scholarly journals Distribution and extent of electronic medical record utilisation in eye units across the United Kingdom: a cross-sectional study of the current landscape

BMJ Open ◽  
2017 ◽  
Vol 7 (5) ◽  
pp. e012682 ◽  
Author(s):  
Shin Bin Lim ◽  
Humma Shahid
Keyword(s):  
Information Transfer ◽  
Data Transfer ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
Remote Access ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Electronic Survey ◽  
The United Kingdom ◽  
The Uk

ObjectivesOphthalmology units across the UK vary widely in their adoption of electronic medical records (EMR). There is a lack of evidence to show the extent and progress of EMR adoption. The aim of this study was to capture a snapshot of the current landscape of EMR use, as a baseline for comparison in future studies.SettingAn electronic survey questionnaire was sent to all NHS ophthalmology Units in the UK.ParticipantsA total of 104 National Health Service (NHS) ophthalmology units participated in the survey, which was carried out over 6 months from December 2013 to June 2014.Primary and secondary outcome measuresRespondents were asked about technology usage pertaining to specific processes in the clinic workflow. This allowed us to determine the extent of EMR usage and details about current use or planned implementation by each unit.Results77.6% (n=104) of NHS ophthalmology units responded. 45.3% (n=48) of units were currently using an EMR and a further 26.4% (n=28) of units plan to implement EMR within 2 years. 70.8% of units with a current EMR system use Medisoft. EMR is used by all clinicians in 37.5% and by all subspecialties offered at the unit in 27.0%. In 56.3%, new clinical notes are entered into EMR only by clinicians. All imaging devices are networked to EMR in 28.3%. In 46.7%, EMR is accessible by other specialties within the same hospital. 71.1% would recommend EMR to a colleague.ConclusionsEMR has the potential to address current limitations of patient information transfer and sharing in ophthalmology. It is pleasing to see a significant proportion of units already engaging with EMR or having plans to do so in the near future. However, differing EMR systems and lack of remote access mean further optimisation of these record systems are needed to allow data transfer between units.

scholarly journals ‘I decided not to go into surgery due to dress code’: a cross-sectional study within the UK investigating experiences of female Muslim medical health professionals on bare below the elbows (BBE) policy and wearing headscarves (hijabs) in theatre

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e019954 ◽  
Author(s):  
Abida Malik ◽  
Hafsah Qureshi ◽  
Humayra Abdul-Razakq ◽  
Zahra Yaqoob ◽  
Fatima Zahra Javaid ◽  
...  
Keyword(s):  
Hospital Medicine ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Dress Code ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Operating Theatres ◽  
Uniform Policy ◽  
The Uk ◽  
The Impact

ObjectivesThe objective of this study is to explore the impact of workplace dress code policies and guidance that may influence inclusivity and opportunities in the workplace.DesignQuantitative, self-completion cross-sectional survey.SettingBritish Islamic Medical Association conference.ParticipantsEighty-four female medical healthcare professionals with a range of ethnicities and wide geographical coverage.Primary and secondary outcome measuresThe study reports on the experiences of female Muslim healthcare professions wearing the headscarf in theatre and their views of the bare below the elbows (BBE) policy. Percentage of positive answers and their respective 95% CIs are calculated.ResultsThe majority of participants agreed that wearing the headscarf was important for themselves and their religious beliefs (94.1%), yet over half (51.5%) experienced problems trying to wear a headscarf in theatre; some women felt embarrassed (23.4%), anxious (37.1%) and bullied (36.5%). A variety of different methods in head covering in operating theatres were identified. The majority of respondents (56.3%) felt their religious requirement to cover their arms was not respected by their trust, with nearly three-quarters (74.1%) of respondents not happy with their trust’s BBE uniform policy alternative. Dissatisfaction with the current practice of headscarves in theatre and BBE policy was highlighted, with some respondents preferring to specialise as GPs rather than in hospital medicine because of dress code matters. The hijab prototype proposed by the research team also received a positive response (98.7%).ConclusionsOur study suggests that female Muslims working in the National Health Service (NHS) reported experiencing challenges when wearing the headscarf in theatre and with BBE policy. The NHS needs to make its position clear to avoid variations in individual trust interpretation of dress code policies. This illustrates a wider issue of how policies can be at odds with personal beliefs which may contribute to a reduction in workforce diversity.

