Improving Attendance and Patient Experiences During the Expansion of a Telehealth-Based Pediatric Otolaryngology Practice

2020 ◽  
pp. 019459982096591
Author(s):  
Caroline M. Kolb ◽  
Kristen Born ◽  
Karen Banker ◽  
Patrick C. Barth ◽  
Nicole Leigh Aaronson
Keyword(s):  
Large Scale ◽  
Administrative Support ◽  
Tertiary Care ◽  
Missed Appointments ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Pediatric Otolaryngology ◽  
Common Causes ◽  
Technical Issues ◽  
English Speaking

Objective To determine the rates and primary causes of missed appointments (MAs) for telehealth visits and present remedies for improvement. Methods This cross-sectional survey was conducted at a tertiary care pediatric otolaryngology practice during expansion of telehealth-based visits. A review of questionnaire responses was performed for 103 consecutive patients with MAs over 50 business days from March 20, 2020, to May 29, 2020. Families were asked a brief survey regarding the cause of the MA and assisted with technical support and rescheduling. MA rates and causes were analyzed. Results The overall MA rate during the initiation of telehealth services was significantly increased at 12.4% as compared with clinic-based visits of a similar duration before COVID of 5.2% ( P < .001). Technical issues were the most common causes of MAs (51.3%). Of the caregivers, 23.8% forgot or reported cancellation of the appointment. Five percent of patients were non–English speaking and scheduled without translator support. Minorities and patients with public insurance represented 53.6% and 61.9% of MAs, respectively. Discussion Technical difficulties were the most commonly reported cause of missed telehealth appointments. Optimization of applications by providing patient reminders, determining need for translator assistance, and reducing required upload/download speeds may significantly reduce rates of MAs and conversions to other communication. Implications for Practice Clear, concise education materials on the technical aspects of telehealth, platform optimization, and robust technical and administrative support may be necessary to reduced missed telehealth appointments and support large-scale telehealth operations. An assessment of institutional capacity is critical when considering telehealth expansion.

scholarly journals Disparities in Access to Pediatric Otolaryngology Care During the COVID-19 Pandemic

2021 ◽  
pp. 000348942110487
Author(s):  
Yvonne Adigwu ◽  
Beth Osterbauer ◽  
Christian Hochstim
Keyword(s):  
Barriers To Care ◽  
Median Income ◽  
Missed Appointments ◽  
Poverty Level ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
High School Degree ◽  
Pediatric Otolaryngology ◽  
Student’S T ◽  
Zip Code

Objective: Racial/ethnic minority pediatric otolaryngology patients experience health disparities, including barriers to accessing health care. Our hypothesis for this study is that Hispanic or economically disadvantaged patients would represent a larger percentage of missed appointments and report more barriers to receiving care during the COVID-19 pandemic. Methods: A cross-sectional survey utilizing a modified version of the Barriers to Care Questionnaire was administered via telephone to no-show patients, and median income by zip code was collected. Chi-squared, logistic regression, and Student’s t-tests were used to investigate any differences in those who did and did not keep their appointments as well as any differences in mean questionnaire scores. Results: No-show patients were more likely to be Hispanic than not (OR 2.3, 95% CI: 1.3, 3.9, P = .002) and to live in a zip code that had a median income less than 200% of the federal poverty level (OR 1.7, 95% CI: 1.2, 2.4, P = .004). Respondents with a high school degree tended to report more barriers to care compared to those with less education. Conclusion: In our study, we identified ethnic, financial, and logistic concerns that may contribute to patients failing to keep their appointments with the otolaryngology clinic. Future studies are needed to assess the efficacy of measures aimed to reduce these barriers to care such as preventive plans to assist new patients and expanding telehealth services.

Knowledge and Practice of Mothers Regarding the Prevention and Management of Malnutrition Among Preschool Children – A Cross Sectional Survey

2017 ◽  
Vol 9 (5) ◽  
Author(s):  
Mahfouz R. Nath ◽  
C. Kanniammal
Keyword(s):  
Preschool Children ◽  
Good Practice ◽  
Strong Association ◽  
Educational Status ◽  
Nursing Interventions ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Economic Class ◽  
Common Causes ◽  
Knowledge And Practice

Malnutrition remains one of the most common causes of morbidity and mortality among children throughout the world. Malnutrition has been responsible, directly or indirectly for 60% of the 10.9 million deaths annually among children under five. The research study was aimed to assess the knowledge and practice of mothers of preschool children regarding the prevention and management of malnutrition. The design used was descriptive cross sectional survey. The study was conducted in a coastal setting of Trivandrum district with a sample size of 115. Data collection was done by self administered structured questionnaire by conducting mothers meeting at selected Anganwadis. According to the results of the study 19.1% of mothers had good knowledge and 34.8 % of mothers had poor knowledge. Regarding practice only 24.3 % of mothers reported good practice while 36.6 % of mothers reported poor practice. There was a strong association between the knowledge and Practice of mothers and selected socio demographic variables such as educational status of mothers and socio economic class (p less than 0.01)). The study findings can be used for planning targeted nursing interventions in coastal areas for mothers of preschool children.

