scholarly journals An Integrated Care Strategy for the Follow-up of Patients With COVID-19–Associated Chemosensory Dysfunction

2020 ◽  
pp. 019459982095071 ◽  
Author(s):  
Luca Giovanni Locatello ◽  
Giandomenico Maggiore ◽  
Chiara Bruno ◽  
Michele Trotta ◽  
Oreste Gallo
Keyword(s):  
Health Care ◽  
Integrated Care ◽  
Level Of Care ◽  
Italian Hospital ◽  
The Future ◽  
Integrated Pathway ◽  
Health Care Strategies

The proportion of patients with residual olfactory and gustatory dysfunction after COVID-19 is increasing, and practical health care strategies need to be developed to manage this novel situation in otolaryngology services worldwide. Starting from our experience in a large Italian hospital, we estimated that >1500 people will complain of some form of olfactory and gustatory dysfunction in the future months in our region. We want to share our logistical and clinical integrated pathway that is aimed to screen and refer each patient to the most appropriate level of care in order to optimize resources and avoid overwhelming the available clinics.

School Nurses on the Front Lines of Medicine: The Approach to a Student After a Syncopal Event: Don’t “PASS OUT”

2018 ◽  
Vol 33 (4) ◽  
pp. 222-227 ◽  
Author(s):  
Gretchen Hackett ◽  
Jodi Brady ◽  
Robert P. Olympia
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
School Setting ◽  
School Nurses ◽  
Initial Assessment ◽  
Level Of Care ◽  
Primary Health ◽  
Life Threatening ◽  
Medical Emergencies

Students presenting with syncope and/or seizure occur occasionally in the school setting. Several studies have shown that seizures as well as respiratory distress are the most common medical emergencies that prompt school nurses and staff to contact emergency medical services (EMS) to transport students to the closest emergency department (Knight 1999, Olympia 2005). It is important to develop a differential diagnosis for syncope, to initiate stabilization of the student with life-threatening symptoms, and to triage these students to an appropriate level of care (back to the classroom, home with their guardian with follow-up at their primary health care provider’s office, or directly to the closest emergency department via EMS). This article describes the initial assessment and management of two students presenting after syncopal events.

From common sense to evidence-based: An evaluation of survivorship planning.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 76-76
Author(s):  
Sam Gaster
Keyword(s):  
Health Care ◽  
Cancer Survivors ◽  
Health Care Providers ◽  
Common Sense ◽  
Care Providers ◽  
Care Plans ◽  
Follow Up Care ◽  
The Future ◽  
The Impact

76 Background: The Institute of Medicine’s (IOM; 2005) seminal report, From Cancer Patient to Cancer Survivor: Lost in Transition, recommended survivorship care plans (SCPs) as a common sense approach to improve the care of cancer survivors. The American Society of Clinical Oncology (ASCO; Mayer et al., 2014) reiterated the importance of these plans and provided strategic guidance for their implementation. The American College of Surgeons’ Commission on Cancer requires SCP delivery from accredited cancer programs as of 2015. Despite the push from these organizations, SCPs remain understudied (Mayer, Birken, Check, & Chen, 2014). The impact of SCPs on patient outcomes is poorly understood. Additionally, there is limited data on patients’ preferences for SCPs. This evaluation describes the use and assessment of SCPs at six regional cancer centers in the Midwest. Methods: Feedback was collected from 30 cancer survivors after receipt of a SCP. Responses were collected with 22-item questionnaire. Outcomes included survivors’ satisfaction with the clarity and detail of SCPs, likelihood to use SCPs in the future, intention to share SCPs with other health care providers, and perceived knowledge about treatment and follow-up care. Results: Over 75% (n = 23) of survivors agreed that SCPs were easy to understand. Ninety-three percent (n = 28) of survivors indicated that SCPs contained the right amount of information. Fifty-three percent (n = 16) of survivors are very likely to use their SCP in the future, whereas 47% (n = 14) are somewhat likely to use their SCP in the future. The majority (77%; n = 23) of survivors intend to share their SCP with another health care provider. Ninety-seven percent (n = 29) of survivors felt more knowledge about their treatment and follow-up car as a result of receiving a SCP. Conclusions: This evaluation highlights the many benefits of SCPs for cancer survivors. Results suggest that SCPs educate survivors about their treatment and follow-up care. Additionally, results indicate that many survivors intend to share SCPs, perhaps allowing for better coordination between oncology and primary care. Further research is warranted on the adoption of healthy lifestyle behaviors and receipt of routine health care after delivery of SCPs.

scholarly journals Health, Social, and Functional Characteristics of Older Adults With Continuing Care Needs: Implications for Integrated Care

2018 ◽  
Vol 31 (7) ◽  
pp. 1085-1105 ◽  
Author(s):  
Cara L. Brown ◽  
Verena Menec
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Hospital Stay ◽  
Integrated Care ◽  
Personal Characteristics ◽  
Health Care Use ◽  
Continuing Care ◽  
Level Of Care ◽  
Functional Characteristics ◽  
Care Needs

