Download or read book Evaluation de la pertinence des hospitalisations aux urgences du centre hospitalier universitaire de Caen written by Clémence Rogue and published by . This book was released on 2018 with total page 96 pages. Available in PDF, EPUB and Kindle. Book excerpt: Dans un contexte de maitrise des dépenses passant par une diminution du nombre de lits pour les hospitalisations à temps complet et une fréquentation toujours plus importante du service des urgences, il semble judicieux d’optimiser les ressources disponibles.L’objectif principal est d’évaluer la pertinence des hospitalisations au sein du service des urgences du centre hospitalier universitaire de Caen et d’identifier les causes d’admissions non pertinentes. Nous avons recueilli rétrospectivement les données de 675 patients hospitalisés durant la période du 5 Janvier au 19 Janvier 2018. Nous avons évalué la pertinence des admissions avec la version française de l’outil AEP créée par Davido. Pour les hospitalisations dites non pertinentes, un médecin urgentiste et un médecin généraliste ont donné leur avis propre sur l’adéquation de l’admission. Les principaux critères satisfaisant la grille AEPf sont les actes chirurgicaux ou médicaux prévus dans les 24 heures et le traitement intraveineux. Ainsi 7.7% des hospitalisations étaient jugées inappropriées, principalement dues à un problème social et à l’attente d’une procédure ou d’un avis thérapeutique voire diagnostique. Sur les 52 hospitalisations non pertinentes selon la grille AEPf, 48% étaient jugées comme adaptées par les deux experts et seulement 11% étaient injustifiées. Ils étaient en désaccord pour 21 admissions portant sur la prise en charge possible en ambulatoire. Il semble important de détecter rapidement des situations de précarité et d’améliorer la disponibilité des divers ressources, tant médicale que matérielle en ambulatoire

Download or read book Evaluation de la pertinence des hospitalisations demand es par le service d urgences m dicales du C H U de Caen written by Myriam Duteil and published by . This book was released on 1993 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Evaluation de la pertinence des lettres d admission aux urgences du CHU de Caen et des pratiques des m decins g n ralistes sur leur laboration written by Maxime Antonelli and published by . This book was released on 2016 with total page 164 pages. Available in PDF, EPUB and Kindle. Book excerpt: Le courrier médical d’adressage aux urgences est essentiel dans la communication entre médecins pour la transmission des informations médico-sociales. Il représente la première source d'information pour le médecin urgentiste et est parfois le seul lien entre la ville l’hôpital. L'objectif de l'étude était d'analyser la qualité des lettres d'admission aux urgences du CHU de Caen et d'évaluer les pratiques des médecins généralistes sur leur élaboration. L’étude comportait deux enquêtes prospectives observationnelles et descriptives complémentaires. La première avait pour objectif d'analyser les lettres d'adressage des patients admis aux urgences entre le 9 novembre et le 7 décembre 2015. La deuxième évaluait les pratiques et le ressenti des médecins généralistes Caennais sur leur rédaction. Toutes les lettres des médecins adressant les patients aux urgences ont été inclues. Pour la deuxième enquête, les médecins inclus devaient exercer une activité de médecine générale fixe et régulière à Caen. Les données ont été recueillies à l'aide d'une grille de lecture, des dossiers médicaux archivés puis par téléphone auprès des généralistes. Dans la première étude, 427 lettres ont été analysées. Les médecins de SOS médecins avaient recours plus souvent aux lettres types (p=0,03) et mentionnaient d’avantage le critère allergie (p=0,002) que les généralistes. Dans la seconde étude, 23 médecins généralistes ont répondu à notre questionnaire, 59% étaient favorables à l’utilisation d’une lettre type pour adresser les patients aux urgences. La mise en place d'une lettre d'admission type permettrait d'uniformiser et d’améliorer les pratiques, ce d'autant plus que les médecins généralistes y seraient favorables.

