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Vaccine Feb 2024Healthcare workers (HCW) are at risk of contracting vaccine-preventable diseases and spreading these infections to their patients. Vaccination against preventable...
Healthcare workers (HCW) are at risk of contracting vaccine-preventable diseases and spreading these infections to their patients. Vaccination against preventable diseases prior to clinical training can mitigate this risk. Accreditation guidance can be used as an opportunity to enforce desirable norms and standards. Standards from 144 national accreditation organizations spanning 123 member states listed in the Directory of Organizations that Recognize/Accredit Medical Schools by the Foundation for Advancement of International Medical Education and Research were reviewed and summarized. Findings were further stratified by World Bank income group and WHO region. While higher-income countries were more likely to have accreditation guidelines available than lower- or middle-income countries, few national medical school accreditation bodies specifically request immunization status of trainees as a standard. Further, almost none mention specific antigens for which immunity should be assessed. These findings should be used by medical school and other health professional training accreditation bodies to inform future policy direction to protect trainees as future HCW.
Topics: Humans; Schools, Medical; Vaccination; Education, Medical; Health Personnel; Accreditation
PubMed: 37127525
DOI: 10.1016/j.vaccine.2023.04.026 -
Journal of Cardiothoracic and Vascular... Mar 2024The Intersocietal Accreditation Commission (IAC) is a nonprofit accrediting organization committed to ensuring the quality of diagnostic imaging and related procedures.... (Review)
Review
The Intersocietal Accreditation Commission (IAC) is a nonprofit accrediting organization committed to ensuring the quality of diagnostic imaging and related procedures. It comprises a collaboration of stakeholders spanning numerous medical professionals and specialties. In a recent initiative, IAC Echocardiography introduced a new accreditation specifically for Perioperative Transesophageal Echocardiography (PTE). This accreditation process is anchored in rigorous clinical peer review to ensure diagnostic quality and report accuracy, thus maintaining high standards of medical care. The authors present the inaugural 4 sites to achieve IAC accreditation for PTE, which have collaborated to share their experiences in achieving this accreditation. This review endeavors to offer actionable insights and proven solutions to navigate the accreditation journey for others. Mirroring the IAC Standards and Guidelines for PTE accreditation, this review is divided into three pivotal sections as follows: (1) organization of a perioperative echocardiography service, including stakeholder engagement to facilitate the application for accreditation; (2) performance of examinations and reporting; and (3) instituting quality improvement strategies and establishing a robust program. The pursuit of accreditation in PTE is to transcend a mere compliance exercise. It signifies a dedication to excellence, continual growth, and, above all, to the well-being of patients.
Topics: Humans; Echocardiography, Transesophageal; Accreditation; Echocardiography; Quality Improvement
PubMed: 38087669
DOI: 10.1053/j.jvca.2023.11.019 -
Clinical Chemistry and Laboratory... Sep 2023Knowledge of the stability of analytes in clinical specimens is a prerequisite for proper transport and preservation of samples to avoid laboratory errors. The new...
OBJECTIVES
Knowledge of the stability of analytes in clinical specimens is a prerequisite for proper transport and preservation of samples to avoid laboratory errors. The new version of ISO 15189:2022 and the European directive 2017/746 increase the requirements on this topic for manufacturers and laboratories. Within the project to generate a stability database of European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group Preanalytical Phase (WG-PRE), the need to standardise and improve the quality of published stability studies has been detected, being a manifest deficit the absence of international guidelines for the performance of stability studies on clinical specimens.
METHODS
These recommendations have been developed and summarised by consensus of the WG-PRE and are intended primarily to improve the quality of sample stability claims included in information for users provided by assay supplier companies, according to the requirements of the new European regulations and standards for accreditation.
RESULTS
This document provides general recommendations for the performance of stability studies, oriented to the estimation of instability equations in the usual working conditions, allowing flexible adaptation of the maximum permissible error specifications to obtain stability limits adapted to the intended use.
