Position Statement (position + statement)

Distribution by Scientific Domains
Distribution within Medical Sciences


Selected Abstracts


Interdisciplinary Care for Older Adults with Complex Needs: American Geriatrics Society Position Statement

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2006
Geriatrics Interdisciplinary Advisory Group
First page of article [source]


Proposed Next BACCN Position Statement

NURSING IN CRITICAL CARE, Issue 4 2010
Catherine Plowright
No abstract is available for this article. [source]


Australian and New Zealand Society for Geriatric Medicine Position Statement , Indigenous Ageing in Australia

AUSTRALASIAN JOURNAL ON AGEING, Issue 2 2010
Article first published online: 8 JUN 2010
No abstract is available for this article. [source]


Australian and New Zealand Society for Geriatric Medicine Position Statement , Geriatric Services in General Hospitals

AUSTRALASIAN JOURNAL ON AGEING, Issue 1 2010
Article first published online: 25 MAR 2010
First page of article [source]


Breastfeeding: for the sake of the Europe and the world: European Society for Social Pediatrics and Child Health (ESSOP) Position Statement

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 3 2009
G. GökçayArticle first published online: 23 FEB 200
First page of article [source]


The Management of Anal Fissure: ACPGBI Position Statement

COLORECTAL DISEASE, Issue 2008
K. L. R. Cross
First page of article [source]


The Management of Acute Severe Colitis: ACPGBI Position Statement

COLORECTAL DISEASE, Issue 2008
S. R. Brown
First page of article [source]


The Management of Malignant Large Bowel Obstruction: ACPGBI Position Statement

COLORECTAL DISEASE, Issue 2007
P. J. Finan (Chairman)
First page of article [source]


The Treatment of Anal Fistula: ACPGBI Position Statement

COLORECTAL DISEASE, Issue 2007
J. G. Williams (Chairman)
First page of article [source]


AWHONN Issues Three New Position Statements

NURSING FOR WOMENS HEALTH, Issue 5 2002
Article first published online: 9 MAR 200
No abstract is available for this article. [source]


Position statement: Nonanesthesiologist administration of propofol for GI endoscopy,,§

HEPATOLOGY, Issue 6 2009
John J. Vargo MD
First page of article [source]


Position statement on the role of health care assistants who are involved in direct patient care activities within critical care areas

NURSING IN CRITICAL CARE, Issue 1 2003
The British Association of Critical Care Nurses
Summary ,Intensive care has developed as a speciality since the 1950s, and during this time, there have been major technological advances in health care provision, leading to a rapid expansion of all areas of critical care ,The ongoing problem in recruiting qualified nurses in general has affected, and continues to be a problem for, all aspects of critical care areas ,During the past decade, nursing practice has evolved, as qualified nurses have expanded their own scope of practice to develop a more responsive approach to the complex care needs of the critically ill patient ,The aim of this paper is to present the British Association of Critical Care Nurses (BACCN) position statement on the role of health care assistants involved in direct patient care activities, and to address some of the key work used to inform the development of the position statement [source]


Population screening and early detection of ovarian cancer in asymptomatic women

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 5 2009
Anne E. NELSON
The National Breast and Ovarian Cancer Centre position statement: ,Population screening and early detection of ovarian cancer in asymptomatic women', was developed and agreed following a Forum in February 2009 attended by key Australian stakeholders. The final position statement and supporting background information have been endorsed by key Australian colleges and agencies. Position statement on population screening and early detection of ovarian cancer in asymptomatic women 1There is currently no evidence that any test, including pelvic examination, CA125 or other biomarkers, ultrasound (including transvaginal ultrasound), or combination of tests, results in reduced mortality from ovarian cancer. 2There is no evidence to support the use of any test, including pelvic examination, CA125 or other biomarkers, ultrasound (including transvaginal ultrasound), or combination of tests, for routine population-based screening for ovarian cancer. 3Further validation in large clinical trials is required before current or new biomarkers could be recommended for routine use in a population screening setting. [source]


Financing of Emergency Medicine Graduate Medical Education Programs in an Era of Declining Medicare Reimbursement and Support

