Multidisciplinary team decision is rare and decreasing in percutaneous vascular interventions despite positive impact on in-hospital outcomes

VASA ◽  
2019 ◽  
Vol 48 (3) ◽  
pp. 262-269 ◽  
Author(s):  
Christian-Alexander Behrendt ◽  
Tilo Kölbel ◽  
Thea Schwaneberg ◽  
Holger Diener ◽  
Ralf Hohnhold ◽  
...  
Keyword(s):  
Multidisciplinary Team ◽  
Positive Impact ◽  
Cross Sectional Study ◽  
Invasive Treatment ◽  
Cross Sectional ◽  
Hospital Outcomes ◽  
Vascular Intervention ◽  
Medical Specialties ◽  
Team Decision ◽  
The Impact

Abstract. Background: Worldwide prevalence of peripheral artery disease (PAD) is increasing and peripheral vascular intervention (PVI) has become the primary invasive treatment. There is evidence that multidisciplinary team decision-making (MTD) has an impact on in-hospital outcomes. This study aims to depict practice patterns and time changes regarding MTD of different medical specialties. Methods: This is a retrospective cross-sectional study design. 20,748 invasive, percutaneous PVI of PAD conducted in the metropolitan area of Hamburg (Germany) were consecutively collected between January 2004 and December 2014. Results: MTD prior to PVI was associated with lower odds of early unsuccessful termination of the procedures (Odds Ratio 0.662, p < 0.001). The proportion of MTD decreased over the study period (30.9 % until 2009 vs. 16.6 % from 2010, p < 0.001) while rates of critical limb-threatening ischemia (34.5 % vs. 42.1 %), patients´ age (70 vs. 72 years), PVI below-the-knee (BTK) (13.2 % vs. 22.4 %), and rates of severe TASC C/D lesions BTK (43.2 % vs. 54.2 %) increased (all p < 0.001). Utilization of MTD was different between medical specialties with lowest frequency in procedures performed by internists when compared to other medical specialties (7.1 % vs. 25.7 %, p < 0.001). Conclusions: MTD prior to PVI is associated with technical success of the procedure. Nonetheless, rates of MTD prior to PVI are decreasing during the study period. Future studies should address the impact of multidisciplinary vascular teams on long-term outcomes.

scholarly journals Do Community Free-Medication Service Policy Improve Patient Medication Adherence? A Cross-Sectional Study of Patients With Severe Mental Disorders in Beijing Community

2021 ◽  
Vol 9 ◽  
Author(s):  
Junli Zhu ◽  
Qingzhi Huang ◽  
Wei Lu ◽  
Yun Chen ◽  
Bin Li ◽  
...  
Keyword(s):  
Mental Health ◽  
Medication Adherence ◽  
Mental Health Problems ◽  
Positive Impact ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Patient Medication ◽  
Multi Stage ◽  
Service Policy ◽  
The Impact

Background: Nowadays, mental health problems have become a major concern affecting economic and social development, with severe mental health disorders being the top priority. In 2013, Beijing began to implement the Community Free-Medication Service policy (CFMS). This article aims to evaluate the effect of the policy on medication adherence.Methods: In this study, multi-stage sampling was used to select representative patients as samples. Some of the baseline data were obtained by consulting the archives, and information about patient medication adherence measured by Brooks Medication Adherence Scale was obtained through face-to-face interviews. Logistic regression was used to examine the impact of the policy.Results: Policy participation had a significant positive impact on medication adherence (OR = 1.557). The effect of policy participation on medication adherence in the Medication-only mode and Subsidy-only mode were highly significant, but it was not significant in the Mixed mode.Conclusion: This study found that the CFMS in Beijing as an intervention is effective in improving the medication adherence of community patients. However, the impact of the policy is not consistent among service modes. Reinforcement magnitude and frequency should be considered when designing reinforcement interventions.

scholarly journals What is the impact on the readmission ratio of taking into account readmissions to other hospitals? A cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025740 ◽  
Author(s):  
Karin Hekkert ◽  
Ine Borghans ◽  
Sezgin Cihangir ◽  
Gert P Westert ◽  
Rudolf B Kool
Keyword(s):  
Quality Of Care ◽  
The Netherlands ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Discriminative Ability ◽  
Cross Sectional ◽  
Medical Specialties ◽  
C Statistic ◽  
The Impact

