scholarly journals Audit on structure of assessment for remote consultation during COVID-19 pandemic

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S73-S73
Author(s):  
Astha Das ◽  
Margaret Kuklewicz
Keyword(s):  
Sudden Change ◽  
Management Plan ◽  
Remote Access ◽  
Vulnerable Groups ◽  
National Guidelines ◽  
Remote Consultation ◽  
Policy Makers ◽  
Record Keeping ◽  
Standards Of Practice ◽  
Remote Consultations

AimsAccording to the Royal College of Psychiatry, GMC guidelines and NHS England, it is necessary to consider remote consultation to enable service delivery to those requiring shielding or facing additional health risk, and to avoid transition of infection.To audit whether the standards of Mobile and Remote access work are met.To audit whether the standards of Consent to Examination and Treatment are met.To also evaluate whether the remote consultation due to the COVID-19 pandemic is being explicitly documented or not.To suggest to the policy makers the need to establish some standards of practice concerning remote consultation and consent in the COVID-19 pandemicMethodInclusion criteria – sample of service users who had remote consultation in April, May, and mid-June 2020 by doctors of MHSOP community mental health team at Bassetlaw Hospital.Data collection: Retrospective.Data source(s) used: Patient/Client medical/care recordsAnticipated benefits of this audit: Due to the nature of current COVID-19 pandemic situation, it is essential to minimise contacts with vulnerable groups to prevent transmission of infection. It is anticipated that the number of remote consultations will grow in the forthcoming months.This audit creates an opportunity to develop a new policy and improve the quality of remote consultations documentation.ResultDocumentation for remote consultation was done in 81% of case notes whereas documentation of consent obtained was present in 57% of patients’ electronic notes.90% of entries had documentation of ‘addressed concerns’. Around 50-70% of patients’ documents showed good record keeping on domains of ‘ability to maintain effective communication’, ‘mental state examination’, ‘risk assessment’ and ‘ability to understand medication plus side effects’.About 40% of documentation met standards for good record keeping on ‘management plan’, ‘concerns raised’, ‘chance given to ask about management plan’.ConclusionMost of the standards of good consultations are being met despite the change in the type of Consultation due to COVID-19. However, there are identified areas for improvement which could be focused on. For example, documentation can be clearer when consent is gained for remote consultation. It should not be presumed that, as patients are booked in a certain type of clinic, they have been properly consented beforehand.Key Success: Almost in all domains 40% have met the standardsKey Concerns: There are areas where a lot of evidence is partially documented.The above results can be explained as a consequence of a sudden change in the normal working pattern in a community-based setting, having minimal protocols and procedures on standards of working in the situation of COVID19 remote consultation.Following this audit, we aim to increase the amount of information recorded during remote consultation.The plan is to develop a template that would cover the requirements for a remote consultation recommended by national guidelinesThe proposal of a letter template following a remote consultation will be disseminated to the MHSOP CMHT teams for any suggestions/approval.

scholarly journals An Integrated Coastal Sediment Management Plan: The Example of the Tuscany Region (Italy)

2020 ◽  
Vol 8 (1) ◽  
pp. 33 ◽  
Author(s):  
Enzo Pranzini ◽  
Irene Cinelli ◽  
Luigi E. Cipriani ◽  
Giorgio Anfuso
Keyword(s):  
Stability Index ◽  
Management Plan ◽  
Sediment Management ◽  
Coastal Sediment ◽  
National Guidelines ◽  
Management Actions ◽  
Erosion Processes ◽  
Human Effects ◽  
Sufficient Magnitude ◽  
Sound Management

This paper presents the results of a study carried out to support the Region of Tuscany Coastal Sediment Management Plan, with the main aim of establishing the sediment budget considering the time span from 1981–1985 to 2005 for the 56 coastal sectors into which the 215 km-long continental sandy coast of Tuscany (Italy) was divided. The sand stability (according to a stability index) and colour compatibility (according to the CIEL*a*b* colour space with an acceptability range conforming to national guidelines) were determined in order to assess the possibility of using the available sediment in accreting sectors to nourish the beach in eroding areas. Only in two cases—i.e., the updrift of a harbour (at Viareggio) and in a convergence zone (at Marina di Pietrasanta)—are the volumes of sufficient magnitude to support a large nourishment project; however, the mean sand size is too small to guarantee efficient nourishment, even with medium-term stability. In contrast, the colour difference, in most of the cases, was shown to be acceptable. Other small sediment stocks, suitable for colour but not for grain size, can be used for periodic ephemeral nourishment works to support seasonal tourist activities. The limited resources available make it necessary to adopt a plan for their optimal use from a regional perspective. This kind of study is of great interest for the proposal of sound management actions to counteract the increasing erosion processes linked to climate change phenomena and human effects on rivers and coastal systems.