Knowledge and awareness about MERS-CoV among the dental students in Chennai

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 847-851
Author(s):  
Nithyanandham Masilamani ◽  
Dhanraj Ganapathy
Keyword(s):  
College Students ◽  
Large Scale ◽  
Preventive Measures ◽  
Positive Impact ◽  
Educational Programs ◽  
Dental Students ◽  
Professional Organizations ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mode Of Transmission

Middle East Respiratory Syndrome (MERS) induced by new ß coronavirus MERS-(CoV) had first been described in Saudi Arabia in September 2012. MERS-CoV communication inside the population is often identified with clustered households and cramped communal spaces. The purpose of the study is to assess the knowledge and awareness of MERS-CoV among dental students in India. This was a questionnaire-based cross-sectional survey of 100 dental college students in Chennai. The self-designed questionnaires contained ten questions focused on the knowledge and awareness of MERS-CoV amongst dental college students. Questionnaires were circulated through an online website survey planet. After the responses were received from 100 participants, data were collected and analyzed, .87% are aware of MERS-CoV through media 13% from professional channels. 84%are aware of the clinical manifestation of MERS-CoV. 81%Are aware of the mode of transmission of MERS-CoV. 76%are aware of the preventive measures against MERS -CoV.68%. Are aware of the incubation period of MERS-CoV. 74%aware of PCR as a diagnostic test for MERS-CoV. This study concluded that dental students had strong awareness and knowledge of MERS. Also, there are a few differences in information and behaviours that require change. Large-scale health educational programs on MERS also should be facilitated by professional organizations to expand their reach and to strengthen knowledge to have a positive impact on their behaviour.

scholarly journals Public Health Workforce Burnout in the COVID-19 Response in the U.S.

2021 ◽  
Vol 18 (8) ◽  
pp. 4369
Author(s):  
Kahler W. Stone ◽  
Kristina W. Kintziger ◽  
Meredith A. Jagger ◽  
Jennifer A. Horney
Keyword(s):  
Public Health ◽  
Health Workforce ◽  
Work Experience ◽  
Large Scale ◽  
Health Workers ◽  
Public Health Workforce ◽  
Cross Sectional Survey ◽  
Public Health Response ◽  
Cross Sectional ◽  
The U.S

While the health impacts of the COVID-19 pandemic on frontline health care workers have been well described, the effects of the COVID-19 response on the U.S. public health workforce, which has been impacted by the prolonged public health response to the pandemic, has not been adequately characterized. A cross-sectional survey of public health professionals was conducted to assess mental and physical health, risk and protective factors for burnout, and short- and long-term career decisions during the pandemic response. The survey was completed online using the Qualtrics survey platform. Descriptive statistics and prevalence ratios (95% confidence intervals) were calculated. Among responses received from 23 August and 11 September 2020, 66.2% of public health workers reported burnout. Those with more work experience (1–4 vs. <1 years: prevalence ratio (PR) = 1.90, 95% confidence interval (CI) = 1.08−3.36; 5–9 vs. <1 years: PR = 1.89, CI = 1.07−3.34) or working in academic settings (vs. practice: PR = 1.31, CI = 1.08–1.58) were most likely to report burnout. As of September 2020, 23.6% fewer respondents planned to remain in the U.S. public health workforce for three or more years compared to their retrospectively reported January 2020 plans. A large-scale public health emergency response places unsustainable burdens on an already underfunded and understaffed public health workforce. Pandemic-related burnout threatens the U.S. public health workforce’s future when many challenges related to the ongoing COVID-19 response remain unaddressed.

scholarly journals Influence of language skills on the choice of terms used to describe lung sounds in a language other than English: a cross-sectional survey of staff physicians, residents and medical students

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044240
Author(s):  
Abraham Bohadana ◽  
Hava Azulai ◽  
Amir Jarjoui ◽  
George Kalak ◽  
Ariel Rokach ◽  
...  
Keyword(s):  
Medical Students ◽  
Dual Language ◽  
Language Skills ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
C Language ◽  
Audio Recordings ◽  
Chest Auscultation ◽  
English Speaking

IntroductionThe value of chest auscultation would be enhanced by the use of a standardised terminology. To that end, the recommended English terminology must be transferred to a language other than English (LOTE) without distortion.ObjectiveTo examine the transfer to Hebrew—taken as a model of LOTE—of the recommended terminology in English.Design/settingCross-sectional study; university-based hospital.Participants143 caregivers, including 31 staff physicians, 65 residents and 47 medical students.MethodsObservers provided uninstructed descriptions in Hebrew and English of audio recordings of five common sounds, namely, normal breath sound (NBS), wheezes, crackles, stridor and pleural friction rub (PFR).Outcomes(a) Rates of correct/incorrect classification; (b) correspondence between Hebrew and recommended English terms; c) language and auscultation skills, assessed by crossing the responses in the two languages with each other and with the classification of the audio recordings validated by computer analysis.ResultsRange (%) of correct rating was as follows: NBS=11.3–20, wheezes=79.7–87.2, crackles=58.6–69.8, stridor=67.4–96.3 and PFR=2.7–28.6. Of 60 Hebrew terms, 11 were correct, and 5 matched the recommended English terms. Many Hebrew terms were adaptations or transliterations of inadequate English terms. Of 687 evaluations, good dual-language and single-language skills were found in 586 (85.3%) and 41 (6%), respectively. However, in 325 (47.3%) evaluations, good language skills were associated with poor auscultation skills.ConclusionPoor auscultation skills surpassed poor language skills as a factor hampering the transfer to Hebrew (LOTE) of the recommended English terminology. Improved education in auscultation emerged as the main factor to promote the use of standardised lung sound terminology. Using our data, a strategy was devised to encourage the use of standardised terminology in non-native English-speaking countries.

