Abstract:
BACKGROUND/OBJECTIVE:Cincinnati Children's Hospital Medical Center created the Intermediate Improvement Science Series (I(2)S(2)) training course to develop organisational leaders to do improvement, lead improvement and get results on specific projects. DESIGN METHODS:Each multidisciplinary class consists of 25-30 participants and 12 in-class training days over 6 months. Instructional methods include lectures, case studies, interactive application exercises and dialogue, participant reports and assigned readings. Participants demonstrate competence in improvement science by completing a project with improvement in outcome and/or process measures. They present on their projects and receive feedback during each session and one-on-one coaching between sessions. RESULTS:Since 2006, 279 participants in 11 classes have completed the I(2)S(2) course. Participant evaluations have consistently rated satisfaction, learning, application, impact and value very high. Large and statistically significant changes were observed in pre-course to post-course self-assessment of knowledge of five quality improvement topics. Approximately 85% of the projects demonstrated measurable improvement. At follow-up, 72% of improvement projects were completed and made a part of everyday operations in the participant's unit or were the focus of continuing improvement work. Many changes were spread to other units or programmes. Most (88%) responding graduates continued to participate in formal quality improvement efforts and many led other improvement projects. Nearly half of the respondents presented their results at one or more professional conference. CONCLUSIONS:Through the I(2)S(2) course, the authors are developing improvement leaders, accelerating the shift in the culture from a traditional academic medical centre to an improvement-focused culture, and building cross-silo relationships by developing leaders who understand the organisation as a large system of interdependent subsystems focused on improving health.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Kaminski GM,Britto MT,Schoettker PJ,Farber SL,Muething S,Kotagal URdoi
10.1136/postgradmedj-2012-000890repsubject
Has Abstractpub_date
2013-02-01 00:00:00pages
78-86issue
1048eissn
0032-5473issn
1469-0756pii
postgradmedj-2012-000890repjournal_volume
89pub_type
杂志文章abstract::We report a case of severe chronic iron deficiency anaemia secondary to blood loss from gastric angiodysplasia. The clinical features, diagnosis and management of this uncommon condition are discussed. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.744.865
更新日期:1987-10-01 00:00:00
abstract::The protean neurological manifestations of human immunodeficiency virus (HIV) infection are reviewed. Both the central nervous system and peripheral nervous system may be affected and many of the complications may occur in individuals with acquired immunodeficiency syndrome (AIDS)-related complex, or who are seroposit...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.64.749.180
更新日期:1988-03-01 00:00:00
abstract::Aspirin was first synthesised 100 years ago and its preparation and marketing is generally reckoned to have been the foundation of the pharmaceutical industry. For most of the time since then it has been used for the relief of pain and fever. The modern phase of aspirin use commenced with the reporting in 1974 of a ra...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.74.876.587
更新日期:1998-10-01 00:00:00
abstract::In a cross-over study, 10 healthy adult volunteers received 1 g cefaclor and 1 g cephalexin orally 1 hour after a standard breakfast. Serum levels of cefaclor rose somewhat faster and were higher than those of cephalexin in the first 60 minutes. At the end of the second hour the serum concentration of cephalexin was 5...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract:BACKGROUND:Sarcoidosis is a chronic, multisystem disease characterised by non-necrotising granulomatous inflammation of unknown aetiology. Most commonly, the lungs, lymph nodes, skin and eyes are affected in sarcoidosis; however, nervous system involvement occurs in approximately 5%-15% of cases. Any part of the nervou...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2016-134475
更新日期:2017-07-01 00:00:00
abstract::Six cases of tuberculous meningitis, all occurring in patients over the age of 65, are described. All patients presented with an acute illness, primarily with a confusional state. Headache was a symptom in only two patients and the cases were not confined to ethnic minority groups. The mortality was 50%. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.707.586
更新日期:1984-09-01 00:00:00
abstract::Paradoxical vocal cord motion disorder (PVCM), also called vocal cord dysfunction, is an important differential diagnosis for asthma. The disorder is often misdiagnosed as asthma leading to unnecessary drug use, very high medical utilisation and occasionally tracheal intubation or tracheostomy. Laryngoscopy is the gol...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2006.052522
更新日期:2007-03-01 00:00:00
abstract::Churg-Strauss syndrome is a systemic vasculitis. Its most frequent complications are heart diseases and asthma. Usually, cardiological manifestations are pericarditis, cardiac failure and myocardial infarction. Endobronchial granulomas identified by bronchoscopy are unusual. We present the case of a man with congestiv...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.71.836.365
更新日期:1995-06-01 00:00:00
abstract::Elective root replacement in Marfan syndrome has improved life expectancy in affected patients. Three forms of surgery are now available: total root replacement (TRR) with a valved conduit, valve sparing root replacement (VSRR) and personalised external aortic root support (PEARS) with a macroporous mesh sleeve. TRR c...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2013-305132rep
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Right ventricular (RV) fractional area change and tricuspid annular plane systolic excursion (TAPSE) are recognised methods for assessing RV function. However, the way in which these variables are affected by varying degrees of pulmonary hypertension (PH) has not been well characterised. METHODS:RV end-syst...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2007.059642
更新日期:2008-01-01 00:00:00
abstract::The clinical presentation and management of spontaneous rupture of the middle third of the oesophagus is described in two patients. Early presentation and treatment in one case led to uncomplicated recovery. In the other patient late presentation and diagnosis resulted in delayed surgical intervention with an unsucces...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.634.559
更新日期:1978-08-01 00:00:00
abstract::Three patients are described in whom one or more carotid territory transient ischaemic attacks (TIAs) were preceded by sneezing, straining, or bending over. It is argued that the mechanism involved dislodgment of embolic material from the site of carotid atheroma. This mechanism should be considered as an alternative ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.75.881.145
更新日期:1999-03-01 00:00:00
