scholarly journals EP.WE.213Short-term impact of COVID-19 on surgical services in a tertiary hospital

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
N Hamer ◽  
A Brown ◽  
V Sharma ◽  
T Jha ◽  
D Garg ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Service Provision ◽  
Tertiary Hospital ◽  
Healthcare Systems ◽  
Surgical Service ◽  
Surgical Services ◽  
Tertiary Centre ◽  
Additional Strain ◽  
The Uk ◽  
And Training

Abstract Aim Since December 2019, SARS-CoV-2 has dramatically impacted the global landscape. One of the biggest challenges has been the additional strain put on healthcare systems. Although there are numerous studies on the effects of COVID-19 on intensive care beds and ventilator availability, there has been little exploration into the wider impacts of COVID-19 on the provision of other services. This study was designed to explore how COVID-19 has impacted surgical service provision at a large NHS hospital. Methods We compared the number and types of general surgical procedures carried out in a tertiary centre in the six months prior to the UK COVID-19 outbreak (September 2019-February 2020) and the six months after (March 2020-August 2020). Results We found that since March 2020 there has been a 70% decrease in the amount of operations taking place, with numbers dropping from a pre-COVID total of 1761 to a post-COVID total of 529. This mainly affected elective procedures with emergency surgeries remaining relatively constant (48 pre-COVID vs 44 post-COVID). Conclusion COVID-19 has caused a significant decrease in the number of surgeries being undertaken. This is due to a combination of factors including staffing issues, reduced investigative capacity, and national mandates on the cessation of non-urgent procedures. Although this mainly affected elective operations, it will have wider implications on future NHS workload and training. The knock on effects will inevitably result in a rise in delayed and emergency presentations with worse patient outcomes.

EVALUATION OF THE SHORT-TERM IMPACT OF COVID-19 IN A LARGE DISTRICT GENERAL HOSPITAL

2021 ◽  
pp. 14-15
Author(s):  
Natalie Hamer ◽  
Ashley Brown ◽  
Trisha Jha ◽  
Oladiran Olatunbode ◽  
Madan Jha
Keyword(s):  
Intensive Care ◽  
General Hospital ◽  
Service Provision ◽  
District General Hospital ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Surgical Service ◽  
Short Term ◽  
Tertiary Centre ◽  
Additional Strain

Intro: Since December 2019, SARS-CoV-2 has had a dramatic impact on the global landscape. One of the biggest challenges has been the additional strain that the virus has put on healthcare systems. Although there has been much data on the direct affects of COVID-19 on intensive care beds and ventilator availability, there has been little exploration into the wider impacts that the restrictions brought about by COVID-19 have had on the provision of other healthcare services. We designed this study to explore how Aim: COVID-19 has impacted surgical service provision at a tertiary centre. We Methods: compared the number and types of general surgeries carried out at a single hospital in the six months prior to the initial UK COVID-19 outbreak (September 2019 - February 2020) and the six months after (March 2020 - August 2020). We found that since March 2020 there has been a 70% decrease i Results: n the number of operations being carried out, with numbers dropping from a pre-COVID surgery number of 1761 to a post-COVID number of 529. This mainly affected elective procedures however, with emergency surgeries remaining relatively constant (48 pre-COVID vs 44 post-COVID). COVID-19 has Conclusion: caused a signicant decrease in the number of surgeries being undertaken. This is due to a combination of factors including stafng issues, reduced investigation, and national mandates requesting the cessation of non-urgent procedures. Although this has mainly affected elective operations, it is likely to have a larger impact in the future as surgical waiting lists continue to grow

scholarly journals Assembly Line ICU: what the Long Shops taught us about managing surge capacity for COVID-19

2020 ◽  
Vol 9 (4) ◽  
pp. e001117
Author(s):  
Callum Oakley ◽  
Craig Pascoe ◽  
Daivd Balthazor ◽  
Davinia Bennett ◽  
Nandan Gautam ◽  
...  
Keyword(s):  
Critical Care ◽  
Critical Care Unit ◽  
Assembly Line ◽  
Tertiary Hospital ◽  
Multiple Organ ◽  
Adaptive Responses ◽  
Whole Process ◽  
The Uk ◽  
Care Capacity ◽  
And Training

