BACKGROUND:In 2013 a General Practitioner Cooperative(GPC) was introduced at the Emergency Department(ED) of our hospital.One of the aims of this co-located GPC was to improve throughput of the remaining patients at t...BACKGROUND:In 2013 a General Practitioner Cooperative(GPC) was introduced at the Emergency Department(ED) of our hospital.One of the aims of this co-located GPC was to improve throughput of the remaining patients at the ED.To determine the change in patient flow,we assessed the number of self-referrals,redirection of self-referrals to the GPC and back to the ED,as well as ward and ICU admission rates and length of stay of the remaining ED population.METHODS:We conducted a four months' pre-post comparison before and after the implementation of a co-located GPC with an urban ED in the Netherlands.RESULTS:More than half of our ED patients were self-referrals.At triage,54.5%of these selfreferrals were redirected to the GPC.After assessment at the GPC,8.5%of them were referred back to the ED.The number of patients treated at the ED declined with 20.3%after the introduction of the GPC.In the remaining ED population,there was a significant increase of highly urgent patients(P<0.001),regular admissions(P<0.001),and ICU admissions(P<0.001).Despite the decline of the number of patients at the ED,the total length of stay of patients treated at the ED increased from 14 682 hours in the two months' control period to 14 962 hours in the two months' intervention period,a total increase of 270 hours in two months(P<0.001).CONCLUSION:Introduction of a GPC led to efficient redirection of self-referrals but failed to improve throughput of the remaining patients at the ED.展开更多
Reflection is considered crucial and widely used in educational setting to help teachers to question their teaching practice and promote their professional development.Be a reflective practitioner is very important bo...Reflection is considered crucial and widely used in educational setting to help teachers to question their teaching practice and promote their professional development.Be a reflective practitioner is very important both for inservice and preservice teachers.Through reflecting on routine teaching practices,teachers can identify the strengths and weaknesses of each session and make improvements upon the inadequacies so that to promote and enhance professional development and practice.In this article,a reflective teacher presents her developing process as a reflective practitioner which is encouraging and inspiring to provide other practitioners in the similar context with a different perspective and reference.展开更多
A general practitioner(普通医生),a psychiatrist(精神病医生),a surgeon(外科医生),and a psthologist(病理学家)went duck hunting.It wasn’t long before they saw a birdfly over.The GP raised hfs rifle,aimed,and said,“I’m...A general practitioner(普通医生),a psychiatrist(精神病医生),a surgeon(外科医生),and a psthologist(病理学家)went duck hunting.It wasn’t long before they saw a birdfly over.The GP raised hfs rifle,aimed,and said,“I’m not mally sure that is a duck.”展开更多
文摘BACKGROUND:In 2013 a General Practitioner Cooperative(GPC) was introduced at the Emergency Department(ED) of our hospital.One of the aims of this co-located GPC was to improve throughput of the remaining patients at the ED.To determine the change in patient flow,we assessed the number of self-referrals,redirection of self-referrals to the GPC and back to the ED,as well as ward and ICU admission rates and length of stay of the remaining ED population.METHODS:We conducted a four months' pre-post comparison before and after the implementation of a co-located GPC with an urban ED in the Netherlands.RESULTS:More than half of our ED patients were self-referrals.At triage,54.5%of these selfreferrals were redirected to the GPC.After assessment at the GPC,8.5%of them were referred back to the ED.The number of patients treated at the ED declined with 20.3%after the introduction of the GPC.In the remaining ED population,there was a significant increase of highly urgent patients(P<0.001),regular admissions(P<0.001),and ICU admissions(P<0.001).Despite the decline of the number of patients at the ED,the total length of stay of patients treated at the ED increased from 14 682 hours in the two months' control period to 14 962 hours in the two months' intervention period,a total increase of 270 hours in two months(P<0.001).CONCLUSION:Introduction of a GPC led to efficient redirection of self-referrals but failed to improve throughput of the remaining patients at the ED.
文摘Reflection is considered crucial and widely used in educational setting to help teachers to question their teaching practice and promote their professional development.Be a reflective practitioner is very important both for inservice and preservice teachers.Through reflecting on routine teaching practices,teachers can identify the strengths and weaknesses of each session and make improvements upon the inadequacies so that to promote and enhance professional development and practice.In this article,a reflective teacher presents her developing process as a reflective practitioner which is encouraging and inspiring to provide other practitioners in the similar context with a different perspective and reference.
文摘A general practitioner(普通医生),a psychiatrist(精神病医生),a surgeon(外科医生),and a psthologist(病理学家)went duck hunting.It wasn’t long before they saw a birdfly over.The GP raised hfs rifle,aimed,and said,“I’m not mally sure that is a duck.”
