To obtain, in a survey-based study, detailed information on the faculty currently responsible for teaching radiation biology courses to radiation oncology residents in the United States and Canada.
In March-December 2007 a survey questionnaire was sent to faculty having primary responsibility for teaching radiation biology to residents in 93 radiation oncology residency programs in the United States and Canada.
The responses to this survey document the aging of the faculty who have primary responsibility for teaching radiation biology to radiation oncology residents. The survey found a dramatic decline with time in the percentage of educators whose graduate training was in radiation biology. A significant number of the educators responsible for teaching radiation biology were not fully acquainted with the radiation sciences, either through training or practical application. In addition, many were unfamiliar with some of the organizations setting policies and requirements for resident education. Freely available tools, such as the American Society for Radiation Oncology (ASTRO) Radiation and Cancer Biology Practice Examination and Study Guides, were widely used by residents and educators. Consolidation of resident courses or use of a national radiation biology review course was viewed as unlikely by most programs.
A high priority should be given to the development of comprehensive teaching tools to assist those individuals who have responsibility for teaching radiation biology courses but who do not have an extensive background in critical areas of radiobiology related to radiation oncology. These findings also suggest a need for new graduate programs in radiobiology.
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The easing of trade rules has done little to ease the movement of physicians between Canada and the US. Borders may be breaking down when it comes to the transfer of goods, Milan Korcok reports, but for physicians the moats in front of those borders appear to be getting deeper and more difficult to cross.
In the preparation for accreditation in Copenhagen County the commitment of clinical leaders and staff members is crucial. The objectives of these surveys are to examine the leaders' and the staff's assessment of quality improvement and their expectations and knowledge about accreditation, as well as the staff's advice concerning the further planning.
Two surveys among clinical leaders and staff members were carried out.
Statistically, significant differences between staff and leaders were found in many areas concerning quality improvement and knowledge about accreditation. Leaders and staff both had high expectations of the use of accreditation as a tool for quality improvement, thus no statistically significant difference between expectations were found.
The overall positive expectation for accreditation as a tool for quality improvement is an excellent basis for the accreditation process. The different assessments in quality among leaders/staff and positions show the need to involve all personnel in the organization. A survey about patient experiences includes the same subjects as the survey among staff and leaders. A striking discrepancy between the evaluation of quality by patients and by the leaders and staff in specific areas was found; therefore further investigations will be carried out.
To examine the association between compliance with hospital accreditation and 30-day mortality.
A nationwide population-based, follow-up study with data from national, public registries.
Public, non-psychiatric Danish hospitals.
In-patients diagnosed with one of the 80 primary diagnoses.
Accreditation by the first version of The Danish Healthcare Quality Programme for hospitals from 2010 to 2012. Compliance were assessed by surveyors on an on-site survey and awarded the hospital as a whole; fully (n = 11) or partially accredited (n = 20). A follow-up activity was requested for partially accredited hospitals; submitting additional documentation (n = 11) or by having a return-visit (n = 9).
All-cause mortality within 30-days after admission. Multivariable logistic regression was used to compute odds ratios (ORs) for 30-day mortality adjusted for six confounding factors and for cluster effect at hospital level.
A total of 276 980 in-patients were identified. Thirty-day mortality risk for in-patients at fully (n = 76 518) and partially accredited hospitals (n = 200 462) was 4.14% (95% confidence interval (CI):4.00-4.28) and 4.28% (95% CI: 4.20-4.37), respectively. In-patients at fully accredited hospitals had a lower risk of dying within 30-days after admission than in-patients at partially accredited hospitals (adjusted OR of 0.83; 95% CI: 0.72-0.96). A lower risk of 30-day mortality was observed among in-patients at partially accredited hospitals required to submit additional documentation compared with in-patients at partially accredited hospitals requiring a return-visit (adjusted OR 0.83; 95% CI: 0.67-1.02).
Admissions at fully accredited hospitals were associated with a lower 30-day mortality risk than admissions at partially accredited hospitals.
PURPOSE: To examine the availability and quality of clinical guidelines on perioperative diabetes care in hospital units before and after a randomised clinical trial (RCT) and international accreditation. DESIGN/METHODOLOGY/APPROACH: Interventional "before-after" study in 51 units (38 surgical and 13 anaesthetic) in nine hospitals participating in a RCT in the greater Copenhagen area; 27 of the units also underwent international accreditation. FINDINGS: The proportion of units with guidelines increased from 24/51 (47 percent) units before to 38/51 (75 percent) units after the trial. Among the 27 units without guidelines before the trial, significantly more accredited units compared to non-accredited units had a guideline after the trial (9/10 (90 percent) compared to 5/17 (29 percent). The quality of the systematic development scale and the clinical scales improved significantly after the trial in both accredited units (both p
Gardam, Lemieux, Reason, van Dijk and Goel argue that healthcare-associated infections (HAIs) are "a pressing and imminent concern in the context of patient safety." Accreditation Canada supports the position taken by these authors. The prevention and control of two HAIs of great concern, methicillin-resistant Staphylococcus aureus and Clostridium difficile, are an integral part of the Accreditation Canada program. A coordinated approach to combating HAIs and developing a culture of infection prevention and control is necessary, one that involves front-line healthcare professionals, senior leadership, national and provincial partners and the public. Since 2005, Accreditation Canada has increasingly strengthened the accreditation program in this area through a number of new strategies, including enhanced standards, required organizational practices, performance measures and indicators and the introduction of education programs. Optimizing the value of accreditation through an integrative approach with organizations' quality improvement programs will contribute to effectively combating HAIs and developing a culture of infection prevention and control.
Several institutions in Canada offer fellowship training in interventional cardiology (IC). However, no national mechanism exists to ensure uniformity of training or assessment of final competency.
A cross-sectional survey was carried out for physicians completing IC training from 2007 to 2009. The survey used a semistructured questionnaire to determine compliance with training components recommended by Accreditation Council for Graduate Medical Education (ACGME) and American College of Cardiology (ACC).
Sixty-six (78%) of 85 trainees from 15 programs participated in the study. All programs were affiliated with a university and associated with accredited programs in adult cardiology. Annual procedural volume of >1,500 and faculty volume of >250 were reported for 67% and 70% of programs. Annual trainee percutaneous coronary intervention volume of 250-350 was reported by 29%, 350-450 by 47%, and >450 by 24% of respondents. All respondents reported regular participation in case management rounds, and 54% reported formal instruction of structured curriculum; 91% reported participation in research, and 38% reported mandatory attendance in outpatient clinic. All respondents reported annual and 61% reported =2 performance evaluations per year; 45% of respondents reported formal trainee assessment of program and faculty.
Canadian IC training meets ACGME/ACC recommendations for procedural volume and academic activity. However, participation in outpatient clinics and compliance with administrative requirement of faculty and program assessment by trainee was suboptimal. Formal accreditation is highly desirable to standardize program content and administration for optimal IC training.
Comment In: Catheter Cardiovasc Interv. 2011 Aug 1;78(2):187-821786390
The Canadian Food Inspection Agency (CFIA) has developed a program to accredit external laboratories to conduct Trichinella digestion assays for export purposes. Accredited laboratories are responsible for staffing, equipment and operating test facilities under the auspices and guidance of the CFIA. The CFIA's Centre for Animal Parasitology provides training, proficiency samples, audits and other support for the accreditation process. The program has also been adapted for use in laboratories conducting Trichinella digestion tests for surveillance and food safety purposes and provides a useful template for others wishing to develop similar systems.