Managing and Measuring Emergency Department Care: Results of the Fourth Emergency Department Benchmarking Definitions Summit.
health; impact; length; performance-measures
BACKGROUND: A shared language and vocabulary are essential for managing emergency department (ED) operations. This Fourth Emergency Department Benchmarking Alliance (EDBA) Summit brought together experts in the field to review, update, and add to key definitions and metrics of ED operations. OBJECTIVE: Summit objectives were to review and revise existing definitions, define and characterize new practices related to ED operations, and introduce financial and regulatory definitions affecting ED reimbursement. METHODS: Forty-six ED operations, data management, and benchmarking experts were invited to participate in the EDBA summit. Before arrival, experts were provided with documents from the three prior summits and assigned to update the terminology. Materials and publications related to standards of ED operations were considered and discussed. Each group submitted a revised set of definitions prior to the summit. Significantly revised, topical, or controversial recommendations were discussed among all summit participants. The goal of the in-person discussion was to reach consensus on definitions. Work group leaders made changes to reflect the discussion, which was revised with public and stakeholder feedback. RESULTS: The entire EDBA dictionary was updated and expanded. This article focuses on an update and discussion of definitions related to specific topics that changed since the last summit, specifically ED intake, boarding, diversion, and observation care. In addition, an extensive new glossary of financial and regulatory terminology germane to the practice of emergency medicine is included. CONCLUSIONS: A complete and precise set of operational definitions, time intervals, and utilization measures is necessary for timely and effective ED care. A common language of financial and regulatory definitions that affect ED operations is included for the first time. This article and its companion dictionary should serve as a resource to ED leadership, researchers, informatics and health policy leaders, and regulatory bodies.
Yiadom Maame Y A B; Napoli Anthony; Granovsky Michael; Parker Rebecca B; Pilgrim Randy; Pines Jesse M; Schuur Jeremiah; Augustine James; Jouriles Nicholas; Welch Shari
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
2020
2020-04-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1111/acem.13978" target="_blank" rel="noreferrer noopener">10.1111/acem.13978</a>
Anemia from A to zinc: Hypocupremia in the setting of gastric bypass and zinc excess.
copper deficiency; gastroenterology and hepatology; health; hematology; nutrition; patient; pharmacology
Hypocupremia can result in a bi-lineage deficiency of leukocytes and erythrocytes. Although commonly seen from gastrointestinal malabsorption, hypocupremia can be further exacerbated with excessive zinc intake causing increased fecal copper excretion. Dietary supplementation is prevalent in the outpatient setting and must be considered as a possible source of hematologic pathologies.
Tatineni Vineeth; An Julie Y; Leffew Matthew R; Mahesh Sameer A
Clinical case reports
2020
2020-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1002/ccr3.2741" target="_blank" rel="noreferrer noopener">10.1002/ccr3.2741</a>
Bone mineral density in adolescent urinary stone formers: is sex important?
Bone; children; disease; fracture; health; inflammation; kidney-stones; nephrolithiasis; osteoporosis; Pediatrics; risk; Sex; Urolithiasis; Urolithiasis
Urinary stone disease (USD) is affecting a greater number of children and low bone mineral density (BMD) and increased skeletal fractures have been demonstrated in stone patients; however, the mechanism(s) driving bone disease remain unclear. This pilot study was undertaken to assess an adolescent kidney stone cohort's BMD and evaluate for an inverse correlation between BMD and urine concentration of lithogenic minerals and/or inflammatory levels. Prospective case-control study was carried out at a large pediatric center. 15 participants with USD (12-18 years of age, 8 female) were matched by age, sex, and body mass index to 15 controls. Lumbar and total body BMD z-score did not differ between groups. When stone formers were separated by sex, there was a significant difference between male stone formers vs. controls total body BMD z-score (Fig. 1). BMD z-score did not significantly correlate with urine calcium, oxalate, citrate or magnesium. Higher urine IL-13 did significantly correlate with higher total body BMD z-score (r = 0.677, p = 0.018). Total body BMD z-score did significantly correlate with body mass index (BMI) as expected for the control group (r = 0.6321, p = 0.0133). However, this relationship was not present in the USD group (r = - 0.1629, p = 0.5619). This is a small but hypothesis-generating study which demonstrates novel evidence of male-specific low BMD in adolescent stone formers. Furthermore, we demonstrated a positive association between urine