Objective: To identify older adults who could benefit from integrated care, we examined (a) health, social, and functional characteristics of older, hospitalized adults who required continuing care on discharge and (b) associations between these characteristics and potentially unnecessary health care use. Method: Personal characteristics were extracted from patient charts ( N = 214) and examined in relation to three outcomes: discharge to institutional care, unnecessary hospital stay (alternative level of care), and long hospital stay. Results: Twenty-nine percent of the sample was discharged to an institution, 32.7% was coded as alternate level of care, and 27.6% had a long length of stay. Independent predictors of potentially avoidable health care use were mental and behavioral issues, living alone, functional status, and preadmission concerns about the patient managing in the community. Discussion: High users of health care services were identifiable prior to hospital admission, supporting the use of community-based integrated care approaches.

scholarly journals Precision health care strategies for older adults with diabetes in Indonesia: a Delphi consensus study

2021 ◽  
Vol 30 (3) ◽  
pp. 221-7
Author(s):  
Satriya Pranata ◽  
Shu-Fang Vivienne Wu ◽  
Chun-Hua Chu ◽  
Khristophorus Heri Nugroho
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Self Management ◽  
Clinical Settings ◽  
Delphi Consensus ◽  
Management Level ◽  
Glycemic Target ◽  
Health Care Strategies ◽  
Precision Health

BACKGROUND Studies on precision health care for older adults with diabetes in Indonesia are still limited. This study was aimed to reach the experts consensus on the suitable precision health care strategies for older adults with diabetes. METHODS A total of 10 experts (4 physicians, 4 nurses, and 2 dietitians) agreed to participate in the 3-round interview using Delphi technique. The experts should have at least 5 years of experience in teaching or working as health professionals in a hospital. RESULTS Consensus was reached that precision health care consisted of eight elements: self-management, interdisciplinary collaborative practice, personalized genetic or lifestyle factors, glycemic target, patient preferences, glycemic control, patient priority-directed care, and biodata- or evidence-based practice. The strategies of precision health care for diabetes were divided into seven steps: conducting brief deducting teaching; assessing self-management level and risk of cardiovascular disease; organizing a brainstorming session among patients to exchange experiences on glycemic target and specific target behavior; making a list of patients’ needs and ranking the priorities; setting a goal and writing action; doing follow-up; and reporting the goal attempts. CONCLUSIONS The eight elements of precision health care provided the basis of precision health care strategies for diabetic older adults, which are the real and measurable strategies for precision health care implementation in clinical settings.

Longitudinal changes in health care utilization by adult survivors of childhood cancer in the Childhood Cancer Survivor Study (CCSS).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6030-6030
Author(s):  
Jacqueline N. Casillas ◽  
Qi Liu ◽  
Melissa M. Hudson ◽  
Mark Greenberg ◽  
Mark W. Yeazel ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Childhood Cancer ◽  
Adult Survivors ◽  
Care Utilization ◽  
Level Of Care ◽  
Longitudinal Changes ◽  
Survivors Of Childhood Cancer ◽  
Over Time

6030 Background: The incidence of late effects increases as childhood cancer survivors age. Survivors require lifelong care focused on the risks arising from prior cancer therapy (survivor-focused care). Methods: We assessed longitudinal changes in health care utilization in adult survivors of childhood cancer participating in the CCSS. Utilization at baseline and most recent follow-up was classified into one of three mutually exclusive hierarchical categories: no health care, general medical care, or survivor-focused care. Relative risk (RR) and 95% confidence intervals (CI) were calculated for predictors of reduction in care over time from survivor-focused to general or no care. Multivariable models, adjusted for key treatment exposures, were created to assess the risk factors for reductions in level of care over time. Results: Among 8591 eligible survivors, mean age at last follow-up was 35.1 years (SD=7.8) with a mean of 11.6 years (SD=2.2) since baseline. Of 3993 (46%) survivors who reported survivor-focused care at baseline, 2383 (59.7%) reported a lower level of care at follow-up. Among 4598 (54%) not receiving survivor-focused care at baseline, 915 (20%) reported survivor-focused care at follow-up. Baseline predictors of a decreased level of care were no health insurance (RR=1.5, 95% CI 1.2-1.9), male sex (RR=1.4, 95% CI 1.2-1.6), being 10-19 years from diagnosis compared with 20+ years (RR=1.4, 95% CI 1.1-1.7). In contrast, factors associated with a maintenance in survivor-focused care were Canadian residency compared to U.S. residency with insurance (RR=0.7, 95% CI 0.6-0.9), unemployment (RR=0.8, 95% CI 0.7-0.9), physical limitations (RR=0.7, 95% CI 0.6-0.9), cancer-related pain (RR=0.7, 95% CI 0.5-0.8), poor emotional health (RR=0.7, 95% CI 0.5-0.9), having mild-moderate (RR=0.5, 95% CI 0.4-0.6) or severe-disabling chronic health condition (RR=0.6, 95% CI 0.5-0.7). Conclusions: Less than a third of adult survivors of childhood cancer report survivor-focused care. Rates decrease over time. Targeted interventions to maximize survivor-focused care in at-risk survivors should be tested so preventive and risk-reducing opportunities are not lost.

Are You Ready to Shape the Future of Health Care?

ASHA Leader ◽  
2011 ◽  
Vol 16 (6) ◽  
pp. 9-9
Author(s):  
Paul R. Rao
Keyword(s):  
Health Care ◽  
The Future
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