The Patient Outcomes of Surgery-Hand/Arm (POS-Hand/Arm): A New Patient-Based Outcome Measure

2006 ◽  
Vol 2006 ◽  
pp. 278-279
Author(s):  
K.C. Chung
Keyword(s):  
Patient Outcomes ◽  
Outcome Measure

scholarly journals Variation in end-stage renal disease patient outcomes: what we know, what should we know, and how do we find it out?

1993 ◽  
Vol 3 (11) ◽  
pp. 1738-1747
Author(s):  
P Kurtin ◽  
A R Nissenson
Keyword(s):  
Patient Outcomes ◽  
Outcome Measure ◽  
Disease Patient ◽  
Patient Specific ◽  
Quality Cost ◽  
Current State ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

The size and expense of the ESRD program exceed all predictions made when the program was first initiated. Although the effectiveness of dialytic therapy is unquestioned, its value (quality/cost) is actively debated in this era of constricting resources. To better evaluate the quality of the ESRD program, it is essential to first define and quantitate the outcomes of dialytic care. Although mortality is a convenient outcome measure, it may be affected by many patient-specific as well as other factors that must be considered when evaluating and comparing new and existing technologies or advances. Quality of life is only beginning to be used in depth as an outcome measure, and much work is needed to standardize research methodology and thus move this area forward. The following review describes the current state of knowledge regarding outcomes of ESRD patients and proposes areas for future investigation, which should help increase the understanding of the value of the ESRD program to patients, providers, and payors.

scholarly journals The Ability to Provide Quality Chest Compressions Over Lacrosse Shoulder Pads

2018 ◽  
Vol 53 (2) ◽  
pp. 122-127 ◽  
Author(s):  
Richard J. Boergers ◽  
Thomas G. Bowman ◽  
Monica R. Lininger
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Patient Outcomes ◽  
Perceived Exertion ◽  
Outcome Measure ◽  
Athletic Trainers ◽  
Sudden Cardiac Arrest ◽  
Rating Of Perceived Exertion ◽  
Chest Compressions ◽  
Compression Depth ◽  
Placement Accuracy

Context:  Performance of quality cardiopulmonary resuscitation is essential for improving patient outcomes. Performing compressions over football equipment inhibits compression depth and rate, but lacrosse equipment has not yet been studied. Objective:  To assess the effect of lacrosse shoulder pads on the ability to provide quality chest compressions on simulation manikins. Design:  Crossover study. Setting:  Simulation laboratory. Patients or Other Participants:  Thirty-six athletic trainers (12 men: age = 33.3 ± 9.7 years; 24 women: age = 33.4 ± 9.8 years). Main Outcome Measure(s):  No shoulder pads (NSP), Warrior Burn Hitman shoulder pads (WSP), and STX Cell II shoulder pads (SSP) were investigated. Outcomes were chest-compression depth (millimeters), rate (compressions per minute), rating of perceived exertion (0−10), hand-placement accuracy (%), and chest recoil (%). Results:  We observed a difference in mean compression depth among shoulder-pad conditions (F2,213 = 3.73, P = .03, ω2 = 0.03), with a shallower depth during the WSP (54.1 ± 5.8 mm) than the NSP (56.8 ± 5.7 mm; P = .02) trials. However, no differences were found in mean compression rate (F2,213 = 0.87, P = .42, ω2 = 0.001, 1–β = .20). We noted a difference in rating of perceived exertion scores (F2,213 = 16.41, P < .001, ω2 = 0.12). Compressions were more difficult during the SSP condition (4.1 ± 1.3) than during the NSP (2.9 ± 1.2; P < .001) and WSP (3.3 ± 1.1; P = .002) conditions. A difference was present in hand-placement accuracy among the 3 shoulder-pad conditions (χ22 = 11.14, P = .004). Hand-placement accuracy was better in the NSP than the SSP condition (P = .002) and the SSP than the WSP condition (P = .001). Conclusions:  Lacrosse shoulder pads did not inhibit the ability to administer chest compressions with adequate rate and depth. With appropriate training to improve hand placement, the pads may be left in place while cardiopulmonary resuscitation is initiated during sudden cardiac arrest.

The Patient Outcomes of Surgery—Head/Neck (POS-Head/Neck): A new patient-based outcome measure

2006 ◽  
Vol 59 (1) ◽  
pp. 65-73 ◽  
Author(s):  
S.J. Cano ◽  
J.P. Browne ◽  
D.L. Lamping ◽  
A.H.N. Roberts ◽  
D.A. McGrouther ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Outcome Measure ◽  
Head Neck

The Patient Outcomes of Surgery-Hand/Arm (Pos-Hand/Arm): A New Patient-Based Outcome Measure

2004 ◽  
Vol 29 (5) ◽  
pp. 477-485 ◽  
Author(s):  
S. J. CANO ◽  
J. P. BROWNE ◽  
D. L. LAMPING ◽  
A. H. N. ROBERTS ◽  
D. A. MCGROUTHER ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Outcome Measure ◽  
Postal Survey ◽  
Clinical Change ◽  
New Techniques ◽  
Post Surgery ◽  
Before And After ◽  
Three Stages ◽  
Surgical Teams ◽  
Effectiveness Studies

