G247(P) A Quality Service Improvement Project on Paediatric Sleep Management in a Paediatric Community Setting

BackgroundCommunity management of atrial fibrillation (AF) often requires the use of electrocardiographic (ECG) investigation. Patients discharged following treatment of AF with fast ventricular response (fast AF) can require numerous ECGs to monitor rate and/or rhythm control. Single-lead ECGs have been proposed as a more convenient and relatively accurate alternative to 12-lead ECGs for rate/rhythm management and also diagnosis of AF. We aimed to examine the feasibility of using the AliveCor single-lead ECG monitor for diagnosis and monitoring of AF in the community setting.MethodsDuring the course of 6 months, this evaluation of a clinical service improvement pathway used the AliveCor in management of patients requiring (1) follow-up ECGs for AF with previously documented rapid ventricular rate or (2) ECG confirmation of rhythm where AF was suspected. Twelve AliveCor devices provided to the acute community medical team were used to produce 30 s ECG rhythm strips (iECG) that were electronically sent to an overreading physician.ResultsSeventy-four patients (mean age 82 years) were managed on this pathway. (1) The AliveCor was successfully used to monitor the follow-up of 37 patients with fast AF, acquiring a combined total of 113 iECGs (median 1.5 ±3.75 per patient). None of these patients required a subsequent 12-lead ECG and this approach saved an estimate of up to £134.49 per patient. (2) Of 53 patients with abnormal pulses, the system helped identify 8 cases of new onset AF and 19 cases of previously known AF that had reverted from sinus back into AF.ConclusionsWe have demonstrated that the AliveCor system is a feasible, cost-effective, time-efficient and potentially safer alternative to serial 12-lead ECGs for community monitoring and diagnosis of AF.

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‘Bikes for Dialysis’: A service improvement project introducing intradialytic exercise to a satellite haemodialysis unit

Physiotherapy ◽

10.1016/j.physio.2021.10.008 ◽

2021 ◽

Vol 113 ◽

pp. e51

Author(s):

S. Gilbert ◽

C. Matthews ◽

D.V. Reddy

Keyword(s):

Service Improvement ◽

Improvement Project ◽

Intradialytic Exercise

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Experiential Learning Curriculum Delivery Approach for Quality Improvement in Resource Limited Settings: Mobile Learning for Point-of-Care Technologies

Global Journal of Health Science ◽

10.5539/gjhs.v11n13p158 ◽

2019 ◽

Vol 11 (13) ◽

pp. 158

Author(s):

Nkosinothando Chamane ◽

Tivani Phosa Mashamba-Thompson

Keyword(s):

Health Care ◽

Primary Health Care ◽

Experiential Learning ◽

Service Delivery ◽

Point Of Care ◽

Service Improvement ◽

Quality Service ◽

Resource Limited Settings ◽

Primary Health ◽

Resource Limited

BACKGROUND: Despite impressive progress that has been made in the provision of health care services to all, the issue of quality service delivery still remains a challenge particularly for point-of-care (POC) diagnostics in resource-limited-settings. Poor competency of primary health care workers in these settings has been shown to be amongst the main contributors to poor quality service delivery. FINDINGS: Participatory-based continuous professional development (CPD) strategies to support technology advancements in health care are recommended. Experiential learning approaches have been shown to be efficient in supplementing traditional teaching methods for both health care students and professionals. These approaches have been shown to further contribute towards continuous skills development and lifelong learning. CONCLUSION: This review therefore provided an overview of literature on experiential learning as one of CPD approaches in relation to health care service improvement in resource-limited setting. In addition, this review has recommended a mobile-based experiential learning approach to help deliver a quality POC technology curriculum to Primary health care-based workers in resource-limited settings.

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A service improvement project exploring the extent of need for allied health care professionals within neuro-oncology in Velindre Cancer Centre.

Neuro-Oncology ◽

10.1093/neuonc/noz167.037 ◽

2019 ◽

Vol 21 (Supplement_4) ◽

pp. iv9-iv9

Author(s):

Rachel Evans ◽

Hayley Williams ◽

Lisa Love-Gould ◽

Owen Tilsley ◽

James Powell ◽

...