ObjectivesReadmissions are used widespread as an indicator of the quality of care within hospitals. Including readmissions to other hospitals might have consequences for hospitals. The aim of our study is to determine the impact of taking into account readmissions to other hospitals on the readmission ratio.Design and settingWe performed a cross-sectional study and used administrative data from 77 Dutch hospitals (2 333 173 admissions) in 2015 and 2016 (97% of all hospitals). We performed logistic regression analyses to calculate 30-day readmission ratios for each hospital (the number of observed admissions divided by the number of expected readmissions based on the case mix of the hospital, multiplied by 100). We then compared two models: one with readmissions only to the same hospital, and another with readmissions to any hospital in the Netherlands. The models were calculated on the hospital level for all in-patients and, in more detail, on the level of medical specialties.Main outcome measuresPercentage of readmissions to another hospital, readmission ratios same hospital and any hospital and C-statistic of each model in order to determine the discriminative ability.ResultsThe overall percentage of readmissions was 10.3%, of which 91.1% were to the same hospital and 8.9% to another hospital. Patients who went to another hospital were younger, more often men and had fewer comorbidities. The readmission ratios for any hospital versus the same hospital were strongly correlated (r=0.91). There were differences between the medical specialties in percentage of readmissions to another hospital and C-statistic.ConclusionsThe overall impact of taking into account readmissions to other hospitals seems to be limited in the Netherlands. However, it does have consequences for some hospitals. It would be interesting to explore what causes this difference for some hospitals and if it is related to the quality of care.

Evaluation of the Electronic Transmission of Medical Findings from Hospitals to Practitioners by Triangulation

2006 ◽  
Vol 45 (02) ◽  
pp. 225-233 ◽  
Author(s):  
E. Ammenwerth ◽  
T. Schabetsberger ◽  
C. Machan
Keyword(s):  
Health Care ◽  
Electronic Communication ◽  
Positive Impact ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Electronic Networks ◽  
High Satisfaction ◽  
The Impact ◽  
Quantitative And Qualitative Methods

Summary Objectives: The need for regional, cross-institutional electronic networks in health care is steadily growing to support seamless, cooperative health care. The aim of this study is to evaluate the impact of electronic transmission between hospitals and practitioners in a Tyrolean health care network, and to derive technical and organizational points for improvement. Methods: Between March and August 2004 we carried out a triangulation-based cross-sectional study, combining a qualitative study based on semi-structured, problem-centric interviews with selected practitioners, with a quantitative study based on a standardized questionnaire survey of all the Tyrolean practitioners that receive electronic messages. The survey was designed to confirm the hypotheses which have been systematically derived from the interviews. Results and Conclusions: The results show high satisfaction and positive impact of electronic communication. The triangulation of quantitative and qualitative methods was found to be useful in order to make the definition and confirmation of the hypotheses more transparent.

scholarly journals AVALIAÇÃO DO IMPACTO DA CAPACITAÇÃO NO TRABALHO PARA O CUIDADO DE PESSOAS COM ESTOMIAS

2019 ◽  
Vol 10 (3) ◽  
Author(s):  
Juliano Teixeira Moraes ◽  
Alexandre Ernesto Silva ◽  
Tarcísio Laerte Gontijo ◽  
Renato Ferreira Ribeiro ◽  
Rafaela Das Graças Santiago Faria
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Positive Impact ◽  
Education Institution ◽  
Cross Sectional Study ◽  
Training Process ◽  
Cross Sectional ◽  
Primary Health ◽  
Primary Health Care Nurses ◽  
The Impact

