A robust clinical review process: the catalyst for clinical governance in an Australian tertiary hospital.

Objective: To determine if a robust clinical review process can influence an organisation's response to adverse patient outcomes.

Design And Setting: Retrospective analysis of the activity and outputs of the Clinical Review Committee (CRC) of a university-affiliated tertiary hospital from 1 September 2002 to 30 June 2006.

Main Outcome Measures: Engagement of clinicians (number on CRC, number interviewed for the clinical review process, number of specific referrals from clinicians); and numbers of cases reviewed, system issues identified, recommendations made to the hospital board, and ensuing actions.

Impact of intensive educational approach to dietary change in NIDDM.

The aim of this study was to compare the effects of an intensive educational approach incorporating longer time, greater simplicity, repetition, and cognitive motivational techniques with a conventional one in subjects with established non-insulin-dependent diabetes mellitus (NIDDM) whose weight, glycemic control, and diet were not optimal. Subjects were randomly allocated to intensive or conventional education. Of 350 subjects, 70 met the study criteria, which included established NIDDM (greater than or equal to 3 mo), suboptimal recent glycemic control, dietary fat intake greater than or equal to 35% of total energy intake, and body mass index greater than or equal to 25 kg/m2.

Unsatisfactory nutritional parameters in non-insulin-dependent diabetes mellitus.

Four-day food records, body mass index and glycosylated hemoglobin levels were measured in 212 subjects with established non-insulin-dependent diabetes, who volunteered for a trial of educational programmes. Of these subjects, 79% were above their ideal body weights and 75% of subjects had a glycosylated haemoglobin level that was above the normal range. Ninety-five per cent of subjects reported a total fat intake greater than 30% of their total energy intake, and 80% of subjects reported total carbohydrate intake of less than 50% of their total energy intake.