scholarly journals Diagnostic routes and time intervals for patients with colorectal cancer in 10 international jurisdictions; findings from a cross-sectional study from the International Cancer Benchmarking Partnership (ICBP)

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023870 ◽  
Author(s):  
David Weller ◽  
Usha Menon ◽  
Alina Zalounina Falborg ◽  
Henry Jensen ◽  
Andriana Barisic ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Cancer Registries ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Time Intervals ◽  
Cross Sectional ◽  
Treatment Data ◽  
The Uk

ObjectiveInternational differences in colorectal cancer (CRC) survival and stage at diagnosis have been reported previously. They may be linked to differences in time intervals and routes to diagnosis. The International Cancer Benchmarking Partnership Module 4 (ICBP M4) reports the first international comparison of routes to diagnosis for patients with CRC and the time intervals from symptom onset until the start of treatment. Data came from patients in 10 jurisdictions across six countries (Canada, the UK, Norway, Sweden, Denmark and Australia).DesignPatients with CRC were identified via cancer registries. Data on symptomatic and screened patients were collected; questionnaire data from patients’ primary care physicians and specialists, as well as information from treatment records or databases, supplemented patient data from the questionnaires. Routes to diagnosis and the key time intervals were described, as were between-jurisdiction differences in time intervals, using quantile regression.ParticipantsA total of 14 664 eligible patients with CRC diagnosed between 2013 and 2015 were identified, of which 2866 were included in the analyses.Primary and secondary outcome measuresInterval lengths in days (primary), reported patient symptoms (secondary).ResultsThe main route to diagnosis for patients was symptomatic presentation and the most commonly reported symptom was ‘bleeding/blood in stool’. The median intervals between jurisdictions ranged from: 21 to 49 days (patient); 0 to 12 days (primary care); 27 to 76 days (diagnostic); and 77 to 168 days (total, from first symptom to treatment start). Including screen-detected cases did not significantly alter the overall results.ConclusionICBP M4 demonstrates important differences in time intervals between 10 jurisdictions internationally. The differences may justify efforts to reduce intervals in some jurisdictions.

scholarly journals What are the benefits and risks of sharing patients’ diagnostic radiological images with them? A cross-sectional study of the perceptions of patients and clinicians in the UK

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033835
Author(s):  
William Allenby Southam Cox ◽  
Penelope Cavenagh ◽  
Fernando Bello
Keyword(s):  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Image Sharing ◽  
Radiological Images ◽  
Registration Number ◽  
Potential Benefits ◽  
The Uk ◽  
Stakeholder Requirements ◽  
Clinical Expert

ObjectivesThe objective for this work was to assess clinical experts’ and patients’ opinions on the benefits and risks of sharing patients’ diagnostic radiological images with them.SettingThis study was conducted outside of the primary and secondary care settings. Clinical experts were recruited at a UK national imaging and oncology conference, and patients were recruited via social media.Participants121 clinical experts and 282 patients completed the study. A further 73 patient and 10 clinical expert responses were discounted due to item non-response. Individuals were required to be a minimum of 18 years of age at the time of participation.Primary and secondary outcome measuresThis study was exploratory in nature. As such, the outcomes to be measured for demonstration of the successful completion of this study were generated organically through the process of the investigation itself. These were: (1) the delineation of the benefits available from, and the risks posed by, widening access to diagnostic radiological images; (2) establishment of the level and nature of demand for access to diagnostic radiological images; and (3) the identification of stakeholder requirements for accessing available benefit from diagnostic radiological images.Results403 usable questionnaires were returned consisting of responses from clinical experts (n=121) and patients (n=282). Both groups acknowledge the potential benefits of this practice. Examples included facilitating communication, promoting patient engagement and supporting patients in accepting health information shared with them. However, both groups also recognised risks associated with image sharing, such as the potential for patients to be upset or confused by their images.ConclusionsThere is a demand from patients for access to their diagnostic radiological images alongside acknowledgement from clinical experts that there may be benefits available from this. However, due to the acknowledged risks, there is also a need to carefully manage this interaction.Trial registration number187752.

scholarly journals The Impact of COVID-19 on Plastic Surgery Training in the United Kingdom, Canada and Australia—A Cross-Sectional Study

2021 ◽  
Author(s):  
Curtis R Budden ◽  
Francesca Rannard ◽  
Joanna Mennie ◽  
Neil Bulstrode
Keyword(s):  
Plastic Surgery ◽  
Statistical Tests ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The United Kingdom ◽  
Surgical Trainees ◽  
Significant Difference ◽  
The Uk ◽  
The Impact