abstract::Two patients with a rise in cardiac troponin T (cTnT) concentrations during the course of lobar pneumonia, without any evidence of acute coronary syndrome or renal failure, are presented. The increase in cTnT concentration is considered a highly sensitive marker of cardiac injury, although it may also rise in other co...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.78.918.244
更新日期:2002-04-01 00:00:00
abstract:PURPOSE:Workplace-based assessments (WBAs) were originally intended to inform learning and development by structuring effective observation-based feedback. The success of this innovation has not yet been established due in part to the widely varied tools, implementation strategies and research approaches. Using a conce...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2015-133917
更新日期:2017-03-01 00:00:00
abstract::This purports to be the first recorded case of carcinoma of the pancreas presenting as a mechanical obstruction of the colon. The literature relating to some other rare modes of presentation is reviewed, and a comment made on the desirability of routine post-mortem studies. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.57.663.66
更新日期:1981-01-01 00:00:00
abstract::A case of Peutz-Jeghers syndrome with polyps in the gall bladder is presented. No previous description of this finding has been reported. The literature regarding known sites of polyposis in this condition is reviewed. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.56.655.373
更新日期:1980-05-01 00:00:00
abstract::The need to restrain service users will vary according to the area of practice within which practitioners are employed. Many of the principles that relate to the issue of restraining service users are, however, applicable to all, or most, health and social care settings. While the emphasis should be on pre-emptive act...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pmj.2003.007302
更新日期:2004-01-01 00:00:00
abstract::The use of sulphasalazine in inflammatory bowel disease is often limited by intolerance or allergy. In previous studies 5-aminosalicylic acid (5ASA), the active ingredient of sulphasalazine, coated with an acrylic resin, has been shown to be as effective as sulphasalazine in maintaining remission. In this study coated...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.722.1047
更新日期:1985-12-01 00:00:00
abstract:BACKGROUND:Despite obesity being a major risk factor for ischaemic stroke (IS), the association between body mass index (BMI) and IS in patients with hypertension remains uncertain. OBJECTIVE:To assess the association between BMI and IS among elderly hypertensive patients in China. METHODS AND RESULTS:We recruited 35...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2019-137457
更新日期:2020-03-27 00:00:00
abstract::When plasma renin activity is related to sodium balance as evaluated from urinary sodium excretion, a physiological index of normality is obtained along with the ability to detect subtle variations in renin secretion. This has made it possible to correlate more closely the antihypertensive action of propranolol with t...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,评审
doi:
更新日期:1976-01-01 00:00:00
abstract::The effective training of facilitator/ tutors is crucial to the success of a problem-based learning approach to medical education. New skills are needed to accomplish the change from giver of information to facilitator of learning, coach, and guide. This paper outlines considerations for the design of a tutor training...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.72.850.474
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVES:To explore the relationship between cognitive impairment and conventional measures of disability in multiple sclerosis (MS), quality of life (QOL) and employment status using the brief international cognitive assessment for multiple sclerosis (BICAMS) in the routine outpatient clinic. METHODS:62 patients wi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2016-134071
更新日期:2017-03-01 00:00:00
abstract::Severe acute respiratory syndrome (SARS) is a newly emerged infectious disease with a significant morbidity and mortality. The major clinical features include persistent fever, chills/rigor, myalgia, malaise, dry cough, headache, and dyspnoea. Older subjects may present without the typical febrile response. Common lab...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2004.020263
更新日期:2004-07-01 00:00:00
abstract::The effects of nilvadipine on the peripheral circulation in the lower extremities using a duplex system of two-dimensional colour and pulse Doppler ultrasonography were studied in 32 patients with type 2 diabetes mellitus and mild essential hypertension. The patients (19 men and 13 women) were randomly divided into tr...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/pgmj.71.840.613
更新日期:1995-10-01 00:00:00
abstract::Fibrosing colonopathy is a recently described complication of cystic fibrosis, of unknown aetiology but possibly related to treatment with high-dose pancreatic enzyme supplements. We have used a whole gut perfusion technique to study subclinical gut inflammation in cystic fibrosis patients; concentrations of haemoglob...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1996-03-01 00:00:00
abstract::A 44 year old female presented with a subacute myelopathy in association with pelvic venous thrombosis. It is inferred from the temporal relationship of these events that the patient suffered a subacute spinal venous infarction. This is discussed along with the aetiology, anatomical distribution and management of the ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.742.669
更新日期:1987-08-01 00:00:00
abstract::Patients with Cushing's syndrome rarely become pregnant. This is a high risk situation both for the fetus and the mother, if untreated. We report a patient with Cushing's syndrome due to adrenocortical adenoma who became pregnant and was successfully treated with ketoconazole during the last period of pregnancy. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.66.773.221
更新日期:1990-03-01 00:00:00
abstract::This article reviews the unique pharmacological properties of methadone and outlines its appropriate clinical application, with focus upon its use in the treatment of chronic pain. Although methadone is most widely known for its use in the treatment of opioid dependence, methadone also provides effective analgesia. Pa...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2004.022988
更新日期:2004-11-01 00:00:00
abstract::Schönlein-Henoch purpura may be complicated by hypoproteinaemia, which in most patients is due to the development of nephrotic syndrome. However, in some proteinuria is insignificant and enteric protein loss has been suggested as the cause. A case with supportive evidence for this is reported. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.655.361
更新日期:1980-05-01 00:00:00
abstract::A host/vector system suitable for large-scale production of HBsAg has been constructed and optimized in terms of the expression plasmid and yeast host strain in order to permit fermentation to very high cell densities. The final expression plasmid contains the coding sequence of the major HBsAg protein (P24) flanked b...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00