The purpose of this study was to develop and validate a new patient-based outcome measure for hand/arm disorders for use in audit, clinical trials and effectiveness studies. There were three stages. First, we carried out interviews with 40 patients with hand/arm disorders to develop and pilot questionnaire content. Second, in a postal survey with 165 pre- and 181 post-surgery patients, we reduced the number of items and identified scales. Third, in a postal survey with 132 pre- and 204 post-surgery patients we evaluated the psychometric properties of the measure. Findings confirmed the acceptability, reliability, validity and responsiveness to clinical change of the questionnaire. The Patient Outcomes of Surgery-Hand/Arm (POS-Hand/Arm) is a new surgical outcome measure that can be used before and after surgery (29 and 33 items, respectively) to evaluate and compare new techniques, surgical teams and units.

Detecting change in patient outcomes in a rural ambulatory rehabilitation service: the responsiveness of Goal Attainment Scaling and the Lawton Scale

2016 ◽  
Vol 40 (1) ◽  
pp. 63 ◽  
Author(s):  
Louis Baggio ◽  
David J. Buckley
Keyword(s):  
Confidence Interval ◽  
Activities Of Daily Living ◽  
Patient Outcomes ◽  
Daily Living ◽  
Goal Attainment ◽  
Outcome Measure ◽  
Rehabilitation Service ◽  
Rehabilitation Services ◽  
Goal Attainment Scaling ◽  
Ambulatory Rehabilitation

Objective The Wagga Wagga Ambulatory Rehabilitation Service (WWARS) clinicians felt the Australian Modified Lawton’s Instrumental Activities of Daily Living Scale (Lawton Scale) was unresponsive to changes detected in many patients following their individualised programs. This study examined the performance of the Goal Attainment Scaling (GAS) concomitantly with the Lawton Scale in ambulatory rehabilitation patients. Methods Consecutive patients (n = 83) of WWARS were evaluated pre and post treatment with the Lawton Scale and GAS. The statistical properties, particularly responsiveness, of the scales were compared. Results Statistically significant change (P < 0.001) was observed following treatment on both the Lawton Scale and GAS. Mean GAS scores changed by 38.7% compared with 8.3% for the Lawton Scale. GAS demonstrated a greater effect size (Cliff’s δ) of 1.67 (95% confidence interval 1.51–1.91) than the Lawton Scale 0.83 (95% confidence interval 0.57–0.94). In 33.7% of patients, the Lawton Scale was invariant but improved with GAS. Conclusions GAS was a more responsive measure than the Lawton Scale in rural ambulatory rehabilitation patients. Consequently, GAS is recommended as a performance outcome measure in the evaluation of ambulatory rehabilitation services to supplement standardised outcome measures such as the Lawton Scale. What is known about the topic? GAS has been shown to be more responsive in detecting changes in patient outcomes than the original Lawton’s Instrumental Activities of Daily Living Scale when assessing the requirements of the elderly for geriatric services and for people with acquired brain injury undergoing cognitive rehabilitation. Its responsiveness in patients with greater casemix diversity, such as those found in rural ambulatory rehabilitation services, remains uncertain. What does this paper add? This study demonstrates GAS is more responsive than the Lawton Scale for detecting clinically meaningful change in a rural Australian ambulatory rehabilitation service delivering programs to people with heterogeneous goals. What are the implications for practitioners? GAS facilitates the delivery of patient-centred care, accommodates the heterogeneity of patient-centred goals for evaluation, and better measures goal-achievement. Global standardised measures such as the Lawton Scale may be useful for the comparison of differing patient populations, but a weakness is they may not capture the individualised goals valued by each patient seen in rehabilitation. Consequently, GAS should be considered as an additional outcome measure in the evaluation of ambulatory rehabilitation services in assessing program effectiveness and possibly for service comparison. Furthermore, ongoing training and support in GAS application should be provided to ensure the maintenance of accurate goal setting and scaling.

scholarly journals P15 Admission avoidance in acute epistaxis: a prospective national audit during the initial peak of the COVID-19 pandemic

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
◽  
Chloe Swords
Keyword(s):  
Emergency Department ◽  
Patient Outcomes ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Presentation Rate ◽  
Binary Logistic Regression ◽  
Primary Outcome Measure ◽  
Binary Logistic Regression Analysis ◽  
National Audit ◽  
Initial Peak

