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Academic Alternate Relationship Plans for internal medicine: a lever for health care transformation.

https://arctichealth.org/en/permalink/ahliterature129973
Source
Open Med. 2011;5(1):e28-32
Publication Type
Article
Date
2011
Author
Allison Bichel
Maria Bacchus
Jon Meddings
John Conly
Author Affiliation
Department of Medicine, Calgary Health Region, and University of Calgary, Calgary, Alberta.
Source
Open Med. 2011;5(1):e28-32
Date
2011
Language
English
Publication Type
Article
Keywords
Alberta
Diffusion of Innovation
Health Care Reform - methods
Health Care Surveys
Health Services Accessibility - organization & administration
Health services needs and demand
Humans
Internal Medicine - education
Poisson Distribution
Program Development
Schools, Medical - organization & administration - trends
Notes
Cites: Can Fam Physician. 2000 Jul;46:1438-4410925758
Cites: Can Respir J. 2009 Mar-Apr;16(2):49-5419399308
Cites: Can J Cardiol. 2008 Mar;24(3):195-818340388
Cites: CMAJ. 1999 Jun 15;160(12):1710-410410632
PubMed ID
22046217 View in PubMed
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Achievement of objectives: internal medicine fourth year clinical clerkship.

https://arctichealth.org/en/permalink/ahliterature227292
Source
Med Teach. 1991;13(1):29-37
Publication Type
Article
Date
1991
Author
H. Ho Ping Kong
K. Robb
D. Cleave-Hogg
K. Evans
Author Affiliation
Department of Medicine, Toronto Western Hospital, Canada.
Source
Med Teach. 1991;13(1):29-37
Date
1991
Language
English
Publication Type
Article
Keywords
Adult
Aged
Canada
Clinical Competence
Decision Making
Education, Medical - standards
Humans
Internal Medicine - education
Medical Staff, Hospital - standards
Middle Aged
Physician-Patient Relations
Questionnaires
Abstract
The clinical clerkship in Canadian Medical Schools is intended to provide senior medical students with opportunities to gain practical knowledge of clinical medicine, develop technical skills, learn to use judgement and experience first-hand clinical decision making. Assessment of rotations in internal medicine were undertaken in order to understand more fully the nature of medical clerkship experiences. We found that medical clerks in our programme were exposed to a high proportion of undifferentiated problems and an adequate case mix. They performed a wide range of technical procedures. There were, however, certain gaps in the clerks' experiences both in the specialty areas, and in therapeutic and technical procedures. Recognition of these gaps in the clerkship experiences suggest that further deliberation of goals and objectives is required and issues of achievement of competencies need to be addressed.
PubMed ID
1865796 View in PubMed
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[A comparison of the pattern of readmissions of long-term/geriatric patients and internal medicine patients].

https://arctichealth.org/en/permalink/ahliterature223564
Source
Ugeskr Laeger. 1992 Jun 29;154(27):1901-6
Publication Type
Article
Date
Jun-29-1992
Author
K. Vennervald
Author Affiliation
Københavns Amts Sygehus i Glostrup, medicinsk afdeling C.
Source
Ugeskr Laeger. 1992 Jun 29;154(27):1901-6
Date
Jun-29-1992
Language
Danish
Publication Type
Article
Keywords
Aged
Denmark
Female
Geriatrics - statistics & numerical data
Hospital Departments - statistics & numerical data
Humans
Internal Medicine - statistics & numerical data
Long-Term Care
Male
Middle Aged
Patient Readmission - statistics & numerical data
Abstract
A comparison was undertaken between the frequencies of admission of medical patients over the age of 64 years and long-term/geriatric patients admitted to a large county hospital. The pattern of readmission is described in relation to the age groups and sex. The period of observation was nine months. In the investigation, the relationship between the distribution of men and women in the normal population was taken into consideration and a correction factor was calculated. A total of loll patients (CP) discharged from an acute medical department (AM) had 1954 readmissions (GI). In the long-term medical department (LMA) 158 CP had a total of 328-GI. The number of CP readmitted in each age group and sex reflects the representation of the group concerned in the background population, although a tendency was observed for slightly more admissions, the older the CP were. No difference in the pattern of readmission was observed concerning CP readmitted from AM and readmitted to all departments including AM. Similarly, despite some scatter, there was no difference in the GI pattern in CP discharged from LMA and readmitted to all departments including LMA. In addition, no significant difference in the GI pattern was observed as compared with the AM patient group and the LMA patient group. As patients referred to LMA have, quite naturally, poorer performance than the patients who were discharged directly from medical or surgical departments, it may be concluded that, after treatment in LMA, no difference between the patient groups was found if the GI frequency was taken as a yardstick. As GI, just as other measurements of turnover, only provides an expression of the status at a given moment, the author considers that it is of importance both for the departmental and the political planning that the GI frequency is followed as part of the current assessment.
PubMed ID
1509549 View in PubMed
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[A controlled study of the short-term and long-term effects of a "train the trainers" course--secondary publication].

