Top PDF Balancing Medical Resident Education and Workload while Ensuring Quality Patient Care

Balancing Medical Resident Education and Workload while Ensuring Quality Patient Care

Balancing Medical Resident Education and Workload while Ensuring Quality Patient Care

be seen as an interesting conclusion due to the limitation of considering data from all hospitals. Since each hospital has its own set of specific requirements and preferences, it virtually becomes impossible to incorporate all possible constraints and preferences from all hospitals to provide the most robust solution possible, majorly because there probably doesn't exist an overall solution that fits the needs of all hospitals while agreeing with the preferences of all chief residents. Development of resident rotation schedules using Policy C can have tremendous impacts on resident scheduling process because since the clinic constraints fall into the category of hard constraints, and since policy C is the most relaxed clinic policy, schedules developed using Policy C can result in resident rotation schedules which are more flexible in terms of ambulatory rotations for the residents and at the same time maintain continuity of care. Thus a schedule generated keeping policy C in consideration will be less restrictive than those generated by the other policies since it just ensures the minimum ACGME guideline for clinic rotations, which is at least 1 clinic in 5 weeks. However, the lack of a clear pattern clinic visits for Policy C schedules, may affect the clinics ability to organize instructional events for its residents.
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Long Term Care Medical Education in the US: Training Medical Students, Resident Physicians, and Practicing Physicians.

Long Term Care Medical Education in the US: Training Medical Students, Resident Physicians, and Practicing Physicians.

A 2009 study published in the Journal of the American Medical Directors Association (JAMDA) found that having an AMDA Certified Medical Director (CMD) contributes positively to a nursing home’s quality of care. Analysis of data showed that quality of care scores represented a 15% improvement for facilities with Certified Medical Directors (CMDs). The data also addresses how other factors – including facility size, not-for-profit status, and higher registered nurse (RN) hours per patient day – relate to the presence of a CMD to impact the quality of care in nursing homes (Rowland 2009).
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Impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation

Impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation

Resident evaluations are subjective, and may not trans- late to objective improvements in medical knowledge and clinical performance. However, resident perceptions provide faculty direct feedback on resident understand- ing and priorities. Studies have shown that faculty mem- bers and residents perceptions are often not aligned [13 – 15]. Rose, et al. found that although both residents and faculty members agreed on the need to improve in- traoperative education, there was significant disparity in perceptions of resident preoperative preparation, and in- traoperative and postoperative feedback between resi- dents and surgical faculty [13]. Much of this disparity was centered on the residents being more focused on the technical aspects of the procedure while faculty felt that natural history of disease and patient outcomes were more important [14]. Similarly, Juve et al. found that faculty members reported spending significant time teaching on patient issues related to the cases that they were actively managing with residents, but residents felt that this interaction was part of patient care responsibil- ities rather than teaching and defined teaching as a dis- cussion of topics beyond those associated with patients that they were managing [15]. They found that use of teaching tool for residents and faculty members to meet the residents ’ desire beyond the scope of active patient care was associated with improvement and better align- ment of resident and faculty perceptions [15].
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Resident duty hour modification affects perceptions in medical education, general wellness, and ability to provide patient care

Resident duty hour modification affects perceptions in medical education, general wellness, and ability to provide patient care

Methods: Senior residents from an internal medicine training program in Canada responded to an anonymous online survey immediately before and 6 months after the implementation of duty hour reform. The survey contained questions relating to three major domains: resident wellness, ability to deliver quality health care, and medical education experience. Mean pre- and post-intervention scores were compared using the t -test for paired samples. Results: Twenty-three of 27 (85 %) senior residents completed both pre- and post-reform surveys. Residents perceived significant changes in many domains with duty hour reform. These included improved general wellness, less exposure to personal harm, fewer feelings of isolation, less potential for error, improvement in clinical skills expertise, increased work efficiency, more successful teaching, increased proficiency in medical skills, more successful learning, and fewer rotation disruptions.
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Addressing the Accreditation Council for Graduate Medical Education Competencies: An Opportunity to Impact Medical Education and Patient Care

