Can We Trust the Quality of Routine Hospital Outpatient Information in the UK?

1998 ◽  
Vol 3 (4) ◽  
pp. 203-206 ◽  
Author(s):  
Alison Shaw ◽  
Maggie Somerset ◽  
Liz Dunn ◽  
Tim Peters ◽  
Alex Faulkner ◽  
...  
Keyword(s):  
Systematic Evaluation ◽  
Management Decision ◽  
Complete Agreement ◽  
Specific Data ◽  
Administration System ◽  
Hospital Outpatient ◽  
The Uk ◽  
Patient Administration System ◽  
Good Agreement

Background: A validation study of routine hospital outpatient data was carried out as part of a broader project focusing on outpatient re-attendance. The aim was to compare two patient administration system (PAS) data items with the same information collected directly from hospital clinicians. Methods: A total of 140 cases from four specialties at four National Health Service hospitals was randomly selected for comparison. The specific data items compared were the grade of doctor seen and the management decision taken following an outpatient appointment. The proportion of cases in which there was agreement was calculated, together with kappa values and relevant statistics indicating the accuracy of the PAS data when compared with information compiled immediately after the consultation by the relevant clinician. Results: There was agreement between the clinician's data and the PAS data in 118/140 (84.3%) cases for grade of doctor seen and in 105/139 (76.7%) cases for the management decision. There was complete agreement for both items in 88/139 (62.6%) cases. Kappa values indicated good agreement between the two data sources. However, ‘sensitivity’ statistics suggested that the likely accuracy of each data item varied. Conclusion: Although there was good agreement within individual categories between the two sources, 37% of patient computerised records held at least one inconsistency in this small study focusing on only two data items. Further systematic evaluation is needed to test the extent to which other items are similarly discrepant.

scholarly journals Non-attendance rates among patients attending different grades of psychiatrist and a clinical psychologist within a community mental health clinic

2004 ◽  
Vol 28 (1) ◽  
pp. 5-7 ◽  
Author(s):  
Ronan McIvor ◽  
Emma Ek ◽  
Jerome Carson
Keyword(s):  
Health Clinic ◽  
Clinical Psychologist ◽  
Junior Doctors ◽  
Attendance Rates ◽  
Administration System ◽  
Medical Interventions ◽  
Community Mental Health Clinic ◽  
Linear Contrast ◽  
Patient Administration System

Aims and MethodTo examine non-attendance rates in patients seen by psychiatrists of different grades and a consultant clinical psychologist. Rates were obtained from the patient administration system over a 21-month period.ResultsA planned linear contrast showed that the clinical psychologist's patients had the lowest rate of non-attendance (7.8%), followed in turn by those of consultant psychiatrists (18.6%), specialist registrars (34%) and senior house officers (37.5%).Clinical ImplicationsFactors such as continuity of care, perceived clinical competence and the provision of non-medical interventions might have an impact on attendance rates. These results indicate the difficulty in reconciling the training needs of junior doctors with the provision of continuity and quality of care for patients. Reminder systems for people seeing training doctors might be an effective way of reducing non-attendance rates.

Evolution of the public administration system. The Republic of Estonia

2020 ◽  
Vol 22 (4) ◽  
pp. 82-118
Author(s):  
YANA TOOM ◽  
◽  
VALENTINA V. KOMLEVA ◽  
Keyword(s):  
Public Administration ◽  
Administration System ◽  
The Public ◽  
Administrative Reforms ◽  
Social Sphere ◽  
External Threats ◽  
The Social ◽  
The Republic

The article studies the main stages and features of the evolution of the public administration system in the Republic of Estonia after 1992. This paper presents brief geographical and socio-economic characteristics that largely determine the development of the country’s public administration. The evolution of the institution of the presidency, executive, and legislative powers are considered. The role of parliament and mechanisms for coordinating the interests of different groups of the population for the development of the country is especially emphasized. The authors analyze the state and administrative reforms of recent years, which were aimed at improving the quality of services provided to the population, increasing the competitiveness of different parts of Estonia, as well as optimizing public spending and management structure. The introduction of digital technologies into the sphere of public administration, healthcare, education, and the social sphere is of a notable place. Such phenomena as e-residency, e-federation, and other digital projects are considered. The development of a digital system of interstate interaction between Estonia and Finland made it possible to create the world’s first e-federation, and the digitization of all strategically important information and its transfer to cloud storage speaks of the creation of the world’s first e-residency, a special residence of data outside the country’s borders to ensure digital continuity and statehood in the event of critical malfunctions or external threats.

