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1.
Educ. med. (Ed. impr.) ; 21(6): 397-402, nov.-dic. 2020.
Artigo em Espanhol | IBECS | ID: ibc-198378

RESUMO

En este documento se refieren las bases legales nacionales y, más en concreto, las autonómicas andaluzas que dan respaldo a la figura del profesor contratado doctor vinculado y a la posibilidad de convocar las plazas correspondientes en las facultades de medicina de las universidades públicas españolas. Se exponen, asimismo, las características asistenciales y académicas que deben darse para llevar a cabo la convocatoria pública de dichas plazas. Se resume, a continuación, cuál es la situación actual existente en relación con dicha figura del profesorado en las facultades de medicina españolas. Se analizan también las ventajas y las posibles limitaciones que actualmente se derivan de contar con profesores contratados doctores vinculados y ello tanto para los médicos especialistas eventualmente interesados en optar a una de estas plazas como para el centro sanitario y la facultad de medicina correspondientes. Finalmente, se reseña la posible utilidad del documento elaborado por la Conferencia Nacional de Decanos de Facultades de Medicina de España (CNDFME) en la Asamblea General que se celebró en la Facultad de Medicina de Oviedo del 17 al 19 de mayo del 2018 y actualizado en marzo de 2020


A discussion is presented on the national legal foundations, and more specifically, those of Andalusia, that support the figure of the tenure-eligible lecturer and the possibility of filling the corresponding positions in the faculties of medicine in Spanish public universities are discussed. The clinical and academic characteristics that they must have in order to fill those public positions are also presented. The current situation as regards such a figure as a lecturer in Spanish faculties of medicine is then summarised. An analysis is made of the advantages and the possible limitations arising from having a tenure-eligible lecturer, and how this affects both the medical specialists possibly interested in opting for one of these positions, as well as for the corresponding health centres and faculties of medicine. Finally, mention is made of the possible use of the document prepared by the National Conference of Medical Faculty Deans (CNDFME) in the General Assembly held in the Oviedo Faculty of Medicine from 17 to 19 May 2018, and updated in March 2020


Assuntos
Humanos , Educação Médica/legislação & jurisprudência , Docentes/legislação & jurisprudência , Faculdades de Medicina/legislação & jurisprudência , Acreditação/normas , Docentes/normas , Espanha , Faculdades de Medicina/normas , Contratos/normas
4.
Methodist Debakey Cardiovasc J ; 16(3): 199-204, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33133355

RESUMO

Americans expect their doctors to have the competence to deliver high-quality care and expect safeguards to be in place that assure their doctors are competent. However, competence requires knowledge, and people have trouble assessing their own knowledge and level of competence. Because external assessment is required, several organizations have taken on the roles of defining and assuring medical competence. For example, professional organizations such as the American College of Cardiology (ACC) have developed consensus documents that define core competencies for cardiologists. External organizations such as the Accreditation Council for Graduate Medical Education and the American Board of Internal Medicine (ABIM) have defined training requirements for cardiologists, and the ABIM has developed a process to certify that physicians maintain their competence, although the process has generated considerable criticism from the profession. Recently, the ACC and ABIM have worked together to make the certification process less onerous and more meaningful. This paper provides a brief summary of the history and ongoing efforts to assure the competence of cardiologists.


Assuntos
Acreditação , Cardiologistas/educação , Cardiologia/educação , Certificação , Competência Clínica , Educação de Pós-Graduação em Medicina , Acreditação/normas , Cardiologistas/normas , Cardiologia/normas , Certificação/normas , Competência Clínica/normas , Currículo , Educação de Pós-Graduação em Medicina/normas , Humanos
5.
Ann Biol Clin (Paris) ; 78(5): 555-564, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33026350

RESUMO

Biochemical diagnosis of hereditary metabolic diseases requires the detection and simultaneous identification of a large number of compounds, hence the interest in metabolic profiles. Amino acid chromatography allows the identification and quantification of more than forty compounds. As part of the accreditation process for medical biology examinations according to standard NF EN ISO 15189, the group from SFEIM recommends an approach to accredit amino acid chromatography. Validation parameters and recommendations are discussed in this specific framework.