Abstract Background Surgical trainees worldwide have been thrust into a period of uncertainty, with respect to the implications COVID-19 pandemic will have on their roles, training, and future career prospects. It is currently unclear how plastic surgery trainees are being affected by COVID-19. This study examined the experience of plastic surgery trainees in Canada, the UK, and Australia to determine trainee roles during the early COVID-19 emergency response and how training changed during this time. Methods A cross-sectional survey-based study was designed for plastic surgery trainees in the UK, Canada and Australia. In total, 110 trainees responded to the survey. Statistical tests were conducted to determine differences in responses, based on year of training and country of residence. Results In total, 9.7% (10/103) of respondents reported being deployed to cover another service. There was a significant difference between redeployment based on country (p = 0.001). Within the UK group, 28.9% of respondents were redeployed. For trainees not deployed, 95.5% (85/89) reported that there has been a reduction in operative volume. Ninety-seven (94.1%) respondents reported that there were ongoing teaching activities offered by their program. The majority of trainees (66.4%) were concerned about their training. There was a significant difference between overall concern and country (p < 0.05). Conclusion In these unprecedented times, training programs in plastic surgery should be aware of the major impact that COVID-19 has had on trainees and will have on their training. The majority of plastic surgery trainees have experienced a reduction in surgical exposure but have maintained some form of regular teaching.

scholarly journals Trends in acid suppressant drug prescriptions in primary care in the UK: a population-based cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041529
Author(s):  
Devin Abrahami ◽  
Emily Gibson McDonald ◽  
Mireille Schnitzer ◽  
Laurent Azoulay
Keyword(s):  
Population Based ◽  
Cross Sectional Study ◽  
Prescribing Patterns ◽  
Secondary Outcome ◽  
Clinical Practice Research Datalink ◽  
Sectional Study ◽  
Cross Sectional ◽  
Number Of Patients ◽  
The Uk ◽  
Over Time

ObjectiveTo examine proton pump inhibitor (PPI) and histamine-2 receptor antagonist (H2RA) prescribing patterns over a 29-year period by quantifying annual prevalence and prescribing intensity over time.DesignPopulation-based cross-sectional study.SettingMore than 700 general practices contributing data to the UK Clinical Practice Research Datalink (CPRD).ParticipantsWithin a cohort of 14 242 329 patients registered in the CPRD, 3 027 383 patients were prescribed at least one PPI or H2RA from 1 January 1990 to 31 December 2018.Primary and secondary outcome measuresAnnual prescription rates were estimated by dividing the number of patients prescribed a PPI or H2RA by the total CPRD population. Change in prescribing intensity (number of prescriptions per year divided by person-years of follow-up) was calculated using negative binomial regression.ResultsFrom 1990 to 2018, 21.3% of the CPRD population was exposed to at least one acid suppressant drug. During that period, PPI prevalence increased from 0.2% to 14.2%, while H2RA prevalence remained low (range: 1.2%–3.4%). Yearly prescribing intensity to PPIs increased during the first 15 years of the study period but remained relatively constant for the remainder of the study period. In contrast, yearly prescribing intensity of H2RAs decreased from 1990 to 2009 but has begun to slightly increase over the past 5 years.ConclusionsWhile PPI prevalence has been increasing over time, its prescribing intensity has recently plateaued. Notwithstanding their efficacy, PPIs are associated with a number of adverse effects not attributed to H2RAs, whose prescribing intensity has begun to increase. Thus, H2RAs remain a valuable treatment option for individuals with gastric conditions.

scholarly journals Usage of unscheduled hospital care by homeless individuals in Dublin, Ireland: a cross-sectional study

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e016420 ◽  
Author(s):  
Clíona Ní Cheallaigh ◽  
Sarah Cullivan ◽  
Jess Sears ◽  
Ann Marie Lawlee ◽  
Joe Browne ◽  
...  
Keyword(s):  
Electronic Patient Record ◽  
Significant Proportion ◽  
Homeless People ◽  
Cross Sectional Study ◽  
Patient Record ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medical Inpatients ◽  
Bed Days