Download or read book valuation de la pertinence des hospitalisations aux urgences du centre hospitalier de Chamb ry written by Diane Fournier (auteur en médecine).) and published by . This book was released on 2012 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Le but de cette étude était d'évaluer le taux de pertinence des hospitalisations dans le service des urgences du centre hospitalier de Chambéry et d'identifier les causes des hospitalisations injustifiées. Ce travail devrait permettre d'établir un plan d'action pour réduire ces dernières. Une analyse rétrospective a été menée utilisant la version française de l'Appropriateness Evaluation Protocol. Les données nécessaires étaient extraites des dossiers médicaux des patients hospitalisés du 27 juin au 3 juillet 2011. 213 patients ont été inclus. Les admissions inappropriées s'élevaient à 24%, dont 17.5% justifiées et 6.5% non justifiées. Les causes les plus fréquentes de non pertinence étaient l'attente due à une procédure diagnostique, l'attente d'un avis spécialisé, la nécessité d'une surveillance clinique, et le besoin d'un soutien psychologique. Le pourcentage de non pertinence était significativement plus élevé chez les femmes. Parmi les hospitalisations non justifiées, 45% étaient liées à l'organisation des soins, 44% étaient liées au patient ou à sa famille, et 11% étaient liées à une demande expresse du médecin traitant. Conclusion : Les urgences de Chambéry affiche un taux d'hospitalisation non pertinente comparable à ceux observés dans les études françaises ou étrangères. Il est difficile d'agir sur les admissions hospitalières liées au patient ou sa famille, ou liées à la demande expresse du médecin traitant. Un tel projet représente un coût financier important et le bénéfice en termes de qualité de soins reste à démontrer.

Download or read book EVALUATION DE LA PERTINENCE DES HOSPITALISATIONS AU SERVICE D ACCUEIL DES URGENCES DU CENTRE HOSPITALIER GENERAL DE ROANNE LOIRE written by XAVIER.. JACOB and published by . This book was released on 1998 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book valuation de la pertinence des hospitalisations partir du service des urgences en fonction des crit res de l AEP Appropriateness Evaluation Protocol written by Valérie Blanchard-Pontoizeau and published by . This book was released on 2003 with total page 210 pages. Available in PDF, EPUB and Kindle. Book excerpt: Peut-on envisager de rationaliser les hospitalisations à partir du SAU ( Service d'Accueil des Urgences) et quels outils doit-on utiliser ? Ce travail propose une présentation des différents outils d'évaluation de la pertinence des hospitalisations utilisés à travers le monde et une étude prospective, réalisée au SAU du CHU de Nantes, portant sur 586 dossiers, utilisant l'un de ces outils : l'AEP (Appropriateness Evaluation Protocol).

Download or read book valuation de la prescription de radiologie anticip e par l infirmier d accueil des urgences dans le centre hospitalier universitaire de Caen written by Kevin Planchon and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction : La fréquentation des services d'urgences ne cesse d'augmenter en France. Environ 35 % des consultations sont liées à des traumatismes légers de membres, nécessitant souvent une radiologie. La nécessité de réduire la durée moyenne de séjour n'est plus à prouver : de manière individuelle pour améliorer la prise en charge du patient ou plus globalement pour le bon fonctionnement du service. Nous avons cherché à déterminer si la prescription anticipée de radiologie par l'infirmier à l'accueil des urgences (autorisée par le pacte de refondation des urgences) permet de diminuer le temps de passage des patients. Matériel et méthode : Après la formation des infirmiers, 464 patients porteurs d'un mono traumatisme de membre sont inclus selon une allocution un pour un durant 7 mois. Le critère principal de jugement est la durée moyenne de séjour dans le service. Résultats : Il est démontré une réduction de la durée moyenne de séjour de 33 mn IC 33 [18 ;49] pour les patients du groupe intervention. Elle reste significative lors des études en sous-groupes, notamment en isolant les traumatismes de membres inférieurs ou supérieurs. Les prescriptions anticipées des infirmiers sont appropriées et donc non associées à un surcoût ou risque d'irradiation inutile. Conclusion : La mise en place d'un protocole de prescription de radiologie anticipée par l'infirmier d'accueil du service des urgences du CHU de Caen permet une diminution de la durée moyenne de séjour des patients reçus pour traumatismes légers. Ce type de procédure, acceptée et sécurisée, est une piste de réflexion pour améliorer le fonctionnement des services d'urgences débordés et libérer du temps médical précieux.

