CJEM Articles: Russell D. MacDonald
Displaying 1-4 of 4 results
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November
2005
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Brian Schwartz, Bruce V. Sawadsky, Chris Mazza, P. Richard Verbeek, Russell D. MacDonald
Emergency medical services (EMS) is increasingly recognized to be an integral part of the health care system. Given the expanding role and scope of EMS, there is need for structured education of emergency physicians interested in pursuing subspecialization in EMS. In 2001, a group of academic emergency specialists at the University of Toronto developed the first Canadian EMS Fellowship Program. This paper describes the development, current status, and future directions of this Program. The University of Toronto EMS Fellowship Program may serve as a template for the development of similar programs elsewhere in Canada and internationally.
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September
2004
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Brent Crawford, Russell D. MacDonald, Valerie F. Krym
Objectives: Despite evidence-based clinical practice guidelines for the emergency management of asthma, substantial treatment variation exists. Our objective was to assess compliance with the Canadian Association of Emergency Physicians (CAEP) / Canadian Thoracic Society (CTS) Asthma Advisory Committee's "Guidelines for the emergency management of asthma in adults" in the emergency department (ED) of a university-affiliated tertiary care teaching hospital.
Methods: This retrospective study was conducted in a Canadian inner city adult ED. Investigators reviewed all ED records for the period from Jan. 1, 2001, to Dec. 31, 2001, and identified adult patients (i.e.,
>18 years of age) with a primary ED diagnosis of asthma. Hospital records were then reviewed to document compliance with the CAEP/CTS asthma guidelines. Descriptive statistics, including means, standard deviations and frequencies were used to summarize information.
Results: Overall compliance with the guidelines was 69.6%, (95% confidence interval, 64.7%-74.5%), but compliance ranged from 41.4% for severe asthma, 67.1% for moderate asthma, and 88.6% for mild asthma. Interobserver reliability for compliance assessment was excellent.
Conclusions: Despite publication and dissemination of evidence-based guidelines for the management of acute asthma in adults, guideline compliance at a university-affiliated, inner city, tertiary care teaching hospital ED is suboptimal.
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Needs assessment and staff education to effect long-term change in emergency medicine in rural NepalJuly 2004 6 4Russell D. MacDonald, Valerie F. Krym
Medical work in developing countries is challenging and rewarding. To make a lasting impact on the local community, a health care worker must be willing to listen to the needs of the people. The long-term impact of a needs assessment and staff education on emergency medicine at a rural hospital in Nepal is presented.
The Scheer Memorial Hospital is a 102-bed non-governmental, not-for-profit hospital in Banepa, Nepal. Nepalese and ex-patriot health care professionals staff the hospital. Medical supplies are obtained from local manufacturers or as donations from foreign organizations. The hospital waives fees for those who cannot afford care.
Two academic emergency physicians with expertise in international health undertook a needs assessment to assist in planning for long-term health care goals related to emergency medicine. The assessment focused on health care planning and education of the local health care staff. Based on interviews and objective assessments, a plan was developed and implemented to address 4 key areas: physical plant, equipment, staff training and essential tasks.
Sustainable positive change was accomplished by acknowledging local customs and standards of care, meeting the needs of local health care staff and using available resources.
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July
2000
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Russell D. MacDonald
