Audit On Quality of Clinical Information Sent From Secondary Care to General Practioner in Merseyside-UK

AbstractThe Institute for Security and Social Services for State Workers (ISSSTE) is a large public provider of health care services that serve around 13.2 million Mexican government workers and their families. To attain process efficiencies, cost reductions, and improvement of the quality of diagnostic and imaging services, ISSSTE was set out in 2019 to create a digital filmless medical image and report management system. A large-scale clinical information system (CIS), including radiology information system (RIS), picture archiving and communication system (PACS), and clinical data warehouse (CDW) components, was implemented at ISSSTE’s network of forty secondary- and tertiary-level public hospitals, applying global HL-7 and Digital Imaging and Communications in Medicine (DICOM) standards. In just 5 months, 40 hospitals had their endoscopy, radiology, and pathology services functionally interconnected within a national CIS and RIS/PACS on secure private local area networks (LANs) and a secure national wide area network (WAN). More than 2 million yearly studies and reports are now in digital form in a CDW, securely stored and always available. Benefits include increased productivity, reduced turnaround times, reduced need for duplicate exams, and reduced costs. Functional IT solutions allow ISSSTE hospitals to leave behind the use of radiographic film and printed medical reports with important cost reductions, as well as social and environmental impacts, leading to direct improvement in the quality of health care services rendered.

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Vision-related Quality of Life in Patients With Glaucoma: the Role of Illness Perceptions

10.21203/rs.3.rs-934290/v1 ◽

2021 ◽

Author(s):

Qiqi Zhang ◽

Wenzhe Zhou ◽

Di Song ◽

Yanqian Xie ◽

Hao Lin ◽

...

Keyword(s):

Quality Of Life ◽

Illness Perceptions ◽

Linear Regression Analysis ◽

Illness Perception ◽

Clinical Information ◽

Cross Sectional Study ◽

Cross Sectional ◽

Illness Perception Questionnaire ◽

Related Quality

Abstract Purpose: To explore the predictive effect of illness perceptions on vision-related quality of life (VRQoL) in Chinese glaucoma patients.Methods: In this cross-sectional study, 97 patients with glaucoma completed the Brief Illness Perception Questionnaire (BIPQ), the Glaucoma Quality of Life-15 (GQL-15), and a questionnaire with sociodemographic and clinical information. Correlation analysis and hierarchical linear regression analysis were performed.Results: The BIPQ total score was positively correlated with the scores of the total GQL-15 and its four dimensions. Chronic comorbidities, type of glaucoma, best-corrected visual acuity (BCVA), mean defect (MD) of visual field in the better eye, and identity in the BIPQ were the critical predictors of VRQoL. Illness perceptions independently accounted for 7.8% of the variance in the VRQoL of glaucoma patients.Conclusions: Patients with stronger illness perceptions who perceive themselves as having more glaucoma symptoms are likely to experience worse VRQoL. Illness perceptions in glaucoma patients deserve clinical attention, and further studies are needed to examine whether cognitive interventions targeting illness perceptions can improve VRQoL.

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Communication and access to information in assessing the quality of multiprofessional care of patients

Einstein (São Paulo) ◽

10.1590/s1679-45082010ao1298 ◽

2010 ◽

Vol 8 (3) ◽

pp. 303-307

Author(s):

Leny Vieira Cavalheiro ◽

Paola Bruno de Araújo Andreoli ◽

Nadia Sueli de Medeiros ◽

Telma de Almeida Busch Mendes ◽

Roselaine Oliveira ◽

...