scholarly journals Internet privacy in Canada: a public interest perspective

2021 ◽  
Author(s):  
Julie Gustavel
Keyword(s):  
Personal Information ◽  
Online Environment ◽  
Informational Privacy ◽  
Online Data ◽  
Policy Makers ◽  
Privacy Concerns ◽  
Record Keeping ◽  
Internet Privacy ◽  
Legislative Action ◽  
Individual Privacy

Issues about informational privacy have emerged in tandem with the escalating increase in nformation stored in electronic formats. Data protection is a pressing issue not only because files of personal information are being kept in greater detail and for longer periods of time, but also because the data can be retrieved and compared or matched without delay, regardless of geography. While defenders of information technology cite efficiency and safety among the countervailing benefits, concerns from an increasingly tech-savvy public have introduced a sense of urgency to demand tough legislation. Although many studies have provided evidence of online privacy concerns, few have explored the nature of the concern in detail, especially in terms of government policy for our new online environment. Bill C-6, Canada's recent legislative action, has provided a practical basis from which to appraise governments' role in privacy protection. With this in mind, the paper will be divided into two parts. Part one will be undertaken to: (A) evaluate the arguments of critics as well as defenders of contemporary record-keeping practices and the philosophical conceptions of privacy, which underlie them; and, using these themes (B) provide a comprehensive assessment of the effectiveness of Bill C- 6, examining the ways in which policy makers have begun to treat privacy as both a commodity and a secondary adjunct to business activity. Part two of the paper, purposes a series of recommendations or, more specifically, a framework for Bill C-6 that would, more effectively, protect individual privacy from private entities, who collect online data.

scholarly journals A quality improvement (QI) project on improving trainee confidence in conducting remote psychiatric consultations at Pennine Care National Health Service (NHS) Foundation Trust in the United Kingdom (UK)

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S209-S210
Author(s):  
Rachel Moir ◽  
Roshelle Ramkisson ◽  
Seri Abraham ◽  
Shevonne Matheiken
Keyword(s):  
Real Time ◽  
Response Rates ◽  
Psychiatric Consultation ◽  
Time Data ◽  
Remote Consultation ◽  
Safe Patient Care ◽  
Pdsa Cycle ◽  
Real Time Data ◽  
The Uk ◽  
Remote Consultations

AimsWhen the coronavirus disease 2019 pandemic hit the UK, clinicians within Pennine Care NHS Foundation Trust (a five-borough mental health trust) were faced with the challenge of rapidly switching to a novel way of assessing patients remotely.The idea for a QI project on trainees’ experience with remote consultations was conceived in April 2020. We present our February 2021 results here.We aimed to improve trainee confidence in conducting remote psychiatric assessments by at least 40%, to ensure effective and safe patient care during their 6 months placement.MethodOur discovery process included surveying trainees in April 2020 to explore experiences with remote psychiatric consultations, a literature search of current UK guidance and a local audit. The audit reviewed documentation of consent to remote consultations, with reference to standards as per NHS England remote consultation guidance. Key change ideas included publication of an article, ‘Remote consultations – top tips for clinical practitioners’, video-simulated remote consultations and a session on remote consultations in the trainee induction.In the first ‘plan-do-study-act’ (PDSA) cycle, we presented key findings from the article in a video presentation, which was sent trust-wide. We measured confidence in conducting remote assessments pre- and post-presentation via a feedback survey. Unfortunately, response rates were low and in the second PDSA cycle we targeted a smaller cohort of trainees at the August 2020 induction, although encountered similar difficulties. In the third PDSA cycle, we collected real-time data using an interactive app at the February 2021 trainee induction, and measured pre- and post- confidence following a presentation and a video-simulated remote consultation.Result2/34 respondents had accessed previous remote psychiatric consultation training and12/35 had some telepsychiatry experience. Pre-induction trainee confidence results revealed: extremely uncomfortable (16%), not confident (31%), neutral (47%), confident (6%) and very confident (0%) and post-induction confidence was 0%, 22%, 52%, 26% and 0%, respectively.ConclusionOur project started during the first peak of the pandemic, which may be a reason for initial limited response rates. Our results suggest that the remote psychiatric consultation trainee induction session has shown some improvement in trainee confidence; the ‘confident’ cohort improved from 6% to 26%.Our next steps include collecting similar real-time data, mid-rotation and uploading video-simulated remote consultations to the Trust Intranet. We plan to complete the local audit cycle. We also plan to incorporate patient experience (from an ongoing systematic review) to inform a potential triage process post-pandemic, choosing between face-to-face versus remote consultations.

scholarly journals Food Security in Ghanaian Urban Cities: A Scoping Review of the Literature