https://arctichealth.org/en/permalink/ahliterature154394
Source
Ugeskr Laeger. 2008 Oct 27;170(44):3553-6
Publication Type
Article
Date
Oct-27-2008
Author
Sune Rubak
Lene Mortensen
Charlotte Ringsted
Bente Malling
Author Affiliation
Arhus Universitetshospital, Skejby, Paediatrisk Afdeling, Viborg Hospital, Medicinsk Afdeling, og Aarhus Universitet, Center for Medicinsk Uddannelse. sr@alm.au.dk
Source
Ugeskr Laeger. 2008 Oct 27;170(44):3553-6
Date
Oct-27-2008
Language
Danish
Publication Type
Article
Keywords
Case-Control Studies
Clinical Competence
Denmark
Education, Medical, Graduate - methods
Educational Measurement
Feedback
Humans
Internal Medicine - education
Learning
Orthopedics - education
Professional Competence
Questionnaires
Teaching - methods
Abstract
This is an intervention-study discussing the long-term effects of a 3-day "Train the trainers course" (TTC). In the intervention (I) group 98.4% of doctors participated in a TTC, both specialists and trainees. Knowledge about teaching skills increased in the I group by 25% after the TTC; a result which was sustained at six months. Teaching behaviour was significantly changed as the use of feedback and supervision had increased from a score of 4 to 6 (max. score = 9).
A 3-day residential TTC has a significant impact on knowledge gain concerning teaching skills, teaching behaviour and clinical learning culture after six months.
PubMed ID
18985941 View in PubMed
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[Acute respiratory diseases in patients with chronic pathology of the internal organs].

https://arctichealth.org/en/permalink/ahliterature222421
Source
Ter Arkh. 1993;65(3):48-53
Publication Type
Article
Date
1993
Author
A A Krylov
Source
Ter Arkh. 1993;65(3):48-53
Date
1993
Language
Russian
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Chronic Disease
Disease Outbreaks - statistics & numerical data
Female
Hospitalization - statistics & numerical data
Humans
Incidence
Internal Medicine - statistics & numerical data
Male
Middle Aged
Respiratory Tract Diseases - epidemiology
Russia - epidemiology
Urban Population - statistics & numerical data
Abstract
Follow-up of 2400 patients aged 17-84 who had previously had influenza or other acute respiratory diseases documented aggravation of the background illness in 34.1% of them. Because of the aggravation 15.3% of the cases were referred to hospitals. Augmentation of symptoms was primarily observed in chronic nonspecific pulmonary lesions (57.9%), bronchial asthma (30.5%), rheumatic fever (38.1%), peptic ulcer (31.6%), renal (42.7%) and thyroid (42.9%) diseases, climacteric neurosis (31.3%), neurovegetative disorders (61.1%). Typical symptoms and syndromes of aggravated background illnesses, principles of managing combined diseases and of respiratory affections prevention in the above patients are presented.
PubMed ID
8059385 View in PubMed
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Addressing postdischarge adverse events: a neglected area.