ACADEMIC EMERGENCY MEDICINE, Issue 7 2004
Michael R. Baumann MD
Abstract In May 2004, the Society for Academic Emergency Medicine (SAEM) National Affairs Committee was tasked with evaluation of graduate medical education (GME) funding in the face of declining Medicare reimbursement and support, and its implications for emergency medicine. This article was developed to educate the SAEM membership on the current status and climate of funding for GME and to serve as the basis of a position statement from SAEM on this topic. The paper presents the history and background on GME financing followed by currently known changes from the recently signed Medicare Act of 2003. [source]


Effective management of adverse effects while on oral chemotherapy: implications for nursing practice

EUROPEAN JOURNAL OF CANCER CARE, Issue 2010
K. HARROLD rn, bsc ( hons ), chemotherapy, iv access clinical nurse specialist
HARROLD K. (2010) European Journal of Cancer Care19, 12,20 Effective management of adverse effects while on oral chemotherapy: implications for nursing practice The publication of guidelines by the United Kingdom National Patient Safety Agency and the National Confidential Enquiry into Patient Outcome and Death which looked into deaths within 30 days of systemic anticancer therapy and the more recent position statement from the United Kingdom Oncology Nursing Society have all highlighted the need for an improvement in the care and management of patients receiving oral chemotherapy. While it is essential that patients are aware of the rationale behind dose interruption and modification if they are to effectively deal with toxicities and complications that may arise, they also require access to a clear line of communication in order to facilitate early intervention. The value of pre treatment patient education and ongoing support for these patients has already been extensively documented and while a multidisciplinary team approach in this is vital, nurses are ideally placed to take a leading role in these two aspects of treatment management. This article aims to detail and review current best management practices for the most commonly reported toxicities associated with capecitabine, an oral chemotherapeutic agent used in the management of patients with colorectal cancer. Only if both the patient and the health care professional supporting them are aware of best management practices will the impact of toxicities be minimised and treatment outcomes optimised. [source]


The implementation of intravenous tissue plasminogen activator in acute ischaemic stroke , a scientific position statement from the National Stroke Foundation and the Stroke Society of Australasia

INTERNAL MEDICINE JOURNAL, Issue 5 2009
Ad Hoc Committee representing the National Stroke Foundation, the Stroke Society of Australasia
Abstract Intravenous tissue plasminogen activator (tPA) has been licensed in Australia for thrombolysis in selected patients with acute ischaemic stroke since 2003. The use of tPA is low but is increasing across Australia and national audits indicate efficacy and safety outcomes equivalent to international benchmarks. Implementing tPA therapy in clinical practice is, however, challenging and requires a coordinated multidisciplinary approach to acute stroke care across prehospital, emergency department and inpatient care sectors. Stroke care units are an essential ingredient underpinning safe implementation of stroke thrombolysis. Support systems such as care pathways, therapy delivery protocols, and thrombolysis-experienced multidisciplinary care teams are also important enablers. Where delivery of stroke thrombolysis is being planned, health systems need to be re-configured to provide these important elements. This consensus statement provides a review of the evidence for, and implementation of, tPA in acute ischaemic stroke with specific reference to the Australian health-care system. [source]


Review of the potential photo-cocarcinogenicity of topical calcineurin inhibitors

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 6 2005
Position statement of the European Dermatology Forum
ABSTRACT, Topical Calcineurin Inhibitors (TCIs) used for the treatment of atopic eczema modify the immune regulatory function of the skin and may have the potential to enhance immunosuppressive ultraviolet (UV) effects. Current recommendations on UV protection in eczema patients treated with PCIs are inconsistent and have given rise to uncertainty and anxiety in patients. Therefore, the European Dermatology Forum (EDF) developed a position statement which reviews critically the available data with regard to the problem, especially analysing and commenting the limitations of rodent models for the human situation. There is no conclusive evidence from rodent trials to indicate that long-term application of TCIs is photococarcinogenic. There is a need for further studies to investigate the validity of mouse models as well as long-term cohort studies in patients using TCIs. Available data suggest that long-term application of TCIs is safe, that there is no evidence of increased skin cancer risk and that it is ethical to treat patients with TCIs when indicated. [source]


Screening for hepatitis B, C and non-alcoholic fatty liver disease: a survey of community-based physicians

