ABSTRACT
INTRODUCTION: It is very important that patients are given sufficient time to consider the implications of surgical treatment. PATIENTS AND METHODS: The authors audited the consenting practices for patients undergoing surgery in a busy ENT unit. RESULTS: The first cycle demonstrated that 15% of patients were providing written consent for surgery on the same day as their operation. Subsequent to a simple change in departmental policy, this was reduced to 2%. The medicolegal implications of this audit are discussed with reference to current recommendations. CONCLUSIONS: This simple policy change not only protects the hospital trust from potential litigation but also provides a smooth journey for the patients from diagnosis to making the decision to operate and finally to undergoing surgery.
Subject(s)
Informed Consent/statistics & numerical data , Otolaryngology/organization & administration , England , Humans , Medical Audit , Prospective StudiesABSTRACT
Collected data on 3,342 outpatients over 2 years. A 4-year follow-up of successful outcomes was conducted on each of the cases. Hospitalized patients showed a 30% success rate. The success rate for the group that was recommended for no treatment was 60%. The success rate for patients who completed outpatient treatment increased to 78%. A patient's expectation of outcome, the clinician's assessment of reason for referral, the diagnosis, and age were the most powerful predictors of success. These findings demonstrate the following: (a) procedures for assessment and intervention can be successful; and (b) a significant portion of the population can be served by intervention with proper selection.
Subject(s)
Ambulatory Care , Mental Disorders/rehabilitation , Outcome and Process Assessment, Health Care , Adolescent , Adult , Hospitals, Psychiatric , Humans , Male , Mental Disorders/psychology , Middle Aged , MotivationABSTRACT
Evaluated Recruit Temperament Survey (RTS) responses and aptitude test scores as potential predictors of psychiatric illness among 1,082 Navy hospital corpsmen. Twenty-six RTS items discriminated significantly between those corpsmen who became psychiatric casualties during a 4-year criterion period and those who did not; these items appeared to assess a construct of preservice personal and vocational adjustment. Scores on the aptitude measure were unrelated to illness incidence. The validity of the discriminating RTS items taken in combination for predicting psychiatric hospitalization among corpsmen was .28 with a cross-validity of .22. Implications of these findings for the use of measures such as the RTS in psychiatric screening were discussed.
Subject(s)
Allied Health Personnel , Aptitude Tests , Mental Disorders/diagnosis , Military Psychiatry , Personality Inventory , Humans , Male , Occupations , Probability , Social Adjustment , TemperamentABSTRACT
The authors recorded diagnoses and total number of sick days for 148 men before and after treatment for alcoholism in a Navy alcoholic rehabilitation center. Over a 4-year period (2 years before and 2 years after treatment), there was a reduction of sick days for each man and a reduction of alcohol-and nonalcohol-related complaints. The authors stress the importance of valid evaluation criteria for alcohol rehabilitation programs.
