patients. Continued recruitment of pediatric TBI participants into a biobank amidst the COVID-19 pandemic not only necessitates adaptive changes to traditional recruitment methods but also requires an evaluation of emergency department (ED) utilization by TBI-presenting patients.ObjectiveThe primary objective of this exploratory retrospective study was to evaluate pediatric TBI-related ED utilization during the pandemic. The secondary objective was to appraise the efficacy of the research team’s internal screening processes.MethodsPotential participants (ie, individuals who met all inclusion criteria and would be approached by a consenter) were screened from an ED’s electronic health record system. Data regarding their visit were recorded in a Health Insurance Portability and Accountability Act–compliant manner, which were cleaned through Google Sheets. Cleaned data were then coded as either a screening variable or a hospital utilization variable to examine the effects of the pandemic on internal operations and hospital utilization patterns. The variables were compared between select months during the pandemic in 2020 to analogous months in 2019 in the R programming language via the two-sample Student t test and the Mann-Whitney-Wilcoxon rank-sum test.ResultsThe sample (N=2321) consisted of 1245 entries from 2019 and 1076 entries from 2020. A significantly greater proportion of potential participants (P<.001) were identified in 2020 (222/633, 35.1%) than in 2019 (195/908, 21.4%). A significantly greater proportion of potential participants (P<.001) had a visit reason indicative of a TBI in 2020 (181/222, 81.5%) than in 2019 (103/195, 52.8%). A significantly greater proportion of these injuries (P=.02) occurred inside (39/181, 21.5%) in 2020 than in 2019 (11/103, 10.7%). No significant difference was found across the mechanism of injury categories reported for potential participants between 2019 and 2020. Potential participants were significantly older (P=.006) in 2019 (mean 8.93 years) than in 2020 (mean 7.31 years). Screeners spent significantly longer (P=.03) to identify potential participants in March 2020 (55 minutes) than in March 2019 (32 minutes), but spent significantly less time (P=.01) to do so in July 2020 (22 minutes) than in July 2019 (42 minutes). Screening coverage was significantly lower (P<.001) in March 2020 (241.8 hours) than in March 2019 (346.5 hours). Screening coverage was significantly greater (P<.001) in April 2020 (611.5 hours) and July 2020 (513.5 hours) than in April 2019 (470.5 hours) and July 2019 (404.3 hours), respectively.ConclusionsThere was a significant increase in the rate of incoming TBI cases to the ED during the COVID-19 pandemic, warranting continued enrollment with added safety measures. Additionally, refinement of internal processes improved the accuracy of data collection. As demonstrated in this study, researchers can leverage ongoing data collection to facilitate process improvements and evaluate the impact of unexpected global events on their research.

Quality assurance in Greek Higher Education and the imperative to use English

ABSTRACT This article examines how dominant discourses disseminated through quality assurance processes in Greek Higher Education (re)define academic work and language use in a globalised HE field. Drawing on Bernstein's theory of pedagogic discourse, we approach government-led external evaluations of university departments as official policy texts that encode the evaluative criteria of quality institutions and valorise specific forms of knowledge and conduct. Our analysis of empirical material derived from selected HE departments illustrates that performance measurement systems interlink English as a default language with mobility and research activity in a unified discourse of quality constructing a selective understanding of how Higher Education Institutions and academics are expected to attain international visibility.

Positive signs on physical examination are not always indications for endotracheal tube intubation in patients with facial burn

BackgroundAfter clinical evaluation in the emergency department (ED), facial burn patients are usually intubated to protect their airways. However, the possibility of unnecessary intubation or delayed intubation after admission exists. Objective criteria for the evaluation of inhalation injury and the need for airway protection in facial burn patients are needed.MethodsFacial burn patients between January 2013 and May 2016 were reviewed. Patients who were and were not intubated in the ED were compared. All the intubated patients received routine bronchoscopy and laboratory tests to evaluate whether they had inhalation injuries. The patients with and without confirmed inhalation injuries were compared. Multivariate logistic regression analysis was used to identify the independent risk factors for inhalation injuries in the facial burn patients. The reasons for intubation in the patients without inhalation injuries were also investigated.ResultsDuring the study period, 121 patients were intubated in the ED among a total of 335 facial burn patients. Only 73 (60.3%) patients were later confirmed to have inhalation injuries on bronchoscopy. The comparison between the patients with and without inhalation injuries showed that shortness of breath (odds ratio = 3.376, p = 0.027) and high total body surface area (TBSA) (odds ratio = 1.038, p = 0.001) were independent risk factors for inhalation injury. Other physical signs (e.g., hoarseness, burned nostril hair, etc.), laboratory examinations and chest X-ray findings were not predictive of inhalation injury in facial burn patients. All the patients with a TBSA over 60% were intubated in the ED even if they did not have inhalation injuries.ConclusionsIn the management of facial burn patients, positive signs on conventional physical examinations may not always be predictive of inhalation injury and the need for endotracheal tube intubation in the ED. More attention should be given to facial burn patients with shortness of breath and a high TBSA. Airway protection is needed in facial burn patients without inhalation injuries because of their associated injuries and treatments.

