...Study selection: Studies conducted in sub-Saharan Africa to assess the effects of interventions designed to reduce maternal mortality. Data extraction: Search of Medline database for the years 1988 to 1998 with additional manual search of references cited in Medline-referenced studies. Data synthesis: Few of the 34 intervention studies identified used a double-blind, randomized controlled trial design (4/34), or outcome measures directly related to maternal mortality or maternal health (7/34). Six of the studies produced reasonably convincing evidence of a positive effect on maternal health outcomes. Of these, three showed that changes in delivery practices brought about improved maternal outcomes, two found that a combined intervention consisting of upgrading of emergency obstetric services and community education increased the number of major obstetric complications treated, and one showed that a range of improvements in hospital equipment and management reduced facility-based maternal mortality ratios. No study sought to reduce maternal mortality associated with unsafe termination of pregnancy. Conclusions: More than a decade after the launching of the Safe Motherhood Initiative, there exists little evidence regarding which interventions...
Words: 4315 - Pages: 18
... and the process steps down to the support department that provides the next maximum amount of services to additional support departments. Double apportionment: The double apportionment method initially allocates each support department to the whole thing, including the other departments. Therefore, every maintenance department obtains an allocation from every support department. After the initial allocation, the step-down technique is used to allocate the costs that endure in the support departments after the leading apportionment, then for all support departments entails of direct costs and allocations from other support departments. 2. Base case conditions and Allocation Matrix: Patient Services Departments Adult Medicine Obstetrics Pediatrics Total Support Services Departments Administration...
Words: 6416 - Pages: 26
...University of Central Florida College of Medicine Obstetrics and Gynecology Clerkship Revised 5/4/11 lab 1 | P a g e University of Central Florida College of Medicine Obstetrics and Gynecology Clerkship Revised 5/4/11 lab 2 | P a g e TABLE OF CONTENTS GENERAL INFORMATION ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ 4 RECOMMENDED TEXTS/RESOURCES ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ 5 DIDACTIC EXPERIENCE ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ 6 IMPORTANT LOCATIONS ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ 7 OBSTETRICAL SERVICE: FLORIDA HOSPITAL AND WINNIE PALMER HOSPITAL ‐‐‐‐‐‐‐‐‐‐‐‐ 8 GYNECOLOGIC AND GYNECOLOGIC ONCOLOGY SERVICES: FLORIDA HOSPITAL AND WINNIE PALMER HOSPITAL ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ 11 COMMUNITY WEEK AND SPECIALTY CLINICS‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐14 TIPS FOR A SUCCESSFUL OB/GYN ROTATION ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ 15 LOGGING PATIENT ENCOUNTERS (THE PATIENT PASSPORT) ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ 16 CLERKSHIP ATTENDANCE POLICY ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ 19 CLERKSHIP OBJECTIVES ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ 20 THE CASE...
Words: 8194 - Pages: 33
...Guideline Title Training Needs Analysis (TNA) and Training Plan: For Staff Caring for Women and the Newborn Moira Hodgson, Midwife Manager/Training Lead Dr. Stephen Sturgiss January 2010 Updated June 2011 to incorporate Newcastle Birthing Centre Staff requirements January 2013 Author Clinical Director Approval Effective from Review Next review 1 1. Introduction The training and development of staff is pivotal to the Trust and Directorate’s overall vision and objectives for maternity services in regard to the delivery of safe, effective and quality client care. It is also important that learning and development resources are targeted appropriately to ensure their efficacy whilst reflecting both service priorities and governance requirements. 2. Purpose and scope The Directorate is committed to ensuring a highly motivated and highly skilled workforce that can serve the women, babies and families in our care both safely and effectively. The unit has adopted a systematic approach to training for all relevant staff groups who provide care. This training needs analysis (TNA) and training plan outlines the minimum training needs of all relevant staff groups within the Directorate and provides details of the comprehensive programme of educational sessions. The TNA focuses on the service specific training requirements considered to be mandatory by the Directorate to meet policy and CNST requirements. Trust wide mandatory training requirements are identified...
Words: 4430 - Pages: 18
...rising costs and attempt to recover from declining revenues, the board of directors’ for a community hospital located in a predominately large East Coast city made the decision to merge the obstetrics and pediatrics units of the hospital. Unfortunately, the board of directors face several obstacles pertaining to the combination of the two services, such as the current situation that many of the obstetricians left the hospital to become employed at the nearby medical center which has large labor and delivery rooms in addition to utilizing the latest technology and equipment. In order to combine the two services the hospital needs to update the existing obstetrics equipment with state-of- the-art equipment that will enable the hospital to be competitive, and increase the size and efficiency of the labor and delivery unit rooms in collaboration with the pediatric unit. Currently, the hospital is well known for their pediatric trauma services in addition to the specialized pediatric oncology service who admits hundreds of patients to the facility each year. The pediatric physicians’ group was recognized nationwide and handles referrals from pediatricians throughout a four-state area. Thus, by combining the pediatrics services with the obstetrics service, and in addition to changing their obstetrics’ focus from routine deliveries to high risk pregnancy deliveries, the hospital will have the ability to overcome the current competitive disadvantage the hospital faces when compared with...