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 9 2009
J. B. KALLMAN
Summary Background, Screening guidelines for hepatitis B (HBV) and hepatitis C viruses (HCV) as well as a position statement for non-alcoholic fatty liver disease (NAFLD) have been put forth by different sources, but awareness of these guidelines and their impact on the physician practices have not been assessed. Aim, To assess the attitudes of primary care physicians (PCPs), gastroenterologists (GEs) and hepatologists (HEPs) regarding screening for HBV, HCV and NAFLD. Design, A survey questionnaire was sent to community-based PCPs and GEs to assess issues related to HBV, HCV and NAFLD. The same questionnaire was sent to hepatologists (HEPs). The questionnaire contained 10 items related to demographic and practice patterns of these physicians, 35 items related to HBV, 35 items related to HCV and 29 items related to NAFLD. Results, A total of 214 physicians (103 PCPs, 59 GEs and 52 HEPs) completed the survey. A majority of PCPs, GEs and HEPs agreed on most screening issues for these causes of liver disease. Nevertheless, within group comparison of physicians (guideline aware versus guideline unaware) showed significant differences in accurate response between those who were aware of guidelines and those who were not aware. Conclusions, A large percentage of PCPs and GEs were unaware of official guidelines for viral hepatitis B and hepatitis C. Those aware of guidelines were more likely to screen appropriately and avoid unnecessary testing. More needs to be done to assess awareness and the impact implementation of guidelines in hepatology. [source]


British Association of Critical Care Nurses position statement on prescribing in critical care

NURSING IN CRITICAL CARE, Issue 5 2009
Kate Bray
ABSTRACT Background: Nurses in the UK are now one group of non-medical staff who can prescribe. This practice is evolving for critical care nursing staff who care for critically ill patients during their stay in hospital through ward and outpatient follow-up after admission to critical care. Aim: The purposes of this paper were to present existing information regarding prescribing to support nurses in critical care currently prescribing and to inform those who are intending to prescribe. Methods: To develop the position statement, a search of the literature was conducted using key databases. To ascertain the current level and type of prescribing in critical care, a short questionnaire was sent by email to British Association of Critical Care Nursing members, and the results of this are presented in Appendix A. Outcomes/Results: Evidence was found in relation to the history, context in critical care, educational requirements and issues of consent related to non-medical prescribing. Conclusions: The position statement is based upon evidence from the literature, National Health Service policy and the Nursing and Midwifery Council regulations. It takes account of the critical care patient pathway before, during and after an admission to critical care. [source]


Health care assistants' role, function and development: results of a national survey

NURSING IN CRITICAL CARE, Issue 4 2003
The British Association of Critical Care NursesArticle first published online: 31 JUL 200
Summary ,,Intensive care has developed as a speciality since the 1950s; during this time there have been major technological advances in health care provision leading to a rapid expansion of all areas of critical care ,,The ongoing problem of recruiting appropriately qualified nurses has affected staffing levels in many units and continues to be a national problem. For many, the answer lies in employing health care assistants to support the work of registered nurses ,,A key aim of the British Association of Critical Care Nurses is to promote the art and science of critical care nursing by providing representation for its members, by responding to political and professional change and by producing and publishing position statements ,,A primary component of the work surrounding the development of this second position statement was the gathering of contemporary information in relation to the role of health care assistants within critical care units throughout the UK, through a survey of 645 critical care units within the UK ,,At present the impact upon the role of the critical care nurse is not fully understood, with research in this area suggesting that although there is a role for the health care assistant in the critical care environment, this should only be undertaken with a full analysis of this impact upon the work of the registered nurse [source]


Position statement on the role of health care assistants who are involved in direct patient care activities within critical care areas

NURSING IN CRITICAL CARE, Issue 1 2003
The British Association of Critical Care Nurses
Summary ,Intensive care has developed as a speciality since the 1950s, and during this time, there have been major technological advances in health care provision, leading to a rapid expansion of all areas of critical care ,The ongoing problem in recruiting qualified nurses in general has affected, and continues to be a problem for, all aspects of critical care areas ,During the past decade, nursing practice has evolved, as qualified nurses have expanded their own scope of practice to develop a more responsive approach to the complex care needs of the critically ill patient ,The aim of this paper is to present the British Association of Critical Care Nurses (BACCN) position statement on the role of health care assistants involved in direct patient care activities, and to address some of the key work used to inform the development of the position statement [source]