ObjectivesHomeless people lack a secure, stable place to live and experience higher rates of serious illness than the housed population. Studies, mainly from the USA, have reported increased use of unscheduled healthcare by homeless individuals.We sought to compare the use of unscheduled emergency department (ED) and inpatient care between housed and homeless hospital patients in a high-income European setting in Dublin, Ireland.SettingA large university teaching hospital serving the south inner city in Dublin, Ireland. Patient data are collected on an electronic patient record within the hospital.ParticipantsWe carried out an observational cross-sectional study using data on all ED visits (n=47 174) and all unscheduled admissions under the general medical take (n=7031) in 2015.Primary and secondary outcome measuresThe address field of the hospital’s electronic patient record was used to identify patients living in emergency accommodation or rough sleeping (hereafter referred to as homeless). Data on demographic details, length of stay and diagnoses were extracted.ResultsIn comparison with housed individuals in the hospital catchment area, homeless individuals had higher rates of ED attendance (0.16 attendances per person/annum vs 3.0 attendances per person/annum, respectively) and inpatient bed days (0.3 vs 4.4 bed days/person/annum). The rate of leaving ED before assessment was higher in homeless individuals (40% of ED attendances vs 15% of ED attendances in housed individuals). The mean age of homeless medical inpatients was 44.19 years (95% CI 42.98 to 45.40), whereas that of housed patients was 61.20 years (95% CI 60.72 to 61.68). Homeless patients were more likely to terminate an inpatient admission against medical advice (15% of admissions vs 2% of admissions in homeless individuals).ConclusionHomeless patients represent a significant proportion of ED attendees and medical inpatients. In contrast to housed patients, the bulk of usage of unscheduled care by homeless people occurs in individuals aged 25–65 years.

scholarly journals 417 COVID-19 and the Return to Head and Neck Outpatient Activity in The United Kingdom: What Is the New Normal?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
D Jaikaransingh ◽  
S Bola ◽  
S Winter
Keyword(s):  
United Kingdom ◽  
Head And Neck ◽  
Natural Ventilation ◽  
Cross Sectional Study ◽  
Protective Equipment ◽  
Cross Sectional ◽  
Safety Measures ◽  
Face To Face ◽  
The United Kingdom ◽  
The Uk

Abstract Background We aim to investigate current head and neck outpatient practices across the United Kingdom during the COVID-19 pandemic. Method A cross-sectional study comprising of an online 20-item survey was emailed to members of the British Association of Head and Neck Oncologists (BAHNO). Topics covered included safety measures, protective equipment used and protocols around the use of flexible nasendoscopy (FNE) in clinic. Results 117 participants completed the survey covering 66 Trusts across the UK. There was a significant reduction in face-to-face clinic patients compared to pre-pandemic numbers. Room down-time after FNE ranged from 0-6 hours and there was a significant increase in allocated down-time after the patient had coughed or sneezed. Natural ventilation existed in 36% of clinics and the majority of responders didn’t know the calculated Air Change Per Hour (ACPH) of the room (77%). Where ACPH was known, it often did not match the allocated room down-time. Conclusions Adaptations are being made across the UK to maintain staff and patient safety, but more can still be done by liaising with hospital infectious diseases and the hospital estates team to clarify outpatient protocols.Outpatient activity will likely remain limited and alternative strategies will need to develop to manage the backlog in face-to-face clinics.

scholarly journals Screening for Cancer-Related Neuropathic Pain in the Oncology Outpatient Setting in the United Kingdom

2013 ◽  
Vol 6 (1) ◽  
pp. 208-216 ◽  
Author(s):  
Alison Birtle ◽  
Susan Davidson ◽  
Gary Atkinson ◽  
Chantal van Litsenburg
Keyword(s):  
Neuropathic Pain ◽  
United Kingdom ◽  
Clinical Judgment ◽  
Daily Practice ◽  
Cross Sectional Study ◽  
Outpatient Setting ◽  
Cross Sectional ◽  
The United Kingdom ◽  
The Uk ◽  
Survey Responses