Objetivo: Avaliar um processo de capacitação de enfermeiros Atenção Primária da Saúde para o cuidado à saúde da pessoa com estomias produziu impacto no ambiente de trabalho. Método: Estudo transversal, realizado com 32 egressos do processo de capacitação realizado por instituição pública de ensino superior. Foi realizada entrevista e a utilização de um instrumento validado para avaliação do impacto de treinamento. Resultados: Os participantes eram em sua maioria sexo feminino, com idade entre 20 a 40 anos, apresentavam entre 5 e 15 anos de formação e atuavam a menos de 10 anos na Atenção Primária da Saúde. A avaliação demonstrou que a estratégia educativa produziu impacto no trabalho. Conclusão: Estratégias de capacitação que articulam instituições de ensino e serviço favorecem o conhecimento.  Medir o impacto do treinamento no trabalho possibilita avaliar quanto a ação educativa pode propiciar mudança de comportamentos no serviço. Descritores: Estomia; Educação; Capacitação em serviço.EVALUATION OF THE IMPACT CAPACITATION AT WORK FOR THE CARE OF PEOPLE WITH STOMIESObjective: To evaluate the impact of the capacitation of primary health care nurses on the health care of the person with stomies. Methodology: A cross-sectional study was carried out with 32 Primary Health Care nurses who participated in the training process proposed by a public higher education institution in Divinópolis-MG. An interview was conducted using a validated instrument to evaluate the training impact. Results: The evaluation showed that in 11 of the 12 items of the scale, the percentage of concordants (partial and total) is superior to 62%, which showed positive impact of the training process in the work environment. Conclusion: Training strategies that articulate teaching and service institutions favor knowledge. Measuring the impact of on-the-job training makes it possible to evaluate how much the educational action can lead to a change in behavior in the service.Descriptors: Estomy, Education, Training in service.EVALUACIÓN DEL IMPACTO DE LA CAPACITACIÓN EN EL TRABAJO PARA EL CUIDADO DE PERSONAS CON ESTOMIASObjetivo: Evaluar el impacto de la capacitación de enfermeros de la Atención Primaria de Salud para el cuidado a la salud de la persona con estomias. Metodología: Estudio transversal, realizado con 32 enfermeros de la Atención Primaria de la Salud que participaron del proceso de capacitación propuesto por institución pública de enseñanza superior en Divinópolis-MG. Se realizó una entrevista con la utilización de un instrumento validado para evaluar el impacto de entrenamiento. Resultados: La evaluación demostró que en 11 de los 12 ítems de la escala, el porcentaje de concordantes (parciales y totales) son superiores al 62%, lo que demostró impacto positivo del proceso de capacitación en el ambiente de trabajo. Conclusión: Estrategias de capacitación que articulan instituciones de enseñanza y servicio favorecen el conocimiento. Medir el impacto del entrenamiento en el trabajo posibilita evaluar cuánto la acción educativa puede propiciar cambio de comportamientos en el servicio.Descriptores: Estomia, Educación, Capacitación en servicio.

scholarly journals The Role of the Unitary Prevention Delegates in the Participative Management of Occupational Risk Prevention and Its Impact on Occupational Accidents in the Spanish Working Environment

2020 ◽  
Vol 17 (16) ◽  
pp. 5678
Author(s):  
Raúl Payá Castiblanque
Keyword(s):  
Safety Management ◽  
Positive Impact ◽  
Health And Safety ◽  
Cross Sectional Study ◽  
Working Environment ◽  
Occupational Accidents ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Management Indicators ◽  
The Impact

The aim of this research was to study the impact of the unitary prevention delegates (UPDs) on the Spanish working environment. To this end, a cross-sectional study was carried out using microdata from the National Survey on Health and Safety Management in Companies (ENGE-2009) with a sample of 5147 work centres. To measure the relationship between the presence of UPD in workplaces with preventive management indicators and damage to health, individual and multiple logistic regression models were carried out, calculating the crude (cOR) and adjusted (aOR) odds ratios by sociodemographic covariates, with their corresponding 95% confidence intervals (95% CI). Ambivalent results were obtained. On the one hand, a positive impact of the UPDs was found, in the management of prevention showing a higher probability of prevention plans being carried out (aOR = 3.97; 95% CI: 3.26–4.83), risk assessments (aOR = 5.96; 95% CI: 4.44–8.01) and preventive actions were planned (aOR = 3.01; 95% CI: 2.55–3.56), as well as 1.56 times less likely to register minor occupational accidents (aOR = 0.64; 95% CI: 0.53–0.76). On the other hand, the presence of the UPDs did not promote the activation of a participatory culture and did not reduce the probability of suffering serious and fatal accidents at work. In conclusion, UPDs need to activate workers’ participation to improve results.

scholarly journals The impact of lack of affection and poor social ties in the nurses work environment: evidence from a Portuguese sample

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Margarida Ferreira ◽  
Diogo Guedes Vidal ◽  
Carlos Ferreira ◽  
Susana Gregório
Keyword(s):  
Work Environment ◽  
Social Ties ◽  
Positive Impact ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Care Plans ◽  
Nursing Diagnosis ◽  
The Impact ◽  
Doctors And Nurses

