Bmc Health Serv Res
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Bmc Health Serv Res · Jan 2013
A mixed methods descriptive investigation of readiness to change in rural hospitals participating in a tele-critical care intervention.
Telemedicine technology can improve care to patients in rural and medically underserved communities yet adoption has been slow. The objective of this study was to study organizational readiness to participate in an academic-community hospital partnership including clinician education and telemedicine outreach focused on sepsis and trauma care in underserved, rural hospitals. ⋯ A mixed methods approach proved useful in assessing organizational readiness for change in small organizations. Further research on variable operational definitions, potential influential factors, appropriate and feasible methods and valid instruments for such research are needed.
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Bmc Health Serv Res · Jan 2013
Historical ArticleChanges in FDA enforcement activities following changes in federal administration: the case of regulatory letters released to pharmaceutical companies.
The United States (US) Food and Drug Administration (FDA) is responsible for the protection of the public health by assuring the safety, effectiveness and security of human drugs and biological products through the enforcement of the Federal Food, Drug and Cosmetic Act (FDCA) and related regulations. These enforcement activities include regulatory letters (i.e. warning letters and notice of violation) to pharmaceutical companies. A regulatory letter represents the FDA's first official notification to a pharmaceutical company that the FDA has discovered a product or activity in violation of the FDCA.This study analyzed trends in the pharmaceutical-related regulatory letters released by the FDA during the period 1997-2011 and assessed differences in the average number and type of regulatory letters released during the last four federal administrations. ⋯ Most regulatory letters released by FDA headquarters were related to marketing and advertising activities of pharmaceutical companies. The number of regulatory letters was highest during the second Clinton administration, diminished during the Bush administrations, and increased again during the Obama administration. A further assessment of the impact of changes in federal administration on the enforcement activities of the FDA is required.
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Bmc Health Serv Res · Jan 2013
Multicenter StudyDevelopment and psychometric properties of a scale for measuring internal participation from a patient and health care professional perspective.
Effective patient-centred health care requires internal participation, which is defined as interprofessional patient-centred teamwork. Many scales are designed for measuring teamwork from the perspective of one type of health care professional (e.g. physician or nurse), rather than for the use for all health care professionals as well as patients. Hence, this paper's purpose is to develop a scale for measuring internal participation from all relevant perspectives and to check its psychometric properties. ⋯ The analysis of the scale's psychometric properties resulted in good values. The scale is a promising instrument to assess internal participation from the perspective of both patients and staff. Further research should investigate the scale's psychometric properties in other interprofessional health care settings to examine its generalizability as well as its sensitivity to change.
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Bmc Health Serv Res · Jan 2013
Randomized Controlled Trial Multicenter StudyA multicentre, double-blind, randomised, controlled, parallel-group study of the effectiveness of a pharmacist-acquired medication history in an emergency department.
Admission to an emergency department (ED) is a key vulnerable moment when patients are at increased risk of medication discrepancies and medication histories are an effective way of ensuring that fewer errors are made. This study measured whether a pharmacist-acquired medication history in an ED focusing on a patient's current home medication regimen, and available to be used by a doctor when consulting in the ED, would reduce the number of patients having at least 1 medication discrepancy related to home medication. ⋯ A pharmacist-acquired medication history in an ED focusing on a patient's current home medication regimen available to be used by a doctor at the time of consulting in the ED reduced the number of patients having at least 1 home medication-related discrepancy.
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Bmc Health Serv Res · Jan 2013
Comparative StudySecondary care intervals before and after the introduction of urgent referral guidelines for suspected cancer in Denmark: a comparative before-after study.
Urgent referral for suspected cancer was implemented in Denmark on 1 April 2008 to reduce the secondary care interval (i.e. the time interval from the general practitioner's first referral of a patient to secondary health care until treatment is initiated). However, knowledge about the association between the secondary care interval and urgent referral remains scarce. The aim of this study was to analyse how the secondary care interval changed after the introduction of urgent referral. ⋯ Urgent referral had a positive effect on the secondary care interval, and Vejle Hospital remarkably managed to shorten the intervals even further. This finding indicates that the shorter secondary care intervals not only result from the urgent referral guidelines, but also involve other factors.