ABCD position statement on screening for gestational diabetes mellitus

PRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 4 2007
FRCP Consultant Physician, S Robinson MD, Senior Lecturer
Abstract Gestational diabetes mellitus is an increasingly common medical problem seen in pregnancy. A randomised clinical trial, published in 2005, showed improved perinatal morbidity and mortality in pregnancies of women with actively managed gestational diabetes. Prior to 2003 the evidence base for screening and treating all women with gestational diabetes was not strong enough for the National Institute for Clinical Excellence (NICE), in its 2003 antenatal guidelines, to recommend universal screening for gestational diabetes. As we await the review of these original 2003 NICE guidelines we offer a pragmatic approach for the detection of glucose intolerance in pregnancy. Copyright © 2007 John Wiley & Sons. [source]


Making sense of emergency surgery in New South Wales: a position statement

ANZ JOURNAL OF SURGERY, Issue 3 2010
Stephen A. Deane
Abstract Background:, Emergency surgery is a major component of the provision of surgical services and makes up a substantial volume of the workload of surgeons in many hospitals. It is often more complex and surgically challenging than elective surgery. However, little attention has been concentrated on the management or resource requirements of emergency surgery. Method:, This article identifies principles for models of emergency surgery care and describes how they can be incorporated into a redesign of emergency surgery. They have been developed and are endorsed by experienced surgical staff routinely coping with the challenges of emergency surgery. Results:, The benefits of redesigning emergency surgery will be realized by an active partnership between managers, surgeons and surgical teams. The anticipated clinical benefits include improved patient outcomes, enhanced patient and surgical team satisfaction, and increased trainee supervision in emergency surgery. Significant management benefits will ensue from high rates of emergency operating theatre utilization, reduced patient cancellations and reduction in after-hours costs. This unplanned but predictable workload will be managed in a planned and predictable fashion. Conclusion:, Reform of emergency surgery services is a necessity and not a choice. The development of the emergency surgery guidelines for New South Wales is a step in the right direction. The principles identified in the guidelines should be adapted and implemented across Australia if sustainable, safe and efficient emergency surgery services are to be provided. Patients will expect nothing less. [source]


Population screening and early detection of ovarian cancer in asymptomatic women

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 5 2009
Anne E. NELSON
The National Breast and Ovarian Cancer Centre position statement: ,Population screening and early detection of ovarian cancer in asymptomatic women', was developed and agreed following a Forum in February 2009 attended by key Australian stakeholders. The final position statement and supporting background information have been endorsed by key Australian colleges and agencies. Position statement on population screening and early detection of ovarian cancer in asymptomatic women 1There is currently no evidence that any test, including pelvic examination, CA125 or other biomarkers, ultrasound (including transvaginal ultrasound), or combination of tests, results in reduced mortality from ovarian cancer. 2There is no evidence to support the use of any test, including pelvic examination, CA125 or other biomarkers, ultrasound (including transvaginal ultrasound), or combination of tests, for routine population-based screening for ovarian cancer. 3Further validation in large clinical trials is required before current or new biomarkers could be recommended for routine use in a population screening setting. [source]


Better data needed from pregnancy registries,

BIRTH DEFECTS RESEARCH, Issue 2 2009
Gerald G. Briggs
Abstract This article is a consensus position statement from the Research Committee of the Organization of Teratology Information Specialists (OTIS). The Committee believes that more specific information on the timing and dose of drug exposures from pregnancy birth defect registries sponsored by pharmaceutical companies (herein called pregnancy registries) would improve the estimation of risk for developmental toxicity (i.e., growth alteration, structural anomalies, functional/neurobehavioral deficits, or death). Specifically, the Committee believes that the exposure timing should be stated in gestational weeks and days rather than simply weeks. In addition, the Committee believes that the exposure dose should be stated in patient-specific terms, such as body weight (mg/kg) or body surface area (mg/m2) rather than simply dose strength. Although the focus of this position is pregnancy registries, it also is applicable to any source of medication-induced embryo-fetal toxicity. Birth Defects Research (Part A), 2009. © 2008 Wiley-Liss, Inc. [source]


Optometrists Association Australia position statement on driver vision standards

CLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 4 2002
Peregrine Horton MScOptom
First page of article [source]


