ABSTRACT
STUDY DESIGN: Longitudinal audit. OBJECTIVES: To develop evidence-based maps of rehabilitation for different lesion categories. SETTING: Midlands, UK. METHODS: Over a 5-year period data for all newly injured neurologically damaged patients aged 18 years or more were collected and analyzed (n=280). Data were collected from a functional independence measure (the Needs Assessment Checklist), patient records (paper and electronic) and patient goal planning records. The patients were grouped into different lesion categories. Standard milestones that patients in a given category would be expected to reach in rehabilitation were identified using goals set at goal planning meetings. Time when patients reached these milestones and variation between patients around time in reaching these milestones were calculated. RESULTS: Median times from onset to admission, onset to rehabilitation and length of rehabilitation are given. Pictorial representations of rehabilitation (rehabilitation maps) were produced, using goals identified, median times of achievement and variation. This paper provides examples of these maps from one particular group, T8-T12 Frankel A. CONCLUSION: Pathways of care can be used in a number of ways: to identify the need for service change; to audit service change; to provide evidence-based expectations for staff, patients and external parties; to look at variances affecting care; to make this service transparent; to provide figures for comparison with other philosophies of care; and to ensure consistency across the service.
Subject(s)
Clinical Audit , Evidence-Based Practice , Process Assessment, Health Care , Spinal Cord Injuries/rehabilitation , Humans , Longitudinal Studies , Patient Care Planning , Program Development , United KingdomABSTRACT
In oculoplastic surgery, the internal canthus is a particular feature of great importance. An analysis has been carried out with 10 MRI tests of the internal canthi and the authors will outline the major difficulties, before detailing a protocol which would enable further studies of pathological canthi.
Subject(s)
Eyelids/anatomy & histology , Magnetic Resonance Imaging , Adult , Female , Humans , MaleABSTRACT
This is a report of the gray scale ultrasound findings of pancreatic carcinoma occurring in a child. Although this tumor is rare, the preoperative diagnosis can be made if the physician is aware of this possibility. 99 mTc sulfur colloid radionuclide scan, liver spleen scan, gallium scan, and ultrasound examinations are helpful in distinguishing the site of origin of upper abdominal masses.