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3615
Author(s):  
Robert Akparibo ◽  
Richmond Nii Okai Aryeetey ◽  
Evans Atiah Asamane ◽  
Hibbah Arabah Osei-Kwasi ◽  
Elysa Ioannou ◽  
...  
Keyword(s):  
Food Security ◽  
Grey Literature ◽  
Food Samples ◽  
Vulnerable Groups ◽  
Cross Sectional ◽  
Policy Makers ◽  
Urban Food Security ◽  
Scoping Literature Review ◽  
Food Safety And Quality

Urbanisation in Ghana could be negatively impacting the state of food security, especially in economically vulnerable groups. Food supply, safety, and quality are all aspects of food security which could be impacted. We conducted a scoping literature review to understand the nature and magnitude of evidence available on the urban food security situation in Ghana. A literature search was conducted in Medline, CINAHL, Embase, Global Health, Scopus, Web of Science, Africa Wide Information and Google Scholar to identify relevant peer-reviewed and grey literature. 45 studies, mainly cross-sectional surveys/food samples analysis, met the inclusion criteria. The majority of studies were concentrated in the Greater Accra Region (n = 24). Most studies focused on food safety and quality (n = 31). Studies on supply and stability were, however, scarce. Qualitative research methods were uncommon in the included studies. The existing literature on food security are concentrated in two regions: The Greater Accra and Ashanti regions. Future studies exploring food security in urban Ghana should focus on exploring the lived experiences and perceptions of food insecurity and food stability by urban-dwellers using qualitative methods. The evidence suggesting that the safety/quality of foods sold in Ghanaian markets is poor should be a concern to consumers and policy makers.

Patient and clinician satisfaction with video consultations during the COVID-19 pandemic: an opportunity for a new way of working

2020 ◽  
pp. 146531252097367
Author(s):  
Emer Byrne ◽  
Simon Watkinson
Keyword(s):  
Teaching Hospital ◽  
Service Evaluation ◽  
Remote Consultation ◽  
Cross Sectional ◽  
Face To Face ◽  
Level Of Satisfaction ◽  
The Future ◽  
Clinician Satisfaction ◽  
High Level ◽  
Remote Consultations

Objective: To assess satisfaction of patients and clinicians with virtual appointments using Attend Anywhere for their orthodontic consultation and to identify any areas where the technology could be further utilised. Design: Service evaluation involving descriptive cross-sectional questionnaire. Setting: Orthodontic Departments at Royal Blackburn Teaching Hospital and Burnley General Teaching Hospital. Participants: Patients and clinicians involved in video consultations. Methods: Patient- and clinician-specific questionnaires were designed and those involved in virtual clinics were invited to complete these at the end of their consultation. The questionnaires focused on setting up and connecting to the virtual clinic, assessing if the correct types of patients were involved in the clinics and satisfaction with these types of remote consultations. Results: A total of 121 questionnaires (59 patient and 62 clinician) were completed. Of the patients, 93% found the instructions provided to access the consultation easy to follow and 70% of clinicians did not report any connection issues. In 90% of cases, a virtual appointment was seen to be appropriate by the clinician. Respondents showed a high level of satisfaction with 76% of patients saying a remote consultation was more convenient than face-to-face, and 66% reporting they would, if appropriate, like more appointments like this in the future. Conclusion: The overall satisfaction among patients with virtual clinics introduced during the COVID-19 pandemic was generally high. The majority of patients would, where appropriate, prefer more virtual appointments in the future in comparison to face-to-face appointments and it was found to be more convenient for the patient.

Scottish Intercollegiate Guidelines Network (SIGN) guidelines on tonsillectomy: a three cycle audit of clinical record keeping and adherence to national guidelines

2002 ◽  
Vol 116 (6) ◽  
pp. 453-454 ◽  
Author(s):  
Alun Williams ◽  
Patrick Lee ◽  
Alastair Kerr
Keyword(s):  
Sore Throat ◽  
Clinical Record ◽  
National Guidelines ◽  
Record Keeping ◽  
The Third ◽  
Progressive Improvement ◽  
Clinical Records ◽  
The Impact

Scottish Intercollegiate Guidelines Network (SIGN) guidelines on the indication for tonsillectomy in the management of sore throat were published in January 1999. To determine adherence to these guidelines in our unit, clinical records were examined on admission for tonsillectomy. Three cohorts were analysed. The first listed prior to SIGN, the second after SIGN and the third after presentation of the results of cohorts 1 and 2. The records were examined for documentation of the number of attacks of tonsillitis in the preceding year. The first cohort revealed poor documentation of attacks of tonsillitis (30 per cent). Thesubsequent cohorts showed progressive improvement in record keeping (74 per cent and 96 per cent). The adherence to SIGN guidelines for those with adequate documentation also improved (75 per cent, 80 per cent, 93.5 per cent). The importance of adequate record keeping to enable audit of practice and the impact of national guidelines on practice are discussed.