Assuntos
Aminoácidos/análise , Cromatografia/normas , Testes Diagnósticos de Rotina/normas , Erros Inatos do Metabolismo/diagnóstico , Acreditação/normas , Adulto , Aminoácidos/sangue , Aminoácidos/líquido cefalorraquidiano , Aminoácidos/urina , Amniocentese/normas , Líquido Amniótico/química , Análise Química do Sangue/métodos , Análise Química do Sangue/normas , Coleta de Amostras Sanguíneas/normas , Criança , Cromatografia/métodos , Cromatografia Líquida/normas , Testes Diagnósticos de Rotina/métodos , Feminino , Humanos , Recém-Nascido , Erros Inatos do Metabolismo/sangue , Erros Inatos do Metabolismo/líquido cefalorraquidiano , Erros Inatos do Metabolismo/urina , Triagem Neonatal/métodos , Triagem Neonatal/normas , Fase Pré-Analítica , Gravidez , Diagnóstico Pré-Natal/métodos , Diagnóstico Pré-Natal/normas , Espectrometria de Massas em Tandem/normas , Urinálise/métodos , Urinálise/normas , Coleta de Urina/normas
6.
Hum Resour Health ; 18(1): 71, 2020 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-33076909

RESUMO

Regulation of the health workforce and accreditation of educational institutions are intended to protect the public interest, but evidence of the impact of these policies is scarce and occasionally contradictory. The body of research that does exist primarily focuses on policies in the global north and on the major health professions. Stress on accreditation and regulatory systems caused by surges in demand due to the COVID-19 pandemic, privatization of education, rising patient expectations, and emergence of new health worker categories has created urgency for innovation and reform. To understand and evaluate this innovation, we look forward to receiving manuscripts which contribute to the evidence base on the implementation, management, and impact of health worker education and practice regulation, including the intersection of education accreditation and workforce regulation policy. We particularly look forward to manuscripts from underrepresented parts of the globe and underrepresented health workforce sectors that address policy effectiveness, explore different models of regulation, and present innovations that we can all learn from.


Assuntos
Acreditação/normas , Ocupações em Saúde/educação , Mão de Obra em Saúde/normas , Infecções por Coronavirus/epidemiologia , Política de Saúde , Humanos , Pandemias , Pneumonia Viral/epidemiologia
7.
Am J Pharm Educ ; 84(6): ajpe8135, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32665719

RESUMO

The COVID-19 pandemic has disrupted all facets of pharmacy education, including accreditation and certification activities. In a very short period of time, Doctor of Pharmacy (PharmD) programs and pharmacy technician programs had to convert to teaching classes online, experiential education sites had to figure out how to train student pharmacists and pharmacy technicians while ensuring their safety, continuing pharmacy education providers had to move their in-person courses online, and the Accreditation Council for Pharmacy Education (ACPE) had to postpone accreditation site visits. Given the challenges faced by our constituencies, the ACPE implemented processes and suggested solutions that stayed within the boundaries of the standards while at the same time allowing flexibility so that organizations could achieve their educational outcomes even given the constraints produced by the pandemic.


Assuntos
Acreditação/organização & administração , Infecções por Coronavirus/epidemiologia , Educação em Farmácia/organização & administração , Pneumonia Viral/epidemiologia , Acreditação/normas , Betacoronavirus , Educação a Distância , Educação em Farmácia/normas , Humanos , Inovação Organizacional , Pandemias , Aprendizagem Baseada em Problemas
8.
J Surg Res ; 255: 9-12, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32540582

