scholarly journals Service evaluation for services for younger people with dementia in east locality of north Wales

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S20-S20
Author(s):  
Asha Dhandapani ◽  
Sathyan Soundararajan ◽  
Sharmi Bhattacharyya
Keyword(s):  
Time Frame ◽  
Service Evaluation ◽  
Young Onset ◽  
People With Dementia ◽  
North Wales ◽  
Number Of Patients ◽  
Time To Diagnosis ◽  
Working Age ◽  
The Impact ◽  
Timely Referral

AimsTo evaluate Young-onset dementia (YOD) services in terms of referral, its appropriateness, time to diagnosis and other criteria as per protocol that we have adapted.MethodCase notes of those under 65 referred to Memory service for cognitive assessment between July 2017 and June 2018 were retrospectively reviewed to look at the time to diagnosis, appropriate referrals, post-diagnostic support, etc.ResultCompared to the previous evaluation, the number of patients referred to had increased from 47–48/ year earlier to 63/year. Only 1/3 were appropriate referral over the 10-year period whereas between 2017 and 2018 more than half were appropriate referrals. More than half of them were seen within 12 weeks of referral (35/63 available). Only 132/252 were diagnosed as having some form of dementia in the previous evaluation which was about 13 cases of YOD a year. In contrast, in our new evaluation 19 patients were diagnosed with some form of dementia. Inappropriate referrals had reduced by more than 50%. Appropriateness and timely referral had improved in this time frame.ConclusionDementia is considered ‘young onset’ when it affects people under 65 years of age. It is also referred to as ‘early onset’ or ‘working age’ dementia. However, this is an arbitrary age distinction that is becoming less relevant as increasingly services are realigned to focus on the person and the impact of the condition, not the age. Teaching sessions to educate primary & secondary care clinicians on appropriateness and timely referrals have helped in improving the care for patients with YOD. Services need to be developed further to be able to diagnose & support those with YOD. Repeat evaluations every year would help to inform improvement in quality & appropriateness of referrals.

scholarly journals Understanding the needs and experiences of people with young onset dementia: a qualitative study

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e021166 ◽  
Author(s):  
Luisa I Rabanal ◽  
John Chatwin ◽  
Andy Walker ◽  
Maria O’Sullivan ◽  
Tracey Williamson
Keyword(s):  
Interpretative Phenomenological Analysis ◽  
Help Seeking ◽  
Late Onset ◽  
Psychological Impact ◽  
Young Onset ◽  
People With Dementia ◽  
Health And Social Care ◽  
Young Onset Dementia ◽  
The Uk ◽  
The Impact

AimDespite an estimated 40 000 people diagnosed with young onset dementia (YOD) in the UK, there is a general lack of awareness of the condition when compared with late onset dementia. The aim of this study was to explore the experiences and needs of people living with YOD (younger than 65 years) and gain an understanding of the issues that impact on them.SettingParticipants’ homes, support group premises or university rooms.Participants14 people with a diagnosis of YOD from a northern UK city.DesignSemistructured, in-depth interviews were audio recorded, transcribed and analysed cross-sectionally following principles of interpretative phenomenological analysis.ResultsFour superordinate themes are reported on ‘process of diagnosis’, ‘the impact of living YOD’, ‘needs of people with YOD’ and ‘living well with YOD’. Nine subordinate themes captured participant experiences of developing cognitive difficulties, after being diagnosed with YOD, and subsequently living with the condition. Key issues that emerging included a lack of general awareness of YOD; how this can delay help seeking; commonalities in prediagnosis trajectories; retrospective understanding of prediagnosis symptom patterns; the difficulties of obtaining a firm diagnosis; the importance of face-to-face support and difficulties associated with daily living. Participants also described the emotional and psychological impact of the condition and the importance of formal and informal support networks.ConclusionsPeople who have a diagnosis of YOD regard themselves as distinct from older people with dementia. Despite similar symptoms, the context in which they experience the condition creates a range of distinct psychosocial concerns not commonly well addressed by health and social care services. As awareness of YOD continues to grow, the development (or adaptation) of services that take into account the idiosyncratic needs of people with YOD should be addressed.