Emission characteristics of particulate matter emitted by typical off-road construction machinery.

Off-road machinery, especially construction equipment, is one of the most important pollutant sources of the deterioration in the air quality of Chinese urban areas owing to its large quantity and to the absence of stringent emission requirements. In this study, we used a portable emission measurement system (PEMS) to measure the exhaust pollutant emission characteristics for 13 pieces of construction machinery including excavators and hydraulic crushers under different working conditions, such as real-world operating condition, free accelerating condition, and overloading condition, innovatively adopting the method of synchronizing video recording and emission measurement to divide the operation process of construction machinery under different working conditions into different action stages. In addition, the relationship between the emission characteristics and the maintenance history of 13 pieces of construction machinery was analyzed. The present study exploits this recent progress to enrich the measurement method of off-road mobile machinery light absorption coefficient (LAC), which does not depend on the measurement environment and the type of equipment. There are three significant findings from the study that can be noted. To begin with, the exhaust LAC in the excavation operation stage was the highest in the real-world operating condition. The main reason for it is that the engine load was suddenly increased during this stage; due to the response lag characteristics of the turbocharger, the intake charge was delayed, so the quality of oil and gas mixture in the cylinder becomes worse, and the concentration of local mixture is higher. Therefore, insufficient combustion of the mixture leads to a large amount of soot formation. Second, when the real-world operation is unavailable, the free accelerating condition was not applicable, but the overflow loading condition is suitable for replacing the real-world operating condition to measure the excavator exhaust LAC. Finally, as for in-use construction machinery, regular maintenance is an effective measure to reduce the engine exhaust LAC. Our findings contribute to improving the efficiency and accuracy of the environmental protection department's evaluation of the exhaust LAC of off-road mobile machinery and promoting the application of different technologies for high-emission off-road mobile machinery to reduce pollutant emissions so that it can continue to be used.

Child Abuse Screening in the Emergency Department Before and After Implementation of a Formal Screening Tool

Background: &#x0D; Child abuse and neglect is a leading cause of mortality and morbidity in children. Victims of abuse often present to emergency departments due to these injuries. Early identification of suspected child abuse by emergency department staff allows the opportunity for intervention prior to a devastating injury. Signs of child abuse can be subtle and may not always be identified. Recent efforts have worked to improve suspected child abuse identification by implementation of validated screening protocols. Specifically, the IU Health Riley Emergency Department has recently implemented a new child abuse screening tool (effective on 15Apr2021). The Covid-19 pandemic has further exacerbated this issue, creating social isolation and additional socioeconomic stressors that contribute to child abuse. &#x0D; Method: &#x0D; A retrospective chart review was conducted to analyze patients identified for child abuse evaluation in the Riley emergency department. Patients prior to the implementation of the screening tool were identified by those undergoing a social work evaluation for child abuse. For patients presenting after implementation of the screening tool, all patients with a positive screen were reviewed. Charts were then reviewed for baseline demographics, diagnostic testing performed, and injuries identified. All data was recorded in an electronic Redcap database. &#x0D; Results: &#x0D; Implementation of a formal screening tool increased the number of patients identified for a child abuse evaluation (1.34% vs 3.17%) and those evaluated who had an injury also increased (1.15% vs 1.81%). More patients received a head CT scan after implementation of the screening tool (0.89% vs 1.07%), while the percentage of patients with an abnormal head CT decreased (62% vs 45%). &#x0D; Conclusions: &#x0D; Implementation of a formal screening tool for child abuse in the emergency department successfully improved identification of patients that should be further evaluated for child abuse. These results may be used to support implementation of the tool in additional emergency departments.

