scholarly journals Satisfaction with healthcare services among refugees in Zaatari camp in Jordan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nesreen A. Salim ◽  
Shroq Hafedh Meyad ◽  
Faleh A. Sawair ◽  
Julian D. Satterthwaite ◽  
Samiha Sartawi
Keyword(s):  
Health Resources ◽  
Working Hours ◽  
Healthcare Services ◽  
Service Improvement ◽  
Dental Services ◽  
Key Indicators ◽  
Satisfaction Rates ◽  
Self Administered Questionnaire ◽  
Satisfaction With Healthcare Services

Abstract Background Feedback on satisfaction regarding healthcare services is vital for continuous improvement of the service delivery process and outcome. Aims and methods The objective of this study was to assess the satisfaction of refugees with the medical and dental services in Zaatari camp, under 3 domains with 20 key indicators (human and physical health resources, interaction and reactivity, and administration) using a self-administered questionnaire. Results Of the 500 participants, the satisfaction rate was 72.5%. Young participants and participants with a shorter stay in the camp showed higher overall satisfaction rates (P ≤ 0.01). Within the domains, ‘interaction and reactivity’ achieved the highest satisfaction score, whereas ‘administration efficiency’ was ranked the lowest. As for elements within the domains, the most acceptable were the sufficient number of staff and the working hours, availability of radiological services and proper care for children, reasonable waiting time and asking for medical history in every visit. Whereas difficulty to access healthcare services, difficulty to be referred to hospitals, lack of follow up and lack of dental services were the least acceptable. Conclusion In conclusion, whereas refugees were generally satisfied with the provided services, this study indicates that there are areas for further service improvement. This study highlights a significant gaps in healthcare services which if not addressed have the potential to amplify oral/medical health problems.

scholarly journals P007 Service evaluation of the nurse-led telephone advice line in the wake of COVID-19: a report of audit and staff satisfaction

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Julia Day ◽  
Janet Ball ◽  
Jayne Down ◽  
Raj Sengupta
Keyword(s):  
Service Use ◽  
Single Point ◽  
Working Hours ◽  
Work Load ◽  
Service Evaluation ◽  
Service Improvement ◽  
Staff Satisfaction ◽  
Telephone Advice ◽  
Staff Workload

Abstract Background/Aims  The Rheumatology nurse advice line (NAL) at the Royal National Hospital for Rheumatic Diseases (RNHRD, Bath) provides a vital service for direct patient access to specialist advice via a designated voicemail system. Increasing numbers and difficulty connecting call returns have increased staff workload, reduced efficiency and impacted on staff satisfaction. An audit was therefore undertaken to evaluate service use and efficiency, paired with formal assessment of staff satisfaction in order to identify areas for improvement. Methods  The total number of monthly calls through the NAL during 2020 were counted. A subset of consecutive calls were audited in detail, documenting temporal parameters in relation to the call being logged, returned and concluded. The number of clinicians and attempts required to contact the patient was noted. An anonymised staff satisfaction questionnaire was completed by NAL nurses and administrators. Data was analysed using Excel. Results  An average 653 calls per month (range 340-894) came through the NAL between January and September 2020. 97 consecutive patient contacts were audited from August 2020. Multiple attempts were required to successfully return the call in 19.6% of cases (n = 19/97). Of those, 68.4% (n = 13/19) of calls needed ≥ 2 nurses to contact the patient. In general, the first attempt to return the call was prompt (average 7.6 hours, range 0.1-27.7). However, the time to conclude the call from the patient’s first call log ranged from 0.1 - 142.6 hours (average 12.7 hours) with increased time associated with difficulties contacting the patient or when further advice was required from a Rheumatology doctor (18.5%, n = 18/97). Staff surveys revealed 67% of staff felt that the NAL is a good service to offer patients. However, 67% of staff did not feel the NAL in its current format was easy to manage. Specific comments included that the lack of rota'd responsibility, unpredictable workload and time inefficiencies were barriers to managing the service. Conclusion  From this data, we conclude that patient calls are returned promptly, but utilising a system of voicemail and unscheduled call returns is inefficient and contributes to staff dissatisfaction. This data has driven change for service improvement. To improve efficiency, calls will be answered live by an administrator during working hours and patients given a call-back time. A doctor will be named as a single point of contact for the nurses to seek additional advice and a nurse rota will designate responsibility for NAL calls to reduce work-load uncertainty. Follow up service evaluation will include staff and patient satisfaction questionnaires, and repeat audit, with consideration of ways to support frequent service users. Disclosure  J. Day: None. J. Ball: None. J. Down: None. R. Sengupta: None. V. Flower: None.