scholarly journals 963 Management of Acute Gallstone-Related Complications at Great Western Hospital (GWH): Re-Audit

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Castelhano ◽  
J Bartlett ◽  
H Wooler ◽  
A Theofilis ◽  
A Mahmoud ◽  
...  
Keyword(s):  
Service Provision ◽  
Clinical Audit ◽  
Time Frame ◽  
Surgical Department ◽  
Related Disease ◽  
Western Hospital ◽  
Number Of Patients ◽  
The Impact ◽  
Current Guidelines ◽  
Reason For Admission

Abstract Aim Gallstone related disease accounts for a third of the admissions to the Surgical Department. In June 2019, a clinical audit was undertaken at Great Western Hospital assessing the number of patients who underwent cholecystectomy, following initial diagnosis, in accordance to current guidelines. The results demonstrated a very low number of patients had cholecystectomy, within the targeted time frame, which led to the implementation of a dedicated operative “hot gallbladder” list weekly. In June 2020, we re-audit the service to evaluate the impact of the change implemented. Method A retrospective observational analysis of patients admitted to the Hospital in June 2020 with gallstone related disease. Data was collected using the Surgical on-call lists, these were analysed and patients selected according to the reason for admission, only gallstone related issues were considered in this analysis. Finally, via Medway, the time from admission to surgery was assessed. Results Despite the disruption in service provision due to COVID-19, the implementation of the “hot gallbladder” list led to a 10.7% increase in timely cholecystectomies, bringing the overall compliance to 14%. There was also a significant reduction in biliary relate re-admissions, from 58% to 37%. Despite 47.3% of patients were still awaiting surgery, the waiting list was reduced by 5.2% in only 1 year. Conclusions This study demonstrated that the implementation of the “hot gallbladder” list has improved the compliance with the current guidelines. The change has brought us in line with the national average of 15%, as estimated by RCSEng, therefore demonstrating the efficacy of the weekly list.

scholarly journals Impact of COVID-19 on Presentation of Sudden Sensorineural Hearing Loss at a Single Institution

2020 ◽  
pp. 019459982097468
Author(s):  
Divya A. Chari ◽  
Ayush Parikh ◽  
Elliott D. Kozin ◽  
Meaghan Reed ◽  
David H. Jung
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Time Frame ◽  
Absolute Number ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Academic Center ◽  
Number Of Patients ◽  
Increased Risk ◽  
The Impact

The coronavirus disease 2019 (COVID-19) pandemic resulted in widespread unprecedented changes to the health care system. Herein, we sought to assess the impact of the viral outbreak on clinical presentations of sudden sensorineural hearing loss (SSNHL) at a single academic center. Our results demonstrate a decrease in the absolute number of patients presenting with SSNHL to our institution during the initial onset of the COVID-19 pandemic compared to an analogous time frame 1 year prior. However, the ratio of patients with SSNHL compared to total patients evaluated was largely similar during the 2 time periods. Based on data from our institution, the COVID-19 virus does not appear to confer a significantly increased risk for the development of SSNHL.

scholarly journals Impact of the SARS-CoV-2 pandemic on emergency surgery services—a multi-national survey among WSES members

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Martin Reichert ◽  
◽  
Massimo Sartelli ◽  
Markus A. Weigand ◽  
Christoph Doppstadt ◽  
...  
Keyword(s):  
Emergency Surgery ◽  
Elective Surgery ◽  
Perforated Appendicitis ◽  
Surgical Patients ◽  
Patient Treatment ◽  
Surgical Patient ◽  
Structural Problems ◽  
Number Of Patients ◽  
Time To Diagnosis ◽  
The Impact