Association between utilization patterns and racial disparities in hospice enrollment among women dying of ovarian cancer.

142 Background: Goals of care conversations are associated with less aggressive end of life care and may be most effective in an outpatient setting. Yet, the relationship between initial utilization of care and subsequent hospice enrollment is unknown. We evaluated whether inpatient, outpatient and emergency department (ED) evaluation and management (E/M) visits differed by patient race/ethnicity, and whether less outpatient management was associated with failure to enroll in hospice in a sample of women dying of ovarian cancer. Methods: Women diagnosed with first and only ovarian cancer who died between 2000 and 2016 and had ≥ one inpatient and outpatient ovarian cancer E/M encounter between diagnosis and the last two months of life in SEER-Medicare were included (N = 8,806). Women whose proportion of outpatient E/M encounters fell below the median were classified as having low outpatient management (vs. high). Multivariable-adjusted logistic regression was used to estimate the association of: (1) race/ethnicity with outpatient management, and (2) outpatient management with hospice enrollment, stratified by race/ethnicity. Models were adjusted for stage at diagnosis, histology, survival time, age, Charlson score, geographic region, and year. Results: In this sample, 29.2% of ovarian cancer E/M took place in an inpatient setting, 66.4% outpatient, and 4.4% in the ED. Non-Hispanic Black women had 53.9% of their E/M occur in an outpatient setting, compared to 67.6% in non-Hispanic White women, 60.7% in Hispanic women, and 64.2% in women of other races (p &lt;.001). Black women had 78% greater odds of low outpatient management when compared to non-Hispanic White women (adjusted OR 1.78, 95%CI: 1.46-2.18). Women with low (vs. high) outpatient management had 33% greater odds of not enrolling in hospice (adjusted OR 1.33, 95%CI: 1.20-1.48). The association of low outpatient management with not enrolling in hospice was most pronounced among Black women (Black adjusted OR: 1.54, 95%CI: 1.02-2.32 vs. Non-Hispanic White adjusted OR: 1.32, 95%CI: 1.18-1.48). Conclusions: Although most ovarian cancer care takes place in an outpatient setting, Black women have the lowest proportion of outpatient care, and low outpatient management was associated with not enrolling in hospice. When deploying interventions to improve goals of care conversations for women with ovarian cancer, racial/ethnic disparities in care settings must be considered.

تقويم مهارات التذوق الادبي لدى طلبة كلية التربية جامعة واسط

The study aimed to evaluate The literary appreciation Skills of the Students of the Department of Arabic Language at the college of Human Education at the university of wasit , the research sample consisted of (90) students of the Arabic Language Department of (45) Students in the third stage . To achieve the goal of the research, the researcher prepared atest to measure Literary appreciation skills consisted of (19) Paragraphs . After verifying the validity of the perform ance after presenting it to agroup of experts and Speciaists ,the Stability of the performance was also calculated by the method of repetition ,and it reached the Coefficient of Consistency. The researcher developed a number of treatments that Contribute to Solving this problem . Among the most important proposals are to Conduct a study to know the level of literary ,analysis among students of the Arabic Language Department in Iraqi universities to Conduct a study to identify the difficulties ,that Students of the Arabic language Department face in Studying literature. And to Conduct A Comparative Study to find out the level of literary appreciation and the level of literary Criticism among Students of the Arabic Language Department in universities Iraqi. ,Students ,the department Evaluation ,Skills ,Literary taste Key words: . Of Arabic language

Evaluation of emergency department (ED) visits by oncology patients: A running comparison to admissions and ED visits under the CMS OP-35 ruling.

