Regional needs assessment for emergency physician audit and feedback

CJEM ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 542-548
Author(s):  
Rakesh Gupta ◽  
Mathew Mercuri ◽  
Amy McCulloch ◽  
Sandra Monteiro ◽  
George Mastoras ◽  
...  

ABSTRACTObjectivesAudit and feedback is widely used to improve physician performance. Many data metrics are being provided to physicians, yet most of these are driven by the regulatory environment. We sought to conduct a needs assessment of audit and feedback metrics that were most useful to clinicians within our health care region.MethodsWe conducted a Web-based survey of five clinical practice sites in our region and asked that physicians rank 49 clinical practice metrics. In addition, we assessed their readiness for audit and feedback and their preferences for data confidentiality. We collected data on duration of training, gender, and site of practice (academic v. community) allowing for comparison between groups.ResultsA total of 104 emergency medicine physicians participated in the survey (52.3% response rate). There was a significant readiness for participation in audit and feedback activities. Top ranked metrics were emergency department return rates and colleague's assessment of collegiality and quality of care, which were common across all sites. Small yet significant differences were noted between genders and academic v. community practitioners.ConclusionThis study represents the first regional analysis of physician preferences for audit and feedback activities and implementation. It demonstrates that physicians are interested in audit and feedback activities and provides a roadmap for the development of a regional audit and feedback structure. It will also be used as a guiding document for regional change management.

2015 ◽  
pp. 1227-1241
Author(s):  
Leonor Teixeira ◽  
Vasco Saavedra ◽  
Carlos Ferreira ◽  
Beatriz Sousa Santos

This chapter outlines a study that examines the role of Information and Communication Technologies (ICTs) in management of a rare and chronic disease, hemophilia. Evidence in literature shows how the adoption of ICTs can improve the management of chronic conditions. Furthermore, these tools may also give response to rare diseases' needs, while greatly improving the quality of life of those patients. A Web-based application that was developed to facilitate communication between Healthcare Professionals (HCPs) and patients in a specific Hemophilia Treatment Center (HTC), to improve the utility and quality of clinical data and treatment information, as well as to help the management of resources involved in a specific rare chronic disease, represents a practical case presented in this chapter. This technological solution allows the management of inherited bleeding disorders, integrating, diffusing, and archiving large sets of data relating to the clinical practice of hemophilia care, more specifically the clinical practice at the Hematology Service of Coimbra Hospital Center.


Author(s):  
Leonor Teixeira ◽  
Vasco Saavedra ◽  
Carlos Ferreira ◽  
Beatriz Sousa Santos

This chapter outlines a study that examines the role of Information and Communication Technologies (ICTs) in management of a rare and chronic disease, hemophilia. Evidence in literature shows how the adoption of ICTs can improve the management of chronic conditions. Furthermore, these tools may also give response to rare diseases’ needs, while greatly improving the quality of life of those patients. A Web-based application that was developed to facilitate communication between Healthcare Professionals (HCPs) and patients in a specific Hemophilia Treatment Center (HTC), to improve the utility and quality of clinical data and treatment information, as well as to help the management of resources involved in a specific rare chronic disease, represents a practical case presented in this chapter. This technological solution allows the management of inherited bleeding disorders, integrating, diffusing, and archiving large sets of data relating to the clinical practice of hemophilia care, more specifically the clinical practice at the Hematology Service of Coimbra Hospital Center.


2020 ◽  
pp. 191-198

Background: Binocular and accommodative vision problems are common after mild traumatic brain injury (mTBI). Traditionally, the management of visual dysfunctions following mTBI included in-office vision rehabilitation with a trained eye care provider. The concept of providing telehealth for remote vision rehabilitation in mTBI patients is a relatively novel practice that has not been widely utilized until the recent outbreak of the 2019 novel coronavirus (COVID-19) pandemic. Case Report: We describe the implementation of telehealth for remote vision rehabilitation during COVID-19 within the Veterans’ Health Administration (VHA) system in an adult patient with multiple confirmed histories of mTBI. Conclusion: Our telehealth remote vision rehabilitation was successfully implemented utilizing established VHA’s web-based videoconferencing tools. Therapeutic goals identified prior to COVID 19 were addressed without any challenges. The delivery of vision rehabilitation intervention via telehealth allowed for the continuance of services within the home setting that led to improvements in functional vision, decreased perception of performance challenges, and improved quality of life.


2018 ◽  
Author(s):  
Azizeh Khaled Sowan ◽  
Meghan Leibas ◽  
Albert Tarriela ◽  
Charles Reed

BACKGROUND The integration of clinical practice guidelines (CPGs) into the nursing care plan and documentation systems aims to translate evidence into practice, improve safety and quality of care, and standardize care processes. OBJECTIVE This study aimed to evaluate nurses’ perceptions of the usability of a nursing care plan solution that includes 234 CPGs. METHODS A total of 100 nurses from 4 adult intensive care units (ICUs) responded to a survey measuring nurses’ perceptions of system usability. The survey included 37 rated items and 3 open-ended questions. RESULTS Nurses’ perceptions were favorable with more than 60.0% (60/100) in agreement on 12 features of the system and negative to moderate with 20.0% (20/100), to 59.0% (59/100) in agreement on 19 features. The majority of the nurses (80/100, 80.0% to 90/100, 90.0%) agreed on 4 missing safety features within the system. More than half of the nurses believed they would benefit from refresher classes on system use. Overall satisfaction with the system was just above average (54/100, 54.0%). Common positive themes from the narrative data were related to the system serving as a reminder for complete documentation and individualizing patient care. Common negative aspects were related to duplicate charting, difficulty locating CPGs, missing unit-specific CPGs, irrelevancy of information, and lack of perceived system value on patient outcomes. No relationship was found between years of system use or ICU experience and satisfaction with the system (P=.10 to P=.25). CONCLUSIONS Care plan systems in ICUs should be easy to navigate; support efficient documentation; present relevant, unit-specific, and easy-to-find information; endorse interdisciplinary communication; and improve safety and quality of care.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ali Jasem Buabbas ◽  
Tareq Mohammad ◽  
Adel K. Ayed ◽  
Hawraa Mallah ◽  
Hamza Al-Shawaf ◽  
...  

