scholarly journals Impact of the hospital built environment on treatment satisfaction of psychiatric in-patients

2020 ◽  
pp. 1-12
Author(s):  
Nikolina Jovanović ◽  
Elisabetta Miglietta ◽  
Anja Podlesek ◽  
Adam Malekzadeh ◽  
Antonio Lasalvia ◽  
...  
Keyword(s):  
United Kingdom ◽  
Patient Satisfaction ◽  
Built Environment ◽  
Treatment Satisfaction ◽  
Psychiatric Hospitals ◽  
Hospital Environment ◽  
Patient Treatment ◽  
Single Sex ◽  
Patient Interviews ◽  
The United Kingdom

Abstract Background A hospital built environment can affect patients’ treatment satisfaction, which is, in turn, associated with crucial clinical outcomes. However, little research has explored which elements are specifically important for psychiatric in-patients. This study aims to identify which elements of the hospital environment are associated with higher patient satisfaction with psychiatric in-patient care. Methods The study was conducted in Italy and the United Kingdom. Data was collected through hospital visits and patient interviews. All hospitals were assessed for general characteristics, aspects specific to psychiatry (patient safety, mixed/single-sex wards, smoking on/off wards), and quality of hospital environment. Patients’ treatment satisfaction was assessed using the Client Assessment of Treatment Scale (CAT). Multi-level modelling was used to explore the role of environment in predicting the CAT scores adjusted for age, gender, education, diagnosis, and formal status. Results The study included 18 psychiatric hospitals (7 in Italy and 11 in the United Kingdom) and 2130 patients. Healthcare systems in these countries share key characteristics (e.g. National Health Service, care organised on a geographical basis) and differ in policy regulation and governance. Two elements were associated with higher patient treatment satisfaction: being hospitalised on a mixed-sex ward (p = 0.003) and the availability of rooms to meet family off wards (p = 0.020). Conclusions As hospitals are among the most expensive facilities to build, their design should be guided by research evidence. Two design features can potentially improve patient satisfaction: family rooms off wards and mixed-sex wards. This evidence should be considered when designing or renovating psychiatric facilities.

scholarly journals Open Appendicectomy under Spinal Anesthesia—A Valuable Alternative during COVID-19

2021 ◽  
Vol 07 (02) ◽  
pp. e69-e72
Author(s):  
Dinh Van Chi Mai ◽  
Alex Sagar ◽  
Oliver Claydon ◽  
Ji Young Park ◽  
Niteen Tapuria ◽  
...  
Keyword(s):  
United Kingdom ◽  
Patient Satisfaction ◽  
Spinal Anesthesia ◽  
Stated Preference ◽  
Case Series ◽  
District General Hospital ◽  
Complication Rates ◽  
Open Appendicectomy ◽  
Surgical Department ◽  
The United Kingdom

Abstract Introduction Concerns relating to coronavirus disease 2019 (COVID-19) and general anesthesia (GA) prompted our department to consider that open appendicectomy under spinal anesthesia (SA) avoids aerosolization from intubation and laparoscopy. While common in developing nations, it is unusual in the United Kingdom. We present the first United Kingdom case series and discuss its potential role during and after this pandemic. Methods We prospectively studied patients with appendicitis at a British district general hospital who were unsuitable for conservative management and consequently underwent open appendicectomy under SA. We also reviewed patient satisfaction after 30 days. This ran for 5 weeks from March 25th, 2020 until the surgical department reverted to the laparoscopic appendicectomy as the standard of care. Main outcomes were 30-day complication rates and patient satisfaction. Results None of the included seven patients were COVID positive. The majority (four-sevenths) had complicated appendicitis. There were no major adverse (Clavien-Dindo grade III to V) postoperative events. Two patients suffered minor postoperative complications. Two experienced intraoperative pain. Mean operative time was 44 minutes. Median length of stay and return to activity was 1 and 14 days, respectively. Although four stated preference in hindsight for GA, the majority (five-sevenths) were satisfied with the operative experience under SA. Discussion Although contraindications, risk of pain, and specific complications may be limiting, our series demonstrates open appendicectomy under SA to be safe and feasible in the United Kingdom. The technique could be a valuable contingency for COVID-suspected cases and patients with high-risk respiratory disease.

