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Articles by A Businger
Total Records ( 3 ) for A Businger
  A Businger , U Guller and D. Oertli

Hypothesis  The 50-hour workweek limitation for surgical residents in Switzerland has a major effect on surgical training, resident quality of life, and patient care.

Design  Survey study.

Setting  Residencies in Switzerland.

Participants  Surgical residents and surgical consultants.

Main Outcome Measures  An anonymous survey was conducted in Switzerland. Of 93 surgical departments contacted, 52 (55.9%) responded; of their 281 surgical residents and 337 surgical consultants, 405 (65.5%) returned a completed survey.

Results  Residents and consultants indicated a negative effect of the 50-hour workweek limitation on surgical training (62.8% and 77.2%, respectively) and on quality of patient care (43.0% and 70.1%, respectively) (P < .001 for both). Most residents and consultants reported that operative time (76.9% and 73.4%, respectively) and overall operating room experience (73.8% and 84.8%, respectively) were negatively affected by the work hour limitation. Only 8.1% of residents and 4.9% of consultants perceived the work hour limitation as beneficial to surgical training. Conversely, 58.4% of residents and 81.5% of consultants considered that residents' quality of life had improved (P < .001).

Conclusions  Most surgical residents and surgical consultants perceive the work hour limitation as having a negative effect on surgical training and on the quality of patient care. Despite somewhat improved resident quality of life, the work hour limitation for surgical residencies in Switzerland appears to be a failure.

  A Businger , U Stefenelli and U. Guller

Burnout is a pathologic reaction in response to long-term work-related stress. The aim of this study was 2-fold: first, to assess the prevalence and degree of burnout among surgical residents and surgeons in Switzerland and, second, to identify predictors of burnout in the surgical community. Four hundred five of 618 anonymous questionnaires (65.5%) were returned. Among respondents, 3.7% and 35.1% showed high and moderate degrees of burnout, respectively. Respondents with high and moderate degrees of burnout had higher summary scores of perceived stress (P < .001). In multiple logistic regression analysis, the strongest predictors of burnout were poor interaction with nurses, disturbances due to telephone consultations, and high overall workload. To reduce burnout, new work models should be sought, in addition to decreasing work intensity and workload rather than restricting work hours alone.

  J. L Schnipper , C. L Roumie , C Cawthon , A Businger , A. K Dalal , I Mugalla , S Eden , T. A Jacobson , K. J Rask , V Vaccarino , T. K Gandhi , D. W Bates , D. C Johnson , S Labonville , D Gregory , S Kripalani and for the PILL CVD Study Group

Background— Medication errors and adverse drug events are common after hospital discharge due to changes in medication regimens, suboptimal discharge instructions, and prolonged time to follow-up. Pharmacist-based interventions may be effective in promoting the safe and effective use of medications, especially among high-risk patients such as those with low health literacy.

Methods and Results— The Pharmacist Intervention for Low Literacy in Cardiovascular Disease (PILL-CVD) study is a randomized controlled trial conducted at 2 academic centers—Vanderbilt University Hospital and Brigham and Women’s Hospital. Patients admitted with acute coronary syndrome or acute decompensated heart failure were randomly assigned to usual care or intervention. The intervention consisted of pharmacist-assisted medication reconciliation, inpatient pharmacist counseling, low-literacy adherence aids, and tailored telephone follow-up after discharge. The primary outcome is the occurrence of serious medication errors in the first 30 days after hospital discharge. Secondary outcomes are health care utilization, disease-specific quality of life, and cost-effectiveness. Enrollment was completed September 2009. A total of 862 patients were enrolled, and 430 patients were randomly assigned to receive the intervention. Analyses will determine whether the intervention was effective in reducing serious medication errors, particularly in patients with low health literacy.

Conclusions— The PILL-CVD study was designed to reduce serious medication errors after hospitalization through a pharmacist-based intervention. The intervention, if effective, will inform health care facilities on the use of pharmacist-assisted medication reconciliation, inpatient counseling, low-literacy adherence aids, and patient follow-up after discharge.

Clinical Trial Registration— Identifier: NCT00632021.

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