scholarly journals Widespread gaps in the quality of care for primary biliary cholangitis in UK

2021 ◽  
pp. flgastro-2020-101713
Author(s):  
Mathuri Sivakumar ◽  
Akash Gandhi ◽  
Eathar Shakweh ◽  
Yu Meng Li ◽  
Niloufar Safinia ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Medical Records ◽  
Clinical Symptoms ◽  
Primary Biliary Cholangitis ◽  
Cholestatic Liver Disease ◽  
Patient Demographics ◽  
Risk Patients ◽  
Wide Scale ◽  
The Uk

ObjectivePrimary biliary cholangitis (PBC) is a progressive, autoimmune, cholestatic liver disease affecting approximately 15 000 individuals in the UK. Updated guidelines for the management of PBC were published by The European Association for the Study of the Liver (EASL) in 2017. We report on the first national, pilot audit that assesses the quality of care and adherence to guidelines.DesignData were collected from 11 National Health Service hospitals in England, Wales and Scotland between 2017 and 2020. Data on patient demographics, ursodeoxycholic acid (UDCA) dosing and key guideline recommendations were captured from medical records. Results from each hospital were evaluated for target achievement and underwent χ2 analysis for variation in performance between trusts.Results790 patients’ medical records were reviewed. The data demonstrated that the majority of hospitals did not meet all of the recommended EASL standards. Standards with the lowest likelihood of being met were identified as optimal UDCA dosing, assessment of bone density and assessment of clinical symptoms (pruritus and fatigue). Significant variations in meeting these three standards were observed across UK, in addition to assessment of biochemical response to UDCA (all p<0.0001) and assessment of transplant eligibility in high-risk patients (p=0.0297).ConclusionOur findings identify a broad-based deficiency in ‘real-world’ PBC care, suggesting the need for an intervention to improve guideline adherence, ultimately improving patient outcomes. We developed the PBC Review tool and recommend its incorporation into clinical practice. As the first audit of its kind, it will be used to inform a future wide-scale reaudit.

scholarly journals Strategies for the management of pulmonary arterial hypertension in patients with congenital heart disease

2020 ◽  
Vol 4 (S1) ◽  
Author(s):  
Nathalie Liew ◽  
Zoya Rashid ◽  
Robert Tulloh
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Congenital Heart ◽  
Standard Management ◽  
Advanced Therapies ◽  
Pulmonary Arterial ◽  
The Uk

Abstract Background Pulmonary hypertension (PH) is commonly seen in adults who have congenital heart disease (CHD). Therapy is available for pulmonary arterial hypertension (PAH) and has greatly benefitted many patients with PAH related to CHD (PAH-CHD) over the last 15 years, with evidence of improved quality of life and prognosis in those with Eisenmenger syndrome and repaired PAH-CHD. In this review, we describe the standard management and advanced therapies for PAH, which are available in specialist PH centres around the UK and Ireland, and how these are used in PAH-CHD. Decisions around the choice of therapy are governed by commissioning and available evidence. Conclusion We explain the different pathways for action and the variety of medications now at our disposal to help this important group of patients.

scholarly journals Availability of ‘Do-It-Yourself’ orthodontics in the United Kingdom

2021 ◽  
pp. 146531252110216
Author(s):  
Annabelle Carter ◽  
Susan Stokes
Keyword(s):  
Web Search ◽  
Dental Treatment ◽  
Limited Information ◽  
Treatment Length ◽  
Do It Yourself ◽  
Dental Professional ◽  
The Uk ◽  
Product Costs ◽  
Age Range

Objective: To identify the number of companies providing Do-It-Yourself (DIY) orthodontics and explore information available on websites for DIY brace providers operating in the UK. Design: Web search and review of websites providing DIY braces. Setting: Leeds, UK. Methods: A Web search was completed in November 2020 and April 2021 of all companies providing DIY braces for UK consumers. Each website was evaluated, and the following data collected: name; year started operating; costs; process; involvement of a dental professional; average ‘treatment’ length; retention; consent process; information on risks and benefits; aligner material; social media presence; age suitability; and consumer ratings on Trustpilot. Quality of website information was assessed via the DISCERN tool. Results: Seven DIY orthodontic companies were operating in the UK. Websites reviewed revealed the following: product costs were in the range of £799–£1599, ‘treatment’ length quotes were in the range of 4–12 months; Trustpilot reviews were in the range of 1.6–4.8 stars; and websites claimed their aligners were suitable for individuals with an age range of 12–18 years. Quality of content regarding risks described on websites varied, and there was limited information regarding involvement of a dental professional. Quality of websites information scored ‘poor’ or ‘very poor’ on the DISCERN scoring. Conclusions: There has been an increase in the number of DIY orthodontic companies operating in the UK over the last three years. There is a need to determine whether these products constitute dental treatment in their own right. If so, it is crucial to ensure these are regulated appropriately with adequate information available to satisfy informed consent and have greater transparency over dental professional involvement to safeguard the public.