Words: 1140 - Pages: 5
...fistulas. The first is obstetric fistula which is a devastating illness that affects young girl who suffers from prolonged labor and the second one is traumatic fistula where it is caused by violent sex or rape. As a result it causes tearing of the vaginal and bladder tissue and passes feces and urine involuntarily. Both fistulas were once a global problem but in the US women are educated to postpone early marriage and pregnancy until their young body mature to have a child. Also a cure was discovered by two American surgeons J. Marion Sims and Thomas Addis Emmet, that cure was c-section and surgical procedure to fix the tearing of bladder and vaginal tissue. Although fistula is eradicated in industrialized countries, it is still a major problem for young girls in the most impoverished rural and remote area of in the developing countries especially the sub-Saharan African and some Middle East countries. To eliminate fistula several NGO’s have been working with those countries that has been affected by fistula. Hamlin Fistula Ethiopia Foundation (UFE) and United Nation Population Foundation (UNFPA) are to name a few. On this paper we will address on the ngo’s strategic approach on national and international level, are their enough funds available, what ethical issues they are facing, and what are the weakness and strength of the ngo’s approaches toward the problem on international healthcare. Women’s Nightmare: Fistula Among the two fistulas obstetric fistula affects and...
Words: 2607 - Pages: 11
...Price et al. 1986). The prevalence of eating disorders among pregnant women is unknown, but the low body weight and sexual inactivity of anorexic women suggests that this disorder is much less common than in the general population. Markedly reduced fertility rates have been confirmed in long-term outcome studies of these patients (Brinch et al. 1988). Comparable data are not available for bulimia, but most of these patients are of normal weight and they are more likely to be married than anorexics. Although the prevalence rate for bulimia in women is approximately 1 % (King, 1986; JohnsonSabine et al. 1988), and partial syndromes are also common, no cases were reported in a random series of 119 primigravidae (Kumar & Robson, 1984) or in 92 obstetric patients referred for assessment by a liaison psychiatrist (Appleby et al. 1989). Such low rates of diagnosis may be due to the reluctance of patients to disclose details of their behaviour in the absence of specific questions about dietary habits and attitudes to weight...
Words: 2752 - Pages: 12
...accompanying instructor resources. Cases in Healthcare Finance Case Questions © Health Administration Press, 2010. Reproduction without permission is prohibited. CASE 4 QUESTIONS APPLE VALLEY FAMILY PRACTICE Cost Allocation Methods 1. Briefly describe the differences in the four allocation methods discussed in the case. (Hint: Don’t discuss the mathematics of the schemes, but rather how they differ conceptually.) Which of the four methods is conceptually the most reasonable? 2. What are the allocations to each patient services department, and resulting profitability, under the four allocation methods using the base case cost amounts (Exhibit 4.1) and allocation rates (Exhibit 4.2)? 3. Now consider the sensitivity of the results to changes in the...
Words: 6883 - Pages: 28
...........................................................................................5-6 Problems and Opportunities ........................................................................................................6-7 Objectives and Goals .......................................................................................................................... 7 Action Programs .................................................................................................................................. 8 Works Cited ………………………...………………………………………………………………………………….. 8 Management Summary Winter Park Memorial Hospital Dr. P. Phillips Baby Place is a state of the art obstetrics hospital. The difference in our service from other obstetric hospitals in the area is that The Baby Place provides five-star amenities as well as 24/7 concierge service. This service allows patients to feel comforted and well taken care of. Not only does Winter Park Memorial hospital provide five-star amenities, it also provides exceptional expertise. “Winter Park Memorial Hospital houses a Level II Neonatal Intensive Care Unit (NICU) with comprehensive neonatal and diagnostic facilities for premature babies and other critically ill newborns. Our NICU cares for premature babies born up to 8 weeks early, babies with respiratory distress, babies with diabetic moms,...
Words: 995 - Pages: 4
...3546 Obstetric-Gynecology Resident Education Regarding Barrier and Over-the-Counter Contraceptives: A National Study 1 Amie Y. Miklavcic, M.D., M.M.S., and Christine R. Isaacs, M.D.2 Abstract Background: The study was conducted to assess obstetrics-gynecology resident knowledge about barrier and over-the-counter (OTC) contraceptives and identify strengths and weaknesses in resident education. Methods: We developed a survey for distribution among 50 randomly selected U.S. obstetrics-gynecology residency programs. Results: Of 202 respondents, only 57% and 36% of residents reported adequate knowledge to counsel patients regarding latex vs. nonlatex condom use, respectively. Ninety-six percent knew spermicides were nonprotective against sexually transmitted diseases (STDs); however, there was limited knowledge about delivery options. Only 17% had ever fit or prescribed a diaphragm, and 30% reported knowledge in performing a fitting. Greater than 80% of residents stated they received no formal didactics addressing the use of condoms, spermicides, or diaphragms. Limited experience regarding Cycle Beads and natural family planning was expressed. Conclusions: Obstetrics-gynecology residents receive little formal training about barrier and OTC contraceptive options and seek more education because of their awareness of inadequate knowledge. Introduction he Accreditation Council for Graduate Medical Education (ACGME) and Residency Review Committee require that all obstetrics-gynecology...