Abstract Background Significant evidence has pointed out the positive impact of caring with love. Nurses are the healthcare professionals whose love gives a self–sacrificing spirit. However, little is still know about how lack of affection and unhealthy social ties affects Nurses in the work environment. This study sought to explore the association between affection, social ties and work environment. Methods Descriptive, correlational and cross-sectional study conducted with 36 Nurses of a private hospital in a city of Porto, Portugal. The ‘Fantastic Lifestyle’ and ‘Nursing Practice Work Environment’ scales, adapted and validated to the Portuguese population, with good internal consistency and reliability, were applied. The study was conducted between February and March 2020. Statistical analyses were performed through SPSS. Results Female nurses (80.6%), single (61.1%) and with an average age of 29 years (SD = 5.15) prevailed. 94.4% almost always have someone to talk to about important matters and 88.9% report that they almost always gave and received affection. Weak social ties negatively affect the perception that doctors and nurses have a good working relationship (χ2 = 8.145; P = 0.043) and collaboration (χ2 = 8.145; P = 0.043), resulting in a depreciation of colleagues skills (χ2 = 8.603; P = 0.014). Lack of affection negatively affects the perception of doctors and nurses collaboration (χ2 = 17.708; P = 0.001), the updating of nursing care plans (χ2 = 9.267; P = 0.008) and the relevance of nursing diagnosis applicability (χ2 = 7.650; P = 0.022). Conclusions Findings encourage the need to pay attention to nurses’ affection level and social ties strengthen, once the imbalance of one of these dimensions negatively influences the quality of work environment, impacting the quality of health care provided.

scholarly journals Integrated Clinical Pathways: Communication and Participation in a Multidisciplinary Team

2021 ◽  
Vol 9 (B) ◽  
pp. 1549-1555
Author(s):  
Mateja Šimec ◽  
Sabina Krsnik ◽  
Karmen Erjavec
Keyword(s):  
Health Care ◽  
Clinical Pathway ◽  
Multidisciplinary Team ◽  
Care Delivery ◽  
Clinical Pathways ◽  
Health Care Team ◽  
Cross Sectional Study ◽  
Cost Of Care ◽  
Cross Sectional ◽  
The Impact

BACKGROUND: An integrated clinical pathway (ICP) is a key method for structuring or planning processes of care, enabling the modernization of health-care delivery and coordination of multiple roles, forming a complete, patient-centered multidisciplinary health-care team and establishing the sequence of activities, promoting individual and team communication, collaboration, networking, and transparency, and reducing the cost of care. AIM: As there is a research gap in the area of communication among members of a multidisciplinary team for the treatment of patients through an ICP, the aim of this study was to determine the impact of communication of a member of a multidisciplinary team on the active participation of an individual in this multidisciplinary team. METHODS: A cross-sectional study of three ICPs, forchronic kidney disease, stroke, and total hip arthroplasty was conducted in a typical Slovenian general hospital. RESULTS: The results show that in the analyzed hospital, two of the three clinical pathways are not yet fully integrated. CONCLUSION: There is a weak influence of staff communication within a multidisciplinary team on an individual’s participation in this multidisciplinary team, indicating the need for various activities to actually implement clinical pathway “integration,” and promote better communication within teams to strengthen participation in multidisciplinary patient care pathways.

scholarly journals Impact of formative assessment on the outcome of summative assessment – a feedback based cross sectional study conducted among basic science medical students enrolled in MD program

2017 ◽  
Vol 8 (4) ◽  
pp. 38-43 ◽  
Author(s):  
Sanjib Das ◽  
Kusai M Alsalhanie ◽  
Samal Nauhria ◽  
Vivek R Joshi ◽  
Safeer Khan ◽  
...  
Keyword(s):  
Formative Assessment ◽  
Basic Science ◽  
Positive Impact ◽  
Summative Assessment ◽  
Cross Sectional Study ◽  
Independent Learning ◽  
Medical Sciences ◽  
Weak Point ◽  
Cross Sectional ◽  
The Impact

