scholarly journals The Perioperative Patient Experience During COVID-19

2021 ◽  
pp. 000313482110611
Author(s):  
Andrew T. Dippre ◽  
Kristen M. Quinn ◽  
Melinda Walto ◽  
Rupak Mukherjee ◽  
Prabhakar K. Baliga ◽  
...  

Background Access to elective surgical procedures has been impacted by the COVID-19 pandemic. Methods We sought to understand the patient experience by developing and distributing an anonymous online survey to those who underwent non-emergency surgery at a large academic tertiary medical center between March and October 2020. Results The survey was completed by 184 patients; the majority were white (84%), female (74.6%), and ranged from 18 to 88 years old. Patients were likely unaware of case delay as only 23.6% reported a delay, 82% of which agreed with that decision. Conversely, 44% felt that the delay negatively impacted their quality of life. Overall, 82.7% of patients indicated high satisfaction with their care. African American patients more often indicated a “neutral” vs “satisfactory” hospital experience ( P < .05) and considered postponing their surgery ( P < .01). Interestingly, younger patients (<60) were more likely than older (≥60) patients to note anxiety associated with having surgery during the pandemic ( P < .01), feeling unprepared for discharge ( P < .02), not being allowed visitors ( P < .02), and learning about the spread of COVID-19 from health care providers ( P < .02). Discussion These results suggest that patients are resilient and accepting of changes to health care delivery during the current pandemic; however, certain patient populations may have higher levels of anxiety which could be addressed by their care provider. These findings can help inform and guide ongoing and future health care delivery adaptations in response to care disruptions.

1985 ◽  
Vol 11 (2) ◽  
pp. 195-225
Author(s):  
Karla Kelly

AbstractUntil recently, physicians have been the primary health care providers in the United States. In response to the rising health care costs and public demand of the past decade, allied health care providers have challenged this orthodox structure of health care delivery. Among these allied health care providers are nurse practitioners, who have attempted to expand traditional roles of the registered nurse.This article focuses on the legal issues raised by several major obstacles to the expansion of nurse practitioner services: licensing restrictions, third party reimbursement policies, and denial of access to medical facilities and physician back-up services. The successful judicial challenges to discriminatory practices against other allied health care providers will be explored as a solution to the nurse practitioners’ dilemma.


Author(s):  
Hesam Seyedin ◽  
Morteza Rostamian ◽  
Fahimeh Barghi Shirazi ◽  
Haleh Adibi Larijani

Abstract Providing health care in times of complex emergencies (CEs) is one of the most vital needs of people. CEs are situations in which a large part of the population is affected by social unrest, wars, and food shortages. This systematic review study was conducted to identify the challenges of health-care delivery in CEs. We searched terms related to health-care delivery and CEs in PubMed, Web of Sciences, Science Direct, and Google scholar databases, as well as Persian databases SID and Magiran. The searching keywords included: “Health Care, Complex Crises, War, Humanitarian, Refugees, Displaced Persons, Health Services, and Challenges.” Of 409 records, we selected 6 articles based on the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. Studies were analyzed through qualitative content analysis. The results show that CEs affect health-care delivery in 4 primary areas: the workforce, infrastructure, information access, and organization of health services. These areas can pose potential threats for health-care providers and planners at times of emergencies. Thus, they should be informed about these challenges to strengthen the health-care system.


2015 ◽  
Vol 10 (3) ◽  
pp. 327-343 ◽  
Author(s):  
Adam Oliver

AbstractThis Special Section of Health Economics, Policy and Law begins with an article on the different ways in which one might incentivise improved performance among health care providers. I asked five experts on performance management, Gwyn Bevan, Tim Doran, Peter Smith, Sandra Tanenbaum and Karsten Vrangbaek, to write brief reactions to the article and to the notion of performance management in health care in general. The commentators were given an open remit to be as critical as they wished to be, and their reactions can be found in the pages that follow. I would like to thank Albert Weale for reviewing all of the articles, and Katie Brennan for serving as the catalyst for this collection.