RESUMO

BACKGROUND: Case number requirements by the Accreditation Council for Graduate Medical Education (ACGME) have recently changed in general surgery residency and pediatric surgery fellowship. Overall, pediatric surgery fellowship case volumes remain high, but there may be limited exposure to many index cases. We hypothesize that pediatric antireflux surgery is decreasing nationally, and this trend is independent of the fluctuating number of pediatric surgery fellows. MATERIALS AND METHODS: A review of publicly available ACGME case reports from 2003 to 2018 was performed. Both open and laparoscopic antireflux surgery cases were evaluated. Analyzed data included average case number per fellow, minimum and maximum case numbers, and number of fellows each year. Simple and multiple linear regression analyses were performed. RESULTS: We identified a significant relationship (P < 0.001) between the total number of antireflux procedures and the years of operation. The slope coefficient was -1.45, meaning the number of operations decreased by an average of 1.45 per year from 2003 to 2018 . The number of fellows fluctuated during this time period (range: 24-45). With multiple linear regression analysis, we found that the number of fellows did not affect the decline of antireflux surgery seen over the years (P = 0.91). CONCLUSIONS: Case numbers continue to be an important topic in ACGME discussions for surgical residency and subspecialty fellowships. Our review has shown a national decline in the number of pediatric antireflux surgeries performed in pediatric surgery fellowship. Identifying additional trends in surgical management of diseases may aid in the evolution of the pediatric surgery curriculum.


Assuntos
Currículo , Fundoplicatura/educação , Refluxo Gastroesofágico/cirurgia , Internato e Residência/normas , Especialidades Cirúrgicas/educação , Acreditação/normas , Criança , Competência Clínica , Fundoplicatura/estatística & dados numéricos , Humanos , Internato e Residência/estatística & dados numéricos , Especialidades Cirúrgicas/normas , Especialidades Cirúrgicas/estatística & dados numéricos
10.
J Surg Res ; 253: 79-85, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32335394

RESUMO

BACKGROUND: The American College of Surgeons Commission on Cancer has incorporated documentation of critical elements outlined in Operative Standards for Cancer Surgery into revised standards for cancer center accreditation. This study assessed the current documentation of critical elements in partial mastectomy (PM) and sentinel lymph node biopsy (SLNB) operative reports. MATERIALS AND METHODS: Operative reports for PM + SLNB at a single academic institution from 2013 to 2018 were reviewed for compliance and surveyor interobserver reliability with the Oncologic Elements of Operative Record defined in Operative Standards and compared with a nonredundant American Society of Breast Surgeons Mastery of Breast Surgery (MBS) quality measure for specimen orientation. RESULTS: Ten reviewers each evaluated 66 PM + SLNB operative reports for 13 Oncologic Elements and one MBS measure. No operative records reported all critical elements for PM + SLNB or PM alone. Residents completed 36.4% of operative reports: Element documentation was similar for PM but varied significantly for SLNB between resident and attending authorship. Combined reporting performance and interrater reliability varied across all elements and was highest for the use of SLNB tracer (97.1% and κ = 0.95, respectively) and lowest for intraoperative assessment of SLNB (30.6%, κ = 0.43). MBS specimen orientation had both high proportion reported (87.0%) and interrater reliability (κ = 0.84). CONCLUSIONS: Adherence to reporting critical elements for PM and SLNB varied. Whether differential compliance was tied to discrepancies in documentation or reviewer abstraction, clarification of synoptic choices may improve reporting consistency. Evolving techniques or technologies will require continuous appraisal of mandated reporting for breast surgery.


Assuntos
Acreditação/normas , Neoplasias da Mama/cirurgia , Documentação/normas , Excisão de Linfonodo/estatística & dados numéricos , Mastectomia Segmentar/estatística & dados numéricos , Centros Médicos Acadêmicos/organização & administração , Centros Médicos Acadêmicos/normas , Centros Médicos Acadêmicos/estatística & dados numéricos , Mama/patologia , Mama/cirurgia , Neoplasias da Mama/patologia , Institutos de Câncer/organização & administração , Institutos de Câncer/normas , Institutos de Câncer/estatística & dados numéricos , Documentação/estatística & dados numéricos , Feminino , Fidelidade a Diretrizes/normas , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Excisão de Linfonodo/instrumentação , Excisão de Linfonodo/métodos , Excisão de Linfonodo/normas , Mastectomia Segmentar/instrumentação , Mastectomia Segmentar/métodos , Mastectomia Segmentar/normas , Padrões de Prática Médica/organização & administração , Padrões de Prática Médica/normas , Padrões de Prática Médica/estatística & dados numéricos , Indicadores de Qualidade em Assistência à Saúde/normas , Indicadores de Qualidade em Assistência à Saúde/estatística & dados numéricos , Reprodutibilidade dos Testes , Biópsia de Linfonodo Sentinela/normas , Biópsia de Linfonodo Sentinela/estatística & dados numéricos
14.
Pain Physician ; 23(1): E7-E18, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-32013284