ObjectivesTo safely expand and adapt the normal workings of a large critical care unit in response to the COVID-19 pandemic.MethodsIn April 2020, UK health systems were challenged to expand critical care capacity rapidly during the first wave of the COVID-19 pandemic so that they could accommodate patients with respiratory and multiple organ failure. Here, we describe the preparation and adaptive responses of a large critical care unit to the oncoming burden of disease. Our changes were similar to the revolution in manufacturing brought about by ‘Long Shops’ of 1853 when Richard Garrett and Sons of Leiston started mass manufacture of traction engines. This innovation broke the whole process into smaller parts and increased productivity. When applied to COVID-19 preparations, an assembly line approach had the advantage that our ICU became easily scalable to manage an influx of additional staff as well as the increase in admissions. Healthcare professionals could be replaced in case of absence and training focused on a smaller number of tasks.ResultsCompared with the equivalent period in 2019, the ICU provided 30.9% more patient days (2599 to 3402), 1845 of which were ventilated days (compared with 694 in 2019, 165.8% increase) while time from first referral to ICU admission reduced from 193.8±123.8 min (±SD) to 110.7±76.75 min (±SD). Throughout, ICU maintained adequate capacity and also accepted patients from neighbouring hospitals. This was done by managing an additional 205 doctors (70% increase), 168 nurses who had previously worked in ICU and another 261 nurses deployed from other parts of the hospital (82% increase).Our large tertiary hospital ensured a dedicated non-COVID ICU was staffed and equipped to take regional emergency referrals so that those patients requiring specialist surgery and treatment were treated throughout the COVID-19 pandemic.ConclusionsWe report how the challenge of managing a huge influx of patients and redeployed staff was met by deconstructing ICU care into its constituent parts. Although reported from the largest colocated ICU in the UK, we believe that this offers solutions to ICUs of all sizes and may provide a generalisable model for critical care pandemic surge planning.

scholarly journals Service provision and training for endoscopic ultrasound in the UK

2011 ◽  
Vol 2 (3) ◽  
pp. 188-194 ◽  
Author(s):  
J. Meenan ◽  
K. Harris ◽  
K. Oppong ◽  
C. McKay ◽  
I. Penman ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Service Provision ◽  
The Uk ◽  
And Training

scholarly journals Patient Satisfaction on Surgical Service Decision Time in Emergency Department of A Tertiary Hospital in Indonesia

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Shabrina Adzania ◽  
Nucki Nursjamsi Hidajat ◽  
Elsa Pudji Setiawati
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Tertiary Hospital ◽  
Decision Time ◽  
Satisfaction Level ◽  
Surgical Service ◽  
Cross Sectional ◽  
Surgical Services ◽  
Validated Questionnaire ◽  
Spearman Correlation Test

Background: Patient satisfaction survey is essential for evaluating and developing plans to improve health services' quality. One of the emergency department service quality indicators is decision time. Overcrowding of the emergency room as a result of long decision time may cause dissatisfaction among patients. This study aimed to evaluate the satisfaction level of patients receiving surgical services and the correlation between the satisfaction level and  surgical service decision time.Methods: A cross-sectional descriptive analytical study was conducted from September to November 2019 at the emergency department of Dr. Hasan Sadikin General Hospital. The consecutive sampling method was applied and a total of 110 patients met the inclusion and exclusion criteria. Patient satisfaction was assessed using a validated questionnaire and data on decision time was obtained from the patient’s medical record. Spearman correlation test was used to analyze the data.Results: This study discovered that most of the respondents were satisfied with the service (92.7%) and that decision was mostly made in less than 2 hours (79.1%). A weak negative correlation (ρ = - 0.144), was identified between decision time and patient satisfaction, albeit insignificant (p = 0.067), with a confidence interval of 95% (α = 5%).Conclusion: This study suggested that there is no correlation between patient satisfaction and decision time. Thus, decision time is not the main factor that determines patient satisfaction.

scholarly journals EP.WE.268Impact of COVID-19 on surgical services in a District General Hospital in the UK: benefits versus drawbacks

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Islam El-Abbassy ◽  
Hesham El-Hakim ◽  
Mei Kei Wong ◽  
Robert McIntyre
Keyword(s):  
General Hospital ◽  
District General Hospital ◽  
Surgical Service ◽  
Remote Consultation ◽  
Face To Face ◽  
Surgical Services ◽  
Number Of Patients ◽  
Service Activity ◽  
The Uk ◽  
The Impact