Kusumi Kirsten; Schwaderer Andrew L; Clark Curtis; Budge Kevin; Hussein Nazar; Raina Rupesh; Denburg Michelle; Safadi Fayez F
Urolithiasis
2020
2020-03-31
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1007/s00240-020-01183-w" target="_blank" rel="noreferrer noopener">10.1007/s00240-020-01183-w</a>
A Single Funding Source For Public-sector Care
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Kuehn J L
Psychiatric Services
2004
2004-02
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1176/appi.ps.55.2.192" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.55.2.192</a>
The Case Of Sam
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Kuehn J L
Psychiatric Services
2002
2002-04
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1176/appi.ps.53.4.481-a" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.53.4.481-a</a>
Schizophrenia: Cognitive Theory, Research, And Therapy
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Herman L C
Psychiatric Services
2009
2009-10
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1176/appi.ps.60.10.1407" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.60.10.1407</a>
Behavior And Medicine, 2nd Edition - Wedding,d
Environmental & Occupational; Health; Health Care Sciences & Services; Public
Hartung P J
Medical Care
1996
1996-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1097/00005650-199605000-00011" target="_blank" rel="noreferrer noopener">10.1097/00005650-199605000-00011</a>
The Effect Of Services And Stigma On Quality Of Life For Persons With Serious Mental Illnesses
consequences; Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public; rejection; satisfaction; self-esteem
Marcussen K; Ritter C; Munetz M R
Psychiatric Services
2010
2010-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1176/ps.2010.61.5.489" target="_blank" rel="noreferrer noopener">10.1176/ps.2010.61.5.489</a>
Role Of The Social Milieu In Health And Wellness
attendance; differentials; Economics; economy; education; education; General & Internal Medicine; Health; Health systems; income inequality; mortality; Political systems; public-health; quality-of-life; religious involvement; Social milieu; Spirituality; united-states; Wellness
Mallin R; Hull S K
Primary Care
2008
2008-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/j.pop.2008.07.003" target="_blank" rel="noreferrer noopener">10.1016/j.pop.2008.07.003</a>
Race, Incarceration, And Health - A Life-course Approach
course perspective; cumulative disadvantage; employment; Geriatrics & Gerontology; Health; income; life course; marital-status; marriage; mortality; poverty; prison; race; racial-inequality; socioeconomic-status
London A S; Myers N A
Research on Aging
2006
2006-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1177/0164027505285849" target="_blank" rel="noreferrer noopener">10.1177/0164027505285849</a>
Transforming Madness: New Lives For People Living With Mental Illness: Four Reviews
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Frese F J
Psychiatric Services
1999
1999-08
Journal Article or Conference Abstract Publication
n/a
Talking To Families About Mental Illness: What Clinicians Need To Know
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Frese F J
Psychiatric Services
2011
2011-11
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1176/ps.62.11.pss6211_1398" target="_blank" rel="noreferrer noopener">10.1176/ps.62.11.pss6211_1398</a>
Recovery From Schizophrenia: An International Perspective
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Frese F J
Psychiatric Services
2007
2007-09
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1176/appi.ps.58.9.1230" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.58.9.1230</a>
Neurodevelopment And Schizophrenia
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Frese F J
Psychiatric Services
2006
2006-06
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1176/appi.ps.57.6.887" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.57.6.887</a>
Living Outside Mental Illness: Qualitative Studies Of Recovery In Schizophrenia
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Frese F J
Psychiatric Services
2004
2004-09
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1176/appi.ps.55.9.1073-a" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.55.9.1073-a</a>