Abstract Background The SARS-CoV-2 pandemic is a major challenge for health care services worldwide. It’s impact on oncologic therapies and elective surgery has been described recently, and the literature provides guidelines regarding appropriate elective patient treatment during the pandemic. However, the impact of SARS-CoV-2 pandemic on emergency surgery services has been poorly investigated up to now. Methods A 17-item web survey had been distributed to emergency surgeons in June 2020 around the world, investigating the impact of SARS-CoV-2 pandemic on patients and septic diseases both requiring emergency surgery and the time-to-intervention in emergency surgery routine, as well as experiences with surgery in COVID-19 patients. Results Ninety-eight collaborators from 31 countries responded to the survey. The majority (65.3%) estimated the impact of the SARS-CoV-2 pandemic on emergency surgical patient care as being strong or very strong. Due to the pandemic, 87.8% reported a decrease in the total number of patients undergoing emergency surgery and approximately 25% estimated a delay of more than 2 h in the time-to-diagnosis and another 2 h in the time-to-intervention. Fifty percent make structural problems with in-hospital logistics (e.g. transport of patients, closed normal wards etc.) mainly responsible for delayed emergency surgery and the frequent need (56.1%) for a triage of emergency surgical patients. 56.1% of the collaborators observed more severe septic abdominal diseases during the pandemic, especially for perforated appendicitis and severe septic cholecystitis (41.8% and 40.2%, respectively). 62.2% had experiences with surgery in COVID-19-infected patients. Conclusions The results of The WSES COVID-19 emergency surgery survey are alarming. The combination of an estimated decrease in numbers of emergency surgical patients and an observed increase in more severe septic diseases may be a result of the fear of patients from infection with COVID-19 and a consecutive delayed hospital admission and diagnosis. A critical delay in time-to-diagnosis and time-to-intervention may be a result of changes in in-hospital logistics and operating room as well as intensive care capacities. Both reflect the potentially harmful impact of SARS-CoV-2 pandemic on emergency surgery services.

The impact of young onset dementia on the family: a literature review

2010 ◽  
Vol 23 (3) ◽  
pp. 356-371 ◽  
Author(s):  
Emma Svanberg ◽  
Aimee Spector ◽  
Joshua Stott
Keyword(s):  
Literature Review ◽  
Literature Search ◽  
Service Development ◽  
Systematic Literature Search ◽  
Young Onset ◽  
People With Dementia ◽  
The Family ◽  
Young Onset Dementia ◽  
The Individual ◽  
The Impact

ABSTRACTBackground: The needs of younger people with dementia have become increasingly recognized in service development. However, little is known about the impact of a diagnosis of young onset dementia on people aged under 65 years and their families. This paper reviews the literature on the experiences of younger people with dementia and their families in the U.K., and outcomes for carers.Methods: Twenty-six studies, encompassing a variety of themes concerning this population, were reviewed following a systematic literature search.Results: Results are divided into the impact on the individual and the impact on the family, specifically carer outcomes and the impact on children.Conclusions: The studies reviewed reveal a number of negative outcomes for the individual and carers, and highlight the need for further research.

scholarly journals Increased number of deaths within 24 h of admission during a period of social restriction related to the COVID-19 pandemic: A retrospective service evaluation in a metropolitan palliative care unit

2021 ◽  
pp. 026921632110265
Author(s):  
Rachel Everitt ◽  
Neil Robinson ◽  
David Marco ◽  
Jennifer Weil ◽  
Tamsin Bryan
Keyword(s):  
Palliative Care ◽  
Tertiary Hospital ◽  
Service Evaluation ◽  
Health Care Utilisation ◽  
Palliative Care Unit ◽  
Published Data ◽  
Hospital Inpatient ◽  
Number Of Patients ◽  
Social Restriction ◽  
The Impact