Keyword(s):

Quality Of Care ◽

Healthcare Professionals ◽

Clinical Information ◽

Relevant Information ◽

Cross Sectional Study ◽

Model Group ◽

Cross Sectional ◽

Multiprofessional Team ◽

Under Performing

ABSTRACT Objective: To assess the quality of a multiprofessional healthcare model for in-hospital patients by means of two performance indicators (communication and knowledge about the case). Methods: A cross-sectional study assessed the knowledge that professionals had about the clinical information of patients and the use of communication strategies by the team. Healthcare professionals were interviewed during their work period. Seven occupational categories were interviewed. A total of 199 medical charts were randomly selected for interviews, and 312 professionals of different categories were interviewed. The sample comprised mostly nurses and physical therapists in the charts that were interviewed. Results: There were no statistically significant differences between the expected performing model group and the under-performing model group for sex, location and job. In the under-performing model group, a larger number of professionals correlated with less knowledge. Communication was improved when nurses had the relevant information about interdisciplinary care (97.4%), appropriate use of the Plan of Care form (97.0%), and formalized discussions with physicians (88.2%). In the expected performing model group, it was observed that the higher the number of healthcare professionals involved, the higher the communication levels. Conclusions: This model of care based on case knowledge and multiprofessional team communication performance indices allowed to assess quality of care. This assessment is measurable and there is the possibility of establishing the quality of care delivered.

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The Nature of Insomnia

CNS Spectrums ◽

10.1017/s1092852900026109 ◽

2007 ◽

Vol 12 (S10) ◽

pp. 3-5 ◽

Cited By ~ 3

Author(s):

Thomas Roth

Keyword(s):

Behavioral Therapy ◽

Clinical Information ◽

Negative Results ◽

Behavioral Therapies ◽

Insomnia Treatment ◽

Treatment Use ◽

Patients Experience ◽

Pharmacologic Agents ◽

Impaired Quality

AbstractInsomnia is a disorder characterized by chronic sleep disturbance associated with daytime disability or distress, such as memory impairment and fatigue, that occurs despite adequate opportunity for sleep. Insomnia may present as difficulty falling/staying asleep or as sleep that is nonrestorative. Studies show a strong correlation between insomnia and impaired quality of life. Pain conditions and depression are commonly associated with insomnia, either as secondary or comorbid conditions. In addition, a greater incidence of anxiety, alcohol and drug dependence, and cardiovascular disease is found in people with insomnia. Data indicate insomnia results from over-engaged arousal systems. Insomnia patients experience increased metabolic rate, body temperature, and heart rate, and elevated levels of norepinephrine and catecholamines. Pharmacologic options for the treatment of insomnia include benzodiazepine hypnotics, a selective melatonin receptor agonist, and sedating antidepressants. However, insomnia may be best treated with cognitive-behavioral therapy and instruction in good sleep hygiene, either alone or in concert with pharmacologic agents. Studies on the effects of insomnia treatment use variable methodologies or do not publish negative results, and there are currently no studies of treatment focusing on morbidity. Further research is necessary to better understand the effects of insomnia therapies on medical and psychiatric disorders.In this Clinical Information Supplement, Thomas Roth, PhD, describes the nature of insomnia and its pathophysiology. Next, Andrew D. Krystal, MD, MS, reviews morbidities associated with insomnia. Finally, Joseph A. Lieberman III, MD, MPH, provides an overview of therapeutics utilized in patients with insomnia, including behavioral therapies and pharmacologic options.

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QOLP-10. PATIENT-REPORTED OUTCOMES DURING TREATMENT FOR GLIOBLASTOMA: SYMPTOM BURDEN AND ASSOCIATED IMPACT ON DAILY LIFE

Neuro-Oncology ◽

10.1093/neuonc/noz175.830 ◽

2019 ◽

Vol 21 (Supplement_6) ◽

pp. vi199-vi199

Author(s):

Meghan Hultman ◽

Megan Tipps ◽

Minda Liu ◽

Nilanjana Banerji ◽

Patricia Bruns ◽

...