This article reports the outcomes of a sub-analysis of United Kingdom (UK) data collected during a noninterventional, cross-sectional study conducted in five European countries. The primary aim was to estimate the prevalence of cancer-related neuropathic pain (CRNP) in an outpatient sample of adult cancer patients visiting oncology clinics in the UK for standard care. Secondary aims were to report the nature and characteristics of the cancer and the pain in the patients with CRNP. This sub-analysis also assessed the usefulness of the PainDETECT screening tool as an aid for physicians in identifying the neuropathic component of cancer-related pain in daily practice. Based on physicians’ clinical judgment before reviewing the scores on the PainDETECT tool, the estimated number of outpatients with cancer experiencing chronic pain and considered to have CRNP was 104 of 195 patients (53.3%; 95% confidence interval [CI]: 46.3%- 60.3%). After reviewing patients’ scores on the tool, the estimate was 90 of 195 patients (46.2%; 95% CI: 39.2%-53.2%). Physicians changed from a positive (yes) to a negative (no) diagnosis of CRNP for 16 of 127 patients who had a low PainDETECT end score (<13; indicating that neuropathic pain was unlikely). Of the 11 physicians who completed the usefulness of PainDETECT survey, eight indicated that they would use the questionnaire in future for at least some of their patients, although they also indicated that in the majority of cases (63%), the PainDETECT tool did not help them evaluate whether a patient had CRNP. Because of missing data arising from missing or incomplete survey responses, however, these data should be interpreted with caution, and further studies are required to assess the usefulness of this tool.

scholarly journals COVID-19 and the return to head and neck outpatient activity in the United Kingdom: what is the new normal?

2020 ◽  
Author(s):  
Sumrit Bola ◽  
Dominic Jaikaransingh ◽  
Stuart C Winter
Keyword(s):  
United Kingdom ◽  
Head And Neck ◽  
Natural Ventilation ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Safety Measures ◽  
Web Based ◽  
Face To Face ◽  
The United Kingdom ◽  
The Uk

Abstract Purpose As surgical specialties now begin the graduated return to elective activity and face-to-face clinics, this paper investigates the current head and neck outpatient practices across the United Kingdom. Methods A cross-sectional study comprised of an online 20-item survey was distributed to members of the British Association of Head & Neck Oncologists (BAHNO). The survey was open on a web-based platform and covered topics including safety measures for patients, protective equipment for healthcare staff and protocols for the use of flexible nasendoscopy in the clinic. Results The survey was completed by 117 participants covering 66 NHS Trusts across the UK. There was a significant reduction in face-to-face Otolaryngology, Maxillofacial and Speech and Language clinic patients when compared to pre-pandemic numbers (p < 0.0001). Risk assessments for flexible nasendoscopy were done for 69% of clinics and 58% had an established protocol. Room downtime after flexible nasendoscopy ranged from 0 to 6 h and there was a significant increase in allocated downtime after a patient had coughed/sneezed (p < 0.001). Natural ventilation existed in 36% of clinics and the majority of responders didn’t know the Air Change Per Hour (ACPH) of the clinic room (77%). Where ACPH was known, it often did not match the allocated room downtime. Conclusion There is a wide variation in outpatient activity across the United Kingdom, but adaptations are being made to try and maintain staff and patient safety. However, more can still be done by liaising with allied teams to clarify outpatient protocols.

scholarly journals Examining the Relationship between Toxoplasma gondii and Seropositivity and Serointensity and Depression in Adults from the United Kingdom and the United States: A Cross-Sectional Study

Pathogens ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1101
Author(s):  
Shawn D. Gale ◽  
Lance D. Erickson ◽  
Bruce L. Brown ◽  
Dawson W. Hedges
Keyword(s):  
Toxoplasma Gondii ◽  
The United States ◽  
Cross Sectional Study ◽  
Uk Biobank ◽  
Cross Sectional ◽  
The United Kingdom ◽  
Neuropsychiatric Diseases ◽  
Multiple Regression Modeling ◽  
The Uk ◽  
The Relationship

Infecting approximately one-third of the world’s population, the neurotropic protozoan Toxoplasma gondii has been associated with cognition and several neuropsychiatric diseases including schizophrenia and bipolar disorder. Findings have been mixed, however, about the relationship between Toxoplasma gondii and depression, with some studies reporting positive associations and others finding no associations. To further investigate the association between Toxoplasma gondii and depression, we used data from the UK Biobank and the National Health and Examination Survey (NHANES). Results from adjusted multiple-regression modeling showed no significant associations between Toxoplasma gondii and depression in either the UK Biobank or NHANES datasets. Further, we found no significant interactions between Toxoplasma gondii and age, sex, educational attainment, and income in either dataset that affected the association between Toxoplasma gondii and depression. These results from two community-based datasets suggest that in these samples, Toxoplasma gondii is not associated with depression. Differences between our findings and other findings showing an association between Toxoplasma gondii and depression could be due to several factors including differences in socioeconomic variables, differences in Toxoplasma gondii strain, and use of different covariates in statistical modeling.

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