RESUMO

BACKGROUND: The US Department of Health and Human Services has recommended that physicians performing interventional pain procedures be credentialed based on criteria based guidelines and minimum training requirements. OBJECTIVES: To quantitatively assess gaps in certification related to pain medicine fellowship requirements, we studied the distribution of such procedures in Florida between 2010 and 2016. STUDY DESIGN: This research involved a retrospective analysis with a sample size of n = 1,885,442 interventional pain procedures. SETTING: Data describing interventional pain procedures performed in Florida between January 2010 and December 2016 were obtained from the Florida Department of Health. The National Provider Identifier file and board certification lists from the American Board of Medical Specialties (ABMS), the American Board of Pain Medicine (ABPM), and the American Board of Interventional Pain Physicians (ABIPP) corresponding to this time frame were also obtained. METHODS: The datasets were linked to determine the specialty of physicians performing interventional pain procedures, and whether or not they were pain medicine diplomates of the ABMS, the ABPM, or the ABIPP. The similarity index theta was calculated for the distribution of interventional pain procedure codes among medical specialty groups, and with respect to the practitioners' pain medicine board certification status. RESULTS: Of the interventional pain procedures, anesthesiologists performed 63.5%, physiatrists 19.1%, neurologists or psychiatrists 5.2%, and other practitioners 12.3%. Among procedures performed by anesthesiologists, physiatrists, and psychiatrists or neurologists, 66.2%, 50.3%, and 50.4% were by ABMS pain board-certified practitioners, respectively. Practitioners without ABMS pain medicine boards performed 45.8% of interventional pain procedures. Practitioners without such boards from either the ABMS, ABPM, or ABIPP performed 37.7%. There was very large similarity (theta > 0.9) in the distribution of procedures comparing ABMS pain medicine board-certified practitioners to non-ABMS pain medicine board-certified anesthesiologists, physiatrists, or all other specialties. LIMITATIONS: In countries other than the United States, where pain medicine board certification is relatively recent, there may be a higher percentage of interventional pain procedures performed by individuals without certification than we report. In "opt-out" states, where nurse anesthetists can independently perform interventional pain procedures, the percentage of interventional pain procedures performed by individuals without physician pain medicine board certification may also be higher. The datasets we used do not contain information to allow assessment of outcomes or effectiveness resulting from pain medicine board certification. CONCLUSIONS: Approximately one-third of interventional pain procedures were performed by physicians without at least 1 of the 3 pain medicine board certifications. In addition, the practitioners performed very similar distributions of procedures (i.e., those without pain medicine board certification, overall, have not restricted their practice). These results suggest the need for additional accredited pain medicine fellowship training positions for newly graduated residents. The results also show that, for the recommendations of the Department of Health and Human Services to be satisfied, physicians without board certification performing intervention procedures would need to obtain ABPM or ABIPP certification, or ABMS certification after completion of a full-time Accreditation Council of Graduate Medical Education pain medicine fellowship. KEY WORDS: Chronic pain, education, medical, graduate, specialty boards.


Assuntos
Certificação/tendências , Manejo da Dor/tendências , Médicos/tendências , Conselhos de Especialidade Profissional/tendências , Acreditação/normas , Acreditação/tendências , Certificação/normas , Bolsas de Estudo/normas , Bolsas de Estudo/tendências , Florida/epidemiologia , Humanos , Dor/diagnóstico , Dor/epidemiologia , Manejo da Dor/normas , Médicos/normas , Estudos Retrospectivos , Conselhos de Especialidade Profissional/normas
15.
Rev. Fund. Educ. Méd. (Ed. impr.) ; 23(1): 5-8, ene.-feb. 2020.
Artigo em Espanhol | IBECS | ID: ibc-187793