scholarly journals Techniques for Mitigating the Effects of Smoke Taint While Maintaining Quality in Wine Production: A Review

Molecules ◽  
2021 ◽  
Vol 26 (6) ◽  
pp. 1672
Author(s):  
Ysadora A. Mirabelli-Montan ◽  
Matteo Marangon ◽  
Antonio Graça ◽  
Christine M. Mayr Marangon ◽  
Kerry L. Wilkinson
Keyword(s):  
Global Perspective ◽  
Wine Industry ◽  
Wine Production ◽  
Specific Data ◽  
Main Research ◽  
Initial Severity ◽  
The Subject ◽  
Available Information

Smoke taint has become a prominent issue for the global wine industry as climate change continues to impact the length and extremity of fire seasons around the world. Although the issue has prompted a surge in research on the subject in recent years, no singular solution has yet been identified that is capable of maintaining the quality of wine made from smoke-affected grapes. In this review, we summarize the main research on smoke taint, the key discoveries, as well as the prevailing uncertainties. We also examine methods for mitigating smoke taint in the vineyard, in the winery, and post production. We assess the effectiveness of remediation methods (proposed and actual) based on available research. Our findings are in agreement with previous studies, suggesting that the most viable remedies for smoke taint are still the commercially available activated carbon fining and reverse osmosis treatments, but that the quality of the final treated wines is fundamentally dependent on the initial severity of the taint. In this review, suggestions for future studies are introduced for improving our understanding of methods that have thus far only been preliminarily investigated. We select regions that have already been subjected to severe wildfires, and therefore subjected to smoke taint (particularly Australia and California) as a case study to inform other wine-producing countries that will likely be impacted in the future and suggest specific data collection and policy implementation actions that should be taken, even in countries that have not yet been impacted by smoke taint. Ultimately, we streamline the available information on the topic of smoke taint, apply it to a global perspective that considers the various stakeholders involved, and provide a launching point for further research on the topic.

scholarly journals Toward an Automatic Quality Assessment of Voice-Based Telemedicine Consultations: A Deep Learning Approach

Sensors ◽  
2021 ◽  
Vol 21 (9) ◽  
pp. 3279
Author(s):  
Maria Habib ◽  
Mohammad Faris ◽  
Raneem Qaddoura ◽  
Manal Alomari ◽  
Alaa Alomari ◽  
...  
Keyword(s):  
Neural Networks ◽  
Deep Learning ◽  
Quality Assessment ◽  
Transcript Level ◽  
Assessment Process ◽  
Classification Model ◽  
Systematic Evaluation ◽  
Transcript Levels ◽  
Perceptual Evaluation

Maintaining a high quality of conversation between doctors and patients is essential in telehealth services, where efficient and competent communication is important to promote patient health. Assessing the quality of medical conversations is often handled based on a human auditory-perceptual evaluation. Typically, trained experts are needed for such tasks, as they follow systematic evaluation criteria. However, the daily rapid increase of consultations makes the evaluation process inefficient and impractical. This paper investigates the automation of the quality assessment process of patient–doctor voice-based conversations in a telehealth service using a deep-learning-based classification model. For this, the data consist of audio recordings obtained from Altibbi. Altibbi is a digital health platform that provides telemedicine and telehealth services in the Middle East and North Africa (MENA). The objective is to assist Altibbi’s operations team in the evaluation of the provided consultations in an automated manner. The proposed model is developed using three sets of features: features extracted from the signal level, the transcript level, and the signal and transcript levels. At the signal level, various statistical and spectral information is calculated to characterize the spectral envelope of the speech recordings. At the transcript level, a pre-trained embedding model is utilized to encompass the semantic and contextual features of the textual information. Additionally, the hybrid of the signal and transcript levels is explored and analyzed. The designed classification model relies on stacked layers of deep neural networks and convolutional neural networks. Evaluation results show that the model achieved a higher level of precision when compared with the manual evaluation approach followed by Altibbi’s operations team.

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