CONCLUSIONS
We present this recommendation based on the opinions of the EFLM WG-PRE group for the standardisation and improvement of stability studies, with the intention to improve the quality of the studies and the transferability of their results to laboratories.
Topics: Humans; Pre-Analytical Phase; Chemistry, Clinical; Laboratories; Reference Standards; Accreditation
PubMed: 37021544
DOI: 10.1515/cclm-2023-0221 -
JAMA Network Open Dec 2023Diversity in the physician workforce improves patient care and decreases health disparities. Recent calls for social justice have highlighted the importance of medical...
IMPORTANCE
Diversity in the physician workforce improves patient care and decreases health disparities. Recent calls for social justice have highlighted the importance of medical school commitment to diversity and social justice, and newly established medical schools are uniquely positioned to actively fulfill the social mission of medicine.
OBJECTIVE
To identify diversity language in the mission statements of all medical schools accredited since 2000 and to determine whether the presence of diversity language was associated with increased diversity in the student body.
DESIGN, SETTING, AND PARTICIPANTS
Cross-sectional study of public websites conducted between January 6, 2023, and March 31, 2023. Qualitative content analysis of mission statements was conducted using a deductive approach. Eligible schools were identified from the 2021-2022 Medical School Admission Requirements and American Medical Colleges and American Association of Colleges of Osteopathic Medicine websites. Each school's publicly available website was also reviewed for its mission and student body demographics. All United States allopathic and osteopathic medical schools that have been accredited and have enrolled students since 2000.
EXPOSURE
Content analysis of medical school mission statements.
MAIN OUTCOMES AND MEASURES
Prevalence of diversity language in medical school mission statements and its association with student body racial diversity. Data were analyzed in 5-year groupings: 2001 to 2005, 2006 to 2010, 2011 to 2015, and 2016 to 2020).
RESULTS
Among the 60 new medical schools (33 [55%] allopathic and 27 [45%] osteopathic; 6927 total students), 33 (55%) incorporated diversity language into their mission statements. In 2022, American Indian or Alaska Native individuals accounted for 0.26% of students (n = 18), Black or African American students constituted 5% (n = 368), and Hispanic or Latinx individuals made up 12% (n = 840). The percentage of schools with diversity language in their mission statements did not change significantly in schools accredited across time frames (60% in 2001: mean [SE], 0.60 [0.24] vs 50% in 2020: mean [SE], 0.50 [0.11]). The percentage of White students decreased significantly over the time period (26% vs 15% students in 2001-2005 and 2016-2020, respectively; P < .001). No significant differences were observed in student body racial or ethnic composition between schools with mission statements that included diversity language and those without.
CONCLUSIONS AND RELEVANCE
In this cross-sectional study of US medical schools accredited since 2000, diversity language was present in approximately half of the schools' mission statements and was not associated with student body diversity. Future studies are needed to identify the barriers to increasing diversity in all medical schools.
Topics: Humans; United States; Schools, Medical; Cross-Sectional Studies; Physicians; Medicine; Students, Medical
PubMed: 38095898
DOI: 10.1001/jamanetworkopen.2023.46916 -
Frontiers in Health Services 2024This paper aims to review the healthcare system in the United Arab Emirates (UAE) and the utilisation of international accreditation to improve the quality of healthcare... (Review)
Review
This paper aims to review the healthcare system in the United Arab Emirates (UAE) and the utilisation of international accreditation to improve the quality of healthcare services and to grow its medical tourism industry. Medical tourism has contributed to the UAE's economy. Hence, the country mandated international accreditation in public and private facilities to attract patients and boost medical tourism. Accreditation is recognised worldwide as one of the main drivers for implementing quality and patient safety standards, which has sparked considerable interest in studying the effects and outcomes of such assessments. Therefore, the second aim of this paper is to review the UAE's strategic goals to improve the quality of healthcare services using international accreditation. Although striving to achieve global accreditation attracts tourists, it is essential to understand the needs and outcomes of such assessments. This review showed how the UAE healthcare sector has evolved to improve the quality of its healthcare services through accreditation. While enhancing the quality of such services and increasing the medical tourism industry provided many opportunities for expatriates to move to the UAE, the country should aim to strengthen its medical services by expanding to other Middle Eastern countries. This paper could influence policymakers implementing international accreditation in the UAE and the Middle Eastern region.