RESUMO

Se analiza la complejidad geográfica, cultural y poblacional de la sociedad peruana, y se destacan indicadores importantes para la comparación con realidades latinoamericanas. Tras detallar datos sobre la aparición de la educación médica en el país, se describe el proceso que debe seguir un estudiante para convertirse en médico en Perú. Se narra lo acontecido en relación al crecimiento brusco y desordenado de las escuelas de medicina en los últimos 30 años, junto con el proceso actual, que intenta ordenar la situación. Se plantean estrategias con las cuales se está trabajando para la mejora del sistema en la actualidad


The geographic, cultural and population complexity of the Peruvian society is analyzed, highlighting important indicators for comparison with other Latin American realities. After providing some information on the emergence of medical education in the country, we describe the process that a student must follow to become a doctor. We also cover the abrupt and disorderly growth of medical schools in the last 30 years, as well as the current process that attempts to improve the situation. Finally, we propose strategies to optimize these improvement processes


Assuntos
Humanos , Educação de Graduação em Medicina/organização & administração , Educação Médica/métodos , Acreditação/normas , Currículo/normas , Educação de Graduação em Medicina/tendências , Peru , Certificado de Autorização de Funcionamento
16.
J Am Osteopath Assoc ; 120(1): 35-44, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31904773

RESUMO

Background: Osteopathic distinctiveness is a result of professional education, identity formation, training, credentialing, and qualifications. With the advancement of a single graduate medical education (GME) accreditation system and the continued growth of the osteopathic medical profession, osteopathic distinctiveness and professional identity are seen as lacking clarity and pose a challenge. Summit: To achieve consensus on a succinct definition of osteopathic distinctiveness and to identify steps to more clearly define and advance that distinctiveness, particularly in professional self-regulation, a representative group of osteopathic medical students, residents, physicians, and members of the licensing, GME, and undergraduate medical education (UME) communities convened the 2019 United States Osteopathic Medical Regulatory Summit in February 2019. Key features of osteopathic distinctiveness were discussed. Growth in the profession; changes in health care delivery, technology, and demographics within the profession and patient communities; and associated challenges and opportunities for osteopathic medical practice and patients were considered. Consensus: Osteopathic medicine is a distinctive practice that brings unique, added value to patients, the public, and the health care community at large. A universal definition and common understanding of that distinctiveness is lacking. Efforts to unify messaging that defines osteopathic distinctiveness, to align the distinctive elements of osteopathic medical education and professional self-regulation across a continuum, and to advance research on care and educational program outcomes are critical to the future of the osteopathic medical profession. Recommendations: (1) Convene a task force of groups represented at the Summit to develop a succinct and consistent message defining osteopathic distinctiveness. (2) Demonstrate uniqueness of the profession through research demonstrating efficacy of care and patient outcomes, adding to the public good. (3) Harmonize GME and UME by beginning to align entrustable professional activities with UME milestones. (4) Convene representatives from osteopathic specialty colleges and certification boards to define curricular elements across GME, certification, and osteopathic continuous certification. (5) Build on the Project in Osteopathic Medical Education and Empathy study.


Assuntos
Acreditação/normas , Educação de Pós-Graduação em Medicina/normas , Medicina Osteopática/organização & administração , Medicina Osteopática/normas , Conferências de Consenso como Assunto , Humanos , Estados Unidos
17.
Transfusion ; 60(5): 912-917, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31970781

RESUMO

BACKGROUND: The Accreditation Council for Graduate Medical Education requires milestone reporting of the Six General Core Competencies. Additionally, Graduate Medical Education (GME) is transitioning to adopt competency-based education methodologies including entrustable professional activities (EPAs) for objective, observable, and measurable milestone progression. The College of American Pathologists published 19 EPAs, including one for transfusion-related adverse events. This survey study includes developing EPAs for transfusion reaction evaluation and assessing residents before and after implementing these EPAs. STUDY DESIGN AND METHODS: Three transfusion reaction EPAs were developed and implemented in July 2018 for the Postgraduate Year (PGY) 2 pathology residents. An online, anonymous survey was sent to all 21 pathology trainees before and one year after EPA implementation. In July 2018 and August 2019, each survey included the same six multiple-choice, single-response, confidence questions, with a rating scale of extremely, very, slightly, or not at all confident. This study was approved by the hospital's Institutional Review Board for Health Sciences Research and GME Committee. RESULTS: Analysis was performed on PGY2-4 residents. In 2018, 13 of 20 participants were analyzed. In 2019, 15 of 19 participants were analyzed. Number and percentage of responses were reported. The results showed an increase in trainee confidence, with the greatest improvement among the first class to use the EPAs. CONCLUSION: EPAs provide an effective framework for objective and measurable progression of trainees. One year after the implementation of transfusion reaction EPAs at our site, the trainees showed enhanced confidence levels in handling Blood Bank and Transfusion Medicine Services coverage.