Download or read book The Globalization of Managerial Innovation in Health Care written by John Kimberly and published by Cambridge University Press. This book was released on 2008-12-18 with total page 395 pages. Available in PDF, EPUB and Kindle. Book excerpt: An examination of patient classification systems in fifteen different countries throughout the world.

Download or read book Organizing Smart Buildings and Cities written by Elisabetta Magnaghi and published by Springer Nature. This book was released on 2021-02-01 with total page 190 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United Nations included sustainable cities and communities in its 2030 SDGs. Cities and, on a smaller scale, neighborhoods, building managers and firms are now adopting technologies and information systems to help achieve the energy, economic, social and environmental transition. This volume gathers contributions on the key organizational success factors for this transition. To do so, it analyzes the role of information systems, use of data, and technological assistance solutions from multiple perspectives. The goal is to develop a framework that can successfully apply information systems to organizational and environmental issues for smart cities and smart buildings. Accordingly, the book addresses living-lab experiment evaluation techniques, and provides critical analyses of the role of the environment, context and users’ behavioral responses. In addition, it discusses key questions on the efficient management of resources, need for appropriate IT solutions, and employing co-creation with users to improve planning and organization.

Download or read book Central Banking in Turbulent Times written by Francesco Papadia and published by Oxford University Press. This book was released on 2018-03-09 with total page 347 pages. Available in PDF, EPUB and Kindle. Book excerpt: Central banks came out of the Great Recession with increased power and responsibilities. Indeed, central banks are often now seen as 'the only game in town', and a place to put innumerable problems vastly exceeding their traditional remit. These new powers do not fit well, however, with the independence of central banks, remote from the democratic control of government. Central Banking in Turbulent Times examines fundamental questions about the central banking system, asking whether the model of an independent central bank devoted to price stability is the final resting point of a complex development that started centuries ago. It dissects the hypothesis that the Great Recession has prompted a reassessment of that model; a renewed emphasis on financial stability has emerged, possibly vying for first rank in the hierarchy of objectives of central banks. This raises the risk of dilemmas, since the Great Recession brought into question implicit assumptions that the pursuit of price stability would also lead to financial stability. In addition, the border between monetary and fiscal policy was blurred both in the US and in Europe. Central Banking in Turbulent Times asks whether the model prevailing before the Great Recession has been irrevocably altered. Are we entering, as Charles Goodhart has hypothesized, into the 'fourth epoch' of central banking? Are changes to central banks part of a move away from the global liberal order that seemed to have prevailed at the turn of the century? Central Banking in Turbulent Times seeks to answer these questions as it examines how changes can allow for the maintenance of price stability, while adapting to the long-term consequences of the Great Recession.

Download or read book Community Psychology written by Geoffrey Nelson and published by Palgrave Macmillan. This book was released on 2005-01-15 with total page 608 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is the first up-to-date text written specifically for the international market on psychology in the community. Community Psychology covers the history and foundations of the field, key concepts and values, community research, community action, and the application of psychology in various settings, integrating the values/politics and scientific/research aspects of community work. Written by experienced authors in the field, this text will be internationally invaluable.

Download or read book Studies in Empowerment written by Robert E Hess and published by Routledge. This book was released on 2014-04-04 with total page 245 pages. Available in PDF, EPUB and Kindle. Book excerpt: This adaptable book offers diverse applications of the empowerment model to the promotion of mental health and the prevention of mental illness. Topics span the developmental trends of empowerment as an individual achievement, a community experience, and a professional aim in relation to social intervention strategies and tactics.

Download or read book Psychological Sense of Community written by Adrian T. Fisher and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 382 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this book, the authors have explored a series of different types of communities - moving from the basic idea of those based at a specific location all the way to virtual communities of the internet. A key feature of this book is the research focus that emphasizes the theory-driven analyses and the diversity of contexts in which sense of community is applied. The book will be of great interest to those concerned with understanding various forms of community and how communities can be mobilized to achieve wellbeing.