Addressing the Accreditation Council for Graduate Medical Education Competencies: An Opportunity to Impact Medical Education and Patient Care

1999 that perhaps could have the greatest im- pact on medical education as a continuum since the Flexner report and ultimately could influence the quality of healthcare of our nation (that is, if those of us responsible for medical education at all levels see this as an opportunity and not as a way to simply satisfy an external accrediting body). This document was originally designed for resident education, but the competency-based concepts have already perme- ated the thinking in and stimulated the responsible parties for undergraduate education. Those respon- sible for continuing medical education have previ- ously questioned the efficacy of traditional continu- ing education and want to see knowledge and performance linked.
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The effect of patient care order sets on medical resident education: a prospective before-after study

The effect of patient care order sets on medical resident education: a prospective before-after study

Order sets are becoming a ubiquitous tool for quality improvement and this study suggests that they do not appear to impair resident education, and may impart a benefit. This will require validation in larger studies with concurrent controls, across multiple centers, and across several disease-types. Finally, beneficial effects on con- tinuing medical education and professional development among fully-trained professionals who use order sets (particularly in non-academic settings) might also be ex- pected, and should be measured objectively in future stud- ies. Ultimately, such research may enable order sets to assume a role in both medical education and continuing professional development educational plans and curricula.
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Patient’s perspective on improving the quality of acute medical care: determining patient reported outcomes

Patient’s perspective on improving the quality of acute medical care: determining patient reported outcomes

The majority of patients reported reassurance as a rele- vant outcome of ED care. Reassurance seems to be a broad concept, as different explanations are given. Most patients explained reassurance as relief of the feelings of anxiety or insecurity. These feelings were mostly triggered by not knowing the cause of symptoms and whether symp- toms could become even more severe. In these cases, in general, reassurance could be reached by a clear explana- tion about the cause of symptoms or a treatment plan. For example, patient 18: “Reassurance is important. If they tell you the diagnosis cancer, that isn’t really reassuring. However, knowing what you’re suffering from is always better than not knowing. Reassurance includes being well-informed.” Others just wanted to hear ‘everything
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The Impact of Workload Variability on Load Balancing Algorithms

The Impact of Workload Variability on Load Balancing Algorithms

Load balancing is essential to take advantage of all the available resources on cluster systems and therefore, to obtain their optimal performance ([9, 13]), especially on heterogeneous clusters. And the ability to deal with variability is essential for designing efficient and scalable load balancing algorithms. All the decisions related to load balancing are taken considering some kind of system state information. If this state suffers smooth variations, it is easy to maintain updated information about it. But when the system state is highly variable, the information may be out of date by the time the load balancing decisions are taken. Therefore, the probability of taking wrong decisions increases critically ([17]).
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Nursing Education to Prevent Resident Falls in Long-Term Care

Nursing Education to Prevent Resident Falls in Long-Term Care

factors for falls were explored at the individual and facility level to determine the cause of a fall and the impact of preventive interventions on the daily life of the resident. The staff was instructed that some intrinsic factors that can cause falls include age (greater than eighty-five years old), muscle weakness, visual impairment, foot disorders, transfer dependence, and wheelchair dependence. Other intrinsic factors are low body mass index and weight loss, gait impairment, chronic medical conditions, bowel/bladder incontinence and urgency, Parkinson’s disease, orthostatic hypotension, hypotension, Alzheimer’s disease, diabetes, arthritis and accompanying discomfort, cardiovascular disease, chronic obstructive pulmonary disease, depression, obstructive sleep apnea, end-stage renal disease, stroke, and acute illness.
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Altering workplace attitudes for resident education (A.W.A.R.E.): discovering solutions for medical resident bullying through literature review