Assuntos
Acreditação , Bancos de Sangue/normas , Competência Clínica , Internato e Residência , Patologia Clínica , Medicina Transfusional/normas , Acreditação/normas , Ritmo Circadiano , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Estudos de Coortes , Educação Baseada em Competências/normas , Educação de Pós-Graduação em Medicina/normas , Avaliação Educacional/normas , Humanos , Internato e Residência/normas , Patologia Clínica/educação , Patologia Clínica/normas , Patologia Clínica/estatística & dados numéricos , Percepção , Padrões de Prática Médica/normas , Padrões de Prática Médica/estatística & dados numéricos , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Medicina Transfusional/educação , Medicina Transfusional/organização & administração , Reação Transfusional/epidemiologia , Confiança
18.
Malar J ; 19(1): 18, 2020 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-31937329

RESUMO

BACKGROUND: In India, Accredited Social Health Activists (ASHAs) deliver services for diagnosis and treatment of malaria, although unlicensed medical practitioners (UMPs) (informal health providers) are most preferred in communities. A cross sectional survey was conducted to: (i) assess knowledge and treatment-seeking practices in the community, and (ii) explore the diagnosis and treatment practices related to malaria of UMPs working in rural and tribal-dominated high malaria endemic areas of central India, and whether they adhere to the national guidelines. METHODS: A multi-stage sampling method and survey technique was adopted. Heads of the households and UMPs were interviewed using a structured interview schedule to assess knowledge and malaria treatment practices. RESULTS: Knowledge regarding malaria symptoms was generally accurate, but misconceptions emerged related to malaria transmission and mosquito breeding places. Modern preventive measures were poorly accessed by the households. UMPs were the most preferred health providers (49%) and the first choice in households for seeking treatment. UMPs typically lacked knowledge of the names of malaria parasite species and species-specific diagnosis and treatment. Further, irrational use of anti-malarial drugs was common. CONCLUSIONS: UMPs were the most preferred type of health care providers in rural communities where health infrastructure is poor. The study suggests enhancing training of UMPs on national guidelines for malaria diagnosis and treatment to strengthen their ability to contribute to achievement of India's malaria elimination goals.


Assuntos
Serviços de Saúde do Indígena/normas , Malária/diagnóstico , Malária/terapia , População Rural , Acreditação/normas , Estudos Transversais , Doenças Endêmicas/prevenção & controle , Doenças Endêmicas/estatística & dados numéricos , Características da Família , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Índia/epidemiologia , Entrevistas como Assunto , Licenciamento/normas , Alfabetização/estatística & dados numéricos , Malária/epidemiologia , Malária/prevenção & controle , Ocupações , Tamanho da Amostra , Razão de Masculinidade , Fatores Socioeconômicos
19.
Ann Vasc Surg ; 65: 145-151, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31904519