The Family Guide To Mental Health Care
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Frese F J
Psychiatric Services
2013
2013-08
Journal Article or Conference Abstract Publication
n/a
Evolving Psychosis: Different Stages, Different Treatments
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Frese F J
Psychiatric Services
2007
2007-03
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1176/appi.ps.58.3.416-a" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.58.3.416-a</a>
Criminalization Of Mental Illness: Crisis And Opportunity For The Justice System
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Frese F J
Psychiatric Services
2009
2009-11
Journal Article or Conference Abstract Publication
n/a
Comprehensive Care Of Schizophrenia: A Textbook Of Clinical Management, 2nd Edition
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Frese F J
Psychiatric Services
2013
2013-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1176/appi.ps.640504" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.640504</a>
Experiences Of Belittlement And Harassment And Their Correlates Among Medical Students In The United States: Longitudinal Survey
abuse; education; gender discrimination; General & Internal Medicine; Health; mistreatment; perceptions; perspectives; school; sexual harassment; us women physicians
Frank E; Carrera J S; Stratton T; Bickel J; Nora L M
Bmj-British Medical Journal
2006
2006-09
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1136/bmj.38924.722037.7C" target="_blank" rel="noreferrer noopener">10.1136/bmj.38924.722037.7C</a>
Identifying Families' Shared Disease Experiences Through A Qualitative Analysis Of Online Twin-to-twin Transfusion Syndrome Stories
children; Emotions; Health; high-risk pregnancy; information; laser-surgery; Lived experience; Obstetrics & Gynecology; parents; perspective; prenatal-diagnosis; psychological-aspects; Psychosocial; Qualitative; stress; Twin-to-twin transfusion syndrome (TTTS)
Fischbein R; Meeker J; Saling J R; Chyatte M; Nicholas L
Bmc Pregnancy and Childbirth
2016
2016-07
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1186/s12884-016-0952-6" target="_blank" rel="noreferrer noopener">10.1186/s12884-016-0952-6</a>
Embracing The End Of Life: Help For Those Who Accompany The Dying
Environmental & Occupational; Health; Health Care Sciences & Services; Public
Engel J
Journal of Palliative Care
2012
2012
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1177/082585971202800310" target="_blank" rel="noreferrer noopener">10.1177/082585971202800310</a>
Ebola Control: The Cuban Approach
General & Internal Medicine; Health
Ebrahim S; Squires N; Diaz M B; di Fabio J L; Reed G; Bourne P G; Keck W; Chalkidou K
Lancet
2014
2014-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/s0140-6736(14)62329-1" target="_blank" rel="noreferrer noopener">10.1016/s0140-6736(14)62329-1</a>
Competency in combining pharmacotherapy and psychotherapy: Integrated and split treatment
Psychiatry; Health; Health Care Sciences & Services; Public; Environmental & Occupational
Moore J L
Psychiatric Services
2008
2008-03
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1176/appi.ps.59.3.332" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.59.3.332</a>
The Psychosis-Risk Syndrome: Handbook for Diagnosis and Follow-up
Psychiatry; Health; Health Care Sciences & Services; Public; Environmental & Occupational
Montesano V
Psychiatric Services
2012
2012-02
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1176/appi.ps.2012p191a" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.2012p191a</a>
Beyond Medication: Therapeutic Engagement and the Recovery From Psychosis
Psychiatry; Health; Health Care Sciences & Services; Public; Environmental & Occupational
Montesano V
Psychiatric Services
2011
2011-02
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1176/appi.ps.62.2.227" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.62.2.227</a>
A SURVEY OF RECENT LITERATURE ON MEDICAL WASTE
Health; Public; Environmental Sciences & Ecology; Environmental & Occupational
Medical waste appears, on the surface, to be dangerous. Public perception of medical waste is, in general, inaccurate. After syringes washed up on the beaches of New York and New Jersey in the summers of 1987 and 1988, and fanned by the sensationalism of the media, public outcry over medical waste peaked. This paper examines the recent journal literature about medical wastes and examines definitions, risks (both real and perceived), and methods of minimizing risks (including legislation). The consensus in the recent articles on medical waste is that medical waste is no more dangerous than non-medical waste.