Background: COVID-19 has led to implementation of wide-ranging social restriction measures with consequent impact on health care utilisation in many domains. There is little published data on the experience of palliative care services catering to a population with low case numbers of COVID-19. Aim: This study aimed to consider the impact of COVID-19 on utilisation of inpatient palliative care in the context of low community transmission, and low numbers of cases in hospital. Design: A retrospective service evaluation examining differences in number of admissions, diagnoses, number of deaths and time from admission to death, across three discrete 8-week time periods spanning the early COVID-19 pandemic. Setting/participants: All admissions ( n = 194) to a metropolitan tertiary hospital inpatient palliative care unit in Melbourne during the study period. Results: An initial 16.9% fall in admissions was followed by a return to baseline admission numbers, with a 46.7% increase in number of deaths compared to baseline. The number of deaths within 24 h rose from 10.8% to 37.3% ( p < 0.01). The number of patients with non-malignant diagnoses increased from 32.4% to 52%, and those with non-malignant diagnoses were more likely to die rapidly ( p < 0.01). There were no patients with COVID-19 infection. Conclusion: Increased numbers of deaths within 24 h of admission occurred on the palliative care unit despite low COVID-19 case numbers in the wider community, and in the setting of widespread social restriction measures. More research is needed examining the health-related consequences of such restrictions for individuals not infected with COVID-19.

Model-Based Projection of Dementia Prevalence in China and Worldwide: 2020–2050

2021 ◽  
pp. 1-9
Author(s):  
Fangyu Li ◽  
Wei Qin ◽  
Min Zhu ◽  
Jianping Jia
Keyword(s):  
Control Strategies ◽  
Health Planning ◽  
Simulation Method ◽  
The United States ◽  
Dementia Prevalence ◽  
Risk Of Death ◽  
Model Based ◽  
People With Dementia ◽  
Number Of Patients ◽  
The Impact

Background: Current and future incidence and prevalence estimates of dementia are essential for public health planning. Objective: The objective was to establish prediction model of incidence and estimate the prevalence of dementia in the Chinese and worldwide population from 2020 to 2050. Methods: A model-based method was used to project the dementia prevalence from 2020 to 2050 in China, which required incidence, the mortality rate for individual without dementia, and the relative risk of death. Furthermore, we detected the impact of intervention on the prevalence projection for dementia using a simulation method. We applied the same method to other projections worldwide. Results: In 2020, the model predicted 16.25 million (95%confidence interval 11.55–21.18) persons with dementia in China. By 2050, this number would increase by approximately three-fold to 48.98 million (38.02–61.73). Through data simulation, if the incidence of dementia decreased by 10%every 10 years from 2020 after intervention and prevention, the number of dementia cases by 2050 was reduced by 11.96 million. This would reduce the economic burden by US $639.04 billion. In addition, using this model, dementia cases grew relatively slowly over the next few decades in the United States of America, the United Kingdom, and Japan, with percentage changes of 100.88%, 65.93%, and 16.20%, respectively. Conclusion: The number of people with dementia in China is large and will continue to increase rapidly. Effective interventions could reduce the number of patients drastically. Therefore, prevention and control strategies must be formulated urgently to reduce the occurrence of dementia.

scholarly journals Increased Use of Blood Transfusions to Manage Urological Conditions during the COVID-19 Pandemic

2020 ◽  
Vol 104 (11-12) ◽  
pp. 849-852
Author(s):  
Paolo Capogrosso ◽  
Luigi Candela ◽  
Piercarlo Rossi ◽  
Cristian Guarasci ◽  
Fabio Muttin ◽  
...  
Keyword(s):  
Healthcare System ◽  
Negative Impact ◽  
Delayed Diagnosis ◽  
Time Frame ◽  
Blood Transfusions ◽  
Transfusion Rate ◽  
Deferred Treatment ◽  
The North ◽  
Number Of Patients ◽  
The Impact