Standardized Tendon Fenestration with Injection of Autologous Blood for Treatment of Lateral Epicondylitis

2020 ◽  
Author(s):  
Chul Ki Goorens ◽  
Pascal Wernaers ◽  
Joost Dewaele
Keyword(s):  
Tennis Elbow ◽  
Autologous Blood ◽  
Lateral Epicondylitis ◽  
Pain Scale ◽  
Short Term ◽  
Shockwave Therapy ◽  
Other Substances ◽  
Injured Tendon ◽  
Satisfaction Rates

AbstractLateral epicondylitis (LE) of the elbow is often treated with conservative methods. Several techniques including injections with different substances are widely performed. No standardization exists. This prospective study describes the results of the short-term follow-up of 56 patients with mean age 48 years (range: 30–68 years) treated with the Instant Tennis Elbow Cure Medical device, which fenestrates the injured tendon in a standardized way through a holder of 12 small needles. Depth and position of the needles are determined beforehand by ultrasonography. Unprepared autologous blood was injected through the holder in the tendon. Visual analog pain scale (VAS) decreased significantly in rest by 61% and during activity by 47% after 6 weeks. VAS decreased significantly in rest by 79% and during activity by 66% after 3 months. VAS did not remain significantly different after 6 months. Satisfaction rates were 71% after 6 weeks and 82% after 6 months. This suggests that the therapeutical effect sustains and in some cases increases over time. Patient Related Tennis Elbow Evaluation score ameliorated after 3 months by 71%. Comparative studies are needed to confirm this effect versus other techniques as physiotherapy, shockwave therapy, and injections with other substances.

scholarly journals Real-world effectiveness of app-based treatment for urinary incontinence: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040819
Author(s):  
Pontus Rygh ◽  
Ina Asklund ◽  
Eva Samuelsson
Keyword(s):  
Urinary Incontinence ◽  
Cohort Study ◽  
Real World ◽  
Short Form ◽  
Pelvic Floor Muscle ◽  
Controlled Trial ◽  
Healthcare Services ◽  
International Consultation ◽  
The Mean

ObjectivesThe efficacy of app-based treatment for stress urinary incontinence (SUI) has been demonstrated in a randomised controlled trial (RCT). In this study, we investigate the user characteristics and the effectiveness of the same app when freely available, and compare these results with the RCT.DesignProspective cohort study.ParticipantsDuring a 17-month period, 24 602 non-pregnant, non-postpartum women older than 18 years downloaded the app and responded anonymously to a questionnaire. Of these, 2672 (11%) responded to the 3-month follow-up.InterventionThree months’ use of the app Tät, containing information, a pelvic floor muscle training programme and lifestyle advice.Main outcome measuresChange in symptom severity (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF)) and subjective improvement (Patient Global Impression of Improvement (PGI-I)).ResultsOf the respondents, 88% lived in Sweden and 75% (18 384/24 602) were incontinent with a mean age of 45.5 (SD 14.1) years. The UI types, based on symptoms, were SUI (53%), urgency UI (12%), mixed UI (31%) and undefined (4%). The mean ICIQ-UI SF score was 8.2 (SD 4.0) at baseline. The mean ICIQ-UI SF score reduction at follow-up was 1.31 (95% CI: 1.19 to 1.44) with a larger reduction in those with more severe incontinence at baseline (severe/very severe 3.23 (95% CI: 2.85 to 3.61), moderate 1.41 (95% CI: 1.24 to 1.59) and slight 0.24 (95% CI 0.06 to 0.42). When the results were weighted to match the distribution of severity in the RCT, the ICIQ-UI SF score reduction was 2.2 compared with 3.9 in the RCT. Regarding PGI-I, 65% experienced improvement compared with 92% in the RCT.ConclusionsThe app Tät was effective for self-management of UI even in the real world. Although the reduction in incontinence symptoms was less than in the RCT, two-thirds of the users improved. App-based treatment reaches many women without requiring resources from ordinary healthcare services.

