A total of 351 women who gave birth in the Paddington and North Kensington Health District were studied in order to establish a factual basis for recording height and shoe size as indicators of pelvic adequacy. Because only 19 women had radiological pelvimetry assessment, type of delivery and length of labour were used as proxy measures of disproportion. Of the 57 women with a shoe size <4;, 21% were delivered by caesarean section compared with 10% of the group with shoe size between 4; and 6 and only 1% of the group with shoe size 36;. Similar relations with height were not generally found. The data were further examined using logistic regression models of the expected percentages of mothers having an adverse delivery. The models confirmed and extended the more simple analysis.
Objectives 1) Identify causes of increased patient wait times in a high‐volume outpatient cancer clinic; and 2) use quality improvement tools to implement changes to reduce patient wait times. Methods Baseline patient wait times for 10 faculty members in the Department of Head and Neck Surgery at the University of Texas MD Anderson Cancer Center (Houston, TX) outpatient head and neck cancer clinic were calculated. Patient workflow and scheduling processes were recorded and analyzed. The faculty with the lowest patient wait times was interviewed, and best practices were identified. Two physicians piloted interventions. Clinic templates were standardized and load‐leveled, and the total patients scheduled per hour was based on the physician's calculated capacity per hour. Paired t tests were used to analyze data, and P values <0.05 were considered significant. Results The baseline patient wait time average was 71 minutes (range 33–122 minutes). Several factors were found to increase patient wait times, including scheduling too many patients in a short time interval at the beginning of clinic hours and exceeding the physician's patient capacity per hour. For physicians implementing changes, the patient wait time was reduced significantly. For physician 3, the average wait time was reduced from 122 minutes to 52 minutes (57% decrease, P < 0.01) For physician 5, the wait time was reduced from an average of 89 minutes to 62 minutes (30% decrease, P < 0.01). Conclusion By applying principles for quality improvement, such as identifying and benchmarking best practices, load‐leveling, and standardizing clinic scheduling, patient wait times were significantly reduced. Level of Evidence 4 Laryngoscope, 130:E151–E154, 2020
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