e18683 Background: The incidence of emergency department (ED) visits by oncology patients has grown in recent years. Some visits are medically unnecessary or could be prevented with improved prophylactic measures. Centers for Medicare &amp; Medicaid Services (CMS) implemented the Hospital Outpatient Quality Reporting (OQR) Program, to which hospitals must report data on quality measures of care furnished in the outpatient setting. One of the proposed measures, OP-35, evaluates admissions and ED visits by patients receiving outpatient chemotherapy, assessing for ten potentially preventable visits. These ten visit reasons included are: anemia, nausea, vomiting, dehydration, neutropenia, diarrhea, pain, pneumonia, fever, and sepsis. This study evaluated the incidence and reasons for ED visits by patients receiving outpatient chemotherapy, as well as outcomes following these visits in order to assess appropriate prophylactic treatment related to outpatient chemotherapy at our institution. Methods: This single-center, retrospective chart review was conducted at The University of Arizona Cancer Center. We collected data using an electronic medical record and included oncology patients with active cancer who had ED visits from January 1, 2018, to December 31, 2018. Data points included baseline demographics; malignancy; ED visit reason; clinic visit history; past ED visits; treatment and supportive care data; and outcome of the ED visit. Results: Study authors included 205 of the 1,659 screened encounters. Approximately 70% of the encounters involved patients with solid tumors and 30% with hematologic malignancies. Nearly 50% of hematologic malignancy patients presented to the ED for potentially preventable reasons, while 32.8% of solid tumor patients had potentially preventable visits. The most common preventable ED visit reasons in both groups were pain, fever, nausea, vomiting, and dehydration. In our analysis, over 90% of patients presenting for neutropenia and fever had received appropriate growth factor prophylaxis when indicated based on their chemotherapy regimen. Of the patients presenting for nausea or vomiting, it was determined 95.3% had received appropriate antiemetic prophylaxis. Conclusions: This study showed that the incidence of potentially preventable visits was numerically higher in the hematologic cancer group compared with the solid tumor group. In addition, this study showed that a number of patients who were admitted to the ED with nausea/vomiting or neutropenia/fever received appropriate guideline-recommended prophylactic or supportive care therapy, regardless of the OP-35 proposed CMS core measure determination that these visit reasons should be considered preventable. These findings highlight the need for CMS to further review OP-35 to include information addressing the use of appropriate supportive care in the future.

Performance Evaluation of Outpatient Department Waiting Line System in a City Hospital in Nigeria

In this paper, performance evaluation of outpatient department waiting line system in a city hospital in Nigeria has been studied using a multiple server queuing model. The relevant data used in the research were collected for a period of four weeks through direct observations and interviews. The results of the research showed that with Two Doctors for the morning session patients spent an average of 1.0233hours in the system, out of which 0.932hours are spent on the queue with 95.45% Doctor Utilization. When the numbers of the Doctors were increased to 3, 4 and 5, it was found that a patient will spend an average of 0.125hours, 0.0975 hours and 0.0924hours in the system respectively. In each of the 3, 4 and 5 Doctors increased, the system will have 63.64%, 47.73% and 38.18% Doctors utilization respectively. With one Doctor for the evening session, the system has 54.55% Doctor Utilization and patient spent0.2hours in the system. The overall results showed that there is need to increase the number of Doctors to 3 or 4 for the morning session to achieved optimal service delivery while one Doctor in the evening session should be maintained. The results from the research could serves as important information to the management of the hospital for better services delivery.&#x0D; Keywords: Doctors, Patient, Doctor Utilization, Queuing model, Evaluation

Heparin-induced thrombocytopenia presenting as splenic hemorrhage following cardiac surgery: a case report

BackgroundHeparin-induced thrombocytopenia with thrombosis (HITT) is a paradoxical prothrombotic complication of anticoagulant therapy. As many as 3% of patients undergoing cardiac surgery develop clinical HIT presenting as thrombocytopenia with or without thrombosis within 5–10 days of heparin exposure. Thrombotic complications associated with HIT carry a mortality rate of 5–10%.Case presentationWe report a case of atraumatic splenic hemorrhage due to splenic vein thrombosis as the main indicator of HIT following cardiac surgery in a 62-year-old woman. She presented to the emergency department on day nine following coronary artery bypass graft surgery with acute weakness, dizziness, and malaise. Her evaluation in the emergency department found anemia and thrombocytopenia. A coagulation profile revealed a markedly elevated d-dimer. She underwent a computed tomography scan of the chest, abdomen and pelvis for suspected bleed and was found to have splenic vein thrombosis, right atrial filling defects consistent with atrial thrombus and mild to moderate hemoperitoneum. Surgical consultation was obtained due to splenic hemorrhage. Hematology was consulted on post-operative day 10, however, she unfortunately developed left sided weakness concerning for stroke. A magnetic resonance imaging scan of the brain demonstrated infarct involving distribution of the right anterior cerebral artery. A transesophageal echocardiogram demonstrated a large immobile thrombus within the right atrium with a second, mobile thrombus arising from the left tricuspid valve annulus. Due to a 4Ts score of 7 and markedly positive platelet factor 4 (PF4) IgG antibody a serotonin release assay was not performed given the high probability of HIT. She was cautiously treated with bivalirudin and was transitioned to warfarin anticoagulation. In the following days her platelet count recovered and 3 months later a transthoracic echocardiogram revealed solution of the intracardiac thrombi.ConclusionsAtraumatic splenic hemorrhage is an unusual presentation of HIT that is reminiscent of the rare bilateral adrenal hemorrhage due to adrenal necrosis that also occurs in HIT. Alternative anticoagulation is the mainstay of therapy for HIT despite hemorrhage, given the underlying acquired hypercoagulability. Despite similarities of the presentation between splenic hemorrhage and bilateral adrenal hemorrhage, splenic hemorrhage is rarely described in the literature. HIT should be considered in patients presenting with thrombocytopenia following cardiac surgery.

