Errors in medical practice are not uncommon and may contribute significantly to health care costs and result in harm to patients 1. The risk of serious drug errors in anaesthesia may be higher than other specialties 2. This is hardly surprising, considering that the average anaesthetist administers at least a quarter of a million drugs during a practice lifetime 3. The reported incidence of drug error during anaesthesia varies considerably from 1:133 (0.75%) to 1:5475 (0.02%) 4-7. Differences in study design and data collection may account for some of this discrepancy. Limited data exist for South Africa 8,9. This prospective study was undertaken to determine the incidence of drug administration errors and near-misses at three tertiary-care hospitals in South Africa. Hospitals A and C had predominantly adult patients and Hospital B was a specialist paediatric hospital. MATERIALS AND METHODS The study was approved by the Ethics Committees of the universities to which the hospitals were affiliated. Anaesthetists were asked to complete a study form for every anaesthetic performed during a six-month period. They were asked to indicate whether a drug administration error or near-miss (an incident with * M.B., Ch.B.

Background Approaches to address unmet mental health care needs in supportive housing settings are needed. Collaborative approaches to delivering psychiatric care have robust evidence in multiple settings, however such approaches have not been adequately studied in housing settings. This study evaluates the implementation of a shifted outpatient collaborative care initiative in which a psychiatrist was added to existing housing, community mental health, and primary care supports in a women-centered supportive housing complex in Toronto, Canada. Methods The initiative was designed and implemented by stakeholders from an academic hospital and from community housing and mental health agencies. Program activities comprised multidisciplinary support for tenants (e.g. multidisciplinary care teams, case conferences), tenant engagement (psychoeducation sessions), and staff capacity-building (e.g. formal trainings, informal ad hoc questions). This mixed methods implementation evaluation sought to understand (1) program activity delivery including satisfaction with these activities, (2) consistency with team-based tenant-centered care and with pre-specified shared lenses (trauma-informed, culturally safe, harm reduction), and (3) facilitators and barriers to implementation over a one-year period. Quantitative data included reporting of program activity delivery (weekly and monthly), staff surveys, and tenant surveys (post-group surveys following tenant psychoeducation groups and an all-tenant survey). Qualitative data included focus groups with staff and stakeholders, program documents, and free-text survey responses. Results All three program activity domains (multidisciplinary supports, tenant engagement, staff capacity-building) were successfully implemented. Main program activities were multidisciplinary case conferences, direct psychiatric consultation, tenant psychoeducation sessions, formal staff training, and informal staff support. Psychoeducation for tenants and informal/formal staff support were particularly valued. Most activities were team-based. Of the shared lenses, trauma-informed care was the most consistently implemented. Facilitators to implementation were shared lenses, psychiatrist characteristics, shared time/space, balance between structure and flexibility, building trust, logistical support, and the embedded evaluation. Barriers were that the initial model was driven by leadership, confusion in initial processes, different workflows across organizations, and staff turnover; where possible, iterative changes were implemented to address barriers. Conclusions This evaluation highlights the process of successfully implementing a shifted outpatient collaborative mental health care initiative in supportive housing. Further work is warranted to evaluate whether collaborative care adaptations in supportive housing settings lead to improvements in tenant- and program-level outcomes.

Objective: To ascertain the frequency of depressive disorder in women after miscarriage.

Objective: To gauge the prevalence of burnout among postgraduate trainees and consultants working in psychiatry department, Services Hospital Lahore, Pakistan. Methods: 31 trainee and consultant psychiatrists in Services Hospital Lahore, Pakistan participated in this cross-sectional study. Abbreviated Maslach Burnout Inventory (aMBI) measured burnout. It consisted of 9 items, relating to emotional exhaustion, depersonalization and personal accomplishment. Each item is scored on a seven-point Likert scale. For Emotional Exhaustion and Depersonalization, higher scores predicted greater burnout; Personal Accomplishment demonstrated the opposite, hence its scores were inverted. Participants with moderate scores in 2 or more dimensions were identified as suffering from burnout syndrome. Data was analyzed by SPSS 25.0. Result: Mean age of participants was 34.87 ± 8.06 years. 52% were female. 58% were consultants, with average experience of 7 years; 61% practiced in more than one place. 32.3% of participants had burnout syndrome. Emotional Exhaustion subscale showed the highest scores i.e. 7.06 ± 3.43. 71% of participants demonstrated moderate or high burnout in this scale. Average Depersonalization score was 2.94 ± 2.42, while that for Personal Accomplishment was 3.29 ± 2.25. Conclusion: A significant portion of the sample reported moderate and high level of emotional exhaustion. On the contrary, we found low levels of depersonalization in the sample. Most psychiatrists reported adequate levels of personal achievement. These results are reassuring because, despite the presence of emotional burnout, psychiatrists still have capacity to empathize and provide adequate patient care. Key Words: burnout, psychiatry, trainees, consultants, Lahore, Pakistan How to cite: But. A., Rahman S., Rahman Minahil. Burnout in Postgraduate Trainees and Consultants working in Psychiatry Departments of Teaching Hospitals in Lahore, Pakistan. Esculapio 2021;71(01):83-87