Altering workplace attitudes for resident education (A.W.A.R.E.): discovering solutions for medical resident bullying through literature review

abuse [6]. Similar statistics have been mentioned in other studies in North America [7, 8]. In a study of United Kingdom (UK) residents, it was reported that 37 % self-identified as having been bullied and 84 % of these residents had experienced one or more bullying behaviors [4]. Cyberbullying, an emerging method of bullying through technology such as text message and email, was seen to occur in almost half of medical resi- dents at a UK institution [9]. In a study of family med- ical residents in Canada, 45 % reported experiencing a form of intimidation, harassment, and/or discrimination during their training, and over half had experienced this behavior more than once [10]. Similar rates were re- ported in Ireland, South Australia, New Zealand and other regions of Canada [2, 11–15]. Reported rates of medical trainee mistreatment are even higher in Asia and Africa, ranging from 77 % in Nigeria to 97 % in Oman [16–23]. The majority of these studies have found that main source of inappropriate behavior, harassment, and belittlement of physicians-in-training is from their fellow physicians in superior positions [6, 10, 16, 21, 24, 25]. The most common form of abuse in medical training is verbal [8, 10, 16, 17, 20, 26] and these comments are commonly belittling, undermining, or humiliating [10, 21].
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Networking TCP/IP routing and workload balancing

Networking TCP/IP routing and workload balancing

The first way to achieve load balancing is to use a DNS function to pass out multiple addresses for the same system name. The DNS will serve a different IP address each time a request is made for the address record for your system name. In the following example, each address corresponds to a different system. This allows you to provide load balancing across two separate systems. In the case of clients on the private networks, they receive a different address for each request. This is a common DNS function. Notice that the public DNS also has two address entries. These addresses are translated using static NAT so that if you are on the Internet, you can reach the two systems.
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Video Visits:  A closer look at patient satisfaction and quality of virtual medical care

Video Visits: A closer look at patient satisfaction and quality of virtual medical care

satisfaction is a key driver to achieving reimbursements through varying programs provided by CMS and other Federal Health Care agencies. Physicians are able to boost production and incorporate more patients on their schedules to accommodate the patient population. Patients who are too sick or may be prone to spreading communicable diseases to other patients or medical staff (especially during flu season), have an advantage of seeking medical care through video visits which prevents putting oneself and others at risk. Not only do Physicians gain an opportunity to see more patients, but patients are able to save time and money from having to visit a provider in person.
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Dynamic Divisible Load Balancing Algorithm for Balancing Workload in Cloud Computing

Dynamic Divisible Load Balancing Algorithm for Balancing Workload in Cloud Computing

In the static load balancing algorithm the choice of moving the load does not depend upon the current scenario of the system. These algorithms needn't bother with the data in regards to current environment of the system. This kind of algorithms has serious drawbacks in the event of sudden disappointment of system resource, assignments and furthermore undertaking can't be shifted during its execution for load balancing. Static load balancing algorithms are not pre-emptive and in this way each machine has no less than one task allocated for itself. The four distinct sorts of Static load balancing process are Round Robin algorithm, Central Manager Algorithm, Threshold algorithm and randomized algorithm.
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Quality of medical care for the elderly in out-patient conditions according to the sociological survey

Quality of medical care for the elderly in out-patient conditions according to the sociological survey

The necessity of an enhanced training and skills at communication with persons who elder than a working age was marked by 62.4% of the doctors and 36.1% of the respondents did not need an enhanced training. One of the most important reasons of the further training was the need of improving medical skills, as this category of the patients is characterized by high morbidity and mortality (37.3%), although there were psychological features of the given group of the population (25.4%). The answers for the question “Where persons of elderly ages should be followed up?” were different: 91.4% asked that they should attend polyclinics according to a residence, and only 8.6% of the respondents (all of them work in regional center facilities) chose specialized centers.
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Information Technology in Ensuring the Quality of Education at Private Colleges in Russia

Information Technology in Ensuring the Quality of Education at Private Colleges in Russia

Resolving the above issues will be possible on the basis of information orientation of the system of higher juridical education. Graduates of economic-juridical colleges must not only have an idea of the capabilities of information society but be able to effectively and professionally use them. It is the processes of enhancing the educational activity of economic-juridical colleges that can substantially impact on the existing situation through the implementation and development of new forms of learning and the practice of advanced learning. The primary goal is to acquaint students with the fundamentals of modern information technology, trends in their development, principles of constructing information models, conducting the analysis of results obtained, and applying modern information technology in professional activity. “Information Technology in Juridical Activity” should, in our view, hold a special place among disciplines studied at college, since we should build the whole educational process on its groundwork and it is this discipline that is a toolbox for one’s future juridical activity.
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The Role of the Federal Government in Ensuring Quality of Care in Long-Term Care Facilities