PubMed: 38449575
DOI: 10.3389/frhs.2024.1329252 -
Family Medicine Sep 2023Family medicine is the most demographically diverse specialty in medicine today. Specialty associations and the Accreditation Council for Graduate Medical Education...
BACKGROUND AND OBJECTIVES
Family medicine is the most demographically diverse specialty in medicine today. Specialty associations and the Accreditation Council for Graduate Medical Education (ACGME) urge residency programs to engage in systematic efforts to recruit diverse resident complements. Using responses from program directors to the ACGME's mandatory annual update, we enumerate the efforts in resident recruiting. This allows us to compare these statements to the recommendations of two highly respected commissions: the Sullivan Commission on Diversity in the Healthcare Workforce and the Institute of Medicine's In the Nation's Compelling Interest: Ensuring Diversity of the Healthcare Workforce.
METHODS
We compiled the annual updates from 689 family medicine programs and analyzed them using a qualitative method called template analysis. We then classified the efforts and compared them to the recommendations of the Sullivan Commission and Institute of Medicine (IOM).
RESULTS
Nearly all (98%) of the programs completed the portion of the annual update inquiring about recruiting residents. The Sullivan Commission and IOM recommended 23 steps to diversify workforce recruiting. We found that programs engaged in all but one of these recommendations. Among the most frequently employed recommendations were doing holistic reviews and using data for planning. None mentioned engaging in public awareness campaigns. Programs also implemented eight strategies not suggested in either report, with staff training in nondiscrimination policies being among the most frequently mentioned. Among program efforts not included in the Sullivan Commission or IOM recommendations were extracurricular activities; appointing diversity, equity, and inclusion (DEI) committees or advocates; subinternship (Sub-I) experiences; recruiting at conferences; blind reviews; legal compliance; and merit criteria. In total, we found 31 interventions in use.
CONCLUSIONS
The Sullivan Commission's guidance, IOM recommendations, and program-developed initiatives can be combined to create a comprehensive roster of diversity recruiting initiatives. Programs may use this authoritative resource for identifying their next steps in advancing their recruiting efforts.
Topics: United States; Humans; Family Practice; Accreditation; Education, Medical, Graduate; Health Personnel; Internship and Residency
PubMed: 37696020
DOI: 10.22454/FamMed.2023.664616 -
Brain & Spine 2023The establishment of local neurosurgery training programs in Nepal has proven critical for the expansion of the discipline across the country. This paper aims to...
INTRODUCTION
The establishment of local neurosurgery training programs in Nepal has proven critical for the expansion of the discipline across the country. This paper aims to describe the evolution, current status, challenges, and future directions of academic neurosurgery in Nepal.
RESEARCH QUESTION
What is the current status and international standing of academic neurosurgery in Nepal?
MATERIAL AND METHODS
Information related to growth and development in Nepal was obtained from universities and regulatory bodies in Nepal. Variables described are the current number of neurosurgeons, the number of neurosurgical centers and centers with accreditation for training, the description of existing training models, the number of graduates, and the contribution of Nepalese neurosurgeons to world literature.
RESULTS
Formal neurosurgical training started in Nepal in 1999. Of 67 hospitals with neurosurgical facilities, 10 (14.9%) are accredited. Three training models (MCh, NBMS, and FCPS) currently exist. Of 116 neurosurgeons currently practicing in the country, 47 (40.5%) are homegrown. The contribution of the Nepalese neurosurgical community to the world includes the training of the first two Maldivian neurosurgeons and an increasing presence in world neurosurgical literature.