Abstract Background Telepathology is the practice of reviewing and exchanging pathological images through telecommunication systems to obtain diagnoses remotely. Studying the factors that make such a system successful and favourable is important to ensure the merits of its implementation in clinical practice. Objective This study aims to evaluate the success of a telepathology system from the users’ perspectives, using specific evaluation criteria, namely: system quality, information quality, technical service quality, user satisfaction, and benefits. Methods A sequential explanatory mixed methods design was adopted in this study, which consists of two phases. Initially, a questionnaire was distributed via WhatsApp to all of the pathologists (total: 45) working at governmental hospitals in Kuwait. Followed by, semi-structured interviews with ten senior pathologists. Results Forty pathologists responded to the questionnaire, giving an 89% response rate. There were 42.5% of the respondents aged between 35–44 years old, and 52.5% were male. The quantitative results reveal that most of the respondents were satisfied with the quality of the telepathology system with a mean of 2.6025 (Standard Deviation (SD) = 0.47176), whereas they were dissatisfied with the quality of the information with a mean of 2.4100 (SD = 1.580) and the technical support services with a mean of 2.2750 (SD = 0.99535). In addition, there was disagreement on the benefits of telepathology in clinical practice among the pathologists with a mean of 2.4667 (SD = 0.77552). The qualitative results indicate that the lack of interest in and little experience with using the system were behind the general dissatisfaction of most of the respondents. All of the interviewees were satisfied with the performance of the telepathology system and considered it successful; however, the quality of the technical support services, including training workshops, was deemed deficient. Conclusion This study concluded that telepathology system in Kuwait is functioning well and has been successful in its implementation; however, pathologists are dissatisfied with it, mainly due to the deficient quality of the technical support services provided. In addition, the successful implementation of such advanced technologies requires careful steps to be taken on multiple levels: technical, organisational, and managerial. Recommendations were suggested.


Author(s):  
Anna Eleftheriou ◽  
Aikaterini Rokou ◽  
Christos Argyriou ◽  
Nikolaos Papanas ◽  
George S. Georgiadis

The impact of coronavirus infectious disease (COVID-19) on medical education has been substantial. Medical students require considerable clinical exposure. However, due to the risk of COVID-19, the majority of medical schools globally have discontinued their normal activities. The strengths of virtual teaching now include a variety of web-based resources. New interactive forms of virtual teaching are being developed to enable students to interact with patients from their homes. Conversely, students have received decreased clinical training in certain medical and surgical specialities, which may, in turn, reduce their performance, confidence, and abilities as future physicians. We sought to analyze the effect of telemedicine on the quality of medical education in this new emerging era and highlight the benefits and drawbacks of web-based medical training in building up future physicians. The COVID-19 pandemic has posed an unparalleled challenge to medical schools, which are aiming to deliver quality education to students virtually, balancing between evidence-based and experience-based medicine.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eun-Sil Choi ◽  
Hyun-Sun Jeon ◽  
So-Jung Mun

Abstract Background This cross-sectional study aimed to examine the relationship between sleep habits and oral disease symptoms in adolescents. Methods Among 62,276 adolescents who participated in the 13th Korea Youth Risk Behavior Web-based Survey (2017), we selected a total of 54,766 adolescents (age, 12–18 years; male, 49.9%) for the final analysis, after excluding those who did not report their sleep duration. The 13th Korea Youth Risk Behavior Web-based Survey data were obtained from a stratified, multistage, clustered sample. Independent variables included general characteristics, oral health behavior, sleep types, sleep duration, and sleep quality; dependent variables comprised oral disease symptoms. Sleep was categorized according to bedtime astype A (bedtime < 1 a.m.) and type B (bedtime ≥ 1 a.m.). Data were analyzed using logistic regression analysis. Statistical significance was set at p < 0.05. Results After adjusting for all covariates, adolescents with type A sleep had a higher risk of toothache on chewing (OR = 1.08, 95% CI 1.02–1.15) than adolescents with type B. Adolescents who slept for 6 h or less each night had a higher risk of pain in the tongue and buccal mucosa (OR = 1.35, 95% CI 1.18–1.54), gingival pain, and bleeding (OR = 1.31, 95% CI 1.19–1.45) than those who slept for more than 8 h. Adolescents with low quality of sleep had a higher risk of toothache or throbbing (OR = 1.70, 95% CI 1.60–1.81), toothache on chewing (OR = 1.73, 95% CI 1.65–1.82), and halitosis (OR = 1.51, 95% CI 1.41–1.59) than those with high quality of sleep. Conclusions Our findings indicate that some oral symptoms are related to sleep duration and quality. It is essential to inculcate good sleeping habits in adolescents by emphasizing the effects of inadequate sleep duration and quality.


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