Words: 2600 - Pages: 11
...current staff have varied years of experience, and education. Some have not completed an intermediate or advanced fetal monitoring course. Many have not had updated education in reference to the newest nomenclature set forth by the National Institute of Child Health and Development (NICHD) in 2009. Standardizing the interpretation and the communication of varied fetal heart rate (FHR) patterns among all staff is needed to decrease intrapartum mistakes, decrease liability exposure and improve patient outcomes. Improving staff competencies in the interpretation, communication, documentation and management of fetal heart rate tracings is critical to these goals (HANYS (Healthcare Association of New York State), The American Congress of Obstetrics and Gynecology (ACOG) New York State Department of Health [HANYS, ACOG, NYSDOH], 2011). The National Certification Corporation (NCC) recently launched a public campaign named “Just Ask”. The campaign is designed to educate and encourage patients to ask for certified nurses and nurse practitioners. It is the goal of this proposed quality improvement initiative to have all perinatal staff be updated and certified in electronic fetal monitoring by the NCC by the year 2015. Purpose Litigation caused by the misinterpretation and management of electronic fetal monitoring (EFM) tracings continue to be a common issue in adverse outcomes in term pregnancies in the United States. Allegations in reference to the communication, interpretation...
Words: 1279 - Pages: 6
...Polytechnic Institute in Troy, New York, a prestigious university in the field of engineering. After graduating Cum Laude, she attended the University of North Texas Health Science Center in Fort Worth to complete her master’s degree in medical sciences. Dr. Escarzaga completed her medical degree at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine in El Paso. During her medical school training, she was honored to be inducted into the Alpha Omega Alpha Honor Medical Society. Her residency training in obstetrics and gynecology took place in her hometown of Houston at Baylor College of Medicine. During her residency, Dr. Escarzaga was the Administrative Chief Resident. She particularly enjoyed the training she received in minimally invasive surgery during her residency, discovering her passion for surgery and following a patient from diagnosis to post-op care. She also gained valuable experience and training in high risk obstetrics during...
Words: 677 - Pages: 3
...techniques with this patient is fueled by the importance of follow up from abnormal PAP smear results. High-grade squamous intraepithelial lesion (HSIL) depicts changes to the cervical cells with a high association to precancerous or cancer cells (American Congress of Obstetrics and Gynecology, 2016a). Further, the patient has a potential cervical intraepithelial lesion (CIN) that may be a precancerous lesion and requires diagnosis by colposcopy (ACOG, 2016a). Cervical changes,...
Words: 878 - Pages: 4
...more experience serious complications. These range from chronic infections to disabling injuries (Such as Obstetric fistula). Maternal death and disability rates mirror the huge discrepancies that exist between the haves and the have-nots both within and between countries. Safe Motherhood begins before conception with proper nutrition and a healthy life style and continues with appropriate prenatal care, the prevention of complications when possible, and the early and effective treatment of complications. The ideal result is a pregnancy at term, without unnecessary interventions, the delivery of a healthy infant, and a healthy post partum period in a positive environment that supports the physical and emotional needs of the woman, infant and family. Working for the survival of mothers is a human rights imperative. It also has enormous socio-economic ramifications-and is a crucial international priority. Both the international conference on Population and Development and Millennium Development Goals call for a 75 percent reduction in maternal mortality between 1990 and 2015. This three prolonged strategy is key to the accomplishment of the goal: -All women have access to contraception to avoid unintended pregnancies. -All pregnant women have access to skilled care at the time of birth. -All those with complications have timely access to quality emergency obstetric care. In countries such as China, Cuba, Egypt, Honduras, Jamaica, Malaysia, Sri Lanka, Thailand and Tunisia...
Words: 8030 - Pages: 33
...Analysis): • Facilities with largest costpool • Administration with largest cost pool in Calculation 1 • Finance with largest costpool in Calculation 2 Results • Adult Medicine: uses greatest amount of Facilities services so profit greatly increased when Facilities costs are changes to Adminstration or Finance (not as much) • Obstetrics: uses least amount of Facilities so profit decreases when costs are shifted into Administration and Finance • Pediatrics: profitability decrease when Adminstation has largest cost pool but profitability increase when Finance has largest cost pool In conducting a sensitivity analysis we will need to keep the allocation rates the same as their base case values while only making changes to the cost pool amounts are. Examining our base case reveals that Facilities represents the largest cost pool. The largest cost pool is represented by Administration in Calculation 1 and Finance in Calculation 2. Observations show that the profit of Adult Medicine increases when Facilities costs are transferred to Adminstration, since it takes up the greatest proportion of Facilities services, or Finance. Either of these same shifts causes a decrease in profitability for Obstetrics. For Pediatrics, profitability is lessened when shift is to Administration and heightened when shift is to...
Words: 268 - Pages: 2
