Communication plays key role in OB patient expectations

Obstetrics is a medical specialty with high profe sional liability exposure. Every aspect of an adverse OB outcome has become an opportunity for a legal review. Common root causes in adverse outcomes include communication failure, poor teamwork, and system failures. Indeed, poor communication is a significant factor in OB‐related malpractice claims. This excerpt from the booklet Risk Management Pearls for Obstetrics highlights those causes (particularly poor communications) and provides strategies to address them.     

Executive compensation committee plays key role in board's stewardship

Board members charged with a facility's stewardship should include executives among the key assets involved, and the way to assure executive compensation committee, says Jos. Michael Galvin.     

Responding to the recruiting call. How Children's Hospital of Philadelphia seeks healthcare pros

The global shortage of healthcare professionals has touched every healthcare institution, and despite its renown, Children's Hospital of Philadelphia (CHOP) is no exception. In fact, the hospital's strategic addition of suburban facilities has exacerbated the situation. The recruitment plan builds on a strong new image campaign, and sharpens the focus on nurses, student nurses and allied health professionals. Direct mail is used--a first for recruitment at CHOP. The hospital's Web site is used as well as postings on numerous Internet job boards. Finally, the campaign also uses more traditional methods, such as print advertising.     

胎儿MRI：出生缺陷产前影像学诊断的生力军

产前影像学诊断包括产前胎儿超声和胎儿MRI,是出生缺陷二级防控的重要手段。胎儿MRI的优势为安全性高,迄今尚未发现3.0 T及以下MRI检查会对孕妇和胎儿造成任何不良后果;而且MRI以其软组织对比好、大视野、多方位及多参数成像,具有无辐射、非侵入性,不受孕妇肥胖体型、羊水量过少、胎头钙化等因素影响的特点,成为产前超声诊断中、晚孕期胎儿疑似结构异常的重要补充手段。胎儿MRI检查的目的是确认胎儿超声检查结果,或者胎儿超声怀疑胎儿结构异常,但是不能明确诊断时。由于胎儿MRI检查,可能获得比胎儿超声更多的信息,因此可弥补胎儿超声检查的不足。胎儿MRI的适应证包括:对产前超声检查怀疑胎儿中枢神经系统畸形、脑室扩张、脑中线结构异常、后颅窝增宽或小脑蚓部异常等,唇裂是否合并腭裂或牙槽骨异常,胎儿耳廓畸形是否合并外耳道闭锁或中耳、内耳发育不良,怀疑胎儿心外大血管畸形的进一步确诊,对胎儿腹、盆部肿块定位及定性,对胎儿肠道畸形、泌尿道生殖道畸形及单绒毛双胎并发症,对胎儿疾病治疗前、后疗效进行评价及对预后与严重疾病终止妊娠前进行评估等。胎儿MRI检查结果可为产前诊断、优生优育及遗传咨询提供相关信息,为胎儿疾病治疗方案制定、分娩方式选择及医患沟通提供依据。尽管胎儿MRI可以对胎儿解剖进行标准及完整的评估,但是仍然不作为产前影像学诊断的首选。     

Horticultural therapy--the role gardening plays in healing.

Horticultural therapy is an adjunct therapy--to be used in addition to occupational and physical therapies, and combining means used by both. It is meant to increase the motivation of the physically and/or mentally handicapped, while at the same time stimulating the five senses and furnishing a means of self-gratification and self esteem. Now that neurologically orientated psychologists are identifying schizophrenia as being biologically based and capable of being reversed with exercise, it is time to study the many benefits of gardening as a therapy method.     

Public health response to metallic mercury spills in Kansas.

Local and state public health officials are called on to respond to environmental public health hazards just as they historically have been called on to respond to communicable disease outbreaks. Recent experience with metallic mercury spills in Kansas suggests that neither the legal authority nor the scientific knowledgebase is as well developed for response to environmental hazards as for communicable disease threats.