Download or read book Community Psychology written by Julian Rappaport and published by New York : Holt, Rinehart and Winston. This book was released on 1977 with total page 508 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book What Nazism Did to Psychoanalysis written by Laurence Kahn and published by Taylor & Francis. This book was released on 2022-09-09 with total page 157 pages. Available in PDF, EPUB and Kindle. Book excerpt: What Nazism Did to Psychoanalysis explores the impact Nazism had on the evolution of psychoanalysis and tackles the enigma of the transformation of individual hate into mass psychosis and of the autocratic creation of a neo-reality. Addressing the effects of the Holocaust on the psychoanalytic world, this book does not focus on the suffering of the survivors but the analysis of the concrete mechanisms of destruction that affected language and thought, their impact on the practice of psychoanalysis and the defences that psychoanalysts tried to find against the linguistic, legal and symbolic chaos that struck the foundations of reality. Laurence Kahn discusses the struggle against the appropriation, by the Nazi language, of key terms such as demonic nature, drives, ideals and, above all, the Selbsterhaltungstrieb (the self-preservation drive), which became, with Hitler, the axis of the living space policy, the "Lebensraum". Covering key topics such as trauma, transgenerational issues, silence and secrecy and the depredation of culture, this is an essential work for psychoanalysts and anyone wishing to understand how strongly the development of psychoanalysis was affected by Nazism.

Download or read book Transformational Processes in Clinical Psychoanalysis written by Lawrence J. Brown and published by Routledge. This book was released on 2018-10-09 with total page 360 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this book, Lawrence J. Brown offers a contemporary perspective on how the mind transforms, and gives meaning to, emotional experience that arises unconsciously in the here-and-now of the clinical hour. Brown surveys the developments in theory and practice that follow from Freud’s original observations and traces this evolution from its conception to contemporary analytic field theory. Brown emphasizes that these unconscious transformational processes occur spontaneously, in the blink of an eye, through the "unconscious work" in which the analyst and patient are engaged. Though unconscious, these processes are accessible and the analyst must train himself to become aware of the subtle ways he is affected by the patient in the clinical moment. By paying attention to one’s reveries, countertransference manifestations and even supposed "wild" or extraneous thoughts, the analyst is able to obtain a glimpse of how his unconscious is transforming the ambient emotions of the session in order to formulate an interpretation. Brown casts a wide theoretical net in his exploration of these transformational processes and builds on the contributions of Freud, Theodor Reik, Bion, Ogden, the Barangers, Cassorla, Civitarese and Ferro. Bion’s theories of alpha function, transformations, dreaming and his clinical emphasis on the present moment are foundational to this book. Brown’s writing is clear and aims to describe the various theoretical ideas as plainly as possible. Detailed clinical material is given in most chapters to illustrate the theoretical perspectives. Brown applies this theory of transformational processes to a variety of topics, including the analyst’s receptivity, countertransference as transformation, the analytic setting, the paintings of J.M.W. Turner, "autistic transformations" and other clinical situations in the analysis of children and adults. Transformational Processes in Clinical Psychoanalysis will be of great interest to all psychoanalysts and psychoanalytic psychotherapists.

Download or read book Psychoanalysis and Projective Methods in Personality Assessment written by Benoît Verdon and published by Hogrefe Publishing. This book was released on 2020 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Unique synthesis from the French School of psychoanalytical projective methods This unique book synthesizes the work of leading thinkers of the French School of psychoanalytical projective methods in personality assessment. The French School is a direct successor to Rorschach's and Murray's original approaches using the Rorschach Test and the Thematic Apperception Test (TAT). Underlying this method is the idea of the coexistence of conscious and unconscious processes, of opposite instinctual pairs, and of agents that are ruled by conflicts (Freud). Transitional activity is seen as part of an intermediate space, a mediator space, and bearer of messages between the subject and the clinician (Winnicott). This book brings to life the important contributions of the French School, firstly exploring its theories and methods and then its clinical applications. Detailed case studies from different stages of life examine the psychopathology of everyday life with its severe and disabling states of suffering. Contemporary advances in research and clinical work are presented, and the groundbreaking early work of Nina Rausch de Traubenberg, Vica Shentoub, and Rosine Debray are also critically reread and discussed. Clinical tools adapted for clinicians and researchers in the appendices include a useful schema to facilitate the interpretation of the Rorschach and TAT together, a list of latent solicitations for the TAT, and the current version of the TAT Scoring Grid. This book is essential reading for clinical psychologists, psychiatrists, psychotherapists, researchers, and students interested in applying psychoanalytical theory to projective methods"--