The Role of the Federal Government in Ensuring Quality of Care in Long-Term Care Facilities

The Geri-Med consent order also provides for the review and analysis of nutrition and wound care provided at seven facilities by the University of Pennsylvania's Institu[r]

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Quality-Ensuring Profits

Quality-Ensuring Profits

Many of us who are ill-informed consumers are happy that better-informed consumers are out there giving sellers an incentive to keep quality at a rea- sonable level, so the underlying idea of this model fits our intuition well. A version of it can found for the monopoly context in chapter 2 of Jean Tirole’s 1988 book, The Theory of Industrial Organization. In his model, a monopoly seller chooses quality to be low or high. Some consumers can observe the quality before buying, while others cannot. In equilibrium, the seller will always choose high quality if there are sufficiently many informed consumers, while if there are not, he will choose high quality with some probability in the mixed strategy equilibrium that then exists. This paper’s one-period model with just assumption A2, not A1 or A3, is essentially the Tirole model transferred to a competitive market.
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Reducing teacher workload: the ‘Re-balancing Feedback’ trial

Reducing teacher workload: the ‘Re-balancing Feedback’ trial

The ‘rebalancing feedback’ trial indicates that it is possible for schools to investigate the impact of school-led initiatives designed to improve working conditions by reducing workload. But this is not enough. As well as removing from the diet of teachers’ lives the unnecessary, the inefficient and the ineffective, there needs to be a sharp focus on bringing in the necessary, the efficient and the effective in their places. In essence, it is important to use this research – and others in the same field – to investigate how to use the opportunity of reducing workload to increase student learning.
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Ensuring Culturally Effective Pediatric Care: Implications for Education and Health Policy

Ensuring Culturally Effective Pediatric Care: Implications for Education and Health Policy

Educational programs may include a component that allows the individual participant to analyze per- sonal beliefs and values. Programs may focus on the communication aspects of providing culturally effec- tive health care by exploring how assumptions and stereotypes influence interactions between health care professionals and patients or their families as well as between health care professionals. Programs need not be all-inclusive or completely group-spe- cific to discuss variations in the values and commu- nication styles of various cultural groups. Indeed, training in the provision of culturally effective care may include teaching physician skills that are appli- cable to interacting with many cultural groups as well as those that are targeted at providing care to a specific cultural group. Because individuals are in- fluenced by their own personal experiences and may or may not subscribe to group assumed norms, in- dividuals who share the same cultural background may think and act quite differently. For this reason, it is important that programs intended to address the cultural values and practices of specific groups not perpetuate stereotypes. Also, culture is not static; changes occur over time. An appreciation of cultural change and the significance of intracultural diversity (variation among individuals within the same cul- ture) helps to prevent cultural stereotyping. 39 Pro-
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Resource Monitoring and Workload Balancing Model for Public Cloud

Resource Monitoring and Workload Balancing Model for Public Cloud

Abstract- Workload balancing in the cloud computing environment has an important impact on the performance. Good workload balancing makes cloud computing more efficient and improves user satisfaction. This paper introduces a better workload balance model for the public cloud based on the cloud partitioning concept with a switch mechanism to choose different strategies for different situations. When the nodes are at idle status dynamic round robin algorithm is used.when the nodes are in normal status the algorithm which applies the game theory to the workload balancing strategy is used to improve the efficiency in the public cloud environment. A game theoretic frame work for obtaining a user optimal workload balancing scheme as been presented for non-cooperative game the structure of Nash equilibrium is used to select appropriate nodes to balance the workload The goal of cloud based architecture is to provide elasticity and ability to expand capacity on-demand. The workload balancing feature efficiently reduces the waiting time at each process steps.
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