ART Monitoring: An End to Frequent Clinic Visits and Needle Sticks?

2020 ◽  
pp. 39-53
Author(s):  
Jan Gerris
Keyword(s):  
Needle Sticks ◽  
Clinic Visits

671-P: Patients Feel Responsible for Self-Care and Understand That Clinic Visits Are Vital, but Want More Interim Support

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 671-P
Author(s):  
RACHEL WOLF ◽  
KATE A. YEAGER ◽  
JANE CAUDLE ◽  
CLAIRE WAN ◽  
CATHERINE S. BARNES ◽  
...  
Keyword(s):  
Self Care ◽  
Clinic Visits

scholarly journals Enhancing Patient-Provider Communication With the Electronic Self-Report Assessment for Cancer: A Randomized Trial

2011 ◽  
Vol 29 (8) ◽  
pp. 1029-1035 ◽  
Author(s):  
Donna L. Berry ◽  
Brent A. Blumenstein ◽  
Barbara Halpenny ◽  
Seth Wolpin ◽  
Jesse R. Fann ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Clinic Visit ◽  
Self Report ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Control Group ◽  
Cancer Symptoms ◽  
Patient Reported ◽  
Life Issues ◽  
Clinic Visits

Purpose Although patient-reported cancer symptoms and quality-of-life issues (SQLIs) have been promoted as essential to a comprehensive assessment, efficient and efficacious methods have not been widely tested in clinical settings. The purpose of this trial was to determine the effect of the Electronic Self-Report Assessment–Cancer (ESRA-C) on the likelihood of SQLIs discussed between clinicians and patients with cancer in ambulatory clinic visits. Secondary objectives included comparison of visit duration between groups and usefulness of the ESRA-C as reported by clinicians. Patients and Methods This randomized controlled trial was conducted in 660 patients with various cancer diagnoses and stages at two institutions of a comprehensive cancer center. Patient-reported SQLIs were automatically displayed on a graphical summary and provided to the clinical team before an on-treatment visit (n = 327); in the control group, no summary was provided (n = 333). SQLIs were scored for level of severity or distress. One on-treatment clinic visit was audio recorded for each participant and then scored for discussion of each SQLI. We hypothesized that problematic SQLIs would be discussed more often when the intervention was delivered to the clinicians. Results The likelihood of SQLIs being discussed differed by randomized group and depended on whether an SQLI was first reported as problematic (P = .032). Clinic visits were similar with regard to duration between groups, and clinicians reported the summary as useful. Conclusion The ESRA-C is the first electronic self-report application to increase discussion of SQLIs in a US randomized clinical trial.

scholarly journals 581 The Effects of the COVID Pandemic on Burn Clinic

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S142-S142
Author(s):  
Theresa L Chin ◽  
Rita Frerk ◽  
Victor C Joe ◽  
Sara Sabeti ◽  
Kimberly Burton ◽  
...  
Keyword(s):  
Burn Injury ◽  
Univariate Analysis ◽  
Medical Facility ◽  
Burn Care ◽  
Appointment Date ◽  
Encrypted Communication ◽  
Time Of Presentation ◽  
Staying At Home ◽  
Clinic Visits ◽  
At Home

Abstract Introduction The COVID19 pandemic has led to anxiety and fears for the general public. People were concerned about coming to a medical facility where the virus might be transmitted. Furthermore, stay-at-home orders that were implemented during the pandemic did not apply to clinic visits but contributed to people staying at home even for medical care. We hypothesized that there were delays in burn care due to the pandemic. Methods We queried our clinic data for number of clinic visits and new burn evaluations by month. Patients referred to our clinic from March 15, 2020 to Sept 15, 2020 were reviewed for time of presentation after injury. Days from injury date to clinic referral date and days from clinic referral date to appointment date were calculated. Patients who were referred but did not show and were not seen in our ED were not included because injury date could not be determined. Univariate analysis was performed. Results As seen in Figure 1, our in-person clinic volume decreased in April and May 2020 but rebounded in June 2020 as compared to the number of clinic visits for the same months last year. Similarly, in Figure 2, our new burn evaluations decreased in April and May 2020 compared to our new burn volume from 2019. However, our video telehealth visits increased in March and April then decreased in June-August. Conclusions Our burn clinic remained open to see patients with burn injury throughout the pandemic, however, clinic visits were delayed early in the pandemic. While we had an increase in video telehealth, it does not account for the decrease in clinic visits. This may be due to low enrollment in the electronic medical record encrypted communication platform and/or limited knowledge/access to the technology. Additional care may have been informally given via telephone but not well captured. Furthermore, burn care was delivered in the following months. Additional investigation is necessary to see if the incidence of burn injury decreased.

