scholarly journals A Cross-Sectional Analysis of the BC Children’s Hospital Cleft Palate Program Waitlist

2019 ◽  
Vol 27 (4) ◽  
pp. 311-318 ◽  
Author(s):  
Leslie Tze Fung Leung ◽  
Christine A. Loock ◽  
Rebecca Courtemanche ◽  
Douglas J. Courtemanche

Objective: A 2016 review of the BC Children’s Hospital Cleft Palate - Craniofacial Program (CPP) revealed that one-third of patients met the program’s care recommendations and half met the American Cleft Palate-Craniofacial Association guidelines. This study reviews patients on the CPP waitlist and determines median wait times and missed clinical assessments as well as identifies how wait times are influenced by medical complexity, specialized speech service needs, vulnerability, and distance from clinic. Design: Cross-sectional. Setting: BC Children’s Hospital Cleft Palate—Craniofacial Program. Patients: Five hundred seventy-six waitlisted patients. Main Outcome Measures: Additional wait time after recommended appointment date. Correlation of additional wait time with diagnosis, number of specialists required, speech services needed, vulnerability, and distance from the clinic. Missed plastic surgery, speech, and orthodontic assessments according to CPP team recommendations and ACPA guidelines. Results: Patients had a median additional wait time of 11 months (interquartile range: 5-27). Longer additional wait times were associated with a craniofacial diagnosis ( P = .019), a need for formal speech assessments or evaluations ( P < .001), or a requirement to see multiple specialists ( P < .001). Vulnerability and distance from clinic did not affect wait times. Plastic surgery assessments were not available at the preschool and preteen time points for 45 (8%) patients, 355 (62%) patients were unable to access speech assessments, and 120 (21%) were unable to complete an orthodontic assessment. Conclusion: Patients wait up to an additional year to be seen by the CPP and miss speech, orthodontic, and surgical assessments at key developmental milestones. Additional resources are required to address these concerns.

2020 ◽  
Vol 7 (5) ◽  
pp. 665-672
Author(s):  
Saif Khairat ◽  
Malvika Pillai ◽  
Barbara Edson ◽  
Robert Gianforcaro

Positive patient experiences are associated with illness recovery and adherence to medication. To evaluate the virtual care experience for patients with COVID-19 symptoms as their chief complaints. We conducted a cross-sectional study of the first cohort of patients with COVID-19 symptoms in a virtual clinic. The main end points of this study were visit volume, wait times, visit duration, patient diagnosis, prescriptions received, and satisfaction. Of the 1139 total virtual visits, 212 (24.6%) patients had COVID-19 symptoms. The average wait time (SD) for all visits was 75.5 (121.6) minutes. The average visit duration for visits was 10.5 (4.9) minutes. The highest volume of virtual visits was on Saturdays (39), and the lowest volume was on Friday (19). Patients experienced shorter wait times (SD) on the weekdays 67.1 (106.8) minutes compared to 90.3 (142.6) minutes on the weekends. The most common diagnoses for patients with COVID-19 symptoms were upper respiratory infection. Patient wait times for a telehealth visit varied depending on the time and day of appointment. Long wait times were a major drawback in the patient experience. Based on patient-reported experience, we proposed a list of general, provider, and patient telehealth best practices.


2010 ◽  
Vol 17 (4) ◽  
pp. 170-174 ◽  
Author(s):  
Brian W Rotenberg ◽  
Charles F George ◽  
Kevin M Sullivan ◽  
Eric Wong

BACKGROUND: Obstructive sleep apnea (OSA) is a highly prevalent disorder that is associated with significant patient morbidity and societal burden. In general, wait times for health care in Ontario are believed to be lengthy; however, many diseases lack specific corroborative wait time data.OBJECTIVE: To characterize wait times for OSA care in Ontario.METHODS: Cross-sectional survey. A survey tool was designed and validated to question physicians involved in OSA care about the length of the wait times their patients experience while traversing a simplified model of OSA care. The survey was sent to all otolaryngologists and respirologists in the province, as well as to a random sample of provincial family physicians.RESULTS: Patients waited a mean of 11.6 months to initiate medical therapy (continuous positive airway pressure), and 16.2 months to initiate surgical therapy. Sleep laboratory availability appeared to be the major restriction in the patient management continuum, with each additional sleep laboratory in a community associated with a 20% decrease in overall wait times. Smaller community sizes were paradoxically associated with shorter wait times for sleep studies (P<0.01) but longer wait times for OSA surgery (P<0.05). Regression analysis yielded an r2of 0.046; less than 5% of the wait time variance could be explained by the simplified model.CONCLUSION: Patients experienced considerable wait times when undergoing management for OSA. This has implications for both individual patient care and public health in general.


Author(s):  
Hong Tu Nguyen ◽  
Thi Thuy Ha Dang ◽  
Bich Ngoc Hoang ◽  
Thi Luong Nguyen

Purpose: To describe some subclinical characteristics of Shigella dysentery in children of the Gastroenterology Department at the Vietnam National Children’s Hospital in 2019 and review the results of treatment in these patients. Methods: A cross-sectional descriptive study was conducted on patients under 15 years of age admitted to the Gastroenterology Department at Vietnam National Children's Hospital. Results: The CRP index increased to 81.8%, of which the increase was mainly in the S.sonnei group. The rate of the most common bacteria strain is S.sonnei accounting for 87.1%, followed by S.fexneri 11.8%, S.dysenteriae encountered a case of 1.1%. No cases of stool culture resulted in S.boydii. The cure rate with Ciprofloxacin is 89.5%. The recovery rate is quite high, 93.3%, the percentage of patients who are also significantly better at 6.7% and there is no case of treatment failure. Conclusions: The number of leukocytes and CRP in the peripheral blood is increased in most cases. The main antibiotic used is Ciprofloxacin, the treatment effectiveness with Ciprofloxacin antibiotic is 89.5%, the cure rate is high and there is no case of treatment failure.