Burke E L
Journal of Environmental Health
1994
1994-05
Journal Article or Conference Abstract Publication
n/a
Work values and job satisfaction of family physicians
Psychology; metaanalysis; Health; primary-care physicians; trends; medical-students; school; specialty choice; Medical career development; Work values; life-style; Career specialty choice; general-surgery; Job satisfaction; personality scale scores; Physician Values in Practice Scale; Values assessment
Theory and prior research suggest linkages between work values and job satisfaction. The present study examined such linkages in a group of workers in a professional occupation. Family physicians (134 women, 206 men, 88% Caucasian) responded to context-specific measures of work values and job satisfaction. ANOVA results indicated a work values hierarchy of Autonomy, Service, Lifestyle, Scholarly Pursuits, Management and Prestige in decreasing order of importance. Canonical correlation analysis yielded a significant function with three work values collectively predicting job satisfaction: Lifestyle (negatively) and Service and Scholarly Pursuits (positively) in decreasing order of magnitude. The study findings may be useful to medical students in the specialty choice process, to medical school faculty advising such students, and to currently practicing physicians contemplating career specialty change. Future research may examine work values and job satisfaction differences across employment and geographic settings, give increased attention to cultural variables, and include intervention studies and longitudinal designs. (C) 2013 Elsevier Inc. All rights reserved.
Bouwkamp-Memmer J C; Whiston S C; Hartung P J
Journal of Vocational Behavior
2013
2013-06
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/j.jvb.2013.02.001" target="_blank" rel="noreferrer noopener">10.1016/j.jvb.2013.02.001</a>
Disentangling Consumer and Provider Predictors of Need for and Comfort with Initiating Advance Care Planning Conversations
Health; Health Care Sciences & Services; Public; Environmental & Occupational
Baughman K R; Ludwick R; Merolla D; Palmisano B R; Hazelett S; Aultman J; Sanders M
Journal of Palliative Care
2012
2012
Journal Article or Conference Abstract Publication
n/a
Biopsychosocial characteristics of overweight and obese primary care patients: do psychosocial and behavior factors mediate sociodemographic effects?
intervention; social support; obesity; self-efficacy; exercise; balance; primary care; General & Internal Medicine; Environmental & Occupational Health; Public; Health; women; behavior; body-mass index; body-mass index; physical-activity; weight management; 7-day recall; decisional; energy intake; energy intake; motivational readiness; physical-activity
Background. The increasing prevalence of obesity and obesity-related conditions in primary care settings challenges the health care system. Thus. we used available baseline data from an on-going clinical trial to examine the biopsychosocial characteristics of overweight and obese primary care patients. The primary research objective was to ascertain whether theoretically important psychosocial and behavioral variables mediate the empirical relationships between sociodemographic factors and body mass index (BMI). Methods. Overweight or obese primary care patients (n = 665) enrolled in an on-going trial of a cognitive-behavioral obesity intervention provided baseline sociodemographic, psychosocial, nutritional, physical activity, and anthropometric data that were analyzed via multiple regression. Results. Lower educational attainment was associated with a higher BMI after controlling for decisional balance, social support, self-efficacy, energy intake, and energy expenditure (P < 0.05). In contrast, ethnicity was not associated with BMI after controlling for the psychosocial and behavioral variables. Decisional balance and social support variables were associated with BMI and energy intake, but the directions of some of the associations were not consistent with a priori expectations. Conclusions. Overall, we found some evidence of mediation by the psychosocial and behavioral variables of the relationship between ethnicity and BMI, but not for the relationship between education and BMI. In addition, some of the relationships between the psychosocial variables and BMI were opposite of our expectations. (C) 2003 American Health Foundation and Elsevier Science (USA). All rights reserved.
Baughman K; Logue E E; Sutton K; Capers C; Jarjoura D; Smucker W
Preventive Medicine
2003
2003-08
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/s0091-7435(03)00095-1" target="_blank" rel="noreferrer noopener">10.1016/s0091-7435(03)00095-1</a>
Abuses and Apologies: Irresponsible Conduct of Human Subjects Research in Latin America
medicine; ethics; Legal; Health; Government & Law; Social Sciences - Other Topics; Medical Ethics; bioethics; guatemala; vulnerability
This paper explores the vulnerability of Latin American human subjects, and how their vulnerability is ignored due to the complexities and inconsistencies of oversight committees and institutional policies. Secondly, the concept of apology is examined and its meaning to victims of past research abuses.