scholarly journals Maternal adherence to micronutrient supplementation before and during pregnancy in Northwest China: a large-scale population-based cross-sectional survey

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028843 ◽  
Author(s):  
Danmeng Liu ◽  
Yue Cheng ◽  
Shaonong Dang ◽  
Duolao Wang ◽  
Yaling Zhao ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Large Scale ◽  
Northwest China ◽  
Population Based ◽  
Shaanxi Province ◽  
Micronutrient Supplementation ◽  
Cross Sectional Survey ◽  
Start Time ◽  
Cross Sectional ◽  
Scale Population

ObjectivesTo report the situation of maternal micronutrient supplementation before and during pregnancy in Northwest China and to examine the rates of and factors related to the adherence to micronutrient supplementation among pregnant women in this region, where dietary micronutrient intake is commonly insufficient.DesignA large-scale population-based cross-sectional survey.SettingTwenty counties and ten districts of Shaanxi Province.ParticipantsA sample of 30 027 women were selected using a stratified multistage random sampling method. A total of 28 678 women were chosen for the final analysis after excluding those who did not provide clear information about nutritional supplementation before and during pregnancy.Main outcome measuresMaternal adherence to micronutrient supplementation (high and low) were the outcomes. They were determined by the start time and duration of use according to Chinese guidelines (for folic acid (FA) supplements) and WHO recommendations (for iron, calcium and multiple-micronutrient (MMN) supplements).ResultsIn total, 83.9% of women took at least one kind of micronutrient supplement before or during pregnancy. FA (67.6%) and calcium (57.5%) were the primarily used micronutrient supplements; few participants used MMN (14.0%) or iron (5.4%). Adherence to supplementation of all micronutrients was low (7.4% for FA, 0.6% for iron, 11.7% for calcium and 2.7% for MMN). Higher educational levels, higher income levels, urban residence and better antenatal care (including pregnancy consultation and a higher frequency of antenatal visits) were associated with high adherence to micronutrient supplementation.ConclusionMaternal micronutrient supplementation before and during pregnancy in Northwest China was way below standards recommended by the Chinese guidelines or WHO. Targeted health education and future nutritional guidelines are suggested to improve this situation, especially in pregnant women with disadvantaged sociodemographic conditions.

scholarly journals Patients’ attitudes toward conventional and herbal treatments for depression and anxiety: A cross-sectional Israeli survey

2021 ◽  
pp. 002076402199238
Author(s):  
Or Burstein ◽  
Alon Shamir ◽  
Nurit Abramovitz ◽  
Ravid Doron
Keyword(s):  
Adverse Effects ◽  
Large Scale ◽  
Prescription Medications ◽  
Depression And Anxiety ◽  
Cultural Backgrounds ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Cultural Aspects ◽  
Final Sample ◽  
Choice Of Treatment

Background: As many patients view conventional antidepressants and anxiolytics negatively, it is not surprising that the willingness to apply these treatments is far from ideal, thus posing a critical barrier in promoting an effective and durable treatment. Aim: The present study aimed to explore patients’ attitudes toward conventional and herbal treatments for depression and anxiety, while considering cultural and demographic factors, to further elucidate the antecedes that putatively determine the treatment’s outcome. Methods: During June 2017, a cross-sectional survey was conducted using stratified sampling from a large-scale Israeli volunteer online panel. The final sample included 591 Jewish Israeli adults that reported they were suffering from depression or anxiety. Results: A heterogeneous range of attitudes toward treatment was found: for example, a large group of patients did not utilize prescription medications (39%), a professional consultation (12.9%), or any form of treatment (17.4%). Interestingly, these patients were significantly more likely to support naturally-derived treatments and were less concerned with scientific proof. Further, adverse effects were demonstrated as a prominent factor in the choice of treatment. A higher incidence of adverse effects was associated with an increased willingness to consider an alternative herbal treatment. Noteworthy attitudes were found in orthodox-Jewish individuals, who showed similar consultation rates, but utilized more psychological, rather than pharmacological treatments. Conclusions: It is proposed that patients’ perspectives and cultural backgrounds are needed to be taken into consideration during the clinical assessment and choice of treatment. The findings imply that a particular emphasis should be placed on patients that discard conventional pharmacological options and on distinct cultural aspects. Several recommendations for revising the current policy are advocated to promote more culturally-informed and patient-oriented care.

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