81 Integrating A Front Door Frailty Service in the Emergency Department: Results of A Pilot Study

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
L Dunnell ◽  
A Shrestha ◽  
E Li ◽  
Z Khan ◽  
N Hashemi
Keyword(s):  
Emergency Department ◽  
Hospital Admissions ◽  
Admission Rate ◽  
Community Services ◽  
Service Improvement ◽  
Specialist Nurse ◽  
Front Door ◽  
Medication Changes ◽  
Health Service Improvement

Abstract Introduction Increasing old age and frailty is putting pressure on health services with 5–10% of patients attending the emergency department (ED) and 30% of patients in acute medical units classified as older and frail. National Health Service improvement mandates that by 2020 hospital trusts with type one EDs provide at least 70 hours of acute frailty service each week. Methodology A two-week pilot (Monday–Friday 8 am-5 pm) was undertaken, with a “Front Door Frailty Team” comprising a consultant, junior doctor, specialist nurse and pharmacist, with therapy input from the existing ED team. They were based in the ED seeing patients on arrival, referrals from the ED team and patients in the ED observation ward—opposed to the usual pathway of referral from the ED team to medical team. Data was captured using “Cerner” electronic healthcare records. A plan, do, study, act methodology was used throughout with daily debrief and huddle sessions. Results 95 patients were seen over two weeks. In the over 65 s, average time to be seen was 50 minutes quicker than the ED team over the same period, with reduced admission rate (25.7% vs 46.5%). The wait between decision to admit and departure was shortened by 119 minutes. Overall, this led to patients spending on average 133 minutes less in the ED. 64 patients were discharged, of which 44 had community follow-up (including 37.5% of 64 referred to acute elderly clinic and 25% to rapid response). 47 medications were stopped across 25 patients. Conclusion The pilot shows that introduction of an early comprehensive geriatric assessment in the ED can lead to patients being seen sooner, with more timely decisions over their care and reduction in hospital admissions. It allowed for greater provision of acute clinics and community services as well as prompt medication review and real time medication changes.

Dental Disease Nonbattle Injury Rates of Deployed NATO Militaries in the Middle East Region: A Scoping Review

2020 ◽  
Author(s):  
Matthew Vaughan ◽  
Troy McGowan ◽  
Greg Mahoney
Keyword(s):  
Scoping Review ◽  
Dental Treatment ◽  
Significant Proportion ◽  
Healthcare Services ◽  
Dental Disease ◽  
Operational Effectiveness ◽  
Dental Services ◽  
Injury Rates ◽  
East Region ◽  
Middle East Region