Design of IT Governance Evaluation Using COBIT Framework through Capability Maturity in Department of Transportation Cirebon

IT Governance Evaluation has not been carried out optimally because supervision and evaluation of IT is only done if there are complaints from work units regarding IT services. These problems relate to the services that need to be provided to users of the information system, starting from the operations that need to be carried out on data security, sustainability aspects, training of human resources that support the processes of the information system and related to the support processes that should first be determined to be able to give service. This research method used qualitative research by using COBIT 5 framework dealing with the system analysis and design using the Usecase Diagram, Activity Diagram, Sequence Diagram, and Class Diagram tools. The programming language used is PHP Hypertext Prepocessor (PHP) while the database uses MySQL. This application was created to provide information about managing the IT Governance Evaluation in Department of Transportation Cirebon. The results of this study is IT Governance Evaluation using Cobit 5 Framework. Regarding to the IT Governance using COBIT 5, the Capability Maturity Level is at 3.28 that means defined-process. It represents that the IT Governance has been implemented to reach the goal of this organization. This assessment was aimed to determine the capabilities of IT performance and make recommendations for the proper management of IT Performance Management so that it can be used as a guide that can be used by the user and can increase the use of facilities optimally for better improvement of Department of Transportation Cirebon.

How do close-circuit television cameras impact crimes and clearances? An evaluation of the Milwaukee police department’s public surveillance system

ABSTRACT This study uses quasi-experimental analyses to estimate the effectiveness of police-operated CCTV cameras in Milwaukee, Wisconsin. Most studies have focused on how cameras can deter crime. But, like many other agencies, the Milwaukee Police Department strategically deployed their cameras in high-crime, high-traffic intersections to aid criminal investigations. Thus, this study examines the impact of CCTV cameras on crimes and crime clearances. We also examine the differential impacts of CCTV in three treatment groups: all intersections that received a new camera, intersections where new cameras were installed alongside existing cameras, and intersections where only new cameras were installed. We used propensity score matching to create comparison groups of camera-free intersections, then employed difference-in-differences estimation with negative binomial and Poisson panel regression models to determine whether CCTV cameras have an impact on various categories of crimes and clearances. Despite overall crime declines in Milwaukee during the study period, we found that treatment intersections experienced more crimes post-intervention than comparison areas, likely because camera operators were using them to detect incidents that would have otherwise gone unreported. We also found limited evidence that CCTV cameras improve clearances.

Evaluation of emergency department visits in patients treated with immune checkpoint inhibitors.