Ann Janet Woolcock 1937–2001

2014 ◽  
Vol 25 (2) ◽  
pp. 313
Author(s):  
Babette Smith
Keyword(s):  
Airway Hyperresponsiveness ◽  
Asthma Management ◽  
Asthma Severity ◽  
Management Plan ◽  
Respiratory Medicine ◽  
National Guidelines ◽  
Alfred Hospital ◽  
Postgraduate Studies ◽  
Mcgill University ◽  
The University

Ann Woolcock graduated in medicine from the University of Adelaide and pursued postgraduate studies in respiratory medicine with Professor John Read at the University of Sydney. Her MD thesis, awarded in 1967, was on the mechanical behaviour of the lungs in asthma. From 1966 to 1968 she worked with Professor Peter Macklem at McGill University in Canada, then returned to the University of Sydney to continue researching asthma. Her work in asthma and epidemiology showed that asthma was caused by allergens but that there is a genetic component. Her clinical research was a major contribution to better outcomes in asthma, in particular, the demonstration and practical measurement of airway hyperresponsiveness and her subsequent research that examined its contribution to asthma severity and the ways in which treatments were able to reduce it. In 1989 she wrote, with others, the world's first national guidelines for asthma management, the Australian Asthma Management Plan. In 1984, she was appointed to a personal chair of Respiratory Medicine at the University of Sydney. She founded the Institute of Respiratory Medicine in 1985, based at Sydney's Royal Prince Alfred Hospital. After her death, the Institute was renamed the Woolcock Institute of Medical Research in her honour.

WhatsApp guidelines – what guidelines? A literature review

2019 ◽  
Vol 25 (9) ◽  
pp. 524-529 ◽  
Author(s):  
Maurice Mars ◽  
Christopher Morris ◽  
Richard E Scott
Keyword(s):  
Clinical Practice ◽  
Ethical Issues ◽  
Instant Messaging ◽  
Healthcare Delivery ◽  
Modern Society ◽  
Professional Communication ◽  
Sensitive Information ◽  
Inclusion Criteria ◽  
National Guidelines ◽  
Record Keeping

Introduction Instant messaging (IM) is pervasive in modern society, including healthcare. WhatsApp, the most cited IM application in healthcare, is used to share sensitive patient information between clinicians. Its use raises legal, regulatory and ethical concerns. Are there guidelines for the clinical use of WhatsApp? Can generic guidelines be developed for the use of IM, for one-to-one and one-to-many healthcare professional communication using WhatsApp as an example? Aim We aimed to investigate if there are guidelines for using WhatsApp in clinical practice. Method Nine electronic databases were searched in January 2019 for articles on WhatsApp in clinical service. Inclusion criteria: paper was in English, reported on WhatsApp use or potential use in clinical practice, addressed legal, regulatory or ethical issues and presented some form of guideline or guidance for WhatsApp use. Results In total, 590 unique articles were found and 167 titles and abstracts met the inclusion criteria. Twenty-one articles identified the need for general guidelines. Twelve articles provided some form of guidance for using WhatsApp. Issues addressed were confidentiality, identification and privacy (eight articles), security (seven), record keeping (four) and storage (three). Mandatory national guidelines for the use of IM for patient-sensitive information do not appear to exist, only advisories that counsel against its use. Conclusion The literature showed clinicians use IM because of its simplicity, timeliness and cost effectiveness. No suitable guidelines exist. Generic guidelines are required for the use of IM for healthcare delivery which can be adapted to local circumstance and messaging service used.

The concept of ‘flexicurity’: a new approach to regulating employment and labour markets

2004 ◽  
Vol 10 (2) ◽  
pp. 166-186 ◽  
Author(s):  
Ton Wilthagen ◽  
Frank Tros
Keyword(s):  
Trade Unions ◽  
Industrial Relations ◽  
Labour Markets ◽  
Vulnerable Groups ◽  
Work Organisation ◽  
The European Union ◽  
Policy Makers ◽  
New Approach ◽  
The One ◽  
National Governments

This article deals with the new policy concept of ‘flexicurity’ in view of the emerging flexibility-security nexus currently faced by the European Union, national governments, sectors of industry, individual companies and workers. On the one hand there is a strong demand to make labour markets, employment and work organisation more flexible. At same time, an equally strong demand exists for providing security to employees – especially vulnerable groups – and for preserving social cohesion in our societies. Policy-makers, legislators, trade unions and employers’ organisations have a strong need for new theory-inspired policy models and concepts that promise to reconcile these goals of enhancing both flexibility and security that at first sight seem incompatible. This article discusses the origins, conditions and potential of ‘flexicurity’ as policy or strategy at various levels of industrial relations. It also outlines a research agenda.

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