Utilisation of Antimicrobial Stewardship (AMS) Electronic Interventions (i-Vents) as a metric of pharmacy AMS at Cambridge University Hospitals (CUH) NHS Foundation Trust

BackgroundTelephone consultations are already employed in specific neurological settings. At Cambridge University Hospitals, the COVID-19 pandemic initially prompted almost all face-to-face appointments to be delivered by telephone, providing a uniquely unselected population to assess.ObjectivesWe explored patient and clinician experience of telephone consultations; and whether telephone consultations might be preferable for preidentifiable subgroups of patients after the pandemic.MethodsClinicians delivering neurological consultations converted to telephone between April and July 2020 were invited to complete a questionnaire following each consult (430 respondents) and the corresponding patients were subsequently surveyed (290 respondents). The questionnaires assessed clinician and patient goal achievement (and the reasons for any dissatisfaction). Clinicians also described consultation duration (in comparison to face to face) while patients detailed comparative convenience and preference.ResultsThe majority of clinicians (335/430, 78%) and patients (227/290, 78%) achieved their consultation goals by telephone, particularly during follow-up consultations (clinicians 272/329, 83%, patients 176/216, 81%) and in some disease subgroups (eg, seizures/epilepsy (clinicians 114/122 (93%), patients 71/81 (88%)). 95% of telephone consultations were estimated to take the same or less time than an equivalent face-to-face consultation. Most patients found telephone consultations convenient (69%) with 149/211 (71%) indicating they would like telephone or video consultations to play some role in their future follow-up.ConclusionTelephone consultations appear effective, convenient and popular in prespecified subgroups of neurological outpatients. Further work comparing telephone, video and face-to-face consultations across multiple centres is now needed.

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Bradley, Dr John Richard, (born 28 March 1958), Consultant Physician and Nephrologist, since 1994, and Director of Research and Development, since 1999, Cambridge University Hospitals NHS Foundation Trust; Fellow and Director of Studies in Medicine, Trinity Hall, Cambridge, since 2001

10.1093/ww/9780199540884.013.284574 ◽

2016 ◽

Keyword(s):

Research And Development ◽

University Hospitals ◽

Cambridge University ◽

Consultant Physician

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Troop, Patricia Ann, (Mrs P. A. Dittner), (born 5 April 1948), Deputy Chairman, Cambridge University Hospitals Foundation Trust, 2013–15 (non-executive Director, 2009–10; Senior Independent non-executive Director, 2010–13); independent consultant on public health and health policy, since 2005

10.1093/ww/9780199540884.013.38067 ◽

2007 ◽

Keyword(s):

Public Health ◽

Health Policy ◽

Executive Director ◽

University Hospitals ◽

Cambridge University ◽

Deputy Chairman ◽

Independent Consultant

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Urology general practitioner advice and guidance: A service evaluation of its effectiveness

Journal of Clinical Urology ◽

10.1177/2051415819860373 ◽

2019 ◽

Vol 12 (6) ◽

pp. 455-461

Author(s):

Brendan Berry ◽

Nikesh Thiruchelvam

Keyword(s):

General Practitioner ◽

National Health Service ◽

Secondary Care ◽

Service Evaluation ◽

University Hospitals ◽

Level Of Evidence ◽

Cambridge University ◽

Care Services ◽

Clinical Benefits ◽

Data Points

Objective: This study aims to assess the effectiveness of the Urology Advice and Guidance (A&G) referral pathway within the National Health Service (NHS). It seeks to identify whether the A&G system helps to prevent unnecessary referrals to secondary care services and endeavours to see whether there is any variability in consultant responses to A&G queries, and whether this affects how patients are subsequently managed. Patients and methods: This study uses patient data collected by Cambridge University Hospitals NHS Foundation Trust over a six-month period between 2016 and 2017. The correspondence from 192 A&G referrals was analysed to extract 11 data points from each referral to help analyse the aims of the study. Results: The results showed that almost half of all A&G referrals could be avoided if general practitioners made better use of the urology guidelines made available to them. The results also demonstrated that A&G referrals were more appropriately managed when guidance was given by a consultant with subspecialty interests in line with the referral. Conclusion: The aims of this study were appropriately met, and the study outlines how improvements in the A&G service could offer both financial and clinical benefits to primary and secondary care services alike. Level of evidence: 3b

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Genome-Based Analysis ofEnterococcus faeciumBacteremia Associated with Recurrent and Mixed-Strain Infection

Journal of Clinical Microbiology ◽

10.1128/jcm.01520-17 ◽

2017 ◽

Vol 56 (3) ◽

Cited By ~ 5

Author(s):

Kathy E. Raven ◽

Theodore Gouliouris ◽

Julian Parkhill ◽

Sharon J. Peacock

Keyword(s):

Retrospective Study ◽

Mixed Infection ◽

Pairwise Comparison ◽

Bloodstream Infections ◽

University Hospitals ◽

Recurrence Rates ◽

Content Type ◽

Cambridge University ◽

Time Period ◽

Vancomycin Resistant

ABSTRACTVancomycin-resistantEnterococcus faecium(VREfm) bloodstream infections are associated with high recurrence rates. This study used genome sequencing to accurately distinguish the frequency of relapse and reinfection in patients with recurrentE. faeciumbacteremia and to investigate strain relatedness in patients with apparent VREfm and vancomycin-susceptibleE. faecium(VSEfm) mixed infection. A retrospective study was performed at the Cambridge University Hospitals NHS Foundation Trust (CUH) between November 2006 and December 2012. We analyzed the genomes of 44E. faeciumisolates from 21 patients (26 VREfm isolates from 12 patients with recurrent bacteremia and 18 isolates from 9 patients with putative VREfm/VSEfm mixed infection). Phenotypic antibiotic susceptibility was determined using a Vitek2 instrument. Genomes were compared with those of a further 263E. faeciumisolates associated with bacteremia in patients at CUH over the same time period. Pairwise comparison of core genomes indicated that 10 (71%) episodes of recurrent VREfm bacteremia were due to reinfection with a new strain, with reinfection being more likely with increasing time between the two positive cultures. The majority (78%) of patients with a mixed VREfm and VSEfm infection had unrelated strains. More than half (59%) of study isolates were closely related to another isolate associated with bacteremia from CUH. This included 60% of isolates associated with reinfection, indicating acquisition in the hospital. This study provides the first high-resolution insights into recurrence and mixed infection byE. faeciumand demonstrates that reinfection with a new strain, often acquired from the hospital, is a driver of recurrence.

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