Keyword(s):

Patient Education ◽

Health Care Professionals ◽

Service Improvement ◽

Language Therapy ◽

Support Worker ◽

Improvement Project ◽

Cancer Centre ◽

Future Care ◽

Limited Opportunity ◽

Research And Education

Abstract Given the highly complex and holistic needs of neuro-oncology patients, gold standard guidelines recommend that support is best served by a coordinated multi-disciplinary team (MDT) to provide seamless care from diagnosis to end of life (NICE 2018). Allied Healthcare Professionals (AHPs) including occupational therapy (OT), physiotherapy (PT), speech and language therapy (SLT) and dietitians (DT) are recognised as key professions within the MDT. As there is no designated AHP team at Velindre Cancer Centre, input can be reactive and fragmented with limited opportunity for patient education or service developments. The aim of the project was to scope and evaluate the level of AHP need the neuro-oncology population attending Velindre Cancer Centre. A service improvement grant funded a Band 4 Therapies support worker to conduct the project. The project involved a number of elements including the implementation of a revised neuro-oncology screening tool, strategic effort to improve patient education and self-management and engaging patients and staff to guide future service developments. The mixed methods approach yielded rich quantitative and qualitative data. The results demonstrated that whilst AHP input was beneficial to patient care, significant unmet needs were highlighted and demands for services exceeded the teams’ capacity. Therefore a designated neuro-oncology therapies team should be a central consideration for future care to enable timely, responsive, equitable and seamless MDT working. Greater AHP resource would also enable greater AHP involvement in research and education to revolutionise care in order to fully meet the needs of this vulnerable and complex patient group.

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An investigation of the knowledge of intimate partner violence among clinical staff working with male substance misusers

Advances in Dual Diagnosis ◽

10.1108/add-02-2019-0001 ◽

2019 ◽

Vol 12 (3) ◽

pp. 105-116

Author(s):

M. Aurora Falcone ◽

Tim Meynen

Keyword(s):

Intimate Partner Violence ◽

Partner Violence ◽

Intimate Partner ◽

Clinical Staff ◽

Service Improvement ◽

Improvement Project ◽

Senior Staff ◽

Content Type ◽

Knowledge And Skills ◽

Drug And Alcohol

Purpose The purpose of this paper is to describe a Service Improvement Project aimed at assessing the level of knowledge of intimate partner violence (IPV) of clinical staff working in Community Drug and Alcohol Services (CDAS) in four boroughs of South London. Design/methodology/approach Clinical staff (n=90) completed a survey which was based on the Capability Framework (Hughes et al., 2015), developed to describe the key capabilities required to work with men who misuse drug and alcohol and perpetrate IPV. Two separate surveys were prepared for clinical (core) staff (n=76) and for manager (senior) staff (n=14). Findings The Capability Framework provided a useful structure for identifying key strengths and gaps in knowledge and skills related to substance use and IPV treatment in frontline CDAS staff. Significant strengths which emerged in the “core staff” survey related to the importance of assessing IPV and being empathic. Gaps related to the confidence in working with these issues and receiving support. Significant strengths which emerged in the “senior staff” survey related to the availability of supervision, information and training on IPV. Gaps related to using the Capability Framework and discussing IPV in supervision. Originality/value Findings have important implications for the development of training addressing gaps in current knowledge and skills required when working with IPV in the context of drug and alcohol misuse.

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User preference for HIV self-testing or self-sampling within a free online sexual health service: a service evaluation

International Journal of STD & AIDS ◽

10.1177/0956462419868882 ◽

2019 ◽

Vol 30 (12) ◽

pp. 1239-1242

Author(s):

Paula Baraitser ◽

Adam Black ◽

Stuart Amos-Gibbs ◽

Gillian Holdsworth ◽

Elena Ardines ◽

...

Keyword(s):

Health Service ◽

Sexual Health ◽

Hiv Testing ◽

Service Evaluation ◽

User Preference ◽

Service Improvement ◽

Improvement Project ◽

Advantages And Disadvantages ◽

Self Testing ◽

Sexual Health Service

The objective of this study was to evaluate a service improvement project offering HIV testing through either self-testing or self-sampling in an online sexual health service by measuring type of test chosen and the reason for this choice. We created a web-page offering choice of online self-sampling or self-testing with information on the advantages and disadvantages of both methods. Anyone aged over 18 years resident in England, Scotland or Wales could order either type of test. We describe the characteristics of users, the tests chosen and the reasons for the choice. A total of 1502 HIV testing orders were placed and 1466 (97.6%) testing kits were dispatched after exclusion of multiple orders by the same user. Sixty-seven per cent of users chose self-testing (n = 984) and the rest chose self-sampling (n = 482, 32.9%). The most frequent reasons for choosing self-testing were: immediate results (n = 264, 46.9%), ability to complete the test themselves (n = 168, 29.8%), less blood required (n = 67, 11.9%) and the privacy of testing at home (n = 55, 9.8%). Public sector provision of self-testing as an adjunct to clinic-based HIV testing services is likely to be highly acceptable to UK populations. However, a proportion will prefer self-sampling, and maintaining choice of testing modality is important.

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