scholarly journals 594. Characteristics of an At-Risk Patient Population Presenting to a Philadelphia Student-Run Free Clinic within 30 Days of Hospital Visit

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S360-S360
Author(s):  
Kaitlyn Thomesen ◽  
Matthew Lipow ◽  
Tess S Munoz ◽  
Sara K Schultz
Keyword(s):  
At Risk ◽  
Patient Population ◽  
Urgent Care ◽  
Risk Patient ◽  
Syringe Exchange ◽  
Hospital Visit ◽  
Readmission Rates ◽  
Care Clinic ◽  
Medical Needs ◽  
Clinic Visits

Abstract Background 30-day readmission rates are the parameter that hospitals and insurance companies use to measure clinical quality of care and set reimbursement levels for care (McCormack, et al., 2013). The 2019 readmission rate for United States hospitals was 14.9%; however, reported readmission rates vary in accuracy due to exclusion of at-risk populations or patients who seek care outside the hospital network (America’s Health Rankings, 2020; Gupta, et al., 2018). As coordinators of a student-run urgent care clinic operating within a Philadelphia syringe exchange and harm-reduction social services organization, we serve an at-risk patient population that includes a large portion of individuals who are transiently housed, people who engage in sex work, and people who use drugs (PWUD). We sought to determine our at-risk population’s impact on current readmission rates and the ability of hospitalization to meet their unique medical needs. Methods We conducted a retrospective review of 607 electronic charts for patients who sought care at our student run clinic associated with a syringe exchange in Kensington, Philadelphia from January 2017 to January 2020, and identified patients who visited our clinic within 30 days of self-reported hospitalization. We identified time since hospitalization, purpose for hospitalization, and reason for clinic visit. Results Of 607 visits, 100 (16.5%) self-reported hospitalization within 30 days clinic presentation. Of these 100 clinic visits, 64% presented with the same chief complaint as their reason for hospitalization, and 21% presented with a complication related to their hospital visit. 33% of visits associated with previous hospitalization were from infections associated with IV drug use, including abscess, cellulitis, and osteomyelitis. On average, patients presented 7.5 days following hospital departure. Conclusion We identified a high incidence of clinic visits for medical needs associated with recent hospitalization, particularly injection-related infection, which suggests insufficient hospital care for this at-risk population. The number of readmissions for this population is underestimated due to their ability to seek medical care outside of the hospital network. Disclosures All Authors: No reported disclosures

scholarly journals 1042. The Attitude of Patients With HIV about Telehealth for Their HIV Care

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S550-S551
Author(s):  
Dima Dandachi ◽  
Bich Dang ◽  
Thomas Giordano Giordano
Keyword(s):  
Hiv Transmission ◽  
Personal Information ◽  
Critical Role ◽  
Retention In Care ◽  
Hiv Care ◽  
Structural Factors ◽  
Personal Factors ◽  
Response Distribution ◽  
Related Factors ◽  
Clinic Visits