https://arctichealth.org/en/permalink/ahliterature158206
Source
Jt Comm J Qual Patient Saf. 2008 Feb;34(2):85-97
Publication Type
Article
Date
Feb-2008
Author
Dennis Tsilimingras
David Westfall Bates
Author Affiliation
Department of Internal Medicine, Wayne State University School of Medicine, Detroit, USA. dtsilimingras@yahoo.com
Source
Jt Comm J Qual Patient Saf. 2008 Feb;34(2):85-97
Date
Feb-2008
Language
English
Publication Type
Article
Keywords
Aftercare
Canada
Hospitals, Teaching
Humans
Internal Medicine
Patient Discharge
Quality Assurance, Health Care
Safety Management
Treatment Outcome
United States
Abstract
Postdischarge safety is an area that has long been neglected. Recent studies from the United States and Canada found that about one in five patients discharged home from the general internal medicine services of major teaching hospitals suffered an adverse event.
MEDLINE, Cochrane databases, and reference lists of retrieved articles were used in a literature search of articles published from 1966 through May 2007.
Patient safety research has focused mostly on adverse events in hospitalized patients. Although some data are available about the ambulatory setting, even fewer studies have been done focusing on adverse events following hospital discharge. Only two studies conducted in North America have examined the incidence rate of all types of postdischarge adverse events. On the basis of the available evidence, key areas of opportunity to improve postdischarge care are as follows: (1) improving transitional care, (2) improving information transfer through strategic use of electronic health records, (3) medication reconciliation, (4) improving follow-up of test results, and (5) using screening methods to identify patients with adverse events.
Limited evidence suggests that about one in five internal medicine patients suffers an adverse event after discharge from a North American hospital. The risk of postdischarge adverse events should be recognized by patient safety experts as an important area of concern.
PubMed ID
18351193 View in PubMed
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[Admission and discharge at a department of internal medicine in greater Stockholm].

https://arctichealth.org/en/permalink/ahliterature251225
Source
Lakartidningen. 1976 Mar 24;73(13):1207-9
Publication Type
Article
Date
Mar-24-1976

[Admission pattern at a department of internal medicine. Factors of significance for readmission within three months after discharge]

https://arctichealth.org/en/permalink/ahliterature72578
Source
Ugeskr Laeger. 1998 Apr 13;160(16):2396-400
Publication Type
Article
Date
Apr-13-1998
Author
S B Christensen
T. Gjørup
Author Affiliation
Medicinsk afdeling, Sundby Hospital.
Source
Ugeskr Laeger. 1998 Apr 13;160(16):2396-400
Date
Apr-13-1998
Language
Danish
Publication Type
Article
Keywords
Adult
Aged
Denmark
English Abstract
Female
Follow-Up Studies
Humans
Internal Medicine - statistics & numerical data
Length of Stay
Male
Middle Aged
Patient Admission
Patient Discharge
Patient Readmission
Registries
Abstract
The aim of the study was to investigate factors of significance for readmission of patients in a department of internal medicine. The study was based on hospital computerized data files. All admissions from the 1st of January to the 31st of December 1995 were included. During that period the department had 6061 admissions of 4152 patients. The readmission rate was 1.46. All patients were followed three months after discharge. Within that period 1119 (27%) of the patients were readmitted. A high frequency of readmission was especially found within the first ten days after discharge. Length of stay in hospital did not influence readmission rate. Women, patients in the age group 71-90 years and patients with chronic diseases were more likely to be readmitted. The demonstrated factors relating to a high readmission rate are difficult to influence. A prospective study including the primary health care system and a clinical evaluation of the patients is needed to examine causes of the high number of readmission within the first ten days after discharge.
PubMed ID
9571814 View in PubMed
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[Admissions to the medical wards. Are resources used in accordance to patients' needs?]