Economic Growth and Biodiversity Loss in an Age of Tradable Permits

CONSERVATION BIOLOGY, Issue 4 2006
JON ROSALES
comercio de emisiones; límite y comercio; proceso ciencia-política; Protocolo de Kyoto Abstract:,Tradable permits are increasingly becoming part of environmental policy and conservation programs. The efficacy of tradable permit schemes in addressing the root cause of environmental decline,economic growth,will not be achieved unless the schemes cap economic activity based on ecological thresholds. Lessons can be learned from the largest tradable permit scheme to date, emissions trading now being implemented with the Kyoto Protocol. The Kyoto Protocol caps neither greenhouse gas emissions at a level that will achieve climate stability nor economic growth. If patterned after the Kyoto Protocol, cap-and-trade schemes for conservation will not ameliorate biodiversity loss either because they will not address economic growth. In response to these failures to cap economic growth, professional organizations concerned about biodiversity conservation should release position statements on economic growth and ecological thresholds. The statements can then be used by policy makers to infuse these positions into the local, national, and international environmental science-policy process when these schemes are being developed. Infusing language into the science-policy process that calls for capping economic activity based on ecological thresholds represents sound conservation science. Most importantly, position statements have a greater potential to ameliorate biodiversity loss if they are created and released than if this information remains within professional organizations because there is the potential for these ideas to be enacted into law and policy. Resumen:,Cada vez más, los permisos comerciables son parte de la política ambiental y de los programas de conservación. La eficacia de los esquemas de permisos comerciables para atender la causa principal de la declinación ambiental,crecimiento económico,será baja a menos que los esquemas limiten la actividad económica con base en umbrales ecológicos. Se pueden aprender lecciones del mayor esquema de permisos comerciables a la fecha, la comercialización de emisiones implementada con el Protocolo de Kyoto. El Protocolo de Kyoto no limita a las emisiones de gases a un nivel que logre la estabilidad climática ni al crecimiento económico. Si se sigue el modelo del Protocolo de Kyoto, los esquemas de límite y comercio tampoco reducirán las pérdidas de biodiversidad porque no considerarán al crecimiento económico. En respuesta a estas fallas para limitar el crecimiento económico, las organizaciones profesionales preocupadas por la conservación de la biodiversidad deberían emitir declaraciones sobre su posición respecto a umbrales ecológicos y de crecimiento económico. Las declaraciones luego pueden ser usadas por políticos para infundir estas posiciones en el proceso ciencia ambiental-política a nivel local, nacional e internacional cuando estos esquemas estén siendo desarrollados. La infusión de lenguaje que demanda la limitación de actividades de crecimiento económico con base en umbrales ecológicos es ciencia de la conservación sólida. Más notablemente, las declaraciones de posición tienen un mayor potencial para reducir las pérdidas de biodiversidad si son creadas y publicadas que si esta información permanece dentro de las organizaciones profesionales porque existe el potencial para que estas ideas se constituyan en leyes y políticas. [source]


The Status of Bedside Ultrasonography Training in Emergency Medicine Residency Programs

ACADEMIC EMERGENCY MEDICINE, Issue 1 2003
Francis L. Counselman MD
Abstract Bedside ultrasonography (BU) is rapidly being incorporated into emergency medicine (EM) training programs and clinical practice. In the past decade, several organizations in EM have issued position statements on the use of this technology. Program training content is currently driven by the recently published "Model of the Clinical Practice of Emergency Medicine," which includes BU as a necessary skill. Objective: The authors sought to determine the current status of BU training in EM residency programs. Methods: A survey was mailed in early 2001 to all 122 Accreditation Council for Graduate Medical Education (ACGME)-accredited EM residency programs. The survey instrument asked whether BU was currently being taught, how much didactic and hands-on training time was incorporated into the curriculum, and what specialty representation was present in the faculty instructors. In addition, questions concerning the type of tests performed, the number considered necessary for competency, the role of BU in clinical decision making, and the type of quality assurance program were included in the survey. Results: A total of 96 out of 122 surveys were completed (response rate of 79%). Ninety-one EM programs (95% of respondents) reported they teach BU, either clinically and/or didactically, as part of their formal residency curriculum. Eighty-one (89%) respondents reported their residency program or primary hospital emergency department (ED) had a dedicated ultrasound machine. BU was performed most commonly for the following: the FAST scan (focused abdominal sonography for trauma, 79/87%); cardiac examination (for tamponade, pulseless electrical activity, etc., 65/71%); transabdominal (for intrauterine pregnancy, ectopic pregnancy, etc., 58/64%); and transvaginal (for intrauterine pregnancy, ectopic pregnancy, etc., 45/49%). One to ten hours of lecture on BU was provided in 43%, and one to ten hours of hands-on clinical instruction was provided in 48% of the EM programs. Emergency physicians were identified as the faculty most commonly involved in teaching BU to EM residents (86/95%). Sixty-one (69%) programs reported that EM faculty and/or residents made clinical decisions and patient dispositions based on the ED BU interpretation alone. Fourteen (19%) programs reported that no formal quality assurance program was in place. Conclusions: The majority of ACGME-accredited EM residency programs currently incorporate BU training as part of their curriculum. The majority of BU instruction is done by EM faculty. The most commonly performed BU study is the FAST scan. The didactic component and clinical time devoted to BU instruction are variable between programs. Further standardization of training requirements between programs may promote increasing standardization of BU in future EM practice. [source]