e24160 Background: Immune checkpoint inhibitors (ICIs) are the main drugs for immunotherapy. Their efficacy comes at the expense of adverse events including immune-related adverse events (IRAEs). The emergency department (ED) is an important encounter point in the cancer care. However, the data on the causes of ED visits is scarce. Therefore, we evaluated the ED visits of patients treated with ICIs and tried to determine the predisposing factors. Methods: We performed a retrospective review of adult cancer patients treated with ICIs for any cancer type between 09/2014 and 06/2019 in Hacettepe University Cancer Center. The data about ED visits after the first dose of ICIs to six months after the last dose of ICIs was collected from the hospital registries. Baseline characteristics, stages and types of patients’ tumors, types of ICI, causes for emergency visits and hospital admissions were recorded. Results: A total of 221 patients were included. The median age was 60.7 years (18-86) and 65.6% of patients were males. Median follow-up was 9 months (0.2-55). Nivolumab was the most common immunotherapy (67.9%). Melanoma was the most common diagnosis (27.6%) followed by kidney and lung cancer. 90% of patients had advanced disease and more than half of patients were treated with two or more lines of therapy. The 83 patients (37.6%) had at least one emergency department (ED) visit. Half of these visits resulted in hospital admissions. Thirty-eight patients had more than one ED visits with 14 patients having three or more ED visits. Immune-related adverse events comprised less than 10% of the ED visits with most of the ED visits were related to symptoms attributable to disease burden itself. The median time to ED visit after the first dose of ICI was 126 days. While baseline ECOG status, age, polypharmacy (defined as the regular use of five or more drugs), concomitant chemotherapy, eosinophilia and lactate dehydrogenase levels didn’t significantly increase the risk, patients with regular opioid use and baseline neutrophilia ( &gt; 8000) had a statistically significant risk of ED visits (p values 0.001 and 0.19 respectively). These two factors remained significant in the multivariate analyses. Conclusions: In this study, almost 40% of ICI treated patients had ED visits. Recognition and addressing of this patient group’s problems in the ED is very important as evidenced by ability to discharging half of patients from the ED. Collaboration between the other specialists like emergency medicine specialists is vital for improving the care of patients treated with immunotherapy.

Chemotherapy remote care monitoring program (CRCMP): Integration of an SMS text patient-reported outcome (PRO) in the electronic health record (EHR) to identify patients needing pharmacist intervention for chemotherapy-induced nausea and vomiting (CINV).

2001 Background: CINV is a feared side effect of cancer therapy. Despite advances in management, CINV is a common cause for emergency department (ED) evaluation and other unplanned health care utilization. The University of Michigan Rogel Cancer Center initiated the CRCMP to proactively identify patients (pts) experiencing CINV and intervene prior to the need for urgent evaluation. Methods: Pts receiving highly emetogenic chemotherapy are identified by administration of a NK1 antagonist. Once enrolled in the CRCMP, pts receive a daily text message survey for 7 days after treatment. The survey is based on the validated MASCC anti-emesis tool (MAT). Responses are stored within a flowsheet in the EHR. Responses above a set threshold trigger a message to the team pharmacist for intervention. Data presented was reviewed from EHR and claims data. Results: In 8 mo, 652 pts received a NK-1 antagonist (2244 total cycles) and 387 pts enrolled in the CRCMP (59%). Each pt enrolled for an average of 1.8 cycles of chemo (range 1-8). Of patients enrolled, 61.4% were female and 86.2% were Caucasian. Chemotherapy intent was curative for 51.7% and palliative for 48.3% of pts. Pts enrolled most commonly received cisplatin-based (29.7%) followed by carboplatin-based (22.5%), and 5-fluoruracil-based (20.9%) therapy. Text message response rate was 94% (N=18,143 responses of 19,256 total messages sent). During 861 cycles of therapy, 7% of responses noted vomiting and 33% of responses noted nausea. Since implementation of CRCMP, total hospitalization, ED, and urgent care use has decreased (p=0.029) compared to historical data. When utilization for nausea-related diagnoses was considered, the reduction was more notable (Table). Conclusions: Pts engaged in the CRCMP for CINV, allowing for rapid assessment of PROs by a pharmacist. Health care utilization related to nausea was reduced following implementation of CRCMP. While these changes were numerically small, reduction in unnecessary care utilizing PROs can contribute to high value care for cancer patients. [Table: see text]

Service Quality Evaluation in the Internal Supervision Department and the Level of Customer Satisfaction “Applied Study on Baron Hotel”

Service Quality Evaluation in the Internal Supervision Department and the Level of Customer Satisfaction “Applied Study on Baron Hotel”

On-the-Job Training Program Evaluation of Business Administration and Accountancy Departments of University of Saint Louis

This study was conducted to assess the implementation of the on-the-job training program Business Administration and Accountancy Departments of the University of Saint Louis, one of the Higher Education Institutions in the Northern Philippines. The study utilized a descriptive method of research and a total of 142 undergraduate students who had their on-the-job training among government and private financial and non-financial institutions responded in the school year 2018-2019 were the respondents of the study and this reflects a 100% responses rate of the target respondents. Using a questionnaire that assesses the implementation of the on-the-job training program by the institution and partner agencies, results reveal that the on-the-job training program of the School of Accountancy, Business and Hospitality is effective and well-implemented for both institutional and company provisions from pre-orientation to post- on-the-job training activities. It further revealed that on-the-job training /Internships programs are able to train students to be more equipped and ready in their future careers and students manifested positive experience as exposures to real-life workplace environment and practices.