<b><i>Introduction:</i></b> Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to an extensive reorganization of the healthcare system in Italy, with significant deferment of the treatment of urology patients. We aimed to assess the impact of deferred treatment during the SARS-CoV-2 pandemic on the need for blood transfusions in 3 Italian urology departments. <b><i>Methods:</i></b> We reviewed hospital chart data on blood transfusions at the urology units of 3 academic centers in the north of Italy from March to April 2020. Data were compared with values from the same time frame in 2019 (March to April 2019). <b><i>Results:</i></b> We observed significant reductions of the number of patients admitted to the urology units from March to April 2020 (373 vs. 119) and the number of performed surgeries (242 vs. 938) compared to 2019. Though, the number of transfused blood units was comparable between the 2 years (182 vs. 252), we found a greater mean number of blood units transfused per admission in 2020 (0.49 vs. 0.22; <i>p</i> &#x3c; 0.0001). As a whole, the transfusion rate for hematuria was higher in 2020 than in 2019 (36 vs. 7.9%; <i>p</i> &#x3c; 0.0001). <b><i>Discussion/Conclusion:</i></b> The observed increased number of blood transfusions needed throughout the SARS-CoV-2 era could have had a negative impact on both patients and the healthcare system. It is possible to speculate that this is the consequence of a delayed diagnosis and deferred treatment of acute conditions.

Evaluating the impact of nurse practitioner involvement in a pleural procedures clinic

2020 ◽  
Vol 29 (14) ◽  
pp. 816-820
Author(s):  
Eleanor Peter
Keyword(s):  
Nurse Practitioner ◽  
Disease Incidence ◽  
Service Evaluation ◽  
Educational Opportunities ◽  
Structured Interviews ◽  
Number Of Patients ◽  
Key Staff ◽  
The Impact ◽  
Model Of Practice ◽  
Work Burden

Background: Pleural disease incidence is increasing and there has been a move towards outpatient management. Pleural clinics have been developed for patients to be assessed and have pleural procedures for diagnostic and symptomatic purposes. Aim: The study aimed to assess the impact of nurse practitioner (NP) involvement in a pleural procedures clinic on clinic capacity, and staff and patient experience. Methods: A mixed-methods service evaluation was completed in a medium-sized general hospital. The number of patients seen in clinic over a 6-month period at the beginning of NP involvement was compared with the number of patients seen 1 year later. Semi-structured interviews of key staff stakeholders were conducted. Findings: Clinic capacity increased from 4.57 to 5.86 patients per list. NP involvement increased access, improved patient care, reduced work burden for other staff and improved educational opportunities. Conclusion: The impact of NP involvement in the pleural clinic was seen as positive and increased clinic capacity. The same model of practice could be considered elsewhere.

The impact of GP referrals on overcrowding in emergency departments and acute medicine

2021 ◽  
Vol 27 (2) ◽  
pp. 1-6
Author(s):  
Ayaz A Abbasi ◽  
Shams Khan ◽  
Victor Ameh ◽  
Ilyas Muhammad
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Patient Flow ◽  
General Medicine ◽  
Service Evaluation ◽  
Urgent Care ◽  
Ambulatory Assessment ◽  
Acute Medicine ◽  
Number Of Patients ◽  
The Impact

Background/Aims A long-standing issue common to most emergency departments worldwide is overcrowding, and the UK is no exception. Overcrowding can have many adverse consequences, such as increased medical errors, decreased quality of care and poor patient outcomes. This service evaluation aimed to review the number of patients referred to acute specialties by their GPs and to evaluate the impact of these referrals on the flow of patients in and out of the emergency department and acute medicine. Methods GP referral letters were collected at an emergency department in Greater Manchester, England, between 15 May 2019 and 28 May 2019. A proforma was used by a consultant in acute medicine and a consultant in emergency medicine to evaluate each letter. Result A total of 139 GP referrals were received by the emergency department, of which 43 were to general medicine and 96 to other specialties. Of the latter, 54 cases were directed to the emergency department, 20 were directed to a different specialty and 23 did not have a specialty clearly specified. The majority of referrals were for gastrointestinal conditions or abdominal pain, with the next largest category being chest infections. Most of these patients were eventually seen in the trust's ambulatory assessment area to relieve pressure on the emergency department. Conclusions Planned and specific use of urgent care centres and ambulatory assessment areas can help to relieve pressure on emergency departments, but appropriate intervention at the primary care level is also necessary to improve patient flow.

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