Aultman J M
Journal of Law Medicine & Ethics
2013
2013
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1111/jlme.12025" target="_blank" rel="noreferrer noopener">10.1111/jlme.12025</a>
Epidemiology of trauma: Childhood adversities, neighborhood problems, discrimination, chronic strains, life events, and daily hassles among people with a severe mental illness
1st-episode psychosis; adults; Childhood trauma; community; Health; national comorbidity survey; posttraumatic-stress-disorder; prevalence; Psychiatry; quality-of-life; schizophrenia; Serious mental illness; stress; symptoms; world-trade-center
Trauma during childhood and adolescence is a common event among people with a serious psychological disorder. Few studies assess a wide range of stressors for this population. This is surprising given that these stressful events are implicated in poorer outcomes related to course and treatment of mental health problems. This study of 214 people with serious mental illness examines the prevalence of childhood traumas, perceived neighborhood problems, discrimination, chronic strains, negative life events, and daily hassles. We use regression analyses to determine if these stressors are associated with quality of life. Results show that 95% of the sample report at least one childhood adversity. Perceived neighborhood problems, experiences of discrimination, chronic strains, life events, and daily hassles were also common. Examining the relationship between demographic factors and stressors suggests that older respondents, Whites, those who have never been married, and people diagnosed with Schizophrenia reported fewer stressors compared to those who are older, non-White, ever married, or suffering from other types of mental health problems. Finally, three of the six types of stressors were related to lower quality of life and depression. We discuss the implications of these findings for the treatment of severe psychological problems. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
Adams R E; Ritter C; Bonfine N
Psychiatry Research
2015
2015-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/j.psychres.2015.10.012" target="_blank" rel="noreferrer noopener">10.1016/j.psychres.2015.10.012</a>
THE RELATIONSHIP BETWEEN SOCIAL TIES AND SURVIVAL AMONG BLACK-AND-WHITE BREAST-CANCER PATIENTS
alameda county; Environmental & Occupational Health; follow-up; Health; Heart disease; life stress; men born; mortality; networks; Oncology; predictors; Public; support
The relationship between social ties, stage of disease, and survival was analyzed in a population-based sample of 525 black and 486 white women with newly diagnosed breast cancer. There were significant differences between the two race groups in reported social ties. Using logistic regression to adjust for the effects of age, race, study area, education, and the presence of symptoms, there was little or no evidence for an association between individual network measures of social ties and stage of disease. However, a summary measure of social networks was found to be associated modestly with late stage disease, attributable in part to significantly more advanced disease among black, but not white, women reporting few friends and relatives [relative risk (RR) = 1.8; 95% confidence interval (CI) = 1.1-3.0]. With adjustments for differences in stage of disease and other covariates, and with the use of Cox proportional hazards modeling to estimate hazard ratios, the absence of close ties and perceived sources of emotional support were associated significantly with an increased breast cancer death rate. White women in the lowest quartile of reported close friends and relatives had twice the breast cancer death rate of white women in the highest quartile (RR = 2.1; 95% CI = 1.1-4.4). Notably, both black and white women reporting few sources of emotional support had a higher death rate from their disease during the 5-year period of follow-up (RR = 1.8; 95% CI = 1.3-2.5). This association was stronger for black women (RR = 1.9; 95% CI = 1.3-3.0) and for women presenting with late stage disease (RR = 1.9; 95% CI = 1.3-2.7). Although the absence of close ties was associated with late diagnosis among black women, and was associated with poorer survival among white women, the absence of sources of emotional support had a consistent effect on both groups of women. These data suggest that functional (''perceived emotional support'') rather than structural (''social network'') measures of social relationships may be important in influencing disease prognosis.
