Ultrasound quality assurance and equipment governance

A case is presented to show the importance of good governance of ultrasound medical imaging equipment. Issues relating to the large numbers and diverse range of users and equipment are identified. Based on experience gained over 25 years, supporting upwards of 1000 systems, discussions consider why and how the testing of ultrasound systems should be approached by both the medical physics expert and end user. The management of the process is presented in the context of professional guidance and monitoring organisations’ standards are considered to give a suggested best practice.     

A randomised controlled trial to evaluate the efficacy of a health maintenance clinic intervention for patients undergoing elective primary total hip and knee replacement surgery

AimThis paper is the report of a study exploring the efficacy of a health maintenance clinic intervention for patients with severe osteoarthritis of the hip and knee whilst awaiting primary joint replacement surgery.BackgroundHistorically in the UK patients with severe osteoarthritis waited many months for their hip and knee replacement surgery. The waiting time was often in the absence of support and advice relating to symptom management. A health maintenance intervention was developed to provide support to patients whilst awaiting their joint replacement and to optimise their health status ahead of the procedure.MethodsA randomised control trial (RCT) compared usual care (pre-operative assessment only) to a new intervention (health maintenance clinic plus pre-operative assessment). A sample of 250 people with osteoarthritis waiting for joint replacement were recruited via an orthopaedic out-patient department between 2005 and 2006. To assess the effectiveness of the intervention outcome, measures were recorded at two points in time (on referral to the waiting list and at 2 weeks prior to surgery).ResultsNo significant difference between the total score on the disease specific outcome measure was found (p = 0.69). However, participants in the experimental group were significantly more satisfied with their care (p = 0.001) and had fewer incidences of postponement of surgery (p = 0.002).ConclusionA tailored intervention for symptom management in the pre-operative period increases patient satisfaction which may have a positive impact on concordance and postoperative recovery. Also, reducing the number of surgical postponements has a positive economic value for health care providers.     

内部控制下医院科研经费信息化平台建设

急剧增加的科研经费增加风险控制和管理的难度,在内部控制的概念和理论的指导下,通过建设科研经费信息化管理平台,打通科研管理系统和财务管理系统的边界,通过与信息化办公系统、财务系统、物资系统的整合,实现对科研项目经费的有效监督、实时控制、全过程管理,从而提高财务服务的效率和效果.     

Issues with implementing a high‐quality lung cancer screening program

Answer questions and earn CME/CNE After a comprehensive review of the evidence, the United States Preventive Services Task Force recently endorsed screening with low‐dose computed tomography as an early detection approach that has the potential to significantly reduce deaths due to lung cancer. Prudent implementation of lung cancer screening as a high‐quality preventive health service is a complex challenge. The clinical evaluation and management of high‐risk cohorts in the absence of symptoms mandates an approach that differs significantly from that of symptom‐detected lung cancer. As with other cancer screenings, it is essential to provide to informed at‐risk individuals a safe, high‐quality, cost‐effective, and accessible service. In this review, the components of a successful screening program are discussed as we begin to disseminate lung cancer screening as a national resource to improve outcomes with this lethal cancer. This information about lung cancer screening will assist clinicians with communications about the potential benefits and harms of this service for high‐risk individuals considering participation in the screening process. CA Cancer J Clin 2014;64:351–363. © 2014 American Cancer Society.     

The implementation of evidence-based practice in the management of adults with functional voice disorders: A national survey of speech-language pathologists

Abstract

This study examined Australian speech-language pathologists’ (SLPs) use of evidence-based practice (E³BP) when treating adults with functional voice disorders (FVDs). It was hypothesized that SLPs would report using the available evidence to care for their clients but may be limited by time and skills. Fifty-eight SLPs completed a 26-item survey. A combination of indirect and direct voice therapy was most frequently reported, with hum and nasal consonants, pitch extension, elimination of glottal attack, and diaphragmatic breathing being the most frequently used techniques. In the absence of higher levels of evidence, 98% of respondents reported they relied on clinical experience to guide their clinical decision-making. Despite a lack of research evidence supporting this decision, SLPs also reported simultaneously using a combination of direct voice therapies to cater to the needs of their individual clients. Barriers to EBP were lack of time, specialty training and high quality evidence. To improve SLPs’ management of adults with FVDs, it is suggested that SLPs need both greater access to voice training and to use practice-based evidence by actively collecting and reporting clinical data.