Abstract Background The world is facing a pandemic of SARS-CoV-2 that disrupted our healthcare system and the way we deliver healthcare. For people with HIV (PWH), the ability to be retained in care plays a critical role in improving health outcomes and in preventing HIV transmission. Several definitions exist for retention in care, but they are centered around outpatient clinic visits. It is now more important than ever to understand PWH’s attitudes about using telemedicine for HIV care instead of face-to face clinic visits. Methods We administered a one-time survey to PWH presenting to an outpatient HIV center in Houston, Texas, from February–June 2018. The survey items were used to assess PWH’s attitudes towards and concerns for telehealth and explanatory variables. Results 371 participants completed the survey; median age was 51, 36% were female, and 63% African-American. Overall, 57% of respondents were more likely to use telehealth for their HIV care if available, as compared to one-on-one in-person care, and 37% would use telehealth frequently or always as an alternative to clinic visits. Participants reported many benefits including ability to fit better their schedule, decreasing travel time, and privacy but expressed concerns about the ability to effective communication and examination and the safety of personal information. Factors associated with likelihood of using telehealth include personal factors (US-born, men who have sex with men, higher educational attainment, higher HIV-related stigma perception), HIV-related factors (long standing HIV), and structural factors (having difficulty attending clinic visits, not knowing about or not having the necessary technology). There was no association between participants with uncontrolled HIV, medication adherence, and likelihood of using telehealth. Survey items and response distribution Conclusion Telehealth programs for PWH can improve retention in care. A modification of the definition for retention in care, incorporating telehealth, should be considered. Availability and confidence using various telehealth technologies need to be addressed to increase acceptability and usage of telehealth among PWH. Disclosures All Authors: No reported disclosures

Should Routine Postoperative Clinic Visits Be Phased Out?

2018 ◽  
Vol 7 (1) ◽  
pp. 22-28
Author(s):  
Cristen N. Litz ◽  
Margaret McGuire ◽  
Paul D. Danielson ◽  
Nicole M. Chandler
Keyword(s):  
Clinic Visits

scholarly journals Outpatient clinic visits during heat waves: findings from a large family medicine clinical database

2018 ◽  
Vol 35 (5) ◽  
pp. 567-570 ◽  
Author(s):  
Devesh Vashishtha ◽  
William Sieber ◽  
Brittany Hailey ◽  
Kristen Guirguis ◽  
Alexander Gershunov ◽  
...  
Keyword(s):  
Family Medicine ◽  
Outpatient Clinic ◽  
Heat Waves ◽  
Large Family ◽  
Clinical Database ◽  
Clinic Visits

scholarly journals Difficulty in Assessing Quality of Life Outcomes in a Fluctuating Disease: A Hypothesis Based on Gastroparesis

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Vic Velanovich
Keyword(s):  
Quality Of Life ◽  
Steady State ◽  
Disease Process ◽  
Preliminary Finding ◽  
Median Number ◽  
Underlying Assumption ◽  
Clinical Encounters ◽  
Idiopathic Gastroparesis ◽  
Clinic Visits

An underlying assumption of quality of life outcome research is that after some intervention a “steady-state” of quality of life is reached which can be identified as an endpoint, and, hence, the “outcome.” However, in some disease processes, no so such steady-state is reached. The hypothesis presented is that a disease process with a waxing and waning course will make it difficult to determine a quality of life endpoint. After clinical observation, a pilot study of patients with either diabetic or idiopathic gastroparesis with gastric neurostimulation their records were reviewed to identify the number of clinic visits, the number of clinic visits in which the patients were asymptomatic, much improved, improved, no change, worse, or much worse. These changes were defined as “transitions.” A “transition ratio” was calculated by dividing the number of transitions by the number of clinic visits. Preliminary results showed that of 32 patients, the median number of clinic encounters was 8 (1–35), and the median number of transitions 4 (0–22). The average transition ration was . In the case of gastroparesis, over half of all clinical encounters were associated with a transition. The implication of the hypothesis and preliminary finding suggests a difficulty to identify when the symptomatic endpoint was reached. Other methods to assess the effects of treatment in such a disease process are required to fully understand the effects of treatment on quality of life.

Parental attitude toward unaccompanied clinic visits of adolescents

2008 ◽  
Vol 20 (3) ◽  
Author(s):  
Jacob Urkin ◽  
Natalia Bilenko ◽  
Nurit Barak ◽  
Joav Merrick
Keyword(s):  
Parental Attitude ◽  
Clinic Visits
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