Background: Assessment is an integral part of all forms of learning. Formative assessment in different forms have evolved as a mean to find the learning gaps (what students already know in compare to what they need to know). As a result it becomes possible to give appropriate feedback to the students to close this gap. Summative assessment on the other hand is purposefully designed to make judgments about students’ performance and produce grades.Aims and Objectives: The main purpose of this study is to explore students’ view with regards to the impact of formative assessment on the outcome of summative assessment in basic science MD program.Materials and Methods: A cross sectional descriptive study was conducted involving 142 students of an International medical school. A questionnaire was designed, pretested, and finally used to record different opinions of the students and data was collected, analyzed, and interpreted.Results: Majority of the respondents (78%) favored that the feedback collected from formative assessment remains important for them as it helps to fill their learning gaps. Respondents by large (76.8%) also agreed that formative assessment helps the faculty to identify student’s weak point. A huge percentage (80.8%) of respondents was in agreement that formative assessment inspires them for deep learning and regular study. However, a fair number of respondents (36.4%) thought that frequently scheduled formative assessment impede their independent learning thus negatively impact their performance in summative exam.Conclusion: Formative assessment if scheduled properly can have a positive impact on the summative assessment.Asian Journal of Medical Sciences Vol.8(4) 2017 38-43

Professionals’ perceptions of the impact of a family justice center: a four-year, cross-sectional study

2020 ◽  
Vol 12 (4) ◽  
pp. 223-238
Author(s):  
Christine Murray ◽  
Alexandra Lay ◽  
Brittany Wyche ◽  
Catherine Johnson
Keyword(s):  
Interpersonal Violence ◽  
Design Methodology ◽  
Positive Impact ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Content Type ◽  
The Family ◽  
The Usa ◽  
The Impact

Purpose The purpose of this study is to explore the perspectives held by professionals affiliated with an FJC through a cross-sectional survey. The family justice center (FJC) model is expanding rapidly in the USA and internationally. Despite the rapid growth of the FJC movement, there is a need for more research to document the impact of FJCs on victims and survivors, professionals working in FJCs and the broader community. Design/methodology/approach The current paper focuses on perspectives of professionals who serve victims of family and interpersonal violence and it includes the results of a four-year, cross-sectional survey of professionals working in a community that established an FJC. Data analyzes examined differences in perspectives of professionals based on timing (i.e. from before an FJC was established to the time when the center was in operation for three years) and based on whether professionals worked primarily onsite at the FJC location. Findings The findings demonstrated that although some statistically significant differences were identified that suggest a positive impact of an FJC for professionals, more research is needed to further explore how professionals’ perspectives and experiences are impacted through the establishment of an FJC. Originality/value This study is the first-known cross-sectional examination of the perspectives of professionals working within an FJC model over a multi-year period.

scholarly journals The impact of maternal health care utilisation on routine immunisation coverage of children in Nigeria: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026324 ◽  
Author(s):  
Onyekachi Ibenelo Anichukwu ◽  
Benedict Oppong Asamoah
Keyword(s):  
Positive Impact ◽  
Cross Sectional Study ◽  
Mediation Effect ◽  
Sectional Study ◽  
Immunisation Coverage ◽  
Cross Sectional ◽  
Routine Immunisation ◽  
Positive Effects ◽  
Birth Attendance ◽  
The Impact

ObjectiveTo examine the impact of maternal healthcare (MHC) utilisation on routine immunisation coverage of children in Nigeria.DesignIndividual level cross-sectional study using bivariate and multivariable logistic regression analyses to examine the association between MHC utilisation and routine immunisation coverage of children.SettingNigeria Demographic and Health Survey 2013.Participants5506 women aged 15–49 years with children aged 12–23 months born in the 5 years preceding the survey.Primary outcome measuresFully immunised children and not fully immunised children.ResultsThe percentage of children fully immunised with basic routine childhood vaccines by the age of 12 months was 25.8%. Antenatal care (ANC) attendance irrespective of the number of visits (adjusted OR (AOR)1–3 visits2.4, 95% CI 1.79 to 3.27; AOR4–7 visits3.2, 95% CI 2.52 to 4.13; AOR≥ 8 visits3.5, 95% CI 2.64 to 4.50), skilled birth attendance (SBA) (AOR 1.9, 95% CI 1.65 to 2.35); and maternal postnatal care (PNC) (AOR 1.7, 95% CI 1.46 to 2.06) had positive effects on the child being fully immunised after adjusting for covariates (except for each other, ie, ANC, SBA and PNC). Further analyses (adjusting stepwise for each MHC service) showed a mediation effect that led to the effect of PNC not being significant.ConclusionsThe percentage of fully immunised children in Nigeria was very low. ANC attendance, SBA and maternal PNC attendance had positive impact on the child being fully immunised. The findings suggest that strategies aimed at maximising MHC utilisation in Nigeria could be effective in achieving the national coverage target of at least 80% for routine immunisation of children.

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