ABSTRACT Introduction The occurrence of dental emergencies, now termed as dental disease nonbattle injuries (D-DNBIs), has long been an impacting factor on militaries’ operational effectiveness. Owing to D-DNBIs contributing to low morale, the removal of personnel from duty, causing logistical hardships, and requiring deployable dental teams to operate in theater, there remains a significant benefit in the reduction in the occurrence of D-DNBIs. No study to date has reviewed D-DNBI rates specific to a modern military, and insight into whether militaries are seeing improvements in their dental preparedness remains to be gained. Materials and Methods A scoping review was conducted in accordance with the guidelines set out by Joanna Briggs Institute. Databases searched included SCOPUS, PubMed, OVID, and DOSS. Six hundred and one articles were initially screened, and six articles were included in the final review. Results A D-DNBI rate of 172 per 1,000 members per year was reported across the coalition, with the U.S., UK, and French militaries reporting on their dental experience. Both the French data and one UK study reported significantly higher D-DNBIs than their U.S. counterparts, who described 124 D-DNBIs per 1,000 members per year. A significant proportion of these D-DNBIs were reported to be “preventable,” which raises questions on the efficacy of garrison healthcare services. Dental disease nonbattle injury rates appear to be largely consistent with what was first reported decades ago, and there remains ongoing and significant value in expeditionary dental services providing supportive healthcare for any deployed military personnel. Conclusion Rates of D-DNBIs appear to be stable with what was historically reported when an international coalition is considered, with national variation. There remains a significant number of D- DNBIs which require dental treatment within the operational theater, and further efficiencies can be gained from predeployment treatment of “preventable” D-DNBIs.

scholarly journals Experiences of recovery from colorectal cancer surgery after hospital discharge among the oldest old: A qualitative study

2021 ◽  
pp. 205715852199445
Author(s):  
Kristina Sundt Eriksen ◽  
Sissel Iren Eikeland Husebø ◽  
Hartwig Kørner ◽  
Kirsten Lode
Keyword(s):  
Colorectal Cancer ◽  
Thematic Analysis ◽  
Oldest Old ◽  
Healthcare Services ◽  
Hospital Data ◽  
Colorectal Cancer Surgery ◽  
Discharge From Hospital ◽  
Depth Interviews ◽  
Inductive Thematic Analysis

Colorectal cancer affects a large number of people aged ≥80 years. Little is known about how they manage after discharge from hospital. The aim of this study was to explore the experiences of individuals aged ≥80 years recovering from surgery for colorectal cancer, and the challenges they may encounter after discharge from hospital. Data were collected between January and March 2016 through in-depth interviews with ten participants approximately one month after surgery. Inductive thematic analysis was employed to analyse the data. The COREQ checklist was used in reporting this study. Two themes were identified: Managing the recovery from CRC surgery, and Insufficient follow-up from the healthcare services after CRC surgery. The findings indicate that older people treated for colorectal cancer manage surprisingly well after discharge despite challenges in their recovery; however, there are seemingly areas of improvement in their follow-up healthcare.

scholarly journals Single-lead ECGs (AliveCor) are a feasible, cost-effective and safer alternative to 12-lead ECGs in community diagnosis and monitoring of atrial fibrillation

2021 ◽  
Vol 10 (1) ◽  
pp. e001270
Author(s):  
Jonathan James Hyett Bray ◽  
Elin Fflur Lloyd ◽  
Firdaus Adenwalla ◽  
Sarah Kelly ◽  
Kathie Wareham ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Community Setting ◽  
Cost Effective ◽  
Ventricular Rate ◽  
Service Improvement ◽  
Community Monitoring ◽  
Ventricular Response ◽  
Community Diagnosis ◽  
New Onset