https://arctichealth.org/en/permalink/ahliterature73721
Source
Tidsskr Nor Laegeforen. 1990 Oct 30;110(26):3362-5
Publication Type
Article
Date
Oct-30-1990
Author
E. Bjørnstad
O. Bergesen
B. Nordhaug
U. Abildgaard
G. Stene-Larsen
Author Affiliation
Medisinsk avdeling, Aker sykehus, Oslo.
Source
Tidsskr Nor Laegeforen. 1990 Oct 30;110(26):3362-5
Date
Oct-30-1990
Language
Norwegian
Publication Type
Article
Keywords
Adult
Aged
English Abstract
Female
Health Resources - utilization
Health services needs and demand
Hospital Departments - utilization
Humans
Internal Medicine - statistics & numerical data
Male
Middle Aged
Norway
Patient Admission - statistics & numerical data
Abstract
Medical and social data on 980 consecutive admissions to the Medical Department, Aker Hospital, Oslo, were recorded prospectively with emphasis on patients' requirements and the Department's use of available resources. 73% of the admissions were acute, 4% were considered unnecessary. Half were because of chronic illness. Although 88% of the patients' requirements could have been met at a local hospital, 59% were treated in specialized units. 12% were admitted to the day unit at reduced cost for an average stay of three days. 41% of the patients were over 70 years of age, 37% lived alone and 14% needed rehabilitation. A main reason for admission was the patient's inability to take care of him/herself at home, in nearly all cases the main reason being acute illness or deterioration. Therefore many of the patients seemed to need care in an acute geriatric unit. At any one time the reason for 20-25% of the patients being in the department was delay in providing care at home or in a nursing home.
PubMed ID
2256059 View in PubMed
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Adverse drug reactions as a cause for admissions to a department of internal medicine.

https://arctichealth.org/en/permalink/ahliterature190300
Source
Pharmacoepidemiol Drug Saf. 2002 Jan-Feb;11(1):65-72
Publication Type
Article
Author
Tom Mjörndal
Marit Danell Boman
Staffan Hägg
Martin Bäckström
Bengt-Erik Wiholm
Anders Wahlin
Rune Dahlqvist
Author Affiliation
Division of Clinical Pharmacology, University Hospital of Umeå, Sweden. tom.mjorndal@pharm.umu.se
Source
Pharmacoepidemiol Drug Saf. 2002 Jan-Feb;11(1):65-72
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Drug Therapy - statistics & numerical data
Drug-Related Side Effects and Adverse Reactions
Female
Hospitalization - statistics & numerical data
Humans
Internal Medicine - statistics & numerical data
Male
Middle Aged
Prospective Studies
Sweden
Abstract
To assess the occurrence and pattern of adverse drug reactions as a cause for acute hospital admission.
In 681 randomly selected patients, acutely admitted to a clinic of internal medicine at a Swedish university hospital, information was collected from their medical records about current symptoms and use of drugs, previous diseases and the results of medical investigations and tests. In addition, a standardized interview according to a questionnaire was carried out. A group of experts in clinical pharmacology assessed the data obtained from the patients' case records and the results of the interviews, and then, according to WHO criteria, judged the probability that an adverse drug reaction could have caused or contributed to the actual admission to hospital.
Out of the 681 cases included, 94 (13.8%) had symptoms and signs that were judged as drug-related and that had caused or contributed to the admission. Eighty-two patients (12.0%) had altogether 99 symptoms that were classified as adverse drug reactions. Of these, 91% were type A reactions. The relationship between the medication and the reaction was judged certain in eight, probable in 17, and possible in 74 cases. The most common adverse drug reactions were cardiovascular (36.3%). Twelve patients (1.8%) had symptoms indicating intoxications.
The prevalence of drug-related problems causing or contributing to admission to a clinic of internal medicine is high and is dominated by type A reactions, i.e. reactions in principle predictable and preventable. This implies a possibility to increase drug safety by preventive measures.
PubMed ID
11998554 View in PubMed
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357 records – page 1 of 36.