Analysis of Determinants of Ranks in the Department Evaluation

Analysis of Determinants of Ranks in the Department Evaluation

Preprocedural Cross-Sectional Imaging Prior to Percutaneous Peripheral Arterial Disease Interventions.

Preprocedural cross-sectional imaging (PCSI) for peripheral artery disease (PAD) may vary due to patient complexity, anatomical disease burden, and physician preference. The objective of this study was to determine the utility of PCSI prior to percutaneous vascular interventions (PVIs) for PAD. Patients receiving first time lower extremity angiograms from 2013 to 2015 at a single institution were evaluated for PCSI performed within 180 days, defined as computed tomography angiography (CTA) or magnetic resonance angiography (MRA) evaluating abdominal to pedal vasculature. The primary outcome was technical success defined as improving the target outflow vessels to <30% stenosis. Of the 346 patients who underwent lower extremity angiograms, 158 (45.7%) patients had PCSI, including 150 patients had CTA and 8 patients had MRA. Of these, 48% were ordered by the referring provider (84% at an outside institution). Preprocedural cross-sectional imaging was performed at a median of 26 days (interquartile range: 9-53) prior to the procedure. The analysis of the institution's 5 vascular surgeons identified PCSI rates ranging from 31% to 70%. On multivariate analysis, chronic kidney disease (odds ratio [OR] = 0.35; 95% confidence interval [CI]: 0.17-0.73) was associated with less PSCI usage, and inpatient/emergency department evaluation (OR = 3.20; 95% CI: 1.58-6.50) and aortoiliac disease (OR = 2.78; 95% CI: 1.46-5.29) were associated with higher usage. After excluding 31 diagnostic procedures, technical success was not statistically significant with PSCI (91.3%) compared to without PCSI (85.6%), P = .11. When analyzing 89 femoral-popliteal occlusions, technical success was higher with PCSI (88%) compared to procedures without (69%) P = .026. Our analysis demonstrates that routine ordering of PCSI may not be warranted when considering technical success of PVI; however, PCSI may be helpful in treatment planning. Further studies are needed to confirm these findings in another practice setting, with more prescriptive use of PCSI to improve procedural success, and thereby improve the value of PCSI.

1406 Same-Day Discharge Following Vaginal Hysterectomy with Pelvic Floor Reconstruction: A Pilot Study

Study Objective Determine safety and feasibility of same-day discharge in patients undergoing vaginal hysterectomy with pelvic floor reconstruction. Design Prospective cohort pilot study. Setting Single academic medical center. Patients or Participants Women undergoing vaginal hysterectomy with pelvic floor reconstruction were considered for inclusion in the study. Interventions Same-day discharge or overnight hospitalization following surgery. Measurements and Main Results A total cohort of 55 women undergoing vaginal hysterectomy and pelvic floor reconstruction for pelvic organ prolapse and/or urinary incontinence was identified. The control group consisted of 19 women that were planned for overnight hospitalization. The intervention group had 36 women that were planned for same-day discharge. In the intervention group, 63.9% of patients (n=23) were successfully discharged home and 36.1% (n=13) required an unplanned overnight admission. Reasons for unplanned admission included persistent anesthetic effects (dizziness/nausea/drowsiness) (n=9; 69%), uncontrolled pain (n=1, 7.7%), fever (n=1, 7.7%), anemia (n=2, 15.4%), with return to operating room for hematoma evacuation (n=1; 7.7%). Voiding trial was passed on first attempt in 30 patients (54.5%). The percentage of successful voiding trials on the first attempt was 30.8% for patients requiring unplanned admission and 78.9% for patients with planned overnight hospitalization (p = 0.011). There were no significant differences in the number of emergency department visits (p=0.677) or unplanned office visits (p=0.193) between the control and intervention groups. Conclusion Same-day discharge after vaginal hysterectomy with pelvic floor reconstruction appears to be safe and feasible. Patients who were discharged the same-day did not require a higher volume of emergency department or office evaluations.