The Royal Medico-Psychological Association

1969 ◽  
Vol 115 (521) ◽  
pp. 487-488
Keyword(s):  
United Kingdom ◽  
Psychiatric Hospitals ◽  
Postgraduate Teaching ◽  
The United Kingdom ◽  
Education Committee ◽  
And Training

A questionnaire on postgraduate teaching and training facilities was prepared and circulated by the Education Committee late in 1965, and, after approval by Council, the report on this survey has been published (R.M.P.A., 1968). To find out what changes in teaching and training facilities had taken place in up to 21/2 years, a second questionnaire was circulated to all psychiatric hospitals in the United Kingdom approved by the Conjoint Board as providing training for the D.P.M. The second questionnaire was shorter and simpler than the first, some questions of doubtful value being eliminated and others re-phrased to make them less ambiguous.

How the Sans Everything and Ely inquiries put reform of psychiatric hospitals onto the United Kingdom government agenda

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Martin Powell ◽  
Claire Hilton
Keyword(s):  
United Kingdom ◽  
Psychiatric Hospitals ◽  
Historical Case Study ◽  
Historical Case ◽  
Content Type ◽  
Focusing Events ◽  
The United Kingdom ◽  
The Media ◽  
United Kingdom Government ◽  
The 1960S

PurposeThe purpose of this study is to draw on multiple streams analysis (MSA) and to investigate how policy change emerged from two inquiries into allegations of abusive hospital care in National Health Service (NHS) hospitals in the United Kingdom (UK) in the 1960s.Design/methodology/approachThe methodology of this study is regarding a historical case study of two inquiries.FindingsThe Sans Everything and Ely inquiries had the same legal standing and terms of reference, but the second put psychiatric hospital reform on the agenda, while the first did not. The main factor making Ely rather than Sans Everything the turning point seems to have been concerned with “agency”, linked with a few key individuals.Research limitations/implicationsA study of 1960s event necessarily relies heavily on documentary and archival sources, and cannot draw on interviews which are an important ingredient of many case studies.Originality/valueThe originality of the study is to examines inquiries, which have been largely neglected in MSA, despite their obvious potential role in placing issues on the agenda. Previous studies of MSA have devoted little attention to the ability of the media to provide the focus on “focusing events”.

scholarly journals SURG-13. DAY-CASE IMAGE-GUIDED BIOPSY FOR BRAIN TUMOURS: A DECADE OF EXPERIENCE FROM A SINGLE NEUROSURGICAL UNIT IN THE UNITED KINGDOM

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi242-vi242
Author(s):  
Victoria Wykes ◽  
Simon McElligott ◽  
Joy Roach ◽  
Jonathan Duffill ◽  
Crispin Weidmann ◽  
...  
Keyword(s):  
United Kingdom ◽  
Patient Satisfaction ◽  
Brain Tumour ◽  
Brain Tumours ◽  
Enhanced Recovery ◽  
Day Case ◽  
Tissue Samples ◽  
Image Guided ◽  
The United Kingdom ◽  
Guided Biopsy

Abstract In the United Kingdom widespread adoption of day-case image-guided biopsy (DIB) for brain tumour has yet to develop. We review a decade of experience of DIB for suspected supra-tentorial brain tumour and recommend discharge criteria for patients post-operatively. 30-day complications, post-operative admissions into hospital and patient satisfaction are examined. METHODS Published protocols and procedures for DIB of brain tumours were used. Tissue samples were sent for fixed histological preparation without intraoperative neuropathological assessment. All patients undergoing an image-guided biopsy for tumour were retrospectively identified from operative logbooks (01/10/2006–30/09/2016), and information recorded from online records. Patients completed satisfaction questionnaires. RESULTS 706 image-guided biopsies for supratentorial tumour were performed of which approximately 60% were identified pre-operatively as candidates for DIB. 92% of DIB patients were successfully discharged 6 hours postoperatively. 4.5% of DIB patients were admitted directly from the day-case unit following identification of a postoperative haematoma >2 cm diameter on CT head performed at 4 hours. 3/401 DIB patients (< 1%) required surgical evacuation for the haematoma, all made a full recovery, with no delay to commencing their oncological management. A diagnostic accuracy of 98% was achieved. Overall 90% of patients were satisfied about the timing of their discharge from hospital and 92.5 % felt they had enough medical support following discharge. DISCUSSION Conscious sedation with enhanced recovery techniques, lack of intra-operative neuropathological analysis and a stream lined service with robust communication between patients, carers/families and the oncology allied medical professionals has ensured that DIB for diagnosis of tumour is safe, reliable and feasible for most patients and is not associated with increased morbidity or mortality. The procedure is well tolerated with good patient satisfaction. We recommend that patients with a good pre-operative functional baseline, requiring a supra-tentorial biopsy are offered day-case surgery in a dedicated unit specialising in this procedure.

Sign in / Sign up

Export Citation Format

Share Document