Author(s):  
Kathy Gates ◽  
Quintin A. Hecht ◽  
Marjorie A. M. Grantham ◽  
Andrew J. Fallon ◽  
Malisha Martukovich

Purpose The purpose of this review article is to discuss how boothless audiometry may help address changes in hearing health care services and provide progressive tools to expand beyond traditional audiology clinic visits. The primary drivers for these changes include the COVID-19 pandemic, our aging population, comorbid effects of unidentified hearing loss, and the critical need for effective communication between patients and providers. This review article highlights key features and technical specifications of boothless audiometry, provides an overview of Food and Drug Administration (FDA)–approved boothless audiometry products, and describes how to leverage these products to increase access to hearing health services across the continuum of health care. Method Boothless audiometry literature was reviewed using PubMed and audiometry technology websites. FDA-approved boothless audiometry products were reviewed, and audiological features were categorized. Civilian and Department of Defense subject matter experts were consulted. Conclusions Boothless audiometry technology introduces opportunities for early audiometric assessment outside of the audiology clinic, in settings where traditional testing has been less possible, or even impossible, such as military environments, clinic waiting areas, schools, and nursing homes. This technology allows health care providers to identify individuals with significant hearing loss early and seek comprehensive services to prevent and treat hearing loss. By expanding the current hearing health care delivery model via boothless audiometry technology, the following benefits may be achieved, which can result in better outcomes overall: increased access to care, early identification and treatment of hearing loss, and reduced impact from the comorbid effects of hearing impairment.


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Diego Sadler ◽  
◽  
Jeanne M. DeCara ◽  
Joerg Herrmann ◽  
Anita Arnold ◽  
...  

Abstract Background Re-allocation of resources during the COVID-19 pandemic has resulted in delays in care delivery to patients with cardiovascular disease and cancer. The ability of health care providers to provide optimal care in this setting has not been formally evaluated. Objectives To assess the impact of COVID-19 resource re-allocation on scheduling, testing, elective procedures, telemedicine access, use of new COVID-19 therapies, and providers’ opinions on healthcare policies among oncology and cardiology practitioners. Methods An electronic survey was conducted by a cardio-oncology collaborative network through regional and state chapters of the American College of Cardiology, American Society of Clinical Oncology, and the International Cardio-Oncology Society. Descriptive statistics were reported by frequency and proportion for analyses, and stratified categorically by geographic region and specialty. Results One thousand four hundred fifteen providers (43 countries) participated: 986 cardiologists, 306 oncologists, and 118 trainees/internal medicine. 63% (195/306) of oncologists vs 92% (896/976) of cardiologists reported cancellations of treatments/elective procedures (p = 0.01). 46% (442/970) of cardiologists and 25% (76/303) of oncologists modified the scope of their practice (p = < 0.001). Academic physicians (74.5%) felt better supplied with personal protective equipment (PPE) vs non-academic (74.5% vs 67.2%; p = 0.018). Telemedicine was less common in Europe 81% (74/91), and Latin America 64% (101/158), than the United States, 88% (950/1097) (p = < 0.001). 95% of all groups supported more active leadership from medical professional societies. Conclusions These results support initiatives to promote expanded coverage for telemedicine, increased access to PPE, better testing availability and involvement of medical professional societies to help with preparedness for future health care crisis.


1991 ◽  
Vol 158 (S10) ◽  
pp. 9-16 ◽  
Author(s):  
Carol C. Nadelson

Ethical principles are influenced by personal values and beliefs, and by societal context. They are not immutable. In medicine, as new technologies have developed and changes in health-care delivery have resulted, historically held views about the responsibilities, obligations and relationships between health-care providers and patients have been challenged.


Author(s):  
Priti Agarwal ◽  
Romy Biswas

Background: Patient satisfaction is a means of measuring the effectiveness of health care delivery. This serves as a means of improvement among health care providers to give an acceptable level of patient satisfaction. Aims and Objectives: To assess the level of satisfaction and reasons of dissatisfaction among patients regarding health care services in a rural hospital of Darjeeling District, West Bengal.Methods: A cross-sectional survey was done on 110 patients with the help of PSQ-18 questionnaire. The samples were drawn by systematic random sampling            .Results: The overall mean satisfaction score was 3.57 and S.D. ±0.69. The mean score was highest in general satisfaction domain which was found to be 3.76 with S.D ± 1.08 and lowest in time spent with doctor where mean score was 2.92 and S.D. ±1.07. 69.3% of the patients were satisfied with the services offered by the hospital. The time spent by the doctor with the patient was less and this was the major reason of dissatisfaction.Conclusions: More than half of the patients were satisfied with the services provided by the hospital. The findings of the study can facilitate the development of targeted, objectively prioritized programs for the improvement and advancement of health care delivery systems. 


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