2020 ◽  
Author(s):  
Amira M. Shalaby ◽  
Amira F. EL-Gazzar

Abstract Background: Congenital anomalies (CA) are common causes of infant’s and childhood deaths and disability. Objectives: The aim of the study is to determine the prevalence, describe the types and risk factors of congenital anomalies among newborns admitted to Neonatal Intensive Care Unit (NICU) of a Children's Hospital. Study design: It is a prospective observational study(analytic cross sectional study) was performed and screening of the newborn admitted at NICU of a Children's Hospital during the period of 6 months from 1 to 12-2017 to the end of 5-2018. The sample was 346 newborns, 173 cases and 173 control. We collected data using a record checklist and an interviewing questionnaire.Results: There were a significant difference between cases and control concerning gestational age (P=0.001), single or multiple babies (P=0.002), residence (P=0.001), consanguineous marriage (P=0.01) and family history of unfavorable outcome (P=0.001). We also found that the most common type of congenital anomalies was gastrointestinal anomalies 63 cases (36.4%) with tracheoesophageal fistula 17 cases (27%) being the most common GIT anomalies. Then the musculoskeletal anomalies being the second common anomalies 14.5% with diaphragmatic hernia 10 cases being the most common in musculoskeletal anomalies followed by other anomalies (22 multiple +1Conjoined Twins 23 cases (13.3%) followed by circulatory anomalies 22 cases (12.7%), followed by CNS anomalies 18 cases (10%). Conclusion: The prevalence of congenital anomalies was 22.97%. The most common anomalies were gastrointestinal anomalies (GIT), musculoskeletal anomalies, multiple anomalies and circulatory system anomalies. The risk factors were consanguineous marriage, positive family history, urban areas, full-term and singleton pregnancies.


2021 ◽  
Vol 62 (4) ◽  
Author(s):  
Nguyen Van Dung ◽  
Nguyen Thi Thinh ◽  
Pham Van Phu

A cross-sectional survey on 523 pairs of mother and suffered from acute respiratory infections child6-23 months old treated at the Maternity and Children’s Hospital of Ha Nam provine in 2016-2018to assess the nutritional status of children and describe some mother’s child-feeding practices. Theresults showed that: The rates of stunting and wasting of children were high: 21.2% and 11.1%(respectively); the rate of underweight was 14.0%. The rates of mothers who breastfeed their babieslate after the first hour after birth and of mothers who give complementary foods too early or too late(before 6 months or after 8 months of age) were quite high: 62.5% and 53.0% (respectively); the rateof mothers squeezed colostrum before first breastfeeding was 24.3%. Children who were started oncomplementary feeding at the wrong time compared with those who were fed at the right time hadhigher rates of stunting: 24.2% and 18.8% (respectively) (OR=1, 4; 95%CI 0.9-2.3) but no statisticallysignificant difference (p=0.1075); the rate of underweight malnutrition was also higher: 19.5% and7.8% (respectively) statistically significant difference (OR=2.9; 95%CI 1.6-5.3; p=0.0001).


CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S106-S106
Author(s):  
J. MacKay ◽  
P.R. Atkinson ◽  
M. Howlett ◽  
E. Palmer ◽  
J. Fraser ◽  
...  

Introduction: Patient morbidity and mortality are influenced by delay in access to care and lack of continuity of care. Patients frequently present to the emergency department (ED) for care despite being registered with a primary care (PC) provider. Advanced access is an open scheduling system promoted by the College of Family Physicians of Canada that triages primary care (PC) patients to be seen within 24 hours, reducing care delay. We wished to determine the prevalence of formal triage systems in PC appointment allocation. Methods: We performed linked cross sectional surveys to quantify the number of ambulatory patients presenting to a tertiary urban ED (with an annual census of 56,000 visits) who felt unable to access primary care. PC practices were also surveyed to assess use of formal triage methods and measure access using the metric of time to third next available appointment. Descriptive statistics were calculated. Results: In the patient survey, 381 of 580 patients consented to participate. Of those, 324 patients reported reasons for their ED visit. Perception that wait time for PC was “too long” was reported in 73/324 (23%); 86% reported wait times of greater than 48 hours. The PC practice response rate was 63.8% (46/ 72). The mean time to third next available appointment was 7.7 (95% CI 4.9-10.5) days (median 5 days, range 0-50 days). No PC practice reported utilizing a formal triage system when booking appointments. Conclusion: No primary care practices in the surveyed region used a formal triage system to allocate appointments, despite a range of wait times that extended up to 50 days. The safety of primary care appointment allocation may be improved with introduction of a formal triage system, especially if overall wait times cannot be reduced.


Author(s):  
Yu.O. Volkov ◽  
Ad.A. Mamedov ◽  
L.M. Makarova ◽  
E.A. Ryzhov ◽  
B.A. Tkachenko

The article presents a rare clinical case of hamartoma of the tongue in combination with a cleft palate, diagnosed in a newborn child, as a manifestation of a severe congenital malformation of the maxillofacial region. The preparation and successful implementation of the first stage of treatment of this combined pathology and subsequent rehabilitation in a multidisciplinary children's hospital are described in detail on the basis of continuity in the work of specialists and an interdisciplinary approach.


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