Abstract Background COVID-19 outbreak led to significant changes in health services worldwide. This study aims to assess the impact of this outbreak on the surgical services in a small District General Hospital and to highlight any benefits that we can take forward. Methods Data were collected retrospectively comparing the surgical service activity during the two months (April and May 2020) around the peak of COVID-19 first wave in the UK and the similar two-month period the year before when activity was at its usual pre-COVID level. A short questionnaire on the use and satisfaction of remote consultation was circulated to all hospital consultants. Results The total number of patients presenting to the emergency department in all specialities almost halved during the COVID-19 crisis. The number of emergency surgical admissions decreased. All elective lists were cancelled and more patients were managed conservatively. In April and May 2020, 156 patients had outpatient surgical consultations. Only 14 of them were face-to-face, whereas the rest were done either by telephone or video calls. This is compared to 472 patients who had face-to-face consultations in April and May 2019. The results of the questionnaire showed that over 90% of the consultants felt telemedicine consultations were satisfactory and that they would have an important role in the future. Conclusion COVID-19 had serious impacts on surgical services regarding cancellation of elective lists and prolongation of waiting time. Despite these drawbacks, the increased confidence with telemedicine services was a significant benefit.

‘I’m an expert in me and I know what I can cope with’: Patient expertise in rheumatoid arthritis

2014 ◽  
Vol 10 (3) ◽  
pp. 249-261 ◽  
Author(s):  
Tessa Sanderson ◽  
Jo Angouri
Keyword(s):  
Rheumatoid Arthritis ◽  
Meta Analysis ◽  
Healthcare Systems ◽  
Specific Knowledge ◽  
Active Involvement ◽  
Domain Specific ◽  
Access To Health ◽  
Patient Expertise ◽  
Domain Specific Knowledge ◽  
The Uk

The active involvement of patients in decision-making and the focus on patient expertise in managing chronic illness constitutes a priority in many healthcare systems including the NHS in the UK. With easier access to health information, patients are almost expected to be (or present self) as an ‘expert patient’ (Ziebland 2004). This paper draws on the meta-analysis of interview data collected for identifying treatment outcomes important to patients with rheumatoid arthritis (RA). Taking a discourse approach to identity, the discussion focuses on the resources used in the negotiation and co-construction of expert identities, including domain-specific knowledge, access to institutional resources, and ability to self-manage. The analysis shows that expertise is both projected (institutionally sanctioned) and claimed by the patient (self-defined). We close the paper by highlighting the limitations of our pilot study and suggest avenues for further research.

The Duties of Doctors In Medical Education: A Letter To The Editor (Preprint)

2019 ◽  
Author(s):  
Sneha Barai
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Role Models ◽  
Role Model ◽  
General Medical Council ◽  
Future Generations ◽  
Medical Council ◽  
Positive Role ◽  
The Uk ◽  
And Training

UNSTRUCTURED The UK General Medical Council (GMC) explicitly states doctors have a duty to ‘contribute to teaching and training…by acting as a positive role model’. However, recent studies suggest some are not fulfilling this, which is impacting medical students' experiences and attitudes during their training. As such, doctors have a duty to act as role models and teachers, as specified by the GMC, which it seems are not currently being fulfilled. This would improve the medical students’ learning experiences and demonstrate good professional values for them to emulate. Therefore, these duties should be as important as patient care, since this will influence future generations.

Best practice for chronic oedema in community settings: what can we learn?

2020 ◽  
Vol 25 (12) ◽  
pp. 610-614
Author(s):  
Garry Cooper-Stanton
Keyword(s):  
Service Provision ◽  
Best Practice ◽  
Evidence Base ◽  
Community Services ◽  
Guidance Document ◽  
Community Settings ◽  
Tissue Viability ◽  
Delivery Of Care ◽  
Specialist Nurses ◽  
The Uk

There are various opportunities and challenges in the delivery of care to those diagnosed with chronic oedema/lymphoedema. Service provision is not consistent within the UK, and non-specialist nurses and other health professionals may be called on to fill the gaps in this area. The latest best practice guidance on chronic oedema is directed at community services that care for people within their own homes in primary care. This guide was developed in order to increase awareness, knowledge and access to an evidence base. Those involved in its creation cross specialist fields (lymphoedema and tissue viability), resulting in the document covering a number of areas, including an explanation of chronic oedema, its assessment and management and the association between chronic oedema and wet legs. The document complements existing frameworks on the condition and its management and also increases the available tools within chronic oedema management in the community. The present article provides an overview of the guidance document and discusses its salient features.

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