Reynolds P; Boyd P T; Blacklow R S; Jackson J S; Greenberg R S; Austin D F; Chen V W; Edwards B K
Cancer Epidemiology Biomarkers & Prevention
1994
1994-04
Journal Article
n/a
Practicing psychiatry in the community: A manual - Vaccaro,JV, Clark,GH
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Munetz M R
Psychiatric Services
1997
1997-09
Journal Article
n/a
The effectiveness of outpatient civil commitment
Environmental & Occupational; Health; Health Care Sciences & Services; involuntary; Psychiatry; Public
The effects of outpatient civil commitment on community tenure and functioning were studied in a group of 20 patients with a history of recurrent hospitalizations, noncompliance with outpatient treatment, and good response to treatment. During the first 12 months of outpatient commitment, patients experienced significant reductions in visits to the psychiatric emergency service, hospital admissions, and lengths of stay compared with the 12 months before commitment. They significantly increased the number of appointments kept with their psychiatrist. It appears that when used judiciously, outpatient civil commitment is a helpful tool in maintaining hospital recidivists in the community.
Munetz M R; Grande T; Kleist J; Peterson G A
Psychiatric Services
1996
1996-11
Journal Article
n/a
Documenting informed consent for treatment with neuroleptics: An alternative to the consent form
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Clinicians can comply with Ohio state regulations for documenting patients' informed consent for treatment with neuroleptic medication by checking a box in the medical record stating that a periodic discussion of informed consent has occurred and writing a note about the discussion in the narrative record, The authors discuss clinicians' experience with this alternative to the conventional consent form in a large community support agency, Although the approach has been largely successful, implementation has been hindered by some clinicians' incomplete understanding of the informed consent process, Continued training is needed to bring the ideal of informed consent into clinical practice.
Munetz M R; Peterson G A
Psychiatric Services
1996
1996-03
Journal Article
n/a
COGNITIVE-BEHAVIORAL THERAPY OF SCHIZOPHRENIA - KINGDON,DG, TURKINGTON,D
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Munetz M R
Psychiatric Services
1995
1995-08
Journal Article
n/a
COGNITIVE THERAPY WITH SCHIZOPHRENIC-PATIENTS - PERRIS,C
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Munetz M R
Psychiatric Services
1995
1995-08
Journal Article
n/a
Contemporary issues in the treatment of schizophrenia - Shriqui,CL, Nasrallah,H
Environmental & Occupational; Health; Health Care Sciences & Services; Psychiatry; Public
Muentz M R
Psychiatric Services
1996
1996-05
Journal Article
n/a
Physicians' attention to parents' concerns about the psychosocial functioning of their children
depression; dysfunction; epidemiology; General & Internal Medicine; Health; management; pediatric primary care; prevalence; psychiatric-disorders; psychopathology; service utilization
Background: Epidemiological data indicate that approximately 20% of children have psychosocial problems, yet less than 2% of children are seen by mental health specialists each year. Primary care physicians tend to identify children with psychosocial problems when parents discuss concerns with them. Objective: To examine factors related to physicians' attention to parental disclosures. Design: Parents reported the psychosocial functioning of themselves and their children. Physicians reported the psychosocial functioning of 75; children and whether the parent disclosed psychosocial concerns to them. Setting: Ambulatory care clinic of a community-based, university-affiliated, residency training program. Participants: Seventy-five parents of children aged 2 to 16 years who presented for routine primary care, and 26 physicians. Main Outcome Measures: Beck Depression Inventory (parental distress), Eyberg Child Behavior Inventory (child behavior problems) , physician and parent report. Results: Physicians identified 50.0% of children with clinically significant behavior problems. Logistic regression indicated that parental disclosure was the only significant predictor of physician identification (P<.002). When children had clinically significant behavior problems, physicians were more likely to report disclosures by parents (45.0% vs 5.7% for parents of children with and without behavior problems, respectively). Physicians were more likely to report parental disclosure when parents reported personal psychosocial distress (38.9% for distressed vs 5.7% nondistressed parents). Conclusions: Parental disclosure of concerns was a better predictor of physician identification of child psychosocial problems than was the presence of child behavior problems. Physicians responded more frequently to the disclosures of potential problems by parents of children with clinically significant psychosocial problems. They also attended more frequently to disclosures about behavior problems when the parent was also experiencing psychosocial distress.
Wildman B G; Kizilbash A H; Smucker W D
Archives of Family Medicine
1999
1999-09
Journal Article
<a href="http://doi.org/10.1001/archfami.8.5.440" target="_blank" rel="noreferrer noopener">10.1001/archfami.8.5.440</a>