ABSTRACT
BACKGROUND: Optimizing endoscopy efficiency is becoming increasingly important. This study profiled ERCP availability and assessed resource leveling as a strategy to enhance efficiency. DESIGN: All ERCPs performed at an academic teaching hospital between January 2007 and December 2008 were reviewed. Procedure timeliness (time between admission and ERCP) and demand were analyzed to assess resource utilization. RESULTS: Data were recorded for 393 ERCPs. Profiling identified an unequal distribution of waiting times from admission to procedure due to restricted ERCP availability. Use of resource leveling methodology demonstrated that a small increase in procedure availability (one additional half day per week) would significantly reduce the hospital stay of ERCP patients. CONCLUSIONS: Resource leveling can be applied to balance procedure provision with demand to cope with fluctuations in demand. The impact of resource leveling can be truly measured only by implementing these changes and prospectively studying the effect.
Subject(s)
Cholangiopancreatography, Endoscopic Retrograde/statistics & numerical data , Health Services Needs and Demand/organization & administration , Hospitals, Teaching/organization & administration , Humans , Ireland , Length of Stay , Resource Allocation , Retrospective StudiesABSTRACT
BACKGROUND: The ability to critically appraise the calibre of studies in medical literature is increasingly important for medical professionals. AIM: This prospective controlled study evaluated the impact of a 6-h Evidence Based Medicine (EBM) Workshop on the critical appraisal skills of medical trainees. METHODS: Individuals attended three 2-h workshops over a 3-week period, incorporating didactic lectures in statistics, clinical trial design, appraising research papers and practical examples. Appraisal skills were assessed pre- and post-training based on grading the quality of randomised control studies (level 1 evidence), cohort studies (level 2 evidence) and case-control studies (level 3 evidence) [From Oxford Centre for Evidence Based Medicine Levels of Evidence (2001), http://www.cebm.net/critical_appraisal.asp ]. RESULTS: Overall grading improved from 39% (pre-course) to 74% (post-course), P = 0.002, with grading of levels 1, 2 and 3 studies improving from 42 to 75%, 53 to 61% and 21 to 84%, respectively. CONCLUSIONS: We conclude that a 6-h formal EBM workshop is effective in enhancing the critical appraisal skills of medical trainees.
Subject(s)
Clinical Competence , Curriculum , Education/statistics & numerical data , Educational Measurement , Evidence-Based Medicine/education , Health Knowledge, Attitudes, Practice , Education, Medical, Graduate , Humans , Ireland , Prospective Studies , Students, MedicalABSTRACT
A replicator method of carrying out primary sensitivity tests on urine specimens is described. The results are compared with conventional sensitivity tests. Of 438 specimens examined, the procedure indicated a suitable antibiotic in all but 7 and yielded an incorrect result likely to mislead in 14 instances, in each case accompanied by several correct sensitivity reports. Results are available within 24 hours.