Keyword(s):

Quality Of Life ◽

Brain Tumor ◽

Daily Life ◽

Symptom Burden ◽

Clinical Information ◽

Symptom Experience ◽

Surgical Interventions ◽

Patient Reported ◽

Late Treatment

Abstract INTRODUCTION Glioblastoma is the most common primary malignant brain tumor, with an annual incidence of 3–4 new cases per 100,000 people. Despite advances in chemotherapy, radiotherapy, and surgical interventions, prognosis remains poor. Aims of treatment for life-limiting diagnoses should extend beyond increasing survival time to include palliation of symptoms and promotion of quality of life. Here we describe patient-reported symptoms both early and late in the glioblastoma treatment trajectory, as well as their associated interference with daily life. METHODS Fifty patients with newly diagnosed glioblastoma were recruited between September 2015-March 2018. Demographic and clinical information was collected from medical records. Patients also completed the brain tumor-specific MD Anderson Symptom Inventory (MDASI-BT) approximately every 8 weeks from completion of chemoradiation through cessation of active disease treatment. Both individual and categories of related symptoms reported in the initial two (early treatment) and final two (late treatment) MDASI-BT assessments were examined for symptom frequency, severity, and relationships between symptom severity and interference with daily life. Patients still receiving treatment or who completed < 4 total MDASI-BT assessments were excluded from the analysis. RESULTS The most commonly reported symptoms were often, but not always, consistent with the symptoms rated as most severe. This was true for individual symptoms as well as categories of symptoms. The most common/severe symptoms also changed from early to late treatment. Overall symptom burden was positively correlated with symptom interference in daily life (r=0.67, p< 0.0001). Regression analysis identified different symptoms as predictors of interference in early as opposed to late treatment, and these predictors did not necessarily align with the most common/severe symptoms. CONCLUSION Symptom experience for patients with glioblastoma is complex and dynamic. Attention to symptom trajectories for patients with glioblastoma may direct approaches to assessment, early identification, and symptom management, thus promoting better quality of life.

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Using telemedicine to improve access, cost and quality of secondary care for people in prison in England: a hybrid type 2 implementation effectiveness study

BMJ Open ◽

10.1136/bmjopen-2019-035837 ◽

2020 ◽

Vol 10 (2) ◽

pp. e035837 ◽

Cited By ~ 1

Author(s):

Chantal Edge ◽

Julie George ◽

Georgia Black ◽

Michelle Gallagher ◽

Aftab Ala ◽

...

Keyword(s):

Focus Groups ◽

Secondary Care ◽

Normalisation Process Theory ◽

Effectiveness Study ◽

Female Prisoners ◽

Implementation Effectiveness ◽

Hybrid Type ◽

Access Cost

IntroductionPeople in prison tend to experience poorer health, access to healthcare services and health outcomes than the general population. Use of video consultations (telemedicine) has been proven effective at improving the access, cost and quality of secondary care for prisoners in the USA and Australia. Implementation and use in English prison settings has been limited to date despite political drivers for change. We plan to research the implementation of a new prison-hospital telemedicine model in an English county to understand what factors drive or hinder implementation and whether the model can improve healthcare outcomes as demonstrated in other contextual settings.Methods and analysisWe will undertake a hybrid type 2 implementation effectiveness study to gather evidence on both clinical and implementation outcomes. Data collection will be guided by the theoretical constructs of Normalisation Process Theory. We will prospectively collect data through: (1) prisoner/patient focus groups, interviews and questionnaires, (2) prison healthcare, hospital and wider prison staff interviews and questionnaires, (3) routine quality improvement and service evaluation data. Up to four prisons and three hospital settings in Surrey (England) will be included in the telemedicine research, dependent on their telemedicine readiness during the study period. Prisons proposed include male and female prisoners, remand (not yet sentenced) and sentenced individuals and different security categorisations. In addition, focus groups in five telemedicine naïve prisons will provide information on patient preconceptions and concerns surrounding telemedicine.Ethics and disseminationThis study has received National Health Service Research Ethics Committee, Her Majesty’s Prison and Probation Service National Research Committee and Health Research Authority approval. Dissemination of results will take place through peer-reviewed journals, conferences and existing health and justice networks.

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