CONCLUSIONS
Although comparable to other countries with similar economies, Nepal still faces some challenges to the sustainability and further developments of Neurosurgery. Continued concerted efforts will help Nepalese neurosurgeons achieve the goal of securing self-reliance in neurosurgical education.
PubMed: 38020989
DOI: 10.1016/j.bas.2023.101779 -
Annals of Surgical Oncology May 2024
Topics: Humans; Neoplasms; Quality of Health Care; Medical Oncology; Accreditation
PubMed: 38252265
DOI: 10.1245/s10434-024-14962-1 -
Academic Radiology Dec 2023With the Accreditation Council for Graduate Medical Education recently updating their common program requirements to include components of psychological safety as a core... (Review)
Review
RATIONALE AND OBJECTIVES
With the Accreditation Council for Graduate Medical Education recently updating their common program requirements to include components of psychological safety as a core principle, radiology training programs and academic radiology institutions will need to evaluate psychological safety within their residency programs and implement practices to sustain a safety culture. This article reviews current literature to present a concise guide for radiology programs on best practices for implementing psychological safety, considering the plethora of literature that is available.
MATERIALS AND METHODS
We searched PubMed for published studies evaluating safety culture in medical education and residency. The key words used were Psychological Safety, Education, Radiology, Workplace Culture, and Leadership.
RESULTS
Ninety two studies were reviewed that contributed to the topics examined throughout this manuscript, including a brief history of psychological safety, evolving challenges, and a summation of best practices at the institutional, interpersonal, and individual levels that can result in a sustainable psychologically safe culture for radiology residents.
CONCLUSION
This article will highlight unique considerations pertinent to a radiology residency program, including suggestions for creating a less stressful environment during case conferences, fostering and supporting residents who are struggling, and inclusive psychological safety practices that also consider non-resident contributors to a residency program, such as attending physician faculty and non-physician radiology technicians.
Topics: Humans; United States; Internship and Residency; Education, Medical, Graduate; Radiology; Curriculum; Accreditation
PubMed: 37743164
DOI: 10.1016/j.acra.2023.08.032 -
Surgery For Obesity and Related... Oct 2023Intragastric balloon (IGB) placement and endoscopic sleeve gastroplasty (ESG) are the 2 primary endoscopic bariatric therapies currently performed in the United States....
BACKGROUND
Intragastric balloon (IGB) placement and endoscopic sleeve gastroplasty (ESG) are the 2 primary endoscopic bariatric therapies currently performed in the United States. Procedural selection is often based primarily on patient preference. There is a paucity of comparative data between these interventions.
OBJECTIVES
The aim of this study is to compare the short-term safety and efficacy of IGB to ESG in the largest, direct comparative analysis to date.
SETTING
Accredited bariatric centers across the United States and Canada.
METHODS
We retrospectively analyzed patients who underwent IGB or ESG from 2016 to 2020 from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. IGB patients were propensity matched (1:1) to ESG patients. We compared readmissions, reinterventions, serious adverse events (SAE), weight loss, procedure time, and length of stay between the 2 interventions. All outcomes were measured within 30 days of the initial procedure.
RESULTS
A total of 1998 pairs of patients who underwent IGB and ESG were propensity matched with no difference in baseline characteristics. Patients who underwent ESG had more readmissions within 30 days. Patients who underwent IGB had more outpatient treatments for dehydration and re-interventions, with 3.7% of patients undergoing early balloon removal less than 30 days from implantation. Both procedures had similarly low rates of SAE (P > .05). ESG led to greater total body weight loss at 30 days.
CONCLUSIONS
ESG and IGB are both safe procedures with comparably low rates of SAE. Higher rates of dehydration and re-interventions after IGB suggest that ESG is perhaps better tolerated.
Topics: Humans; Obesity; Gastric Balloon; Retrospective Studies; Dehydration; Treatment Outcome; Gastroplasty
PubMed: 37120354
DOI: 10.1016/j.soard.2023.03.018