RESUMO

BACKGROUND: The Medicare Access and CHIP Reauthorization Act (MACRA) brings with it increased regulatory requirements not traditionally addressed by standard vascular laboratory accreditation, which is based on accuracy. The new quality improvement project of the Intersocietal Accreditation Commission (IAC) may satisfy an improvement activity (IA) of the MACRA. We hypothesize that other IAs in the MACRA such as timeliness of test results or patient care quality performance requirements can be met by analyzing data already being collected by the vascular laboratory. After a process improvement strategy, we chose to review progress in our vascular laboratory related to time to interpretation (TI), patient check-in to study completion (study time), wait time for first available outpatient venous duplex scan (wait time), technologist productivity, and critical results reporting. METHODS: Data from our hospital-based vascular laboratory were collected from 2010 to 2016. TI was collected through our reporting software VascuPro (Consensus Medical), and study time and wait time were obtained from electronic medical records (EMR) (Epic). Technologist productivity was calculated by commercially available productivity tools, and compliance with critical results reporting was calculated quarterly as per our quality assurance program. Appropriateness of carotid duplex scan testing was performed by expert review of International Classification of Disease codes used to request the test. RESULTS: TI analysis comprised 91,352 studies with a mean of 3.3 hr between test completion and final interpretation. The TI improved from 5.0 to 2.1 hr on weekdays and was longer on weekends (4.9 hr; P < 0.001). The study time improved from 29.8 to 27.2 min and was 14.9 min shorter on the weekends (P < 0.001). The wait time ranged from a mean of 1-2.08 days. Technologist productivity improved from 90.7% to 93.6%. Critical results reporting quarterly audits showed a 100% compliance rate. On expert review, the International Classification of Disease code on carotid duplex scan requests in the EMR was deemed inaccurate in 17.4% of cases. CONCLUSIONS: TI and study time improved; wait time and critical results reporting remained steady. Most of the data are readily available in a vascular laboratory standard EMR. The plan-do-study-act (PDSA or Shewhart Cycle) principle is critical to process improvement and needed as we transition from traditional accreditation mostly based on test accuracy to one demanding efficiency, timeliness, patient satisfaction, productivity, accountability, and appropriateness of testing. Process improvement studies will improve patient care and satisfaction, increase efficiency and throughput, while satisfying changing IAC standards and preparing for upcoming regulatory requirements of the MACRA.


Assuntos
Acreditação , Artérias Carótidas/diagnóstico por imagem , Serviços de Laboratório Clínico , Medicare Access and CHIP Reauthorization Act of 2015 , Melhoria de Qualidade , Indicadores de Qualidade em Assistência à Saúde , Ultrassonografia Doppler Dupla , Acreditação/economia , Acreditação/normas , Agendamento de Consultas , Serviços de Laboratório Clínico/economia , Serviços de Laboratório Clínico/normas , Eficiência , Humanos , Medicare Access and CHIP Reauthorization Act of 2015/economia , Medicare Access and CHIP Reauthorization Act of 2015/normas , Formulação de Políticas , Melhoria de Qualidade/economia , Melhoria de Qualidade/normas , Indicadores de Qualidade em Assistência à Saúde/economia , Indicadores de Qualidade em Assistência à Saúde/normas , Estudos Retrospectivos , Fatores de Tempo , Ultrassonografia Doppler Dupla/economia , Ultrassonografia Doppler Dupla/normas , Estados Unidos , Fluxo de Trabalho
20.
Public Health Rep ; 135(1): 25-32, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31729938

RESUMO

OBJECTIVES: Public health accreditation is a 7-step process that starts with a period of preapplication during which a health department assesses its readiness for accreditation. However, no tools with established reliability and validity that quantitatively measure a local health department's (LHD's) capacity for accreditation are available to complete this initial step. We developed and validated a survey to measure accreditation capacity for LHDs. METHODS: From January through April 2015, we administered a cross-sectional electronic survey instrument with 15 questions that tapped into domains of capacity for public health accreditation. We analyzed and grouped responses by using a confirmatory maximum likelihood factor analysis with oblique rotations. We assessed reliability by using Cronbach α, and we assessed validity by comparing responses with previously established instruments. We administered the survey to 174 LHD directors in Colorado, Kansas, and Nebraska, 153 (88%) of whom responded. RESULTS: The factor analysis produced a 3-factor model of accreditation capacity, suggesting that accreditation capacity depends on 3 distinct latent constructs: support for accreditation, preparation, and planning and approach. The model had good scale reliability (average Cronbach α = 0.7) and validity (average factor correlation = 0.43). CONCLUSIONS: The survey developed and scored in this analysis can be used by LHDs to inform the feasibility of initiating the time-intensive and costly process of accreditation.


Assuntos
Acreditação/normas , Governo Local , Saúde Pública/normas , Inquéritos e Questionários/normas , Estudos Transversais , Humanos , Reprodutibilidade dos Testes
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