Introduction
Outcomes in stroke patients are improved by a co-ordinated organisation of stroke services and provision of evidence-based care. We studied the organisation of care and application of ...guidelines in two neighbouring health care systems with similar characteristics.
Methods
Organisational elements of the 2015 National Stroke Audit (NSA) from the Republic of Ireland (ROI) were compared with the Sentinel Stroke National Audit Programme (SSNAP) in Northern Ireland (NI) and the United Kingdom (UK). Compliance was compared with UK and European guidelines.
Results
Twenty-one of 28 ROI hospitals (78%) reported having a stroke unit (SU) compared with all 10 in NI. Average SU size was smaller in ROI (6 beds vs. 15 beds) and bed availability per head of population was lower (1:30,633 vs. 1:12,037 p < 0.0001 Chi Sq). Fifty-four percent of ROI patients were admitted to SU care compared with 96% of UK patients (p < 0.0001). Twenty-four–hour physiological monitoring was available in 54% of ROI SUs compared to 91% of UK units (p < 0.0001). There was no significant difference between ROI and NI in access to senior specialist physicians or nurses or in SU nurse staffing (3.9/10 beds weekday mornings) but there was a higher proportion of trained nurses in ROI units (2.9/10 beds vs. 2.3/10 beds (p = 0.02 Chi Sq).
Conclusion
Whilst the majority of hospitals in both jurisdictions met key criteria for organised stroke care the small size and underdevelopment of the ROI units meant a substantial proportion of patients were unable to access this specialised care.
Virtual practice is increasingly transforming service delivery in many professions, particularly with the rapid shift to virtual work during the COVID-19 pandemic. Regulatory authorities face intense ...pressure to facilitate this type of work while upholding their legal mandate to protect the public. However, there are many legal and ethical complexities associated with regulating professionals who engage in virtual practice. Regulatory activities in the public interest have changed to encompass the following: ensuring that standards provide guidance for virtual practice on topics such as consent, documentation, and privacy 12; changing entry-to-practice requirements to include digital competencies; facilitating interjurisdictional virtual practice through licensure and liability insurance changes 34; and adapting continuing competence requirements and disciplinary procedures to reflect modern digital environments 5. Our knowledge synthesis project is shaped by the question: How is the public interest conceptualized when regulating professionals engaged in virtual practice? To answer this, we are conducting two inter-related activities that we will report on in our presentation: (1) A scoping review to map the diverse and interdisciplinary academic and grey literature on this topic; and (2) Policy case studies to examine specific challenges and promising practices across Canada. These deeper dive case examples include the role of professional regulation in the expansion of for-profit telehealth in British Columbia, implementation of a regulatory sandbox for legal innovation in Ontario, new standards of practice for disruptive technologies in the Canadian optical and dental fields and the impact on competition, and an interjurisdictional registration pilot for nurses in Alberta and Saskatchewan. There has been a recent push for regulatory policy reform based on current evidence 67. This knowledge synthesis will help inform regulatory innovation and research in Canada, particularly given the rapid expansion of digitally-enabled work for regulated professionals over the past year.
Living between the Lines Hoover, Carole (Review of: Calkins, Lucy McCormick; Harwayne, Shelley)
Notes on Literacy,
07/1993, Letnik:
19, Številka:
3
Book Review
Living between the Lines Wilkinson, Lyn (Review of: Calkins, Lucy McCormick; Heinemann, Shelley Harwayne)
Australian Journal of Language and Literacy,
02/1993, Letnik:
16, Številka:
1
Book Review
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