Abstract Introduction In March 2020, UK epistaxis guidelines were issued incorporating major shifts in standard practice, namely the recommended use of dissolvable products and discharge of patients with non-dissolvable packs. The aim of this audit was to assess patient outcomes following epistaxis care during the initial COVID-19 peak, exploring factors relating to unscheduled re-presentations. Methods A UK-wide prospective multicentre national audit was performed over 12-weeks from 6th April 2020 at ENT departments treating adults with epistaxis. The primary outcome was re-presentation within 10-days. Univariable binary logistic regression analysis was used to identify significant determinants of the primary outcome measure. Results 83 centres from all four UK nations submitted 2,631 cases, the majority of which were Emergency Department (ED) referrals (89.7%). ENT clinicians used a dissolvable intranasal product in 34.7% of patients overall (n = 816/2,351), and in 61.1% of those receiving an intranasal product (n = 816/1,336). 54.6% were discharged from the ED following ENT review. The overall re-presentation rate was 19.5% for ED discharges (n = 245/1,259) and 9.9% for ED admissions (n = 104/1,046). 6.8% of ED discharges and 5.7% of ED admissions were admitted following their re-presentations (n = 86 and 60 respectively). Not being packed by ED clinicians, antiplatelet medications, failed cautery and recent epistaxis treatment were predictors of re-presentation within 10-days. Discussion Re-presentation data were similar to the 2016 UK Epistaxis Audit, however, there was a notable shift towards alternative packing techniques and reduced admission. This highlights that many patients who would previously have necessitated admission may be safely discharged from ED.

scholarly journals Patient outcomes in orthopaedic surgery

2008 ◽  
Vol 90 (6) ◽  
pp. 192-193
Author(s):  
Stephen Cannon
Keyword(s):  
High School ◽  
Patient Outcomes ◽  
Orthopaedic Surgery ◽  
Outcome Measure ◽  
Patient Reported Outcome ◽  
Patient Reported Outcome Measure ◽  
Seaside Resort ◽  
Patient Reported ◽  
Measuring Outcomes ◽  
Short Time

Until a short time ago an orthopaedic surgeon could be forgiven for thinking that a PROM was an attractive stretch of land found in many a seaside resort or perhaps an over-hyped end-of-term event at an American high school. However, the day of the patient-reported outcome measure is now with us – and justifiably so. I think that it is only by truly measuring outcomes that we can receive an informed 360-degree appraisal of our efforts.

The measurement of patient outcomes

1993 ◽  
Vol 101 ◽  
pp. 55-75
Author(s):  
Simon A. Naji ◽  
Trevor A. Sheldon
Keyword(s):  
Patient Outcome ◽  
Patient Outcomes ◽  
Final Section ◽  
Outcome Measure ◽  
Outcome Measurement ◽  
Main Section ◽  
Different Types ◽  
Patient Outcome Measure

In this chapter, we describe the role of patient outcome measurement in quality assurance under six main section headings. In the first section: ‘Why measure outcomes?’, we attempt to state a clear and logical case for considering the inclusion of patient outcome measurement in all systematic assessments of the quality of health care. In, ‘Problems of measuring patient outcomes’, we acknowledge and elaborate upon some of the commonly encountered theoretical and practical difficulties of patient outcome measurement, and upon some of the ways in which such issues might be addressed within specific contexts. The third section: ‘Characteristics of a good measure’, considers some of the basic scientific and practical properties which should be considered when choosing a patient outcome measure for a particular context. ‘Types of measures’ considers some of the general features of the different types of measures currently available. ‘Quality of Life’, looks more closely some theoretical and practical aspects of that particular, and increasingly popular, area of patient outcome measurement. The final section offers a summary description of where we are now, and where we can go from here.

The effectiveness of interruptive prescribing alerts in ambulatory CPOE to change prescriber behaviour & improve safety

2021 ◽  
pp. bmjqs-2020-012283
Author(s):  
Oliver Cerqueira ◽  
Mohsain Gill ◽  
Bishr Swar ◽  
Katherine Ann Prentice ◽  
Shannon Gwin ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Search Strategy ◽  
Outcome Measure ◽  
Time Lapse ◽  
Current Evidence ◽  
Cochrane Library ◽  
Order Entry ◽  
Rapid Transition ◽  
Collection Form ◽  
The Cochrane Library

BackgroundPrescribing alerts of an electronic health record are meant to be protective, but often are disruptive to providers. Our goal was to assess the effectiveness of interruptive medication-prescriber alerts in changing prescriber behaviour and improving patient outcomes in ambulatory care settings via computerised provider order entry (CPOE) systems.MethodsA standardised search strategy was developed and applied to the following key bibliographical databases: PubMed, Embase, CINAHL and The Cochrane Library. Non-comparison studies and studies on non-interrupted alerts were eliminated. We developed a standardised data collection form and abstracted data that included setting, study design, category of intervention alert and outcomes measured. The search was completed in August 2018 and repeated in November of 2019 and of 2020 to identify any new publications during the time lapse.ResultsUltimately, nine comparison studies of triggered alerts were identified. Each studied at least one outcome measure illustrating how the alert affected prescriber decision-making. Provider behaviour was influenced in the majority, with most noting a positive change. Alerts decreased pharmaceutical costs, moved medications toward preferred medications tiers and steered treatments toward evidence-based choices. They also decreased prescribing errors. Clinician feedback, rarely solicited, expressed frustration with alerts creating a time delay.ConclusionThe current evidence shows a clear indication that many categories of alerts are effective in changing prescriber behaviour. However, it is unclear whether these behavioural changes lead to improved patient outcomes. Despite the rapid transition to CPOE use for patient care, there are few rigorous studies of triggered alerts and how workflow interruptions impact patient outcomes and provider acceptance.

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