BackgroundCommunity management of atrial fibrillation (AF) often requires the use of electrocardiographic (ECG) investigation. Patients discharged following treatment of AF with fast ventricular response (fast AF) can require numerous ECGs to monitor rate and/or rhythm control. Single-lead ECGs have been proposed as a more convenient and relatively accurate alternative to 12-lead ECGs for rate/rhythm management and also diagnosis of AF. We aimed to examine the feasibility of using the AliveCor single-lead ECG monitor for diagnosis and monitoring of AF in the community setting.MethodsDuring the course of 6 months, this evaluation of a clinical service improvement pathway used the AliveCor in management of patients requiring (1) follow-up ECGs for AF with previously documented rapid ventricular rate or (2) ECG confirmation of rhythm where AF was suspected. Twelve AliveCor devices provided to the acute community medical team were used to produce 30 s ECG rhythm strips (iECG) that were electronically sent to an overreading physician.ResultsSeventy-four patients (mean age 82 years) were managed on this pathway. (1) The AliveCor was successfully used to monitor the follow-up of 37 patients with fast AF, acquiring a combined total of 113 iECGs (median 1.5 ±3.75 per patient). None of these patients required a subsequent 12-lead ECG and this approach saved an estimate of up to £134.49 per patient. (2) Of 53 patients with abnormal pulses, the system helped identify 8 cases of new onset AF and 19 cases of previously known AF that had reverted from sinus back into AF.ConclusionsWe have demonstrated that the AliveCor system is a feasible, cost-effective, time-efficient and potentially safer alternative to serial 12-lead ECGs for community monitoring and diagnosis of AF.

Evaluation of ‘the R-Model’ crisis intervention de-escalation training for law enforcement

2019 ◽  
Vol 93 (4) ◽  
pp. 271-289 ◽  
Author(s):  
Jillian Peterson ◽  
James Densley ◽  
Gina Erickson
Keyword(s):  
Law Enforcement ◽  
Crisis Intervention ◽  
Health Resources ◽  
Police Department ◽  
Preliminary Evidence ◽  
Outcome Evaluation ◽  
Calls For Service ◽  
Model Research ◽  
One Year

This study presents findings from a process and outcome evaluation of a custom crisis intervention and de-escalation training for law enforcement, delivered in-house to a suburban Minnesota police department (the R-Model: Research, Respond, Refer). Individual officer survey data showed the R-Model significantly decreased stigma and increased self-reported knowledge of mental health resources over baseline. Knowledge of resources held at the 4-month follow-up. One-year follow-up data at the agency level, showed decreases in the number of crisis calls for service and the number of repeat calls to the same addresses, even when compared to crisis call rates at similar police departments. Findings provide preliminary evidence that the R-Model may be an effective model that warrants additional study.

Peer Review of Paediatric Endocrine Services in the UK: A Template for Quality and Service Improvement

2021 ◽  
pp. 1-6
Author(s):  
John Schulga ◽  
Heather Mitchell ◽  
S. Faisal Ahmed ◽  
Assunta Albanese ◽  
Justin Warner ◽  
...  
Keyword(s):  
Peer Review ◽  
National Level ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
British Society ◽  
Service Improvement ◽  
Paediatric Endocrinology ◽  
Test Feasibility ◽  
Specialist Nurses ◽  
The Uk

<b><i>Background:</i></b> Independent peer review of healthcare services can complement existing internal-, institutional-, and national-level regulatory mechanisms aimed at improving quality of healthcare. However, this has not been reported for paediatric endocrinology services in the UK. We aimed to test feasibility and acceptability through a first cycle of a national peer review of paediatric endocrine services. <b><i>Methods:</i></b> Tertiary centres in paediatric endocrinology across the UK were assessed against 54 quality standards, developed by the British Society for Paediatric Endocrinology and Diabetes (BSPED) in five domains of healthcare by a team comprising paediatric endocrinologists and specialist nurses. The evaluation was supported by a self-assessment. A post-peer-review questionnaire was used as feedback. <b><i>Results:</i></b> All 22 centres in the UK underwent independent peer review between 2011 and 2017. Each served a median population of 2.6 million (range 1–8 million) and offered 1,872 (range 779–6,738) outpatient consultations annually. A total of 43 (range 30–49) standards were met in combined evaluation of all centres. Variance of adherence for essential standards ranged from 52 to 97% at individual centres with 90% adherence demonstrated by 32% of centres. Post-review feedback showed 20/22 (95%) validating the utility of the peer review. <b><i>Conclusions:</i></b> The BSPED peer review of all UK centres providing paediatric endocrine services is shown to be feasible and provides a quality benchmark for replication by national services.

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