Health care assistants' role, function and development: results of a national survey

NURSING IN CRITICAL CARE, Issue 4 2003
The British Association of Critical Care NursesArticle first published online: 31 JUL 200
Summary ,,Intensive care has developed as a speciality since the 1950s; during this time there have been major technological advances in health care provision leading to a rapid expansion of all areas of critical care ,,The ongoing problem of recruiting appropriately qualified nurses has affected staffing levels in many units and continues to be a national problem. For many, the answer lies in employing health care assistants to support the work of registered nurses ,,A key aim of the British Association of Critical Care Nurses is to promote the art and science of critical care nursing by providing representation for its members, by responding to political and professional change and by producing and publishing position statements ,,A primary component of the work surrounding the development of this second position statement was the gathering of contemporary information in relation to the role of health care assistants within critical care units throughout the UK, through a survey of 645 critical care units within the UK ,,At present the impact upon the role of the critical care nurse is not fully understood, with research in this area suggesting that although there is a role for the health care assistant in the critical care environment, this should only be undertaken with a full analysis of this impact upon the work of the registered nurse [source]


Kaizen: A Method of Process Improvement in the Emergency Department

ACADEMIC EMERGENCY MEDICINE, Issue 12 2009
Gregory H. Jacobson MD
Abstract Introduction:, Recent position statements from health care organizations have placed a strong emphasis on continuous quality improvement (CQI). CQI finds many of its roots in kaizen, which emphasizes small, low-cost, low-risk improvements. Based on the successful Kaizen Programs at organizations such as Toyota, the authors thought the emergency department (ED) would be an ideal environment to benefit from such a program. Objectives:, The authors sought to create a CQI program using a suggestion-based model that did not require a large time commitment, was easy to implement, and had the potential to empower all physicians in the department. It would not take the place of other improvement efforts, but instead augment them. The hypothesis was that such a program would foster sustainable engagement of emergency physicians in system improvement efforts and lead to a continuous stream of low-cost implementable system improvement interventions. Methods:, A CQI program was created for the physician staff of the Department of Emergency Medicine at Vanderbilt University Medical Center, focusing on a suggestion-based model using kaizen philosophy. Lectures teaching kaizen philosophy were presented. Over the past 4 years, a methodology was developed utilizing a Web-based application, the Kaizen Tracker, which aids in the submission and implementation of suggestions that are called kaizen initiatives (KIs). The characteristics of the KIs submitted, details regarding resident and faculty participation, and the effectiveness of the Kaizen Tracker were retrospectively reviewed. Results:, There were 169, 105, and 101 KIs placed in the postimplementation calendar years 2006, 2007, and 2008, respectively. Seventy-six percent of KIs submitted thus far have identified a "process problem." Fifty-three percent of KIs submitted have led to operational changes within the ED. Ninety-three percent of the resident physicians entered at least one KI, and 73% of these residents submitted more than one KI. Sixty-nine percent of the attendings entered at least one KI, and 89% of these attendings submitted more than one KI. Conclusions:, Over the past 4 years, the Kaizen Program at Vanderbilt has been widely and frequently used within the ED. It has resulted in over 400 changes in our adult ED system and has met the challenge of using CQI to drive ED improvements. There are limitations to this study, including the fact that its impact on patient outcomes remains unknown. However, this Kaizen Program may be an excellent tool for other departments to assist with quality improvement and should be studied with a multicenter prospective approach. [source]